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.

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Title
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.
Author
Paré, Ambroise, 1510?-1590.
Publication
London :: printed by E: C: and are to be sold by John Clarke at Mercers Chappell in Cheapeside neare ye great Conduit,
1665.
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Subject terms
Medicine -- Early works to 1800.
Surgery -- Early works to 1800.
Anatomy -- Early works to 1800.
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http://name.umdl.umich.edu/A55895.0001.001
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"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." In the digital collection Early English Books Online 2. https://name.umdl.umich.edu/A55895.0001.001. University of Michigan Library Digital Collections. Accessed June 6, 2024.

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CHAP. XIV. Of the Palliative Cure of the Gout and the material causes thereof.

* 1.1HEre also must we consider the causes whence this disease proceeds, the temper of the di∣seased body, the parts affected, and those from whence it proceeds. For as these are not alwaies alike, so neither can one and the like remedy be useful in every Gout. For first those which proceed of a cold cause require other remedies, then those which arise from a hot, and that which proceeds from any one simple humor, then that which ariseth from diverse mixed together. For Choler alone causeth cruel pains, but tempered by the admixture of Phlegm, it becomes more gentle. Furthermore some remedies are good in the beginning, some in the encrease, and some at other times. Neither may we use repercussives in the Scia∣tica, as we may in the Gout of the feet and other joints; unless peradventure the part be fearfully inflamed.* 1.2 Taking these things to consideration we must observe that the Palliative cure of that Gout, which cannot absolutely be helped, as that which is hereditary and inve∣terate, is performed by four scopes. The first is by appointing a convenient diet in the six things which are termed not-natural. The second by evacuating and diverting the antecedent matter, both by purging and phlebotomy. The third by topick medicines according to the condition of the mor∣bifick humor and nature. The fourth by correcting the symptoms, but especially the pain, whereof in these affects there is oft-times so great excess by reason of the inexplicable and invincible malig∣nity of the virulent quality associating the humor that it alone is oft-times sufficient to kill the pa∣tient. And because the variety of morbifick causes, brings a variety of remedies, fitted to these four intentions,* 1.3 therefore it behoovs a Physician to be most attentive in the distinction of the cau∣ses. For he may be easily deceived and mistake one for another; for arthritick pains procee∣ding from a cold matter, if they be mitigated by the application of Narcotick and cold medi∣cines, it may induce us to believe that the material cause is hot, though really it be not so; for Nar∣coticks asswage pain, not for that they are contrary to the caus thereof, but because they take away

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the sense by induceing a numnesse; on the contrary, the material cause may sometimes seem cold,* 1.4 which notwithstanding is hot, for that it becomes better by application of hot medicines, that is, by takeing an argument from that which helps, because contraries are cured by contraries, and the like preserved by the like. But herein consists the error, for that hot medicines profit not by their contrariety, but by the attenuation of he gross matter, by the rarefaction of the skin, and dis∣sipating them into air. Whence you may gather,* 1.5 that an argument drawn from that which helps and hurts, is very deceitful: moreover it may happen that a large quantity of cold matter flowing down from the brain, may cause great pain by reason of the virulencie, and a small quantity of cho∣ler mixed therewith, which serves for a vehicle to carry down the tough and slow phlegm into the joints, whence the patient becomes thirsty and feaverish by reason of the heat and inflammation of these parts, whereby such as are less cautelous and heedy will easily be induced to believe that some hot matter is the occasion of this Gout. Now when as not some one simple humor, but diffe∣rent by reason of mixture, causeth the Gout, the yellowish colour of the part may deceive one,* 1.6 as, if the evil matter should proceed from choler only, which by the tenuity of its substance leaving the center, easily possesseth the circumference of the body or part: and notwithstanding much phlegm being as it were enraged by the admixtion of a little choler, may be the chief cause of the disease, and may peradventure be discovered by the encrease of pain in the night season.* 1.7 A feaver a∣riseing by means of pain and watching may encrease the conceived opinion of choler, which atte∣nuating and diffusing the humors, drives them into the joints, and causeth fiery urines, tinctured with much choler, and a quick pulse. Yet notwithstanding the Physician shall be in an error, if deceived with these appearances, he attempt the cure of this Gout, as ariseing from a hot,* 1.8 and not from a cold cause: yet I am not ignorant that the cure of the proper disease must be neglected for the cure of the symptoms. Besides also it may come to pass that choler may be the cause of the Gout,* 1.9 and notwithstanding no signs thereof may appear in the skin and surface of the affected part, because the coldness of the ambient air, and the force of applyed Narcoticks may have destroyed the colour of the juices lying thereunder, and as it were imprinted a certain blackness.* 1.10 It also happens that the body being over-charged with a great quantity of gross & viscid humors the expulsive faculty may discharge some portion thereof unto the joints, but leave the rest impact in the cavity of some en∣trail, where causing obstruction and putrefaction, may presently cause a fever, and that intermitting, if it be small, and obstruct only the lesser veins, and these of the habit of the body. Wherefore then it is not sufficient that the Physician employ himself in the cure of the Gout, but it behooves him much to attend the cure of the feaver, which if it be continual, it discredits the Physician, and en∣dangers the patient; if it be intermitting, it easily becomes continual, unless it be withstood with fit remedies, that is, unless you let blood, the belly being first gently purged, and nature be present∣ly freed by a stronger purge of the troublesome burden of humors. Now it is convenient,* 1.11 the purge be somewhat stronger then ordinary; for if it should be took weak, it will stir up the humors, but not carry them away, and they thus agitated will fall into the pained and weak joints, and cause the Gout to encrease, By this it appears how deceitful that conjecture is, which relies and is groun∣ded on one sign, as often as we must pronounce judgment of morbifick causes. Wherefore to con∣clude, we must think that opinion most certain concerning the matter of the disease,* 1.12 which is strengthened with multiplicity of signs, as those which are drawn from the colour of the part, the heat or coldness manifest to the touch, those things that help and hurt, the ptients familiar and usul diet, temper, age, region, season of the year, propriety of pain, the exacerbation or excess thereof, in what daies, and in what hours of the day, the length of these fits, the urine and other excrements coming from the patients body. But for that not a few are in that heresie,* 1.13 that they think that we must neither purge nor let blood in the Gout, we must here convince that opinion; For seeing that physick is the addition of that which wants, and the taking of those things that are supefluous, and the Gout is a disease which hath its essence from the plenty of abundounding hu∣mors, certainly, without the evacuation of them by purging and bleeding, we cannot hope to cure, ether it, or the pain which accompanies it. Metrius, in his Treatise of the Gout writes,* 1.14 that it mu•••• be cured by purging, used not only in the declination, but also in the height of the disease, which we have found true by experience; and it is consonant to this saying of Hippocrates; in pains we must purge by the stool. Besides also, Galen professeth that in great inflammations, fevers and pains, he knew no greater nor surer remedy then to let blood, even to the fainting of the patient. If thoe which are in this case shall not become better by purging and phlebotomy conveniently prescribed, then it happens by the means of drunkenness, gluttony, and the like distemper. For hence abundance of crude humors are heaped up, which by their contumacy yield themselves less obedient to medicines. Therefore such gouty persons as are intemperate and given to gluttony and venery; may hope for no health by use of medicines.

Notes

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