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

Chap. 6. Of the Dropsie.

HIppocrates makes two kinds of Dropsies; namely, An Universal, and a Particular. An Uni∣versal Dropsie, is that which is in the whol Body, or over the whol Belly: a Particular, is that which is only in one part: hence there is the Dropsie of the Head, Breast, and Womb; of which, here we shall not speak, but only of the Universal.

Galen gives three kinds of this Universal Dropsie; namely, Ascites, Tympanites, and Anasarca, or Leucophlegmasia.

Ascites is a swelling of the Belly, caused of a serous Humor; nor doth the Belly only swell, but many times the Feet, Legs, Thighs, and Cods. Nay, an Ascites somtimes begins with a swelling in the Feet, which ascends after to the Legs, and so to the Thighs and Belly.

This serous Humor, as it is of the Nature of Water, it is cold; but as it is salt, it hath in it heat, which then is encreased by the neerness of the Bowels, and more by the putrefaction which it gather∣eth by long continuance: hence comes a Feaver and Thirst, namely, from the stinking salt vapors which do infect the mouth of the Stomach.

It falls out somtimes, that this Watery Humor, is not contained in the Cavity of the Belly, but in certain Bladders growing to the parts of the lower Belly.

An Example whereof is given by Schenkius, Lib. 3. Observation; and Mauritius Cordaeus, Com. 5. in Hipp. Lib. 1. of Diseases in Women. Galen supposed (and almost all Physitians, new and old, have followed him) that every Dropsie comes of a cold Liver, which cannot Sanguisie or make Blood compleatly, but instead thereof much Water, Flegm, or Wind. Which Opinion, as it is most true in Anasarca, and approved; so in Ascites and Tympanites it is much questioned by many

Modern Writers, because in the opening of many that died of Dropsies, the Liver hath been sound very sound, as is manisest by many relations in those Authors mentioned. Moreover, Hippocrates 2. Prorrhet. wittily affirms that a Dropsie may come either from the Liver, or from some empty part: by an empty part, he meaneth all that space from the Ribs to the Guts, and the parts contemed in it. Also Hipp. 4. de morb. Mulierum, mentions a Dropsie coming from the Spleen. To which places of Hippocrates they usually answer thus, That the Liver is alwaies affected either primarily or secon∣darily; so that there is never a Dropsie before there is a hinderance of Sanguification, or breeding of Blood. But two Reasons do strongly oppose this Doctrine: The first is from the Experience be∣fore mentioned, namely, That if the Liver ought necessarily to suffer in the producing of a Dropsie, it would never be found free and unknit in the Dissection of a dead Body. The second is, That if the Liver should breed watery Blood, it would be sent into the whol Body, as in Anasarca; nor can a sufficient reason be given, why that serous Humor bred in the Liver should be sent to the Belly, and not to other parts.

As for the cold distemper of the Liver, that is denied by Trallianus, Avicenna, and others, who affirm that a Dropsie may arise from a hot distemper of the Liver, and cannot be cured but by cooling means. And this may be maintained by the Authority of Hippocrates, in 2. Progn. A Dropsie (saith he) coming after an acute disease, is evil, for it doth not take away the Feaver. If there∣fore a Dropsie may come while the Feaver is, it is cleer that there is still a hot distemper. Neither could that ever please me, which is usually spoken by Galens Servants, That the Native heat is dis∣solved by a hot distemper, and much diminished, and that diminished heat may be called cold. For so in a Hectick Feaver, and other constant Feavers, in which the Natural Heat is much diminished, we should alwaies blame a cold distemper, and the Symptomes which follow should be impured to cold, and not to heat. From whence, who doth not perceive that there would arise a great consusion in the searching into the Causes of Symptomes.

Among the late Writers, Carotus Piso, whom Sennertus followed, hath dived most deep into the true Causes of Ascites, which he affirms to come from a serous Matter contained in the Meat and Drink, which by reason of some preternatural Cause, is stayed too long in the Gate and Hollow Veins, not sent into the Body, as in a Natural state and condition it useth to be, but into the capaci∣ty of the Abdomen. This serous Humor is retained in the Veins, from the whol Body, by reason the attractive faculty of the Parts, to which it should be carried, is either hurt or hindered.

Now the chief parts which draw the serous Matter, are the Liver and the Spleen. For they attract the Chylous Matter in which the moisture of Meat and Drink is contained. As also the Spleen draws Drink to its self, pure and without mixture; as Hippocrates taught, and Experience confirms, That they who drink much after Meat, do presently avoid it by Urine; which learned Authors say, is by reason the Spleen sucks the watery Matter before there is a perfect Concoction made in the Stomach.

The Attraction or drawing quality of the Liver and Spleen, is lost chiefly by defect and weakness of Natural Heat: the Natural heat is debilitated by a cold or hot distemper, or by Suffocation.

A cold distemper coming either from too cold a Diet, from loss of too much Blood and Spirits, or any other Cause, doth destroy the Natural Heat of the Liver and Spleen, and so hinder their Actions.

A hot Distemper doth disperse the Native Heat; whence being made weaker, the Liver and the Spleen become less Active. This comes from Feavers, much Wine, or hot Meats.

Lastly, The Natural Heat is weakned by Suffocation, when there is too much Blood in the Veins, especially if it be foul, as when the Terms of Hemorrhoids are stopt, by which the blood was clensed formerly, but now by stoppage corrupted.

Also the Attraction or drawing vertue of those parts, is hindered by Obstructions, which hinder the free passage of the serous Matter. So a Dropsie followeth a Scirrhus of the Liver and Spleen, not only because those parts being weakened cannot produce good Blood, but especially because they are not able to attract, and send to other parts whatsoever is drunk.

Here it may be objected, That in a Dropsie the whol Body is nourished by Blood bred in the Li∣ver of a Chylous Matter, which it draweth to it self. We answer, That the Liver doth better at∣tract that which is most familiar unto its self, and most sit to be made blood; but it draweth to it less than is sufficient, by reason of the weakness of the attractive faculty. Hence it is that the Body grows lean, because it draws some water along with the Chylus, and leaves the rest in the Meseraick Veins, and the Veins of the lower Belly, which is by degrees carried into the Capacity of the Abdomen.

We do not deny that Sanguisication or making of Blood, is hindered in a Dropsie, especially when the distemper is very cold or very hot, or the Obstruction or Scirrhus great, for then there cannot be a perfect making of blood. But we deny that that is the next and immediate Cause of a Dropsie; but rather an effect thereof, when the Water corrupted in the Abdomen, doth also corrupt the Bo∣wels that swim therein.

Next to the Liver and the Spleen, the Reins do attract the watery Matter which is in the hollow Vein, and free the whol body from the superfluity thereof, so that if at any time they do not their office, there remains much matter in the veins, which being sent to the Abdomen do quickly make an Ascites; now the attraction of the Veins may cease for divers Causes, because of a Cold Distem∣per, Tumors, Ulcers, and Obstructions, which wil Diminish, Abolish, and intercept their Fun∣ction.

Lastly, The distribution of Water is hindered from some external Cause, as when much cold Water is drunk, which Nature cannot govern, nor sufficiently distribute into the Veins: So Carolus Piso reports of a yong man that had a Tertian Ague, and drinking Water exceedingly in his Fit fel into an Ascites, from which by the taking of one Lozenge of Diacarthamum he was Cured by dis∣charging the Water which was in the Abdomen, but if he had continued drinking so much water any louger, he had not been so easily Cured, because it would have brought great obstructions and a cold distemper of the Bowels, by reason of the loss of natural heat.

But it is questioned of many by what wayes that serous matter should be carried by the Veins into the Capacity of the Abdomen, to whom we may plainly answer, by saying from Hippocrates that in a living body al things are passing to and fro, so that in time of necessity not only thin and serous Matter, but also that which is very thick may be sent through the insensible passages: So in a Pleuri∣sie blood and matter wil pierce through the thick substance of the Pleura and Membrane which covers the Lungs, and be spit forth at the mouth: So in a Fracture of the Leg or Thigh, which hapens with∣out hurt to the Muscles and Skin, the matter which floweth from the broken bone, pierceth through the substance of the other parts and wets the boulsters and rowlers.

So also in a Dropsie often times a great quantity of Water is vented in one day by giving of Quick∣silver, which cannot be except the Water conteined in the Abdomen do pass through the Tunicles of the Guts.

Nor is the Objection of Fernelius of any force, when he saith that Nature had in vain made so many open wayes, if the Humors can pass through those invisible passages: For we Answer, That in an ordinary and natural motion of Humors ordained for the nourishment of the whol body, those passages are necessary through which they may easily flow, but in an extraordinary case, provident Nature doth find out extraordinary wayes by which she may cast out hurtful Matter, or at least send it to a place less dangerous.

Fernelius Objects again, That in them who have died by a stoppage of Urine for twenty dayes to∣gether, it was never perceived that any Water went through those blind passages: We Answer, That Nature doth not alwayes work the same way in preternatural Causes, nor send hurtful Humors to the same places, but especially to those parts which are more disposed to receive them through weak∣ness.

So in the Suppression or Stoppage of Urine, the Serous Humor flowes openly through the Veins and Arteries and fils them, and if it find any part weaker than the rest it falls forceably upon it: hence it is that some die of the hurt of one or other remarkable part. So nothing hinders (if the parts of the Abdomen in which the Veins and Arteries end) be grown weak, but that the Watery Humor may be sent into its capacity or hollowness.

Nor is that true which Fernelius would infer, namely, That a Dropsie never comes from suppres∣sion of Urine, for Reason and Experience teacheth the contrary: as we shewed afore in the Dis∣course of the Loss of Attraction in the Reins: but you must observe that the Stoppage of the Urine doth make an increase of Water rather in the branches of the hollow Vein, then of the Gate Vein or Vena Porta, by which the watery Humor chiefly flows into the capacity of the Abdomen as ap∣pears by what followeth.

Therfore we may Answer this Question, by saying, That the water got into the hollow of the Abdo∣men, by the insensible passages though there are also other manifest wayes by which it may pass.

Hippocrates, Aph. 55. Sect. 7. hath shewed them, for (saith he) they who have much Water a∣bout the Liver, if it get into the Omentum, or Kels, their belly will be filled with Water, and then they die. The meaning of which Aphorism is (though Galen did not plainly see it) that the Water from the Liver doth flow into the Branches of the Vena Porta which go to the Omentum, and when they are filled, either by their Tunicles made thin by Diapedesis or Rarefaction, or by the mouths of the Vessels being opened by Anastomosis, the Water gets into the Cavity of the Abdomen: This happens often in the Spleen also, when it draws Water in abundance from the Stomach, as appears by many sayings of Hippocrates; and in lib. 4. de morbis, he saith, That Water may press from the Spleen to the Omentum or Kell, in these words, Drink is also carried into the Stomach with which when it is filled the Spleen takes it from thence and sends it to the Veins and the Omentum. From which we may perceive, That Water chiefly gets into the Abdomen, by the Veins of the Omentum which are called Epiploicae, and Gastrepiploicae, although it may pass also through their Veins.

Besides the aforesaid Causes of a Dropsie, which are more ordinary, there are mentioned by Au∣thors some less usual, confirmed by Observation: and these come from the disorder of some peculiar part, not only of the Liver and Spleen, but also of the Mesentery, Sweet-bread Stomach, Guts, Reins, Bladder, and Womb, namely, when the Homiosis, or faculty to convert nourishment into themselves is hurt, from s••me great Disease, so that their proper nourishment is corrupted and tur∣ned into Water. So Galen, Comment. Aph. 55. Sect. 7. saith, that watery Bladders are somtimes in the out-side of the Liver, which being broken, send Water downwards into the Cavity of the Ab∣domen, the encrease whereof breeds a Dropsie.

Fernelius supposeth that the Liver being very dry, hath clefts like the parched Earth, and that through them there flows a constant Water which fills the Cavity of the Abdomen. Others say that a Dropsie may come from the Guts, if they be perforated or pierced through, and yet the Patient dieth not presently but a watery Humor still flows through them into the Cavity. It comes also from the Kidneys, if they be much Ulcerated, and water flow from them. So Platerus reports of one that in a Dropsie had many Ulcers in both Kidneys, from whence both matter and water flowed into the Cavity. There is also a Story in Sennertus, taken out of John Heinzius, of a certain Wo∣man who had a Dropsie from the distemper of the Womb, whose Bowels were all sound, except the Testicles or Stones, which were found to be swollen as big as the Head of a new-born Child, being blew, hollow, and full of Ulcers, from which there came a serous Matter which caused the Dropsie.

The Dropsie called Tympanites, hath its name from Tympanum, a Drum, because the Abdomen is stretched out like a Drum, and if you strike it with your hand, it sounds like it. This stretching comes from wind shut up in the Cavity of the Abdomen. But somtimes this wind is in the Cavity of the Guts; which Platerus observed, saying in some that have been thought to die of a Tympany, after they were opened, have had no wind coming forth of the Cavity of the Belly; neither did their Bellies, but their Guts sink, especially the thin Guts, which were so stretched with wind that they came forth so rouled together that they could not be again thrust into the Belly.

But we must observe that the wind which causeth a Tympany, is seldom contained in the Belly a∣lone, but for the most part mixed with Water; as in an Ascites, not only Water, but Wind also is contained; and both these Dropsies have their name of that which predominateth: if there be more wind than water it is a Tympany; but if more water than wind, an Ascites: but if they be equal, it is between both; ••o that we may doubt whether that Dropsie be a Tympany, or an Ascites.

The Material Cause of Wind, is a crude Humor and thick, whether it be Flegm or Melancholly, which being stirred and made thin by heat, sends forth thick vapors, which are hard to be dissolved, and these are called Flatus.

This Crude and thick Humor, is partly in the Stomach and Guts, but especially between the Mem∣branes of the Midriff and Guts, from whence it is more hard to be moved than from the Cavity of the parts aforesaid. The 11. Aph. Sect. 6. of Hippocrates, makes this very probable; They who have pains and gripings about the Navel and Loyns, which cannot be removed, have a dry Dropsie. For because the Mesentery is joyned to the Guts by the fore part, and to the Loyns by the hinder part, we may easily perceive that the pains which reach from the Navil to the Loyns, come from the Mesentery. Besides, The greatness of the pain, shews that the Cause is deep in the substance of the part, and cannot be removed: For if it were in the Cavity of the Stomach and Guts, it would easily be remedied.

Concerning the Efficient Cause, Authors differ; some say from a cold, some from a hot distemper. They which accuse a cold distemper, think they have Galen on their side, who saies that wind is bred of a weak heat. To whom we answer, That heat may be said to be weak in respect of the Matter which cannot be discussed or dissolved thereby. But this is to be imputed to the Matter, which is ra∣ther defective than the Heat, which is commonly too great and Preternatural. And we must ac∣knowledg with the Learned, That a burnt Melanchollick Humor is most fit to breed a Tympany, which proceedeth from the parching heat of the Bowels; which heat doth stir that Matter, and pro∣duceth from it thick vapors that are hard to be dissolved.

The Dropsie called Anasarca, comes of a Flegmatick Humor spread through the whol Body, and therefore the Body is swoln and white; from whence the Disease is called Leucophlegmatia. This Flegm comes from a cold Liver, which instead of good Blood, produceth crude and flegmatick; which when it cannot be turned into the substance of the parts, leaveth the crude part that is unfit for Nourishment upon them, and makes them swell; hence comes Anasarca, or Leucophlegmatia.

This Disease beginning, is called Cachexia, or an evil Habit, and turns into Leucophlegmatia, from which it differs but in degree.

The Anteced••nt Causes are, all things that cool the Liver too much, and hinder its Concoction, as too much cold and moist Diet, the stopping of the Terms or Hemorrhoids, Obstructions, cold Tu∣mors,

Scirrhus and large bleeding, and other great Evacuations, by which the Native heat is dimi∣nished.

The Signs of a Dropsie, and every sort of it, may be known by what hath been said.

In an Ascites, you may know that there is water in the Abdomen by its greatness, lost Swelling, and broad, and if you press the sides, you shall easily hear a noise of Water, and when the Patient turns from one side to the other, and then the whol Belly lieth as it were on that side: then the Feet and Cods swell, but the higher part grow less; the Urine is little and thick, somtimes red, because there goes but little water to the Reins and Bladder, and staies long there, by which means it becomes red and thick. In the progress or encrease of the Disease, there is difficulty of Breathing, by reason of the abundance of water which lieth upon the Diaphragma or Midriff, especially when the Patient lieth down, and therefore he is forced to stand or sit most usually. There is a troublesom thirst from the saltness of the Humor, with which the Stomach swimmeth. And lastly, there is a constant lin∣gering Feaver from the corruption of the Water, which at length doth corrupt all the Bowels swim∣ming therein.

In a Tympany, the Belly being strook, sounds like a Drum; the Bulk of the Belly is less burden∣som than in an Ascites: There were formerly pains about the Navel and Reins, when the Patient lieth with his face upwards, his Belly remains hard and stretched forth, nor doth it turn aside when he tur∣neth himself.

Lastly, In an Anasarca, not only the Belly, Thighs, and Leggs, but also the Hands, Arms, Breast, Face, and whol Body swel; and wheresoever you thrust your finger upon it, it will pit, and leave an impression. The color of the Skin is pale and Earthy, the Flesh soft and loose, the Water thin and white, breathing difficultly, and somtimes a lingering Feaver.

As to the Prognostick: Every Dropsie is dangerous, and hard to be cured, and the more hard by how much the elder, but Anasarca is least dangerous; but Ascites and Tympany are somtimes one more dangerous than another, according to their Causes. So if Ascites come from a Scirrhus of the Liver, or Ulcer of some internal part, it is more dangerous than a Tympany; but if it come of drin∣king too much Water, or new Obstructions, it is less dangerous.

A Dropsie is more easily cured in Servants than in Free-men, in Country men than in Noble men; for they will be better constrained to abstain from Drink and the like, and be more patient than they who have liberty.

A Dropsie from the hardness of the Spleen, is less dangerous, than from the hardness of the Liver, because the Spleen is not so Noble a part.

A Dropsie coming upon an acute Disease, is evil; nor will it abate the Feaver, but cause pain and death. Hipp. 2. Prognost.

They whose Liver being full of water, discharge it into the Omentum or Caul, their Belly is filled with Water, and they die. Hipp. Aph. 55. Sect. 7.

He who hath Water between the Skin, or an Anasarca, if that water which is in the Veins flows in∣to the Belly, the disease is cured. Hipp. Aph. 14. Sect. 6. This Aphorism seems coutrary to the former. But this contrariety is answered, by saying that Hippocrates in the former, by Belly, un∣derstood the Cavity of the Abdomen; but in this, Belly its self; for if the water flow through the Belly, the Disease is at an end. Which Opinion is more clearly explained by Hippocrates, in Coacis, in these words: In the beginning of a Dropsie, if there come a flux of the belly, without want of Concoction, or Crudity, it is prevented. You must mark that it is in the beginning; for if a flux come upon an old Dropsie, it is not so safe, because commonly there is some fault in the Bowels by continuance, as a Scitrhus, or corruption of substance, which begets new matter, and death also. Henee Hipp. in Prorrh. saith, that they who are to be cured of the Dropsie, must be Euspiagchnous, that is, those that have sound Bowels, free from the great Diseases mentioned. Otherwise, if a flux of the Belly happen with a Scirrhus or corruption of the Liver, they die presently, as Galen shews 2. ad Glau. cap. 5. And Avicen saith thus: Straitness of breath, and flux of the belly signifie death within three daies.

Little Urine in Dropsies, is evil; the less, the worse, because the Drink runs into the Belly, and not into the Reins. Hence Hipp. in Coac. saith, Little and thick Urine, and a Dropsie that is Feaverish, is deadly: but if the quantity of Urine encrease, we may hope well. Which is elegant∣ly laid down by Celsus: And then (saith he) there is hope of Health, when they void more Urine than they drink: Therefore it is good every day to measure the Urine, and the Drink, and the Bel∣ly with a string, especially while Physick is given, to see whether it grow less or not; for if it encrease notwithstanding the Medicines, it is desperate.

Imposthumes, or spots in the Legs or Hydropical men, are deadly. Hippocrates confirms this 7. Epid. in the History of Bion and Ctesipthon; the one whereof died presently after an impost∣hume which ran in his left Knee: the other after he had a red and blewish gathering in his right Thigh.

Men that are cured by Medicines for Dropsies, if they fall again into the same, are desperate, Hipp. in Coac. For it signifieth that there is some incurable fault lurking in the Bowels, which after the water is emptied, reneweth it again.

If the Patient have sound Bowels, and strength, eat his meat, and concoct well, and be not sick af∣ter; breath freely, have no pain, cough, or thirst, and his tongue grow not rough, so much as in his sleep; if Medicines presently purge him; and if without Medicines he be bound, and in a Natural order; and if his Urine change according to his Diet, or if he be not faint. If all these things be pre∣sent, the Patient is recovered; if some of them, there is hopes of amendment; if none, he is de∣sperate.

In a dry Dropsie, to piss by drops is evil. Hipp. in Coacis.

A Tympany in a Melanchollick Body, is deadly, and Remedies are given in vain.

If in a Leucophlegmatia, a strong Diarrhoea follow, the Disease is cured. Hipp. Aph. 29. Sect. 7. but this Diarrhoea must be at the beginning, or at least before the Disease be old, or the strength of the Party weakened; but if it happen when the Patient is weak, it is dangerous.

The Cure of the Dropsie consists in the Evacuation of the Matter, whether it be in the whol Body, or in the Abdomen or Belly; in taking away the Cause that produced that Matter, and in strengthe∣ning of the Bowels, especially the Liver.

The chief and most ordinary Causes are, great Obstructions, and Scirrhus or hard Tumors, the Cure of which Diseases is to be taken out of their proper Chapters. But if they will not suffice, you must use these following, which are more proper in Dropsies, and vary them according to the variety of Causes, and the Bodies sick.

And first, you must give an ordinary Purge, by an opening Apozeme that expels slegm and water, made thus:

Take of the Roots of Eryngus, Madder, Smallage, Parsley, and Elicampane, of each one ounce: Valerian, Asarabacca, Dwarf-Elder, and Flower deluce Roots, of each half an ounce: the Bark of the Roots of Capars, and inward Bark of an Ash and Tamarisk, of each six drams: the Leavs of Agrimony, Ceterach, Maiden-hair, Germander, St. Johns-wort, Wormwood, and the lesser Cen∣taury, of each one handful: Sold anella, or wild Mercury half a handful: the seeds of Carrots, Parsley, and Fennel, of each half an ounce: scraped Liquoris, and Raisons stoned, of each one ounce: clean Senna one ounce and an half: Agarick tied in a clout three drams: the seeds of Dwarf-Elder, and Jallap Roots, of each one dram and an half: Ginger and Cloves, of each one dram: Broom, Elder, and Tamarisk flowers, of each one pugil: Boyl them in equal parts of stee∣led Water, and white Wine added towards the end, to a pint and a quarter. When it is strained, dissolve therein, Syrup of Succory with Rhubarb, four ounces. Make a cleer Apozeme, aromati∣zed with three drams of Cinnamon, for four morning draughts.

After Universal Purging, let the Patient take this following Pouder once a week:

Take of Clean Senna, Gummy Turbith, Hermodacts, Dwarf-Elder seeds, Jallan, and Mechoa∣can, of each one dram: Cream of Tartar two drams: Cambugia, half a dram: the pouder of Diamber, Diarrhodon Abbatis, and Fennel seeds, of each one scruple: Sugar candy three drams: Make a Pouder of them all, of which infuse two drams, or two drams and an half all night in four ounces of white Wine. Let him take the Wine and the Pouder in the morning.

The Syrup of Rhamus solutivus, or Buckthorn, made of the Juyce of its Fruit, called Rhein Ber∣ries, with Sugar, given one ounce at a time, doth wonderfully purge water. It must be taken pre∣sently after Dinner.

Or give the Magistral Syrup made of the Decoction of the Apozeme afore mentioned, the dose of Purgers being encreased; or this following:

Take of the Juyce of Damask Roses two pints: the Juyce of the Roots of Danewort, Flower∣deluce, Succory Leaves, and Agrimony, of each half a pint: the seeds of Danewort, Mechoacan Roots, and of the best Rhubarb, of each two ounces: Spicknard three drams: yellow Sanders two drams: Crystal of Tartar one dram and an half: infuse them a whol night, and after a little boy∣ling strain them; then put as much white Sugar as is of the Liquor: boyl it into a Syrup; and add to it of the salt of Wormwood half an ounce. Let him take two drams with opening Broth once in a week.

Or instead of this Syrup, or at other times when it is not taken, you may give these Pills, which purge the evil Humors, and also open Obstructions.

Take of the best Aloes, steeped in the Juyce of Wormwood, half an ounce: Gum Ammoniack dis∣solved in Vinegar and strained, the best Myrrh, and Crocus Martis prepared with Sulphur, of each three drams: Salt of Wormwood and Tamarisk, of each two drams: Diagridium, and Troches of Albandal, of each one dram: Saffron, Ginger, and Salgem, of each one scruple: With Oxymel of Squils make a Mass of Pills, of which give half a dram twice in a week two hours before Dinner.

Also Purging Wines are much commended for the cure of the Dropsie, of which there are divers Forms. But these are best:

Take of the Roots of Asarabacca, and Mechoacan, of each two ounces: the French Flower∣deluce, and Bark of the Roots of Danewort and Elder, of each one ounce: Elicampane Roots half an ounce: dry Wormwood and Dodder of Time, of each one pugil: clean Senna one ounce: Soldanella or Sea-foal-foot two drams: the Troches of Rhubarb and Agrimony, of each one dram: Mace and Cinnamon, of each half a dram: Scammony four scruples: white Wine two pints and an half: Infuse them three daies in Balneo Mariae; the vessel being well stopped, keep it without straining. Let him take two or three ounces in the morning, twice or thrice in a week.

Among Medicines for drawing forth of Water, the Juyce of French Flowerdeluce is very much commended, if it be drawn forth with white Wine, it may be given to three ounces; it provoketh stool and urine very powerfully. But because it is very offensive to the mouth and stomach with its sharpness, it useth to be mixed with Manna or Honey. Massaria gives it thus:

Take of Juyce of Flowerdeluce newly drawn with white Wine, three ounces; the best Manna one ounce and an half. Mix them for a Potion.

Platerus in his Observations; I gave (saith he) to one in a Dropsie, of the Juyce of Flowerde∣luce to drink with Honey two ounces, and he often pissed and purged; and after he had taken it twice or thrice, his Belly ceased swelling, and his Feet, and he was cured.

Rhubarb is commended of some, because it purgeth noxious Humors, and strengtheneth the Li∣ver. And Stocherus saith that he cured many with the use of Rhubarb given every third or fourth day, one or two drams in an opening Decoction. Also in Scoltzius his Epistles, there is a famous Story of one who was cured of a Dropsie, only by the use of Rhubarb, which he took every day in such a quantity as was necessary to purge.

The Troches of Rhubarb are much commended by all Authors. And Mathaeus de Gradi reports that a certain Duke of Orleans, was cured with them alone, taking two drams twice in a week.

Michael Paschalius saith that he cured a Dropsie with the same, making them into Pills, by reason of their bitterness.

The Chymists commend the Extract of black Hellebore., Aquila Coeleftis, and Mercurius vitae, and they mix them with other vulgar Medicines, from whence followeth a plentiful Evacuation of Water. But they had need of strong Bodies who take them.

Mercurius dulcis works most gently, and Mercurius Diaphoreticus. But Antimonium Dia∣phoreticum cures without manifest Evacuation, if it be calcined with Salt-Peter till it be white: but the Diaphoretick or Sweating Medicine made of the Butter of Antimony, cures all kinds of Drop∣sies best.

But you must observe in the giving of all sorts of Purges, That they, especially if strong, are not to be given often, as Galen teacheth Lib. 9, Cata Topous, because they weaken the body, and then there will more water be bred afterwards. Therefore you must prescribe strengtheners and openers oftener than purgers. And Experience teacheth us, That the Evacuation by Urine in this Disease hath better success than that by stool.

Instead of Purgers, you may give Clysters, which discuss wind, purge water, and take down the belly, made thus:

Take of Mallows, Mercury, and red Coleworts, of each one handful: Soldanella or wild Mer∣cury half a handful: Annis, Caraway, and Dill seeds, of each three drams: Chamomel, Meli∣lot, French Lavender and Broom flowers, of each one pugil: boyl them to a pint. In the strai∣ning dissolve of Diacatholicon one ounce: Hiera Picra half an ounce: Oyl of Dill and Lillies, and of common Honey, of each two ounces. Make a Clyster twice in a week. Or,

Take of very sowr Leaven half an ounce: common Salt one pugil: Boyl them in as much Water as is sufficient: strain it, and add to it, the Ʋrine of a Child four ounces: Oyl of Rue three ounces: Clarified Honey one ounce. Make a Clyster. This Valeriola commends highly.

This following Clyster, brings forth Water in abundance:

Take of Coloquintida one dram, Infuse it for a night in three ounces of white Wine: when it is strained add thereto, Tripe Broth one pint: common Oyl two ounces: Salt-Peter melted one ounce: strong Vinegar one spoonful: make a Clyster. Or,

Take of the Pulp of Coloquintida one dram: Clean Bran one handful: boyl them in white Wine for a Clyster. Or,

Take of Carthamus seeds one ounce: the best Agarick half an ounce: the pulp of Coloquintida three drams: Centaury the less, Germander, and both the Wormwoods, of each half a handful: boyl them to a pint. In the straining dissolve of Oyl of Chamomel, Rue, and Capars, of each one ounce: Honey of Roses two ounces: make a Clyster. Or,

Take of the Emollient Decoction one pint: thick vomiting Wine, the Infusion of Crocus metal∣lorum four ounces: Diaphoenicon one ounce: make a Clyster.

Blood-letting here, is for good Reason omitted, except the Disease come from stoppage of the Terms or Hemorrhoids. And then you must not bleed except it be in the beginning of the Dis∣ease, before the Liver be grown too cold.

Issues, Blisters and Scarrifications, use to cause Gangrenes, or mortifications in a Dropsie, be∣cause the heat of the part being smal, is quickly extinguished: Therefore it is better wholly to ab∣stain from these kind of Remedies, although somtimes they have done some people good.

Paracentesis, or cutting of the Skin, is seldom to be used, because few are cured thereby, especial∣ly because the Patients, or their kindered will not yield to it before the Disease is confirmed, and the Bowels are so putrefied that there is no hope. Therefore for the most part they die the second or third day after they are cut. The wiser sort will have the Incision made in the beginning or encrease of the Disease, before the Bowels are corrupted. Neither is it necessary at that time, because the dis∣ease being smal may more safely be cured with other Medicines.

Among emptying Medicines, Sweatings are accounted most profitable, which, as they are alwaies good in Anasarca, so in a Tympany, or Ascites, they somtimes hurt, namely, when driness of the Liver (which is usual) causeth the Disease. Moreover, it is commonly impossible to make men in Dropsies sweat. But if the Liver be not dry, Sweats are good in all kinds of Dropsies, especially when they decline, to discuss the reliques of the watery Humor by the Habit of the Body. So Vale∣riola reports that he cured an Ascites with a Decoction of Guajacum given fourty daies together. It is good to make the Decoction with steeled Water and Wine. The Chymicks commend Antimoni∣um Diaphoreticum.

Martinus Rulandus makes a Sudorifick of Juniper Berries, which because they are forceable to provoke Urine, may do good both waies. It is thus made:

Take of Juniper berries bruised three handfuls: Sack as much as is sufficient: boyl them to halfs and give two ounces every morning, covering warm after it.

Horatius Reserus in Scholtzius, boasteth that he hath cured many Boyes, and some Women of the Anasarca with Syrup of St. Ambrose, which is a Sudorifick: Its description is in an old Dispensatory called Luminare majus, thus:

Take of Gromwel seeds husked two ounces: spring Water half a pint: boyl them till three or four ounces of water only remain; which being strained, mix it with as much Sack, and give it warm; it will sweat him plentifully if he be covered warm.

But those Medicines are best which purge by Urine, and the Cure is commonly better this way.

One of the chief, is two ounces of the Juyce of Chervil given every morning in Wine for many daies.

Opening Wines that purge by Urine are good in this case; as this,

Take of Elicampane, Smallage, Fennel, and Flowerdeluce Roots dried, of each one ounce and an half: Roots of Valerian, Gentian, Asarabacca, and Squils or Sea Onions, of each one dram: the middle Bark of an Elder, and Sassaphras, of each six drams: dried Wormwood, Agrimony, Germander, and Maiden-hair, of each two drams: the tops of Centaury the less, and Broom flow∣ers, of each one dram: Parsley, Annis, and Dill seeds, of each one dram and an half: Cinna∣mon two drams: Spicknard half a dram: bruise them together, and infuse them in white Wine some few daies, and let him drink thereof every morning.

The steeled compound Wine prescribed in the Obstruction of the Liver, is good for the same.

The Decoction of Juniper mentioned, is to be reckoned among the Diureticks. And if you fear it is too hot, you may make it in Water, and put a little Spirit of Vitriol to it.

Fonseca commends the use of Turpentine washed with Barley Water, and he gives half an ounce thereof twice in a week.

And lastly, The Spirit of Salt, Tartar, and Vitriol, given in a true quantity with an Apozeme, or other opening Decoction for some daies, do wonders: because they being very thin, do run into all the parts of the Body, and open them.

The Salts of Wormwood, Juniper, Bean Stalks, and the like, given in white Wine, do the same. Or in want of Salts you may make a Lee of the Ashes of the same, which will be sufficient

Mathiolus upon the 87. Chap. Lib. 1. of Dioscorides, saith, That a Lee made of Juniper Ashes with white Wine, and four or five ounces thereof taken, doth powerfully provoke Ʋrine, so that I have seen some men cured of a Dropsie with it alone.

Moreover, In the whol time of the Cure, you must use strengtheners to the Liver; for it is in vain to purge water, if you do not hinder the encrease of it: which you cannot do except you re∣fresh the Liver, and bring it to its former temper.

Among the chief Strengtheners is Cinnamon Water; of which you may give one Spoonful every morning, and before Supper.

But Galen in his Eight Book Kata Topous commends the Electuary called Cyphoides by the A∣rabians from the Wine whereof it is made, of which you may give half an ounce in the morning, ac∣cording to Hollerius it is thus made,

Take of Curans clensed half a pound: boyl them in old Sack to the consistence of a Pultis, strain them after they are pounded, and then ad of the conserve of Rosemary flowers, Citron barkcandied, and Cinnamon, of each one dram: the Pouder of Aromaticum Rosatum, Diamargariton cali∣dum, and Diacinamom, of each two scruples: Lignum Aloes half a dram▪ Saffron half a scruple: mix them for a soft Electuary.

The Opiates prescribed for the Obstruction of the Liver are here very profitable.

The Conserve of Sea Wormwood is very good, made of one part of the Leaves and three of Su∣gar with which Matthiolus in his Chapter of Wormwood saith some have been Cured.

Poterius makes an Opiate of Conserve of Roses, Specificum, Somachium, and Crocus Martis, and Oyl of Vitriol, by which only Medicine he saith he hath Cured Dropsies. The Specificum Sto∣machium, is Antimony fixed.

The Cure of men in Dropsies lieth much in their drink: therefore there must be care of that, that he drink sparingly, and endure thirst as much as may be: for it is known that many have been Cured only with abstaining from drink and eating of dry meats without other means: For Drink let him take Elicampane or Wormwood, Juniper, or Steeled Wine, or let him use the aforesaid Steel Me∣dicines. Avicen forbids men in a Dropsie to see Waters. But if you fear too much Heat or Dri∣ness, or if the Patient be Abstemious, he may use the Decoction of Juniper, of Guajacum, or Sas∣saphras, or of Madder, which provokes urin very much, either alone, or with white Wine: But be∣cause he must abstain from Drink (as we said) and yet there is great Thirst, it must be asswaged by Fits with washing the mouth with steeled Water and Vinegar, or with often chewing Mastich or the like; for it wil draw water to the mouth, not only (as some think) out of the head alone, but from the Stomach and Cavity of the Abdomen, and therefore it will do much good.

Of Meats we say thus, That he must chuse the Dryest and avoid Sweet meats as the Plague.

While you use Internals, forget not Externals, for they are of great force to discuss the Humor of the Belly; as Fomentations, ••ags, Oyntments, Pultisses, and Plaisters: The Chief are made thus,

Take of Marsh-mallow and Lilly Roots, Cypress barks, Capar barks, middle barks of Ash, Tamarisk, dwarf-Elder, & the greater Snakeweed of each three ounces: Wormwood, Agrimony, Marjoram, Organ, Calamints, Peny-Royal, R••e, Ground-pine, Southernwood, and Elder, of each one handful▪ Parsley, Dill, and Cummin seeds, of each one ounce▪ Chamomel, Melilot, and Broom flowers, of each three pugils: Spickenard, Schoenanth, Nutmegs, Cloves, and Cinna∣mon, of each half an ounce: Salt and Allum, of each half a pound: boyl them all in a Lee made of Oak Ashes, or branches, with this Foment the whol Belly with Spunges dipt therein and strained.

Or,

Take the Ʋrine of a sound Boy, four Pints: Lapis Prunellae, three ounces: boyl them to the consuming of the third part for a Fomentation.

Aqua-pendens Commends Lime Water, in which he dips a new Spunge which wil compass the whol Abdomen; this he strains and binds on, by which he affirmeth, That the Waters that Cause the Dropsie are consumed, the cold and moist distemper of the Bowels are taken away, and the hardness of the Spleen dissolved.

Claudinus quencheth the Lime in a Salt Bath Water, that is either of Brimstone or Salt-peter, and bindeth close the Spunges dipped therein and strained with Rowlers to the Belly, and keeps them there long, and then changeth them.

You may make Bags of the ingredients of the former Fomentation boyled in white Wine, and ap∣plied warm to the belly.

After the Fomentation let the belly be anointed with Oyl of Dill▪ Rue, or Flower-de-luce, mixed with Pouder of ammoniacum, Galangal, Dill, Bay-berries, and the like.

It is also good to anoint with the Oyl of Scorpions according to Matthiolus, and with a little Oyl of Rosemary.

Many do make Oyntments and Liniments of strong Purgers, which draw VVater violently from the Dropsie, and asswage the Swelling of the belly, but they are dangerous, for the Purging Quality getting between the Muscles and the Membranes, doth often stir up a deadly Loose∣ness.

After Liniments, or if they be omitted you may apply Cataplasms or Emplaisters: This follow∣ing is the best,

Take of the Roots of wild Cowcumbers well bruised and steeped twenty four hours in Vinegar of Squills, one pound: clarified Honey two Pints: mix them, and boyl them to the consistance of a Cerat, and ad in the 〈◊〉〈◊〉 your ounces of the Pouder of Cumminseed, make an Emplaister for the belly to be renewed ev••••y day: Or,

Take of dryed Cow-dung one pound: Brimstone and Cummin seeds Poudered, of each two drams: New Wine boyled called Sapa: or of the Ʋrine of a Boy, as much as will make a Cata∣plasm.

A Cataplasm of Rhadishes bruised and laid to the Navel and Reins, doth provoke Stools and Urine.

Galen Commends a Cataplasm of Snails bruised with their Shells, which must be kept to the belly till it fal off of its own accord; it draws water forth violently.

Valeriola makes it in form of a Plaister thus,

Take of Cow-dung one pound: Goats-dung half a pound: boyl them in strong Vinegar, and beat them in a Mortar with three ounces of Brimstone, and one ounce of Allum: the Juyce of Spurge and dwarf-Elder newly drawn, of each three ounces: Lupine and Orobus meal, of each two ounces: the Pouder of Soldanella, Annis, Fennel, and Cummin, of each two drams: common parched Salt, three drams: Turpentine, four ounces: Pitch, six ounces: make a Plaister.

It is worth the Observation which Wierus and Varignana say they have found by Experience that a Toad found in the Woods, cut through the belly and tyed to the Reins, doth provoke Urine violent∣ly; and when you wil evacuate more, apply another.

Petraeus also reports that the Pouder of the same Toad dried and calcined in an Oven, drunk half a dram in Wine or other Liquor, doth wonderfully expel the Dropsie by Urine.

The first Inventor of which Experience desiring thereby to destroy himself, was cured thereby contrary to expectation.

Also this following Cerat made of a Toad is excellent,

Take of Toads two pound: the Juyce of dwarf Elder three Pints: Oyl one pint: Wax half a pound: boyl them in a luted Pot to the consumption of half, strain them for a Cerat; spread this upon a Leather and lay it to the Spleen it evacuateth all waters.

All the time of the Cure you must▪ strengthen the Liver and Stomach, if the humor doth begin to abate, or is not so great that it hinders the Vertue of outward Medicines from coming to the part.

Take of the Oyl of Orange flowers one ounce: the Oyl of Spike three drams: the Oyntment of Roses, the stomach Cerot of Galen, of each two drams: distilled Oyl of Mastich two scruples: the distilled Oyl of Wormwood one scruple: Oyl of Nutmegs one dram and an half: white Wax a little: mix them for a Liniment to be applied to the stomach.

Take of Sea Wormwood three drams: Horehound and Rosemary, of each two drams: Red Roses two pugills▪: Ghamomil flowers and Bay Leaves, of each half an handful: Orange peels and sweet wood, Aloes of each three drams: Cypress Roots, Schoenanth, and Spikenard, of each half an ounce: with two parts of the best Wine, and one part of Wormwood and Agrimony Water make a Decoction, with which Foment the Region of the Liver with a spunge first washt in Worm∣wood Water.

Take of the Oyntment of Roses and Cerot of Sanders, of each three ounces: Red Roses, En∣dive and Sorrel seed, of each one dram: Spikenard, Schoenanth, dryed Wormwood, and Styrax Calamita, of each four scruples: Oyl of Mastich or Wormwood as much as will suffice to make a Liniment to be applied to the same part after the Fomentation.

For the most part in a Dropsie the Thighs, Legs, and Feet have a cold swelling, and for the dis∣cussing of it a Lye is good in which the Roots of Dwarf Elder, and Elicampane, Rosemary Leaves, Marjoram, Thyme, Bayes, Organ, Salt and Allum have been boyled.

Although the things aforesaid are chiefly used, yet somtimes they are not necessary, namely, when the Dropsie comes in a hot and dry Constitution from hot causes which disperse the natural heat, as in vehement Chollerick Feavers, for then cold things for the Liver mixed with warm Openers are best, such as are used in continual Feavers: And the Magistral Syrup above mentioned made of the Juyce of Roses, Succory, and Agrimony.

For ordinary Drink give a Decoction of Succory Roots and Calcitrapa, or white Chamelion, which is not unpleasant; or of other Openers, but in a greater quantity than above, which may quench thirst, asswage the heat of the Liver, and moisten the driness thereof: It is not amiss to con∣firm this Doctrine by a famous example (though it be allowed by Avicen, Trallian, and others) be∣cause it seems strange to some▪ and is of great Consequence: Baptista Montanus reports, Cons. 263. in these words; I saw (saith he) in Venice a certain Predicant Frier that was cured of an Ascites and Tympanites: there were▪ with me many famous Physitians; namely, Papiensis, Eugubinus, Trincavella, and others: He had (as I said) an Ascites with a Tympany, and a Consumption with a Hectick Feaver; therefore we were bound both to dry and moisten: therefore we were in a great contention; I was willing that he should drink much, but things that Open, because he had many ob∣structions▪

and that moisten because he had a Consumption: I prescribed the Syrup of Vinegar with all things that provoke Ʋrine: Eugubinus would not allow him to drink, and told a story of one who was cured by dry things: Papiensis to end the controversie, said, That he should neither drink much, nor at all; we argued till night: the Noblemen brought their Physitians to their Boats, and there Papiensis said to a Nobleman, what he had concealed formerly, If you would have this man cured, there is nothing to be done but what Baptista Montanus saith.

In this case also Medicines of Steel, Tartar, and Vitriol are excellent, because they strongly Open and provoke Urine without any great heat.

But the tart, Vitriol Mineral Waters are best, because they powerfully open the Bowels, provoke Urine, and correct the Distemper of the Bowels, whence experience sheweth us that many Dropsies are every yeer cured at the Spaw.

Avicen reports in the Chapter of the Cure of Ascites, of a Woman which had a great Dropsie and eat an incredible number of Pomegranats, whereby she was cured.

And Varignana reports out of Platearius, That an Old Woman boyled the Juyce of Plantane to the Consumption of half, and gave it to one that had a Dropsie from a Hot Cause every day, and so Cured him.

By these Examples it is plain, That somtimes a Dropsie is Cured with Cold things; and to these we may ad the testimony of Christopher a Vega, lib. 3. art. med. sect. 8. cap. 12. who saith there, We saw one that had a Tympany from the Hot Distemper of the Liver whom we cured with cold things, laying upon the Liver the Juyce of Endive and Succory with a little Vinegar, and giving Endive and Succory to be eaten.