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. 10. Of Pain in the Stomach, called Dolor Ventriculi.

IT is a sad and troublesom sence in that part, from some things that gnaw and stretch it till it break, or be wounded.

In the Stomach, you must consider three parts, which much differ one from the other, namely, its upper Orifice, and its lower, called Pylorus, and the rest of its Body which maketh up the whol Cavity.

The upper Orifice is of exquisite sence, by reason of the great Nerve which it hath from the sixth Conjugation, and therefore pain therein is very sharp, and makes the Heart which is the most noble part, and neer unto it sensible of the same; from thence it is called Cardialgia, and Cardiogmos: for there is such a neer consent between the mouth of the Stomach, and the Heart, that the Ancients called it by the name of the Heart, Cardia.

But if the Membranes of the Cavity, or the Pylorus be pained, it is called simply Dolor Ventriculi, and somtimes Colica Ventriculi, especially when it comes of wind.

The immediate Cause of this pain, is solution of Continuity by things sharp and distending, and they are chiefly Humors, or Wind; and somtimes Worms gnawing the Tunicles.

Sharp and malignant Humors, as green Choller, or black, salt Flegm, corrupt Matter sent into the Stomach from an Imposthume broken in the Liver or Breast, and all other sharp Humors which may cause pain.

Also sharp vapors coming from those Humors use to cause this pain.

The Wind contained in the Cavity of the Stomach doth cause swelling and painful distension, e∣specially if it be restrained within its Tunicles, which makes a very stubborn Disease, and cannot easily be sent out.

The Diseases both of the Stomach it self, and of the parts adjoyning, use to breed this pain, as any great distemper, either hot or cold, and especially an Inflamation, and somtimes a Schirrus or other hard Tumor which maketh a heavy pain; as also Wounds and Ulcers of the same part, and swel∣lings in parts adjoyning by wind or other waies, cause this pain by compression of the Stomach.

Now these Humors and Winds which cause pain in the Stomach, either come from the whol Body, or some parts thereof. From the whol Body, in Feavers, or when the Body is filled with evil Hu∣mors. And from other parts, especially the Liver, Spleen, and Brain: from the Liver there comes Choller; from the Spleen, Melancholly; and from the Head, salt Flegm.

Also this pain may arise from other extraordinary Causes not usual; as Schenkius observes from stones bred in the Stomach, lib. 3. observat. And Fabricius Hildanus, observ. 33. lib. 4 reports that a Woman had a piece of Rind or rusty Bacon two yeers in her Stomach, wherewith she was continually pained, and which after by taking a Vomit, she threw up, and was cured.

The external Causes of this Disease, are either evil qualified, or of sharp Nourishment, which of themselves produce it, or things apt to breed Wind; or things taken in too great a quantity, which putrifie and turn sharp; or things that are too hot, and breed much Choller: As also strong, sharp,

deadly Medicines, either taken in too great a quantity, or not sufficiently corrected, and poyson.

The Diagnostick Signs are from the part affected, and the cause.

And first, when the pain is under the Cartilage Ensiformis or Xiphoides, it shews that the upper Orifice of the Stomach is affected▪ but that it is a true Cardialgia in the mouth of the Stomach, you may know more certainly when there is a most sharp pain from the exquisite sence of the part with such trouble and disturbance that the Patient cannot stay in a place, or in one posture, but often swounds and fainteth by consent and sympathy of the Heart with the Stomach, not only by neerness to it, but also by reason of the dissipation of the Spirits by the pain. Somtimes the Brain consents, by Reason of the famous Nerve which is in the Stomach, and the sharp vapors which are directly sent into the Head from thence, from whence come Cephalalgia, Hemicrania, Vertigo, and Epilepsie.

In other parts of the Stomach there are great pains, but they have not so great Symptomes, and therefore they are like the Chollick, differing only in place.

The Causes also are known by their proper signs. The most manifest are taken from the Excre∣ments; for Choller, Flegm, Wind, or Worms, are voided at the Mouth or Belly, it is easie to conje∣cture that the Disease depends upon these Causes. But if no Humor be discharged we may know when Choller, Flegm, or Wind abounds by their proper signs; and the signs of Worms are to be taken out of their proper Chapter: As also the proper diseases both of the Stomach and parts adjoy∣ning which produce this Disease, are known by their proper signs. The knowledg of the Humor cau∣sing this pain, is also taken from the time of its coming, encrease, and cessation. Some are troubled most violently before meat, and this shews that Choller is predominant, which is stirred in time of emptiness, and drawn to the Stomach, and made more sharp. Some are pained presently after meat, because the raw biting Humors, which before were quiet, and fixed to the Tunicles of the Stomach, are moved when Meat is taken, or they which were in the bottom of the Stomach, are raised up, and disturb the mouth of the Stomach. Others are pained in time of Concoction, because sharp gnawing vapors arise from the Matter, causing the Disease from the heat encreased in the Sto∣mach in time of Concoction. Others are pained four or five hours after meat, because it is corrupted by evil concoction, and so gnaweth the Stomach. Some are worst after sleep, and that comes from a Catarrh from the Head in the time of sleeping, which being heaped up in the Stomach, produceth pain afterwards. Somtimes the pain is appeased after Meat, because the sharpness of the Humors is qualified by the sweetness of the Meat.

As for the Prognostick, it is most certain that Cardialgia is more dangerous than any other disease of the Stomach by reason of the exquisite sence of the Mouth of the Stomach, and its great consent with principal parts.

The danger is more or less, according to the malignity of the Cause, and the vehemency of the symp∣tomes.

A continual acute Feaver joyned with a great pain of the Stomach, threateneth great danger; as Hippocrates saith, Aph. 65. Sect. 5. In Feavers, if there be great heat about the Stomach, and Car∣diogmos, it is evil: for it signifieth that there is a great Inflamation of the Stomach, or abundance of bad Humors contained therein.

The pain of the Stomach coming from Worms or Wind, is commonly least dangerous, because the Cause is not so bad, and not fixed to the part. But somtimes from Worms ghawing in the Stomach, great Symptomes happen, of which the Patient suddenly dieth.

So when the distemper which begets wind, is stubborn and habitual, it is not without danger, for it turneth to a dry dropsie; Hippocrates, Aphor. 11. Sect. 4. In a Cardialgia, coldness of the ex∣tream parts signifieth death at hand.

The Cure of this Disease is to be varied according to the diversity of the Causes. If it come from the Diseases of other parts, you must cure them. But if the Cause be in the Stomach alone, the pain comes either from wind, or sharp Humors and Chollerick, or from Inflamation, Imposthume, or Ulcer.

That which comes from Wind is to be cured by Medicines that discuss and evacuate that flatulent Matter, as also the flegm from whence it comes.

And first you must give a gentle Emollient Laxative Clyster, and presently after another Carmi∣native, that is, expelling wind, and discussing, of the Decoction of Origan, Calamints, Penyroyal, Rue, the lesser Centaury, Annis seeds, Fennel seeds, Carrots, and Cummin seeds, and the like: In which dissolve Benedicta Laxativa, Oyl of Dil, Rue, and Honey of Rosemary.

If the pain continue, you must make a Clyster of equal parts of Sack, or Hippocras, Oyl of Rue, or of Nuts▪ with two ounces of Aqua vitae.

Or make a Clyster of white Wine with Oyl of Juniper, or eight drops of the Chymical Oyl of Cinnamon or Cloves, which doth Miracles.

Then foment the Stomach with this:

Take of Cypress Roots, Galangal, Calamus Aromaticus, of each one ounce: Mints, Origan, Penyroyal, Marjoram, Hysop, Sage, of each one handful: Annis, Fennel, Caraway, and Carrot

seeds, and Bay berries, of each half an ounce: Chamomel, Melilot, Rosemary and Lavender flow∣wers, of each one pugil: beat them, and slice them: put them into two bags, and boyl them in Sack; then squeeze them, and apply them one after another to the Stomach and all the Belly.

When the Matter is not so cold, this Fomentation following may be prepared, which is highly commended by Forestus, because it hath presently cured when other things failed.

Take of Althaea Roots half an ounce: red Roses, Chamomel Flowers, and tops of Wormwood, of each one handful: Boyl them in common Water, and Chamomel Water, to one pint and an half, adding in the end a little Rhenish Wine, Rose Water, and Vinegar. Make a Fomentation.

After Fomentation, anoint with Oyl of Rue, and Dill mixed with Aqua vitae, and a little Chy∣mical Oyl of Sage, or Cloves.

After the anointing, apply a Plaister of Bay-berries, or instead thereof a Cataplasm of Honey and Cummin seed.

While these are doing, if there be loathing, you may provoke vomiting gently, or give a Purge a∣gainst flegm.

After Purging give Oyl of bitter Almonds newly drawn, mixed with white Wine, or Hippocras mixed with Aqua Clareta, or Cinnamon Water.

This following Juleps is most admirable to asswage pain, discuss wind, and strengthen the Sto∣mach.

Take of Wormwood, Centuary the less, and Agrimony, of each half a handful: boyl them to five ounces, and ad to it being strained, one ounce of Sugar. Let him take it two mornings toge∣ther.

Amatus Lucitanus commends highly the distilled Water of Chamomel flowers as a most excellent Remedy to asswage the pains of the Stomach and Entrals, of which you must give three ounces warm. Or in the defect of that, you may make a Decoction of Chamomel flowers, which is so much commended by Forestus, who saith that he cured a Merchant with this only Decoction, once only given, of great pain of his Stomach, which made him to roar; which when he had drunk off, he belched, and fell into a sweat, and all his pain vanished, as by an Inchantment, so that he needed no other help. You may also make a Vomit at the beginning of the disease, which by evacuation may abate the pain, of this Decoction, made with Dill seeds, or Agarick, or the Roots of Asarabacca, dis∣solving therein, Oxymel, Syrup of Vinegar, or of Roses Solutive.

Galen teacheth that a Cupping glass applied to the Stomach doth presently take away pain. But you must use this Caution, That no crude Humor, or very little, lie in the Stomach, otherwise the pain will be encreased.

Also you may with good success apply Bread hot from the Oven, cut in the middle, either by it self, or sprinkled with Spices.

Lastly, If the pain continue violent, you must use a bath of the Decoction of mollifying Herbs that are hot, which is most safe and powerful, for it takes away the pain by discussing the wind, and sending it forth by the open pores, which it will better do, if you give some discussing Medicine to the Patient while he is in the Bath; for both internal and external helps concurring, the work will be done.

The Bath must be very hot that the wind may be the better discussed, and the thick Humors melted.

If by reason of the vehement pain, Clysters can neither be given nor retained, you must give a Purge in the Bath, and let him stay therein an hour, or half an hour, till the power of the Medicine touch the Stomach.

Somtimes when the violence of the pain threateneth danger, you must give Narcoticks, which be∣ing wisely given, bring wonderful effects.

Some mix Narcoticks with their Purges that the pain may be allayed, and the Matter evacuated: such as the Medicine of Elidaeus commended by Forestus, made thus:

Take of Diaphoenicon half an ounce: Philonium Romanum two scruples: with the Water or Decoction of Chamomel make a Potion.

After the pain is gone, let them who are subject to this Disease, be purged once or twice in a month, to take away the immediate cause of wind. And let them use strengtheners, such as were prescribed in the Cure of Concoction hurt.

That pain which comes of Choller, is to be cured by the evacuation thereof, with a gentle vomit or Purge, or with frequent Clysters that are emollient, not sharp or hot.

Afterwards, qualifie the sharpness of the Humors with cooling Juleps that thicken, with Emulsions of the great cold Seeds, new Milk, new Oyl of sweet Almonds, Yolks of Eggs, and the like.

In the mean while omit not Opiates, and other strengtheners prescribed in the former Cures.

And at last, when need requireth, use Narcoticks.

Apply outwardly a Cataplasm of Bread and Milk, with yolks of Eggs, and Saffron.

Or Bread from the Oven broken in the middle and dipt in Vinegar.

Or Foment the part with the Decoction of Chamomil-flowers, Violets, and Water Lillies, or which is best, put the Patient in a warm Bath, for that is most proper.

After the pain is gone lest it should return, let the Patient Purge twice every month, and let the hot Distemper of his Belly be corrected with a Cooling Diet and Convenient Remedies.

That Pain which comes from Inflamation, Imposthume, or Ulcer, may be Cured with the Reme∣dies Prescribed in the following Chapter.