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. 6. Of Singultus, or Hiccough.

SIngultus or Hiccough, is a depraved Motion of the Stomach, by which it desires to expel som∣thing that is hurtful.

It is distinguished from vomiting, because that which is so sent forth, is contained in the Cavity of the Stomach; and it is wholly turned to throw it out: But in Singultus the matter offending is fixed in the Tunicles of the Stomach, therefore it doth contract it self, and shakes its fibres, to exclude it. And that we may comprehend loathing also in this Definition, we say that the expulsive motion of the Stomach is three waies: For either Nature would somtimes rise to expel, and cannot; or it is not sufficiently raised to this motion, and then it is Nausea or loathing: somtimes it riseth and expel∣leth, and then it is Vomiting: or lastly, it riseth to expel, and cannot, and that is Singultus.

This is a Convulsive Motion, not a Convulsion, which is only in the Muscles, and parts given to voluntary Motion.

The immediate Causes of Singultus are propounded by Hipp. Aph. 39. Sect. 6. that is, Empti∣ness and Repletion, as of a Convulsion. But Galen and Avicen ad a third Cause, namely, a pro∣vocation by a sharp matter. Some labor to bring the matter provoking to a kind of repletion, that they may excuse Hippocrates. But when the matter is plain, we need not confound and darken the evidences of things for Authors words: For what is more cleer, than that Singultus comes from the expulsive faculty provoked? Therefore whatsoever can provoke is the immediate cause of Singultus or Hiccough. But Humors and Vapors offending either in quantity or quality may prov••ke the Stomach to expulsion, and so repletion and acrimony are two distinct causes. But it is not ea••e to shew how emptiness makes a Singultus: For since its Essence is in defect, none will say that Nature riseth to expel a defect; but rather will be moved to refresh and repair it, and so it doth rather move the Attractive than the Expulsive Faculty. But if Singultus follow great Evacuations, as in sharp Feavers, and malignant, and purging with Hellebore, it is not simply to be attributed to the Evacuati∣on, but rather to a malignant quality in the Stomach, coming from the Disease, or some Medicine taken.

The Matter causing Singultus is either gathered in the Stomach, or sent from the Liver, Spleen Guts, or other parts; or from the whol Body. So sharp Nourishment, or sharp Medicines, or sharp Humors, or gnawing Worms contained in the Stomach, cause a Singultus by propriety: but infla∣mation of the parts adjacent by water or vapors sent to the Stomach, make it by consent: as also be∣cause the Tumor, especially when the Liver is inflamed, doth compress the Stomach by which the ex∣pulsive faculty is continually provoked. Finally, Humors may be brought from the whol Body, or sharp humors to the Stomach, in diseases of the whol Body, as appears in sharp and malignant Feavers.

The Diagnosis, or knowledg of this Disease, is manifest of it self. But the signs of the Cause are thus to be distinguished, so that if it be by propriety, the disease is more lasting, and there will ap∣pear signs of the Humors contained in the Stomach, and the disease is a••••waged by Vomit. The Hu∣mor contained in the Stomach is known by vomit, belching, taste in the mouth, and by other signs. And finally, if it come from a disease in any other part, you may take the signs thereof from their proper Chapters.

As to the Prognostick: Singultus that comes from any principal Cause as Meat, Drink, or Cold, is not dangerous; as also that which goes before a Crisis by Vomit, and then other signs must be healthful.

If any have the Hiccough in a great Feaver, the Disease is very dangerous, Hipp. in Coacis. For it comes from sharp Humors, and malignant, which pull the Tunicle of the Stomach in wardly, and force its expulsive faculty. And Vallesius saith, that he never knew any extenuated persons taken with a hot and malignant Feaver▪ who had a Singultus, to escape: So it is in Hipp. 3. Epid. Sect. 2. Aegr. 12. A woman living in the Market, had many Hiccoughs upon the twelfth day, and died the fourteenth day of her sickness. Also Platerus observed, that a Singultus coming upon burning Fea∣vers, and continuing, is for the most part a forerunner of death, and the same is deadly in a Dysentery, or bloody flux.

After Vomiting, Singultus and redness of the Eyes is evil, Hipp. Aph. 3. Sect. 7. These two signs coming after Vomiting in acute Diseases, and continuing any time, therefore are said to be deadly, because they declare an inflamation of the Brain or Stomach; which inflamation is not only the cause of Hiccoughs and redness of Eyes, but also of Vomiting. For if Vomiting come from sharp Hu∣mors that gnaw the mouth of the Stomach, and its Tunicles, when those Humors are thrown out by Vomit, the Singultus and vomiting would cease, nor would any sharp vapor be sent to the Eyes, which should make them red: But when Vomiting doth not only not profit, but also brings after it Hiccoughs and redness of the Eyes; it is most certain that these three, namely, Vomiting, Hiccoughs, and Redness of the Eyes, do come from the Inflamation of the Brain or Stomach: for the Brain being inflamed, doth through abundance of blood send it to the Eyes, and into their extream Tunicles, whence comes redness; to which also the Stomach consenting by the Nerves of the sixth Conjugati∣on, is easily from the Inflamation of the Brain brought to Vomit and Hiccough. Also the Stomach inflamed by a concourse of hot blood to the Eyes by reason of the great consent between those parts, brings Vomit, Hiccoughs, and redness of the Eyes, which the beginning of suffocations do demon∣strate, and the appearance of things before the Eyes which are in the Stomach disordered; whence Hippocrates in his Book del ocis in homine, affirms that the Eyes are chiefly hurt by Vomi∣ting.

Singultus from Inflamation of the Liver is hurtful, Hipp. Aph. 17. Sect. 7. which comes then, as Galen shews in his comment upon that Aphorism, when the inflamation is greater and worse, for then it is so great in the Liver that it lieth upon the Stomach, and brings the Singultus: nay, somtimes by conflux of matter, there is somtimes an inflamation or Erysipelas in the Stomach: or else there comes gnawing from the same being sucked into the Tunicles of the Stomach.

The Cure of this disease is directed to the Causes, which as I said, do either produce it by way of Sympathy, or Propriety. The Causes which produce it by sympathy, are the diseases of other parts, which being cured, this is cured, although these Medicines are to be administred then, which are good to allay the Symptome, which shall be afterwards declared.

This Disease by Propriety comes of Flegm, Wind, Choller, or some sharp or malignant Humor.

That which comes from Flegm in the Tunicles of the Stomach is cured by Medicines which cut the Humor, clense and purge it, and by strengtheners of the part, such as were prescribed for the Cure of want of Appetite coming of a cold Cause. To which we may ad these following, as more proper to this disease.

Take of Castor one dram: the juyce of Mints four ounces: Mix them, let the Patient take one spoonful or two every fit: and you may anoint the Stomach with the same Medicine warm, twice or thrice in a day.

He may take Vinegar of Squils often to cut and dissolve the matter contained in the Tunicles of the Stomach, or instead thereof, Oxymel of Squils.

Cloves held often in the mouth do not a little profit.

Also the Elixir Proprietatis of Crollius, is very profitable.

Take of Dill seeds, two or three drams: boyl them a little in eight ounces of the best Wine; of which let the Patient take one ounce first and last. Let the same Seed be put into a cloth, and often smelled to.

When the Disease is violent, these Pills following are very good.

Take of Castor and Myrrh, of each three drams: Sal gem. half an ounce: Diagridium, and Mastich, of each one dram: Agarick newly trochiscated three drams: Aloes, as much as all the rest: make them with Juyce of Mints into a mass, of one dram whereof, make six Pills gilded. Let him take two or three in the morning twice in a week, two hours before meat.

Plaine•• Pills, and almost as good, may be made of Hiera with Oxymel, of which you may give a drama.

In the daies between the taking of Pills, give this Pouder:

Take of Dill seeds half an ounce: Zedoary, Lignum Aloes, Nutmegs, Cloves, and pouder of Diambra, of each one dram. Let him take two scruples in a morning with a little sweet Wine, or put to them three ounces of Common Salt, and let him eat it with all his Victuals.

Apply this Cataplasm following to the Stomach.

Take of Roots of Aristolochium, or long Birthwort, Flowerdeluce, Bay-berries, dried Leaves of Ri••e and Mints, of each three drams: Castor and Myrrh, of each two drams: Cloves, and Hypocisti••, of each one dram. Make a Cataplasm with Honey of Rosemary.

At length, when the disease is stubborn, you must use the Decoction of Guajacum and Baths of Brimstone, as the best Medicines.

That which comes from wind, is cured by the same Medicines, adding thereto things to expel wind.

Apply also Cupping-glasses to the region of the Stomach, which miraculously do presently abate, and take away the windy diseases of the Stomach.

That which comes from a sharp Chollerick Humor, besides those Remedies which were prescribed in want of Appetite coming of a cold distemper, most proper also to this Disease, must be cured by Phlebotomy (if there be Plethory or fulness) by vomiting and gentle purging every third day, thus made:

Take of the pouder of Rhubarb, sprinkled with Endive Water half an ounce: the pulp of Ta∣marinds, two drams: the seeds of Endive and Purslain, and of Spodium, of each one dram: yellow Saunders, and Diagridium, of each half a dram: with syrup of Lemons make a Mass of Pills of half a dram; whereof make Four or Five Pills to be given in the Morning as afore∣said.

Upon other daies let him take Conserve of Roses and Borrage, mixed with a little Triasantalon or the Opiate mentioned in the Cure of Want of Appetite.

Emulsions often used, made of the Cold Seeds, do powerfully asswage the sharpness of the Humor; or in a disease not very hot, the milk of sweet Almonds.

Syrup of Apples, with Syrup of Quinces is to be given in a spoon.

He must take Broth often.

And must drink cold or warm Water or Ptisans often.

The Oyl of sweet Almonds doth asswage the sharpness of the humors.

Let the Stomach be Fomented with a spung dipt in Rose water.

Take of the Cerat of Saunders and Oyntment of Roses, of each one ounce: Mastich half an ounce: Citron peels and pulp of Quinces, of each one dram: with Juyce of Housleek and a little Turpentine, make two Emplaisters, of which lay one to the fore part, another to the hinder part of the stomach.

Anoint the region of the Liver with Cooling Oyntments, because the Humors use to flow from thence to the stomach.

If you suspect any infection, you must give Treacle and other Antidotes, and anoint the stomach with the Oyl of Scorpions according to Matthiolus.

These Medicines following are good against the Hiccough of what cause soever.

First, Expel the Humor offending by Vomit, if the Patient can wel endure it; and Repeat it, if the Disease abate, and give stronger if necessity requires.

As Platerus sheweth in his Practice, of which he gives an example, in his Observations in these words, A Chirurgion being sick began to Hiccough day and night so that he could neither sleep, speakwell, or take meat: at last being thus weak and nothing profiting him, when he was in an ago∣ny, we gave him not without fear but at his own entreaty, a strong Chymical Vomit at hand, by which he vomited abundance of choller green and black, and so was cured.

If the Patient abhor Vomits, Purge him.

But prepare the Humors first or before you repeat it, with cutting and clensing means; after use these following:

• Apply Cupping Glasses to the Back against the Stomach or before.
• Bind the Stomach that it may not be dilated.
• Use Ligatures to the remote parts.
• Take Annis-seed, for they say that doth specifically cure.
• And give often Clysters to draw the Humors from the Stomach.
• Apply yong Creatures to the Stomach.
• And, Take Vinegar of Squils in a spoon.

Neezing doth shake off the Matter which is compacted in the Tunicles of the Stomach; as Chry∣simachus the Physitian in Plato cured Aristophanes by Neezing, when he could not be cured by hol∣ding his breath, and gargling of cold water.

Galen, 8. de comp. med. sec. loc. mentiones the Medicine of Asclepiades, of which he examineth every Simple, and approveth them as if it had al Faculties fit for this intention; namely, To discuss and Evacuate the Matter hurtful, by Stool and Urin, to strengthen the stomach; and lastly to miti∣gate sharpness.

The Composition is thus:

Take of Costus or Galangal, Saffron, Spikenard, Roses, Mastich, of each four scruples: Asarabacca and Aloes of each two scruples: Opium one scruple: with the Juyce of Fleabane make them into little Balls or Cakes, and let him take one of a scruple in weight every mor∣ning.

In imitation of that you may quicklier prepare Pills for one Dose, of one dram of Aloes two or three grains of Laudanum; And if you wil Purge more, give three or four grains of Diagri∣dium.

Duretus testifieth what excellent force Aloes hath in this Disease, in these words, Many when they have been almost dead with the Hiccough, have been cured with Purging five dayes together with Hiera after they have voided black glutinous humors.

Platerus reports in his Observations, That he Cured a Boy of ten yeers old, that was troubled night and day for eight dayes together with the Hiccough, with the Water of green Nuts, distilled with Rhadish first macerated in Vinegar, which he gave as a Vomit; and though he vomited not, yet he was eased; and taking a draught thereof at night, was presently Cured.

Forestus reports, That he Cured one with one draught of the Decoction of Dill-seeds, Carva, Purslain, and white Poppy-seeds, made in smal Ale.

Claudinus doth highly commend Diaphoenicum with Philonium Romanum, when the Cause and the Symptome are very violent.

Lastly, Narcoticks only do alone Cure this when al other things fail, by stupifying of the sense of the part which is too exquisite.