Enchiridion medicum containing an epitome of the whole course of physicke: with the examination of a chirurgion, by way of dialogue betweene the doctor and the students. With a treatise contaning a definition of all those difenses that do chiefly affect the body of a man, and an antidotary of many excelllent and approued remedies for all diseases. Published for the benefit of young students in physicke, chirurgian, and apothecaries.

Of Clysters and their administration.

Doct.

THere remaineth that you shew me the order of Clysters & their administration: what is a Clyster? Stu. A Ciyster is a certaine liquor, inject∣ed into the belly for the remedy of some kind of disease: & this kind of medicine

is not a particular, but a common reme∣dy, not only for the diseases of the bow∣els, but it draweth from all other parts, as from the hollowes of the liuer, it draweth per vonam portam, it draweth melā choly from the splene by his brāch∣es. In like manner it doth dinert, and draw from the vpper parts; it cleanseth and scoureth the intestines, it is the best and safest medicine that can bee giuen, especially being well appointed, for it purgeth without any trouble.

Doct.

How is that medecine to be prepared?

Stud.

In time past, they would take one pound of liquor, as hydromel to scoure, milke, or the decoctiō of camo∣mell to cease paine: in this age they pre∣pare their cly sters of roots, hearbs, and seedes, being artificially boyled, which they cal decoction: in a pound of which decoction, they put one ounce of hony, of rose. to cleanse, of red suger, to stir vp excretion, with a dram of common salt, besides iij ounces of some kind of oyle, to make it more lubrick and stipperie, and with all some cathartick medicine to purge: as for example, if you will

purge the belly: we say

Rec.

• Decoctionis clyster is commin. or remodientis. lib j.
• Dissolue mellis & Sacchar. rub. an ℥ j.
• Catholici. ℥ j. ss
• Olei communis. ℥ iij.
• Fiat clyster.

This I declare for examples sake, not to the intent that the matter should be followed but the maner; for sometimes wee adde in stead of the purging medi∣cines those that be astringent, as Contino∣dium, Plantago, Tapsi barbat an M j. and so make a decoction. In one pound of the strayning you may ad some oyle, iuice: or if the patient be rich, some a stringent syrupe, as of Myttels or Quinces, iij, ounces: and so make an astringent cly∣ster, contrary to the former.

And we must obserue, that somtimes the liquor is to be increased or diminish∣ed, according to the discretion of the Physition; as when the bowels are op∣pressed, as in the dropsie, and in women great with child: also when they are ex∣tended with wind; as in the Colick, and Enterocele, &c. Also when wee would haue the patient to retain the mat∣ter longer then ordinary, we diminish

the quantity. When we would haue the clyster to ascend, as in the vlcers of the Ilions, and paine of the reines; also in the Apoplexie, lethargic, the quātity is to be increased, & to be made more shar∣per. Sometimes also oile is hurtfull: as in Dysenteria, where it maketh the vl∣cers soule and filthy; for then astringents, as oyle of roses or quinces, ought to be added to comfort and strengthen.

Doct.

It hath beene thought of some that clysters may be administred for nourishment; especially being made of broth, milke, egs, wine, and other com∣fortable things, when as the patient is not able through weakenesse or some other accident to swallow: let me heare what your opinion is in that point.

Stud.

It seemeth that Galen was of the contrary opinion, when he denied that the substance of the clyster was not car∣ried beyond the intestinum Ieiunum, from whence some haue supposed that the ficke patient hath beene refreshed with the vapour onely. It is true indeede, that the animal appetite may be satisfied with the vapor of the nourishmēt, but the na∣tural, wil not bee so satisfied, which de∣lighteth

only with substance, & not with vapours, which suddenly and speedily perish, and waste: but it is manifestly proued that the matter of the clyster to transcend the Iemnum intestinum, euen to the stomack, from whence the Mezerdi∣call veines doe draw nourishment: and in thacapassio it hath bin seene that often∣times the clyster hath beene cast vp by vomit: who is hee then that will denie that clysters nourish not, or come vnto the stomacke?

Matthaeus Grad. an interpreter of Ani∣cen doeth affirme, that he had seene a maid, that had taken Suppositories, and forth with with the violent attraction of the stomacke, fell into exceeding vo∣mitings; whereby they were compel∣led to minister vnto her fatte broths and juyces to dull the attractiue facultie, whereby she was recouered.

Doct.

I am of your opinion, that cly∣sters may be giuen to nourish, and haue obserued in diuers patients; who through weakenesse could take no nourishment by the mouth, yet by Clysters nature hath beene well refreshed, and the Patient in the end as well recouered.

But I would now know of you the order that must bee obserued as well by the Physition in the administring of the cly∣ster, as by the patient in receiuing of the same.

Stud.

You shall, and first for the time; it is thought that in the morning be∣tweene seuen and eight of the clocke, the stomacke being fasting, or in the after∣noone about fiue of the clocke, as the Physition shall thinke conuenient, is the fittest time; hauing a great care that it be not administred too hotte for the sen∣sibilitie of the intestines. I haue knowne some that haue brought great torments to the patient, by ministring of a scal∣ding clyster. But after the patient hath receiued the clyster let him by little and little turne himselfe vpon either side; and if the affect bee in the head or vpper parts, let the patient lie vpon his backe; if in the right side, let the patient lie so much the longer vpon the same, and so in like manner vpon the left; retaining the clyster if it be possible the space of an houre.

Afterwards when the clyster shall be sent forth with the excrements; let the

patient refraine meate the space of an houre, that so by that time the vapours dispersed through the body may be set∣led; otherwise, the fumes of the excre∣ments may be hurtfull, &c.

Doct.

Proceed now to the choice of the Remedy.

Stud.

The end of preparing physick is two fold: the first is, to preserue the present health of the body: the second, to reduce that which is lost. Health is preserued by a good diet, and sickenes is recouered by physicke: diet supplieth that which is wanting by the vse of like things; and Physicke being the curer, doth remoue those things that are hurt∣full vnto the faculties, by remedies that are contrary. There are three things that doeth hurt the action that is, the cause, sickenesse, and the symptoms, or accidents that doth follow sicknes. The cause doe precede the disease, euen as the shadow doth the body: the symp∣toms doth follow the disease; therefore the Physition must first endeuour to re∣moue the cause, for otherwise there is lit∣tle hope to cure the disease: and the out∣ward cause doth profit very much to the

knowledg of the inward: & as I haue al∣ready said, the scope of the Physition must be onely to remoue the same. And this cause is twofold, either coniunct or remote; which is commonly called an∣tecedent and consequent: we call that coniunct which imediatly and forth with causeth the disease; as some humor praetor naturä affixed to the part, either by fluxi∣on of congestion: we cal that remote and antecedent, from whence the same con∣iunct cause springeth, and is nourished: that is to say, Plethoria or Cacochymian.

Doct.

What is that Plethoria or Ca∣cochymian?

Stud.

Wee call that Plethoria when there is an imoderate fulnes, through a∣būdāre of blood, or of the 4. humors: the cure wherof doth consist in cuacuation; either by opening of a veine or purgatiō.

Cacochymia is a vitious quality of all the foure humours, or of some one of them: for either blood is distempered, or choler, or flegme, or melancholy; and that body which is so distempered, is cal∣led corpus cachochymicum, a body of an e∣uill complexion, iuice or disposition.

First therefore in the choice of the re∣medie,

we must first be carefull to deale with the cause, before the disease, or the symptom: the antecedent before the con∣iunct: the antecedēt cause, as I haue said, springeth from plethoria, or cacochymian: and the former is remoued by phlebotomi, and the latter by purgation.

In the choice of the remedy also wee must consider in opening of a vein, what weine must be opened, as the Cephalica for the head; the Basilica for the naturall parts; the Epalica, for the middle parts, and the diseases of the stomacke and the splene. In the choice of the remedy, we must also diligently consider the seate of that cacochymia, & whether it may be re∣moued with Aloes & Cassia, or with some cōmon Clyster, for to purge from the first region as from the stomack, from the lu∣testims, from the hollows of the liuer, from the Mesenterio, and the splene, it is sufficiēt oftentimes to vse Rhubarb, Sen∣na, & Agarick, with such like: but where it resteth in the parts more remote, we are then to vse a stronger means, as Scammo∣mack medicins, coloquintiáa, hermodactils, black helebor, & others of the same kind.

In the choice of the remedy we must

also consider the greatnes of the disease: for a great disease doeth require a great remedie; and a lighter, the lighter reme∣die: sometimes a small disease is cured onely by abstinence, frication, exercise, and with light remedies. In the admi∣nistration of a remedy, we must also con∣sider the strength of the sicke, and so dis∣pose the medicine accordingly. And this is an obseruation, that the remedy must be alwares greater then the disease; and before the opening of any veine a cly∣ster must precede, lest the crude humor which for the most part is contained in the first region, be carried into the places that are empty of blood.

Doct.

You haue satisfied me well in the Theorick part: let vs now come to the practise. Shew me your method in the Therapeuticke, part: let me know how you will remedy diseases that proceede of blood; which we will comprehend vnder Synochus, or a continuall feuer. Go to, let me know your method for the curation of a continuall feuer.

Stud.

That shall I most willingly per∣forme, and I hope to your full satisfacti∣on and contentment.

Notes

• De Clyste∣ribus.
• Disenteria.
• Clysteria quomodo adnuni∣stranda.
• De remedij delectu.
• Triasent quae actio∣nem laedunt.
• Vt enim duae, sant pri∣ma & com∣munes cau∣sae morbo∣rum: ple∣thea, & ca∣cochymia, sicremedia, sum m••ssio Sanguinis, & purgatio
• Remedy 〈◊〉〈◊〉