The practice of physick in seventeen several books wherein is plainly set forth the nature, cause, differences, and several sorts of signs : together with the cure of all diseases in the body of man / by Nicholas Culpeper ... Abdiah Cole ... and William Rowland ; being chiefly a translation of the works of that learned and renowned doctor, Lazarus Riverius ...

Chap.10. Of the Immoderate Flux of the Hoemorrhoids.

ALthough the moderate Flux of the Hoemorrhoids be healthful, and preserveth a man from many and grievous Diseases, as Hippocrates taught in epidemii, and in his Aphorisms, as from a Pleurisie, Peripneumonia, or Inflamation of the Lungs; nephritis, or the Stone in the Kidneys; Madness, Melancholly, and innumerable other: Yet the immoderate Flux is most dangerous, and brings other pernicious Diseases, as Weakness of the whol Body, Coolness of the Bowels, and espe∣cially of the Liver; an Atrophy or want of nourishment, an evil Habit, and Dropsie by the loss of Natural Heat, by spending too much Blood which is the treasure of Life, and the cheerisher of the whol Body.

And this Immoderate Flux hath the same Causes which use to provoke other sorts of Bleeding: namely, Blood offending in Quantity or Quality; when it offendeth in Quantity, and is brought in great plenty to the Haemorrhoid Veins, it doth violently dilate them and open their Orifices, by the strength of the Expulsive Faculty: but somtimes too much Blood coming thither, doth oppress the Retentive Faculty.

Hence it comes that she being Defective in her duty, there is a great Flux which must be restrain∣ed by art.

But while Blood off ends in Quality, as sharpness, it stirs up the Expulsive Faculty, to cast forth by those Veins not only the unprofitable but profitable Blood, the Blood Causing this Flux is made sharper by a mixture of Choller, or sharp Water.

This immoderate Flux is known by the loss of Strength, and a Sense of Weakness coming from a long Flux and loss of Blood: As also from an evil yellowish colour of the whol Body, as if it were the Jaundice.

If the Disease come from Quantity of Blood, there went before Causes of increase of Blood, and the Patient bears it wel in the beginning, and is more cheerful; but afterwards the Flux continuing, he grows weak, and dejected.

But if it comes from sharpness and thinness of the Blood, there went before Causes that breed cho∣let or sharp Water, the body is of a Chollerick Constitution and burnt: the blood floweth violent∣ly, and it is very red, shining, and as it were flaming, when otherwise offending only in Quantity it useth to be black and Melancholly.

The Prognostick is gathered easily from what hath been said, when we reckon up those grievous Diseases which come from this.

For the Cure, The Blood must be stanched, or moderated at least, which must be done by Revul∣sives, Derivatives, Thickners, and Astringents.

And first, Phlebotomy is a Revulsive Remedy in every Flux of blood, therefore in the Hae∣morrhoids thus flowing, draw blood from the Arm; and more plentifully if there be signs of fulness and much hath not been lost, otherwise take but little, and at divers times.

Also Frictions and Ligatures of the Superior parts do revel the blood, as also Cupping Glasses ap∣plied to the Shoulders, Breasts, and Hypochondria, which for the better Revulsion may have Scar∣rification in the Shoulders, but they must be often applied to the places afore-mentioned.

Also a Gentle Purge doth derive the Chollerick Humors which make the blood so violent in the Guts; and this must be made of Purging things that have an Astringent Quality, as Rhubarb, My∣robalans, and Tamarinds, such as were prescribed against Vomiting of Blood: And Mercurialis teacheth, That Tamarinds have an especial power to stop this kind of bleeding, whether they be ta∣ken boyled or in substance.

Also sharp French Pruens which are somwhat like Tamarinds being often eaten afore meat, are good: and their use is convenient to keep the body loose, and if these wil not suffice you may ad o∣ther things which were propounded for the Cure of a Belly bound, because by use of Astringents the belly wil be bound, and by straining to discharge the Excrements that are hard, the Veins wil be more open and bleed more.

Afterwards you must use those things that thicken the Blood, and astringe the loose Veins, such as were prescribed for vomiting and spitting of blood, in form of a Julep Pouder, Opiate, and the rest; coming to Narcoticks, as is there said, if great need require.

And besides those Remedies, the Pills of Bdellium are much commended by Authors; which Rondeletius rejecteth, because the Apothecaries have not true Bdellium, and use Mirrh instead there∣of, which causeth bleeding. But Solenander opposeth him, saying by Experience, that he hath found these Pills make of ordinary Bdellium, so cleerly to produce their effect, that he wil not doubt of the composition. Except some should think that the Myrrh is made dull by drying things, and a∣stringents that are mixed therewith. To this we may add what Bauderon in his Dispensatory, and other Modern Writers say, That we have true Bdellium brought from India at this day, which is hard to be distinguished from Myrrh.

The use of these Pills, is after this manner:

Take of Pills of Bdellium one dram: the Troches of Amber, and Terra sigillata, of each one scruple▪ With the Mucilage of Quince seeds extracted with Rose Water. Make a mass of Pills, of which let him take a scruple twice a day, before Dinner and Supper.

At the same time you must use Topicks made after divers forms.

A Fomentation of Mullein boyled in Smiths VVater, or astringent VVine, is best; for that Plant is proper for the pain and bleeding of the Hemorrhoids. But you must diligently observe in the use of Fomentations, that they be either cold, or moderately hot.

A more compound Decoction may be made thus:

Take of Snakeweed Roots half a pound: Plantane, Mullein, Bramble and Oak buds, of each two handfuls and an half: Sumach berries, Pomegranate flowers, green Galls, and Pomegranate peels, of each one handful: Myrtles half a dram: red Roses two pugils: Allum one ounce: boyl these in three parts of Forge water, and one of old red Wine, for a Fomentation.

Martin Ruland commends a Fomentation made of two bags, applied hot by times, made of red cloth, and filled with beaten Acorns and Oak Leaves, and boyled long in strong Vinegar.

Of the Decoction before mentioned, with a greater quantity of every Simple, you may make a Bath to sit in, which the ••ick man must use somwhat cold, as is said of a Fomentation.

Ʋnguentum Comitissae is very good, if you anoint the Back and Hemorrhoids therewith: or you may make for the present this following:

Take of Oyl of Roses, Olives, and Myrtles, of each two ounces: the Juyce of Plantane and Mullein, of each one ounce and an half: red Wine Vinegar one ounce: boyl them till the juyces are consumed: then add of Bole, Sanguis Draconis, Frankinsence, and dross of Iron finely poudered, of each one dram: Wax as much as will make an Ʋnguent.

Rondoletius approves rather of those Oyntments which are made without Oyl, because they are more astringent▪ and they are thus made:

Take of the Juyce of Plantane, Shepheards-purse, and Mullein, of each two ounces: the simple Syrup of Vinegar three ounces: boyl them gently; then add of Bole, Terra sigillata, and Snake∣weed Roots poudered, of each one dram and an half: Sanguis Draconis one ounce: Ceruss wa∣shed two scruples: mix them into the form of a Liniment.

If the Hemorrhoids be ulcerated, you may make this following:

Take of Oyl of Roses two ounces: Frankinsence and Aloes, of each one dram: Sarcocol, Sanguis Draconis, and Bole, of each half a dram: Spodium, and Carabe, of each one scruple: white Starch three drams: Juyce of Plantane one ounce. Make an Ʋnguent.

The Fat of an Eel, which comes out when it is roasted, put to the Oyntments, makes them better by a proper Vertue.

Also you may with profit apply a Cataplasm to the said parts, made thus:

Take of Bole, Aloes, Mastich, Frankinsence, and Sanguis Draconis, of each half an ounce: the stones of Myrobalans, and Galls, of each one dram: mix them with the white of an Egg, and Juyce of Plantane. Make a Cataplasm.

Or the Hairs of an Hare burnt, and Spiders webs mixed with the white of an Egg, will make a Cataplasm, which you must apply to the Vein where it is open, if it appears, or put it gently in.

Suppositories are good for this use, because they are put up into the part.

The Form of them is,

Take of Colophony, and Frankinsence, of each three drams. Bole half an ounce: Ceruss and burnt Lead, of each one dram: Acacia half a dram: pouder them finely, and make them into a Suppository with Goats Suet.

Make Injections into the part by a Syringe of the Juyce of Plantane, and other things mentioned for a Fomentation. The blood of any Creature newly drawn, and injected whi••e it is hot, doth wonderfully restrain any flux of blood from the belly.

The Lungs of a Sheep being hot and bloody, being sat upon, have great power to stop this Blood.

Also Fumigations made of the Decoctions of the Fomentations aforesaid, are good for the same end. To which you may ad those things mentioned in a Dysentery. As also this following:

Take of Frankinsence, Aloes, Mastich, red Roses, Myrtles, and Wormwood, of each half a dram: Troches of Carabe one dram & Make a grass Pouder to be cast upon the hot coals; and let the fume thereof be received in a large funnel by a hollow chair, tying a wooden or silver pipe to the narrow hole, and putting it into the Fundament.

A Fumigation made of Mullein is the best of all.

If you can apply Remedies to the Veins that bleed, it is best therefore that they may appear And therefore let the Patient be laid upon a Table, and strain as if he were at stool till they appear; using an Instrument if there be need. And then apply the afore mentioned Cataplasm of the Hair of an Hare and Spiders Webs, or other very drying Remedies; Bole, Allum, or burnt Vitriol. Al∣so to touch the Vein with Oyl of Vitriol, is good; or in extream danger with Aqua fortis.

Which things, if they prevail not, Hippocrates in his Book of Diet, in acute Diseases, and of the Hemorrhoids, shews the way of tying, cutting, and burning of them; which operation is out of fa∣shion now, as being most painful and perilous. Although Massaria saith that he once saw it, the story whereof will be prositable to be related; for by that you may learn the way of working, and the event. The History is this: Frederick Corsicus of Vincentia, first had the pain, then the im∣moderate flux of the Hemorrboids: And when he had in vain tried many things, went to Padua; where the Physitians by a common consent, concluded that the blood must be stopped. But when many means inwardly and outwardly, were in vain used, in the end finding no Remedy, they con∣cluded to try this Manual Operation: But having no fit Chyrurgion, they sent for a Neapolitan, who professed this Art, and he cut, tied, and burnt the Hemorrhoids of Fabricius thus: First he bound him so that he could no waies move; then he separates the Hemorrhoids from the Intestine; then with a Needle, he passeth throw, and seweth them, and tieth all about strongly: then cutting off the part of the Vein which is above the sewing, he burns it with a hot Iron. It was a painful Opera∣tion from the Ligature, Section, and Burning: So that Frederick had a Feaver, and great pain. But the Chyrurgion gave him a few Medicines by which he was freed both from feaver and pain in a few daies to the admiration of all men there, and recovered from bleeding. But it is not to be o∣mitted, how he being too confident, and neglecting bleeding and purging, which he stood after in need of, keeping no orderly diet; the next yeer he was taken with a pestilent Feaver, and died. From whence we may observe the Precept of Hippocrates, Aph. 12. Sect. 6. That one Hemorrhoid must be kept open. Except the Patient, as Aetius observeth, had rather prevent the danger that comes by stopping of it by a good diet, exercise, bleeding, and purging.

But in an ordinary Cure by Medicines, you must consider the Liver and Spleen, because the Mese∣raick Veins are inserted into them, especially if they be hot or weak. And therefore not unprofitably do we apply Epithems, or cooling and strengthening Oyntments, such as we prescribed in the flux of the Liver, and shal more at large be laid down in the hot distemper, and inflamation of those parts. Somtimes the Obstruction of the Bowels, and Meseraick Veins do cause this Disease; which are to be taken away for the Cure of the Patient. And we have somtimes done it with Pills of Steel, which are prescribed in the Obstruction of the Liver.

The whol time of Cure, let the Patient drink ordinarily Iron Water, or the Decoction of Yar∣row.

At the same time, above all things you must rectifie the blood, which is the chief cause of this flux. Therefore if it be sharp and Chollerick, it is often to be corrected with the infusion of Rhubarb and Tamarinds. If it be hot and thin, with thickening and cooling Medicines: if watery, with dry∣ers: if much, with a slender Diet. For it is vain to think of stopping of the blood, except the origi∣nal of the evil be first taken away. Which Solenander observed, Cons. 22. Sect. 4. in this following History. I remember (saith he) that I had one Ann, a Dukes Daughter, of a great flux of the He∣morrhoids; and because she was far spent, I took much pains to stop the flux. But when I perceived that the first day after they were stopped, she began to swel about the Heart. Being sent for again, the seventh day I opened the Veins again; nor could I safely stop them before I had given gentle Evacutions, and alte••••ng and strengthening things for the Liver.

After you have cured the flux of the Hemorrhoids, you must prevent their return: which is done by good Diet, and bleeding twice or thrice in a yeer, and with an ordinary Purge of a Magistral Syrup, or other Medicine, with an issue made in the Leg, and the like; which are to be altered according to the divers dispositions of Bodies. Moreover, Mineral Waters of Vitriol, Allum, and Iron, are very convenient.

Fonseca commends the Decoction of the Mastich Tree, or the Infusion of it in VVine, for a Pre∣vention, thus made:

Take of the shavings of Mastich wood two ounces: infuse them in twelve Pints of Wine twen∣ty four hours in a warm place, then strain it and drink of it a whol month for ordinary drink: for it hath strength to stop the Haemorrhoids, and strengthen the Stomach.