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. 8. Of Nausea, and Vomiting.

NAusea and Vomiting differ only in degrees, and both are the motion of the Stomach by which it either expelleth or labors to expel things contained therein; therfore Nausea is a desire to Vomit with trouble, and only sending and pewking forth a thin waterish Humor by Salivation: whatsoever troubles the Stomach either in quantity or quality useth to stir that up, when it cannot be voided by reason of the weakness of the Stomach, or the strength of the upper Orifice, or thick∣ness of the Matter, or sliminess.

But Vomiting, which is called in Greek Emetos, or Emesia, is a Depraved motion of the Sto∣mach, which shaketh it, by which the Expulsive Faculty is stirred up by Contraction of the Fibres of the lower part and loosening those in the superior, doth sensibly with a violent Motion throw up∣ward the Matter contained therein, which is troublesom unto it▪ it is called a Depraved Motion both in respect of the Object troubling it, as also in respect of the Motion it self, which is from the bot∣tom of the Stomach to the Mouth of it, turning it, when the natural Motion of the Stomach is Com∣pulsive towards the Guts and the Pylorus.

The Differences of Vomitings are taken from their Causes, which are either External or Inter∣nal; therefore it is Divided first into Natural and Artificial; the Natural again, is either without a Disease, or in the Disease; from whence ariseth a Three-fold Difference, one is called Periodical, another Critical, and another Symptomatical.

Periodical is that which without a Disease, is used for preservation often, from whence we reade in Hippocrates, That the Ancients did Vomit Twice every Month, either at distance, or toge∣ther.

And there are many in our times, who use either every Month, or Week, or Day to Vomit Choller, or Flegm; by which they are Preserved from many Diseases: And this is not proper∣ly a Symptome, because there is no Disease present; but it is rather to be termed a Motion of Na∣ture.

Critical Vomiting often happens in Diseases, and by that the Matter of the Disease, if preparati∣on be first made, is wholsomly Evacuated; either al, by which it is Cured; or in part, by which it is Diminished.

Symptomatical Vomiting comes from Nature provoked and weakned and without ease to the Pa∣tient, because it is not enough, or it is nourished continually with the Matter that maketh the Disease.

Other Differences of Vomitings are taken from the things vomited, for they are either Nourishable or Excrementitious; the first is of Meat, Chylus, or pure or mixed blood: the latter is of Flegm, Chol∣ler, Melancholly, Water, Matter, Worms, and the like.

Artificial Vomiting, generally is whatsoever is from an External Cause: The External Causes, are chiefly Stroaks, Falls, Compression of the lower Belly, Southernly weather, or infectious Air, Poysonous Breath, Stinking Smels, Violent Exercise, Riding, Sayling at Sea, especially in a Southernly wind, beholding or conceiving of some filthy thing: And the like External Causes which provoke Nature, or move the Humors; but especially things taken in have great force, not only vo∣mits called Emetica, and Poysons which we distaste; but also Nourishment either hurtful in their Nature, or hated peculiarly of some; as in Hippocrates, who speaks of one who with eating of Mushromes or Toad-stooles, died Vomiting. The same happened to a Courtier of Antoninus the Emperor, who by eating much mouldy Cheese died Vomiting. The quality of Food wil do the same if it be Fat or Oyly, as also a proposterous order in eating, when moistning and loosning things

are eat after astringents, and also too much food taken, though never so good, as appears in Glut∣tons; for then Nature being over charged, desires to throw out what she cannot concoct, to which she is also stirred up by the evil quality which is brought to those meats by corruption, or evil con∣coction.

The internal Causes are either Antecedent, or Conjunct.

The Antedent Causes either come from the whol Body, or from some proper peculiar part into the Stomach. They come from the whol Body in a Plethory, evil habit or Cathexy, Feavers, and other diseases of the whol Body. The Humors are often derived from some peculiar part into the Sto∣mach in the Inflamation of the Liver, Spleen, or other Obstruction of the Mesentery, from the Terms stopped, or Hemorrhoids, from a Catarrh, or the like. To this you may ad the evil Conformation of the Porus Cholidochus when it is not placed into the Duodenum, but into the Stomach, whence they are called Pichrocholi Ana, who are often troubled with Chollerick Vomits, by reason of this evil Conformation. Al••o this vomiting cometh by the Peristaltick motion of the Guts, when they are stopped in the Chollick, and the humors cannot well get forth, but come upwards; also Worms coming up into the Stomach from the Guts, and pulling the inward Tunicle thereof, do cause vomi∣ting. And lastly, An Imposthume broken in the Splee••, Mesentery, and other parts of the Abdomen, useth to cause a vomiting of Matter.

The Conjunct Causes of Vomiting, are them before mentioned, when they come to the Stomach; for while they were in other, they were antecedent Causes. These are especially divers Humors, some bred in the Stomach, especially Flegm, of which there is often much in the Stomach, by Cru∣dities, and want of Concoction when the Stomach is weak, and turns it into flegm. So also is there somtimes green Choller in the Stomach bred of corrupt Humors, as Galen teacheth, Com. in 2. Progn. and this cleerly appears in sucking Insants, who through corruption of Milk in their Stomach use to avoid green stools like Leeches, or Verdegreese.

This green Choller which comes from corrupt nourishment in the Stomach, is not the same with that which cometh from yellow Choller by adustion and torrefaction.

The Signs of Vomiting are manifest. But the Causes, as they are divers, so they have divers signs.

First then, if Vomiting come from a fault in the Stomach, there are signs of that part being affe∣cted, as loathing of meat, heaviness, extension, swelling in the Region of the Stomach, slow and hand Concoction, sowr and stinking belchings, and other signs that shew the distemper of that part. So if it come from a Common and Organical Disease in the Stomach, as a Tumor, or Ulcer, the signs of these Diseases will discover themselves. But if Vomiting come by sympathy from the whol body or other parts, there will appear some Disease of the whol body, or some part.

The whol Body is affected in Feavers, evil Habit, Jaundice, Atrophy or want of nourishment. But the Principal parts from which the Humors are sent more frequently to the Stomach, are the Brain, Liver, Guts, and Womb.

If the Humors flow from the Brain to the Stomach, there will appear signs of distillations, frothy and flegmy vomitings, and a great loathing at meat time.

If the Humor come from the Liver, it is commonly Choller; and Vomiting before meat, is worse than after; and there appears some▪ disease in the Liver, as pain or tumor.

If the Matter come from the Guts, either there will be Chollick or Illiack passion, or the signs of Worms.

Lastly, If it come from the Womb, there is Conception, suppression of Terms, or other Symp∣tomes.

We may also know by some signs whether the Humor be contained in the Cavity of the Stomach, or stick to the Tunicles thereof. For if it be in the Cavity it is easily cast forth, and there is stretch∣ing in the Stomach, and trouble after Meat, which will not cease till the Humors are sent out by vo∣mit, which are for the most part thrown out alone, and the Meat retained. But if the Humors stick to the Tunicles, vomiting is chiefly after Meat, and the Meat is cast forth without the Humors, but when there is no Meat, there is a loathing, and that which is cast forth, is thick and slimy, and with great straining.

The external Causes are known by relation of the Patient, as if he hath eat or drunk too much, or received a stroak, or eat any evil thing.

The signs of Vomiting to come are shewed by Galen, lib. 3. de cris. cap. ult. as Headach, dark giddiness, trembling of the lower Lip, gnawing at the mouth of the Stomach, often and much spit∣ting.

You must make the Prognostick thus:

Vomiting from Choller and Flegm, which is neither very thick, nor very much, and which hath both those Humors exquisitely mingled, is good. For it is commendable in substance, quantity, and quality. For of all excrementitious Humors, Flegm and Choller are the mildest: if then they

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be vomited well mixed, and in a moderate quantity and consistence, it hath all the laudable con∣ditions.

Chollerick and Flegmatick Vomitings on a critical day are very good: For not only mixed are good, but vomiting of one single, if it cause the Disease. So in Chollerick Feavers, when Choller comes forth critically, or Flegm in Flegmatick Feavers, the Disease is at an end, or at least there is great hopes of recovery.

A Vomiting naturally after a long flux of the Belly, cures the disease, Aph. 15. Sect. 6. for there is a revulsion of the Matter to the contrary part. And this shews that Nature is refreshed, and gets strength: For as the Physitian ought to labor for the retraction of those things that flow to any part. So Nature, when she begins to prevail, makes a repulsion of the Humor, which flows to the part af∣fected, that the part may be refreshed and strengthened.

Little and violent vomiting in a sharp Feaver, is evil; for it is not good to void sparingly in a Crisis; for it signifieth one of these two things: Either abundance of Matter which Nature cannot bear, but must send some of it forth: or the weakness of Nature, which striveth in vain to send for••h that which is superfluous.

Vomitings of divers colors are evil, it signisieth divers Humors lurking in the Body, and therefore Nature will be more put to it with divers enemies; for if it be troublesom to Nature to contend with divers Nourishments, how much more dangerous is it to strive to concoct and tame divers preterna∣tural Humors, especially in acute Diseases, in which there is but short time to fight, which should be long, that there might be more hope of Nature being a Conqueror.

Green Vomiting like Leeks, Verdugreese, as also blew, black, or stinking, is deadly: For it signi∣fieth that there is abundance of Choller of those colors: And all these kinds of Choller use to produce malignant and deadly diseases. And if there be a stink, it shews a great corruption of Humors, with which Nature cannot long consist.

In acute Feavers, Vomiting without mixture of Humors is evil, according to Hipp. 1. Porrhet. For a pure Humor is not only crude, but incapable of Concoction, because it excludeth not only the act, but the power of Concoction. Hippocrates calls every humor that is without mixture, and every Excrement that is hot and crude, Acriton, because it is bred either by the defect of some part, or by reason the watery, serous matter is exhausted by the heat of a Feaver. Therefore in sharp Feavers it shews that there is a great inward inflamation, and for the most part such as Nature can∣not conquer.

As for the Cure: If Vomiting come from a disease in some other part, it needs no other Medicines than those which are agreeable to the disease from whence it comes.

But if it come from Chollerick, Flegmatick, or Melanchollick Humors which stimulate and pro∣voke the Stomach, either by their quantity or quality, you must throw out those Humors by Vomi∣tive Medicines.

But if they be thick and glutinous, or clammy, they are to be cut and clensed, as we shewed in the Cure of want of Appetite.

The best Vomit in this case, is that which is indifferent gentle, and not too weak, as warm Oyl: nor must you give strong ones made of Antimony, which draw violently from remote parts. But such as do clense and dissolve the glutinous Humors, as Gylla Theophrasti, or white Vitriol prepa∣r••d: but Salt of Vitriol brought to a high redness by Calcination, is the stronger.

If Vomits are unpleasant, you must take away the Matter with often Clysters and gentle Purgati∣ons with Rhubarb in them, which astringeth and strengtheneth afterwards.

In Chollerick Vomitings, these Pills following may be prescribed:

Take of Aloes washed with Rose Water three drams: the pouder of Rhubarb sprinkled with Borrage Water one dram: Mastich, red Sanders, and Coral prepared, of each one scruple: With Syrup of Roses Solutive make a Mass of Pills, of which take half a dram, or a dram every other day till the Vomiting be ceased. Or,

Take of Rhubarb poudered one dram: yellow Myrobalans one scruple: Spodium, or burnt Ivo∣ry, and Harts-born shaved, of each six grains. Make a pouder, and give it twice in a week, in a ••••ttle Broth.

Or make a Bolus of Hiera Picra, or three drams of Diacatholicon, with one dram of poudered Rhubarb.

In a most violent Vomiting, give three grains of Laudanum, with two scruples and an half of Co∣chie Pills the less, the Vomit will be stayed, and five hours after they will work downwards. There i•• a good quantity of the purgung Pills in this Receipt, because Laudanum doth astringe, and there∣fore it must be given with Medicines made of Diagridium, and Coloquintida. And if the Medicine do not come away, you must give a sharp Clyster.

After su••f••c••ent purging, you must strengthen the Stomach with Syrup of Quinces, sowr Pome∣grantes, old Conserve of Roses, or Comfry Roots, Conserve of Quinces; or this following Julep, if it be very Chollerick and vehement.

Take of the juyce of sowr Pomegranats six ounces: the juyce of ••lin••s clarified two ounce•• Sorrel Water one pint: white Sugar half a pound: make a ••ulep, in which white it is clarifying boyl gently in a clout of yellow Saunders, red Roses, and Spodium, of each one dram: Let him take four ounces first and last.

Take of Terra Sigillata, or sealed Earth, Bole Armonick red Coral, prepared Pearl, Pur∣slain, and Sorrel seed, of each one dram: shavings of Harts-born, and of dried Mints, of 〈◊〉〈◊〉 one scruple: red Roses half a pugil: Make a Pouder to be taken in B••oth, or the like; or in a spoonful of Chalybiate Water. Or,

Make Tablets thereof with Sugar dissolved in Plantane Water, or an Opiate with Syrup of Quin∣ces, Conserve of Roses, or Comfry Roots.

Some few Grains of the best Mastich, taken in the Morning, is good to stay Vomit∣ting.

Three Grains also of Balsom of Peru taken in a rear Egg, or in Sugar like a Pill, do it better.

Also a Decoction of Beans, or Pease, after the first Water is cast away, with a little Vinegar, is much Commended.

And the Crude Juyce of Quinces, taken Two or Three spoonfuls at a time, doth Won∣ders.

Camphire often smelt to, or taken with a little Rose Water, and a little Pouder of Dia••oscum, is good for the same.

The Spirit of Vitriol mixed with Plantane or Spring Water, to make it sharp, doth also powerful∣ly stay Vomiting.

If it be very violent, make the Water sharper with Spirit of Vitriol; or give it in Sack, or rich Wine; if you want Spirit of Vitriol, use the strongest Vinegar without mixture, one spoonful or two at a time.

One Scruple of Salt of Wormwood, mixed with a spoonful of the Juyce of Lemons, is a most Excellent Medicine; especially in those Vomitings which happen in Malignant▪ Feavers.

If the Patient grow very Weak with Vomiting, give him Laudanum with Conserve of Quinces, or Syrup of dried Roses; and then apply a Cupping Glass to the Stomach, and a Cataplasm of Leaven, pouder of Wormwood, and Orange peels, made up with juyce of Mints.

Apply also outwardly a Fomentation to the region of the Stomach, a new Spunge dipt in Rose∣water and Rose-vinegar; or let the Spunge boyl in strong Vinegar, and apply it hot to the Sto∣mach.

Or make a Fomentation of the Decoction of the Roots of Snake-weed, Plantan-leaves, Purslain, Mints, Bramble-tops, and Willow-tops, and then anoint it with this Oyntment.

Take of Acacia, Hypocistis, grains of Sumach and Myrtles, of each two drams: Mastich and grains of Kermes, of each one dram: Oyl of Myrtles two ounces: Wax as much as is suffici∣ent; make an Oyntment: or apply this following Cataplasm.

Take of Quinces boyled in Rose water and Vinegar, or Marmalate thereof well beaten, three ounces: the pouder of Mastich, Grains of Kermes, and Myrtle berries, and Plantane-seed, of each two drams: with the Juyce of Mints, or Quinces, or Syrup of Wormwood, make a Ca∣taplasm.

Or, Steep a Crust of Bread in Rose Vinegar, and sprinkle it with this pouder following:

Take of red Roses, and Pomegranate flowers, and Coriander seeds prepared, of each one dram and an half: Mastich, red Coral, Sorrel seeds, Spodium, of each half a dram: yellow Saun∣ders one scruple: mix them into a pouder.

Or, Apply this following Emplaister:

Take of Mastich plaister, one ounce: the pouder of Myrtles, and Bistort-Roots, of each half a dram: with the Oyl of Mastich make an Emplaister in the form of a Buckler.

If the Vomiting be very violent, and bring a Feaver Symptomatical, and the Body very full, it is good somtimes to let blood to prevent inflamation which may b•• in the internal parts by reason of the violent straining; and this must be done warily, and but a little, least the strength be a∣bated.

Moreover, It is good to apply Cupping Glasses to the Back and Navel, and to rub and bind the extream parts.

You may bind about the Neck Linnen Clothes dipt in Oxycrate to repel the humors: putting of the hands into cold Water, doth stay al kinds of vomiting.

And Last, When other things avail not, use Narcoticks which do very quickly stop al Evacua∣tions.

In a Flegmatick Vomiting (if it wil not be staid with the aforesaid Vomits) give Pills of Hiera, with Rhubarb and Agarick, or other fit Purges.

Then come to strengtheners for the Stomach, such as were prescribed for the Cure of Want of Ap∣petite: to which ad this following:

Take of Conserve of Roses and Comfry Roots, of each one ounce: confection of Hyacinth, three drams: the pouder of Diambra, and Aromaticum Rosatum, of each half a dram: Troches of Spodium, terra Sigillata, and grana Kermes, of each one scruple: with syrup of Quinces make an Opiate.

The Spirit of Vitriol with Wormwood water, or Juyce of Mints, doth mightily stay Vomiting, and Strengthen the Stomach.

Or, One or two spoonfuls of Aqua Imperialis, given after Vomiting if the Stomach be very Cold.

Apply these things following outwardly:

Take of Wormwood, Mints, and Balm, of each three handfuls: boyl them in a sufficient quantity of Vinegar and Wine, to the consumption of the third Part; make a Fomentation for the stomach.

After apply the Plaister afore-mentioned, or the Cataplasm of Quinces, using the Pouder of Nut∣megs and Cloves, instead of Myrtles and Plantane. Or,

Take of Wormwood and green Mints of each one pound: a Toast dipt in Rose-water weighing half a pound: the Pulp of Quinces, or Marmalat of the same, two ounces: Mastich half an ounce: Mace and Nutmegs, of each two drams: beat them all well together with Oyl of Quinces and make an Emplaister.

Or, Make a Cataplasm of Quinces boyled in strong Vinegar and then beaten with a little Mustard∣seed and Pouder of Cloves.

Or, Apply a Toast dipped in strong Wine and Juyce of Mints, and sprinckled with pouder of Nutmeg, Cloves, Frankinsence, Mastich, and Graines of Kermes.

Villanovanus much Commends sharp Leaven, which he applieth to the Stomach twice or thrice, being steept in strong Vinegar and juyce of Mints: this doth most certainly stop Vomiting after con∣venient Evacuations, and Revulsions.

In a long Vomiting where the Stomach is very Weak, you must use strong Astringents made thus.

Take of the Roots of Snakeweed and Tormentil, Pomegranate peels and flowers, and Hypo∣cistis, of each two drams: Leavs of Mints, and dried Wormwood, of each half an handful: Sumach and Myrtle berries, of each one dram: red Roses one pugil: Cinnamon, Cloves, and Mastich, of each half an ounce: green Galls, and Cypress Nuts, of each two drams: boyl them in Iron water and Red Wine, in which dissolve a little Musk, for sweet things do much asswage Vomiting, of which let the Patient take two ounces every morning, and Foment his stomach with the same.

After the Fomentation apply some Plaister or Cataplasm, made as aforesaid.