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 ...

THE NINTH BOOK OF THE PRACTICE OF PHYSICK. Of the Diseases of the Stomach. (Book 9)

The PREFACE.

AS there are divers Actions of the Stomach, so there are divers Hinderances of those Actions which Cause variety of Diseases: For this part being ordained to Concoct meat, and make the Chyle; for the performance thereof first it is con∣strained to desire Meat and Drink by the Appetite which may be diminished, abolished, or depraved. When it is abolished, it is called Anorexia, & Apositia: When 'tis diminished, it is called Inappetentia, and Loathing: But when it is depraved, it is called Doggshungs, or Pica, or Malacia: Too great desire of Drink is called Sitis Morbosa: These Diseases mentioned do concern the attractive Fa∣culty, they which concern Concoction, as it is diminished, abollished, or depraved, are comprehen∣ded under the name only of Concoction hindered; if the Retentive and Expulsive Faculty be hurt, it consists in Vomiting and Hickocks: There are divers kinds of Vomitings according to the divers Condition and nature of the Matter Vomited forth. And because the Stomach is of exquisite sence of Feeling by reason of the famous Nerve it hath from the sixth Conjugation, it is therefore as other sensible Parts, subject to pains; and it hath somtimes Tumors, (as other parts) and Inflamations, Imposthumes, and Ʋlcers. That therefore we may in this Book explain all the Ordinary Dis∣eases of the Stomach, we will Comprehend it in Eleven Chapters. The First, Of Inappetentia, or Loathing or meat. The Second, Of Fames Canina, or Dogs Appetite. The Third, Of Pi∣ca and Malacia, or Green-sickness. The Fourth, Of Sitis Morbosa, or diseased Thirst. The Fifth, Of Concoction hindered or hurt. The Sixth, Of Hickocks. The Seventh, Of Vomi∣ting. The Eighth, Of Vomiting Blood. The Ninth, Of the Disease called Chollera. The Tenth, Of Pain in the Stomach. The Eleventh, Of its Inflamation, Imposthume, and Ʋcer.

Chap. 1. Of Want of Appetite, or Loathing of Meat.

INappetentia, and Loathing, is either from the abolished or diminished Action of the stomach: When it is Abolished it is called Anorexia, & Apositia: but when it is Diminished it is called Dusorexia, but by Custom Anorexia, & Apositia are used for both.

The Causes of this Disease are divers, which that we may bring into Order, let us consider the Natural Causes of Hunger or Appetite: These are called by Galen, lib. 1. de symp. caus. cap. 7. Symptomes: and are Five, The First whereof is emptiness of the parts. The Second is the Natu∣ral Appetite of those parts so emptied. The Third is the Sucking and Attraction of the Mesaraick Veins in the Stomach and Guts. The Fourth is the sense of their sucking in the Stomach. The Fifth is the Animal Appetite wch cometh from the Nerve in the mouth of the stomach which comes from the Brain, and is endued with great sense and feeling. As also the Melanchollick Humor which comes from the Spleen to the mouth of the stomach, which with its sharpness gnaws the inmost Tu∣nicle of the stomach, and is like sawce to stir up Appetite; which that it may be natural, it is necessa∣ry that al those Causes be in Order; for if there be any fault in either, then there is a hurt or hinde∣rance of Appetite.

Therefore the First Cause which is Emptiness of Parts, if it be wanting there is no Attraction made by them from other parts and the stomach, and so there is no Appetite: now this Emptiness is wanting either when the parts are filled with plenty of crude juyces, by reason of gluttony or drun∣kenness; or for want of exercise, or usual evacuations, or when there is so much fat that it is suffi∣cient to nourish the parts: Also the great stoppage of the pores of the skin, doth hinder the empti∣ness or the parts: or great weakness of the natural heat, so that it can disperse none or but little of the substance of the Parts: or the calling of that heat to the concoction of the matter of a Disease wher∣by the nourishment of Parts is neglected, as in Feavers.

The Second Cause is Natural Appetite, and the Attraction of nourishment to the stomach; and this is depraved when the Parts though empty, wil not draw by the veins, by reason they have lost their strength, but languish and forget their duty: As happeneth in acute, malignant, pestilential, syntectick, and hectick Feavers: And in immoderate evacuations, as in Flux of the Liver, Womb, Haemorrhoids, Bleeding at the Nose, Great Sweat, much Lechery, long Fasting, and the like.

The Third Cause is, The Attraction of the stomach by the Mesaraick Veins, which useth to be de∣praved by stoppage of those veins, by which means the empty Parts cannot attract their Chylus, nor make the mouth of the stomach sensible: so we may perceive in Children troubled with Struma, to consume by a long Flux of Chyle, by reason al the Mesentery is full of Glandles which stop its Veins, and hinder the passage of the Chyle to the Liver, by which means it is sent half concocted forth by siege, and the Parts are deprived of their necessary nourishment.

The Fourth and Fifth Causes, which are Sense of Sucking, and Animal Appetite, do require a good disposition in the Stomach, brain, and nerves: Therefore whatsoever can al••er their dispositions may also destroy Appetite; so every great distemper of the belly, especially if it be hot and dry doth hinder Appetite. Great heat by dispersing the moist substance of the stomach, doth take away Appetite; as also great Cold not only positive as when the bowels are so cold that they are stupified by Air, Water, Frost, Snow, and the like; but also privative, when the native heat is spent, which Galen cals Na••cosis or Stupefaction, as by long bleeding, feavers, and the like, by which the strength of the stomach and other Parts is consumed. Evil also and corrupt Humors; whether hot or cold, do cause want of Appetite: The hot are chollerick, adust, putrid, or virulent, whether they are bred in the stomach for want of Concoction, or brought from other infirm Parts.

The Cold Humors are, Flegmy and Slimy, gathered in the stomach by evil Concoction, or co∣ming from the whol body, as in them who by often Vomitings bring the corruption of other Parts into the stomach.

Or from the Brain by Catarrhs in which the stomalch useth to be troubled with Flegm: The sup∣pression of the Terms and Haemorrhoids also, by choaking and smoothering the natural heat do also diminish the Appetite.

Moreover, The distemper of the Brain and Nerves Cause that the Sucking is not flet in the stomach in them who have lost or depraved the Animal Faculty; therefore they are ••ick in mind, as in an A∣poplexy, Lethargy, Phrenzy, Madness, and the like; as also in a Palsie by reason of the Obstruction

of the Nerve of the sixth Conjugation which comes to the Stomach, or by reason of the stupefaction thereof, by the use of cold and narcotick things.

The knowledg of this Disease is manifest, for the Patient will complain of his want of appetite, and loathing of Meat. But the signs of the Causes are partly manifest, and partly to be discovered by art.

And first, they which cause the want of emptiness, are known by former high feeding, repletion, want of exercise, or evacuation, long sleep, and other Causes of crude Juyces; as also if the body be full, and the Veins swoln. Also the thickness of the Skin signifieth the same, for that hinders the dispersing of the nourishment, as also some great disease in some particular part, by which there is 〈◊〉〈◊〉 dispersing of the Natural heat in the whol Body, so that it is so weak that it cannot concoct the nourishment brought to the parts, and supply its wants.

The signs of the second Cause are manifest, namely acute, malignant, pestilential, and syntectick•• Feavers, strong evacuations, and other Causes, by which there is a great decay of Natural heat in the parts, so that they cannot attract necessary nourishment.

The signs of the third Cause are obstructions, whose signs are known in the diseases of the Liver, Spleen, and Mesentery.

The signs of the fourth and fifth Cause, need a more curious search, and first heat in the Praecordia, especially in the Stomach, thirst, dryness, and bitterness of the Tongue and Jaws, and a Feaver, do signifie a hot distemper of the stomach, and abundance of Choller. And if this hot humor do flow from other parts, the disease of that part will shew it, as inflamation of the Liver, or other part. But if no other part seem to suffer, you must conjecture that the fault is in the Stomach, or that e∣vil meats have been received. To these are joyned Cardialgia, Heart-scalding, Nausea or loathing, Vomiting, and Purging, the Nature of which humors are known by what is sent forth. A cold di∣stemper and much flegm is known by cooling Causes afore going, or such as disperse the Natural heat, and extinguish it; as also from the sence of weight in the Stomach, from sharp belching, or from a slimy thick humor sent out of the mouth, or by stool.

The same is signified by a long Catarrh, and a disease in some part which may send flegm or me∣lancholly to the Stomach, as of the Spleen, Womb, or the like. Also the distempers of the Brain and Nerves are to be known by their proper signs.

As to the Prognostick: As a good Appetite is good in all Diseases; as Hipp. Aph. 33. Sect. 2. saies, To be right in mind, and to be willing to take that which is brought, is good: so want of Ap∣petite useth to be an evil sign. For it sgnifieth a great digression from the Natural state; and it comes, as Galen teacheth, Com. in 3. Epid. either from evil Humors in the Mouth of the Stomach, o•• from the loss of the Faculty, whose duty it was to be sensible of the want of nourishment, and con∣sequently to desire it. So Hipp. in 1 Epid. saith concerning men in Consumptions that died in the time of an Epidemical disease, they alwaies abhorred meat and drink. And so Galen, Comment▪ in 3. Epid. saith that he hath seen many in a Plague time which could take no sustenance, and died: But some who were stronger, and took courage, and did eat, recovered. So in Hipp. 3. Epid. Sect. 1. Aegr. 2. Hermocrates, who died the twenty seventh day, abhorred meat all the time, and in the last daies could not tast. And Sect. 2. of the same Book, Aegr. 6. Euryanactis her daughter, abhorred meat all the while, and drank nothing worth speaking of, died about twelve daies after.

But we must observe, that loathing of meat is sad if it come from the destruction of the Natural heat: but it is not so dangerous if it come from abundance of evil humors, and Cacochymia; as you may see in Hipp. 7. Epid. by the Son of Cleomenis, who without a Feaver abhorred meat for two months, through abundance of crude and viscid flegm, which he at last vomited up. So in the be∣ginning of Diseases, and especially of Feavers, want of Appetite is not so dangerous, because then Nature being busie about the concocting of filthy humors, is called from her usual desire of meat. But after, when the Feaver is appeased, and the humors that caused the Disease being spent, she returns to her old custom.

In Children, want of Appetite is worse than in others, because their substance is moist, and easily dissipated, and requires more use of nourishment to restore them.

In men recovered of a Disease, loathing threateneth a relapse, by reason the reliques of the Disease cause it.

In a continual Disease, loathing and sincere dejections are evil. Hipp. Aph. 6. Sect. 7. loathing is an evil sign in long diseases: but they who are like to escape, have the contrary; that is, a good appe∣tite. But sincere dejections coming, do cause a worse Prognostick; because Hippocrates under∣stands by sincere dejections, such as have no humidity mixed with them, when the humor alone with∣out any Water, is cast forth, whether Choller or Melancholly; for these stools do shew that all the Natural humidity is burnt up by the heat of the Feaver.

In long Diseases of the Guts, loathing of meat is evil, and with a Feaver worse; Hipp. Aph. 3▪ Sect. 6. when there are deep and putrid Ulcers in a dysentery, the Stomach suffering with the Guts

••oth not well concoct, which offence arising higher, affects the mouth of the Stomach with loathing. There are some in Dysenteries, who abhor meat from the beginning of the Disease, by reason of the wil humors which come from the Liver; for the superfluous part of them comes to the mouth of the Stomach, which is not alwaies dangerous. But in long Diseases when it is so, there is either a putri∣••action about the Ulcer, or a great Inflamation, both which are desperate.

The Cure of this Disease, if it come from the distemper of other parts, must be by the Cure of it. But if it come only from a fault in the Stomach, it is to be reduced to a hot or cold distemper joyned with matter.

A hot distemper is to be cured first by purging of Choller gently and often. And this may be made of Rhubarb, Myrobalans, Tamarinds, Syrup of Roses, or of Succory with Rhubarb; Or if the Pati∣••nt be subject to vomiting, you must give him a gentle one.

The same Humor is to be altered with Juleps or cooling Broths, in which you must not omit the Spirit of Vitriol or Sulphur; because all sharp things do not only allay Choller, but provoke an ap∣••etite. Hence it is that we use Sallets in Summer, to provoke appetite.

Or you may alter and purge this Humor at once with a convenient Apozeme, to which, for the Stomach, ad half a handful of Sea Wormwood, and half an ounce of Citron Myrobalans.

After Purging, Marmalad of Quinces is good to strengthen the Stomach; or the Syrup mixed with Syrup of Wormwood, the Lozenges of Diamargariton frigid, or Triasantalon, or Diarrhodon ••bbatis, if there be a suspicion of Obstruction. Or this Opiate:

Take of Candied Lettice, and Guords, of each one ounce: Conserve of Sorrel, Roses, Succory, and Bugloss, of each half an ounce: red Sanders, Coral, and Pearl prepared, of each half a dram: ••he Troches of Spodium and Sorrel seeds, of each one scruple. With Syrup of Lemmons make an Opiate, of which let him take the quantity of a smal Nut morning and evening, drinking after a little Wine and Water.

Anoint the Stomach outwardly with this Oyntment.

Take of Oyl of Roses, Myrtles, and Quinces washed with Vinegar of Roses, of each two ounces: all the Sanders, red Coral, Coriander seed prepared, and red Roses, of each one dram: grana Ker∣••nes and Spodium, of each half a dram: white Wax as much as is sufficient. Make a Liniment, with which anoint the Stomach with your warm hand only twice or thrice in a day, putting in a little Rose Vinegar at the same time.

Or lay on a Rose Cake sprinkled with Rose Vinegar, or steeped therein, which you must remove before it groweth hot.

Lastly, In the continuance of the Disease a Bath is good twice or thrice used, by which many are brought to their former appetites.

Vinegar, and all sharp things are good with their meat.

A loathing cometh from a cold distemper, when flegmy melanchollick humors are gathered into the Stomach, and hinder its office; or being drawn from all other parts of the Body, as in them who using to vomit, draw the impurity of other parts to the Stomach, or from the Brain, Spleen, and Mo∣ther, and other parts.

In the Cure hereof, you must first look at the distemper of the parts from whence they come, which must be amended with Remedies laid down in their proper Chapters.

Then you must apply Medicines to the Stomach by Evacuation of the Humor offending, and strengthening the parts.

Evacuation may be made by vomit or stool.

By Vomit, If the Patient be Nauseous, and easie to vomit, with Medicines for that purpose.

But if the Humors be thick, and fastened upon the Tunicles of the Stomach, and the Patient is not used to vomit, they must be purged, especially with Pils, because they stay longest in the Stomach; as Galen sheweth cap. 7. lib. 4. de sanit. tuenda. Who exceedingly commends Pils of Hiera; which may be given to two scruples or a dram in the morning two hours before meat: and you may make them fresh, thus:

Take of the best Aloes washed with the Juyce of Wormwood one ounce: Agarick trochiscated two drams: the pouder of Rhubarb sprinkled with white Wine one dram: Nutmeg and Spicknard of each half a dram: Salt of Tartar, Mastich, and Cinnamon, of each one scruple: With Syrup of Wormwood make a Mass of Pills; of a dram whereof make six Pills guilded. Let him take them in the morning if you will purge much; or give half a dram two hours before dinner twice or ••hrice in a week, They may be quickened with Diagridium, if you will have them stronger.

If you fear the Liver is too hot, you may mix cool things; as red Roses, Sanders, Diamargariton: and make up the Mass with Compound Syrup of Succory.

Strong Pills are not good, because they wil draw humors from other Parts to the stomach.

If he cannot swallow Pills, you must give him Hiera to drink with a convenient Liquor. Or,

If a Potion shal be unpleasant, make an infusion of Senna, Myrobalans, Rhubarb and Agarick in

Wormwood Wine, or the stomach Decoction, dissolving in it a little of the Electuary of Citrons solutive, if you wil make a stronger.

If this Disease comes from slow, slimy Flegm, before Purging you must dissolve it with Honey of Roses, and Oxymel, with syrup of Hysop and the like, with a cutting and clensing Decoction.

Or, This following Apozeme will do both.

Take of the Roots of common Acorus▪ Cypress, and Calamus Aromaticus, of each one ounce: dried Citron peels, and Sarsa, of each six drams: Wormwood, Mints, Marjoram, Germander, and Chamaepitis, or Ground-pine, of each one handful: Citron and Annis-seeds, of each two drams: Senna, two ounces: Carthamus-seeds bruised, one ounce: Agarick trochiscated, three drams: Dodder of Thyme, or Epithimum Flowers, Sage, Rosemary, and Lavender, of each one pugil: boyl them to a pint and an half: in which dissolve of the Syrup of Wormwood and candied Citron-peels, of each two ounces: make a cleer Apozeme, and scent it with a little Cinna∣mon, and pouder of Aromaticum Rosatum for four mornings draughts: in the first and last wher∣of you may dissolve for the better Purging three drams of the Solutive Electuary of Citrons, with one scruple of the pouder of Rhubarb.

The use of Turpentine is good, because it clenseth al the Bowels; especially if you make it into Pills with Rhubarb.

It is not good to let blood in this Disease, except the Liver be very hot.

After sufficient Purging, you must come to Strengthning; both Internally, and External∣ly: Thus,

Take of Syrup of Wormwood, one ounce: Let him Drink it Fasting many mornings: or Wormwood-wine.

Take Conserve of Mints, Citron peels candied, and candied Mutmegs, of each half an ounce: one candied Myrobalane: of Confectio Alkermes, three drams: the inward skins of Hens∣maws poudered, two drams: Cinnamon and Aromaticum Rosatum, of each one dram: with syrup of Mints make an Opiate: or candy them with sugar of Roses; use it in the morning, drin∣king after it a little Wine.

Salt of Wormwood is good to be put to the aforesaid Medicines, Or, Oyl of Mints Chymi∣cal.

Or, Salt of Wormwood with Orange peels, or either of them to half a dram in Wine, or Broth.

This following Syrup is most excellent:

Take of the syrup of Quinces, and Citron Barks candied, of each two ounces: Cinnamon wa∣ter, one ounce: Oyl of Sulphur twelve drops: mix them to be taken now and then a spoon∣ful.

Clarret Water is usual, and it is made thus:

Take of Cinnamon grosly poudered two ounces: steep them in one pint of Aqua Vitae in a glass; in another glass put six ounces of sugar with half a pint of Rose water: let these Glasses stand two or three dayes; every day shaking them often; then mix them both together and strain them by fil∣tration; keep the Liquor in a Glass close stopt, and let the Patient take a spoonful or two Fa∣sting.

In Paris the Syrup of Wormwood made by Pena is highly esteemed; made thus,

Take half a pound of candied Citron barks sliced: boyl them in equal parts of the Waters of Suc∣cory and Agrimony, make a strong expression and put to it the juyce of Quinces, and Wormwood water, of each half a pint; in which infuse for four dayes four ounces of Schoenanth in a close vessel well glassed and set upon the Embers; dissolve in the straining as much sugar as is needful; then boyl them to a syrup, in which when it is hot dissolve one dram of ash-coloured Amber: keep it in a close Glass.

Cinnamon Water alone is excellent good in a Cold Stomach, or with other Medicines, as Syrup of Wormwood, Mints, or Coral; to which you may also put Amber-greece.

The Syrup of Cinnamon made with Aqua Vitae, according to Quercitanus Dispensatory is no less powerful.

And Cinnamon Water distilled with Juyce of Quinces.

And also the Spirit of Mastich made thus,

Take three ounces of Mastich, one ounce of Galangal, half a pint of spirit of Wine, digest them and distil them.

The Elixir Proprietatis, described by Crollius, is good, if you give twelve or fifteen drops in Wine they wonderfully strengthen the Stomach.

You may make Tablets for the same purpose thus:

Take of the pulp of Rinds of fresh Oranges, and Aromaticum Rosatum, of each two drams: white Sugar dissolved in Orange flower water four ounces. Make Lozenges.

Tablets of Aromaticum Rosatum, Opiata Solomonis, and old Treacle are good for the same.

A Decoction of Guajacum or Sassaphras taken many dayes tog••ther with a little sweating, or without in weak people, is very good in this Disease, being o•• long continuance.

Also Sulphurous and Nitrous Baths, as our Bellilucanae being taken in great quantity many dayes, do powerfully clense the Stomach and Gutts from al slimy filth.

Take of Agrimony, Centaury the less, and common Wormwood, of each half an handful: boyl them to half a pint, and ad one ounce of sugar, drink it, either in a cold or hot Cause.

Hartman exceedingly commends the use of Zeadoary in these words, The often use of Zedoary doth so strengthen the stomach, as nothing more, therefore we may commend it having tryed it of∣ten, and never missed; you must eate it often.

Costaeus Commends hot Wine thus, Hot Wine drunk ordinarily doth am••nd the imbecillity of the stomach: It is usually observed that they who have been continually vexed with Wind and Pain from an evil Concoction when they have begun to drink warm drink, have been cured, and lived after a long time more comfortably.

You must give him Wine in Water, wherein Coriander hath been boyled, for his ordinary Drink.

But observe, That if a hot distemper of the Liver meet with that of a cold stomach, as often it doth, you must give hot Medicines warily, and rather those that are temperate.

Zechius Commends this Bolus following, in these words, That the stomach may be warmed gent∣ly and not dryed, you can use no Medicine inwardly more powerfull.

Take of washed Turpentine two drams: Pouder of Mastich half a dram: Aromaticum rosa∣tum ha••f a scruple: make a Bolus to be taken two hours before meat.

This digestive Pouder is usual to help Concoction,

Take of Coriander seeds prepared half an ounce: sweet Fennel seed and Annis seed of each two drams: Cinnamon and Cloves of each half a dram: Sugar twice as much as the rest: make a Pouder, of which let him take one spoonful after every meal.

The Ballom of Peru is good if you give a few drops in Wine one hour before meat.

Or in form of a Pill, one or two drops in sugar for many dayes.

There are some ordinary Medicines for this, Hippocras Wine, a Decoction of Annis, Coriander and Cinnamon mixed with sugar for ordinary drink.

The Dukes Pouder, commonly so called, made of two parts of Sugar and one of Cinnamon, to sprinkle upon al meats.

A Salt to be eaten with meat, made of Coriander, Annis seeds, long Pepper, Galangal, and Nut∣megg, mixed with an equal proportion of Common salt.

Some Grains of Pepper whol or beaten, taken fasting.

Acrons stuck with Cloves and Cinnamon, and candied with Sugar, Citron, and Orange peels can∣died together, Annis seeds, Fennel, Coriander and Cinnamon infrosted with Sugar, al these men may use as they please.

Citron Peels are more pleasant than the rest, but because it wil grow so dry that it wil hardly be chewed; we are often constrained to make it up in a Mortar with Rose Water, in the form of an Opiate.

Candied Myrobalans and Nutmegs may be used for the same, and be made up as the former, though they are not so apt to grow hard.

The Essences of Annis, Cinnamon, Citron peels, Nutmegs, and Olives, are excellent to strengthen the stomach, and they must be used as above in the Diseases of the Heart.

Of Meats, They which are Salt do most provoke Appetite, and Sharp things in a smal quantity; and mixed with other things lest they cool the Stomach.

Outwardly apply Liniments, Fomentations, and Emplaisters, thus made:

Take of Cypress Roots, Galangal, Flower-de-luce, and dried Citron peels, of each two oun∣ces: Mints, Hysop, Sage, Rosemary, and Marjoram, of each one handful: Annis seeds, Bay∣berries, Nutmegs, Cloves, and Cinnamon, of each three drams: the flowers of Stoechas, Schoe∣nanth, and Rosemary, of each one pugil; slice those that must be sliced; and bruise those that must ••e bruised, according to art, and put them into two Bags with holes pricked through, and steep them in strong Wine, and lay them warm to the stomach one after another.

Take of the Oyl of Wormwood, Mints, and Spike, of each half an ounce: Oyl of Nutmegs, two drams: Wood of Aloes, Mace, and Cinnamon, of each one scruple; with a little Wax make a Liniment, which will be better if you ad six drops of Oyl of Cloves, and of Musk and Amber∣greece, of each eight grains.

Also there is a Liniment of Oyl of Nutmegs, Balsom of Peru, or of Oyl of Wormwood, Mastich, and Balsom of Peru.

Take of the Emplaister of Mastich one ounce: Aromaticum Rosatum one dram: Oyl of Nut∣megs as much as is fit to make a Plaister like a Buckler for the Stomach.

Crato doth wonderfully commend this following Plaister:

Take of Labdanum two ounces: Wax four ounces: Oyl of Nutmegs three drams. Make an Emplaister.

Galen adviseth 7. meth. not to keep these Plaisters long upon the part, for at length they will dis∣solve the heat.

Many Practitioners do not only apply these Remedies before to the Cartilage called Xiphoides, like a sword; but also behind upon the thirteenth Vertebra, because the proper orifice of the Sto∣mach inclineth backward; but the thickness of the Vertebra is such, and of the Muscles under them, that the strength of the Medicine cannot pierce through to the Stomach.

Take of Galangal, and Calamus Aromaticus, of each three drams: Mastich, and Cloves, of each two drams: one Nutmeg: dried Citron peels half an ounce: Annis seeds one dram and an half. Make a bag of these being bruised and put into red silk pricked through, and into musked Cotton, to be worn alwaies upon the Stomach.

The Skin of a Vultur dressed and worn upon the Stomach, is commended for the same: in want of which a Hairs Skin, or a piece of Scarlet may be used.

Chap. 2. Of Dogs Appetite, called Fames canina.

HAving in the former Chapter spoken of Appetite diminished and abolished, now we shall speak of it depraved. And this is done two waies: When it either offendeth in quantity or quality. It offends in quantity when nourishment is required in a greater quantity than Nature would; and this is called Boulimia, or Dogs Appetite: It offends in quality when things are required which are evil, or are not food, and this is called Pica or Kitta. Of the first we shall speak in this Chapter, of the last in the Chapter following.

The word Boulimia comes apo tou bou kai limou, because the Particle Bou put to other words, encrease the signification, as if it were compared to the greatness of an Ox. It is also called Phagedaina, which word is given to Ulcers which eat the flesh and enlarge, and therefore called Ʋlcera Phagedaina, that is, spreading Ulcers. Now it is called Fames Canina, or Dogs Appe∣tite, because they who have it are hungry as Dogs.

But you may observe that these two words, Boulimia, and Fames Canina, are somtimes con∣founded, and used for the same thing: and somtimes distinguished, so that it is called Fames Ca∣nina, when after much feeding they vomit like Dogs. But some purge rather than vomit, when Na∣ture throweth down that which it cannot concoct. In Boulimia, vomit doth not follow, but som∣times Lipothymia. There are some who feed unsatiably, and yet vomit not, nor purge, but concoct all, and if they have not presently more, are sick. As Sennertus reports of a Scholler, who was black colored, who eat not only in the day, but night, and digested it without vomiting; he could not be satisfied with delicate meats, but required gross, and therefore would eat no Bakers Bread, but such as the Country people made, and would eat as many raw Parsnips in a Summer morning as could be bought for six pence, without damage.

Hence it appears that this disease is a Symptome of an action depraved, in respect of quantity, which action being encreased, is called Dog-like, or an Appetite beyond Natural Measure. The part affected is chiefly the mouth of the Stomach. The cause containing, is sence of sucking, and ve∣hement pulling, which stirs up the Appetite.

Galen 2. de symp. caus. cap. 7. reduceth the immediate causes of this Disease to two Heads, in these words: Evil Appetites exceeding in quantity, which are called by some Caninae, are then, when either some evil sharp Juyce biteth the Stomach, or when the whol Body immoderately con∣cocting, wants nourishment; for evil Juyce which is cold, biteth like the Natural sucking, and pro∣duceth appetite by the resemblance of Nature. The immediate cause of a preternatural Appetite, according to Galen, is first a vicious humor, and cold, sticking to the Stomach: Secondly, want of Food by over much concoction.

Evil Humors sticking to the Stomach, cause immoderate Appetite, because they by their too much coldness, sharpness, and sowrness, do constringe, wrinkle, and pull the mouth of the Stomach, and so make a sence of feeling like a natural sucking, and beget a false Appetite.

This Humor is either sowr flegm staying long in the Stomach, or many times Melancholly sent from the Spleen into the Stomach, which in a natural state, and a moderate quantity and quality be∣gets a moderate and natural Appetite; but if it be preternatural and exceed, it makes the Appetite too great.

The want of Food, by reason whereof the Veins do continually suck from the Stomach, either it comes from too great Evacuation by bleeding, purging, vomiting, sweating, and the like, or from too great a Consumption of the alimentary substance, by reason of the immoderate heat of the parts, or the thinness of the humors, and body, and loosness of the pores, watchings, baths, immoderate exer∣cise, much venery; all which do dissolve the substance, making humidity; and by these emptiness being caused, and want of food, the meat is carried from the Stomach sooner than it ought.

Also this Fames Canina, or Dogs Appetite, may come from Worms which devour the Chylus; as Trallianus reports, lib. 7. cap. 4. of a Woman in this Disease, which voided a worm twelve ••ubits long by the use of Hiera, and was cured.

The Hermetical Physitians do lay down another cause of this wonderful Appetite, namely, a cer∣tain dissolving Spirit begot in the Body, which by an inhaerent property doth so readily consume whatsoever meat is taken, so that it doth not allow Nature a lawful and necessary bound of nourish∣ment. This they call a hungery devouring, salt, sharp, vitriol Spirit. For say they, as from divers Salts, Vitriol, Niter, common Salt, and Salt Armoniack, with the like, Aqua fortis is made by Chy∣mistry, which will dissolve the hardest Stones, Mettals, into Liquor in a short time; so that Gold which will not be dissolved in a month by a strong fire, in a quarter of an hour will be dissolved in Aqua regia, and be turned into a Liquor of the same color.

This Doctrine is diligently to be examined; for as the digestion of the Stomach in its Natural con∣dition hath somthing to be admired by the curious Searchers into Nature; so the same being made preternatural hath somthing to be wondered at.

This is wonderful in the Natural digestion of the Belly, that the hardest meats are digested therein, and in three or four hours space are turned into a Chylous Liquor, so thin that it may be strained through the narrowest branches of the Venae lacteae; and that Dogs do turn the hardest bones into the same Liquor, is not to be attributed to a stronger concocting heat, because meat in a pot, al∣though the fire be never so hot, cannot in twenty four hours, or many daies be converted into the same. The Galenists hold that this comes from the faculty of the Stomach, which faculty works not with∣out an Instrument, because if there is an Idiosyncrasia, or a certain proportion of the first qualities, as is commonly reported, its chief action must be from heat; for cold, moisture, or driness, do nothing to that great dissolving of food, and heat, as it is said, hath not that power. Therefore the Idiosyn∣crasia is somwhat more unknown, and not to be expressed. Let us therefore search after it in the Macrocosm or grater World, of which there is a great Analogy or resemblance in the little World. And therefore the more witty Hermets say that there is a certain Spirit or acide Liquor sent from the Spleen into the Stomach, which dissolveth the solid nourishment, and shortly converteth it into Chy∣lous Liquor, and that is the principal Instrument of digestion. And some conjecture that this may be made, because Birds who digest the hardest nourishment have a Spleen round about their Maw; for the flesh which is found about their Stomachs is like the substance of a Spleen; from whence there is a more noble use of the Spleen than what is allowed by the Ancients, who said that it was only for the purging of the grosser sort of Blood; because according to this opinion it serveth for concoction of meat. Therefore if the Spirit or sharp Liquor which comes from the Spleen when it is in its Natu∣ral condition, makes a natural and moderate digestion; the same spirit being altered from its natural condition and defiled, or made sharper or more dissolving, it will sooner dissolve solid nourishment; and when they are so dissolved and thrown from the Stomach, it will make a new immoderate Appe∣tite. We do not conclude that this new Doctrine is certain and undoubted, but we only shew it that solid wits may examine it. And we will talk of it again when we speak of the causes of the hin∣derance of Concoction.

The signs by which this disease is known are manifest; for it will appear to them that eat, and to the standers by, that the Appetite is depraved which causeth such devouring of meat, which after∣wards is thrown up by vomit, and then it is Fames Canina, and if Vomits follow not, then there is fainting, with coldness of the extream parts, and this is called Boulimia.

The signs of the Causes may be found by the Antecedents, Concomitants, and Consequents. These are the signs of a cold distemper, and of sharp humors in the Stomach, belching, and sharp vomiting, crude dejections, or stools, want of thirst, and external Causes of refrigeration afore going. If it come from defect of Nourishment, the Patient is lean, and there are causes present or fore-going of the dissolving of the Humidity; and lastly, the signs of Worms shall be spoken of in their proper Chapter.

The Prognostick of this Disease, is thus: If it come only from External Causes it is not dangerous if they be presently taken away: And if it come of Worms there is little danger, for when they are taken away the Disease is cured.

But it is very dangerous if it follow great Evacuations and meltings of the body; especially if af∣ter meat when the belly is yet ful there come a fainting; for when that which should most help, be∣comes unprofitable, it signifies a great distemper of the Stomach.

So a Dog Appetite continuing with Vomiting and great Purging is dangerous, for it useth to end in an evil habit, dropsie, lethargy, consumption and the like.

As for the Cure, because Fames Canina for the most part takes its Original from Melanchol∣lick and Flegmatick Humors fastened in the Mouth of the Stomach; therefore Medicines must principally be directed to them; such as do empty and change the Humors and also strengthen the part affected.

You must Evacuate by Vomit or Stool with Medicines Prescribed in the Cure of Want of Appe∣tite from a Cold Cause; for although these Diseases are contrary, yet come they from the same Hu∣mors, different in the degrees of Coldness, and second Qualities, and such as diversly affect the Stomach.

Also the Remedies there Prescribed to heat the Stomach and strengthen it both internally and ex∣ternally are excellent, because they not only correct the Cold Distemper, but dry and cause thirst; and thirst coming, hunger is diminished.

Moreover, Wine plentifully taken asswageth hunger, according to Hippocrates, Aph. 21. Sect. 2 And especially the Spirit of Wine, or Aqua Vitae.

They do properly stay Hunger which do much moisten the Stomach, relax it, and asswage the sharpness of humors. As al Fat things and Oyls, as Villanovanus reports, That one thus diseased did eat a hot Loaf dipp'd in Oyl; and a Woman drank the melted Sewet of an Ox with as much warm Oyl at Twice, and both did so Disdain Meat, That they eat nothing in Five Dayes, and were Cured.

Narcotick Medicines by Dulling the too exquisite sense of the Stomach, do lessen this Disease; and new Treacle is most usual for it because besides its stupifying quality it doth correct the malignity of the Humors which is some cause thereof.

But because these are to be used but seldom and not without urgent necessity, somtimes you may use old Treacle, for the reason aforesaid, as also to strengthen.

Five or Six Grains of Amber-greece taken in a rear Eg doth not only strengthen the Stomach, but by a special quality cureth this Disease.

Chap. 3. Of Pica and Malacia.

PIca and Malacia, are a depraved Appetite; by which, evil, unprofitable, and hurtful things are desired.

It is called Kitta or Pica from the bird called a Pye, either in regard of the variety of colours, or because it eateth lumps of Earth, for Women in this Disease use to eat Earth and Chalk, and the like: It is called Malacia by Pliny, for these Women through Weakness of mind, and tenderness, want that right and natural Appetite.

This Disease comes of evil corrupt Humors, which are gathered into the Stomach by reason of its hurt Concoction, or else sent from other parts.

Flegmatick and Melanchollick People are most disposed for the production of these Humors, e∣specially Women, to whom this Disease seems proper and peculiar; although somtimes Boyes and Men, though seldom have the same: Eating of evil Diet doth cause this, want of any natural Eva∣cuation, especially of the Terms, Sadness, Distemper of the Liver and Spleen, Obstructions and Weakness, divers diseases of the Womb, and the like.

These Vitious Humors according to the divers degrees of distempers and other dispositions have a diverse nature, from whence come divers appetites of evil things: For since som Humors are crude and inconcocted, others burnt, and adust; some require sowr things, sharp, bitter, and very cold, so that they are delighted with the continual use of unripe Fruits, Vinegar, Juyce of Lemons, Pome∣granats, and Orenges, cold Water, Snow, Ice, and the like. Others desire Earthy, Dry, and Burnt things, as Gloves, Cinnamon, Nutmegs, and other Spices, Salt-Ashes, Chalk, and the like.

This Disease is Common to Women in the Chlorosis, or Green-sickness; to Women great with Child; and such as have their Terms stopped; which staying in the Body corrupt, and ascen∣ding do infect the Stomach, from whence its Actions are depraved, and chiefly the Appetite is taken from its natural Condition.

Boyes are somtimes troubled herewith, and especially if they are born of a Woman that hath the Chlorosis: Nor are men altogether free from it, although it happen seldom; and they are e••pecial∣ly troubled therewith who are Melanchollick, have Obstructions, or want their usual Flux of the Haemorrhoids.

It is Disputed much among Authors, Whether a Depraved Appetite require those Things which are like to the Preternatural▪ State or Distemper of the Stomach, or those that are Contrary? Galen

raised the first Dispute, cap. 3. artis parvae, where he teacheth, That the Stomach being distempered, doth desire Contraries, and in its natural state and temper it desireth things like to its self. Which Doctrine Avicen following, Fen. 13. lib. 3. tract. 2. cap. 10. speaks thus, When there is an evil Hu∣mor gathered in the stomach, different in quality from its own nature, then it doth require things contrary to it; therefore some desire Clay, Coals, Earth, Loam, Chalk and the like, by reason of the quality that is in them, to dry up and cut that which is contrary to the quality of the Humors: But they who are in health desire judicially rather things like, than contraries; for since fancy is much im∣ployed in stirring up of Appetite, and is much stirred up from the disposition of the body, it is pro∣bable that the humor predominating should move the fancy to desire things like unto it; For as chol∣lerick men both in time of health and sickness, do dream of Fire and Anger: and Flegmatick men of Snow, Ice, and Waters: the Apprehension of which things proceeds from the Humors predomina∣ting in the body: So when the seat of Appetite the mouth of the Stomach is affected by foul humors there long con••inuing, they do imprint their similitudes in the Fancy which stirs up the Appetite to desire things like it though never so contrary to reason, which is now overcome by the force of ima∣gination.

Moreover, If things contrary to the disease or its cause were desired by the continual use thereof, the disease would be cured; daily experience confirmeth this.

By which we are taught, That Virgins in the Green-sickness, and Women with Child, do for the most part desire those things which are agreeable to their present Distemper and evil Habit, so that they who have Salt and Adust Humors long for Coals, Salt, Spices, and the like: but they who have Melancholly or Salt Flegm predominating, desire Vinegar, green Fruits, and the like.

As for the Authority of Galen, some wholly reject it; saying, That if it were true, That Diseased Dispositions should desire their Contraries, al sick men, of evil Habit, would desire Meat of good nourishment; which is not true, for we often see that sick men desire evil meats, and refuse good: and we see that bodies inflamed, whether they are in a preternatural state, as in Feavers; or in▪ a na∣tural, as by violent exercise, require cooling.

Some desire to Reconcile this Opinion of Galens, saying, That in this Pica the distemper upon the Stomach is habitual and connatural, and therefore doth cause an Appetite like to a natural, which is for things like it; which may be thus explained, When we say that every natural temper doth require the like, and every preternatural the contrary; the last is to be understood of distem∣pers which come without overflowing moisture; for they which are with much moisture when it is sucked up by the tunicles of the Stomach, do rather desire things like the moisture with which they are wet, because the Humor which now pierceth al the Tunicles although it be noxious, yet it is not troublesome: On the contrary, when the humor only possesseth part only of the Stomach, or is on∣ly in the bottom, the Stomach desires the contrary to that which is offensive unto it; but if it pos∣sess the whol Stomach, and be soaked into its Tunicles, then the natural Faculty is destroyed and so changed, that it doth not desire any thing but what is like to the Humor so soaked in, and so it may be rightly said that the humors was become as it were connatural.

Platerus and Sennertus do easily free themselves from these difficulties, by flying to an occult qua∣lity, and they take occasion from hence, if the Patients so affected should require things like to the cause of the disease, then by the plentiful use of them the disease would be exceedingly encreased, but we see that they wil devour Chalk, Clay, Coals, and the like trash, and receive not the least hurt thereby, by which men that are sound would be almost killed.

Moreover, They say that Women with Child wil often void salt and sowr humors, and yet not re∣quire salt or sowr things, but the contrary. And lastly they affirm constantly that there is no agree∣ment of Coals, Chalk, raw Flesh, and the like with the Humors. And therefore they say that they must not rest in manifest qualities, and that the Cause of this Symptome and wonderful Appetite cannot be taken from them, but they must fly to some occult quality not to be ex∣plained.

Yet Sennertus confesseth that it is probable that this Appetite depraved, should proceed rather from a like than a contrary quality: but what that quality is cannot be explained, because the things which are desired have no agreement with the humors either sweet, salt, or sowr in manifest qua∣lities.

We may Reconcile al these thus:

The desire of Trash is stirred up by humors of the like nature and temper, but these humors besides their native temper have a certain peculiar fault from corruption, which since it cannot be wel explai∣ned, it may be called an Occult Quality.

The Knowledg of this Disease is easie, for the Patient can relate it; it is manifest that the part af∣fected is the mouth of the Stomach, for that is the Seat of Appetite. The Cause also may be found out by conjecture from the supposed desire of things like. For if they desire Coals, Salt, and the

like, we may gather that the disease depends upon Salt and burnt humors, which will more cleerly appear, if any of those Humors be cast forth by vomit or stool, if there be sharp belchings, or salt, a tast bitter, sowr, or salt.

As to the Prognostick; This Disease is Chronical, of continuance, but not very dangerous, if the Body by Nature or Art may be brought to its old condition, which is not very difficult. For in time the Humor offending may be sent forth by vomiting naturally, or by Medicines: and the Terms or Haemorrhoids stopt, which caused this disease first, may in time be discharged; which if neglected, and Nature sinks under the burden, great diseases follow: For when the first Concoction is hurt, it is necessary that the second and third be corrupted, from whence come great Obstructions, evil ha∣bits, and dropsies. Or if the Humor be carried in greater plenty to the Stomach, and partake of grea∣ter Malignity, somtimes it produceth violent Cardialgiaes, or Heart diseases; from whence fainting, swooning, and somtimes death doth follow.

If Women in this disease begin to abstain from trash, and to eat good meat with less disdain, it is a most certain sign of health at hand.

Women with Child use to be freed of this disease about the fourth month, because then the Child is grown greater, and so consumeth more of the humors, and the mother hath sent it forth by often vomitings; but if it last longer, 'tis dangerous; for it signifies that the evil disposition of the Stomach hath taken deep root, which will hardly be pluckt up.

It is better for people in this disease to desire sharp and sowr things; it is worse if they desire things contrary to Nature, as Avicen teacheth, fen. 13. lib. 2. tract. 2. cap. 20. for it signifies a greater di∣stance from the Natural state, which is harder to be cured.

The Cure of this disease is divers, according to the variety of the Bodies affected.

In Women with Child, few Medicines are to be used, by reason of the unfitness of the subject, and danger of Misearriage, but you may give them gentle things, and such as were prescribed in the Cure of want of Appetite to clense and strengthen the Stomach. Nor must you omit blood-letting, which done sparingly and often, is of great consequence.

But in Virgins of the Clorosis, or green sickness, this disease is cured with the same Remedies, which shall be prescribed for the Cure of Clorosis in its proper place.

But the Pica which is in men, is very seldom, because it comes from obstructions of the Liver and Spleen, you may use those things which shall be prescribed for the Cure of them.

Chap. 4. Of the Thirsty Disease, called Sitis Morbosa.

THe Appetite of Drink, or Thirst, may be three waies hurt, as that of Meat, by diminishing, abo∣lishing, and depraving; it is diminished many times by a sweet insipid humor, which moiste∣neth the Tunicle of the Stomach, or from too much moisture in the whol Body, from whence it is that the parts do not draw the drink from the Stomach. It is abolished by acute Diseases through in∣terception of the sence, when the mind is sick, or because the Natural Faculty is decayed by the ex∣tinction of the Natural heat; from whence Hipp. saith, It is evil not to thirst, when a cause of thirst is taken: and since thirst diminished doth depend upon the same cause, from which want of Appetite is produced, and thirst abolished, is only in acute Diseases, we shall not speak here of them particularly. But we will only speak of thirst depraved, as being most usual: and this is to be divided two waies, and Hunger. The one requiring divers kinds of Drinks; the o∣ther great quantities, and often. That which desireth filthy drink is to be referred to Pica, as when they desire Vinegar, Lemmons, and salt Water. It remains that we speak of thirst encreased, which is an usual Symptome when the Appetite offends in the quantity of Liquor, and much drink is de∣sired.

The immediate Cause is a want of moist nourishment, and driness of the Stomach, and of other parts which make the Stomach sensible of their wants.

This driness and want of moisture, useth to come from all such things which can consume the dewy moisture of the Stomach and the whol Body, and dry it up, and they are hot and dry. The dry do principally suck up the Humor, and the hot things secondarily.

Also this disease is either by Propriety, or by Sympathy. It is by Propriety when the innate moi∣sture of the Stomach is altered and drawn forth by an unequal distemper, dry or hot, or both; som∣times by a simple distemper, but often by that distemper which is joyned with matter; as a salt, sharp, or filthy humor fixed in the mouth of the Stomach, or contained in its Cavity. But that which is by Sympathy, comes by consent from the whol Body, or some part whose Veins having lost their moisture, do suck from the Stomach; as it is in Feavers, Inflamations of the Liver, Lungs, and other parts, as also in hot and dry distempers, especially of the Reins, as you may see in a Diabetes, or in∣voiuntary

pissing, which is called by the name of Dipsacus, by reason of the great thirst which accom∣panieth it.

The outward Causes are all such as extraordinarily heat or dry, as very hot and dry Air, long con∣tinuance in the Sun, or at the fire, use of Salt meats, sharp, and spiced, much use of old rich Wine, great watchings, too much evacuation, especially by purging.

The Hermetical Physitians say, that immoderate preternatural thirst comes from some thirsty spi∣rits which are bred of Sulphureous excrements, which will not be satisfied with simple cooling and moistening, but with other Spirits like unto themselves; as we see in Feavers that a strong thirst is little allayed with much Water, which with sharp Spirits of Vitriol, Sulphur, Salt, and the like, wil be satisfied with a less quantity of Water.

The knowledg is easie, for the Patients will complain. But the Causes are known by their pro∣per signs; as a hot and dry distemper cleaving to the Stomach and other parts; as also sharp, salt, and bitter humors, some whereof are somtimes cast forth, or they have their tasts in their mouths, if the humors are in the Stomach; but if thirst come by consent from other parts, the signs of those Disea∣ses will be manifest.

As to the Prognostick: That thirst which comes from Primary Causes is safest, for that is quen∣ched presently with drink. But that which comes from internal Causes, is more or less dangerous, according to their differences.

That thirst which comes with Feavers, and other easie cures, endeth with them. But if it come from great and dangerous Diseases, it is very dangerous; as in a Dropsie in which thirst is not slacked, but rather encreased with drink.

The Cure of this Disease is often in Feavers, and Inflamations of some parts; which is described sufficiently in our Method of the Cure of Feavers, Sect. 2. Cap. 2.

But if Thirst be contracted by immoderate Evacuations causing a dry distemper of the Stomach, and other Causes, the Cure is by suppressing those Evacuations, and by restoring the empty parts with moist Medicines.

Therefore first, having ordered a restoring Diet, as in a Hectick Feaver, Consumption, and Maras∣mus. Two Remedies prescribed by Galen are the best, 7. meth. namely, Milk and Baths. Although Hippocrates, Aph. 64. Sect. 5. forbids milk to thirsty people, that is to be understood of those who thirst from abundance of Choller, and putrid Humors, in whom Milk is easily putrified; not of those who thirst from driness and Consumption. We shewed the use of Milk in the Cure of a Con∣sumption.

Let the Bath be made of the Decoction of Althaea Roots, and Lilly Roots, with Mallows, and Vio∣let Leaves, and of a Decoction of the Heads, Feet, and Guts of Sheep, or melt fresh Butter, or Oyl in warm Water, to be changed often.

Going out of the Bath, let the Loyns, Back, and Stomach be anointed with Oyl of Violets, the Mar∣row of a Veal Bone, and the like, with which let as much Breast, or Goats Milk be mingled, as they will receive.

Let the Patient in the mean while use restoring Syrups and Lozenges, and other Remedies which shall be laid down in the Cure of an Hectick Feaver.

This following Opiate is excellent:

Take of Eryngus Roots candied, and Conserve of Bugloss, of each two ounces: Conserve of Violets and Borrage flowers, of each one ounce: Confectio Alkermes half an ounce: Diapene∣dion newly prepared without the Species, two drams: with Syrup of sweet Apples make an Opiate, of which let him take the quantity of a Chesnut at the time of thirst, drinking after it a little Bor∣rage Water.

Chap. 5. Of the Hurt Concoction of the Stomach.

THe Concoction of the Stomach called Chylosis, as of all other parts, is hurt three waies, either by diminishing, abolishing, or depraving. This Concoction diminished is called Bradupepsia; the abolished Apepsia; the depraved is called Dyspepsia; all which differences are comprehended in this one word Crudity. Now this Crudity is two-fold: either nidorous, stinking, and acidous, or sharp. The nidorous Crudity is when the nourishment is turned into a stinking, burnt matter, as when the stink of Eggs, or rotten fish, or fryed Oyl, is smelt by belching, which happens often in hot Chollerick Bodies. But a sharp sowr Crudity is when meat turns sowr, and the belchings are sowr, and this comes from a cold distemper. To these you may ad a third difference of Crudities, when by reason of weak heat the matter is imperfectly concocted, and is turned into flegm without sowr∣ness.

The Causes that hinder Concoction in the Stomach may be brought into three Heads, namely, a fault in the Organ, Object, and things External and Internal.

The fault in the Organ comprehendeth all diseases in the Stomach, whether they be Similar, or Organ cal, or Common, all which may overthrow its actions, but distemper is commonly the cause of hurt Concoction; for since Concoction is made by a moderate heat according to Nature, if at any time it want its due moderation, the Concoction is hurt. So a cold distemper of the Stomach which diminisheth the Heat, if it be gentle it only weakeneth the Concoction, and make a Brylypepsia, or slow Concoction. If the cold distemper be greater, it abolisheth Concoction, and makes Apepsia. But a hot distemper doth deprave Concoction, and make a Dyspepsia, which is a difficult Concocti∣on. These distempers are somtimes simple, and in such who have Naturally a weak Stomach, and smal Natural heat; or have a sharp and burning heat, but they are commonly with matter: hence in Hypochondriack Melancholly, much flegm and fermentation of a black Humor use to cause Cru∣dities, Winds, Swellings, Rumblings, and sowr Belchings.

The fault of the Object, that is, the nourishment which is the proper Object of the Stomach, comes many waies, when it offendeth in Substance, Quantity, Quality, time, or Order of being taken.

Nourishment is vitious in respect of its substance, when it is too hard and difficult to be concocted, as Deers flesh, Hairs flesh, especially if old, and made hard with Salt or Smoak, Bread full of Bran, Mushroms, Roots, Pulse, and the like, which are called Dyspepta.

Meats offend in Quantity when too much is taken at once, and therefore cannot be overcome by the heat, hence come Crudities, which are most usual among them who do surfet themselves. If there be less eaten than is required, it may seem to be crude, because too little meat will be burnt and dryed in a Chollerick Stomach.

Meats offend in Quality which are too cold and moist, and windy, or they which are too hot, whereby the thinner part of the Chyle is burnt, and turned into nidorous vapors.

To this may be reduced the Art of Cookery, and Sawce-making; for the divers waies of roasting, boyling, and making of Sawce, do alter the disposition of Meat, by which means they be∣come more easie or hard of Concoction.

The time and order of eating being preposterous, may also spoil the Concoction, as if any one should omit his usual time of eating, and fall to at midnight, or a little before he goes to sleep, fill his Stomach; or if after taking of solid and astringing things, as Cheese, Pears, Quinces, and the like, they take liquid things which do soon corrupt.

Also external things may spoil the Concoction, if they be immoderate: so too cold Air by dulling the natural near, if it be weak or too hot, by dissipating the heat may hinder Concoction; as also im∣moderate exercise, especially after meat, by drawing the natural heat forth from the Stomach to the external parts, and so dispersing it extraordinarily; as also by throwing the Chylus yet imperfect into the Guts. The stoppage of the Belly and other excrements, or an immoderate flux, great wat∣chings, sleep in the day time, great passions of the mind, especialy sadness, and deep study presently after meat, and the like, do not a little hinder the action of the Stomach.

Besides the Causes mentioned, the Hermeticks of late time mention one less usual, and not noted by the Ancients, which also is not plainly demonstrated by them; but it is confirmed by some con∣jectures, not to be contemned; of which we made mention in the explaining of the Causes of Fames Canina. First therefore they ashrm that the Natural Concoction of the Stomach is not made by heat only; but that quick melting of solid meats by which it is converted into Chylus, is from another cause; since Experience teacheth that meat boyling in a pot at a strong fire many daies, will never be dissolved: and bones in a Dogs Stomach are quickly dissolved, and turned into Chylous Liquor; and in the bellies of Fishes which have no actual heat, all that is brought in is dissolved and concocted the same way. Therefore they lay down the principal Cause of this dissolving to be a certain Spirit or sharp Liquor sent from the Spleen into the Stomach, which hath great power to dissolve. And they take this opinion from Galen, by whom it is confirmed that a Melanchollick Humor sent from the Spleen into the Stomach, doth cause appetite, and that either by astringing or wrinkling the inner Tunicle of the Stomach, or pulling of it by its sharpness, which may be opposed; for if it do it by a∣striction, then all astringent things would do the same; and if by pulling, sharp things rather than sowr would provoke Appetite. Therefore they think it more probable, that that humor should stir up Appetite by accident, by causing want of nourishment, by dissolving of that which comes in. And therefore they allow a more noble use of the Spleen than ever the Ancients thought of, namely, to be a chief instrument to serve the Stomach in Concoction: This may be conjectured from Birds which dissolve the hardest seeds, and have a Spleen round about their Stomach or Maw, that it may more po∣werfully inspire that dissolving Spirit, or communicate unto it sowr Liquor. And Helmont from his own experience saith, that that sowr Spirit is very strong in Birds; for he relates that when he was a Boy and kept a Sparrow, he gave it his Tongue, which the Sparrow catching with his Bill disired to

swallow; and that touching the Throat of the Sparrow with the tip of his Tongue, he sound it ex∣ceeding sharp. The dissolving Spirit inherent in the Gizzards of Birds is proved from Physical Pra∣ctice, in which the Gizzards of Hens for to help Concoction are usually prescribed in digestive pou∣ders, and it is credible that they produce that effect by helping the dissolution of the meat, and the same are prescribed in the Stone, and they do much dissolve them; and that is more manifestly de∣clared in that from the Gizzards of Birds, there is a salt taken which is excellent to dissolve the Stone: out of which salt, being in grea plenty in their gizzards, Nature being wi••e and provident knows how to draw a spirit in a living Creature, by help whereof with the natural heat she may dissolve solid nourishment: and it is ordinarily seen, that there is a spirit made of dissolving salt, as of Vitriol, Niter, Armoniack, and common salt, which is more powerful to dissolve.

Therefore the Spirit or sharp Liquor which is sent from the Spleen into the Stomach while it is in its natural state makes a laudable Concoction, but if it be changed it overthrows he actions of the Stomach as aforesaid, from these Positions, That a Dog Appetite was stirred up, when that spirit or acid Liquor, is too active and powerful to dissolve: So on the otherside, if the dissolving power be too weak, or be detective, there followeth a diminished or abolished concoction. Hence Helmont sai••h, That the 1. Aph. of Hipp. Sect. 6. which is this: In long raging of the Guts, if sowr belch∣ings arise, which were not formerly, it is a good sign; is thus to be interpreted, because that sowr belching signifie that that fermentation which was lost by the disease begins to return.

Let us hold up this new Doctrine by our own Experiment, for in the yeer past, 1648. we had a great Flegnatick and Melanchollick Flux for four months, and were brought thereby to extream leanness, by reason al our nourishment turned into a Flegmatick and slimy substance, from the de∣bility of the Stomach which could not wel concoct the same, after many Medicines used al along that time, the chief part wherof prosited little or nothing, at length by the often use of very sharp Vinegar in a few dayes we were perfectly cured of that violent disease; by the force of which Vinegar we may conjecture that the natural sowrness which was almost lost was much restored: We used this Vinegar at our meat with hard Egs, which being cut in pieces we dipped therein, and for some dayes we con∣tinued the use thereof in all our meates: And we manifestly perceived that if the Vinegar was not very sharp it did our Stomach little good.

The Knowledg or Diagno is of this Disease, according to the differences of hurt Concoction is divers: And 〈◊〉〈◊〉, Apepsia and Brady pepsia are known by the same signs only differing in degrees: and these signs are sowr belonings, vomiting or purging forth of food either not, or but half concoct∣ed, some causes of refrigeration went before, there is a weight, extention and inflamation in the sto∣mach, inconvenience by taking cold things; thin urine, waterish, and pale; somtimes thick and red from that impure and silthy juyce which by reason of the imperfection of the first concoction could not be separated from the Chylus, but being sent to the Reins with the serous humor, makes the urin soul, such as meth to be voided by Melanchollick and Scorbutick persons.

See the Explication of this Urine more at large in Sennertus, lib. 3. practimed. part. 8. sect. 2 cap. 7. but the shew Concoction depraved, or Dyspepsia, Nidorous stinking belchings, the like taste or stink in the mouth, sense of thirst and heat, inconvience by hot things.

If the Stomach is affected principall, there wil be the proper signs of its Disease; but if by con∣sent, this sympathy is to be sound out from the proper signs of the part affected: but if the sym∣prome depends upon the fault of external causes, or of the object, it wil appear by the relation of the Patient and those that stand by, from the present or foregoing Constitution of the same.

The Pregnostick is thus made; the fault of Concoction which comes from external causes is easily helped, by taking away those causes is easily helped, by taking away those causes, and by ordering a good diet.

Concoction hurt is more easily cured when it comes of humors which are brought from other parts into the stomach, then when it is only from the stomach: for as if those humors are purged before they fasten any disease in the stomach, concoction is restored.

The Ab••••••shed Concoction of the Stomach is worst of al, because the whol nourishment of the body is frustrated, from whence comes most deadly diseases, as Lientery, Dropsie, Atrophy, and 〈◊〉〈◊〉.

The Concoction Diminished brings its inconveniencies, as Chollick, Cachexy, or evil Habit, and so••••ume divers sorcs of Drop••es.

The Concoction Deptaved is the Cause of many Evils; of Obstructions, Scabs, Feavers, and the l••ke.

〈◊〉〈◊〉 ••ure is wrought by taking away Causes external, antecedent, and conjunct, which do cause, 〈◊〉〈◊〉, and preserve this disease.

And first observe, if the humors be brought from other parts into the stomach, and in this cafe they must first be Evacuated and Revelled, the disease of the part sending those humors is to be amended, and the stomach strengthned, the cures of the diseases of other parts must be taken from their proper Chapters: But the strengtnening of the stomach may be taken from the cure or the Want of Ap∣petite.

But the Hurt which comes to the Concoction from the proper fault of the stomach, that chiefly takes its beg••nning from cold or hot humors; and therfore requires the same cure, which was propoun∣ded for Want of Appetite coming of the same Causes, which we wil not repeat.

Lastly, If the proper Cause of the Hermeticks afore-mentioned be worth observing, you must look to it; first correcting the Evil state of the Lwer, and then restoring the Spirits dissolving, with some acid substance; of whith kind is Spirit of Sulphur, Vitriol, Salt, juyce of Lemons, Pomegra∣nats, Orenges, and Vinegar.

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.

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.

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.

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.

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.

Chap. 11. Of the Inflamation, Ʋlcer, and Im∣posthume in the Stomach.

ALthough al kinds of Tumors may arise in the Stomach as wel as other parts, yet we wil speak here only of a Phlegmon or Inflamation, which is most usual; the other happen seldom, and may be Cured by the same Method with the Tumors of other internal parts.

The Inflamation of the Stomach is a preternatural Tumor coming of Blood which is sent into the substance of the Stomach and its Membranes by the Veins derived from the branches of the Vena Porta.

This Blood is either pure and makes a proper Phlegmon, or mixed with Choller, Flegm, or Me∣lancholly, and makes a Phlegmon Erysipelatous, Oedematous, or Schirrous.

The External Causes may be many, al that inflame the Blood, as hot meats, wine, or al that can drive it to the part; as a blow upon the belly, especially when it is ful; to which you may ad things that are very sharp and very hot, as Cantharides, sublimate.

The signs of this Disease, called Diagnostica, are a great Pain, burning, pricking, distending and beating, reaching to the back; you may feel a Tumor, and somtimes see it, the shoulders are drawn downwards; the breathing is difficult, as also swelling and belching, somtimes blood is vomited; there is a most burning Feaver, with most greivous Symptomes.

If the Inflamation be pure only from blood, it is somwhat gentler; but if it be with Choller called Erysipeals, there are greivous Symptomes, and the febris called Lipyria in which the exterior parts are cold, and the internal burn, and there is an unquenchable thirst; such a kind of Feaver useth to be in an Erysipetous inflamation of the intestines.

Like to this Inflamation of the Stomach, is that which is in the upper part of the Liver by which the Stomach is covered or in that part of the belly which lieth upon it; which is only distinguished by the deadly Symptomes, for then the Stomach hath the most desperate.

From what hath been said is easie to Prognostick and to pronounce this Disease to be for the most part deadly.

But that is most Dangerous which is over the whol Stomach, or its upper part, or which is like to an Erysipetas.

Galen 3. Prorrhet. shews, That much Loathing and Rumbling of the belly, is evil: For it shewes that evil Humors do stick close to the Tunicle of the Stomach, and pul them to provoke Ex∣pulsion.

If the Inflamation do not kill, nor is dispersed, it turns to an Imposthume, which is known by the mitigation of the Pain and the Feaver, while the Tumor remaineth.

After the Imposthume is broken there remaineth an Ulcer which is known by voiding of Matter by Vomit and Stool.

But an Ulcer is produced in the Stomach, not only from an Imposthume, but from other Causes which we shal here reckon up, least we seem defective in the Theory.

The Causes of Ulcers in the Stomach, are either Internal or External.

The Internal are sharp Humors bred in the Stomach, or sent thither from other parts, as yellow Choller, or black, or salt Flegm.

The External are sharp Medicines that Corrode, or Poysons, and Wounds of the Stomach not wel Cured, which turn into Ulcers; as also the breach of some great Veins which could not wel grow to∣gether, after much Vomiting of blood.

An Ulcer bred in the Stomach is known chiefly by Matter which is cast forth by Vomit or Stool, to which principal sign there are others to be added: First there is perceived in the belly a pricking pain joyned with burning, especially when any thing is taken that is strong in quality, either sharp, salt, or sowr, or very hot, or cold: there is also no Appetite, stinking belching, and a constant lin∣gring Feaver.

The Prognostick is alwayes deadly, except the Ulcer be very little, and only in the superficies,

and without a Feaver. For the Membrane of the Stomach being ulcerated, being a Spermatick part, will hardly grow together again: the Nourishment will not be well concocted in a Stomach ill affe∣cted, but will be thrown out before concoction, and so rend the Ulcer. Moreover, Medicines do little good because clensers which are required for cure of Ulcers increase pain; and dryers which al∣so are required, are continually hindred by the Meat and Drink, and Chyle, and other Humors which continually are in a weak Stomach.

The Cure of the afore said Diseases, is several.

And first, the Cure of Inflamation is to begin with Blood-letting often in both Arms, as the strength will endure. And although by reason of swooning and coldness of the extream parts, the strength seem at first to be impaired, yet because it comes from oppression, it requires evacuation, and therefore blood-letting must not be denied.

Moreover, the opening of the Hemorrhoids, if the Patient be used to that evacuation, doth revel Blood from the Stomach. Also Cupping-glasses both dry, and with Scarrification to the Shoulders, Back, and Buttocks, with Ligatures and Frictions of the extream parts, and heating of them (becau••e they are usually cold) with hot cloathes, and anointing with Oyl of Flowerdeluce, and Spike, and other hot things are very good.

We disallow Purges in this case, because they trouble the Humors, and draw them to the part af∣fected.

But Avicen commends the Decoction of Tamarinds, or half an ounce of Cassia dissolved in Whey, or Endive Water if it be given every day to the seventh day, because they purge not by attraction, but by mollifying, mitigate sharpness, and asswage pain. But it is better in the beginning to abstain from all Purges. After the seventh day is past, when there appear some signs of Concoction and de∣clination, you may give a Purge of Rhubarb one dram, with one scruple of red Sanders infused in Borrage Water, adding one ounce or two of Syrup of Roses, that the filth which sticketh to the part may be brought forth more powerfully.

In the mean while, you must every day give Emollient, Cooling, and Lenitive Clysters, such as these:

Take of Chicken Broth, or the Decoction of Mallows and Violets, of each one pint: Cassia new drawn, one ounce: Oyl of Roses and Violets, of each two ounces: Sugar one ounce and an half: With two Yolks of Eggs make a Clyster.

You must give altering and strengthening Medicines at the Mouth, they may be the same which were propounded in the Cure of the Pain of the Stomach from a Chollerick Humor.

But the Syrup of Water Lillies, and of the Juyce of Purslain, are peculiarly good, especially in the beginning, because they supply the place of Repelling Medicines.

Also Emulsions made of the four great cold Seeds, and white Poppy Seeds are good, for they as∣swage pain and heat. As also these following Juleps.

Take of Rose Water three ounces: Plantane Water two ounces: the Juyce of Sorrel and Pome∣granate Wine, one ounce and an half: Sugar of Roses one ounce: Boyl them a little, and strain them. Let him take two ounces twice or thrice in a day.

If the pain be great, you may give the Syrup of Poppy.

Let his Drink be barley Water with Syrup of Violets taken cold.

In the progress of the Disease, you must mix other Medicines with the aforesaid, which may help to dissolve. To this end you may prescribe these following Juleps:

Take of the Syrup of Water Lillies, Apples, and of the Juyce of Purslain, of each one ounce: Syrup of Sea Wormwood half an ounce: Lettice, Sorrel, and Fennel Water, of each three ounces: the pouder of Diamargariton frigid one dram: Make a Julep for three Doses to be taken twice in a day.

To these you may adrestoring Opiates, Narcoticks, and the like, all which are to be varied many waies, according to the Judgment and Wisdom of the Physitian.

Turpentine washed with Wormwood Water, if it be given twice or thrice doth either dissolve or maturate the Imposthume of the Stomach.

Let this following Fomentation be applied in the beginning.

Take of Sorrel Roots two ounces: Endive, Succory, and Mallows, of each one handful: Let∣tice, and white Poppy seeds, of each three drams: white and red Sanders, of each half a dram: Violets, and Water Lillies, of each one pugil. Make a Decoction, adding a little Rose Vinegar. Let the Stomach be fomented warm therewith.

Or make one with the distilled Waters of Lettice, and Water Lillies with a little Vinegar, and Pouder of Triasantalon.

After fomenting, let the part be anointed with Oyl of Roses and Violets mixed, or with this fol∣lowing:

Take of Oyl of Roses one ounce and an half: Oyl of Violets, and Rose Vinegar, and of the

Juyce of Sowthistle, of each half an ounce: Boyl them to the consumption of the Juyces; then ad of red Sanders one dram: red Roses half a dram: Lavender and Camphire, of each half a scru∣ple: as much Wax as will make an Oyntment.

Cataplasms in the beginning are not good, because they burden the part with their weight, and by retaining the heat, encrease the Inflamation.

In the declination, when the Tumor is resolved, which is chiefly to be desired; you may apply a dissolving Fomentation, made thus:

Take of Flower deluce Roots two ounces: the Leaves of Mints, Marjoram, Penyroyal, Sea Wormwood, of each one handful: Annis and Foenugreek seeds, of each two drams: Grains of Kermes one dram: the flowers of Stoechas, Rosemary, Chamomel, of each one pugil: Make a De∣coction, adding in the end a little white Wine. With this foneent the Stomach.

After fomenting, anoint the part with Oyl of Wormwood, Nutineg, Spike, and the like; of which you may make an Oyntment with a little Wax and Pouder, Orris Root, or Cinnamon. But Emplasters and Cataplasms, because they burden the part with their weight, are not here good.

But if the Tumor tend to Suppuration, foment the part with the Decoction of the Flowers of Chamomel and red Roses: Then apply this following Cataplasm:

Take of Althoea Roots two ounces: Brank Ʋrsine, and Roses, of each one handful: Boyl them well, and beat them together: then ad of Barley meal, Lin-seed, Foenugreek and pouder of Cha∣momel, of each half an ounce: white and red Sanders, of each two drams: with Oyl of Roses, and Chamomel. With a little Hens Grease make a Cataplasin, often to be renewed.

After the Imposthume is broken, let the Ulcer be clensed with Hydromel, given in a smal quantity: To which you may ad the Manna of Frankinsence, according to Galens Precept. Or give it with Barley Water with Sugar of Roses in the beginning, in time of heat.

When the Ulcer groweth old, of what Cause soever it come, either from sharp corroding Humors, or burning Medicines, or Poyson, Broths of cool Herbs, and drying of Barley, Almonds, and Sugar of Roses, or new Milk with Sugar, and a little Honey, are very good. At length, Chalybeate Milk and Iron Water for ordinary drink; or Water wherein a piece of Bole-Armenick, or Terra Sigillata hath been steeped, is very excellent. To which you may put a little sharp Wine, if there be but lit∣tle heat in the part.

Then give this Apozeme:

Take of Barley one pugil: Scabious, Agrimany, Burnet, and Maiden-hair, of each half a a handful: Melone seeds two drams: red Roses dried, one pugil: make a Decoction to one pint, in which dissolve three ounces of Syrup of dried Roses. Make an Apozeme for four doses to be reap∣ted often.

Also the Decoction of China, is excellent for internal Ulcers, when there is no Feaver, taken twen∣ty daies, or more, sweating gently, for so the Ulcer will be dried by degrees. But if you fear a con∣sumption, boyl the China Root aforesaid in Chicken Broth, or Pidgeon Broth with the aforesaid Herbs, and Barley made clean.

In an old Ulcer, the drinking of Mineral Waters, either of Vitriol, Iron, or Allum, for a Month to∣gether, are very good.

In the whol time of the Disease to keep the Stomach clean, use gentle Purges, as Rhubarb, Tama∣rinds, Myrobalans, Syrup of Roses, and Diacatholicon, taken once in a week.

Lastly, To heal up the Wound, use these following:

Take of Bole-armenick, Terra Sigillata, red Coral, and Blood-stone wash'd all in Rose Water, of each one dram: Sanguis Draconis, Gum Arabick and Traganth, of each half a dram: white Poppy seeds bruised and parched, Hypocistis, Frankinsence, and Sarcocol, of each one scruple: Sugar of Roses one ounce: Make a Pouder, of which take a dram in Plantane Water, or Conserve of Roses every day.

Or make an Opiate of the same Pouder with Conserve of Comphry and Roses, Syrup of Quinces, and Myrtles. Or you may make Troches of the same Pouder, with the Mucilage of Fleabane seeds, or Gum Traganth. All which the Patient may use by turns, lest he grow weary of the same.

Outwardly, to close the Ulcer, you may apply to the Stomach, a Fomentation of the Decoction of Wormwood, Roses, Pomegranate peels, Galls, Pomegranate Flowers, Myrtles, Frankinsence, Ma∣stich, or the like. And lastly, anoint the part with an astringent Oyntment, or apply an astringent Emplaster.

The End of the Ninth Book.