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 Vomiting Blood.

THis Disease is a casting forth of Blood from the Stomach by the Mouth: And as al other Blee∣ding, it comes from the Veins either by Anastomosis, or opening of them by Diapedesis, or Ra∣refaction, by Rixis breaking, or by Diabrosis corroding, which Diseases of the Veins were shewed in the Cure of Spetting of Blood, called Haemoptysis.

The Causes also are the same.

And First the Conjunct Cause; Excess of Blood in quantity or quality.

Blood offending in Quantity, wil break or open the mouths of the Veins, and so comes Rixis, or Anastomosis, which happeneth in ful bodies.

If it offend in Quality, as when it is too hot, or thin, it may cause an Anastomosis, because heat doth open the Orifices, and thinness makes it flow easily through; The same Qualities may Cause a Diapedesis; for heat doth make thin the Tunicles of the Vessels, and thinness Causeth the Blood to pass through their pores.

Lastly, Sharpness gnaweth and Ulcerateth the Tunicles of the Veins, and so produceth a Dia∣brosis.

The Antecedent Causes are the same with the Conjunct, but they differ in place; for when blood offending either in Quantity or Quality, doth immediately open the Veins: it is called a Conjunct Cause; and the same being contained in the Veins, is called an Antecedent Cause.

The parts sending, of which the chiefare, the Head, Liver, Spleen, and Womb, are antecedent Causes.

Often times Blood is carried from the Head to the Stomach by the Pallat and Gullet, or Oesopha∣gus: and also a violent Catarrh of sharp and Salt flegm, doth corrode the Stomach, and open the Veins thereof.

It is carried from the Liver and Spleen by the Veins that go to the Stomach from the Womb, when blood by the stoppage of the Terms, runs back and opens the Veins of the Stomach, so that some Wo∣men have had their Terms by vomiting blood constantly at the time.

Vomiting of blood comes oftener from the Liver and Spleen, than from other parts, and from the Spleen than the Liver, because it doth more consent with the Stomach. For it is evident by Anato∣my, that the great branch of the Gate Vein, or Porta, goeth to the Spleen, from which many Veins are sent to the Stomach both above and below; and these are so great that being distended with wind or blood, they are as thick as the middle finger: this we have observed in Dissection. Moreover, the Vas breve being wide, as in a natural state, it doth continually send Melancholly into the Stomach; so being in a Preternatural state, it may send great plenty of blood. But observe here, that in this case, that blood is voided by stool as well as vomit, both because a part thereof which went to the Sto∣mach, is sent downwards, and also because the Meseraick Veins are open, and send blood into the Guts, which by its long passage through the Guts groweth black, and comes forth like Tar.

The external Causes are, all things that can wound or bruise, as also great heat which causeth boy∣ling of the blood; hence it is that yong men to the age of thirty five, are very subject to vomit blood, and other bleeding, as also great cold by too much astriction may endanger to break the Veins: the same doth unseasonable Motion and Labor, unusual Exercise, great hallowing, and the like, which move the blood violently in the Veins.

And finally, All the Causes of Blood-spitting afore mentioned. For Blood being violently mo∣ved either in the Veins or Arteries, whether from an external, or an internal Cause, goes soonest to that part which is weakest, and most fit to receive it; and therfore if the Stomach, or the Veins going thither are so disposed, there will be vomiting of Blood rather than any other way of bleeding.

The Diagnostick of this Disease lieth chiefly in the discovery of the part from which the blood comes.

If from the Stomach, the scituation of the part, and the constant pain and heaviness thereof will de∣monstrate, and there is less blood, for the Veins of the Stomach are smal, and it comes with loathing, and there is a biting when they swallow, as also somtimes it comes forth mixed with Meat, Flegm, or Choller,

If it come from the Head, there will be tickling about the Jaws and Pallat; and some blood will be blown out of the Nose with Snot; there went before it some Head-ach or heaviness, which after bleeding ceaseth.

If from the Liver or Spleen there is more plenty of blood, and somtimes a tumor or dolor in the part. From the Liver the blood is red and frothy, from the Spleen it is thick and black. Also Blood from the Liver goes most downwards, because it commonly goes from thence to the Guts through the Meseraicks, and must ascend from them into the Stomach to cause Vomiting, but it doth easier descend. Contrarily, that which comes from the Spleen, is rather by vomit, because the Veins from the Spleen to the Stomach, are shorter and narrower.

Lastly, If from the suppression of the Terms, you may know it from the Woman, and it wil come at those times which wil be more probable, if there be no disease in any other part.

As for the Prognostick: Vomiting of Blood, of what cause soever, is dangerous; for it either threateneth death suddenly; or if it stay in the Stomach, and putrifie, it breeds faintings, swoonings, and suffocations.

Vomiting of blood from suppression of the Terms, is less dangerous than that from the Liver or Spleen; for when they are brought down it is usually cured, as Hippocrates taught, Aph. 34. Sect. 5. in these words: When a Woman vomiteth Blood, if her courses breakdown, she is cured. And in this case only, the opening of the inferior Veins doth provoke the Terms, especially if she take somthing besides for that purpose.

They who after Vomiting of Blood fall into the Dropsie called Ascites, do die thereof. Dodonaeus doth testifie that he never knew any that escaped: and Experience teacheth that a Dropsie from any kind of bleeding is deadly; for it comes from a great dissipation of Natural heat, which cannot be repaired.

For the Cure of this Disease use Medicines which revel the Blood from the Stomach, and correct its distempers and the open Veins with astringents and glutinatives. To which ad those things which concern the part chiefly affected, from whence the Blood is sent into the Stomach, according to the divers Nature, and Disease of the part.

And because Diet is of chiefest concernment in this Disease, let us shew some Rules therefore.

Let his Nourishment be commonly astringent and Emplastick, and cold both actually and po∣tentially, as Barley, Almonds, Rice, Panadoes, Gellies, and especially Starch made without Chalk, and boyled in Milk, which is good also in spitting of Blood: to all these you may alwaies add some Pomegranates, or Vinegar of Roses. Also hard Eggs steeped in Vinegar are good; Bread crums steeped in cold Water, and Chicken Broth, with Sorrel, Purslam, Plantane, and unripe Grapes; the feet and hips of Sheep, Kids, and Calves, boyled to a Jelly, for the first course, let him take that which is a stringent, as a Quince, or sowr Apple, or Pear roasted in the embers, Marmalat of Quin∣ces, or Jelly of sharp Cherries, Medlers, or Services.

Let him abstain from all sharp, salt, peppered, and fried Meats, as also from things that breed much Blood, except he grow weak, and then you may give him them sparingly. He must be but little nourished, for the less Blood is bred, the Disease will be the less, and the empty parts by their attraction will stay the flux.

Let him drink little, only a little Iron Water with a little Juyce of Pomegranates. He must drink no Wine except it be thick and sharp, which we call Tortium, and it must be when there is no Feaver.

Let the Air be cool, without Wind, Sun, or Moon shine; let him sleep little, and not in the day; for although all fluxes are said to be stopped by sleep, yet this by long keeping the heat in the Cen∣ter may be encreased. Let his Belly be loose, and he kept free from passions.

After his Diet is thus ordered, we must go on to Chyrurgery and Medicine.

And first take away a little Blood, often, for the greater Revulsion: and that out of the Liver Vein called Basilica, in the right Arm, if it come from the Liver; in the left, if from the Spleen; or from the Ankle Vein, if from stoppage of the Terms.

Use Frictions and Ligatures to the extream parts, and give clensing Clysters.

Apply Cupping-glasses to the Buttocks, Thighs, and Loyns, and to the Hypochondria.

Give half a scruple of Camphire with four ounces of Oxycrate, or Plantane Water. Which Ron∣deletius commends in his Counsels for excellent.

If you suspect there is congealed Blood, give him a glass of Vinegar and Water, or Oxycrate, for it easily dissolveth blood, and sends it from the Veins of the Stomach, and shuts them up.

And foment the Stomach cold with the same.

When Vomiting ceaseth, to astringe the Veins, use these following:

Take the white of an Egg, Rose Water and Vinegar, of each one dram and an half: Beat them well; then ad two drams of Chalk. Let the Patient take now and then a spoonful. Or,

Take of prepared Coral, Terra Sigillata, Bole-Armenick, Blood-stone, and Troches of Amber, of each one dram: Plantane Water, and Syrup of Myrtles, of each two ounces: mix them for to be used as the former, or the pouder in Broths. Or,

Take of the Juyce of Plantane four ounces: give it cold morning and evening. Galen saith there is nothing better for to stop any kind of Bloody flux.

The Juyce of Purslain and Polyganon, or Knot-grass taken with Sugar, is very good for the same.

Take of Plantane and Purslain Water, of each one ounce and an half: the Syrup of Myrtles half an ounce: the Syrup of Poppies two or three drams: Sal Prunellae one dram: Mix them for a Julep often to be repeated. Or make a Julep of the Decoction of the said Herbs.

Take of old Conserve of Roses, and of Comfry Roots, of each one ounce: of Cydoniatum half an ounce: one candied Myrobalan: Troches of Carabe, and Terra Lemnia, of each two drams: Coral prepared, and Crocus Martis, of each one dram: With the Syrup of dried Roses, make an Oplate to be taken often.

The Troches of Carabe do not only astringe, but dissolve congealed blood, therefore use them often.

The Syrup of Coral is good; but the Tincture drawn newly with the Juyce of Lemmons is better.

When Blood is vomited violently, and will not be cured by what hath been said, so that death threateneth; you must give Narcoticks, either at the Mouth, or by Clysters.

Anoint the Stomach without with Oyl of Roses, and Myrtles washed in Vinegar; and after sprin∣kle on the pouder of Coral, Bole-Armenick, and Terra Sigillata.

Or anoint with this:

Take of the Juyce of Plantane, and Knot-grass, of each one ounce and an half: Vinegar of Roses one ounce: Oyl Olive six ounces: Boyl them till the Juyces are consumed: then ad os San∣guis Draconis, Mastich, Pomegranate peels, and Myrtles, of each two drams: Camphire one scruple: as much red Wax as will serve to make an Oyntment.

Let him drink ordinary Water, wherein Iron hath been quenched, with Syrup of Quinces, and Spirit of Vitriol: also make all his Broths of Iron Water.

Let his Hypochondria and Loins be Fomented with the Decoction of Plantane and Purslain mad in Oxycrate.

Let his hands be put into cold Water, for so al Vomiting is staied.

After use the Oyntment of Galen, called, Refrigerans; washed in Vinegar, to the same parts.

After sufficient Phlebotomy, you must appoint an often and gentle Purge to take away the 〈◊〉〈◊〉, and destroy the Disease, by which the blood wil be purged from Waterish and Chollerick Humors which produce this Disease.

These kinds of Purges, given by a wise Physitian, do Miracles; as we have learnt by Experi∣ence.

They must be made of Rhubarb, Myrobalans, Tamarinds, and Tryphera Persica; which Medi∣cines do al astringe with their Purging, & do no wayes stir the Humors, so that you need not fear they wil provoke Vomiting of blood; you may give them in form of a Bole, with Syrup of Myrtles, •••• of dried Roses; or in form of a Potion, with the Decoction of Succory, Sorrel, Purslain, or the like.

In time of Purging, which may continue three or four dayes in a smal Dose; at night you may give the aforesaid Opiate or Syrup of Coral, or some of the afore-mentioned Astringent and streng∣thening Medicines.

Finally, To prevent, you may give for a long time once in a Week, one dram of the Pouder of Rhubarb, or the Magistral Syrup prescribed for to prevent Spetting of Blood; as also almost al o∣ther Medicines laid down in the Cure and Prevention of that, are very good here.