Medicina practica, or, Practical physick shewing the method of curing the most usual diseases happening to humane bodies ... : to which is added, the philosophick works of Hermes Trismegistus, Kalid Persicus, Geber Arabs, Artesius Longævus, Nicholas Flammel, Roger Bachon and George Ripley : all translated out of the best Latin editions into English ... : together with a singular comment upon the first book of Hermes, the most ancient of philosophers : the whole compleated in three books / by William Salmon ...

CHAP. XX. Of the STONE in the BLADDER.

I. BEfore we come abso∣lutely to the mat∣ter in hand, it is necessary to discuss the Point, VVhe∣ther the Stone in the Blad∣der can be broken by Me∣dicines, or not? That it may be broken many Phy∣sicians do affirm, and bring in proof thereof their Ex∣periences: The reason they render for it is, That Medi∣cines may do it, acting by their tenuity, acidity, aspe∣rity, and their diuretick force: Or, that there is a dissolving Salt, as well as a coagulating One, which Vir∣tues are not to be denied to Herbs, Plants, Metals, Stones, and minerals. AEtius, Lib. 2. tells us how Philagarius cured the Stone in the Blad∣der, with Goats-blood and a Hedge-Sparrow mixt together. Laurembergius cured one of a great Stone by the use of Millepedes. A Jesuite at Rome cured a Printer's Son of the Stone with Millepedes rightly prepared. Turrianus in Ia∣tro, Lib. 4. Pag. 262: saith, He broke a Stone, which was design'd to be cut, by giving a little Pouder of Crystial to drink, or the dis∣soluble substance thereof, viz Calcin'd in a Potter's For∣nace at least nine times, and quenched in Nettle-water, to be reduced to a Calx, then put into a Cellar to melt per deliquium. Rhasis, Lib. 9. saith, He cured a Stone in the Bladder of long standing with his Pills. Horatius Au∣genius, and his Father, with some others, cured several

with the same Medicine. Johannes Prevotius saith, the Stone in the Bladder is bro∣ken by a Plaster of white Onions boiled, and applied to the bottom of the Belly. Hippocrates, Galen, Avicenna, Dioscorides, and others are of the same Opinion. And the Author of this Work knew one who was appoin∣ted to be cut of the Stone, by taking Diureticks, was perfectly cured, of which Horse Raddish was chief, was perfectly cured; so that for more than twenty five years since, he has not been trou∣bled with it. And it is pos∣sible that a thousand more of these Examples may be urged.

II. To all these Things we answer, 1. That all these Examples, and thousands more of the like, can be no Rule to conclude the thing; because all the same Things have been used with all care and circumspection to o∣thers, where the success has not been answerable. 2. That it is probable that the Stones dissolv'd by the afore∣said Medicaments, and such other like, might be only sandy, gritty Concretions, friable, and easily broken; whereas we say, had the Stone been great, and hard like a Flint, the Event would not have succeeded. 3. We can bring also the Opinion & Experience of many great Physicians to the contrary: Hartman is of Opinion the Stone in the Bladder, if it be confirmed, and already come to some magnitude, is scarcely cured by any o∣ther way than by cutting. Barbet saith a crumbling Stone is seldom, a hard Stone can never be wasted away, or cured by Medi∣cines. Guarinonius saith, that scarce ever any one saw the Stone broken by Medicines. I could name multitudes of others of this Opinion; but these may suffice. And truly daily Experience, to our Grief, and the wretched∣ness of miserable Patients, are as demonstrable and ir∣refutable Arguments of the Impossibility of Cure by Medicines without cutting: Though Wincleras, in Misc. curios. An. 76. Obser. 102. saith, he broke the Stone in the

Bladder of a Boy 12 old, and brought it away peace-meal by this Medicine: Take pur∣ple Violet=Seed half an Ounce; Waters of Strawberries, Rest∣barrow, Winter=Cherries, ana q. s. make an Emulsion, to which add Goats Blood two pound; Hog=Lice prepared one Dram; Species Lithontriptice half a Dram; Spirit of Tur∣pentine one Scruple; mix them: Dose two spoonfulfs often given, which made it come away in pieces: Probably this might be such a soft crumbling Stone as Barbet speaks of. I have made trial two or three several times, and the Experiment succee∣ded not; possibly the Stones might be of a flinty Sub∣stance, and therefore the Experiment not to be despi∣sed. The last I tried it up∣on without success, was cut of the Stone; which being extracted, weighed three Ounces, and some odd Grains, and was of a hard and marble=like substance.

III. Moreover, when it is to be considered, that the distance of Place is far, and the ways by which the Me∣dicines pass many: and that if they be strong, they carry large quantities of Matter from the whole Body to the Bladder, and do more hurt by their acrimony and te∣nuity, in scowring off the Lenter, Mucus, or slimy Mat∣ter, which usually sticks to the Stone, and serves it for a Bed; whereby the Stone is made sharper and harder, and thereby raises more in∣tense pains than before: But if they be weak, they lose their Virtue before they come at the urinary Passages and Bladder, whereby they do little or no good at all. I say, all these things being conside∣red, they still confirm me in my Opinion, That if a Stone be large, and of a flin∣ty or Marble-like hardness, or substance, there is no Cure for the same by Medicines, but by the Hand only of the Operator.

IV. Sometimes also we are deceived, and think there is a Stone, when indeed there is none; as is recorded concerning a Noble-Man, who after he had been tor∣mented

with pain and diffi∣culty in making Water, the Physicians and Chyrurgions doubted whether there was a Stone, or no; having used Medicines to no purpose, he was cut for the Stone, as is usual, and was eased of his pain; yet they found no Stone, but a fungous Flesh in the neck of the Bladder, which by degrees was con∣sumed by convenient Me∣dicines. A like Example to this, I can relate of a Patient of mine, viz. Mr. S — not long since one of the Shreiffs of the City of London; who having been for some Months troubled with Pain and Obstruction of Urine, with most other symptoms of the Stone, it was belie∣ved not only by my self, but by some others, to be the Stone: He also for a long time pissed Blood, and made bloody Urine, which some∣times I helpt him of, though it often returned again. He was a strong, lusty, and well-look'd Man, and for all that could be seen, might have lived many years. Be∣ing at his Country-House, at T —, he was afresh taken ill, (as himself, and we all thought, with the Stone:) He immediately came home for London, and sent for me as soon as ever I came into his Company, I saw Death in his face; he took me by the hand, held me, engaged my Company for that day, or 'till night; and withal (as one sensible his End was near) told me, he knew he had not long to be here, and therefore pray'd me to stay with him as long as he li∣ved: I could not deny the Request of so worthy and good a Man; however, af∣ter four or five hours stay with him, he dismist me; and prayed me. I would come to him the next day, and sit with him; which I did five or six hours: He pray'd me I would not leave him, for that it was the last trouble he should put me to; yet being late, dismist me again of his own accord, en∣gaging my Company again. Going to see him the next day, he was insensible, and knew me not, lying, as we supposed by his great groa∣ning in dreadful pain, and under the Agony of Death;

by the force of which Paro∣xysm, he surrendred his vi∣tal Breath. He was imme∣diately opened by — An excellent Chy∣rurgion of this City, nothing was found amiss in his whole Body, save the Lungs on his lest side grew to his Ribs; all the Viscera were sound and firm; nor was there any Stone in either Reins or Bladder: At last opening the Bladder, we found a Fungus or Polypus of Flesh, growing to the bottom of the Blad∣der, and hanging down to the Neck, being as near as I could guess about six In∣ches long, and an Inch and half Diameter, which gave a total suppression of Urine at time of Death: It was this Polypus or Fungus which bled, and almost continually made him make bloody U∣rine, by which at length he was something emaciated; and withal, it had begun, or was in part mortified, where∣upon Death ensued. I re∣late this to shew how easie it is for the best and wisest Men (for there was several skilful; learned, and worthy Persons, in Consultation a∣bout this Gentleman,) to be deceived; and how easie it is for us (notwithstanding all our Knowledge, Skill, and Experience) to err and be mistaken; and when we think we do for the better, even then, to do for the worse? Though I must con∣clude concerning this Per∣son, That if we had truly known what his malady had been, it had been absolute∣ly impossible for the most skilful Artist, or wisest Phy∣sician. to have cured him, or saved his Life.

V. Some are against the using of Lapis Spongiae Lyn∣cis, calcin'd Egg-shells, and such-like, because 'tis thought they may hurt the interme∣diate Parts: But this is not so; for as Sennertus urges, their Efficacy does much de∣pend upon their saline Spi∣rits which get into the Stone, and dissolve it into Atoms, just as Metals and Minerals are dissolved in Aqua-fortis; and Coral, Pearl, and the like, in Vine∣gar: For which Reason, the use of such Medicines are not to be neglected,

VI. Universals having been premised, we must come to the use of Diureticks, what∣soever some Physicians have said to the contrary; and such Things are to be used which may be able to cleanse and open the Reins, but to extend their force to the Bladder also, that so (if the Stone is too big to be avoi∣ded of its own accord the natural way) it may be di∣rected to the neck of the Bladder, and so be either forced out, or taken out by the help of Instruments, and the Hand of a skilful Artist. 'Tis true, that some Physi∣ans (as Avicenna for one) forbid the use of Diureticks, by reason they take away the skinny Coat from off the Stone, thereby causing more vehement pain; yet if we respect the Cure, viz. of expelling a Stone which is but small, (and possibly may come forth of its own ac∣cord, by the help of Diu∣reticks, through the na∣tural passage,) Diure∣ticks must be used, and those which are of the strongest kind also; not only to pre∣vent its future growth, but in order to the expelling of it through the neck of the Bladder and Urethra.

VII. Horatius Augenius commends this; as an excel∣lent thing for this purpose, even to break the Stone: Take Millepedes prepared one ounce; common Spirit of Wine four Ounces; Red Chick-Pease-Broth five Pound; mix them for eight Doses: One or two of which, as you see need requires, may be taken in a day. But the Potestates, or Powers, made of them, as we have taught in the ma∣king the Cantharides (in Lib. 1. Cap. 〈◊〉〈◊〉 Sect. 1. of our Phylaxa Medicinae) will be much more effectual to the same purpose; and may be given from ten, to twenty or thirty Drops, in a Glass of Ale, Mead, or Wine. You may also give the Potestates Lithontripticae, in the place quoted for the same intenti∣on, and in the same Dose and manner; they are a Me∣dicine not enough to be va∣lued for this Disease: For these Powers being of thin, pricking, and volatile Parts,

they open Obstructions, and resolve all tartarous Matter, which breeds the Stone and Gravel, but also dissolves a soft and porus Stone if bred, and then brings it a∣way.

VIII. Goats Blood is said to be a Specifick against the Stone, being taken in sub∣stance, dried, and in pouder, from half a Dram to a whole Dram, in White or Rhenish-Wine, or in our Syrupus Nephriticus. There is something more than or∣dinary in it, as to this mat∣ter, being generated of a food taken from stony, rocky Mountains, and Herbs proper against this Disease: Besides, it absorbs the acid Juice, and encounters the petrefactive Agent in its Root: But it will be much more powerful if you prepare it with our Spiritus Universalis, which will in eight or twelve hours time resolve it, and extract its Essence; this you may give to half a Dram: But if by reason of the unpleasant∣ness thereof the Sick cannot take it, affuse upon this Essence the best rectified Spirit of Wine, so much as may over-top it about four Inohes; and this will extract all the Tincture of Blood, leaving the Spirit behind, which may serve a∣gain for the like occasion. Or thus: Take rectified Spirit of Nitre eight Ounces; put it into a large, well-glazed Ear∣then vessel, or into a large Glass Vesica; put into it Gradatim, Goats Blood dried eight Ounces; so will it dissolve; digest twenty four hours, and you will have a glorious red Essence: Put to it twenty four Ounces of the best rectified Spi∣rit of Wine, by degrees; mix well, digest a Week, then filter, and keep it for Use close stopt. It is a volatile Acid, joined with a volatile Alcalie, and such are the Spirit of Wine, and Essence of the Blood; Dose from ten, to twenty, or thirty, or forty Drops, in any convenient Liquor. It opens all man∣ner of Obstructions in any part of the Body, provokes Urine powerfully, and is an admirable good thing against the Disury and Ischury, viz. where the Water comes scal∣ding, and by drops, or where it is totally supprest.

IX. I have found much good in this following, for bringing away Sand, Gravel, or any mucous Matter ob∣structing the Urine: Take Strasburg Turpentine two Oun∣ces; Oleum Petroleum one Ounce; Oleum Anisii, Bacca∣rum Juniperi, ana half an Ounce; Millepedes prepared, Earth-worms prepared, pure Salt of Tartar, volatile Sal-Ar∣moniack ana three Drams; mix them: Dose from six Drops to twelve, or more; in a Glass of Ale, Wine, or Mead. Sometimes I prepared it thus: Take Strasburg Tur∣pentine two Ounces; Oleum Petroleum one Ounce; Oil of Limons, Caraways, sweet Fen nel-seed, ana half an Ounce; Crabs Eyes, Goats Blood pre∣pared, volatile Sal-Armoniack, volatile Salt of Amber, ana three Drams; strong Tincture of Thebian Opium, made with the best rectified Spirit of Wine, an ounce and half; mix them; Dose from ten Drops, to twenty, thirty, or more, according to age and strength in any proper Ve∣hicle.

X. This is a thing I have often experienced with good success: Take of our Spiritus Universalis two Pound; brui sed Onions, eight Ounces; Parsley bruised four Ounces; digest twenty four hours, strain out by pressing, then pass it through a Filter; Dose from half a spoonful, to a spoon∣ful, or more, in a Glass of Ale, Mead, Wine, or Par∣sley, or Arsmart-water. Or thus: Take common Spirit of Wine a Quart; bruised Oni∣ons, Aniseeds, Parsley roots, ana six Ounces; mix, digest three days; strain, filter, and keep it for Use: Dose three or four spoonsuls in any fit Ve∣hicle.

XI. Laurenbergius, Riveri∣us, and others, mightily commend this, as a thing almost infallible: Take pure Salt of Tartar one Ounce; Parsley-water a Quart; mix, dissolve, and filter it two or three times through brown Pa∣per, that it may become clear; then put into it the fresh out∣ward Rind of Orange peels, so much as to colour it of a Citron∣colour, (viz. about two Ounces;)

after three days, decant the clear, and keep it for Use: The Dose is a spoonfull, or more, in half a Pint of White or Rhenish-Wine, or Wine in which Mustard∣seed, or Horse-Radish-root has been infused.

XII. This is commended by some for to expel the Stone in the Bladder: Take Millepedes prepared, Bedugar, or Sponge of the Briar bush, seeds of purple Violets, ana one Ounce; Species Lithontripticae two Drams; mix them, make a Pouder; Dose two Drams, in ten Ounces of a Diure∣tick Decoction, mixt with two Drams of Spirit of Ju∣niper. It was given at five in the Morning for some time; and a little after, a great quantity of reddish Urine came away, with flakes like Scales of Fishes, which was the Coat or Crust loosned from a larger Stone; and by the continual use thereof, the Sick was freed from his Disease.

XIII. This has been ap∣proved of: Take a Hare with young, calcine it to Ashes; these Ashes mix with an equal quan∣tity of Sugar: Dose two Drams in any convenient Vehicle, as Syrupus Nephriti∣cus, mixt with a Glass of White or Rhenish-Wine: But Arnoldus de Villa nova took a Hare, and fill'd the Bolly with the skin, Saxafrage, Mil∣let, Lapis Lyncis, Lapis Ju∣daicus, Lapis Spongiae, Cink∣foil, and golden Rod, and then calcin'd it; of which he gave a spoonful in a Glass of Wine every day; it broke (says he) and forced away the Stone in the Reins and Bladder.

XIV. I have often given this following Medicine with incredible success: Take Strasburg Turpentine two Oun∣ces; Hercules noster half an Ounce; Bezoar Minerale, Crabs Eyes, Millepedes prepared, ana q. s. mix, and make Pills: Dose two Drams twice a day, drinking after it the following mixture: Take Rbenish-Wine eight Ounces; Syrupus Nephriticus an Ounce; Potestates Litbontripticae fifteen Drops, mix for a Draught. This I have also proved with good Success: Take Balsam

of Peru half a Dram; Oils of Nard and Mastich, ana ten Drops; Oil of Juniper six Drops; Lapis Judaicus prepa∣red, Crabs Eyes fifteen Grains: mix, and give it in White or Rhenish-Wine, or a Decoction of Millet.

XV. If by these, or some of the Medicines mentioned in the former Chapter, the Sick receives no benefit, you must come to manual ope∣ration; how that is to be performed, whether by the Apparatus minor or major, we have taught in our Synopsis Medicinae, Lib. 3. Cap. 16. Sect. 7. & 8. to which we shall refer you. But there is another way of taking out the Stone, which is thus: The Artist puts his Finger up the Anus, and moves the Stone to the fore-part of the Belly, and then by a hole cut in the Mus∣culus Rectus, according to the Duct of the Fibres, above the Os Pubis, he takes out the Stone by the help of the Lapi∣dillium, or a pair of Forceps. The Operation being per∣formed this way, a dripping of the Urine need never be feared, and besides, a larger space is allowed to take out the Stone in. However, this Operations is not without its danger, besides the trouble; for if the Lips of the Wound made in the Bladder, be not united to the Muscles of the Abdomen,, an Exulcera∣tion of the Bladder follows; which both makes much pain, and creates an Ulcer more incurable than the Stone it self. Roussetus com∣mends cutting in the Groin, especially for Children; and is approved by Hildanus, in larger Stones, which cannot be brought to the Perinaeum, it being there taken out with less pain and danger of an Hemorrhage. The hea∣ling of the Bladder is not extraordinary, because it has fleshy Fibres; by the help whereof, and the innate heat, the Wound is the more easily cured.

XVI. Some inject by a Catheter into the Bladder, thinking thereby to break the Stone, for that the Me∣dicines are not altered in their passage, nor lose any thing of their Virtue, as those do which are given by

the mouth, but reach the Stone immediately. I have injected Opiates with good success for giving ease. If the Liquors be sharp, they ought to be such, that brea∣king the Stone, they may not hurt the Bladder; as Waters made of the Ashes of Scor∣pions, Parsley-roots, Knee∣holm, Crabs Eyes, Pellitory of the Wall, Pigeons dung, &c. Baverius injects Petro∣leum in which Lapis Lyncis has been boiled and strained forth, embrocating at the same time with a Decoction of Mallows. He says it wonderfully breaks the Stone in the Bladder. Or you may inject with this: Take a small Lixivium of Pot-Ashes one Pound; crude Opium two Drams; mix, di∣gest twenty four hours; then strain out the Liquor for use.