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. LVIII. Of the Cholick.

WHensoever the guts being obstructed, or otherwise affected, the excrements are hindred from passing forth, and if the fault be in the small guts, the affect is termed Ʋolvulus, I∣leos, and Miserere mei; but if it be in the greater guts, it is called the Colick,* 1.1 from the part affected, which is the Colon, that is, the continuitie of the greater guts; but especially that portion of the greater guts, which is properly and especially named Colon, or the Colick-gut. There∣fore Avicen rightly defines the Colick, A pain of the guts, wherein the excrements are difficultly evacuated by the fundament. Paulus Aegineta reduceth all the causes of the Colick, how various soever, to four heads: to wit, to the grosness, or toughness of the humors impact in the coats of the guts: flatulencies hindred from passage forth: the inflammation of the guts: and lastly, the collection of acrid and biteing humors. Now we will treat of each of these in particular. Al∣most the same causes produce the grosness of humors, and flatulencies in the guts, to wit, the use of flatulent and phlegmatick, tough and viscid meats, yea also of such as are of good nourish∣ment, if sundrie thereof, and of sundry kindes be eaten at the same meal, and in greater quantity then is fit, For hence crudity and obstruction, and at length the collection of flatulencies, where∣on a tensive pain ensues. This kinde of Colick is also caused by the use of crude fruits, and too cold drink, drunken especially when any is too hot by exercise, or any other way: for thus the stomach and the guts continued thereto, are refrigerated, and the humors and excrements therein contained are congealed, and, as it were, bound up.* 1.2 The colick which is caused by the inflamma∣tion of the kidnies, happens by the sympathie of the reins pained or troubled with the stone or gravel contained in them or the ureters. Therefore then also pain troubles the patient at his hips and loins, because the nerves, which arising from the vertebrae of the loins, are oppressed by the weight of the stones and gravel, about the joint of the hip are disseminated into the muscles of the loins and thigh. Also the ureters are pained (for they seem nothing else but certain hol∣low nerves) and also the cremaster muscles, so that the patient's testicles may seem to be drawn upwards with much violence. Hence great, phlegmatick, and cholerick vomiting, and sweat of the whole body, all which do not surcease before that the stone, or gravel shall be forced down into the bladder. Now vomiting happens in this affect, for that the ventricle by reason of its continuitie and neighborhood which it hath with the guts, suffers by consent or sympathie. For the stomach is of the same kinde or matter as the guts are, so that the guts seem nothing else but a certain production of the stomach. Therefore if at any time nature endeavor to expel any thing that is troublesome in the kidnies, ureters, coats of the guts, mesenterie, pancreas, and hypochon∣dries, it causeth a Colick with pain and vomiting. An hot and drie distemper also causeth the Col∣lick, produceing a pricking and biteing pain, by drying the excrements shut up in the guts,* 1.3 as also by wasting as it were the radical humors of that place provided for the lubricateing of the guts. Acrid, viscid and tough phlegm causeth the same. There is also another cause of the Colick which is not so common, to wit, the twineing of the guts, that is, when they are so twined, folded,* 1.4 and doubled, that the excrements, as it were, bound in their knots, cannot be expelled, as it mani∣festly happens in the rupture called Enterocele, by the falling of the guts into the cod: Likewise also worms generated in the Colick-gut, whilst that they mutually fold or twine themselves up, do also twine the Colon it self, and fold it with them. Also the too long stay of the excrements in the guts, whether it shall happen by the peculiar default of the too hot and drie body of the patient, or by his diet, that is, the use of too drie meats, or exercises and pains taken in the heat of the sun, or by the greatness of businesse, the minde being carried away, causeth the colick, with head-ach, and plenty of vapors flying upwards.

I remember I once dissected the body of a boy of some twelve years old,* 1.5 who had his guts fol∣ded with many as it were ties or knots of the restrained, too hard and drie excrements, the which he cast out by his mouth a little before his death, which brought him to his end, being not hel∣ped in time by fitting medicines. Now these are the causes of the colick, according to the opi∣nion of the ancient and modern Physicians, of whose signs I judg it not amiss here to treat in particular. You shall know the patient is troubled with the stone-colick,* 1.6 by the pain which is fixed, and as it were kept in one place, to wit, of the kidnies; by his former manner of life, as if the patient hath formerly voided stones or gravell together with his urine; by the pain of the hips and testicles for the formerly mentioned causes; and lastly, by that the patient casteth forth by stone or urine, for that the great and laborious endeavor of nature to cast forth the stone which is in the kidnies, is propagated by a certain sympathie, and like study of the neighboring parts, stirring up the expulsive faculties each to his work. The signs of a flatulent colick are, a ten∣sive pain, such as if the guts were rent or torn in pieces, together with a noise or rumbling in the bellie. The force of the shut-up winde is sometimes so great, that it rendeth or teareth the guts in ••••nder, no otherwise then a swines bladder too hard blown up; Which when it happens, the patient dies with much vomiting, because the stomach opprest with winde, can contain not imbrace no meat. The colick which is occasioned by the too long keeping in of the excrements, is

accompanied with the weight and pain of the bellie, the tension of the guts, head-ach, apparent hardness of the bellie, and the complaint of the patient that he hath not gone to stool in a long time. That which proceeds from a cholerick inflammation, yields a sense of great heat and pu••∣sation in the midst of the bellie, by reason of the veins and arteries which are in the pancreas and coats of the guts, and there are the other signs of a Phlegmon, although also this as it were inflam∣mation may arise also from salt, acrid and viscous phlegm, which nature can neither expel upwares by vomit, nor downwards by stool; this sundry times is asso••iated with a difficulty of making wa∣ter, for that when as the right gut is inflamed, the bladder is p••essed by reason of their society or neighborhood. The collick which proceeds from the conto••••on of the guts, shews it self by the excessive crueltie of the pain arising, for that the guts are not in their due site and pl••ce, and because the excrements by their too long detension acqui••e a preternatural heat; and this is the cause of the death of many such as have ruptures, for that the gut falling down from the natural place into the cod, being a p••eternatural place, is redoubled, and kept there as it were bound, whereby the excrements being baked, becoming more acridly hot, cause inflammation, and by raising up flatulen∣cies, increase the distension through all the guts, untill at length a deadly He••s or colick arising, they come forth at the mouth.* 1.7 For prognosticks; it is bettter to have the pain in the colick to wan∣der up and down, then to be fixed: it is good also that the excrements are not wholly supprest. But the evill signs that are here, pronounce the affect either difficult or deadly. Now these shew that it is deadly, intolerable tormenting pain, continual vomiting, cold sweat, coldness of the extreme parts, hicketing by reason of the sympathie the stomack hath with the guts, a ph••ens••e by the con∣sent of the brain with the stomach, and oft-times a convulsion, by drawing the matter into the news. But such as have gripeing and pain about their navill and loins, which can neither be helped by medicine nor othe••wise,* 1.8 it ends in a dropsie. The cure must be diversified according to the varietie of the causes, for the stone-collick is cured by medicines proper to the stone; that which is caused by an Enter••cele, is cured by the only restoreing the gut to its place; that which is occasioned by worms, requires medicines fit to kill and cast forth the worms. But that which proceeds from the weakness and refrigeration of the guts and stomack, is cured by heating and strengthening me∣dicines as well applyed outwardly, as taken inwardly by the mouth, or otherwaies. The be∣ginning of the cure of that which is occasioned by tough phlegm and flatulencies, is by the miti∣gation of the pain, seeing there is nothing which more dejects the powers then pain. To this purpose shall you provide baths,* 1.9 Semicupia, fomentations of mallows, marsh-mallows, violet leavs, penie-royal, fennel, Origanum, the seeds of thyme and fenugreek, flowers of camomil, melilote, and other such like, which have power to heat, drie, attenuate, and rarifie the skin, so to dissipate the winde. But all such must be actually hot. Also the belly may be anointed with this following oint∣ment.* 1.10 ℞. olei chamoem. aneth. butyr. recent. an. ℥ i. sem. apii, petros. & galang. an. ʒ ss. aq. vitae, ol salviae aut thymi chimici extract. q. s. The following liniment is much commended by Hollerius. ℞. olei. rut. & nardi. an ʒ vi. galbani cum aq. vit, dissoluti ʒ ii. liquefactis simul adde zibetae gr. iiii croci, gr. vi. fiat lini∣mentum. Also little bags made with millet, oats and salt fried with a little white wine in a f••ying-pan, shall be applied hot upon the bellie and flanks, and renewed before they grow cold. You may, in stead of these bags, use ox-bladders half filled with a decoction of resolving things, as salt, rosem••∣ry, thyme, lavender, bay-berries, and the like: then inject a glyster being thus made. ℞. quatuor ••mel. an. m. i. orig. puleg. calamenth. an. m. ss. anisi, carui an m. ss. fier. an••than p. i. bulliant in hydromele ad lb. i. n quâ dissolve bened. laxat. mellis anthosati, sacc rub. an. ℥i olei aneth. & chamaem. an. ℥i ss. Let a glyster be made to be injected at twice;* 1.11 for the guts being stretched out cannot contain the accustomed d••sis of a glyster: Also this following glyster is much approved. ℞. vini malvat. & olei nucum an. ℥ iii. aq. vitae, ℥ i olei juniperi, & rut. per quintum essent extract. an. ʒ iii Let this be injected as hot as the patient can endure. I have oft-times as by miracle, helped, intolerable pain caused by the winde collick and phlegm with this glyster. Avicen prescribes a carminative glyster made of hyssop, origanum aco∣rus, anis-seeds, and English galengal. Let the patient feed upon meats of good juice and easie di∣gestion, as broths made with the yolks of eggs, saffron, hot herbs and a nutmeg, let him drink good wine, as Muscadine, or hypocras made with good wine, so to heat the stomach and guts. For in Galen's opinion, all windiness is generated by a remiss heat. But if the pain shall continue, a large cupping-glass shall be applied to the navel, to draw and dissipate the windiness; the bellie shall be bound with strong and broad ligatures, to strengthen the guts, and discuss the matter of flatulencies. The patients taught by nature,* 1.12 use this remedie, whilst none admonishing them, they press the belly with their hands in the bitterness of pain. But if the pain cannot be thus appeased, we must come to such medicines as work by an occult property, as the dried gut of a Wolf, for a dram thereof made into powder is given in wine with good success.* 1.13 That colick which is caused, by a cholerick inflammation requires contrary medicines, to wit, blood-letting, and a refrigerating diet; potions made of Diacatholicon and Cassia dissolved in barlie-water, also cooling glysters. A∣vicen prescribes narcoticks, for that being cold, they are contrarie to the morbifick cause which is hot and drie; such are pills of Philonium. Also pills of Hyera picra in the quantity of ℈iv. with opium and saffron, of each one grain, may be used. Also baths are appointed, made of water wherein mallows, marsh-mallows, violet-leaves, flowers of white lilies, lettuce, purslain have been boiled, to correct the acrimonie of the cholerick and hot humors, whence the disease & symptom ariseth. That colick which is like to this, and proceeds from salt, acrid, thick and tough phlegm, is cured, the humor being first attenuated and diffused, and at length evacuated by medicines ta∣ken by the mouth and otherwise, according to the prescription of the learned Physician. But

Avicen cures that which is occasioned by the suppression of the hardened excrements, and tw••ne∣ing of them by meats which have an emollient faculty, such as humecting broths, as that which is made of an old cock tired with running, and threshed to death, and so boiled with dill, polypodie, and a little salt, untill the flesh fall from the bones; also he useth detergent glysters, such as this which follows. ℞. betae, m. i furfuris, p. i. ficus, nu. x. alth. m. i. fiat decoctio ad lb. i. in quà dissolve nitri & muriae an. ʒ ii. sacc. ℥ i. ol. sesamini, ℥ ii. But if the obstruction be more contumacious, you must use more powerful ones made ex cyclamin. centaurio, & hiera diacol. cinth. an. ʒ ii. But if the obstructi∣on do notwithstanding remain, so that the excrements come forth at the mouth, Marianus Sanctu•• wisheth (by the counsel of many who have so freed themselves from this deadly symptome) to drink three pounds of quick-silver with water only. For the doubled,* 1.14 and as it were twined up-gut is unfolded by the weight of the quick-silver, and the excrements are deprest and thrust forth, and the worms are killed which gave occasion to this affect. John of S Germans, that most worthie Apothecary, hath told me that he saw a Gentleman, who when as he could not be f••eed from the pain of the colick by any means prescribed by learned Physicians, at length by the counsel of a certain German his friend, drank three ounces of oil of sweet almonds drawn with∣out fi••e, and mixed with some white wine and pellitorie-water, and swallowed a leaden bullet besmea••ed with quick-silver, and that bullet coming presently out by his fundament, he was wholly freed from his colick.

Notes

• * 1.1

  What Ile••s, or illiaca passio is. What Celica passio or the Colick is. Lib. 3. Lib. 3. c. 43.
• * 1.2

  The manner of the stone-co∣lick.
• * 1.3

  How a hot di∣stemper caus∣eth the colick.
• * 1.4

  The folding of the guts the cause of the colick.
• * 1.5

  An history.
• * 1.6

  Signs whereby we know that the colick pro∣ceeds from this for that cause.
• * 1.7

  Avicen. lib 3. Hip apho••. 10. se••t. 4.
• * 1.8

  The cure.
• * 1.9

  Baths and a∣nodine fomen∣tations.
• * 1.10

  An ointment.
• * 1.11

  Why glisters in the collick must be given in less quanti∣tie.
• * 1.12

  Specifick medi∣cines.
• * 1.13

  The cure of a cholerick col∣lick.
• * 1.14

  The force of quick-si••ver in the unfolding of the guts. An historie.