The workes of that famous chirurgion Ambrose Parey translated out of Latin and compared with the French. by Tho: Johnson. Whereunto are added three tractates our of Adrianus Spigelius of the veines, arteries, & nerves, with large figures. Also a table of the bookes and chapters.

CHAP. XVI. Of an Oedema, or cold Phlegmatick Tumor.

HItherto we have treated of hot Tumors, now we must speak of cold; Cold Tumors are only two,* 1.1 an Oedema, and a Scirrhus. And for all that Hippocrates and the Ancients used the word Oedema, for all sorts of Tumors, in general; yet by Galen and those Physitians which succeeded him, it hath been drawn from that large and general signification, to a more strait and special, only to design a certain species, or kind of Tumor.

* 1.2Wherefore an Oedema is a soft, lax, and painless Tumor, caused by collection of a Phlegmatick humor.

* 1.3The Ancients made eight differences of Tumors proceeding of Phlegm: The first they termed a true and lawful Oedema proceeding from natural Phlegm; from unnatural Phlegm by admixti∣on of another humor they would have three sorts of Tumors to arise; is that, by mixture of blood, should be made an Oedema Phlegmonedes, and so of the rest.

Besides, when they perceived unnatural Phlegm either puffed up by flatulency, or to flow with a waterish moisture, they called some Oedema's flatulent, others waterish; but also when they saw this same Phlegm often to turn into a certain Plaister-like substance, they thought that hence proceeded another kind of Oedema, which they expressed one while by the name of Atheroma, a∣nother while by Steatoma, and sometimes by Melicerides, as lastly, they called that kind of Oedema which is caused by putrid and corrupt flegm,* 1.4 Scrophule. For we must observe that Phlegm some∣times is natural, & offends only in quantity; whence the true Oedema proceeds: otherwhiles it is not natural; and it becomes not natural, either by admixtion of a strange substance, as bloud, choler, or Melancholy, whence arise the three kinds of Oedema's noted formerly by the way; or by the putridness and corruptions of its proper substance, whence the Strumae and Scrophulae proceed; or by concretion, whence kernels and all kinds of Wens, Ganglia, and knots; or by resolution, whence all flatulent and waterish Tumors, as the Hydrocele, Pneumat••cele, and all kinds of Dropsies.

* 1.5The causes of all Oedema's are the defluxion of a Phlegmatick, or flatulent humor into any part, or the congestion of the same made by little and little in any part, by reason of the imbecillity thereof in concocting the nourishment, and expelling the excrement.

* 1.6The signs are a colour whitish and like unto the skin, a sort Tumor, rare and laxe by reason of the plentiful moisture with which it abounds, and without pain, by reason this humor infers no sense of heat nor manifest cold; when you press it with your finger the print thereof remains, because of the grosness of the humor and slowness to motion.* 1.7 Oedema's breed rather in Winter than in Summer, because Winter is fitter to heap up Phlegm; they chiefly possess the Nervous and Glandulous parts, because they are bloudless, and so cold and more fit by reason of their loos∣ness to receive a defluxion; for the same cause, bodies full of ill humors, ancient, and not exer∣cised, are chiefly troubled with this kind of Tumor.

* 1.8An Oedema is terminated sometimes by resolution, but oftner by concretion; seldomer by sup∣puration, by reason of the small quantity of heat in that humor.

A Symptomatical Oedema, as that which follows upon a Dropsie, or Consumption, admits no cure unless the disease be first taken away.

The general cure is placed in two things, that is, in evacuation of the conjunct,* 1.9 and matter pro∣hibiting the generation of the antecedent. We attain to both, chiefly by four means.

The first truly by ordaining a fit manner of living and prescribing moderation in the use of the six things not natural. Wherefore we must make choice of such air as is hot, dry and subtle;* 1.10 we must prescribe Wine of a middle Nature for his drink; let the Bread be well baked; let meats be ap∣pointed which may generate good bloud, and these rather rosted than boyled. Let all fruits be forbidden, as also Broths and Milk-meats; let him eat such Fish as are taken in Stony Rivers; the Patient shall observe mediocrity in feeding, but principally sobriety in drinking, for fear of cru∣dities; after meat let him use digestive powders, or common dridge powder; if his belly be not naturally loose, let it be made so by art.

Let the Patient use exercise before meat, so by little and little to spend this humor,* 1.11 and restore the native heat. Let him sleep little, because much sleep breedeth cold humors; let him avoid grief and sadness. And if he be of a weak body, let him abstain from venery, lest by another weak∣ning by the use of venery added to his present infirmity, he fall into an incurable coldness, from whence a greater measure of crudity will arise. Otherwise, if the body be strong and lusty,* 1.12 by such exercises, and the moderate use of venery, it will be the more dryed and heated.

For so that sentence of Hippocrates is to be understood; That venery is a cure for Phlegmatick diseases, as Galen in his Commentaries tells us.* 1.13 The Physitian may perform the second intention by turning his counsel to that part, from whence the Spring of Phlegmatick humor flows. For if the infirmity arise from the Stomach, or from any other part, the part from whence it comes must be strengthned; if from the whole habit of the body, let attenuating, penetrating, and opening medi∣cines be prescribed. We perform the third intention by evacuating the humor impact in the part with local medicines varied according to the four times of the Tumor.

For Galen, in the beginning and encrease,* 1.14 prescribeth a fomentation of Oxycratum used with a spunge. But if so be that the Oedema be upon the Arm, or Leg, a repelling rowler is very good, that is, such an one as is brought from below upwards.* 1.15 So these medicines following are very fit for the same purpose, ℞ Lixivit ex cineribus sarmentorum, & caulium, an. ℥ iiij, Tartari & Aluminis an. ℥ ss, aceti ℥ ij, mix all together and make a decoction, wherein wet Sponges & foment the place. Also you may use the following Cataplsm, ℞ farinae hordei ℥ iiij, coquantur in Lixivio communi, ad∣dendo pulveris nucis cupressi, corticum granatorum, balausti. an. ℥ i, Myrrhae, Aloes, alum. an. ℥ ss, olei Myrtill. ℥ ij, fiat Cataplasma. In the state and declination, you must use drying and resolving medi∣cines, as, Nucum cupressi, granat. sumach. balausti an. ℥ i, Salviae, origan. calament. Hyssopi, melissae an. m. i, absinthii, plantag. caudae equ. tapsi. bar••. centinod. an. m. ss. alum. tartar. & salis com. an. ʒ i, coquan∣tur cum lixivio; foment it with a Spunge, then presently apply this following Cataplasm. ℞ Rad. Brioniae ℥ ij, absinth. plantag. centin. chamaem. meli••oti peleg. an. m. ss. coquantur in hydromelite, pistentur, trajiciantur, addendo pulveris ros. rub. ch••maem. melil. an. ℥ i, fiat Cataplasm.

Lastly, you may here with good success use resolving Emplaisters and Ointments, first heating,* 1.16 or chafing the part by friction or fomentations, as well moist as dry; otherwise Emplaisters will scarsly do their duty, by reason of the great coldness of the part, being not sufficient of it self to assimilate the nourishment, or to expel the superfluous and unprofitable humor. Let a fomentati∣on be made with white Wine, in which Sage, Rosemary, Thyme, Lavender, Chamomile and Meli∣lote flowers, red Roses, Orris roots, Staechas, and such like have been boyled with a little Vin∣egar added thereunto. Quench hot bricks in the same decoction, and apply them wrapped in lin∣nen clothes to the affected part, for so vapours will breathe forth, which hath an attenuating, pier∣cing, resolving and strenthening faculty. But you may, in stead of the Bricks, fitly apply Hogs or Ox-bladders, filled half full with the foresaid decoction, and that hot. The frictions must be made of hot linnen clothes, for so the native heat together with the bloud and spirits is recalled to the part, and fuliginous humors contained under the skin are resolved, whereby the strength of the part is in some part recovered.

Notes

• * 1.1

  Gal. lib. de ••u∣mo. praeter na∣tu••.
• * 1.2

  What an Oede∣ma is.
• * 1.3

  The differen∣ces of Oedema.
• * 1.4

  By how many wayes Phlegm becomes not natural.
• * 1.5

  The Causes.
• * 1.6

  The Signs.
• * 1.7

  The Progno∣sticks.
• * 1.8

  How Oedema's are termina∣ted.
• * 1.9

  The intentions of curing Oe∣dema's.
• * 1.10

  The diet.
• * 1.11

  Exercise.
• * 1.12

  What to be ob∣served in the use of venery.
• * 1.13

  6 Epid. sect. 5. sen. 23.
• * 1.14

  Lib. 2. ad Glauc. cap. 3.
• * 1.15

  A rowler.
• * 1.16

  What caution to be had in application of Emplaisters.