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

Chap. 9. Of the Disease called Cholera.

THis Disease is a violent sending forth both by Stool, and vomiting corrupt, sharp, and chollerick Humors.

It is called Cholera Apo tes Choles from Choller, as Galen shews from the opinion of the Gnidian Physitians, 2. meth. c. 2. that it comes from yellow Choller and evil humors like it which is sent up∣wards and down-wards. But Alexander Trallianus, lib. 7. c. 14. wil not have this Name to be de∣rived from a Chollerick humor, because Choller is not alwayes vomited, but also often times a serous and Flegmatick Humor; but it comes rather Apo toon Cholastoon from the Intestines which were c••l∣led Cholados by the Antients; because these Humors come from the Intestines and intrals: yet the first Etymology is more to be approved, because it is used not only by Galen, but by Hippocrates 7. epid. text. 19. by Celsus, lib. 4. cap. 11. and Aurelianus, lib. 3. acut. cap. 19. And although a chol∣lerick humor is not alwayes sent forth, yet one like Choller, sharp, biting, and corrupt, is alwayes voided.

Some say the Stomach is the part affected, others the Guts, others both; but we must be of Ga∣len's mind, who saith, 3. de sympt. caus. cap. 2. The part which is principally affected is the Stomach, whose expulsive Faculty is vehemently stirred up, so that it expels the noxious humors at both ori∣fices. But there is no doubt but the Gullet and Guts are secondarily affected.

Therefore this Affect is a Symptome of the expulsive Faculty being hurt, and vehemently stirred up, for it cannot depend upon the retentive faculty debilitated, for then the humors flow by degrees as in Lienteria and Coeliaca Passio: but we must confess that the Disease is more violent if the Reten∣tive Faculty being weak do not resist the expulsive.

Moreover, The Concoction is hurt also, by which evil humors are bred in the Stomach which stir up the expulsive Faculty: but this is an Antecedent Cause, Hipp. 4. de victus ratione in acutis tex∣tu 104. laies down Two kinds of Choller, the one Moist, and the other Dry; the Moist is that which hitherto hath been described, and which is meant only in this definition as being the more usual▪ but the Dry is more rare, and it comes from a windy spirit going from the Stomach and Guts, and griping those parts through which it passeth.

These Winds are produced either from the fiery heat of the Stomach corrupting the meat and ma∣king it stinck, or from windy rank meats, and Onyons, Radishes, and the like. Sennertus addeth another Cause, borrowed from the Hermetical Doctrine, namely, Salt Humors, and Adust in the Hypochondria, which grow hot by the mixture of another humor: For (saith he) as Salts and the Spirits of Salts mixed with sharp Spirits, make abundance of flatuous Spirits, as appears by the mixing of Oyl of Vitriol and Aqua fortis with Salt of Tartar. So doth it fal out in mans Body, by the Commixtion of a Salt and Adust Humor with other Spirits, there are many windy Spirits pro∣duced.

The immediate Cause of this Disease is a Chollerick, Burnt, Sharp, Salt, or rotten Humor in

the Stomach, Guts, Spleen, Mesentery, or Prancreas, or some nourishment of evil quality, some strong deadly Medicine, or poyson taken. Hipp. 7. Epid. Text. 90. doth reckon up almost all the Causes of those evil Humors, in these words: Chollerick Evacuations upwards and downwards, come from eating too much flesh, especially Swines flesh not roasted: Also for meats not formerly u∣sed, from drunkenness with old Wine, and sweet, from Pine Kernels, Locusts, rotten Nuts, and from the use of Garlick, Leeks, Onions, especially from boyled Lettice, Coleworts and the like crude things; also from Tarts, and sweet meats, Honey meats, Fruits soon perishing, especially from Cu∣cumers, Pompions: and these Evacuations happen most in Summer, for then they are easily cor∣rupt, and are indigested.

It is worth the observation from whence so many Chollerick Humors should come, which in this Disease are sent forth by Vomit and Stool? It is usually answered, that they come from the Mesen∣tery, and the places adjacent, and somtimes from the whol Body, which though it be probable, yet we may say, That Humors corrupted in the Stomach, and parts neer therto, do infect other Humors with their Malignity, and that Nature is constrained to send to the Stomach and Guts, as venemous Medicines, Antimony, Coloquintida, Elaterium, and the like, by corrupting of the good Humors, do make an Hypercarthasis, or over-purging.

The signs of this Disease, are an often and plentiful sending forth of Chollerick, sharp, and other corrupt Humors by vomiting and stool; a gnawing of the Stomach and Guts; a swelling with wind, pains, thirst, with much heat and disturbance; great Nauseousness, and loathing, which is somwhat appeased with cold drink, but presently is cast forth with hot. The Pulse is somtimes smal and un∣equal; somtimes with great sweating, and Convulsion of the Thighs and Arms, swooning, coldness of the extream parts, and other grievous Symptoms.

The Causes of this Disease are easily known.

And first, the external are known by relation of the Patient, and those that stand by. If he have taken too much, or food of an evil quality, or poyson, or some violent Medicine.

The internal Causes are known by the quality of those Humors which are sent forth. We conje∣cture that it comes from the fault of the Stomach, if other parts are not distempered, and when there is a continual loathing, gnawing, and pain of the Stomach, the matter is sent forth green; but if it be bred in the Veins, there is commonly a Malignant Feaver adjoyned.

You must make your Prognosticks thus,

If it be very violent, it brings commonly sudden death. If it come from some evil Food, it is less dangerous; for when that is sent forth, the Disease ceaseth.

By how much the greater the Symptomes are, as Swooning, Convulsion and coldness of the ex∣tream parts, by so much neerer at hand, is death.

Hippocrates in Coac. sheweth that this is somtimes Critical to Feavers called Lipyriae, which can no other waies be cured (as he saith) but by a great casting forth of Choller both upwards and downwards; and these Crises or Judgments happen seldom, and ought to be suspected, because they have not the conditions of a good and Health bringing Crisis.

If vomiting begin to cease, and the wan and deadly color of the Face to be restored, there is hope of Health.

In the Cure of this Disease, in the beginning thereof, some evacuation may be allowed while the e∣vil and corrupt Humors do flow forth. And you must help it forward with drinking warm Water with Syrup of Vinegar, or with a great deal of thin Chicken Broth; which if it provoke not Vomit, will allay the sharpness of the Humors. Or you may evacuate them with Rhubarb brought into a Pill with Syrup of Wormwood, and with clensing Clysters.

Also fat mollifying Clysters are to be given, made of Milk, Oyl of Roses, fresh Butter washed with Rose Water, or made of Chicken Broth, or Veal Broth with Yolks of Eggs; with which, as the dis∣ease shall require, you may mix Narcoticks.

Also Clysters of Oxycrate are good, or made of the Decoction of Lettice, Plantane, with a little Vinegar, Syrup of Water-lillies, and Yolks of Eggs.

Also you must qualisie the Humors sharpness with internal Medicines; as with the Decoction of Purslane and Plantane with Syrup of Quinces and dried Roses, with Lapis Prunellae, if there be heat and thirst.

And you must stop Vomiting with those things both internal and external, which were prescribed in the Cure of Chollerick Vomiting, Chap. 7.

Among which, the Narcoticks are best, and especially new Treacle, which given in the quantity of a dram, doth presently stop those violent Evacuations. Laudanum doth the same, if you give four grains thereof.

If there be great weakness (as often happeneth) it is not safe to give the whol dose of Laudanum; but it is better to give one or two grains, and to give it once or twice in a day, as necessity urgeth: for so the force of the Humors will be restrained, and Nature will have time to tame and concoct hem.

After vomiting and purging are stayed by the Medicines aforesaid, & the strength is restored by Cor∣dial means, the Patient seemeth to be past danger; which doth not only somtimes deceive the standers by, but also the Physitians themselves: for after a day or two of rest and intermission, the symptomes return more strong and violent, and destroy the Patient who was made weak by their former encoun∣ter; which danger you must prevent, not only with Restauratives, and things that take away the heat of the Humors, as before mentioned, which must be continued after they are appeased; but especi∣cially with Blood-letting, which doth revel the burnt and boyling blood, and greatly asswage it: and you must do it twice, or thrice, if the strength be not impaired by the first, but rather seem to be refreshed. Some Practitioners adventure in the time of the fit, when the strength is decayed, adven∣ture to open a Vein, because they say the strength is oppressed. But it cannot then be done without danger: and somtimes the Patient presently after dieth, to their shame. For though we acknow∣ledg that there is an oppression of the strength by reason of the superfluous Humor, which is contai∣ned in the Veins, being an Enemy to Nature; yet it cannot be denied but it is greatly decayed by those grievous vomits and stools. It is better therefore first to allay the violence of the Humors, and after the symptomes are asswaged to open a Vein.

And because in this Disease the strength quickly fails by strong evacuations, you must be very care∣ful in the restoring of it by that way which is shewed in the Cure of weakness in the eighth Book, and the third Chapter.