The idea of practical physick in twelve books ... / written in Latin by John Johnston ... ; and Englished by Nich. Culpeper, Gent. ... and W.R.

Title, II. Of organical Diseases.

Chap. 1. Of Diseases of Conformation.

AN organical Disease is the diviation or swerveing of the parts of Mans Body from their natural structure.

Now because to the said Natural structure Conformation, Number, Situation, and Con∣nexion are requisite, therefore there wil be so many differences, and to this title four heads are subjoined; and also because in Conformation or Shaping, three things are required, viz. Figure, Cavity, and Surface, there wil be consequently so many diseases.

Article, 1. Of diseases of Figure.

A disease in Figure, is the swerving of the parts of Mans Body from their natural fi∣gure, depending upon certain peculiar causes.

The Signs are evident, so that it is needless to speak of them.

The Causes, are whatsoever may violate the figure of our bodies either by compounding, or loosening, distorting, or exhausting.

The Cure is not difficult in such as by reason of the Humidity of their bones are yet in a gro∣wing condition. It is hardly to be attempted in persons growen up, in whom the bones, whose figure the external parts do represent, have attained greater hardness and dryness. It is performed,

• 1. By handling and working the part the contrary way,
• 2. By binding with swathes and splints.

It may be repeated, if the former succeeded not, if the hurt be very great and the sick man lusty: and that by brea∣king of the Callus emollients being premised. It ought not to be repeated, if the patient be old, the hurt Less, and the Callus hard.

The differences are from the times of swer∣ving of the parts.

I. Either it happens before the Nativity in the womb, and then the fault is in the shaping faculty, and it is hardly cured.

II. Or in the birth: and then, either the In∣fant was too great, or the Orifice of the Womb too strait.

III. Or after the Birth: where the chief fault is overmuch repletion, which must be cured with Evacuation; Defect of Nutri∣ment, which requires meats easie of digestion, of good juyce, and of little Excrement. See the chapter of Arrophia, Violent motion, either caused by the patient himself, or by the Artist, in which case, fractures of Bones do chiefly happen. The setling of one part upon another, either by reason of the Resolution or Convulsion of the Nerves; in which case we must have respect to the disease it self of the Nerves.

Article, 2. Of Disease of the Cavities.

Point, I. Of Diseases of the Cavities con∣sisting in Excess.

Diseases of the Cavities are those, wherein the natural passages of the parts are hurt. By Cavities or hollow receptacls, we understand both those large Capacities of the Stomach, Brain, Heart, and Womb: as also the passages of the Veins, Arteries, Ureters, &c. and the O rifice or Head of the Vessels and al Cavities whatsoever.

And because the Cavities are hurt, either by way of excess, or in defect; the diseases of the Cavities are divided into such as consist in Excess and such as consist in defect.

Diseases of the Cavities in Excess are, when they are greater than naturally they ought to be.

The SIGNS shal be set down, when we come to speak particularly of them.

The CAUSE is, what ever is of tendency to open, or distend, or fret, and divide the Ca∣vities.

The CURE is performed by Stopping.

They are divided into Anastomosis, Dia∣pedesis, and Diairesis.

I. Anastomosis is when the mouths of the Vessels are too much opened and wide∣ned. It is known by a plentiful shedding forth of such humor or matter, which ought to be contained in the said Cavities. It arises from such things either external or internal, which are apt to loosen, or distend. The Cure tends to shut up, by astringent med••caments (of which in their place) and has an Eye withal to their Causes. The chief astringents are, Leavs of Shepherds-pouch, seeds of Purslane, flo∣wers of Balaustians, smal Dasies, bole Ar∣meniack, juyce of Slowes, new Treacle, pou∣der of Mans Bones, Crocus Martis, &c. As for the differences,

• 1. Either it springs from an External Cause as opening medicaments; and then the causes preceding must be remo∣ved. Or,
• 2. from plenty of Humors especi∣ally blood, burthening the faculty; and then thē signs of those Humours are present. We must go to work, with blood-letting and pur∣ging.
• 3. Or from the Quality of Humors provoking the faculty; and then their signs are present. Evacuations being premised, we must use astringents.

II. Diairesis is, when the Vessels are divi∣ded. 'Tis known by plentiful efflux of matter with pain. It arises from causes which cor∣rode, distend, or break. The Cure requires conjunction or soddering by astringent Medi∣caments. The diffences are taken from the Causes.

• 1. It is either from external Causes, viz. vehement motion, heavy weight, exclama∣tion, leaping, contusion, wounds, sharp & thick medicaments.
• 2. Or from sharp biting hu∣mors, and then the signs of a cholerick or salt humor are present. The Cure consists in alte∣raion by cooling medicaments and such as blunt the sharpness of Humors; by evacuation with choler and water-purgers, &c. and by a cooling and mitigating diet.
• 3. Or from plenty of Hu∣mors, in which case, the Cure is the same with that in the Anastomosis.
• 4. Or from Winds, and then the signs of wind are present, viz. stretching without weight, wandring pain; the Causes engendring win••s were precedent, the disease arose on a sudden, the Urine is ful of bubles, &c.

The Causes are, plenty of moist diet, weak heat, which cannot digest the matter. The Cure requires, that the Cause be evacuated; that winds be expelled by con∣venient Medicaments. White Amber is com∣mended in this Case, old Treacle also and Mi∣thridate, Electuary of Bayberries, Conserve of Sage, Spirit of Turpentine, Oyl of Fenel Seed, Anisseed, Pouder of Citron Peels, &c.

III. Diapedesis, when the Vessels are rari∣fied: 'tis known, by an over plentiful swea∣ting forth of Humors. It arises from rarify∣ing and moistening Causes. The Cure re∣spects the Causes.

Point, 2. Of Diseases of the Cavities in Defect.

Diseases of the Cavities in Defect are, when the Cavities are rendred more straight than is fit.

The SIGNS you shal meet with in the particulars.

The CAUSES of this straitness are Ob∣struction, Constipation, Growing together, Compression, Falling-in, of which in the Dif∣ferences.

The CURE requires the Removal of this Straitness, which varies according to the variety of Differences.

As for the differences, under them five things are contained.

I. Obstruction, which is nothing else, but the shutting up of the passages by Humors or other things. It arises from Humors and things wholly against nature, &c. 'Tis cured by convenient application of deobstructive medicaments. 'Tis divided according to the Causes,

• 1. One sort springs from multitude of Humors; and then Diet is the Cause. Evacu∣ation helps this sort, which must be large, it the Humors be many, having respect to the places. From the Chest by Coughing, from the Sto∣mach by vomiting, from the Belly by Stool.
• 2. Another from thick and clammy humors; and then we must use abstertion, cutting and attenuating: somtimes abstertion alone wil suffice, if the Cavity be open. The medica∣ments ought to be strong, when the viscidity of humors is great, and the place remote; more mild, when the Case is contrary, and alwaies appropriate unto the parts.
• 3. Another is from Stone, Worms, Quittor, Dung, of which we shal speak in its place: and then we must use al Evacuations, either at once, or at divers times. And respect is to be had to the place in which the humors are lodged.
• 4. Another sort is from clotters of Blood, then we must use medicaments which dissolve blood, such as are the Magistery of Crabs-Eyes, Pouder of Rhubard, Tormentil, Sperma ceti not rancid, &c.

You have cutting and deobstructive Me∣dicaments, above in the third Book. The prin∣cipal shal be specified, in the Cure of particular obstructions.

II. Constipation, when the passage is shut up, by flesh or a tumor bred in the cavity. It arises from a Caruncle, Membrane, inflamati∣on, Tunicle, Push; which must be concocted. The Cure requires consumption and evacuati∣on of the matter.

III. Coalescence, is when the wals or sides of the passage grow together, after an ulcer or wound. It arises from flesh growing to the Cavity, from a scar, &c. The Cure requires breaking.

IV. Compression, when the passages are stopped by causes incident from without, which force together the sides thereof. It a∣rises, either from external causes as cold and dryers, where loosening and moistning things are good: or fresh Tumors or Bones, remo∣ved out of their places. The Cure requires their Removal, and has an Eye to the diversity of Causes.

V. Falling in, or falling down, when the passages are straitned by the loosness and falling together of the sides. It arises from over great moisture. 'Tis cured by dryers.

Article, 3. Touching Diseases of the Sur∣face.

Diseases of the Surface are, when the parts decline from their natural Constitution, in the second Qualities.

The chiefest of them are Roughness and Smoothness.

I. Roughness, is a want of that Smoothness which ought to be in a part. It is caused, ei∣ther by addition of a Surface in the solid parts, as in fractures certain scales are seen; and there is need of fetching somwhat off, by abstersive Medicaments: or by taking away, and then sharp things both external, as vapors, Winds, Fumes, Meats, venemous Medica∣ments; and also internal, as over dryness of the parts when their moisture is consumed, bit∣ter choler, salt flegm, &c. In the Cure we must fil up, that which was hollowed, the a∣crimony of humors must be be tempered, and the parts not yet affected must be defended. We must goe to work with moist and clammy medicaments.

II. Smoothness, is a defect of that roughness which ought to be in a part. 'Tis cured with abstersive medicaments, which have withal some astriction, that the tone of the fibres may be repaired; and the spaces in the surface of the part, being dilated by humors, may be a∣gain contracted.

Chap. 2. Of Diseases of Number.

A Disease of Number, is when there is a fault in the number of parts.

'Tis divided into a Disease of number in de∣fect and in excess.

A Disease of number in defect is, when a part which ought naturally to be present is ab∣sent. That part is either Sanguine or Sper∣matick, which is not regenerate or repaired in Specie: or simple, or compound; nor must it be the particle of a part, but a whol part. The Cause is, whatsoever either by way of efficiency or privation of matter, may cause the want of any part. The Cure points us to Restitution, which is made only by nature; the Physitian mean while, preserving the strength of Nature, by defending the natural Heat; by supplying fit matter thereto, viz. blood; and by removing impediments, that is to say, Flesh and such like things. As for what concerns the Differences. Either the fault is original, or through defect of matter necessary to generation; or through the weak∣ness of the natural faculty, which ought to at∣tract, retain, and elaborate the matter; and so it cannot be restored. Or after birth: by cutting, gnawing, putrefaction, refrigerati∣on; and the Cure is to be directed to its cau∣ses.

II. A Disease of Number in Excess, is when there is a thing which naturally ought not to be present. The Cure requires the re∣moval of the said thing, which according to the variety of the things to be removed, must be various lest other parts be hurt, or that they may be hurt as little as may be; it is not to be applied to such things as do not trouble a man. If you consider the differences, The thing su∣perfluous is either wholly against nature, as Stones, Wormes, &c. and then the Cure is to be applied to them: or some entire substance, which arises either through over great plenty of master, and the weakness of the formative faculty in the first shaping of the Child, or by reason of of some vitious quality afterwards. In these Cases, the removal is procured by Fire, and hereunto belong actual Cauteries. Iron, whereunto belong al kind of sharp in∣struments. Medicaments, Causticks, Vesi∣catories, &c. of which we shal speak in their own place, when we handle particular Disea∣ses. A Vesicatory Plaister made up of one ounce of Cantharides or Spanish flies, half an ounce of Terpentine, Olibanum, Myrtle, Ma∣stich, Camphire of each one dram. Oyl of Ro∣ses, of Wax, of each a sufficient Quantity, is very much commended.

Chap. 3. Of Diseases of Mag∣nitude.

Article, 1. Of Tumors.

A Disease of Magnitude, is the swerving of the parts of Mans Body, from their natural magnitude.

It is divided into a Disease of Magnitude encreased, and of magnitude diminished.

Magnitude encreased is a Tumor, which is a swerving of the Parts of Mans Body from their natural State, by encrease of bulke.

The SIGNS are needless to recount; for if it happen in the external parts, it is percei∣ved by the sight, if it be within, it either disco∣vers it self by some external Sign, or by some other internal ones, of which when we come to the sorts. To encrease of Bulk there is somtimes added distemper, if the matter exceed in Qualities, and communicate them to the parts. Solution of Ʋnity, if the Continuity be loosened by fretting, or stretching. Faults in the shaping, either if the figure be corrup∣ted, the Cavities compressed or obstructed.

The Causes are Humors, Winds, solid Sub∣stance, of which we shal treat in their Diffe∣rences.

The CURE requires Imminution or les∣sening that which is overgrown, which if the parts be not sound, it is perfomed by the same medicaments, which are good in Number a∣bounding; if sound, it is performed by les∣sening the Parients diet, digestion, discussion, &c.

The Defferences are sundry.

I. One is from the Humors which is known by the signs of the Humors; it arises from Blood, Choler, Flegm, Melancholick, Seriosi∣ties, whether they be in the part by congestion or affluxion; and whether they are included in a peculiar membrane or not. 'Tis Cured, and that with Difficultie, if it be suddenly dimini∣shed, and be not evacuated by convenient passa∣ges, if a Fever be raised, or the fever that was before augmented. The Cure varies according to the variety of the Differences. 'Tis vari∣ously divided. For,

• 1. Either it is from Hu∣mors stirred up in the part; partly through fault of the part, inasmuch as the concoct ve or expulsive faculty do not perform their Of∣fice; partly of the Aliment, seeing it is viti∣ous and such, as it cannot be overcome by the part, and such as affords great store of Excre∣ments.

• And then the tumor is longer in breed∣ing: does not take up so great room, no cause or sign of any fluxion went before. In the Cure we must have an Eye to Alteration and Evacuation; and the latter must be sensible, if the matter be plentiful, and the part thick; Insensible, if the matter be little in quantity, and soft. Now concerning the Congestion of Humors, observe,
  • 1. That the matter which is Collected in the common cavities, being so encreased that it can be no longer there retained, is poured back to the Cavities and particular pores of the Place.
  • 2. That not only thick and clammy Humors, but also the ichors or thin Liquors, which separate themselves from the thick humors, are brought unto, and stick in the the part affected, especially when they grow cold, out of their own proper place.
  • 3. Also it may proceed from a spirituous matter, whence it is, that a part being weakned by a blow, does somtimes remain continually puffed up and swollen.
  • 4. Also that putrid humors are collected, and hence it is that there wil be smal risings in ulcers.
• 2. Or it is from humors that come into the part from some other place, either by Attraction caused by Heat or pain; or by Transmission, either from the whol Bo∣dy or some parts. Then the signes are con∣trary to congestion. There was no pain in the part, if it came by Transmission; there was, if it happened by afflux. In the Cure we must respect, both the continuing Affluxe, and the tumor which is in breeding, where evacu∣ation has place, either by blood-letting or pur∣gation. Revulsion to the contrary. Deri∣vation to the near parts. Repulsion, Inter∣ception, &c. and also the Affluxe already performed, where the same remedies are useful unless the matter be forced and fixed into the part, which must then be softened and ripened.
• 3. Or from humors shut up in particular mem∣branes or Bags, where the humor is turned in a manner into another substance.
• 4. Or from malignant humors, where the signes of Malig∣nity are present.

II. Another proceeds from Winds, which is hereby known, that there is no heaviness felt, though there be sometimes paine, and the part is sometimes greater, sometimes lesser. It arises from causes ingendering wind, and winds are multiplied and collected either under the skin and about the membranes of the mus∣cles, in the pores themselves of the similary parts or in the membranes of the bowels or in their cavities. It is cured and that with diffi∣culty, if it be contained in the Muscles, be∣cause the flatulent spirit is disposed in al their parts restrained and shut in by the ambient membranes. It is nevertheless cured by eva∣cuation of the matter, discussion thereof, and Roboration of the part.

III. Another proceeds from solid parts, whether they be bones fallen from their own into another place; or soft parts removed out of their place; or arteries, or veins: of which we shal treat in their proper places.

IV. There is another which is taken away by invisible discussion; and then the matter is neither much nor thick; nor deeply situate, nor shut up under a thick and compacted skin. The Body is not impure. Nature is strong: the member growes lighter: the troublesome pulsation ceases.

V. Another, is term inated by Suppuration; and then the matter is more plentiful and thick; lying in a deep place under a thick skin; while quittor is making, a paine and palpitation in the part together with a fever, afflict the patient: whenthe quittor is produced, the heat is dimini∣shed, the paine eased, the tumor becomes poin∣ted, and begins to be soft and white; the quitt or may be felt under a mans finger flowing this way and that, unless the part be thick, or it lie deep.

Another by Induration; and then the mat∣ter is clammy and hard, natural heat strong, the tumor it self diminished, and the Hard∣ness is encreased.

Another by Corruption; and then the part appeares lead-colored and black, and the heat and paine are diminished.

Point, 1. Of an Imposthume.

Two things follow a tumor which proceeds from Humors, viz. an Imposthume, which is sometimies attended with a Cavity.

An imposthume, is a collection of purulent matter or quittor in the Cavity of of some part proceeding from the Humor which causes the swelling.

The Subject, is the parts and their Cavi∣ties.

The Signs, may be fetcht from the third difference of tumors ariseing from humors, where the business of suppuration is hand∣led.

The Cause is the Humor it self, which na∣tural heat ripens and turns into quittor. Hence it is various according to the variety of the Matter.

The Cure, has respect to two certain times or seasons.

• I. When quittor is in making; and then we must act,
  • 1. By anodines and paine-asswa∣gers. Oyl of worms is exceedingly commen∣ded.
  • 2. By Ripeners and that temperatly hot and clammy, in hot tumors, and soft and moist bodies; such as sweet oyl, wheat flower, milk, crummy part of wheaten bread: with such as are yet hotter, in cold tumors, and cold Natures and parts; such as terpentine, fire-rosin, larch-rosin, pine-rosin, sigs, rai∣sons, diachylon simple.
• II. When quittor is made; where we must go to work with.
  • 1. Evacuation, either Insensible, which is dan∣gerous not only where there is great quantity of matter, for feare of hardning the same, but in al cases, by reason of accrimony, which may be increased by delay. Or sensible; and in this case, the Imposthume must be opened; either by more benigne medicaments, amongst which are Diachylon simple with mustard-seed figs, and salt: or by stronger, that is to say, potential and actual Causticks.
  • 2. By Clensing with detergents, viz. Juice of smalladg, of Centory, round birth-wort, wormwood, Betony, Agrimony &c.
  • 3. By breeding of flesh with Sarcotick medicaments.
  • 4. By covering all with a scar, by Epulotict medi∣caments, among which is Emplastrum Dia∣palma.

In respect of the Differences they are many∣fold.

I. Either it is from Blood, and then it is easily ripened, and being ripened it affords laudible quittor. Or from other humors, which arises with difficulty, has somwhat in it like quittor, green and yellow.

II. Or it is pure and simple quittor, like either to pap, hony, suit, oyle lees, and wine dregs, and sometimes mixed with many other things

III. The Impostume is either in fleshy parts, and then it is easily changed into quittor; or near the joints, in nervous and weak parts, which have little Heat in them; and then it is ripened with difficulty.

IV. Either the quittor flowes up and down in the Cavity, and is gathered into the receptacle thereof, or it is shut up into a pecu∣liar membrane and bag.

Point, 2. Of the Hole in an Imposthume.

The Sinus, or holly hole in an Impostume, is when the quittor diffusing it self in the depth thereof, the neighboring skin does not cleave to the flesh beneath it

The Sign is the going before of an impostume, and tents, by which it is best of al searched.

The Cause, is the quittor it self, which being kept in far below, does make by its acri∣mony coney holes as it were, and draws toge∣ther the excrements of the whol Body.

The Cure is imposible, if it have collected a Callus and hardness. Doubtful, if much and unconcocted matter is voided forth, & pain felt in the Hole. Hopeful if little quittor, good and white, come forth, and there be no pain. 'Tis performed,

• I. By Evacuation of the quittor, which is done either by bare clensing, if the Hole tend downwards, with barly wa∣ter, melicratum or mead, and wine sod with hony: or by Opening, so that either the whol cavity be cut asunder, if it be smal; or only the lower Orifice if it be great, and the part cannot be cut without danger.
• II. By pro∣duction of flesh with Sarcotick Medicaments, where note.

That an excrement must be re∣moved, as wel if it be thin as thick, least it stick in the Ulcer, Most with the dryer sort, as Oro∣busmeal, Orice root, Birthwort, Myrrb, Tutty, pompholyx, in such as are dry; with the less dry, as Franckincense, Barly meal, and Bean meal, in such as are dry. If the hole be not wide open, liquid medicaments are to be cast in by a syringe, and to be let alone a good while. By want of pain, and voidence of little quittor and wel digested, we may guess of the soodering and growing together again of the skin and flesh, and by contrary signs of the Contra∣ry.

As for what concerns the defferences, either they are shallow and little; or deep and broad; Either strait or oblique. They tend either upwards or downwards, and that way the worst quittor is evacuated.

Article, 2, Of diseases consisting in Mag∣nitude, diminished.

A disease of Magnitude diminished, is the diminuition of the parts of mans body in their natural magnitude.

There needs no signs, seeing the disease it self is evident.

The Causes are, want of aliment, either because it is drawn away, or because the chan∣nelar e obstructed. Straitness of the place in which a part ought to be augmented: sect∣ion,

putrefaction, refrigeration, ustion: of which in their places.

The Cure is undertaken.

• I. By repairing the part with plenty of good nourishment. in which case drinking of wines, meats of thick juice, little exerci••e, indifferent rubbings, are useful. A Dropax or pitchy medicament, of which see the Pharmacopeia.
• II. By re∣generation, if a member be pluckt away, which is the work of nature alone; only let the Phy∣sitian remove the impedicaments, &c.

Chap. 6. Diseases in Situati∣on.

A Disease of situation or connexion, is the se∣junction of such parts of the Body as ought to be conjoined, and a conjunction of such as ought to be separated.

'Tis needless I should speak of Signs, be∣cause the disease is of it selfe apparent.

The Causes consist in those things by means of which the parts are fastened together, and touching luxation, we shal speak in the follow∣ing Article. Now the connexion of such things as ought to be separate, comes to pass when the intermediate parts are loosned, or the liga∣ments broken, or wounded. The Cure requires the Conjunction of parts disjoined, and se∣paration of parts conjoined.

And because luxations are most frequent of al the diseases of situation: I think it meet in this place, to treat of Luxation in Gene∣rall.

Article. 1. Of Luxation.

Luxation in General is the slipping of a joint out of its natural seat into another, wher∣by voluntary motion is hindered.

The Signs are, the unlikeness of the Member to it self as it was before, in shape and length; Motion hurt; pain, by reason of Compression of the Nerves, Muscles, and tendons; the swel∣ing of that part, in to which the joint is slipt; the hollowness of that place from whence 'tis fallen.

The CAUSES are, al such things which are apt to stretch or violently to force; especi∣ally the laxity or solution of unity of the parts, wherein the joynts are contained, the Con∣traction of the Ligaments, &c. The Cure∣more easie, in children and soft persons. 'Tis hard if the••e be great pain, inflamation, a wound, or dancer of Convulsion. If the Lu∣xation be old and hardned with a callus. If it happen in childhood, and be not cured. If it tend to a Consumption, through cessation of Motion and Compression of the Vessels. If the joynts hurt, serve but few different moti∣ons. If they are departed far from their Cavity. If the Brows or edges of the Bones are broken. 'Tis performed by Reposition o•• Restoring the joynt to its place, which requires,

• 1. Suffici∣ent extension, whereby the bone is forced into its place,
• 2. Reposition with ones hand; or by common Instrumentes, or some devised on purpose.
• 3. By application of astringent Me∣dicaments, that inflamation may be preven∣ted.
• 4. By diligent binding, with swaths and bolsters.
• 5. By putting it into a gentle posture, and so that it may preserve its natural figure.

The Differences are sundry. For,

I. One sort springs from external Causes, a blow, a fal, violent extention before child∣birth, and at the time of the birth: which ought to be prevented. Another from Inter∣nal, when an humor slipt into the Cavity of the Joynt, drives it from its seat.

II. One is Perfect, when the whol Joynt is fallen out of its place, which is termed Ex∣arthrema.

Another is Imperfect, when the joynt is slipt only to the brim of the Socket, which is termed Pararthrema.

III. Another is with Inflamation and Pain, in which case, the pain must first be mitigated, the Inflamation asswaged; lest by distention of the Nervs a Convulsion arise; and afterwards it must be replaced.

IV. Another is accompanied with a Wound which is the most dangerous, especially if the wound be nigh the Joynt, and an accute fea∣ver arise. Here, the Joynt, is forthwith to be restored to its place, if possible. If it cannot be restored, we must attend the Cure of the In∣flamation to the seventh or ninth day.

V. Another is with a fracture, where the Joynt is first to be restored to its place, and the Fracture is to be cured afterwards: if it can∣not be reposed, it is then to be restored, when the Callus is bred.