The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap. 3. Of Pain in the Ears.

PAin of the Ears called Otalgia in Greek, is a violent Disease, both in respect of the part affected, namely, the inward Membrane which goeth about the Cavity of the Ear; as 〈◊〉〈◊〉 by reason of the neerness of the Brain which often suffereth at the same time.

But since al pain comes from the solution of Continuity, al those things do cause pain in the Ears, which do dissolve the Continuity of those sensible parts which compass the Cavity of the Ear: the chief whereof are Distempers both without, and with, Matter, Wounds, Ulcers, or things fallen, or put into the Ears Externally.

A Cold Distemper doth somtimes cause pain in the Ears, and it comes from cold Winds, cold La••hs, and other very cold Causes.

A Hot Distemper without Matter, seldom or never produceth a pain in the Ears, as a cold doth: For Cold is an Enemy to these Nervous and Membranous parts, but Heat is a Friend to them. Nor can it cause any pain but that which is excessive, and wil cause a defluxion of Humors to the parts, and then it is not without Matter. For this Cause neither Galen, nor any of the anci••••t Greeks made mention of a Hot Distemper, although Avicen of al the Arabians have mentioned it.

Now the Cold Matter which causeth pain in the Ears is either flegm or water which comes from the Brain into them, or else wind coming from the Brain or the inferior parts.

But the Hot Matter, is either Choller that fals from the Veins and Arteries into those parts, or Blood, from whence cometh Inflamation.

The afore aid Cause produceth an occult Solution of Continuity from whence cometh Pain. But manifest Solutions of Continuity, as Wounds and Ulcers, are more evident Causes of pain. Wounds come from external Punctures, Cuts, and Contusions. But Ulcers come either after Inflamation and breaking of an Impostume, or from sharp Humors that corrode the parts,

Finally, Things that get into the Ear outwardly, if they be hard, sharp, or any wayes piercing or biting, wil cause pain.

You may know al these Causes thus, If the Distemper be without Matter, there wil be no heavi∣ness, distention, or tumor: And you may know that the Distemper is Cold, when cold Causes have preceded, as travel in Winter, when the pain increaseth in cold weather, or with cold Medicines and decreaseth with hot: but you may know a hot distemper by hot causes preceding, as being long in the Sun, or heat, and when hot Medicin••s hurt, and cold do profit.

If the Pain come from flegm, there wil be a heavin••ss in the Ear, and the Head; as also a Rhewin wil fal upon some other part, besides cold Causes did pr••cede, as cold and Northerly weather, cold meats; or it is winter and the Patient is old, and the like.

If it come from Wind there wil be a great pain without weight or heaviness, not constant, but in∣termitting and with noyse.

That it comes from Water, the Patient wil have other Diseases from the same, as sharp and thin defluctions upon the Teeth, Eyes, Ears, Breast, and other parts; and Evacuation of serous Mat∣ter by Vomit▪ Stool, Urine, or Sweat.

If it come from a Chollerick Humor the pain wil be sharp and pricking, and there wil be sensible heat; it wil be mitigated with cold things, and Choller wil somtimes come forth of the heat▪ the Body is of a Chollerick temper, the Party yong, the Weather hot, and Diet also with the like, by which the Patient is often distempered.

An Inflamation is known by a great beating pain, with great heat and redness about the Cheeks and Temples, to which there is joyned a continual violent Feaver; somtimes Doting, Swooning, Con∣vulsion, and coldness of the extream parts.

A Wound is known by the blood which wil come forth of the Ear, but an Ulcer by the filth, or matter; but because somtimes there is a defluxion of filth from the Brain by the Ears, we must di∣stinguish, for it if comes from the Brain; there w••nt before it a Head-ach and other signs of an Impo∣stume in the Brain: And first the matter is sent forth in great abundance and after by degrees while it is al spent. From an Imposthume in the Ear may come plenty of Matter, but then there went signs before of an Inflamation there, and afterward followed an Ulcer, wh••ch you may know whether it came from an Imposthume or a Defluxion of sharp Humors by the••e signs following; There is a constant Flux of a little filth or matter by degrees; there is felt a pain burning and shooting in the Ear, especially if it be picked. Moreover, We may conjecture of the Difference of the Ulcers, For if it be in the Bone, it is known by the thin Matter yellowish, and by the long continuance o•• the Disease: If it be deep, you shal know it by much Matter: If it be clean, by the ••audible Matter▪ If it be foul, by the thickness and plenty▪ If it be virulent, by the thinness: If putrid, by the stink of it: If it be corroding, by blood following. If fistulous, from the oldness of the Ulcer, the virulen∣cy of the Matter, the callosity and hardness of the flesh.

Finally, If there be any thing fallen into the Ear, either it may be seen, or related by the Pati∣ent.

The Prognostick of pain in the Ears is divers, according to the diversity of the Causes. That which comes from a bare distemper is easily cured. That which comes from a cold ••••egmy ferous, or windy matter, is not very dangerous, but u••eth to continue ••ong▪ But that which cometh from hot humors, and especially such as cause inflamation, is very dangerous, for the Brain being nigh must needs consent, and be also affected; from whence Deliriums, and Convulsons use to proceed. In this Disease yong men are in most danger: for they being of a hot temper, and their blood ••ot, the inflamation is greater; and this dissolveth the natural heat of the Brain, and killeth the Patient: Hence it is that they die for the most part within seven daies. But old men who are colder, have ••ess inflamation, and so are in less danger.

Ulcers in the Ears are hard to be cured, because the Brain being nigh, doth send its excrements to those parts: But those which follow an Imposthume▪ are easier cured, especially if the matter be ••au∣dible. But where the matter is virulent, stinking, or the like, it is difficult, especially if the Ulcer be cavous, and the bone foul.

The Cure, as the Diagnostick and Prognostick, is to be varied according to the Cause.

For if it comes from a bare cold distemper, hot Medicines applied to the Ears are sufficient, such as are in the cure of Deafness, esp••cially Fomentations and Fumes, as also the warm Oyls there de∣scribed. But when a hot distemper comes without matter, it may be cured with Topicks, which are cooling, which we will shew afterwards, and especially with the white of an Egg beaten with Breast milk, and put into the Ear.

If it come from a cold distemper with matter, as flegm, water, or wind, you must use the Medicines prescribed in the cure of Deafness. First, Purge the whol Body, then correct the distemper of the Brain, and apply warm Topicks that discuss unto the Ears.

If it come from a hot distemper with Choller, which is of long continuance, or comes by fits. First revel the humor that floweth to the part by Phlebotomy, by which the hot distemper of the whol Body with the Liver, in which Choller is made, is amended. Then purge the Humor with pro∣per Medicines. You may amend the hot distemper of the▪ Liver with Juleps or cooling Broths, with Whey of Goats milk, with sharp Vitriolat, Mineral Waters, with hot Baths, and the like. And lastly, All things are proper for it which are prescribed in the Cure of the Head from a hot cause▪ But you may use cooling Topicks and Anodines that take away pain, which we shall shew afterwards concerning the Inflamation.

Inflamation of the Ear is cured first by blood-letting, according to the quantity of the humor, for revulsion of it from the Ears, first having given an emollient and cooling Clyster: This must be done in great quantity, at divers times, for the greatness and violence of the Disease requires it. You must

open the Head Vein on that side the Ear is that is pained. If you think it comes from stoppage of Terms or Hemorrhoids, open the lower Veins, first having let blood in the Arm. When the cause is not from thence, it will do good for revulsion to apply Leeches.

Also you make good Revulsions by Frictions and Ligatures of the Arms and Thighs, by cupping the Shoulders and Back with Scarrification, or without.

Somtimes for Derivation it is good to apply Cupping glasses behind the Ears, with Scarrification; as Zacutus Lucitanus teacheth, Obser. 64. lib. 1. Praxis Admirandae, in these words. The Di∣vine old man in his second Book, Epid. Sect. 6. towards the end, saith thus: For pain in the Ear, clap on a Cupping glass. This worthy saying gave much help to a poor man which was in pain; and when al things failed, and he grew weak with watching, and mad with a continual Feaver, being rea∣dy to depart; having opened a Vein, and applied Cupping glasses to the Shoulders and Neck, and taken revelling Clysters, and purging, and the like; as also Anodines into his Ear without any pro∣fit, he was cured only with a Cupping glass with Scarification applied by the Glandles of the Ears, which drew much blood, and took away the inflamation.

The same Zacutus Lucitanus in Praxi ad Histori••s, commends four Hors-leeches applied be∣hind the Ears, which he saith gave much ease to a yong man which had a violent inflamation in his Ears.

The cutting of the Arteries in the Temples of the Forehead, doth produce rare effects for the ap∣peasing of the greatest pain in the Ears, by taking away the hot and windy blood which produced that grievous symptome. The way of doing it, is set down by us, in the Cure of the hot Head-ach.

A Purge against Choller is good, for so the Choller mixed with Blood, which by it is made so fluid, is drawn down, and sent forth.

Afterwards the whol mass of humors is to be tempered with cooling Juleps, made of the Decoction of Lettice, Purslain, Plantane, Sorrel, and the like, with Syrup of Lemmons, Pomegranats, or wild Poppies.

In the mean while, these Medicines are given; you must alwaies apply Topicks, which must al∣waies be Anodine, by reason of the vehemency of the pain, the mitigation whereof must be your chief intent; and this will be more rationally done, if in the beginning and the encrease of the Disease, you mix things that do gently repel; but in the state and declination, things that resolve, such as these following:

Take of new Breast-milk two ounces: the white of an Egg beaten to Water half an ounce: drop these mixed together, warm into the Ear.

Or Milk alone squirted into the Ear from the Breast; this doth much asswage.

Take Plantane and Nightshade, of each one handful: the flowers of Chamomel and Melilot, of each one pugil: Make a Decoction, and let the Patient receive the fume thereof into his Ear by a Funnel.

Take of the Oyl of Water-lillies and Roses, of each one ounce: Mix them, and drop thereof into the Ear; after the fume.

* 1.1 Sows infused in the aforesaid Oyls and strained, are the best Anodines; for these Creatures have especial force to appease pain, and therefore are used in the toothach, hemorrhoids, and the like; or take them asive, and boyl them with Water in the Oyls til the Water be consumed.

If the burning be very violently, you may mix cooling Juyces with the aforesaid Oyls, thus:

Take of the Oyl of Water-lillies, and Roses, of each one ounce: the Juyce of Nightshade and Plantane, of each half an ounce: Mix them, and drop thereof into the Ear.

Rose Vinegar is used of some Practitioners made of two parts of Oyl of Roses, and one part of Vi∣negar, which ought to be suspected, as al strong repelling Medicines; for there wil be danger, lest the humor flowing thither should return to the Brain; and it is a general Precept alwaies to be obser∣ved. That you never lay repelling Medicines to inflamations which are neer unto noble parts: but you may mix gentle Repellers with Anodines and Relaxers; for ••o they wil moderately repress the Defluxion, nor will they drive it far back: Such are the afore mentioned, to which you may ad this following:

Take of the Oyl of Roses, and Water-lillies, of each one ounce and an half: Rose and Plantane Water, of each half an ounce: Breast-milk one ounce: the Mucilage of the Seeds of Fleabane and Quinces drawn with Rose water, of each six drams: mix them. Put some drops thereof warm into the Ears, and bind clouts dipped in the same Liquor about the Ears.

In vehement pain we are constrained to fly to Narcoticks, or Stupifactives; but you must use them seldom, and with much care, because they offend the Brain. Galen saith, 3. de comp. med. sec. loc. I knew one, who only with the use of Opium, took away both speech and sence from his Patient, that he could be cured neither with Opobalsam, nor any other hot Medicine injected. Therefore if necessity constrain, thus they are to be prescribed:

Take of Oyl of Poppy-seeds one ounce and an half: Camphire and Opium of each two grains: mix them, and drop them into the Ear.

Take of the Oyl of sweet Almonds two ounces: the Juyce of Mallows half an ounce: Myrrh half a dram: Saffron half a scruple: Opium three or four grains: mix them for the use afore∣mentioned.

In applying of Topicks, the Rule of Galen is diligently to be observed, which is in lib. 3. comp. medic. sec. loc. cap. 1. that an inflamed Ear be not touched, but let the Medicines be injected by an instrument for to see into the Ear, or a Probe armed with lint and dipt in the Medicines. Then that you ask the Patient if he feel it warm, and if he can endure it hotter? and let it be used so hot as he can suffer: You must put the Probe so armed gently into the Hole of the ear that the Medicine may soak from it into the ear, you must do thus till the passage of the ear be ••illed with the Medi∣cine, then you must dip lint in the same Medicine, and lay it to the Hole of the ear, and round a∣bout.

In the state of the Disease you must mix gently resolving Oyls with Anodines, thus.

Take of Oyl of Chamomel, sweet Almonds and Violets, of each one ounce: the Oyl of Lillies half an ounce: Mix them.

But these Fomentations and Fumigations which are made of the following Decoction, do re∣solve more powerfully.

Take of Marsh-Mallow-Roots one ounce: Mallows, Nightshade, St. Johns-Wort, of each one handful: Linseed half an ounce: the seeds of Mallows, Ma••sh ••allows, and white Poppies, of each two drams: the Flowers of Chamomel, Dill, and Roses, of each one pugil: make a Deco∣ction in Water and Milk for a Fomentation and Fum••gation: ••ate•• taken out of Ashen sticks, being dropt into the Ears easeth pain and dissolveth the cause of it. You must put green Ashen sticks in to the fire, and take the Water that comes from both ends.

If the Tumor cannot be dissolved but it seems to tend to suppuration, which you may perceive by the encrease of pain, by greater Pulsation, and a stronger Fe••ver.

You must help the motion of Nature, and apply this following Cataplasm.

Take the faeces of the former Decoction made for a Fomentation and Fumigation: and put to them of D••cks and Hens-grease, Marrow o•• Vea••, and the Mucilage of Fleabane and Foenu∣greek-seeds, of each one ounce: the Oyl of Chamomel and V••olets, of each ••n•• ounce: Fresh Bu••∣ter one ounce and an half: Saffron half a dram▪ Make a Ca••a••lasm.

A Cataplasm o•• Crums of Bread is also very good; for it a••••w••ge••h pa••ns and furthers supp••rati∣on gently without inflamation: and therefore it is very proper in al Phlegmous or ho•• Tumors: you must make it thus.

Take of the Crums of white Bread one pound▪ boyl it in Goats Milk to a Pultis, then ad of the two Yolks of Eggs, the Oyl of Roses two ounces: Saffron one scruple: Make a Cata∣plasm.

The Cataplasm made of an Onyon, is much commended of Victorius Faventinus. Made thus.

Take one Onyon: Fresh Butter two ounces: Oyl of Chamomel and Roses, of each one ounce: Saffron one scruple: Make a Cataplasm, apply it warm.

The Suppuration being made, the Imposthume breaketh, and the Matter comes forth either by the Membrane of the Ear made thin, or else corroded, and then the Patient must lie upon the Ear that is pained, that the quittour may come forth; and you must drop such things into it as may clense.

Take of the Decoction of Barley four ounces: Honey of Roses one ounce: drop this warm into the Ears at several times.

If an Ulcer come from sharpness of Matter, you must have a peculiar way of Cure; such as is used to an Ulcer caused from a Defluxion of Humors.

And first, because according to the opinion of Galen, 4. de comp. Med. sec. loc. we may not ap∣ply Topicks to any part, except the whol Body be first often purged: we must use ordinary Eva∣cuations by Bleeding and Purging according to the nature and temper of the Patient; and these must be repeated through the whol time of Cure, as often as need requireth.

Then we must apply Drying and Clen••ing Topicks or Medicines to the place affected, beginning with the mildest first.

The Examples of which are these.

Take of the best Honey and old white Wine of each three ounces: boyl them, and skim them: drop of this into the Ear, and stop it with Cotton dipt in the same.

After that it may be stronger; mix the juyce of Horehound, Smallage, Wormwood, and the les∣ser Centaury, or of Sowbread with Honey: boyl them gently, and drop thereof into the Ear.

Or,

Take of the Juyce of Beets one ounce: Horehound half an ounce: the best Honey six drams: ••oyl these a little, then ad of the Syrup of Wormwood two drams: Mix them.

You may make a stronger Medicine thus.

Take of the Juyce of Sowbread one ounce: Myrrh one dram: Saffron half a scruple: Frankin∣sence one scruple: Verdegreece half a scruple: old Wine one ounce and an half: boyl them gently till the Wine be consumed: drop of this twice or thrice in a day into the Ear.

Observe, Before you drop any liquor into the Ear, you wash the ear in warm Hydromel, or wa∣ter and Honey, and wipe it wel with lint upon a Probe armed.

When the Ulcer is sufficiently Clensed, you must come to Cicatrizing. Thus.

Take of Round Birthwort, Pom••granate peels, and Galls, of each half an ounce: boyl them in equal parts of Wine and Smiths-forge-water, to half a pint, when it is strained, ad to it of the juyce of Plantane and Poligonum, of each one ounce: Honey of Roses two drams: mix them, and drop of this into the Ear. Or,

Take of Frankinsence and Myrrh of each one dram: Gum of Juniper half a dram: Sarcocol, and Labdanum, of each one scruple: Make a Pouder of them and mix it with Turpentine into Balls, which you must lay upon the Coals so that the Patient may take the Fume into his Ear by a funnel.

Or, You may mix that Pouder with some of the aforesaid Juyces, and drop thereof into the Ear.

Or, You may mix burnt Allum with white Wine, for this hath a very great Drying quality.

If the Ulcer be stubborn and old, it is nourished by a Defluxion, which you must labor to remove by usual Purges, Diets of Lignum vitae and Sarsa, by Errhins, Masticatories, Cauteries, and other Remedies that wil divert.

Then must you use stronger Medicines to dry the Ulcer; such as we prescribed of juyce, of Sow∣bread, Myrrh, and Verdegreece.

Or this following Medicine of Valescus, with which he saith that he Cured a Priest that had an Ulcer in his Ear from the eighth yeer of his age.

Take of Honey ten drams: Vinegar eight drams: boyl them: take off the scum, and put to one dram of Verdegreece: Mix them.

These must be dropt morning and evening into the Ear, after it is washed with this Decocti∣on.

Take of Wormwood, Marsh Mallows and Agrimony, of each one handful: boyl them in equal parts of water and white Wine put to it towards the conclusion, to half a pint: Dissolve in the strained Liquor Oximel simple one ounce and an half: Allum poudered one dram: wash the ear with this warmed, and after dry it with an armed Probe.

If the pain come from sharp Medicines, drop in the Oyl of sweet or bitter Almonds with Myrrh▪ Aloes, and Saffron: and if it be violent, mix a little Opium, or drop in the Oyl made of yolks of Eggs in a leaden Mortar.

If the Ulcer be very foul, you must use Aegyp••iacum, Dissolved in the aforesaid Juyces.

Lastly, Galen, Aerius, and Others, both Greeks and Arabians do much Commend the Rust of Iron for the drying of Ulcers in the Ear.

Galen, 3. de comp. med. sec. loc. useth Scales of Iron ground or boyled with the sharpest Vine∣gar.

Hollerius in his Comment upon that Chapter doth prefer the Arrabian Preparation, for they first grind the Iron with Vinegar, then they dry it; thus they do seven times, then they make it very fine, and boyl it long with the best Vinegar, while it is as thick as Honey, and then they dry it, and use it with Honey or other liquors.

If the Pain of the Ear come from any thing fallen into it, as a little stone, Cherry-stone, or the like; which wil be very grievous, and somtimes cause Convul••ions, Inflamations, and Death; as Matthaeus de Gradi saith of a Boy of ten yeers had a Cherry-stone in his ear, and through the igno∣rance of the Chirurgeon, he endured great pain, and after died.

You must draw out these things thus.

First, You may try with an Ear-picker which you must carefully attempt, lest your instrument force it further, which often hapeneth.

Therefore if that which is fallen into the ear do fill the hole. it is better to abstain from the use of the Ear-picker, and try these Remedies.

Paulus u••eth to dip his armed Ear-picker in Rozin, Turpentine, Gum, or the like; and to put it into the Ear, turning of it till you get it out by degrees.

If thus you cannot, put hot Oyl continually into the Ear to relax the part, and make the thing contained slippery, so it will easier come forth.

Use Neesings with the mouth and nostrils shut, for so it will be forced out of the Ears.

These are to be followed till the party be freed; for if it continue long in the Ear, it will be infla∣med, and then the thing will be more difficult and dangerous to be drawn forth.

Arculanus upon Rhasis, affirmeth that the Head of a Lizard applied to the Ear, will draw out any thing, and confirmeth it by his own Experience, in these words: In my Experiences for drawing things out of the Ear, this is one; Tie a live Lizard, or one lately dead, with his head to the Ear, for the space of three hours, and when you take it away, you shall find the thing stic∣king to the head of th•• Lizard: and this is good for the extraction of any thing wheresoever it is fastened.

Lastly, If the former Medicines do not prevail, you must come to the use of a Chyrurgical Instru∣ment, which is at large elegantly declared by Fabricius Hildanus, Cent. 1. Observ. 4, 5, 6. and by Aquapendent, in his Chyrurgical Operations, in his Chapter of the Chyrurgery for the Ears.

Somtimes Fle••s get into the Ears, and moving themselves in the Cavity, bring much disturbance. For the taking out of them, make a little ball of dogs hair, and put it into the Ear, so ▪will the Flea by reason of its affection to dogs come into it. Or make a tent, and put it often into the Ear, with a little Turpentine.

Oftentimes through swimming, or washing of the Head, water getteth into the Ears, which is very troublesom: this is shaken forth by hopping on the contrary foot, and holding the Ear down. If this will not do, you must ••uck it out with a reed, or a pair of bellows. If you arm the pipe with tow to make it stick clo••e, and keep the air out of the Ear, it will be better.

Galen and Aetius continue in powring in of Oyl, suppling the Ear, and then wiping it with wool; and after using Oyl for divers times.

And lastly, Put soft and dry Spunge into the Ear often, till it come out dry.

Notes

• * 1.1

  Called •• Ch••s••ip, or Kitchin¦bob, with many feet▪ which be∣ing touch∣ed gather∣eth it self round like a ball.