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 ...

THE SEVENTH BOOK OF THE PRACTICE OF PHYSICK. Of the Diseases of the Breast. (Book 7)

The PREFACE.

BY this name Thorax, or Breast, we mean those parts only which serve for brea∣thing; for although the Heart be contained in the Thorax, yet the Diseases ther∣of shall be set down in a Book by themselves. But in this we will only speak of those which hinder breathing, and hurt the part of Respiration; as Astbma, Pleuresie, Peripneumonia, or Inflamation of the Lungs, Empyema, and Phtysis; and we have ordained proper Chapters for each of them.

Chap. 1. Of Asthma, or Difficulty of Breathing.

THe Breath is hindered by divers Causes, either by sympathy, or propriety of part.

The hinderance of breathing by propriety called Idiopathica, comes from the Lungs distem∣pered, and therefore every Disease of the Lungs hurts their action, which Diseases are either in the substance of the Lungs, or in the Vessels thereof.

In the substance of the Lungs come inflamations, pimples, imposthumes, ulcers, and somtimes a drying, and atrophy of the part; somtimes a serous watery humor is suckt into the spungy substance of the Lungs, and hinders their free dilatation; somtimes, though seldom, there is a schirrus, a stone, or hard swelling in them.

In the Vessels of the Lungs, there are often obstructions, which hindering the free passage of the Air, cause difficulty of breathing.

Breathing is hindered by sympathy or consent from other parts, which are not only neer, but re∣mote, so the Membrane that goeth about the ribs being inflamed, or the Diaphragma, or Mediasti∣num, the breath is hindered. So by custom there is a great and often breathing when the heart is in∣flamed, as in Feavers; and on the contrary, when the Heart is cold, as in dying men, it is diminished

and ceaseth; the same happeneth in swouning or syncope, when the action of the Heart, and conse∣quently Respiration ceaseth.

So in the Empyema, or Dropsie of the Breast, when matter or water is collected in the Cavity of the Thorax, the Dilatation of the Lights, and Respiration is also hindered.

So the Muscles of Breathing being hurt, hinder Respiration, as in wounds and tumors of them, e∣specially in an Apoplexy, when the influence of the Animal Spirits is kept from them.

Moreover, The Inflamation of the Muscles of the Larynx makes difficulty of breathing in a Squinzy.

So also the Diseases of the Hypochondria do hinder Respiration by consent, as tumors of the Li∣ver, Spleen, Sweetbread or Pancreas, do by their weight draw down the Diaphragma to which they are joyned, and so hinder the motion of it. Also vapors and wind sent from those parts compress the Diaphragma, and hinder its action, from whence comes a flatulent Asthma. The same happeneth by the abundance of wind or water contained in the belly of an Hydropical man, and compressing the Diaphragma. Lastly, Vapors coming from the Mother hinder Respiration, from whence this dis∣ease is called, Suffocatio Hysterica.

Among the aforesaid hinderances of Respiration, the Asthma is handled by it self, because the o∣ther depend upon other Diseases; they shall be mentioned in their places.

Although Asthma used generally, comprehendeth in a large signification, all kinds of difficulty of breathing; yet it signifies more specially that shortness of breathing which comes from the stuffing of the Lungs, and the obstruction of the Bronchion, or Gristles of the Wind-pipe; which of its self es∣sentially is without a Feaver, although somtimes it be joyned therewith. And again, it is subdivided into three other kinds; as first, Dyspnoea; the second called also Asthma; the third Orthopnoea.

Dyspnoea is a difficulty of breathing, in which the breath is drawn oftener and thicker, from the stuffing of the Lungs. This is less than Asthma, or Orthopnoea, because the matter obstructing is less, and it rather stops the substance of the Lungs, than Gristles or Bronchia: hence it is that there is no snorting at all, which comes from the commotion of the humors contained in the Bronchia, with the Air continually passing through.

Asthma is a great and often breathing, in which the Diaphragma, the Intercostal Muscles between the Ribs, and of the Abdomen, are violently moved, joyned with snorting and wheesing. For in a true Asthma properly so called, the Btonchia of the Lungs are filled with flegm, which (as is said) being moved by the Air, make that noise.

Orthopnoea is a great difficulty of breathing, in which the Patient cannot breath but sitting, and with the neck extended upright; and the aforesaid Muscles are not only moved vehemently, but al∣so those of the Breast and Shoulders.

The names Dyspnoea and Orthopnoea, as we said of Asthma, are used commonly for all difficulties of breathing, which happen in Pleuresies, or Inflamation of the Lungs, or the like.

The same may be said of Apnaea, which doth not only signifie a depravation of breathing as the former, but also a diminishing or abolishing thereof; and this happeneth in syncope, Hysterical Passions, and strong Apoplexies.

The humor which causeth an Asthma, is for the most part flegm, which falls from the Head into the Lungs, and obstructs the Bronchia or Wind-pipe. Somtimes it comes from crude and serous humors brought by Arteria Venosa into the Lungs, and if these flow to the Bronchia, they produce a true Asthma with snorting; but if to the substance of the Lungs, or smooth Arteries, they cause a bastard Asthma without snorting.

This kind of Asthma, which is unknown to vulgar Physitians (who will acknowledg no other cause but a defluxion from the Head) is confirmed, not only by not snorting, but from the thick and tur∣bulent Urine of the Patient at that time, especially in the sit, because some part of those thick and crude humors in the Veins is sent to the Reins and Bladder. And some Asthmatical men are subject to stoppage of Urine, and when they are so, they are free from it. But when the fit of the Asthma comes, the difficulty of Urine ceaseth, because the matter of the disease contained in the Veins goes from one place to another: We have also seen some subject to a flux in the Belly, who while they were so, were free from the Asthma; but when that stopped, the Asthma returned. Moreover, this kind of Asthma which is without snorting, is so directly opposite to bleeding, that when a Vein is o∣pened in the fit, as soon as it bleedeth, the Patient begins presently to breath better, and in the end, or after a little space, they are cured of their fit. And finally, these kind of Asthmatical men, are for the most part of an ill habit of body, and have an oedematous humor in their feet, which sheweth that the cause of the Asthma at that time came from the Liver, and is contained in the Veins, so that somtimes a Dropsie followeth in many. Hence Aretaeus reckoneth a wind in the Midriff, and bel∣chings, without reason among the signs of an Asthma at hand, which certainly do come from a crude matter moved in the Midriff.

That flatulent matter doth of its self somtimes produce another kind of Asthma, which is called

Asthma flatulentum, or Hypochondriacum; when many thick vapors rising from the Hypochondria, do compress the Diaphragma, and hinder its motion, whence comes great difficulty of breathing, with∣out snorting.

The Knowledg of this Disease, and its kinds, may be by what hath been said.

In a Dispnoea, the breath is thick, without noise or anhelation, and with less trouble.

In an Asthma the Breast is more heavy, the Breath thicker and quicker, with anhelation, snorting, and wheesing.

But in Orthopnoea, the Patient cannot breath but with his neck upright, and if they lie down, they are ready to be choaked.

The Signs of the Causes are these:

If Asthma come from gross humors gathered in the Lungs, the difficulty of breathing comes by de∣grees, by little and little, and is continual.

But if Humors come at a distance from other parts into the Lungs, the difficulty of breathing is not continual For albeit Asthma which comes from matter contained in the Lungs, useth to be encrea∣sed by external causes, as Anger, Southernly winds, and the like; yet in Asthma which comes from matter flowing from another part, the encrease is more manifest. If this matter come from the brain, there is a manifest Catarrh; but if no signs of a Cararrh appear, you must conjecture that the matter comes by the Veins to the Lungs, and the swelling of the feet, and evil habit of body called Cachexia, is a sign that the Liver is affected.

If a thick humor be contained in the Bronchia of the Lungs, the Respiration is with noise and cough; as also by spitting the disease ceaseth, or is diminished.

If the Humor be in the Veins, or substance of the Lungs, there is no noise, and there is seldom any spitting by Cough.

As to the Prognostick. An Asthma is a Chronical disease, and very hard to be cured, and often ends in a Cachexia or Dropsie. Yong men are somtimes cured, and not without great labor, but old men never. Infants except they be speedily cured, die by a Catarrh, which followeth:

They who grow crooked upon an Asthma or Cough, die before they come to ripeness of age, because the gibbosity hindereth the convenient growth of the breast, nevertheless get their due encrease and bigness, but having not room enough to dilate themselves; from whence the heat of the Heart being not sufficiently fanned, the patient dieth.

A Pleuresie, or Peripneumonia commg upon an Asthma, is deadly, because the Lungs being weak∣ned by a long disease, cannot resist so great a disease coming thereupon, and expel the matter.

The Cure of the Asthma is two-fold. namely, in the Paroxysme, and out or it.

In the fit, presently you must open a Vein, a Clyster being given, if the blood do seem any way to abound: for when the Veins are empty of blood, the Respiration is more free. But if the disease be elder, and blood hath been often drawn, it is better to abstain from bleeding, because by diminishing the natural heat, it will encrease flegm.

It is good to open the Veins in the Ancles in this disease, coming by consent from other parts.

After bleeding, or if it be omitted as not thought fit, you must purge flegm, with the things pre∣scribed in the Cure of the cold distemper of the brain, putting to them alwaies things proper for the breast as much as may be.

Vomits, althongh disallowed by some in this disease, yet are they most convenient, as frequent experience hath taught, and somtimes the sit is taken away with a vomit only.

Among these the chief is Aqua Nicotiana, or Tobacco Water. given in the quantity of an ounce; and it may be made into a Syrup with Sugar: In want whereof you may use the Salt of Vitriol, Aqua benedicta Rulandi. Now the reason is excellent why Vomits do so much good in this dis∣ease. For while the thin humor falling from the head insinuateth it self into the Aspera Arteria, and the Bronchia of the Lungs; and the thick falls into the Stomach, and is there so fixed that it can scarce∣ly be taken away. And while the weak heat of the Stomach doth stir the matter, thick vapors are produced, which puffing up the Stomach, compress the Diaphragma, and cause difficulty of brea∣thing. Hence it comes that when the Stomach is emptied, the fit ceaseth, or is much less. Moreover, An Asthma somtimes (nay often, according to Sennertus) cometh of crude humors about the Liver, and in the Veins, which are carried by the Vena Arteriosa into the Lungs, and compress the Bronchia, from whence cometh an Asthma. For the evacuating and revelling of these humors from the Lungs, a Vomit is very good. As also for this cause, the Remedies purging humors downward are very ex∣cellent.

The Juyce of our Flowerdeluce, doth gently move and purge downward, taken to the quantity of half an ounce, with one ounce of Hippocras, which Placerus in his Observations saith he hath used with good success.

You may give two ounces of the juyce of Flowerdeluce, if the former did work suffici∣ently.

Also you may use sharp Clysters often for revulsion. But they must be given in smal quantities, lest by filling the Bowels the Diaphragma be compressed.

You must also use Frictions to the inferior parts, and apply many Cupping-glasses thereon, as also to the Neck. Afterwards you must extenuate and dissolve the thick humors, and discuss the vapors that come from them. For which purpose you may give a spoonful of Cinnamon Water, ei∣ther by its self, or with Syrup of Violets: as,

Take of Cinnamon Water two ounces: Syrup of Violets one ounce; or instead of that, mix with the Water one ounce of Oxymel to discuss the humors better.

It is also profitable to give three, four, or five drops of Chymical Oyl of Sage, Rosemary, or Annis feeds with a little Wine; or sprinkle therewith the Tablets of Diatragacanth frigid, and so let the Patient eat them.

Others commend one scruple of Saffron given in a spoonful of Wine. Also Aqua Clareta thus made is very good.

Take of Aqua vita four ounces: Water of Colts-foot and Scabious, of each two ounces: Cinna∣mon six drams: strain them through an Hippocras Bag. Let him take two or three ounces.

Tobacco taken in a pipe hinders the sit; so doth the Leaf chewed: and also the smoak of Cloves in a pipe.

In the mean time you must use expectorating Medicines, which bring forth the thicker matter up∣wards. As,

Take of the Syrup of Horehound, Liquoris, and Coltsfoot, of each two ounces: Oxymel simple one ounce. Mix them, and let him lick it by little and little.

Take of washed Turpentine one ounce: Ammoniacum two scruples: Flower of Brimstone one scruple: mix them into soft pills, of which let him take one every second hour with half an ounce of the Syrup of Hysop.

Take of the Oyl of sweet Almonds new drawn without fire six ounces: Sugar Candy▪ two oun∣ces: Mix them for a Lambitive. Or

Take of candied Elicampane three drams: Sugar-candy half an ounce: Syrup of Hysop and Horehound, of each one ounce: ammoniacum dissolved in Aqua vitae half a dram. Mix them for a Lohoch. Or,

Take of Conserve of Violets and Elicampane, of each six drams: the pouder of the Electuary Diatragacanth frigid, Diaireos Solomonis, of each one dram: Syrup of Violets and Maidenhair, of each as much as will make a Lohoch.

Take of Althaea Roots one pound: Elicampane four ounces: Quinces, or Marmalet thereof, sixteen ounces: boyl them in Water till they are dry: Beat them and strain them, adding two pints of Honey: boyl them again gently. Take them from the fire, and ad of Cinnamon one dram: flow∣er of Brimstone half an ounce: Liquor is perfumed with Musk and Rose water two drams. Make a soft Electuary; of which let him hold now and then as much as a Hazel nut in his mouth: 'tis also very good to take half an ounce thereof morning and evening, when the fit is off.

Also you must anoint the Breast with Mollifying and discussing Oyntments and Liniments, thus made:

Take of the of Oyl of Chamomel, Flowerdeluce, and sweet Almonds, of each half an ounce: fresh Hens grease, one dram: the Pouder of Marsh-mallow roots and Flowerdeluce, of each one dram: the meal of Linseed and Foenugreek, of each two drams: Gum Ammoniacum dissolved in Wine one dram and an half: Wax, as much as is sufficient. Make a Liniment. Or,

Take of the Mucilage of the seeds of Quinces, Line, and Foenugreek drawn with Scabious and Coltsfoot Water, of each six drams: the Pouder of Flower deluce root and Hysop, of each half an ounce: Saffron one scruple: Oyl of Lillies and sweet Almonds, of each two ounces: Wax as much as will make a Liniment.

If the fit be long, clap a Vesicatory to the hinder part of the head.

Out of the fit you must stop the Defluxion, and also cut, clense, and expectorate that which hath fallen into the Lungs.

For staying the defluxion, all those Remedies are good which were mentioned in the cure of the cold Catarrh.

But you must take a Caution concerning some of them.

First, In Apozems, Syrups, or the like, you must not make them two hot and dry, which by con∣suming of the thin parts, may make the remainder thicker, and so the Disease will be worse, But you must rather mix moisteners, as Raisons, Figs, Liquoris, Jujubes.

Secondly, Instead of Head Medicines, you must use things fit for the Breast, above mentioned.

Thirdly, For the Derivation of the Humors that abounds in the Head, use Errhines, Sternutato∣ries, Gargarisrus, ar Apophlegmatisms: Which last are not so proper, by reason of the neerness of the

part by which the humor runs to the Lu••gs. But Errhines and Sternutatories may be used safely.

Fourthly, To strengthen the Head, and dry it, Fumigations are there commended; which are not so proper in this, especially if taken in at the mouth and nostrils, because they make the breath shor∣ter, and bring the fit. But with them you may air the Patients Caps, without, from the Cham∣ber.

For to clense and expectorate the thick Humors that stick to the Bronchia of the Lungs, the Medi∣cines already mentioned, or these following, may be used.

Take of Elicampane root, and Polypody of the Oak, of each half an ounce: the Leaves of Ori∣gan, Calamints, Hysop, Savory, Maidenbair, Scabious, and Coltsfoot, of each one handful: the seeds of Marsh-mallows, and Cotton, and Carthamus, of each three drams: Liquoris and Raisons stoned, of each six drams: Jujubes, Sebestens, and fat Figs, of each five, make a Decoction to a pint and a quarter of Hydromel; dissolve in the straining a pound and a quarter of white Sugar; make a Syrup well boyled, for a Lambitive.

You may make a better and cheaper Syrup thus.

Take of Elicampane Roots three drams: Spanish Tobacco one dram: infuse them a whol nigh•• in six ounces of Aqua Vitae: in the morning strain them, and ad of the best Sugar four ounces; stir it well upon the fire, and ad of the syrup of Erysimum or Coltsfoot two ounces: Oyl of Sulphu•• as much as will make it sharp: make a Lohoch.

These following are proper for to unstuffe and cleer the Lungs.

Take of Ammoniacum, and Bdellium, dissolved in Vinegar of Squills, of each half an ounce: Flower of Brimstone three drams: the leaves of Coltsfoot and dryed Savory, poudered, Diaireos simple, of each half a dram; with syrup of Hysop and Oximel of Squills make a mass of Pills; of a dram whereof make six Pills, and let him take three of them two hours before supper twice in a week▪ Or,

Take of Aloes Succatrine, half an ounce: Myrrh and Ammoniacum, of each half a dram: Saf∣fron half a scruple: Flower of Brimstone half a dram: with the syrup of Coltsfoot make a mass of Pills, of which let him take a dram two hours afore dinner for some dayes.

Let the Water which is taken out of a hollow Briony Root, be distilled in Balneo Mariae to eight ounces, whereof mix half an ounce of Spirit of Vitriol or Sulphur, let him take every day a spoon∣ful fasting.

Take of Tobacco Leaves, Hysop, white Horehound, and Maiden-hair, of each two handfuls▪ the Roots of Flower-de-luce and Liquoris of each half an ounce: boyl them to a pint and an half, dissolve in the straining of white Sugar one pound▪ of the best Honey half a pound: make a syrup: well boyled, clarified, and perfumed, with a little Saffron and Cinnamon, let him take a spoonful or two every morning.

The Oximel and Syrup of Tobacco invented by Quercetan, prescribed in his Dispensatory, is of the same vertue.

The Tincture of dry Tobacco is drawn with Aqua Vitae, a little thereof mixed with Honey, and that held in the Mouth as big as a Pease or Bean, swallowing it by degrees, this draws Flegm in abun∣dance from the Stomach and Lungs.

Hogs Lice, called Millepedes, or Aselli, in number twelve, put into a linnen Cloth, are to be steep•• in white Wine▪ and then strained and so given to be drunk, and do in a short time clense the Lungs.

Oleum Sacchari doth powerfully dis••olve thick glutinous Humors in the Lungs, and causeth ex∣pectoration: But the Compound Oyl following is best.

Take of the Roots of Flower-de-luce, and Elicampane poudered, of each half an ounce: the Pulp of Dates and Raisons, of each three drams: Citron and Orange peels, of each one dram and an half: Benjamin two drams: Saffron one dram: infuse them two dayes in the spirit of Wine well rectified: then take of the liquor by inclination, dissolve as much Sugar Candy poudered as you can therein, then fire the spirit of Wine stirring them continually till▪ it comes to a liquor as thick Oyl, then mix as much Oyl of Sulphur as will sharpen i••▪

A Decoction of Red Coleworts taken many dayes with a little Sugar, doth help the Asthma.

But the Juyce of Red Coleworts with Sugar of Roses, or Syrup of Coltsfoot, taken in form of a Julep for many dayes is better.

The Spirit of Sulphur doth dissolve slymy Flegm, and open the Bronchia if four or five drops are taken in Broth, or convenient Syrup.

Turpentine is much Commended for this use▪ given often to two or three drams with the Oyl of sweet Almonds or Conserve of Violets, or you may make it into the form of an Opiate thus.

Take of Turpentine well washed in Clotsfoot Water one pound: fat Figgs half a pound: Pe∣nides four ounces: Oyl of sweet Almonds one ounce: mix them into an Opiate.

Saffron in Sawce is good for the Breast; also a Junke•• made of Mustard seed and Honey doth ex∣pectorate.

Oxymel also with Agarick taken two spoonfuls in a morning, doth purge the Lungs.

The flower of Brimstone made into Pills with fresh Butter, given three daies together to one scru∣ple, doth much help the Asthma. Lac Sulphuris doth the same better in ••ight grains, which is the greatest dose.

Also these Tablets following are excellent.

Take of the pulp of Marsh-mallow roots, and of the greater Comphry, of each two ounces: flow¦er of Brimstone two drams: the flower of Benjamin half a dram: Sugar dissolved in white Lilly Water eight ounces: make Tablets, which let the Patient hold often in his mouth.

The Decoction of an old Cock is commended, and it is thus made:

Take of the Roots of Elicampane, and Flower deluce, of each half an ounce: Hysop and Hore∣hound dried, of each six drams: Carthamus seeds one ounce: Annis and Dill seed, of each two drams: Liquoris and Raisons stoned▪ of each three drams: the pouder of Fox Lungs prepared two drams. Beat them, and fill the belly of an old Cock therewith; then boyl him in fifteen pints of Water till his flesh comes from his bones. After it is well strained, set it in a cold place that the thickest may settle, and the thin may be taken off; of which let the Patient take six ounces with one ounce of Oxymel simple.

If you will make it purging, you may ad two or three drams of Senna for every dose, or half an ounce of Manna. Or if you will have it stronger, you may somtimes put in some Electuary that purgeth flegm.

Platerus prefers the following Preparation of a Cock before the rest:

Take an old Cock, kill him, pull him, and draw him; stuff him with these things following: Fox Lungs fresh, or prepared and dried, one ounce: Raisons stoned, and Figs, of each two ounces: Elicampane one dram: Hysop, Savory, Horehound, Thyme, Calaminth, Penyroyal dried, of each one dram: Fennel and Annis seed, of each one dram: Carthamus seeds bruised and Polypody, of each half an ounce: white Tartar one dram: Salt half an ounce: two yolks of Eggs: fresh Butter half an ounce: Cut them and bruise them, and sew them into the Cock, boyl him till his flesh comes from his bones in a large vessel with so much Water as you may need to ad no more: then strain it, and put to ten pints, one pound of pure Honey that it may not quickly corrupt. Let him take a Porrenger full every morning; in which let him dissolve Manna and new drawn Cassia, of each half an ounce, continuing it for a month and longer; which will be the better, if presently after he take a dram of Turpentine with Penides in form of a Bolus, or otherwise.

Ludovicus Septalius in his Practical Observations condemneth these Cock-broths as unprofitable, or hurtful: His Reasons are, Because they do not answer Experience, and have been used in vain by him and other Physitians of Millane. For by long boyling, the nitrous parts (by which those Broths are thought most to profit) do settle, and are lost in the straining: but the slimy, glutinous, thick, and fatty, from the skin, feet, wings, musculous and nervous parts do remain. Hence the matter is made thicker, and less fit to be expectorated.

But Septalius his Experience, must not be preferred before so many famous Physitians Experience, both old and modern. For if it did not profit some which he and others have cured, many other things might hinder, as namely, the evil disposition of the Patient, and contumacy of the disease, or other things not well ordered which concerned the Cure, or the Medicine it self not well made. And whereas he saith, that the nitrous parts do fall to the bottom by long boyling, and are lost in the strai∣ning, it is ridiculous; for only the Earthy parts do settle, but the nitrous part once taken into the liquor, is never separated. Hence it is that the longer you boyl Broth the Salter it is. But this Salt doth cut, extenuate, and open, it is so far from incrassating being salt. Neither hath the flesh, or other parts of a Cock, such a glutinous substance as he imagineth, as you may find in Neats feet▪ or Calves feet, but rather an attenuating quality, because it is full of nitrous substance. And if purging and al∣tering Medicines be made according to the Precepts of Pharmacy and Art, they do leave all their strength in the Decoction, because dayly Experience teacheth us that such Broth of an old Cock doth purge. And if we may oppose our Experience to that of Septalius, we can truly say, that we have found admirable effects of these Broths in violent Asthmaes and Chollicks. But this we use to alter in these Broths; We give many draughts in a day lest it should be spoiled by keeping. But this is the Example of what we prescribe in this disease:

Take of the Roots of Elicampane and Flowerdeluce, of each one dram and an half: Hysop and Coltsfoot, of each one handful: Liquoris and Raisons stoned three drams: fat Figs four: Sen∣na three drams: Polipody of the Oak and Carthamus seeds bruised, of each half an ounce: Annis seeds one dram and an half: Boyl them with the third or fourth part of an old Cock: make a Broth for twelve or fifteen daies.

By this Purging Wine following, Platerus cured a Woman of a Dyspnoea, inclining to a Dropsie:

Take of Flower-de-luce-Roots one ounce: Elicampane, and Squills prepared, of each half an ounce: Horehound one handful: Elder Bark and Danewort, of each one dram: Senna one ounce and an half: Agarick two drams: Ginger one dram: shake them well together, and ad of Wine four pints, boyl them a little: she drank hereof six dayes together when she went to Bed, the Dyspnaea ceased, the Tumor vanished, and she was finely Cured.

But we must observe that we repeat Purging often in this Disease, under divers formes, lest nature should be used too much to one Medicine: So Clensing, Cutting, and Expectorating Medicines, and the rest are to be alterated for the same reason.

Chap. 2. Of Pleuritis, or a Pleurisie.

APleurisie is either True; or Spurious, called a Bastard Pleurisie.

A True Pleurisie is the Inflamation of the Membrane that goeth about the Ribs of the in∣ternal intercostal Muscles.

But a Bastard Pleurisie is the Inflamation of the external intercostal Muscles.

There are also other pains of the Side and other parts of the Breast which are improperly called a Bastard Pleurisie.

When the Mediastinum is inflamed, the Lungs cleave to the ribs, or when serous humors flow from the Head to the Membranes of the Breast, or when Wind doth tear the Muscles or Membranes of the Breast, or vapors rising from the Stomach, as in the Worms.

We have said that in a true Pleurisie not only the Membrane Pleura, but also the internal Muscles are inflamed, because it is impossible but the Inflamation of the Membrane should be communicated to the contiguous Muscles.

Besides, Others do affirm that the Lungs are inflamed in every Pleurisie, and confirm their Opini∣on by Authority, Reason, and Experience: The Authority is that of Hippocrates, lib. de loc. in homine, where he saith, That a Peripneumonia is when both parts of the Lungs are inflamed; but if only one part be inflamed, it is a Pleurisie. Also Reason may seem to confirm this, for the signs of a Pleurisie are also the signs of Peripneumonia; namely, a Cough, continual Feaver, difficulty of Breathing, and spetting of Blood.

Also the Prognostick and Cure is the same in both.

They say moreover, That they have found by experience in the opening of those who have died of Pleurisies that their Lungs appeared alwayes to be inflamed.

It is to be granted that in many the Lungs are affected as wel as the Pleura, for the Defluxion may easily fal upon both; because the Lungs are fastened to the upper part of the Pleura: but we must avouch that often the Pleura alone is only affected, and not the Lungs: or at least they are so lightly affected, that the Disease cannot be said to be an affect of that part. The Authority of Hippocra∣tes in this, is cast off by some as false, and contrary to many of his own Assertions, in which he ac∣knowledgeth the Pleura only as the part affected; especially in his 1. lib. de morbis. where he of∣ten saith, That Choller and Flegm do stick to the side, and cause vehement pain. But Mortiamis doth reconcile this; saying, That Hippocrates speaks in that place of a Peripneumonia which comes of a Defluxion from the Head, a portion whereof fals upon the Pleura, and he cals it by the name of a Pleurisie, that he may distinguish that which inflameth one part of the Lungs, from that which inflameth both: For the same nature of a Disease being in both the Pleurisie and Peripneumonia, makes the likeness of Symptoms in both, being both from inflamation, and nearly adjoyned.

And though many who have died of Pleurisies, have been found to have their Lungs affected, it is not to be concluded that it is so in al; for the most vehement Pleurisies which use to cause-Death, do many times turn into a Peripneumonia. But many do witness, and we have found by experience, That in many bodies dead of Pleurisies, the Pleura only hath been found putrified.

It may be questioned, Why the Pleura, rather than other Membranes, should be inflamed? But the Answer is from Hippocrates, 1. de morb. text. 124. according to the Division of Salius, where he saith, That the side is a very weak part, because it is naked from flesh in respect of other parts, and hath nothing to rest upon; therefore when the humors are moved and inflamed, their Defluxion is easily sent thither.

The matter Causing a Pleurisie is for the most part Chollerick Blood which doth easily penetrate a thick Membrane; As Avicen speaking of a Pleurisie, saith, Except the Humor be thin and Chol∣lerick it cannot pierce into the Membrane. Other Humors may also Cause this Disease so they have a serous Chollerick Humor mixed with them for a Vehicle: I say other Humors not Excrementiti∣ous but Natural, which are contained in the form of blood, and are called either blood it self, or blood that is waterish, or melancholly.

But you must note, that thin Humors make a true Pleurisie, and thick, a Bastard Pleurisie.

Now this blood is carried by the Vessels which nourish the Breast, especially the Vena Axillaris, and Azygos; and if it offend either in quantity, quality, or motion, it is cast upon the Membrane and Muscles adjoyning.

The Difference of Pleurisies is taken from the part affected, and the Causes.

In respect of the place of the pain, it is divided by Hipp. 2. acutor. into an ascending Pleurisie, namely, when the pain reacheth more to the Throat; and a descending Pleurisie, when it goeth down to the Hypochondria. Somtimes it is extended more towards the back, of which Hipp. 3. de morbis makes mention; and somtimes it comes more forward.

In respect of the Cause and the Humor offending, it is called either Sanguineous, coming of blood, Chollerick, Phlegmatick, or Melanchollick.

There is also another excellent Difference made by Hippocrates, 1. acut. where a Pleurisie is di∣vided into a dry and a moist Pleurisie. A dry one is that in which there is little or no spitting, not on∣ly in the beginning, but continuance of the Disease; of which there are divers Causes, as the Crudity of the matter, the thickness and slim••ness thereof, the weakness of the faculty, the obstruction of the Bronchia, or the vehemency of pain. But a moist Pleurisie is that in which there is abundance of spittle, from the beginning of the disease.

The Diagnosis or knowledg of this Disease, is by the signs, as saith Galen, 5. de loc. aff. cap. 8. and elswhere; who reckoneth Five.

• 1 A pricking pain of the side.
• 2 A continual sharp Feaver.
• 3 Difficulty of breathing.
• 4 A hard pulse like a saw.
• 5 An often troublesom Cough.

A pricking pain is chiefly in the Membranes, and comes from a Chollerick matter, and this pain possessing the ••••de, stretcheth it self into the parts adjacent, one while to the Throat, another while to the Hypochondria, by the continuity of the Membrane, which covers the whol Cavity of the Breast. By this sign a Pleuritis is distinguished from a Peripneumonia, in which there is no pain, or very little of the side, except it be joyned with a Pleurisie.

A continual sharp Feaver hath its original from a Fl••gmon or Sanguineous tumor in some part neer the Breast, and therefore is symptomatical: although somtimes an essential Feaver be joyned with a Pleurisie; and gives it somtimes a being, for it often happeneth in the beginning of continual Fea∣vers, that the blood boyling in the veins is expelled by Nature unto some part which is most fit to re∣ceive it; as the sides, and there it breeds an inflamation. The sign of this is, That the Feaver first seizeth upon the Patient, and the second or third day after the pain is in the side. But when the Feaver is symptomatical, then the pain in the side comes first, but the Feaver a little after.

Difficulty of breathing doth necessarily follow in this disease, because the parts inflamed cannot sufficiently distend themselves to draw in a great quantity of Air, which is requisite for the cooling of an inflamed heart.

The Pulse is hard because the Membrane is affected, and stretched forth, which also distendeth the Arteries, and they therefore make that difference of pulse, called Serratilis, like a saw; for when you lay many fingers upon the Arteries of the Pulse, one part seems to be more lifted up than the o∣ther, so that it seems to represent a saw.

A troublesom Cough follows a Pleurisie, because Nature doth continually strive to expel that which is troublesom from the part affected: as also some of the matter sweateth from thence into the Lungs, which moveth the expulsive faculty, whence the Cough cometh.

There is also a spitting of blood as another sign, which is neither in al Pleurisies, nor at al times of the Disease; therfore it is not reckoned as a proper sign. They who say that the Lungs are alwaies affe∣cted in a Pleurisie, do affirm that the blood is spit from the Lungs, and they deny that it can pass from the Membrane about the Ribs to the Lungs, because it is very thick; and also the Membrane about the Lungs is of the same Nature, and cannot therefore be pierced by that blood which is without the Ves∣sels. But Galen doth cleerly confute these, 5. de loc. aff. cap. 3. where he first, shews that the mat∣ter contained in the Cavity of the Breast may be taken into the Lungs, and be sent upwards, by two cleer Examples. The one is those who have received a wound in the Breast that pierceth into its Cavity; for if an injection of Honey and Wine be made into the wound, and it be presently closed at the orifice, in a little time the injection will be coughed up and spit forth, and the Patient wil have the taste of it in his mouth. Another Example is taken from a Fracture of a bone, when the skin is not broken; which while the Callus is growing, and the broken bones begin to glutinate, that blood which flowed to the part affected is carried forth to the skin, and goeth through it, so that it moist∣neth and fouleth all the rowlers and ligatures about the part. Galen also shews the manner how blood, matter, or the like, being contained in the Cavity of the Breast may be taken through the lungs,

namely, by the extream outward orifices of the Bronchia or branches of the rough Artery, which are spread through the Lungs, and end in the superficies of them.

Although the orifices of the Vein Arterial, and Artery Venal are also carried to the superficies of the Lungs, yet the orifices of the Bronchia are more large and open than they. For by how much greater the Body or Trunk of the rough Artery is, than the Trunk of the Venal Artery, or ••rterial Vein, by so much the greater are its branches than theirs; and its orifice than theirs; because all these Vessels are equally divided and distributed into the whol body of the Lungs. Moreover, the substance of the rough Artery, and its Bronchia or branches, are Cartilaginous or grisly, from whence it is that they cannot clo••e together so much as other Vessels; and their orifices are more constantly open, by which they can better receive the matter from the Cavity of the Breast.

But Galen teacheth that the matter contained in the Breast is taken through at the time of brea∣thing, when the Thorax is straightened; for then the Thorax doth press those things that are in the Cavity of it, and drive them into the Lungs, so that some part of them at least is carried into the o∣rifice of the Bronchia. Neither is the softness of the Lungs, which yeild to a compression, and ther∣fore cannot be forced to receive the matter, any hinderance. For this softness is the cause why all the matter is not received; yet it is no obstacle but some part thereof may be received in, although the greatest remain in the Cavity by reaon of the ••oftne••s afore••aid. Let us ad to this Doctrine of Ga∣len, the wonderful providence of Nature, which hath found out waies, not only manifest, but also unknown, and ••omtimes incomprehensible, by which she useth to expel things hurtful; as we said of the matter in Fractures, which is purged forth by the insensible pores of the Muscles, and of the Skin.

A bastard Pleuresie is distinguished from a true, in that the pain is encreased when the Patient lieth on the contrary side, in a true Pleurisie; for then the part inflamed is pulled, and more distended by its own weight▪ but in the other, the Muscles external being inflamed, are compressed when the Patient lieth on the same side, and therefore he hath then greater pain.

The times of this Disease, are known by these signs following:

In the beginning of it, all the symptomes are weaker, the pain and feaver smal, there is a dry Cough, and very little and crude spittle: In the encrease of the Disease, the feaver and pain encrease, and there is more spittle. In the state or height the symptomes are more vehement, want of rest, dotage, pain of the Head; and if the disease will be cured, there is much concocted spittle easily rai∣sed. In the declination, the spittle is perfectly concocted, a free spitting, and decay of all symp∣tomes.

The signs of the Causes, are generally taken from the temper of the Patient, the time of the yeer, the Country, the Diet, and the like. But especially the••e things shew that a Pleurisie comes of pure blood, red and bloody spittle, a stretching and pricking pain, the fulness of the Veins, especially a∣bout the Forehead and Temples, redness of the whol face, a full Pulse, thick and red urine, somtimes with a blew crown.

These signs shew that it comes from Chollerick blood, yellow spittle, a burning feaver, great thirst, a hard and quick pulse, a more acute pricking pain, greater watchings and restlesness, bitterness of the mouth, a thin and very yellow urine.

These signs shew that it comes from Flegmatick blood, a white, viscous, or frothy spittle, sweet and slow in coming forth, a remiss feaver, little thirst, much spittle, a le••s, but heavy pain, more sleep, a little pulse, and not so hard, pase and thick urine.

These signs shew that it comes of Melanchollick blood, black spittle, tough and slow in coming forth, a less pain and feaver, a red urine and dark, a dry Cough, a black and rough tongue, a belly bound.

The Prognostick is taken first from the remission or vehemency of the Symptomes. For if pain, difficulty of breathing, and a feaver be not great, they signifie that the disease is gentle; but if the pain be great, and the Cough, and there is nothing ra••••ed up, and if the feaver be violent with great difficulty of breathing, you must took upon it as a desperate Pleurisie.

A smal pulse, quick, and hard, foreshew death in a Pleurisie. And Galen saith that none of this have been cured; Gal. 4. de praesag▪ ex puls. cap. 5.

An exquisite Pleurisie in which nothing is raised by Cough, or when with the spitting after it began, is restrained, having still the pain and weight in the side, is most dangerous. For it signifieth a very crude disease, which will either shortly kill, or be long in cure.

If the spitting begin with the first, or within three daies, it signifieth the disease will be short; but if it begin late it will be long. Hipp. Aph. 1. Sect. 5.

Yellow Choller mixed with flegm or a little blood, appearing in the beginning of the disease with much spittle, is a sign of recovery.

Very bloody spittle is dangerous; for it signifieth a ruption, either of a Vein, or of the flesh; from whence we expect suppuration: For it is thought that little blood doth breath through.

White, glutinating, and round spittle, is evil, for the clamminess comes from the siery heat which burne••h the matter.

Green and rustick spittle, is evil, but black worst of all: For it signifies the greatest adustion or extinction of the Natural heat.

A plentiful spitting which doth not abate the pain and other symptomes, is evil: For it signifieth great plenty of matter.

A Pleurisie in old men, women with child, and in them that are Asthmatical, or have twice or thrice had the same disease, is dangerous.

Whosoever hath the disease in the side called Pleurisie, and are not clensed of it in fourteen daies, have an Empyema, or collection of matter; Aph. 8. Sect. 5. Others do extend it to the twentieth day.

A Diarrhoea, or loosness coming upon a Pleurisie or Peripneumonia, is evil; Aph, 16. Sect. 6. which we must understand of a Pleurisie, in which there is so great an inflamation that the Liver and Stomach consent therewith, or when the strength is so gone by the disease that the retentive faculty is almost spent. But if the Pleurisie be not so great, and be in a body full of evil humors, the flux of the belly useth then to be healthful, especially if any signs of concoction went before.

A Chollerick and plentiful vomiting in the beginning of a Pleurisie signifieth health to come: For Nature being eased by that evacuation of Choller, doth more easily overcome the disease.

If a Peripneumonia comes from a Pleurisie, 'tis evil; Aph. 11. Sect. 7. For it is the translation of the matter to a more noble part.

If the pain in the Pleurisie, and the Chollerick spitting, go away without reason, the Patient falls mad. Hipp. 3. Prorrhet. For the Choller is carried into the Head, and then the urine looks thin and white.

A Pleurisie which followeth an old disease, or is in a body of evil habit, is dangerous.

Thick bodies used to exercise, do soonest die of Pleurisies and Peripneumonia's, as Hipp. in Coac.

And Experience teacheth us that almost all the Diggers taken with Pleurisies, do die thereof: Because such strong bodies fall not sick, but upon some great cause, and by reason of their thickness they cannot easily sweat, so that the disease cannot breath forth.

They who in a Pleurisie have much noise in their Breast from the spittle, and their countenance de∣jected, with yellowness in their Eyes, and mists; in these death is to be expected, Hipp. in Coac.

They who in Pleurisies have Chollerick tongues at the first, are judged in seven daies; but they who have not much Choller upon their tongue til the third or fourth day, are judged about the ninth day.

For the Cure of a Pleuresie, first the humor causing it is to be revelled, derived, and discussed, and if it cannot wholly be discussed, it must be digested, maturated, and expectorated; as also the Fea∣ver which is commonly essential to a Pleurisie, and not alwaies symptomatical, is to be cured by pro∣per Medicines. All which may be done by the following Remedies.

And first you must (after a Clyster, if the disease be not very violent) open the Basilica on the same ••••de; but if it be violent, give the Clyster afterwards.

You must bleed every day till the pain or feaver grow less; nay, somtimes twice in a day, if the Pleuresie be very violent.

Hippocrates in his 2. lib. deratione victus in acutis, Text. 10. gave an excellent rule to posterity most profitable in practice, That blood be let till the color of it change: For if at the first or second time, ••t appear crude, flegmy, or watery, it is to be continued every day, somtimes twice a day till it appear red or yellowish. But if it appear red in the beginning, you must bleed so often till it become livid or black, for that will signifie, that the last blood came from the part affected, or the neighbor Veins, which is altered by the part inflamed, and of crude is made red, or of red, black or blew by adustion.

Although the observation of that Rule bring commonly good success, yet somtimes you must not expect that change of color, but desist from bleeding; namely, when the strength is little, or the Pa∣tient is of a thin habit of body easily dissolved, or the weather very hot. And although blood-let∣ting is excellent in the beginning of the Disease, yet if it be omitted, or done insufficiently, you may open a Vein after the seventh, ninth, or eleventh day, according to the Example of Hippocrates, who in 3. Epidem. opened a vein for Anaxion in the eighth day, either because he was not sent for sooner, or because that it was a most crude Pleurisie, which will scarce concoct till the eleventh day.

But when he expectorateth freely, then you must abstain from Phlebotomy, which will stop his spitting, and bring him in danger of his life.

But blood-letting is so necessary in the beginning of this Disease, that it must never be omitted, neither in old nor yong, nor women with child, in child-bed, or having their terms; unto all which Experience hath taught us that Phlebotomy is good in this Disease. Yet you must observe some

Rules in bleeding of women in Child-bed, or having their Terms, which you may find hereafter in the Fifteenth Book, and the last Chapter, concerning the Cure of acute Diseases in women that lie inn.

From the beginning of the disease twice or thrice in a day, you must give cooling Juleps, which restrain the heat and boyling of the humor, and stop the defluxion; thus made:

Take of Poppy Water four ounces: Syrup of Violets, or Poppies, one ounce: Sal prunella one dram. Make a Julep.

After the first Phlebotomy let the side be anointed with this Liniment, covering the part with grea∣zy wool sewed into a linnen cloth.

Take of Oyl of Lillies, Chamomel, and sweet Almonds, of each one ounce: fresh Butter, and Hens grease, of each one ounce and an half. Make a Liniment.

Many put Wax to these Liniments, which is not good, because it stoppeth the pores; but the mu∣cilaginous bodies do not, because they cool and astringe.

In a malignant pestilential Pleurisie, you may ad to your Liniments, Oyl of Scorpions of Mathio∣lus, or a little Treacle.

After the second bleeding, you must apply this Fomen••ation, made thus:

Take of Althaea roots, and Lillies, of each two ounces: the Leaves of Mallows, Violets, and Pellitory, of each one handful: Line and Fenugreek seeds, of each one dram: the flowers of Chamomel, Melilot, Elder, and Violets, of each one pugil: Boyl them together, with which fomen•• the side that is pained in a Hogs bladder.

After Fomentation apply the Liniment aforesaid, to which in the progress of the Disease, you may ad more dissolving Oyls; as of Dill and Flowerdeluce; as also the pouder of Flowerdeluce and Saffron. And to the Fomentation ad discussing Herbs, as Origan, Calaminth, Hy••op, and the discussing seeds.

Many other Topicks are very profitable against Pleurisies, which Authors relate; as these:

First, anoint the part with Oyntment of Marsh-mallows, then lay on the pouder of Cummin seed, or a Colewort Leaf heat at the fire, and anointed with the same.

Faventinus mixeth the Oyntment of Althaea with Oyl of sweet Almonds, and after he hath a∣nointed, sprinkles on the pouder of Cummin seeds, and laieth on a Colewort Leaf; and this he commends highly.

Also the Cataplasm following is very profitable.

Take the Residency or Ingredients of the Decoction above mentioned for a Fomentation; beat them in a stone Morter, adding of the Oyl of sweet Almonds, Lillies, and Chamomel, of each two ounces: Hens grease one ounce: Barley and Bean flower, of each as much as is sufficient to make a Cataplasm.

Also a live Hen slit through the back, and sprinkled with the pouder of Flowerdeluce roots, being applied doth very well.

The Paunch of a Sheep laid hot to the part is a very good Anodine: but the Lungs are better.

The Chymical Oyl of Wax being mixt with the Liniments, asswageth pain, and powerfully dis∣cusseth the matter.

Hot Bread from the Oven, dipt in fresh Butter, and applied, doth very much dissolve the matter fixed to the side.

After he hath taken twice or thrice of the Julep aforesaid, you may use Pectoral Juleps thus made:

Take of Barley one pugil: Liquoris and Raisons stoned, of each one ounce: Jujubes twenty: the four great cold Seeds, of each three drams: Bugloss and Violet flowers, of each one pugil: boyl them to a pint and a quarter. Dissolve in the straining, Syrup of Violets and Jujubes, of each two ounces. Make a Julep for four doses to be taken morning and evening.

Or if the Feaver be very sharp, and much watching, you may make the Emulsions following:

Take of Almonds blanched, and steeped in cold Water, one ounce: the four great cold seeds, of each half an ounce: Lettice and white Poppy seeds, of each two drams: beat them in a marb•••• morter, powring on by degrees, the Decoction of Barley and Liquoris one pint and an half: strain it and dissolve in it Syrup of Violets three ounces. Make an Emulsion for three doses to be taken morning and evening.

Some Practitioners in want of sleep give Narcoticks; as Syrup of Poppies, Philonium Romanum, and Laudanum, which are dangerous in this disease: for they stop spitting, and astringe and streng∣then the Breast. From whente often times comes sudden death.

But this must be understood of the whol dose of Narcoticks: for given in a very smal quantity they do good in vehement pain, a thin defluxion which causeth a Cough, and in want of sleep. In which cases I have often given one grain of Laudanum with good success, and somtimes often. But the use of this is most proper in the beginning of the disease; for then the humor flowing to the part may be

restrained, and the encrease of the Disease hindered.

When the Cough is violent, and Nature begins to evacuate by spirting, let the Patient hold often in his mouth Sugar of Roses, Sugar candy or Penides, or the Tablets of Diatragacanth frigid, Syrup of Violets and Jujubes. Or this Eclegma following:

Take of Sugar candy, and Penides, of each one ounce: the pouder of Diatragacanth frigid two drams: Syrup of Violets and Jujubes, of each as much as will make a Lohoch; which let him take often with a Liquoris stick, or make it of Butter, Honey, and Sugar, of each equal parts: the Oyl of Linseed, or of sweet Almonds, being fresh drawn without fire, mixed with Sugar, doth much help the Cough and pain in the Pleurisie, especially if it be drunk in Broth, or any other Deco∣ction.

If the spittle be thick, you must mix some attenuating and cutting Medicines, as Syrup of Coks∣foot, Liquoris, Oxymel simple, pouder of Diaireos, and the like.

You must take these lying with the face upwards, for so they better go to the Lungs.

As the Disease encreaseth, you may use this restoring Medicine to strengthen.

Take of Conserve of Violets one ounce: Conserve of Borrage flowers, and Bugloss roots, of each half an ounce: Confection of Alkermes two drams: pouder of Diamargariton frigid, and Dia∣tragacanth frigid, of each one dram: Sugar of Roses as much as all the rest. Make a Composition covered with Gold to be taken often with a spoon.

Purging is improper in a true Pleurisie, except it be in the declination; and then you may ap∣point this:

Take of Senna half an ounce: Annis seeds one dram: Bugloss and Maiden-hair, of each half a handful: Liquoris and Raisons stoned, of each three drams: the flowers of Bugloss and Violets, of each one Pugil. Boyl them to two ounces: in the straining, dissolve of Rhubarb infused in Sca∣bious Water with a little yellow Sanders, four scruples: the best Manna, and Syrup of Roses, of each one ounce. Make of these a Potion.

In the whol time of the disease, let him take Barley Water for his ordinary drink, made with Li∣quoris, Poppies, and Maiden-hair; and let not his drink be actually cold, for it would hurt the Breast. Wine in this Disease is Poyson, and also all sharp things which provoke Coughing, and by their astringency hinder spitting.

In the declination of the Disease, after purging, and when the Feaver is less, if the pain continue, you may apply to the part, Cupping-glasses with Scarrification two daies together. They may also be applied before the declination, after often bleeding: And if the pain still encrease, and return, you may again let blood, and after Cup with Scarrification.

Zacutus Lusitanus having taken off the Cupping-glasses, applied six Horsleeches with good suc∣cess, as he witnessed, observ. 104. lib. 1. Praxis admirandae.

For the same purpose to discuss the reliques of the matter, having first tried Fomentations and Li∣niments, you may apply with benefit, the Emplaister of Brimstone, and Bay-berries.

Besides vulgar Medicines, there are some proper and specifical, namely the shavings of a Boars Tusk, the ashes of the Pizzle of a Bull or Deer, the flowers of red Poppies, or Corral prepared.

Quercetan in his Dispensatory commends an Apple made hollow, and one dram of Frankinsence put therein and roasted, which the Patient must eat, and drink three ounces of Carduus Water after, then cover himself warm, and sweat. He will have this Medicine used after the third day, and af∣firmeth that many have been restored therewith.

The flowers of Box-tree do so much purge the Blood, that if a dram of them in pouder be given with Poppy Water, and a Vein opened an hour after, the blood will continue pure.

Hors-dung dissolved in Carduus Water, and strained, doth powerfully disperse the pain, and the humor in the Pleurisie.

White Hen-dung given in a dram of the same Water, doth as much.

These Dungs have much Volotile Salt, which is very piercing and discussing.

You may make a Potion of them both thus:

Take of Hemp seed one ounce: bruise them, then put to them, of the white Dung of a Hen, and of Horse Dung, of each half an ounce: dissolve them in five ounces of Carduus Water; strain them, and drink it.

The Blood of a wild Goat given to ten drops with the aforesaid Water, doth powerfully discuss the Pleurisie: In the want thereof, you may give the blood of a tame Goat. But because the strength of him is little, you may give thereof to the quantity of one dram. You must prepare it thus:

Hang up the Goat by the Horns, and bend his hinder Legs backward to his Horns, then cut out his Stones, and take the Blood in a broad Vessel; dry it in the Sun in Summer, or at other times upon an Oven. It is far different from the Goats Blood in the Shops.

The Soot of a Chimney given to a dram is very good, but much rather the spirit of Soot, described by Hartman in his Practice of Physick.

In an Epidemical Pleurisie, Sudoroficks are to be given, such as are prescribed in malignant Fea∣vers, which also ought to be made as proper for this Disease as may be.

A Diarrhoea coming upon a Pleurisie is dangerous: therfore you must give Syrup of Myrtles, which doth stay the Diarrhoea, and also expectorate: and this is to be mixed with other Syrups. Let me Belly and Reins be anointed with astringents, as useth to be done in all Diarrhoea's. Give Clysters made of Barley Water, which, as Galen saith, doth cool and astringe if it be boyled with red Roses, and also Yolks of Eggs be dissolved in it.

Chap. 3. Of Peripneumonia, or Inflamation of the Lungs.

PEripneumonia hath the same essence with a Pleurisie, and is distinguished only by the part affe∣cted, because that is the inflamation of the Lungs, and this of the Membrane that compasseth the Ribs. They differ somwhat in the matter, for a Pleurisie comes often of Choller, but a Perip∣neumonia of Flegm; although all humors (as we said of a Pleurisie) may produce this disease, I mean humors which are like blood, and make up the mass of it. For as thick humors do hardly pe∣netrate the thick Membrane called Pleura, but thin and Chollerick easily; so on the other side, thick flegmatick humors do easily go to the soft and thin substance of the Lungs, and stick close thereto; but thin and Chollerick humors do easily pass by. But this hindereth not, but the Chollerick blood may somtimes cause the Inflamation of the Lungs, as Hippocrates 1. de morbis, describeth the Ery∣sipelas, or Chollerick tumor of the Lungs, which comes from Chollerick blood thrown into the Lungs from the right Ventricle of the Heart by the Arterial Vein. But an oedematous Inflamation comes from flegmatick blood falling upon the Lungs by way of defluxion from the Head. But only excrementitious flegm, falling as a Catarrh from the Brain, can make a Peripneumonia, because it putrifieth in the Lungs, and attracteth blood, by the mixture whereof there is an Inflamation, and this often happeneth in old folk. Mesue saith that this Peripneumonia comes rather of Choller, be∣cause the Lungs are nourished with Chollerick blood which cometh in great plenty to them by the Arterial Vein. To whom we answer, that fresh, thin, and steeming blood made in the right Ventri∣cle of the Heart is carried into the Lungs, which by reason of its purity, is easily governed by Nature, and is sent by the Venal Artery to the left Ventricle of the Heart, and it seldom is altered from its Natural condition, which useth to make a Peripneumonia. But contrarily, a defluxion from the Head cutting through the large passages into the Bronchia of the Lungs, if it there putrifie, will draw blood unto it, and make a Peripneumonia.

This Peripneumonia is somtimes alone without another disease, somtimes it followeth other dis∣eases, as Squinzy or Pleurisie. Galen in Com. 11. Sect. 7. Aphor. teacheth that a Peripneumonia doth follow a Pleurisie two waies: Either when a Pleurisie is turned into a Peripneumonia, or when an inflamation of the Lungs followeth a Pleurisie. This transmutation is when the former disease ceaseth, and the other comes; but it comes upon it when it is white, the former remaineth.

Therefore the immediate internal cause of a Peripneumonia is blood, often flegmatick, seldom chollerick, and most seldom melanchollick, Which either comes from the whol body being pletho∣rick, or cachochymical, that is, full, or of evil habit; or from some part which is replete or di∣stempered.

The External Causes of Peripneumonia and Pleurisie are the same; namely whatsoever defluxi∣on can come to those parts: the chief whereof are: First great exercise and violent motion of the Body, especially after long rest, and high feeding. For then the humors abounding from high diet, and kept in by long rest, by exercise are dispersed, attenuated, and heated, and are after sent to the weaker parts, most fit to receive them, among which the Breast and Lungs are chief, because by strong exercise, there is caused great and often breathing, and so they become wearied, and the sub∣stance of the Lungs being soft and loose can easily receive the humors coming to them.

Secondly, Among the external Causes the cold and Northernly Air is reckoned, when it comes suddenly after a Southern and warm; for the pores are opened by warm Air, and the humors are more fluid, which by the cold Air coming after, are compressed, and the humors sent to the weak parts.

Lastly, From Hipp. lib. of Air, Places, and Waters, the drinking of standing Pools and Lakes, begets the Peripneumonia; for saith the Divine old man, we observe diseases of the Lungs to be most in Marshy Countries.

Also the Signs of a Peripnumonia do agree with the signs of a Pleurisie. Two are the same, as a sharp Feaver, and a Cough; which somtimes is dry, somtimes moist, or with more Flegmatick spittle coloured with Choller or Blood; and in the progress of time, the spittle becomes Mattery when the matter of the Disease grows ripe, and concocted by heat, which somtimes comes to pass when the substance of the Lungs is not hurt; for if they ulcerate, a Consumption wil sollow.

So we may observe, That in sore Eyes that are Mattery, the humors are converted into Matter when the substance of the Eye is neither suppurated, nor ulcerated.

The other signs differ in respect of the part affected; the difficulty of Breathing is greater than in a Pleurisie by reason of the narrowness of the part inflamed, so that the Patient seems to be choaked and cannot breath but with the head upright: For the part cannot be compressed by reason of the extention and repletion, nor be more dilated, although it be much dilated, yet it takes in but little Air, therefore the respiration is quick and often, with snorting: This is augmented by a Feaver by which the breath is hotter, and the desire of cold air is greater.

The Pulse is great, faint, and soft by reason of Flegm and the looseness of the Lungs: yet there is some hardness by the Choller and blood: it is unequal from the compression of the Artery neer the Heart, and in thick Humors most: Somtimes it is intermitting, watery, vermicular, when the Lungs are rotten by too much moisture.

There is a heavy pain that reacheth from the Breast to the Back, somtimes it is between the Shoul∣ders, and somtimes under one only Shoulder, and from thence communicated to the Throat and Pap: Especially in a Cough, somtimes they feel no pain til they begin to Cough: somtimes there is also a pricking pain in the side when it is joyned with a Pleurisie as it often happeneth: Although the Membrane that covers the Lungs be of the same nature with the Pleura, as Galen taught 4. de loc. affect. cap. 5. Yet there is not so great pain in a Peripneumonia as in a Pleurisie, for two Differences which are laid down by Galen in the place afore-cited.

The First is, Because the Nerves that go to the Membrane of the Lungs, are few and very little; but they which go to the Pleura, are many and great.

Th Other is, Because the Breast consists of Bones and Flesh, which wil not be stretched, from whence the pain is greater.

But the Lungs are soft and yeilding, and therefore their pain is less.

There is Redness in the Cheeks, by reason of the hot vapors which fly into the head and carrying with them the thinner blood. And this Colour is most in the Cheeks, because their skin is thinnest.

There are besides these signs, Heaviness, Weakness, and a Tossing, with great sense of Heat in the whol Body.

The Tongue is Yellow, and then it groweth Red; a great thirst, swelling of the Eyes, and of the veins of the Temples.

There is a Delirium, or Doting, when it comes from Choller; and a Coma, when it comes from Flegm.

If the Disease comes of Chollerick blood, the spittle wil be yellow, the heat and thirst greater, more difficulty of breathing with less Heaviness; the air breathed forth is more hot: the Feaver is very violent, the Pulse swift, the Delirium great, the Water thin, yellow and cleer, the age, time of the year, the Country, and Diet before, do al attest for Choller.

If Flegm (which is most ordinary) produce the Disease, the spittle wil be white, viscous, and froathy; the Feaver, burning of the Breast, thirst, and driness of the tongue, wil be less: the weight of the Brea•••• greater; the Pulse slower, and softer; the Age, old; Habit of body, time of the Yeer, and the Country, are cold and moist.

If the Disease come from pure Blood, the Spittle wil be Red; the Urin Red and Thick; the Face more Red; the Veins of the Temples more swoln; with heaviness and distention of the whol body; and other things that declare abundance of blood.

Lastly, If Melancholly blood be the Cause, the Spittle wil be black or blewish; the Tongue black, from the beginning dry and rough; there wil be also heaviness and great sighing between brea∣thing; and al the signs of Melancholly predominating in the whol body.

The Prognostick of this Disease is thus to be made.

A Peripneumonia is more dangerous than a Pleurisie; and for the most part deadly by reason of the necessity of respiration, and the neerness of the Heart.

Celsus saith, That this kind of Disease hath more Danger than Pain; and for the most part Killeth.

But strength of Body, less vehemency of Symptomes, yellow Spittle, not mixed with much Blood, raised in the beginning; a great flux of blood at the Nose in the Critical day; or a flux of the Belly which is Chollerick and froathy; or a flux of the Hemorrhoids or Terms, do shew some hope of recovery.

Imposthumes about the Ears, or inferior parts, being well suppurated and kept open, do foretel re∣covery, as Hipp. in proga.

If a Peripneumonia be turned into a Pleurisie, it is good, and though it seldom happen, as Galen teacheth, Comment. Aphor. 11. Sect. 7. because there is a going from a Disease more dangerous, to one less dangerous. And this transmutation is known by a pricking pain of the side coming thereup∣on, and by abating the shortness of breath.

But the vehemency of the Disease and symptomes do declare a dangerous and deadly Peripneumo∣nia, as want of spittle, continual watching, a Delirium or Coma, coldness of the extream parts, snor∣ting with great difficulty of breathing, blewness and crookedness of the nails.

Moreover, A Peripneumoma coming upon a Pleurisie is most dangerous, as Hippocrates tea∣cheth, Aph. 11. Sect. 7. because the translation of a humor from an ignoble part, to a more noble, is evil; and the strength being spent by the disease foregoing, can endure the force of a new, and wor••e.

When the urine is thick in the beginning of the Disease, and after before the fourth day it becomes thin, death is at hand. Hipp. in Coacis.

The Cure of the Peripneumonia is very like that of the Pleurisie, and there must be first bleeding as much as the strength will permit, once or twice in a day till the disease abate: for since the Lungs are then full of blood, and draw much from the heart, which is inflamed, you need not fear to let blood thrice, four, five, or six times.

But if a Peripneumonia follow a Squinzy, or Pleurisie, you may let blood more warily because the strength is abated by the former Disease.

You must let blood from the Basilica Vein of both arms, if the whol Lungs be equally affected, or from either, on that side the pain is, or on which the Patient sets more weight, or from which he supposeth he raiseth most spittle.

You must bleed women in this disease, first in the Ancle Vein, and after within six hours in the Arm; except it be so desperate that you are constrained at the first to bleed in the Arm. In which case, all the time you bleed, and a little before, you must apply Cupping-glasses to the Thighs.

But after, if the strength will not permit further phlebotomy, you must apply Cupping-glasses to the Shoulders and ••ack, both dry, and with Scarrification, as much as the Patient can suffer.

Also Emollient and loosening Clysters are good revulsives; but you must not use too strong pur∣ging Medicines therein, lest you bring a flux of the Belly, which is most dangerous in this Disease.

If a crude flegmatick humor coming from the head cause this disease, or nourish it, a Vesicatory laid to the hinder part of the Head, doth very much good.

In the mean while use the Juleps and Emulsons prescribed in the Cure of a Pleurisie. Anoint the breast with Oyl of Violets, sweet Almonds, or with fresh Butter, or the like, or with this Lini∣ment:

Take of Oyl of Violets, and Water Lillies, of each one ounce and an half; fresh Butter and Mu∣cilage of Fleabane seeds, of each one ounce: Oyl of Roses half an ounce: the Troches of Camphire one dram. Make a Liniment. Or,

Take of Oyl of Violets three ounces: the Oyl of Pompion seeds, and Breast-milk, of each one ounce: fresh Butter one ounce and an half: Mix them and make a Liniment.

You may provoke spitting with Syrup of Violets and Ju••ubes, and the rest, prescribed in the Cure of a Pleurine. As the Lohochs and Compositions there mentioned, given with this Caution, In a thin matter give things that thicken, and in a thick matter give things that attenuate.

Let his ordinary drink be Barley Water, with Liquoris, as in a Pleurisie.

Purging is not good in this Disease, except in the declining of it, and you must make choyce of such things then, as were prescribed in the Cure of a Pleurisie.

Chap. 4. Of Empyema, or matter in the hollow of the Thorax.

ALthough the word Empyema signifie all Suppuration, yet Custom hath prevailed so that it is taken only for a Collection of matter in the Cavity of the Thorax.

Now there is a Three-fold Cause of the gathering of matter between the Lungs and the Thorax.

The first is an Inflamation suppurated, which happens in a Pleurisie or Peripneumonia; and when the Imposthume is broken, the matter falls into the Cavity of the breast. The same may be in a Squinzy, as Hippocrates teacheth, Aph. 10. Sect. 5. in these words: Whosoever is freed from an

Angina, they have a Disease in the Lungs, and die within seven daies; but if they live longer, it comes to suppuration.

The second is blood falling into the Thorax, where by continuance it must needs come to Suppura∣tion. So Hippocrates, Aph. 20. Sect. 6. If blood be sent into the Belly besides Nature, necessari∣ly it is suppurated. But this suppuration is not alwaies true, and properly so called, a•• Hippocrates teacheth, but rather to be called a corruption, of which there is matter like quittor produced. This Blood may come from a Vein wounded.

The third Cause is flegm falling from the Head & other parts into the Breast, and there putrifying. So Hippocrates, Aph. 38. Sect. 7. The distillations into the upper Belly are suppurated in twenty dales. Galen in his Commentaries, by the upper Belly understands the Breast. But the flegm there putrifying doth not beget a true Pus, or matter, but something like it; as we observe in flegmatick Tumors, as Atheroma, Steatoma, Meliceris, which are kinds of Imposthumes.

The Diagnostick signs are of two sorts: Some declare the disease to be in the beginning; others that it's old, and confirmed.

Hippocrates layeth down Three signs of this Suppuration, beginning 2. Progn.

The first is when the Feaver groweth stronger, because the Pleurisie, or Peripneumonia is not pur∣ged, for while the matter is turning into Pu•• the feaver is encreased, Hipp. Aph. 47. Sect. 1.

The Second is a quaking, which comes when the sharpness of the matter doth twitch the Membra∣nous parts.

The Third is weight, and sence of heaviness in the part; for the humor being contained in the Gavity doth weigh heavier than when it is diffused. Galen addeth in 4. de loc. asf. cap. 9. fluctua∣tion or routing: For (saith he) if any one is forced to turn in his bed, and perceive something to slow down at that time, it is no doubt but that there is much matter contained there. And you may often hear the fluctuation, unless the thickness or plenty of the matter, which fills the whol Cavity of the Thorax, do hinder the sluctuation. To these you may ad dissiculty of Breathing. For although after the Imposthume is broken, the pain of the side ceaseth, and the Diaphragma and Muscles of the Thorax move more freely; yet because the Lungs are oppressed with matter round about them, so that they cannot move freely, and some part of the matter is sucked into the substance of the Lungs, from whence it is that the Lungs are so heavy, and the Bronchia is obstructed, thence is short brea∣thing. For the purulent spittle comes from the filth sent into the Lungs and Bronchia, which shews an Empyema; but this is not alwaies a spitting of matter by reason of its thickness, which keeps it from coming to the Bronchia.

But a long lingering Feaver, partly putrid, partly Hectical, milder in the day, and sharper at night, much sweat, especially at night, a constant troublesom Cough, signifie that the Disease is old and confirmed; as also when the Cheeks grow red, and the Eyes hollow, the Nails crooked, the Legs swel, and Pustuls break forth of the Breast by reason that the sharpest part of the matter breaks out of the Skin; these signifie the Disease confirmed.

You may know which side is affected from Hippocrates, 2. Progn. text. 21: If (saith he) an Empyema be only in one part, you must turn the Patient, and learn whether he be pamed, or hotter in one side than the other, and to ask him if he perceives any burden to hang on the side that is up∣ward, and if it be so, in which side soever the weight is, the suppuration is on the other; as if heat and weight be in both sides, the Pus is contained in the whol Cavity of the Breast. Also Avicen adds a Conjecture which he took from Hipp. 3. de morb. Apply (saith he) a linnen cloth wet to both sides, and that will be dry s••onest which lieth upon the part where the matter is contained. We may lay down another sign from our own Experience, which was not observed by Authers, namely, In the side affected there will he an Oedematory Tumor, from a Potion of the thinnest mat∣ter breathing through the Museles of the Thorax. And when, in suspition thereof there appears such a Tumor, and blowing up of the skin on either side, you may certainly pronounce that the Empyema is there, and you may safely open the side.

The chief Prognostick Signs are given by Hippocrates, 2. Progn. Text. 63. in these words: In Suppurations they chiesly escape, whom the feaver left the same day they broke; and they who pre∣sently desire meat; and are freed from thirst, and have smel, and laudible excrements: and if the Pus be white and even, and of the same color, and when it is voided without pain or great Cough∣ing. But they die whom the feaver leaveth not, or to whom seeming to leave them it returns again, and who are thirsty and have no appetite, have a loose Belly, the Pus green, and livid, or srothy. They die who have all these signs: But they who have but some of them, some die, and some lie long sick.

To these we will adjoyn these following Prognosticks.

They who have an Empyema, and by reason of the abundance of matter, lift up their whol Breast when they Breath, are quickly choaked. Galen, 4. de Loc. Aff. Cap. 7.

If an Empyema is not spit forth in forty daies, it turns into a Consumption, which brings death. Hipp. Aph. 15. Sect. 5.

A Suppuration on both sides of the Thorax, is more dangerous than in one; also that on the l••f•• side is more dangerous than on the right: by reason of the left Ventricle of the heart, which is more greivously affected with the matter gathered on that side.

Whosoever are Burnt or Cut for a Suppuration, if the Matter cometh forth pure and white, they escape: but if it be bloody, foul, and stinking, they die. Aphor. 44. Sect. 7.

If the Matter flow plentifully by Stool and Urine, and the Patient continue strong, it is a sign o•• Recovery, although this Evacuation is very seldom: yet is it spoken of by Galen, Aetius, and Paulus: As also the way declared by Galen through which it passeth, 3. de loc. affect. cap. 4. and com. in aphor. 30. sect. 3. In the first place he speaks thus, This question doth not a little disturbe th•• followers of Erasistratus, who think that there is nothing but spirits in the Arteries. But we find no difficulty in it, because we know that the smooth Artery in the Lungs, so much Pus as it received from an Imposthume broken, can carry the same into the left Ventricle of the heart, which after goe•• to the Re••ns by the great Artery. In the last place, he saith, That the matter▪ contained in the Lung•• doth first come to the Ventricles of the Heart, and then to the great Artery; or by the hollow Vei•• to the outside of the Liver, from thence to the inside, and so to the Guts. From which you may easily see the way by which an Empyema may be purged by stool and urine.

If the Patient grow better, and be almost clensed, and then again raiseth stinking Spittle, he dieth of that which remaineth and returneth. Hipp. in Coac.

For the Cure of this Disease: First, if you cannot hinder the Suppuration of the matter in the Thorax, you must further it by convenient Cataplasms. As,

Take of Marsh-mallow Roots three ounces: fat Figs ten: Raisons stoned one ounce: Cha∣momel and Melilot flowers, of each one pugil. Boyl them all well, then beat them and strain them▪ then ad the flower of Line, Foenugreek seed, and Wheat, of each one ounce: Oyl of Lillies, sweet Almonds, and fresh Butter, and Turpentine, of each one ounce. Make a Cataplasm.

Also to help Concoction, and maturation within, you may give this following Apozeme:

Take of Marsh-mallow Roots, and of the greater Comphry, of each one ounce: Agrimony, Colt••∣foot, Scabious, and Maiden-hair, of each one handful: the four great cold seeds, of each one ounc••▪ Annis seeds one dram: Liquoris and Raisons of the Sun stoned, of each one ounce: the three Cor∣dial Flowers, and Chamomel, of each one pugil: Make a Decoction to one pint and an half; dis∣solve in the straining, Syrup of Colts-foot, Liquoris, and Sugar-candy, of each two ounces. Ma•••• an Apozeme perfumed with the Pouder of Flower deluce Root one dram; for five mornings draughts.

This following Eclegma is good for the same purpose:

Take of the pulp of fat Figs one ounce: fresh Butter two ounces: Oyl of sweet Almonds newly drawn without fire, one ounce: Sugar candy two ounces: Starch two drams. Make a Lo∣hoch.

Venice Turpentine washed with Barley Water given to the quantity of three drams with the pou∣der of Liquoris, doth much profit for Maturation, Discussion, and Clensing.

But if the Empyema will not be spit up (as somtimes it will not) you must come to opening of it, which you must do between the fourth and fifth Ribs, beginning to count from below, with many Cautions, which are elegantly set down by many Chyrurgions, especially by Hierom•• Fabricius ab Aquapendente, in his Book of Manual Operations. But it is more profitable to open the Imposthume which comes from a Pleurisie before it break, and the Pus flow into the Cavity of the Breast, which is known by the Tumor which is against the place of Suppuration, and by other signs of an Empyema. And then you must not open it below, and between the fourth and fifth Rib, be∣cause if you make an orifice far from the imposthume, there wil no matter come forth; but you must open it in the middle of the Tumor, first applying a Caustick. But if no Tumor appear, it is hard to open it before the Imposthume be broken.

But if any will t••y, he must find out the place in which the Patient finds weight, pain, and heat.

And it must be made between two Ribs upon the higher part of the Rib, because there is a Vein and Artery neer the Inferior; which you must observe in the opening of every Empyema. While the matter is taken forth by degrees, let the Patient take a Wound Drink twice a day, which will purge the blood, clense the Ulcer, and hinder putrefaction: As

Take of Sanicle, Bugle, Scabious, Bettony, St. Johns wort, Carduus, Mousear, Burnet, Pere∣winkle, Agrimony, Plantane, of each one handful: the seeds of St. Johns wort, and Carduus be∣nedictus, of each half a dram: Cordial Flowers one pugil: Boyl them in Hydromel to a pint and an half. Take six ounces every time.

With this same Decoction Injections may be made into the Cavity of the Breast.

For his Drink, let him take Hydromel, or Barley Water, or Spring Water with Sugar.

If after the Breast is opened the matter do not flow freely, you must draw it forth with the follow∣ing Plaister, which doth powerfully draw from all Imposthumes.

Take of Rozin of the Pine-tree that is fresh, cleer, and sweet, half a pound: Oyl of Bayes and ••urpentine, of each one ounce: Gum Elemi two ounces. First let the Rozin and the Gum be ••elted and mixed; then ad the Turpentine and the Oyls, and let them boyl a little; then strain ••••em. Make a Plaister thereof for the part: change it once a day in Winter, and twice in Sum∣••er; cut it in two or three places that the matter may pass through.

Chap. 5. Of the Dropsie in the Breast.

THe Dropsie in the Breast is like to Empyema which comes from a serous humor contained in the Cavity of the Breast. The common Practitioners do not describe this Disease, although Hippocrates doth it excellently, 2. Lib. of Diseases called dropsies in the Lungs, thus: There is a Feaver, and a Cough, quick breathing, the feet swell, the Nails are contracted, and they suffer as ••••ey do in an Empyema, but not so violently, and longer; and if you powr any thing in, or apply a ••omentation or fumigation the matter doth not follow; and by this you may know that it is not ••atter, but water that is within: and if you try a long time to discover it by your Ear laid to his ••••de, it boyls inward like Vinegar; after that it goes into the belly, and then he seems to be recovered; But in progress of time, the belly is inslamed, and that endureth the same, or more: some swell in the ••elly, cods, and face. Thus Hippocrates.

This Disease seldom happeneth, it is more often than it is discovered, for it is not ordinarily ••nown. Many relations of it are given by Schenkius, by which it appears that he never see it till ••heir bodies who died of it were opened by him. Therefore we will describe it exactly that a Phy-••••tian may not be deceived.

This serous humor, either may be bred in the Lungs, by the proper fault of them, as when it doth ••ot concoct its own nourishment, but turneth it into Water, which by degrees is sent to the Cavity ••f the Breast, or by bladders breaking upon the Lungs, which are mentioned by Hippocrates in his ••ook of Internal Diseases, and also by others. Or it is sent into the Breast from other parts, as from ••he Hypochondria especially, when the Liver or the Spleen are distempered with a Schirrus or other ••isease by which much water is produced. This watery humor, is either sent by the Veins to the ••ungs which are weak, or else from the Cavity of the Abdomen it is carried to the Breast by Insensi∣••le Transpiration. Now Experience teacheth that this serous humor may be sent from one Belly to ••nother, because the dropsie of the Breast turns into a dropsie of the Belly, and a dropsie of the bel∣••y into the Breast, from whence they are suddenly choaked.

The Diagnosis of this Disease (as hath been said) is very hard, for almost all the signs are the ••ame with the signs of other Diseases of the Breast. But a noise of Water in the breast, is only pe∣••uliar to this Disease, and to Empyema, which may be heard within if the body be moved to and fro, ••r be taken upon a strong mans shoulders and shaken.

But all the Signs which we mentioned from Hippocrates taken together, may make a certain Diag∣••osis. To which you may ad this one, as being most evident to shew the Disease, and by which ••he Dropsie in the breast is only distinguished from other difficulties of breathing: namely, When ••t every first beginning to sleep this difficulty of breathing cometh and hindereth it, and by night en∣••reaseth, and towards morning by degrees abateth.

To these you may ad somtimes, a pain of one Arm or Shoulder, which comes either from the hu∣mor falling from the Head into the Breast, part whereof falls into the Arm, being neer, or from the water contained in the breast, and sent to the Arms by the Axillary Veins of the Arm-holes; or from ••he Refrigeration of the Intercostal Muscles, from which the Nerves are derived to the Arms, or from ••ome other sympathy by way of vicinity: For Hippocrates in Coacis observed this Sympathy of the ••reast and arms, If those parts or lobes of the Lungs which hang towards the right and left side of ••he Chest, be vehemently inflamed, so that they sway or rest upon one side of the Chest or Ribs, the ••atery matter breaks out on the same side of the Body where the Lungs lean or rest.

This is a great Disease, and hard to be cured, for they who have it have their Natural heat very ••eak, and their natural strength also, from some great disease in the bowels: from whence it comes that when the humor collected in the breast is evacuated by Medicines which is very difficult) there ••omes more in the place of it; from whence the disease is not only nourished, but encreased; so that ••t length by abundance of water they fall into the Dropsie called Ascites; yet in the beginning be∣••ore the bowels are much hurt, it somtimes may be cured.

For the Cure of this disease, you must observe two Indications; namely, That the matter contai∣••ed in the breast be evacuated, and that the breeding thereof again be hindered.

It is a hard thing to empty the water contained in the breast, because the waies are not open by which it should be brought forth. Therefore Hippocrates doth advise to open the side, which because ••e never see practised, and never read in any Author that it was done with good success, we cannot

absolutely approve; and we may speak of it as we have of the Opening or Tapping for the Drop∣sie, in its proper Chapter.

Therefore it is better to attempt this Evacuation with Medicines that expel Water, for which pur∣pose al those Medicines prescribed by us in the Cure of the Dropsie, are good. Where we must ob∣serve diligently, That if when the Disease is confirmed, and much serous humor is gathered in the Breast, you give a violent Purge, those humors wil be much moved, from whence there wil come a great Suffocation which wil kil the Patient: therefore be wary, and give your Medicine in a less Dose, though oftener, and mix them with strong Openers that purge Urin, that both the passages may be unstopt, and the Matter carried to the Uritories.

Among Water Purges the Minerals are best, as Mercurius Dulcis, and Mercurius Vitae so corrected that it may work only downward.

Also Diureticks alone, or Medicines to provoke Urin often used are good, because they turn away the matter coming to the breast, to the bladder, and by way of Consequence they bring it also from the breast.

Also Sudorificks are profitable, to the carrying away of this serous matter; and we saw a man of sixty years old, who by the use of a Sweating drink made of Guaiacum and Sarsa taken fifteen days together, and by provoking sweat with the vapor of the Spirit of Wine, was Cured.

Cauteries applied to make Issues in the Thighes and Legs, are also good to take Water from the breast.

You may hinder the breeding of this Water, by amending the faults of those parts which send this Matter.

So if the Lungs be in fault you must apply proper Medicines unto them: if the Liver or Spleen be troubled with Distemper, Obstruction, Schirrus, or the like, you must cure them by Medicines ta∣ken out of their several Chapters.

But those things which do strengthen the Vital and the Natural parts wil alwayes agree, such as are prescribed in the Cure of Weakness, Dropsie and Flux of the Liver.

Chap. 6. Of Haemoptysis, or Spetting of Blood.

ALthough usually the word Haemoptysis doth signifie al manner of Spetting of blood from what part soever it doth proceed whether from the Breast, Lungs, Rough Artery, or from the Jaws, Gums, Pallat, Uvula, Brain, Stomach, Liver, and Spleen. Yet Galen, lib. 1. decris. cap. 5. saith, That Haemoptysis properly is taken for that spetting of blood which comes from the Vital parts, as the Breast, Lungs, and rough Artery.

It is a Symptome in the excretion of those things which are wholly besides Nature.

But since every Symptome depends upon a Disease as its next and immediate Cause: the Cause of this wil be either an Organical, or a Common Disease: The Organical is Two-fold; the opening of the Vessels called in Greek Anastoriosis; and Rarifaction called Diapedesis. Also the Common Disease is Two-fold, namely the breaking of the same Vessels called Rexis, and the Corrosion of them called Diabrosis.

The Internal Cause immediately producing the Diseases is a great quantity of blood.

Blood exceeding in quantity wil either break the Veins or open their Orifices, and so make either a Rexis, or Anastomosis.

The same blood offending in quality, as when it is too hot or too thin, it wil come forth by way of Anastomosis; but because heat wil open the Orifices, and the thinness causeth it to flow more easily: Also the same qualities make a Diapedesis or Rarifaction: for heat doth make thin the Tu∣nicles of the Vessels, and the thinness of the blood causeth it to flow more easily through the pores of those Tunicles.

Lastly, The sharpness of the blood doth gnaw the Tunicles of the Veins and exulcerate them, & so cause a Diabrosis, or Erosion; this also is caused by sharp or salt humors which distil from the head, or coming from other parts to the Lungs.

Moreover, The External Causes do concur for the production of this Disease either mediately or immediately: It is produced immediately by a stroak, fal, wound, or the like; but they produce it mediately which encrease blood, heat and attenuate; as high and hot feeding, stoppage of Terms or Haemorrhoids, too much exercise, great clamor, heat, long staying in the sun, and many others.

Moreover, External Cold may cause the Ruption of the Vessels, by making their Tunicles harder and not so easily to be extended; but with this must be joyned strong Motion, or abundance of Hu∣mors.

The Diagnosis of this Disease is difficult in respect of the part from whence it comes: yet Galen

declareth it in few words; 4. de loc. affect. cap. 6. namely, blood coming from the Gullet and Sto∣mach is put forth by vomit; when it comes from the Vital parts, by Cough: from the Jaws and Wea∣zand, by Hawking: from the Mouth by simple spetting, which wants a more cleer explication when blood comes from the head to the inner parts of the Weazand and the Jaws, it comes forth by Cough∣ing, and so it doth when it comes from the breast; and therefore it is not distinguished by this sign.

Moreover, When blood coming from the Lungs or Breast is brought out by Coughing: There are other necessary signs from which the parts affected may be distinguished.

First therefore when blood comes from the head, although it somtimes cause Coughing; yet the greatest part thereof is put forth by Hawking, and there is a tickling in the Pallat as in a Catarrh: as also when you look into the Pallat it appeareth to be foul, and bloody; and it is more confirmed to be from the Head if at that time the Nose bleed.

When the blood comes from the Lungs, it is distinguished from that which comes from the Breast by Galen in the place mentioned; for that which comes from the Lungs is froathy, in greater plenty, and without pain: but from the Breast, it is black, little, and with pain.

But it may be objected, That blood coming from the breast is carried by the Lungs, and by conse∣quence is froathy, because it is mixed with the air taken in, as that which comes immediately from the Lungs.

And Avicen saith, That blood from the breast is froathy: I Answer, That it is one thing to spet some froath mixed with the blood; and another thing to spet nothing but froath, which only comes from the substance of the Lungs.

Therefore you may observe▪ Three degrees of froath: for it is either wholly froathy from the flesh of the Lungs, which it resembleth, for the Lungs are but a congealed froath; or it comes from the Vessels of the Lungs and is very froathy: or it is mixed with froath and comes from the breast.

But the most certain sign that it comes from the Lungs is taken from the pain, which is fixed and continueth where the solution of continuity is.

And you must observe, That blood is somtimes sent from the Liver, Spleen, Matrix, and other parts into the Lungs and spet forth: so that the Breast is not primarily, but secondarily affected; which thing is hardly to be discovered.

But we may conjecture of it, namely if any of the aforesaid parts be troubled with pain, inflama∣tion, or any other distemper, and there neither is, nor hath been, any other fault in the breast.

You may find out the signs of the Causes from what hath been said: For if blood be brought by the Anastomosis of the Veins, there went before some Cause that opened the mouth of the Vessels, then blood is thrown forth in a pretty quantity and without pain. But if it come forth by Diapede∣sis or Rarefaction, then is it waterish, little, and without pain.

When it breaks forth by Rixis, or Eruption, it is very much; if a Repletion went before, or any External Cause that might break the Vessels.

Lastly, If it comes by Diabrosis, or Corrosion of the Vein, there went before salt and sharp di∣ffillations from the head: The blood is salt, and sharp, and ill coloured; and some Causes of sharp humors were formerly: in the beginning there is but little blood, but after when the Corrosion is greater, then is much blood spet forth, and at last there is a spetting of Matter.

Hippocrates, Aphor. 25. Sect. 4. doth lay down the Prognostick of this Disease, as what kind of blood soever is spet out of the mouth from any part below, it is evil: for every opening of a vessel which letteth blood come forth so, is dangerous; especially in the Lungs; concerning which his A∣phorism chiefly speaks.

But somtimes such spetting of blood may be without hurt; namely, When Nature by a critical Motion doth purge the superfluous blood by those waies. And it is observed, That Women which have had their Terms stopt have without harm at certain times spet blood from their Lungs by the Anastomosis of the veins.

In respect of the Causes. Diapedesis or Rarifaction is less dangerous than Anastomosis or Aper∣tion and Eruption is most dangerous; for unless it be healed within three or four dayes there cometh an inflamation, which being suppurated produceth an Ulcer, from whence cometh a Consumption: Whence Hippocrates saith, Aphor. 15, & 16. Sect. 7. That from spetting of blood there followeth spetting of Matter, and from spetting of Matter a Phthisis or Consumption.

But Diabrosis or Corrosion is most dangerous; and Galen saith, That it is incurable by reason the Ulcer that followeth it is incurable.

The Cure of Haemoptoe or spetting blood, is wrought by Revulsion of blood from the Lungs by correcting the evil quality thereof, and closing the vein that is opened, by astringing and conglutina∣ting means.

First therefore let blood from the Arm on the same side on which you find heaviness or pricking, in a smal quantity often, and at a distance for the better Revulsion.

After that, open the vein in the Foot, and so you wil make a Revulsion to a further distance, and

this will be more profitable if the disease come from obstruction of the Terms. If the Patient be sub∣ject to the Hemorrhoids, you must open them with Hors-leeches.

Also apply Cupping-glasses with Scarrification to the shoulders and back, or without Scarrifica∣on to the Groins and under the Ribs. Rub and bind the extream parts, and in all the time of the Cure, at some distance apply often those Cupping-glasses to the Hypochondria, or under the Ribs.

And let him take the following Julep thrice every day.

Take of Plantane and Poppy Water, of each two ounces: Syrup of dried Roses one ounce: Lapis Prunellae one dram: Mix them for a Julep.

Lastly, You must often purge the serous and Chollerick humors which make the blood more thin and fluid with Medicines that have an astringent Vertue: As,

Take of Rhubarb one dram: yellow Myrobolans half a dram: Tamarinds half an ounce: Infuse them in Plantane Water; strain it and dissolve in it Pouder of Rhubarb half a dram: Sy∣rup of dried Roses one ounce. Make a Potion.

Then give Medicines that close the Orifices of the Vessels by an astringent quality, but such as will not retain the blood in the Breast by too much astriction; therefore mix somtimes with them such as dissolve and expectorate the congealed blood which is out of the Vessels.

Of all which these following are the best:

Take of Bole-Armenick, Terra Sigillata, both sorts of Coral, Blood-stone, of each half a dram: Sugar of Roses half an ounce. With one white of an Egg well beaten with Rose Water, make a Lohoch.

Or you may make one more speedily, and more pleasant thus:

Take of the Water of the white of an Egg well beaten two drams: Sugar of Roses one ounce: white Starch three drams. Mix them for a Lohoch. Or,

Take of Conserve of Roses, and the greater Comfry, of each one ounce: Bole-Armenick and Terra Sigillata, of each one dram: With the Syrup of dried Roses make an Opiate to be often held in the mouth, and swallowed by degrees.

Take of Conserve of dried Roses, Troches of Amber, and of sealed Earth, of each half a dram: prepared Pearls one scruple: Sugar of Roses as much as of all the rest. Mix them and let him take a spoonful thereof one hour before meat.

Take of the Juyce of Purslain twelve ounces: Sugar eight ounces: Boyl them to a Syrup, of which let him often lick.

This is the best for spitting of blood. And if you want Purslain, you may take Plantane.

The Syrup of Comfry according to Fernelius, prescribed by Bauderon, is good for the same.

Take of Yarrow with the white Flower: and yellow Flower, of each two handfuls: Green Roots of Tormentil, with the Leaves if they may be had, otherwise of the dry, one ounce: the grea∣ter Burnet one handful: Conserve of red Roses half a pound: spring Water sixteen pints: put them in a glassed pot covered and luted, that the vapors may not come forth: then boyl them in Bal∣neo Mariae sixteen hours; keep the straining in a glass, and take six ounces thereof every morning, noon, and night.

Take of the Troches of Amber one dram: Plantane and Rose Water, of each one ounce and an half: Syrup of Mirtles and dried Roses, of each half an ounce. Mix them for a Julep.

Take of Spirit of Vitriol half a scruple: Plantane Water four ounces. Mix them for a Potion.

This presently stops blood coming either by Cough or Vomiting.

Two spoonfuls of Syrup of Coral taken every day, is good against all manner of bleeding. But the Tincture of Coral drawn with Juyce of Lemmons, is more powerful.

Quercetan in his Dispensatory, prescribeth this following Water against spitting of blood, which is very excellent.

Take of the Roots of Snakeweed, Comfry, and Tormentil, of each one ounce: Knotgrass, Yarrow, Veronica, Winter-Green, Sanicle, Shepheards-purse with the Roots, of each one handful: Bram∣ble tops, and Mastich wood, of each half a handful: Sumach and Myrtle berries, the seeds of Plantane, Barberries, and white Poppies, of each six drams: the flowers of Water Lillies, Guords, Quinces, and red Roses, of each two pugils. Bruise them and mix them; then steep them four daies at the fire in the Juyces of Plantane, Purslain, Sorrel, and Agrimony, of each two pints: then strain them well, and put to them Acacia and Hypocistis, or Conserve of sloes, of each two ounces: sealed Earth, Bole-Armenick, of each half an ounce: the Electuary of Diatraga∣canth frigid, two drams: then macerate them again four daies, and distill them. Take two or three spoonfuls of this Water alone, or with some proper Syrup.

The Chymical Oyl of Amber doth pierce, astringe, and dry powerfully, if you give two drops thereof in Plantane Water: As Cesalpinus teacheth in his Speculum Artis Medicae.

Mercurialis in his consultations doth highly comm••nd the seeds of white Poppies, or white He••∣ane to be tak en every morning in the quantity of a dram, with Sugar of Roses and Syrup of Pur∣••••ane: So you may also use the white Diacodium or Syrup of Poppies prescribed in the Cure of the Phrenzy.

Amatus Lucitanus doth highly commend the Juyce of Nettles, in these words: They which have vomited blood, after they have been given over by Physitians, have been cured only by the juyce of Nettles drunk five or six daies fasting, in the quantity of four ounces, and by Nettle Broth.

Sanguis Draconis doth wonderfully conglutinate all inward Veins, if you give half a dram thereof with Plantane Water, or other proper Liquor, or Medicine.

The usual Pills to hold under the Tongue, may be made thus:

Take of the Mucilage of Gum Arabick and Tragacanth, drawn with Plantane Water, of each two drams: Mummy and Mastich, of each one dram: Sugar of Roses as much as will make Pills, of which let him hold one continually in his mouth.

And take this following Pouder in his Broths.

Take of red Coral and prepared Pearl, of each half a dram: Gum Arabick and Tragacanth, of each two drams. Make a Pouder.

Or boyl white Poppy seeds and Sumach tied in a clout, in his Broth.

Narcoticks are good in this case, and you must use them thus:

Take of Syrup of Poppies, Jujubes, and dried Roses, of each one ounce: Mix them, and take a spoonful every night. Or,

Take of Syrup of Poppies and Purslain, of each three drams: Terra Sigillata half a dram: Purslain and Plantane Water, of each one ounce and an half. Make a Potion to be taken at night. Or,

Take of Syrup of Myrtles and Poppies, of each one ounce: Bole-Armenick half a dram: mix them to be taken at night.

Somtimes you may give Treacle of four months old, as Galen teacheth, 5. Method. cap. 13. or Philonium Romanum, or Laudanum.

Platerus reports that he cured one, only with the Troches of Winter Cherries, with Opium dis∣solved in Goats milk, taken some daies; and also that he cured a Woman with one ounce and an half of Manna given in Broth, and with blood, and the use of the Tablets following, morning and evening for many daies.

Take of the Seeds of white Henbane poudered finely two scruples: red Coral half a dram: Gum Arabick one scruple: new Violets ten: the Juyce of Barberries two drams: Sugar dissolved in Rose and Plantane Water, two ounces. Make Tablets.

Trallianus, lib. 7. cap. 1. doth highly commend the Blood-stone, by which he saith that he cured many, giving it to four scruples, with the Juyce of Pomegranate, or Knotgrass; but to them who bled not much, he gave it with warm water. But he saith you must sift it well, give it often, that it may better be distributed, and in Wine.

Antony Valerius exercit. ad cap. 27. lib. 1. Hollerij de morb. internis, reports, that he cured, when all means failed, by this Pouder, which he had from Julius Scaliger.

Take of Spodium, red Roses, Bole-Armenick, Terra Sigillata, and Blood-stone, of each half an ounce: red Coral, Amber, and Pearls not perforated, of each two drams and an half: Gum A∣rabick and Tragacanth of each two drams: the seeds of Purslain, Mallows, Ribwort, red Roses, burnt Harts-horn, and white Starch burnt, of each three drams. Make thereof a fine pouder, and give three drams thereof with rain water.

This Pouder Scaliger borrowed of Serapio, who mentioned it in his Book of Spitting of blood; and which Valesus also commends. And you may make Tablets thereof with Sugar dissolved in ••ose or Plantane Water.

The Electuary of Haelideus is like it, and easier made; which was wont to be famous in Germany, ••••d so commended of Gesner, Erastus, and Crato, thus:

Take of the seeds of white Poppy and Henbane, of each ten drams: Terra Sigillata, and red Co∣ral, of each five drams: old Sugar of Roses, as much as will make an Electuary. Give hereof ••e dram morning and evening, after universal Medicines have been given.

But because that spitting is stopped by the use of Astringents, and thence comes difficulty of ••eathing, you must at times use things that mollify the Breast, and also stop bleeding, such as they ••hich are compounded of Gum Arabick, Tragacanth, Starch, and Syrup of dried Roses, Quinces, Mir∣••••s, and Jujubes the Juyce of Plantane and Purslain, while you use Astringents, if the Belly be ••••und give a Clyster or Purge, that leaves some Astringency.

In the whol time of the Cure, if you suspect that there is any congealed blood in the breast, you must dissolve it with Oxycrate thus made, according to Galen, 5. Meth. that it may be pleasant and not provoke Coughing with the V••negar; for so it dissolveth the blood and gently bindeth: Let him take six ounces warm twice or thrice in one day: and if it provoke Coughing sweeten it with Sugar: but you must use this when the bleeding begins to cease; for this also Amber and Mummy mixed with glutinatours and astringents is good.

Also for the allaying the Heat of the Liver, use often a Cooling Epithem to the right side.

Take of Rose, Plantane, and Succory Water, of each four ounces: Vinegar of Roses two ounces: the Pouder of the Electuary of the three Saunders one drani and an half: Camphire one scruple: make an Epitheme to be applied warm to the Liver.

After the use of the Epitheme anoint the same part with Oyntment of Roses, or the Cerat of Saunders, with a little Rose-Vinegar.

Anoynt also the Reins of the Back with Oyl of Roses and Water-Lillies washed with Vinegar; adding a little Camphire to allay the heat of the blood in the hollow Vein: But you must beware of things that are too Astringent, lest they drive the blood from the hollow Vein into the Lungs.

It is also very good to wash the stones with Oxycrate to stop the Flux and allay the heat: for there is a great consent between these parts.

A Bath would also be good to allay the heat of the Bowels; but because they relax and so open the Veins, you must avoid it.

Let him drink Syrup of My••tles, Purslain, and dried Roses; or Sugar of Roses with Barley-wa∣ter, or with the Water wherein Blood-stone or sealed Earth hath been infused. Or mix Conserve of Roses with the Water, or with Water wherein Coriander hath been infused, made sharp with the Spirit of Vitriol: or with the Tincture of Roses.

A weak Decoction of Yarrow drunk ordinarily is good against al bleeding.

If a sharp Defluxion from the Head upon the Lungs, be the Cause of this Disease, besides what hath been said, you may use those Remedies which are prescribed in the Cure of a Hot Ca∣tarrh.

After the Blood is stopped, to keep it from returning you must first abstain from al things that stir the Humors, as violent exercise, great heat, anger, roaring, rich Wines, the meates mentio∣ned which are either salt or spiced.

Conserve of dried Roses must be held in the mouth, especially at bed time.

Take of Conserve of Roses and of Comfry Roots, of each one ounce: the Troches of Amber, and sealed Earth, of each half a dram: red Coral and prepared Pearls of each one scruple: Su∣gar of Roses as much as all the rest: make a mixture, of which let him take a spoonful somtimes one hour before meat.

Let him be purged four times in a yeer, or oftener if occasion be, with the Potion of Rhubarb and Myrobalans above mentioned; to which, instead of Syrup ad one ounce of Manna.

You may with good success give a scruple of torrefied Rhubarb every morning one hour before meat, especially if the blood be very serous, as it is commonly in Haemorrhages.

Also Rhubarb not torrefied given in the same quantity; for so the blood after the serous watery Humor is carried away wil grow thicker: Or, You may give a dram of Rhubarb once every Week.

There is also a Magistral Syrup to clense the blood from thin serous Humors. As,

Take of the Leaves of Bugloss, Fumitory, Hops, Succory, Endive, Agrimony, Plantan••, Maiden-hair, of each one handful: the Tops of Asparagus, Vervain, and Eyebright, of each half an handful: the Seeds of Gourds and Mellons, of each half an ounce: Endive and Dodde•• seed of each two drams: Liquoris scraped, and Raisons, of each one ounce: sweet Prunes twelve: Senna four ounces: Polypody of the Oak two ounces: Agarick tyed in a thin Clout, six drams: Mace one dram: the Three Cordial Flowers & red Pease or Pulse of each one pugil: boyl these to a pint & an half: dissolve in the straining of the juyce of sweet Apples three ounces: sine Sugar o•••• pound and a quarter: make a Syrup boyled well, & sented with yellow Saunders: Then infuse in it one ounce of Rhubarb beaten and tyed in a Clout, let him take an ounce and an half, or two ounce••, with Broth twice in a month.

Make an Issue in the right or lest Leg, as the Liver or Spleen are affected.

Lastly, Let him use for a whol Month Asses-Milk steeled, for prevention of this Disease.

For his Drink, take Water boyled a little with Coriander seeds, or the Decoction of Barley and Liquoris.

Chap. 7. Of Phthisis, or Consumption.

ALthough the word Phthisis signifie every Consumption, yet it is most properly taken for that extenuation of body which cometh after an Ulcer in the Lungs.

For this Extenuation of body comes from a putrid lingring Feaver, which turneth to an Hectick; and this Feaver comes from the Ulcer in the Lungs, from which by reason of their neerness to the Heart putrid Vapors are continually sent thither and cause the Feaver, which after is dispersed from the Heart into the whol body; so al the parts being too cold and dry, and receiving the intempe∣rate putrifying heat, do not wel concoct their nourishment, but are ill nourished, from whence you may plainly perceive a Consumption of the substance of the whol body: for that Feaver by reason of its continuance from the perseverance of the Cause turneth Hectick: and its often joyned with a putrid Feaver, which is known by the Urine, and by the Distempers extraordinary at sometimes, in∣••omuch that in some Consumptions you may observe sits of an intermitting Feaver.

A sharp and Corroding Humor, either coming from other Parts, or breeding in the Lungs, is the immediate Cause of an Ulcer in the Lungs.

First sharp and salt Rhewm falls from the brain, which being violent easily ulcerateth the Lungs: Somtimes Flegm that is not sharp nor salt wil do the same: namely, if it lie long in them and putrifie, and from the putrifaction ariseth an Acrimony, which Corroding Ulcerateth: yet this putrid flegm in the Lungs doth not alwayes ulcerate, as we may observe in a Catarrh when putrid Matter is spet forth, and the Lungs are sound.

But there are two Conditions for the Causing of an Ulcer: one in respect of the matter flowing; another in respect of the Lungs: In respect of the Matter it is required that it should be so disposed, that when it is putrified it begets a sharpness which may cause an Ulcer: In respect of the Lungs, they must be extraordinary tender, and disposed to corruption, which in a word is called a Vitious Constitution of the Lungs, coming from the Parents usually, of which we will speak here∣after.

Now the Humors that Exulcerate and putrifie the Lungs, come from the parts adjoyning, as the Pleura, Mediastinum, Diaphragma, rough Artery, and especially from an inflamation in them, w••••••h comes to Suppuration and turns into an Empyema: of which Hippocrates speaks, Aphor. 15. S•• c. 5. They who fall from a Pleurisie into an Empyema, if the Empyema break in fourty dayes and come away, are Cured; but if not, they fall into a Consumption.

The Humor is in the Lungs when from some vessel broken, corroded, or opened by a wound, the blood flowing doth putrifie; or when an Ulcer is left there from the smal pox.

Somtimes from the evil Constitution of the Lungs, evil Humors proceed; which corrupt their substance and cause a Consumption: and this comes commonly from the Parents, from whence a Con••mption is reckoned among the Haereditary diseases, of which it is the chief, so that we may observe how many whol Families are taken away with this disease.

This evil Constitution of the Lungs is not in the first qualities, but hath some malignant and ve∣nemous quality, by which it becomes infectious: Although we deny not but a soft and loose substance of the Lungs, and therefore more fit for Corruption, doth much conduce to the breeding of this Disease.

This evil Constitution of the Lungs causeth that some fal into Consumptions without a Distilla∣tion, Inflamation, or any other evident Cause, but only from the fault of the part that corrupteth its own nourishment.

Somtimes it comes from a Pustulae bred in the Lungs and broken, which by Hippocrates, 1. de morbis, is made two-fold:

One by him is called, A Crude Pustule, because it never comes to Suppuration, but growing by de∣grees stops the passage of the breath, and at length kils the Patient.

The other is that which cometh to Suppuration, and is called the Imposthume of the Lungs, and these come two wayes, either by Defluxion, or Congestion; and the Matter gathered is either in a Bagg or without it in the very substance of the part.

The thickness of the Bagg often causeth that such an Imposthume is carried many yeers in the Lungs undiscovered, and without any hurt to the body: From whence Hippocrates saith, Aph. 41. Sect. 6. They who have an Imposthume in the body, and feel it not, it is by reason of the thickness of the Matter, or of the place wherein it is that they feel it not: For this Cause many who seemed to be in perfect health have suddenly died by an Imposthume broken within: of which there are Ex∣amples in Ferne••ius, lib. 5. de morbis, de part. ••orb. & sympt. c. 10. among which he mentioneth two Physitians who sore-••aw the danger without signs.

If the matter which comes from the Imposthume broken, flow into the Ventricle of the Heart, the sick presently die: but if it come to the Bronchia, or passages in the Lungs, it may be spit up; if the body be strong, and the matter little in quantity; but commonly there is an ulcer remaining in the Lungs which causeth a Consumption.

Moreover, There are external Causes, as contagion, which is the chiefest; for this Disease is so infectious, that we may observe Women to be infected by their Husbands, and Men by their Wives, and all their Children to die of the same; not only from the infection of their Parents seed, but from the company of him that was first affected.

And this Contagion is more easily communicated to them that are of kin, wherefore it is not safe for a Brother or Sister to enter into the Chamber for the Miasmaza, or vapors infective, which come from their Lungs, and infect the whol Air of the Chamber, and being drawn in by others (espe∣cially if they are any way disposed to the same Disease) beget the same disease in their Lungs.

There are other external Causes, especially very hot or cold Air; the hot Air doth melt down the sharp humors which are contained in the Brain, and sends them to the Lungs. The too cold Air by astringing, compressing, and Squeezing doth cause the like defluxion: But the Air in Autumn is most dangerous, because by its inequality in heat and cold, it causeth sharp and salt distillations; whence Hippocrates saith, Aph. 10. Sect, 3. Autumn is the worst time for People in Consumptions. Secondly, Sharp and salt meats and drinks do cause a Consumption, which sill the Head with salt and sharp vapors. And lastly, all those internal and external Causes which use to produce spitting of blood, which useth to end in a Consumption, may be said to be Causes thereof.

Among the Antecedent Causes, evil humors throughout the whol body, are accounted the chief, which being moved by external causes, are sent to the brain, and from thence to the Lungs. Among which you may reckon the suppression of the Terms, Hemorrhoids, or other usual evacuations, which doth cause Catarrhs and defluxions.

The aforesaid Causes do produce this Disease, especially among those whom Hippocrates calleth Phthirodeis, and Pterugodeis, that is, such as have a straight and distressed breast, a long neck, and shoulder bones sticking forth, who must of necessity fall into this disease, if they have tender Lungs, or any hereditary inclination thereunto. Also they are inclined to a Consumption, who have a weak Head, which is easily filled winh superfluous Humors, which are sent to the Organs or Instruments of the Spirits.

There are no true and proper Differences of Consumptions, but such as come from the variety of their Causes. Yet Hippocrates doth lay down many kinds which are worth the observing, which must be reduced, not to a true Consumption, but to one in general, which is without ulcer of the Lungs. And first lib. 6. epid. sect. 8. text. 47. he sheweth of a Consumption which came from a run∣ning of the Reins, in this History: A Satyre called Grypalopex, being twenty five yeers old, had Nocturnal Polutions, and dayly loss of Seed; who when he came to be thirty yeers of age, fell into a Consumption, and died. For by the continual loss of Seed the nourishment of the body is taken away, by which the solid patts are consumed and dried.

There is another kind in Hipp. 2. de morb. called the Consumption of the back, which comes from too much Lechery, which destroyeth the whol habit of the Body, and takes away the nourishment from the solid parts: this happens to new married folks, who are unsatiable, and is the chiefest of the Consumptions of the back; for Hippocrates laies down four kinds thereof: The first is that men∣tioned, which comes from Lechery. The second is laid down lib. 2. de intern. affect. text. 13. which comes from too much blood, and nourishment going to the Spinal Marrow, by which the Natural heat, and all other faculties are stifled and destroyed. Now Hipp. 5. epid. sheweth that the body may consume by too much blood, in a story concerning one, who, when nothing would nourish him, but he still grew leaner, was perfectly cured, when all other Medicines failed, by bleeding in both Hands as long as the Veins would discharge. The third kind is in the place mentioned, namely, when the marrow of the back is dried, by which the whol body drieth and consumeth. Hippocrates mentioneth two Causes of this driness: one is the obstruction of the veins which go to the back with nourishment; another is the flowing of Choller from the head upon the back, which Hippocrates sheweth in his Book de locis in homine. The fourth is described in the same Book, and it comes from a distillation upon the marrow of the back, in these words: Moreover, when a defluxion falls upon the Back, this kind of consumption cometh with pain in the Loyns, and seeming emptiness to the Patient in the internal parts of the head. In the same Book, numb. 18. he saith thus: When there is a defluxion upon the Marrow, there is a secret undiscernable Consumption. He calls it se∣cret, because when the body decaies, you cannot so easily find out the cause: he calls it undiscerna∣ble, because you cannot perceive the inconveniences of the defluxion at the first. But it ceaseth to be secret and undiscernable, if the defluxion be not only upon the marrow of the back, but also upon the Os Sacrum, and Hip: for then the distillation is apparent, and there is pain and loss of motion, with dejection of mind. These are more cleer in Hippocrates, in his Tenth Book de glandulis, in

these words: There is another Disease which comes from a defluxion from the Head by the Veins upon the Marrow of the Back, and from thence to the Os Sacrum, and Hip, which is a Consump∣tion also which destroyeth, for then the Shoulders and both the feet are weak, and after the leggs, and they alwaies die of it, though they have been formerly cured. This kind of Consumption is to be observed, because it often happeneth, especially to such who have weak Nerves, which will ea∣sily receive the desluxion.

To this kind you may refer that which comes of want and hunger; which Galen mentioneth, lib∣de Marasmo, when the Body decaies for want of nourishment. Now Nourishment is wanting to the solid parts, not only for want or meat, which the Stomach concocteth, and sends to the Liver to make blood for the whol Body: but also when the Chylus which is sufficiently concocted in the sto∣mach cannot pass through the Meseraick Veins, by reason of their obstruction; as it happeneth to them who have a Struma, whose Mesentery for the most part is full of Glandles; by which the milky Veins called Venae Lacteae, are compressed, from whence the whol Body grows lean, and they die of a Consumption.

But the solid parts are deprived of their necessary nourishment when salt blood that is not sit for nourishment is gathered into the Veins, which, as Galen shews, are incurable, 5. Meth. except by Epicrasis, or change of habit. And finally, Galen, lib. de Marasmo, decimo meth. and in other places, speaks of a Consumption from a manifest or hidden Inflamation, from the syncope of the Heart or Stomach, and the like, which may be seen in their proper places.

The Diagnostick signs by which you may know a true Consumption, do some of them, declare a Consumption beginning, or begun, or confirmed, which are very well set down by Hipp. 1. de morbis.

The signs of a Consumption at hand, are in Hipp. Book, mentioned, Text 9. in these words: There is also a Suppuration when flegm flows from the Head upon the Lungs; and first for the most part it flows privately, and causeth a little Cough, and the spittle to be bitter, and a little heat.

In this saying there are contained four signs of an eminent Consumption.

The first sign is, A defluxion from the beginning closely conveighed to the Lungs, because then the matter is little, and because the thinner part of the humor, which floweth about the rough Artery, and doth not vex the Lungs, which otherwise would be more disturbed in the beginning, before they are weakened; thence it is called a secret defluxion, because there is little hurt at the first done thereby.

The second sign is, When the Humor flowing makes but a smal Cough, being at the first but little and thin.

The third sign is, When the spittle is more bitter than usually it was, because the humor that must ulcerate the Lungs must be sweet, sharp, or salt; which qualities being altered by a preternatu∣ral heat, do turn bitter: for it is known that sweet and salt things overmuch boyled, do grow bitter. But in regard that preternatural heat is not very great at the first, the spittle is but a little bitter.

The fourth sign, is a little heat, as being feaverish; for when the matter is not much moved, but receiveth putrifaction from the heat of the place, wherein it hath been long contained, the Feaver cannot be very violent, for the putrid matter can many waies be refrigerated; therfore it is no won∣der if the Feaver be smal in the beginning.

To these signs of Hippocrates we may ad an evil formation of the Breast and Youth, which mee∣ting with the aforesaid signs, must needs declare a consumption to be at hand.

The evil fashion of the Breast is when it is narrow, and the Shoulder-blades stick up like wings, when the fore part of the Breast is narrow, and the hinder part broad, for then the Breast is both smal and evil proportioned. The straightness of the Breast shews want of Natural heat, and the evil pro∣portion shews its weakness. For if the Natural heat were much and vigorous, the breast would have thereby been extended. But such and so great is this disposition, that Hippocrates calls it a Natural Consumption, coming from a principle in Nature. Wherefore they who are thus made must of ne∣cessity fall into a Consumption, except some other disease take them off. Which by the way is ob∣servable, for if they have any acute disease, who are thus inclined, they seldom escape, because the Natural heat is weak and little, and therefore will easily be overcome by a strong disease. Therefore the most wary Physitians in such kind of Natures and habits, do use to prognostick rather death and danger, than health or recovery, when they fall into any disease.

In them who are inclinable to this Disease, Youth is most dangerous, according to Hippocrates, Aph. 9. Sect. 5. especially from Eighteen to Thirty Five yeers, in which time there is much blood for to break the vessels; as also it is then thin and sharp, more proper to open and corrode the Vessels: In Children, the Catarrh is made slow with much Moisture: in Old Men, it is allayed with Cold: but in the Middle Age, for the Reasons aforesaid, it doth often exulcerate.

Moreover, in Youth many distempers come by Diet, by which many ill humors are produced and the blood infected•• as also by reason of violent exercise, as running, wrestling, leaping, fencing, going in the sun, a vein may be broken in the Lungs which may produce a Consumption.

The signs of a Consumption begun, are set down by Hippocrates in his Book of Diseases before mentioned, Text 10. in these words, In progress of time the Lungs are exasperated and ulcerated within by the Catarrh putrifying there, whereby the breast seems ponderous, and there is a pain be∣fore and behind; and there is more sharp heat in the body: and the Lungs by reason of their heat draw moisture from the whol body and especially from the head, which also is made hot from that body, and spetteth forth thick matter.

In these Words there are Six Signs contained of a Consumption begun.

The First sign is, That the Lungs are exasparated in progress of time: that is, The Cough is more violent; for the Disease increasing the Distillation is stronger, and the Lungs are peirced therewith, and provoked to Cough forth that which hurteth them: which Cough doth not only come from the matter flowing down, but from that which flowed formerly: for being not Coughed up it grow∣eth foul by long continuance▪ by which means the Lungs are more forced to expulsion.

The Second sign is, The weight of the Breast which comes from the matter gathered into the Lungs: For albeit the Lungs of themselves do feel little or nothing, yet because they are tyed to the Breast by Membranes, they perceive a weight, when they are burdened.

A Third sign is, A sharp pain before, and behind: for the matter contained in the Lungs doth with its evil quality offend them, as wel as with its quantity and putrifaction, by which the Mem∣branes are pricked, which cause great pain: for the pain in the Membranes is alwayes pricking. Now this pain is perceived before and behind; because these Membranes are joyned before to the Sternon, and behind to the Back: and the cause of this pain is from a great Cough, called by Hippocrates, A Malignant, or Cruel Cough.

The Fourth sign is When sharp Heat falls into the body, and there followeth a violent Feaver: for when through progress of time the matter putrifieth more, it is probable that the Feaver wil be greater; for although the matter from the beginning do only putrifie in the Lungs, yet by reason of the Suppuration made in the Breast with an Ulcer, the filth is communicated to the humors contain∣ed in the Veins; from which come divers sorts or putrid Feavers, and these differ from that Feaver which comes only from the Ulcer in the Lungs, through the filthy vapors which are carried from them into the Heart, which turns to an Hectick; and therefore in a Consumption there is a Hectick Fea∣ver often joyned with a Putrid.

The Fifth sign is, When a great quantity of Flegm falls from the Head to the Lungs: which Hippocrates confirms, when he shews the Cause of that great Defluxion; namely, The Lungs by their Heat drawing Flegm from the whol body: Hence it is that the humors contained in the whol body are the matter of a continual and great Flux which doth so trouble men in Consumptions. The Lungs by the filth which they have contracted, grow hot; by which heat Flegm is drawn from the Brain, which the Brain fetcheth from the whol Body: And this is one of the principal Causes of the extenuation or the whol body: for al the humors, good and bad, are carried to those parts, and so the whol body decayeth.

The Sixth sign is, Spetting of thick rotten Flegm: for when the Matter putrifieth and there is an Ulcer, quittor or filth must needs come from thence, and therefore the Spittle is Mattery: but it is between thick and thin: for after that it hath by long continuance in the Lungs grown thick, it is made thinner by the addition of that which breaks from the Ulcer, and so it becomes moderate, which Hippocrates calls Subcrassum, or Thickish.

To these mentioned Signs of Hippocrates you may ad this as most certain, namely, The Extenua∣ting the body with a lingering and constant Feaver: For besides the putrid Feavers above mentioned which come and go by fits, and grow from the humors which putrifie in the Veins: there is also al∣wayes present a lingering daily Feaver coming from the vapors sent from the Ulcer to the Heart which corrupteth the nourishment of the whol body, and makes it dry and hot, from whence the body must needs grow extenuated.

To there you may ad Sweatings at Night, with which men in Consumptions are often troubled as soon as they begin to sleep: for by sleep the Heat is drawn in which encreaseth the Inflamation of the Lungs; and the heat inwardly increased, causeth abundance of vapors, which are thickned in the skin, and turned into sweat.

Moreover, There is a continual rigor which comes from the sharpness of the matter which pricketh the Membranes.

And Lastly, You may ad sweetness of spittle, which useth to come when it begins to Suppurate, which is the original of Saltness.

Hippocrates shews also the signs of a Consumption confirmed, in his 11. Text of the Book above mentioned in these words, The longer this Disease lasteth, the more absolute matter will be spet, and the Feavers be the sharper, the Cough more frequent and strong. the body will more consume, and yet the body is disturbed downward from Flegm, and this comes from the Brain▪ when any man comes to this he must perish.

In these Words we may observe that there are Five Signs of a Consumption confirmed.

The First is, The Spittle being more Mattery, or rather Matter it self.

The Second is, A strong Feaver, and sharp, more putrifying; and the Ulcer more foul.

The Third is, An often and violent Cough more than formerly; often because of the great pro∣vocation and little evacuation, therefore nature laboreth to do that at divers times which the cannot do at once: and it is a stronger Cough, not only because the greater sharpness of the Water doth more violently stir up the expulsive faculty; but also because of the wearing away of the solid parts, the breast is made more hollow, hence comes a hoars and sounding Cough, as from a hollow place.

The Fourth sign is, Pining and want of Apetite, which makes them leaner; now the want of Appetite comes from the distillation which doth not only fal upon the spirital members, but also upon the natural▪ especially the Stomach, whose mouth is thence weakened to the loss of Appe∣tite; as also from the putrid vapors sent thither either from the Feaver or the Ulcer.

The Last sign is, A loose belly which comes from Flegm falling from the head, by which in time the stomach and guts are weakened, and the retentive faculty destroyed: and this kills the Patient as we shal shew more at large in the Prognosticks.

To these signs of Hippocrates, we may ad some other:

The First is, A great Extenuation of the whol body, so that al the Musculous flesh is consumed, and the bones appear only covered with skin: and hence it is that the nayls are crooked, because the Flesh which was in the tops of the Fingers to hold up the nayls, is consumed.

To this you may ad Difficulty of breathing, both because the Faculty is weak, as also because the Bronchia of the Lungs are stopt with putrid matter; as also because the part is for the most part pu∣trified and consumed, and therefore cannot take in sufficient air to cool the heart; so that what the Lungs cannot do by one breathing, it must do by often.

And Lastly, We may ad, That in a confirmed Consumption that is desperate, the Hair falls off, the Cheeks wax blue, except it be after meat, and then the vapors sent up make the red Lice breed in abundance, and the Feet swel.

Neither need we so many signs, for if any ordinary man, saith Areteus, shal see a man pale, weak, and coughing, and very lean, he wil conclude him to be in a Consumption.

Yet we must observe diligently, That somtimes a violent Catarrh falling upon the Lungs wil re∣semble a Consumption so, that filth like Matter, shal be spit forth, and thence may a Feaver come through putrifaction and extenuation of body: but they who are so are easily cured by diligence in means, therefore let us distinguish this rightly from a Consumption, which is chiefly done by dis∣cerning between putrid Flegm and Matter. Thus;

Matter is of a dun Colour, and less White than Flegm; somtimes of divers Colours, and being put into hot Water it sinketh and dissolveth: but Flegm swims at the top and sticks together by rea∣of its s••••ininess, and wil not dissolve.

But if some of the Spittle dissolve and the rest not, it is made of Flegm and Matter, which often happeneth.

As for the Prognostick, it is very hard to Cure a new Ulcer in the Lungs; but it is impossible to Cure an Old, because it is opened by the continual motion of the Lungs and by Coughing, so that it wil not be united: as also the force of the Medicine is gone before it can come at it, and the lost substance of the Lungs cannot be repaired.

Moreover, An Ulcer, Spittle, Feaver, and Leanness, require contrary Remedies, for those things which dry the Ulcer, do hinder Spittle, increase the Feaver, and Leanness: and Moist things which are good against the Feaver and Leanness, do make the Ulcer more foul.

Somtimes the Ulcer seems Cured, and there is a scab upon it, but with the least motion it fals off, and the Disease returns.

A Consumption which comes from a smal Ulcer of short continuance, although it be difficult, yet is not uncurable if proper Medicines be timely used: And they who have gathered Observations mention many so Cured; now there is most hope when the Patient is strong, the spittle white, even of one colour, and easily raised; if the humor falling from the head pass through the Nose, and if thereupon the Feaver abate, if the Appetite be good, & there be no thirst, & if the belly bound & in good order, if the Patient have a good habit of body, yong, and have his breast large and hairy.

They whose spittle stinketh, or have loose bellies, or cannot spet, are neer death, as Hippocrates teacheth, 1. Prog. & Aph. 11. & 12. Sect. 5. And, Aph. 16. Sect. 7.

A Consumption coming upon an acute Disease doth kill speedily, but if it come from other Cau∣ses it is Chronical, and lasteth many yeers: And Avicen saith, That he knew a Woman that lived twenty three yeers in a Consumption. And Matthew de Gradi saith, That another Woman which was alwayes about the fire, lived in a Consumption twenty eight yeers.

The Cure of this Disease, as is said, is for the most part impossible, if the Disease be Old; but if it be New it may somtimes, and easier when it is but coming upon them who are disposed thereto by

an hereditary disposition, but are not yet fallen into it. Therefore we shal first lay down a Pro∣phylactick or preservative, and then shew how to cure the disease.

Therefore for the amending of the evil disposition in a Consumption, use a cooling diet, and moist, and all such things as correct the blood, and make it mild, and correct its saltness and sharpness: as the Waters of sweet Baths, the use of Milk and the like. As also China Roots boyled in smal Beer; but the Decoction of the Sanders is the best, which is not only good in a Consumption at hand, or begun, but also in salt and thin distillations, and in old bleeding from thence. The Deco∣ction of Guajacum doth wonders upon the same account with the former, either given in distilled Waters, with a little white or red Wine, as the disease will bear it. Now the Decoction of Guaja∣cum, and of Sanders, are made both alike, both for the first and second drink, and given the same way. To these you may ad change of Air, which is good both to prevent and cure, And lastly, those Re∣medies are good which we will lay down for the cure of the disease confirmed, to be used first.

Now the whol Cure consisteth in the clesing and glutinating of the ulcer, by taking away the Causes that produce and nourish it, by opposing the Hectick Feavet, and restraining of the Con∣sumption.

First therefore, because an ill habit of body may encrease the Ulcer of the Lungs, you must use gentle purges, at divers distances, as long as the body is not very low. And these must be made of Manna, Rhubarb, Cassia, or Syrup of Roses, thus:

Take of Barley half a pugil: Liquoris scraped, and Raisons stoned, of each three drams: Ju∣jubes four: the flowers of Bugloss, and Violets, of each half a pugil: boyl them to three ounces: In the straining dissolve Rhubarb infused in Scabious Water with yellow Sanders four scruples: Manna one ounce: Syrup of Roses half an ounce. Make a Potion.

Or give two ounces of Manna with Chicken or ordinary Broth.

Or make a Bolus of Cassia one ounce, and one scruple of the pouder of Liquoris.

In the beginning you may give stronger purges for to draw down the salt and sharp Catarrh which is the chief Cause of the Ulcer, such as are prescribed in a hot Catarrh.

Also before the body be too lean, at the first you may let blood to allay the Feaver, and the acri∣mony of the humor.

But in the beginning of the Cure you must stay and divert the Catarrh from the Breast, otherwise all other things will be in vain. And all those things which were prescribed for the Cure of a hot Ca∣tarrh are good in this case.

Besides a Seton to the Neck, is very good. And Fabricius Hildanus reports that he cured many by this way.

At length you must come to the Cure of the Ulcer; for which, give things that clense, knit, and expectorate. Many there are of this nature. But these following are the best.

Milk doth hit all intentions for Cure: It clenseth with its serous parts, it conglutinateth with its coagulating part, and nourisheth and refresheth with its unctious part. But there are divers kinds of Milk, and Womans Milk is the best, because it is more agreeable to our Natures, especially if it be sucked from the breast. Platerus affirms that he knew many cured by the use thereof; and that one of them did not only recover, but grew so strong, that least his Nurse should want milk for him, he got her with child again.

But because many will not endure that sort, Asses Milk is commended, which because it is very full of Whey, doth easily pierce into the Veins, and excellently clense the Ulcer: the next to this is Goats Milk. Let the Ass be fed with Plantane, Vine Leaves, Brambles, Polyganon, Grass, Barley, and Rye. Let him drink it new milked, warm, therefore let the Ass be brought neer the Cham∣ber, and be milked into a warm Vessel. First let him take it in a smal quantity three or four ounces, that his Stomach may be used to it, encreasing the quantity by degrees to eight or ten ounces, or a pint, and least it should grow sowr or curdle in the Stomach: and that it may agree better with the Lungs, put Sugar of Roses to it, one ounce thereof to eight of milk: let him not sleep after his Milk immediately, but walk gently about the Chamber: let him not eat before the Milk be concocted, and he find a stomach, and that it be more effectual. You must not give it in a strong Feaver, or when there is a pain in the Head, or swelling in the Hypochondria, or a Chollerick flux, according to Hippocrates, Aphor. 64. Sect. 5.

Commonly it is taken only once in a day; but it is better twice; and best if the Patient live only upon it. For besides that it doth work more powerfully in a great quantity, there is a great profit by not mixing it with Broth and other meats, for they will easily putrifie. If therefore the Disease be very desperate, give Milk after purging every six hours with Manus Christi of Pearl and Coral. And least strength should fail, let him intermix a restoring distilled Water.

Sugar of Roses is very profitable, as also the Conserve; by use whereof, Avicen reports that he cured a Woman of a desperate Consumption, so that she was not only sound, but very fat afterwards.

Mesue also witnesseth that many have been recovered by the same, and he directeth that the Con∣serve of Roses be new, not above a yeer old, taken in a great quantity, and often, with Medicines, Meat, and drink, and also by it self at any hour. But first give Clensers, because it will otherwise astringe and retain the excrementitious matter in the Lungs. But when breath begins to fail, and the Patient cannot raise flegm, let him take expectorating things; as Syrup of Hysop and Coltsfoot, and other Lohochs. And if heat arise from drying too much, give Syrup of Violets, Jujubes, the Mucilage of Fleabane and Quinces, and the like.

Montanus, Valeriola, and Forestus, say that they have seen some cured by taking Sugar of Roses in great quantities. An Apothecary whom I knew in a Consumption, made a great quantity of Su∣gar of Roses for himself, and eat it constantly, by which he was cured.

An Infusion of Yarrow, Tormentil, Burnet, and Conserve of Roses made in Balneo Mariae, is ve∣ry good, as it is described in the Chapter of spitting of blood, if it be used twenty daies together.

The Decoction of Bugle in Mutton Broth, doth excellent against a Consumption and inward ul∣cers, it doth a little gently loosen the belly against the Nature of all the Consolidae.

Trallianus, lib. 7. cap. 1. boasts that he cured many with Blood-stone. The preparation and use whereof we have shewed in the Cure of spitting blood.

The Syrup of the Juyce of Ground Ivy is commended by Quercetan, thus made:

Take of the Juyce of Ground Ivy two pound and an half: let it be digested in Balneo Mariae. To this Juyce well refined, put Sugar of Roses one pound; Penides four ounces: Boyl them to Sy∣rup, to be taken now and then a spoonful.

He also addeth the flower of Brimstone to it to make it into a Lohoch, of which he gives four times in a day; and he boasteth that he hath therewith cured many.

The Syrup of the flowers of St. Johns wort, made by Infusion in Balneo Mariae, is very good in this Disease, as also for all inward ulcers.

The Syrup of Comfry is excellent; for it clenseth, healeth, and strengtheneth by astringing; as also Comphry Roots boyled in Broth

It is affirmed that many have been cured by this Hydromel.

Take of China Roots sliced, six ounces: Coltsfoot Roots three ounces: Burdock and Avens Roots, of each three ounces: Elicampane Roots two ounces: Lungwort Leaves, and Scabious Leaves and Roots, both the Veronicaes, Ʋlmaria, and Herb Two-pence, of each two handfuls: all the Capillar Herbs, of each one handful: the tops of Bugle, Bettony, Cowslip flowers, and red Veronica, of each four pugils: Ground Ivy Leaves and Roots three handfuls: Jujubes, Dates, Sebestens, and Raisons stoned, of each one ounce and an half: Spanish Liquoris one ounce and an half. Let them all, being well sliced, boyl in thirty two pints of spring Water till half be consumed, with a little gentle fire: ad to the Liquor being strained, of the best Honey four pound: Boyl it a∣gain, and skim it; then strain it through an Hippocras Bag, putting thereto half an ounce of Cin∣namon, six drams of Coriander seeds: Annis and sweet Fennel seeds, of each three drams: put the Liquor in a large Vessel, and let it work in the Sun; for so it will be done in forty daies; other∣wise it will be longer: but you must keep the Vessel alwaies full and open, that it may froath over: therefore you must make more Hydromel than the Vessel will contain; and if the disease require it you may use it fresh before it worketh till you make another in the Vessel; and you may make this quantity twice or thrice at once, because it must be taken divers months together. Let him take a good draught hereof twice or thrice in a day.

This following Syrup is made more easily, and hath great Vertue:

Take of the Juyce of Ground Ivy, Veronica, and Carduus Benedictus refined, of each eight ounces; in which, boyl gently Maiden-hair, Politrice, Scabious, and Lettice, of each half a hand∣ful: Dissolve in the strained Liquor one pound and an half of white Sugar. Make a Syrup well boyled, adding in the end three drams of the Extract of Juniper; Juyce of Liquoris and the Ex∣tract of Carduus, of each four scruples. Let the Patient take one spoonful an hour before dinner, and another before supper, and another at bed-time.

Cardanus saith, that he cured many Consumptions with this course following: namely, by gi∣ving no other nourishment than Barley Broth made without Flesh, and Water with Sugar, and eve∣ry morning four ounces of the Decoction of the Tails and Legs of Cray-fish made in Barley Water with two drams of Sugar.

Arcaeus, Ingrassias, Fracastorius, and Erastus, say with admiration, That they have cured ma∣ny Consumptions by the use only of Guajacum for a long time continued; yet this in respect of the antecedent cause, which is a hot and sharp humor, seems to be an enemy.

Avenzoar reports that his Grand-father cured a Consumption, with well leavened Bread, and Sal∣let Oyl, and also that he did the same.

This Pouder following is highly commended by Valescus de Taranta, and it is reported to be in∣vented by Haly Abbas, and he saith, that he cured one with it. And Forestus saith that he cured his Brother with the same.

Take of white Poppy-seeds ten drams: Gum Arabick, Starch, and Gum Tragacanth, of each three drams: Purslain-seed, and Mallows-seeds, of each five drams: Pompion, Melons, Cow∣cumbers, Gourds, and Quince seeds, of each six drams: Spodium, and Juyce of Liquoris, of each three drams: Penides the weight of all the rest: make a Pouder: give every morning two drams thereof with the Syrup of Poppies or Jujubes: Let him also take it in Barley, Cream, ar Almond Milk, and with other meats.

Cappivaccius, and Claudinus do approve of Oyl of Vitriol to dry the Ulcer, giving two or three drops with Rose-water or Juyce of Plantane, with a little sugar.

Crollius also commends the Elixir Proprietatis which is made of the Spirit of Sulphur; with the Spirit of Wine, Myrrh, Aloes, and Saffron.

The Chymists do highly commend the Medicines made of Brimstone, as the Flower, Milk, and Balsom thereof, as you may read in their Books: You may use them thus very wel.

Take of the Flower of Brimstone, and Pouder of Frankinsence, of each one scruple: put them into a hollow Apple, then roast it, and let the Patient eat it with sugar every morning for eight or ten dayes together. Or,

Take of Conserve of old Roses, Diamargariton frigid, and Diapenidion, of each one ounce: Flower of Brimstone three drams: make it up with clarified Honey, of which let him take the quan∣tity of an Hazel-nut twice or thrice in a day. Or,

Take of Flor. Sulphuris three drams: Sugar dissolved in Rose-water three ounces: make Lo∣zenges▪ which let him hold in his mouth often. Or,

Take of Lac. Sulphuris half a dram: Magistery of Pearl, and Coral, of each half a scruple: the Emulsion of Melon-seeds made with Coltsfoot or Veronica-water, two ounces: the Julep of Roses six drams: Cinnamon-water, and Manus Christi, with Pearl, of each two drams: Mix them, and let him take two or three spoonful every morning.

Some Chymists commend Antimonium, Diaphoreticum wel Calcined with thrice as much Salt∣peter, so that al the vomiting quality be gone, which must be given every day in Lozenges made with Sugar of Roses, or mixed with Conserve of Roses, or with the Medicines above mentioned.

The Balsom of Peru is good to heal Ulcers in the Lungs, if you give one drop made into a Pill with Sugar, every day.

The Pouder of Burnet, one dram given every day in Broth, is esteemed excellent.

Ruffi Pills are commended by some taken one scruple every day, but made as followeth they do wonders.

Take of the Mass of Ruffi-pills▪ one ounce: Antimonium▪ Diaphoreticum▪ and Gum of Gua∣jacum▪ of each half an ounce: Make a Mass with the Balsom of Peru: of this let him take one scruple every day for one Month.

The Syrup of Coral, and Gelly of Quinces are good for the same.

Rodericus out of Fonseca commends the Decoction of yellow Saunders for a good Medicine a∣gainst Defluxions upon the Lungs; which he prepareth thus:

Take of Succory and Sorrel Water, of each four pints: yellow Saunders sliced three ounces: in∣fuse them one day, then boyl them in Balneo Mariae in a close Vessel three hours: take three ounces of this every morning in Beer for fourty dayes together.

Also al the Medicines which we mentioned for the Cure of Spetting blood, are here very good.

Fumigations may be wel used to dry the Ulcer of the Lungs very wel, and they must be often ta∣ken in at the Mouth and Nose: You may make them thus:

Take of the Gum of Ivy one dram and an half: Frankinsence one dram: Myrrh half a dram: Amber one scruple: Benoimin and Storax, of each half a dram: Hypocistis two scruples: Co∣riander seeds, red Roses, and red Saunders, of each one scruple: Pouder them, and mix them with the Mucilage of Gum Tragacanth: make Troches and cast them upon Coals.

Or, Make plain Fumes of Frankinsence, Myrrh, Mastich, and Benjamin, alwayes in the Cham∣ber that he may take in the dry and sweet scent of them.

You may make a stronger Fumigation, but it is not to be used but in strong bodies. Thus,

Take of Gum Anime, or Gum of Guajacum, two drams: Tobacco half an ounce: dry Colts∣foot one ounce: Hysop, white Horehound, Rosemary, and Orpiment, of each three drams: make a Pouder; put a little thereof into a Tobacco-pipe, take of it twice a day fasting, and half an hour after a dra••ght of this Decoction.

Take of China and Sarsa of each half an ounce: Scabious, Coltsfoot, and ground Ivy, Ʋlma∣ria, Maiden-hair, and Avens Leaves and Roots, of each one handful: whol Barley one pugil: Liquoris scrap'd, and Currens, of each one ounce: boyl them to two pints, and put to it being strai∣ned four ounces of sugar of Roses: Let him take half a pint twice in a day as aforesaid.

For the Rich People you may use a moist Fumigation made of the Decoction of Herbs, which is

a good way to carry the strength of them directly to the Lungs: You may use al such Herbs as are proper for the Lungs and to Cure Ulcers. Take this following for an Example:

Take of green Coltsfoot eight handfuls: Hysop two handfuls: bruise them and put them in a Pot with a little water, lute it close, then set it into the Oven when the Bread is half baked, and then take it out with the Bread, and put a Funnel into a hole made at the top, and so take in the smoak through the mouth at the Lungs, and put it out at the Nose, and it wonderfully provokes spetting.

You must also Morning and Evening use a Cooling Liniment to the Breast. As,

Take of Gum Tragacanth and Arabick of each one dram: infuse them in Rose water a day and a night: put then thereto of Oyl of Violets one ounce and an half: Fresh Butter half an ounce: Sal. Prunellae two drams: Camphire one scruple: Breast-milk as much as will serve: Mix them in a Mortar to an Oyntment.

To Repair a Consumption, or to Prevent or Hinder it besides Restoring Diets, which are princi∣pally made of Barley, Almonds, Pine-nuts, Rice, Nuts, and the like, which Authors declare; Milk commended at first is very good, and a Bath of hot Water of Barley and Almonds bruised: but this is not good in a Catarrh, nor while there is a putrid Feaver, nor when the Lungs are ful of Excrements.

Let his Drink be Water and Sugar, Barley Water, and Liquoris: an Infusion of Liquoris, a thin Hydromel, or a weak Decoction of China.

The End of the Seventh Book.