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 TWELEFTH BOOK OF THE PRACTICE OF PHYSICK. Of the Diseases of the Spleen. (Book 12)

The PREFACE.

ALthough the Spleen may be afflicted with all kinds of Diseases, both Similary, Or∣ganick, and Common: yet we will only speak of those which are most ordinary in practice; and we will contain them in six Chapters. The first shall be of the Inflamation of the Spleen. The second of the Pain. The third of the Obstru∣ction and Tumor, or puffing up of the Spleen. The fourth of the Scirrhus, or hard Tumor. The fifth of Hypochondriack Melancholly. The sixth of the Scurvy.

Chap. 1. Of the Inflamation of the Spleen.

THe Inflamation of the Spleen is of the same Nature with that of the Liver: only it differs in this; That it seldom comes from pure, but from Melanchollick Blood. It hath the same Cau∣ses, both Conjunct, and Antecedent: but the Diagnosis, or knowledg by signs, is different.

The signs of the Spleen inflamed, are swelling and pain in the left side under the Ribs, which som∣times reacheth to the Midriff, and the left Shoulder; also heaviness, and beating in the same side, a constant Feaver, loathing of Meat, Thirst, blackness of the Tongue, trouble som lying on the right side, by reason of the heavine••s of the part lying upon the Stomach then; somtimes troublesom lying up∣on the left, if the Tumor be great, for then it is pressed both by the Stomach, and the Liver; somtimes the Tumor is in the shape of the Spleen, somtimes it fills the whol left Hypochondrion, somtimes it appears below the Navel, when the matter is encreased, and when the Inflamation reacheth to the parts adjacent, and especially to the Navel.

These signs are greater or lesser, according to the divers mixtures of Humors. For if Choller be mixed with Melanchollick Blood, the Urine is more red, the Mouth bitter, the Thirst greater, the Feaver stronger and worse every third day; great watchings, and somtimes do••ing: if it be mixed

with Flegm, the Color is pale, the Feaver and Thirst is less, and the pain less: But if the Blood be only Melanchollick, the hardness is greater, the color is black, and somtimes the Urine, and there is other signs of Melancholly predominating.

The Prognostick is almost the same with that of the Liver inflamed, but less dangerous, because the Liver is the nobler Part. If it kill not the party, either it ends in a Crisis, or it is dissolved or sup∣purated, or grows hard and turns into a Scirrhus. A good Crisis is when the left Nostril bleeds, or when there is a purging by Stool or Urine.

The Cure of this Disease, is the same with that of the Liver: only observe these Diffe∣rences.

First, You must open the left Arm in this, and not so often as in the Inflamation of the Liver, because the Liver being the Fountain of blood, wants greater Evacuation. That which is reported of the Salvatella Vein to discharge the Spleen so properly, is but a conceit, and is now out of use: you may better take blood out of the Liver Vein▪ called Bastica.

Secondly, You must apply those Topicks, or outward Medicines now to the left side.

Thirdly, You must not take such care in the use of binding Medicines outwardly, because the Spleen is not so noble a part, and needs less strengthening.

Other things are to be taken out of the Cure of the Inflamation of the Liver.

Chap. 2. Of the Pain of the Spleen.

SOmtimes the Spleen is pained without Feaver or hardness; and this comes from wind which doth not only stretch the substance of the Spleen, which is almost insensible, but the Membranes that covereth it.

It is easily distinguished from the Inflamation by the Feaver, and hardness being absent, but hard∣ly from the Chollick, because the Colon is just under and over the Spleen: yet the pain of the Spleen is weighty, and in one place; but the pain of the Colon is stretching, sharp, and movable, and runs about the whol Belly.

The Cure of this Disease, is with Clysters that are Carminative, or that expel wind with conve∣nient purging, and with Emollient and Discussing Fomentations mixed with Vinegar: As also with Liniments made of Oyl of Lillies, Chamomel, Capars, and Wormwood, with a little Spike and Vinegar.

If the pain remain after the use of these, apply a Cupping-glass to the left Hypochondrion, if there be no suspition of the Inflamation or Defluxion.

Chap. 3. Of Obstruction, Tumor, or Puffing up of the Spleen.

THe Spleen is no less subject to Obstructions than the Liver, but more, because it receiveth thicker and fouler blood, which is more easily contained in its Veins, or insensible Passages, by reason of the softness and loosness of the part, which is more fit to receive thick Humors. And when thick Humors stick in the substance of the Spleen, it makes a Tumor, and an Inflamation in the part. And if the Humor by long continuance grow thick and hard, it breeds a Scirrhus; but as long as it is moist with Flegm, it is like an Oedema or flegmatick Tumor, which is most usual with them who live in Marshy moist places, or who live upon cold Diet. But if this Tumor be soft and loose, it is called simply an Inflamation, or puffing up, the cause whereof, is partly flegm, and partly wind. They are commonly called Splenitick people who are thus afflicted.

The Causes of the Obstruction of the Spleen, are the same with them of the Liver, and this or that part is, as it is more or less disposed to receive them: Somtimes both Liver and Spleen are affe∣cted together; for a gross Humor can hardly be in one part, but some of it must be carried to the other.

The Obstruction of the Spleen is distinguished from the Obstruction of the Liver, from the Sci∣tuation of the part; for there is a heaviness in the left Hypochondrion, and somtimes pain, especially after running o•• great walking or riding: and when you handle the Hypochondrion, there is a stretching and resistance; Besides, the Face is blewish, and there are other Signs of Me∣lancholly.

This Disease is stubborn and of long continuance, by reason of the softness and loosness of the part, which cannot therefore easily discharge the humor; and if it last long and be not Cured spee∣dily, it turns into a Scirrhus.

The Cure is the same with that of the Obstruction of the Liver, by adding some things which do more properly respect the Spleen, and are fitter to prepare and purge Melancholly.

The Pills of Ammoniacum which follow, are to be added as most excellent, and to be used often,

Take of the best Ammoniacum dissolved in Vinegar of Squills one ounce: the extract of Aloes half an ounce: Crystal of Tartar one dram: Myrrh and Saffron, of each half a dram: Mastich, Benjamine, Salt of Ash, and Wormwood, of each one scruple: with Oxymel of Squills make a mass of Pills. The Dose is half a dram twice in a Week, with Purging between.

In Apozemes and other Opening Drinks, Oxymel simple, and of Squills, or Sea Onyons may be very wel dissolved, to cut and dissolve powerfully the gross and earthy humors.

Of all other Medicines those which are made of Steel are the best to open the Obstructions of the Spleen.

Also you may give Steeled or Ironed Waters for ordinary Drink, which are known to lessen the Spleen (as Celsus saith) by this, because Beasts that are brought up at Smiths houses have little Spleens.

To the Fomentation put Vinegar instead of white Wine, which wil make them peirce better, which is requisite in a gross humor.

Moreover Galen Commends Vinegar exceedingly in the Diseases of the Spleen, used both inward∣ly and outwardly.

Put Hemlock to the Cataplasms; as being most Powerful to Soften, and Discuss Hu∣mors.

There is an Excellent Cataplasm made of Green Tobacco; boyled in Oyl, and White Wine.

Of which also boyled to the Consumption of the Wine, you may make a Rare Lini∣ment.

Amatus Lusitanus, curat. 6. cent. 5. mentioneth a Cure of an Obstruction of the Spleen remain∣ing after a Quartan Ague, That it was taken away with a Decoction of China used twenty dayes after convenient Purging.

Chap. 4. Of the Scirrhus, or Hard Swelling of the Spleen.

THe matter of the Spleen causing obstruction by continuance grows thicker, and makes a Scirrhus: And since the Scirrhus of the Liver and Spleen are both of one Nature, whatsoever we have said of the Scirrhus of the Liver, may be here also useful.

The Knowledg also of the Scirrhus of the Spleen is the same with that of the Liver, but only the hardness is on the contrary side.

It is Distinguished from a Windy Tumor; because there is more Heaviness in a Schirrhus, than in a Windy Tumor, which yeildeth to the Finger, and maketh a Noise; al which are not in a Scirrhus.

If it come only of Melancholly, there wil be evident signs thereof; but if it be mixed with Flegm, there is apparent in the whol body a Phlegmatick evil habit.

The Prognostick also is the same with that of the Liver; only this of the Spleen is more easily Cured; because the less Noble the part is, the stronger Medicines may be Applied without Danger.

And Lastly, The Cure is the same with that mentioned in the Scirrhus of the Liver.

And because it is to be done by degrees, from mild to stronger Medicines: first you must use those Remedies which we said were good for the Obstructions of the Liver and Spleen: and among the Chalybeat Medicines there commended, the Principle is the Pills of Steel, made with Amoniacum, and other things mentioned in the Obstruction of the Liver.

Pills of Aloes, Ammoniacum, and Mercurius dulcis, are the best among the Medicines for the Scirrhus of the Liver.

But this following Opiate is the Medicine wil Cure, if it be not incurable:

Take of Gum Ammoniack, Opopanax, and Bdelium, of each two drams: dissolve them in white Wine: strain and boyl them, then ad of confectio Hamech, and Diaphaenicon, of each two

drams: double Catholicon half an ounce: Pilulae foetidae two drams: make an Opiate, of which let him take half an ounce with twenty grains of Mercurius dulcis for many daies together, and so the Tumor and hardness will vanish.

And besides what was said concerning the Liver, you must observe these following Precepts in in this Disease.

First, Because Blood-letting is much questioned, we resolve that it may be good in the beginning. But it is good for nothing when the Disease is old.

Secondly, The dead or blind Nettle called Galiopsis, or Pliny's Arch-angel, is commended by Solenander and Fonseca, for a special Remedy; the Italians call it the Spleen Herb: this is given boyled in Wine, the quantity of an ounce, or one dram in Pouder, with Wine or other convenient Liquor or Decoction, with most admirable success.

Thirdly, Besides the Fomentations there mentioned, Aquapendens in his Chyrurgery, commends the fomentation of the Belly, with a Spunge dipped in Time Water, and squeezed; and with that he saith he hath cured the Scirrhus of the Spleen and Dropsie.

Fourthly, Besides the Oyntments afore mentioned, Amatus Lusitanus commends this following as admirable, by which he saith he cured a Scirrhus of the Spleen; and he saith that he had it from the Physitians of Ferraria.

Take of Common Oyl three pints: the Marrow of an Ox bone one pound: fresh Butter half a pound: the Juyces of Briony and Sowbread, of each one pint: boyl them gently till the Juyces are almost consumed. Add to the straining, yellow Wax eight ounces: the Pouder of Ceterach or Spleenwort, Capar barks, Tamarisk, and Agnus Castus seeds, of each three drams. Mix them into an Oyntment.

Thus it is described by Amatus; but there is too much for one Patient, therefore you may lessen it thus:

Take of Common Oyl three ounces: Ox Marrow one ounce: fresh Butter half an ounce: the juyce of the Root of Briony and wild Cucumers, of each one ounce and an half: boyl them as afore, and add one ounce of Wax, and of the pouder of Ceterach: Capar and Tamarisk Barks, and Ag∣nus Castus seeds, of each two drams.

Fifthly, The Cataplasms following are excellent:

Take of the Roots of wild Cucumers one pound: Mallows and Violets, of each three handfuls: boyl them till they are soft, beat them and strain them: then add of the Oyl of Capars and Tama∣risk, Vinegar of Squills a little: make a Cataplasm.

Take of sowr Leaven two pound: Boyl it in equal parts of Oyl and Wine to a Pultiss.

Besides the Plaisters mentioned in the Scirrhus of the Liver, these are very good:

Take of Gum Ammonial ••our ounces: Dissolve them in strong Vinegar: then strain them, and boyl them till the Vinegar be consumed: then with a little Wax make a Plaister.

Take of Hemlock four handfuls: Ammoniacum half a pound: Infuse them in Vinegar eight daies: then boyl them til the Ammoniacum be dissolved: then strain them through a linnen cloth, and boyl the Liquor again a little while, and with Wax and Oyl of Almonds, make a Plai∣ster.

Take of the Juyce of Mallows, Cressonis, the Stalks and Roots of Fern, of each two ounces: Gum Ammoniack four ounces: With a little Vinegar, first dissolve them with a gentle fire, then boyl them, and strain them: then boyl them again to the consistence of a Syrup, and with one ounce of Oyl of Capars, and a little Wax, make a Sparadrap for the Spleen, to be renewed every third day.

Aquapendens in the place cited, saith, that he cured many with this Plaister, which is made of two parts of Ammoniacum dissolved in Vinegar, and one of the Juyce of Tobacco; one of the Ro∣zin of the Pine-tree, Turpentine, and Juyce of Danewort; one of Oyl of Capars, and a little new Wax in the Form of a Cerat.

Chap. 5. Of Hypochondriack Melancholly.

ALthough all the parts beneath the Ribs, called Hypochondria, are affected in this Disease, yet its thought the Spleen is most, because it receives the Melancholly, and therefore it is fitly placed among the Diseases of the Spleen.

This Disease comes of Preternatural Melancholly, and other adust Humors, especially Blood, or Choller, or Natural Melancholly.

This Melanchollick Humor is not pure by its self, but commonly mixed with others, as Choller, Flegm, and Water, from whence come the diversity of Symptomes, which hereafter shal be mentioned. These Humors breed in the Spleen, especially when it is distempered with heat, and also in the Liver: hence it is that they draw meat and drink to themselves, which is not concocted, that which is thin of the Chyle sooner than that which is thick: and then the thicker part for want of somthing to car∣ry it, staies in the Meseraick Veins, and the longer it staies, the thicker it grows, and somtimes is burnt: and afterwards coming to those parts, it is not well concocted. Moreover, thine parts in their Natural state should concoct by boyling, now do it by roasting; hence comes this great ad••stion of Humors.

It may also be, that this Disease may be bred without the distemper of the••e parts, from evil Nourishment that breed Melancholly blood; and also from good blood retained too long in the ve••∣sels, and being too much, as in the stoppage of the Terms and Hemorrhoids, which continuing long in the Vessels is burnt, and turned into Melancholly.

It may also come from the Stomach not well concocting, but turning it into a parched Crudity, from which those evil Juyces are bred in the Liver, and the Spleen. And Galen, 3. de loc. affect. cap. 7. following Diocles, thought the proper seat of it was in the Stomach, because in this Disease there are commonly signs of an ill Stomach: But it is more probable that the Stomach should be af∣flicted secondarily from the Liver or the Spleen, as we will cleerly shew hereafter.

These evil Humors are gathered into the Veins and Arteries, which are in the bottom of the Sto∣mach, especially in the great branches of the Gate Vein, the Spleen Veins, and those of the Mesentery, Caul, and Belly, in which they have often great and grievous ferventations or workings; from whence stinking Vapors are sent to the Brain, Heart, and Midriff, which cause those divers Symptomes in those parts, which we shall after mention.

Also the Humors are contained in the Bowels, especially in the Spleen and Sweet-bread, and the Glandles of the Mesentery, the substance of which parts is foft, and like a Spunge, and therefore is more ready to receive them, and harder to cast them forth. Besides, the Glandles which are d••••per∣sed through the Mesentery, to be a prop to Veins and Arteries, and to hinder least they should be pressed by the Guts being full, or by any other thing: If these swell much, they do press upon the Vessels, and hinder the passage of the Humors, whence come Obstructions in those passages.

Boyes and yong men are little subject to this Disease, by reason of their moist temper unfit to breed Melancholly: but men often, because the Humors are burnt by heat in youth; and when that heat decaies, and the thin parts are exhaled, there is a great encrease of Melancholly.

The Antecedent and principal Causes of this Disease, are first Meats of evil Juyce, and hard of Concoction, which are fit to breed Melancholly; as brown Bread, or unleavened, or crusty, Pulse, Cheese, hard Eggs, and fried Meats, Water Fowl, Beef, Venison, Hairs, and all Salt and smoaked Meats, and many other things of hard substance.

Secondly, Great Passions of long continuance, especially Sadness, are very powerful to breed this Disease because they disperse the Spirits, by which means the Concoction is weakened, and so there is great Crudity, which being burnt by the hot Bowels turn into Melancholly.

Thirdly, Idleness, by which the Excrements are retained, especially if there be much study and watching; hence it is that learned men, and such as ••it much are very subject to this Disease.

Lastly, The stoppage of the Terms and Hemorrhoids, both in respect of their quality and quanti∣ty produce it: For when Melanchollick, Salt and burnt Humors, used to be discharged by those waies, if they are stopped they return to the Hypochondria and cause this Disease.

The Knowledg of this is taken from the Symptomes which follow, and they are many, because almost all parts of the Body suffer thereby when it is high: We shall reckon them up, admonishing first, That all do not happen to all Patients, but some to one, some to another, according to the di∣versity of the Humor, and the part affected.

First therefore, the Stomach commonly suffers, not principally, as Galen from Diocles supposed; but secondarily: When Blood coming from the Branches of the Gate Vein, to nourish the Stomach is not good; from whence the Stomach being ill nourished, doth ill concoct, and turns its Meat into corruption. Hence comes a circular Evil, when the Liver and Spleen send evil Blood to the Sto∣mach, and the Stomach breeds evil Chyle to return to them, of which they make bad blood.

Therefore in this Disea••e the Stomach commonly concocteth ill, and turns the chief part somtimes into Water, somtimes into sharp, sowr, and clammy substance; which being not drawn by the Guts and Meseraick Veins, because unfit for nourishment, staies in the Stomach; and coming upwards somtimes fills the Tongue with Spittle, so that the Patients 〈◊〉〈◊〉 much, and somtimes vomit.

Somtimes the Matter in the Stomach boyleth, and fermenteth; from whence comes wind, which doth not only stretch the Stomach, but the parts adjacent, and make the Heart so sick that somtimes

the Patient swooneth. Somtimes the Wind is sent out upwards and downwards, and by insensible transpirati••••, or the Matter causing them is vomited forth.

Yet you must observe that al that is vomited out is not bred in the Stomach, but is sent from the Spleen and other parts to it: for somtimes the humors vomited are so sharp that they set the teeth on edg, and these are sent by the short vessel from the Spleen to the Stomach.

In some there is blood so sent, with Melancholly and other evil Humors, which is cast forth part∣ly upward, and partly downward; as we shewed at large in the Vomiting of Blood.

In this Disease there is often belching and noise beneath the ribs, by reason of the abundance of Wind made of those Crude Humors: hence it was wont to be called the windy Disease. Now, how Wind is bred of Melancholly, we shewed in the Tympany.

Somtimes pains arise in the Stomach and Hypochondria, of the same Wind, which reach to the Back and Loyns, so that you would think it the Stone of the Kidneyes, especially if the Urine be thick and red, as usually it is.

The Belly is often bound, because the Meat is turned into clammy Matter, which sticks to the Guts, which the expulsive Faculty cannot cast out without help of Medicines, and therefore the Patients are constrained to take Purges and Clysters often.

Somtimes there is a Flux of the Belly, if the Humors grow sharp, and have in them much Choller or burnt Melancholly.

There is a heat in the Hypochondria, and a certain Inflamation inward, somtimes in one side, somtimes in another, from hot Humors contained therein, especially when they are moved by in∣ward or outward means; so that the Face will grow hot and red from those vapors; and somtimes there is an Ephemeral, or Feaver, for a day, by those vapors sent through the whol Body.

The Urine is somtimes thick, somtimes thin. Thin, when thick Humors stop the passages through which it is as it were strained, thick, red, and troubled, by reason of the mixture of the thick Mat∣ter, which is very salt, and therefore is called (Materia Tartaria) and it lies at the bottom of the Urinal like a thick Sediment. Or some part of it sticks like red Sand to the sides, which makes ma∣ny fear the Stone without cause, because this same is not bred in the Reins, but in the Liver, from a burnt and salt Humor, and you may know this, because it dissolves between the Fingers like Salt, which will not when it comes from the Reins.

Somtimes there is a Palpitation, or beating of the Heart, by reason of the vapors ascending, which while it labors to expel, make it move violently; and then the Patient thinks himself in great danger.

Somtimes there is a beating in the left Hypochondrion, when hot Humors are there; from whence vapors arise, and make the Pulse or Systole and Diastole of the Arteries greater; so that both the Patient and the standers by may feel it, which is chiefly after heat with Anger, motion, or drin∣king of much Wine. This beating is chiefly in the Coeliack Artery, which is the chiefest in that part. In an old Disease, it is somtimes constant; and this signifies an Habitual and incurable Disease. An Aneurism somtimes followeth this great breathing, from the enlarging of the Coeliack, or some other Artery, and from the hot blood in them, which being very thin and full of many hot Spirits, continu∣ally dilateth and stretcheth the Arteries while there is an Aneurism, such as Fallopius observed, Lib. de tum. preter naturam, cap. 14. in an old woman, who being opened had an Aneurism in her Belly, into which he put his fist. From which, mark by the way, the great providence of Nature, which fearing the breaking of an Artery through too much enlarging, hath made the coat of it as hard as a bone, as Fallopius observed in the same place. Also Paraeus in his sixth Book, Cap. 28. tels the like story of an Aneurism, found not in the Belly, but the Breast, in the Venal Artery, which was so stretched that it could contain his sist; and also the inward Tunicle thereof was like a bone. And we have seen the like about two yeers agone, namely, an Aneurism in the Breast by the dilatation of an Artery, which would hold the fist of a Boy of fifteen yeers old; and the Tunicle thereof was grown like a Gristle.

The evil vapors that ascend from the Hypochondria, produce many Symptomes: for being sent to the Pallat and Tongue they dry those parts, and cause a thirst: when they go to the Lungs and Midriff, they cause shortness of breathing; when to the Membranes of the Brain, Head-ach; when to the Brain, noise in the Ears, dimness of Sight, Giddiness, Fear, and Sorrow, and divers Melanchol∣ly Phansies. And if they be malignant, and very sharp, they cause an Epilepsie, or Falling-sickness: if they come to the Nerves, Convulsions: and if they be stupifying they cause a Numbness, and ba∣stard Palsey, Coma, and Apoplexy, if they get into the Brain. But if these vapors be hot and dry, they dry the Brain, and cause watchings, troublesom sleep, and frightful Dreams: and at first, though they sleep well after Supper til midnight, afterward they wake, some three or four hours, and some sleep again about three or four a clock, others not at all. The reason whereof is this: Because while the Chyle is carried to the parts that serve for the second Concoction, then the evil Humors lying in the Vessels, are stirred, and send up vapors, which being sent by the Veins and Arteries to the Head,

cause watching, and if they be quickly discussed, they sleep again; but if they continue long, they watch the other part of the night.

We have formerly spoken of all these Symptomes, and we say again, That all are not in all men, but more or sewer, according to the variety of the Humors, and parts affected.

This also is to be marked; It is not Essential to Hypochondriack Melancholly, that stretching, hardness, pain. and swelling, should be in the Hypochondria, because the cause is for the most part in the Branches of the Gate Vein, and Arteries adjoyning, and sends from thence vapors to the Heart and Brain. Oftentimes there is stretching in the Liver and Spleen, which signifieth, That the Humors stick in those parts: but if there be no stretchings, it is a sign that the evil Humors lie in the Veins of the Mesentery, Caul, Sweetbread, and Stomach. These proper Symptomes shew that the Stomach is affected with sowr belchings, and stinking, or loathing, vomiting, want of concocti∣on, and somtimes flux of the belly.

As for the Prognostick: This Disease is not deadly for the most part, but of long continuance, many times the whol life, therefore it is commonly called the disgrace of Physitians, because they do seldom cure it; and if the Patient seem to be cured, it returns again in a few months: it is also called the Scourge of Physitians, because they who have it are continually asking new Med••c••nes, and pre∣sently satisfied therewith, and dayly complain to the Physitian for others.

The Flux of the Hemorrhoids doth good in this Disease, if it be moderate; but if it continue long it is dangerous.

A thick Urine is better in this Disease, than a thin and watery, which shews that the thick Hu∣mors are detained in the Body. Black Urine without a Feaver, doth often Cure this Disease.

Its good in this Disease to have a loose Belly, and bad to be bound. Also Vomiting, if the Patient be refreshed thereby, is profitable; but if it continue long, it is dangerous.

A Giddiness, and continual pain in the Head in this Disease, ends in an Epilepsie, Blindness, or Apoplexy.

The Cure of this Disease, is in three things chiefly: first in opening Obstructions: secondly in a∣mending the distempers of the Bowels: and in discharging of the peccant humor, not omitting strengtheners: For which a wise Physitian may use these following.

First give a Clyster, then this Potion:

Take 〈◊〉〈◊〉 Senna half an ounce: Annis seeds, and Cream of Tartar, of each one dram: Bor∣rage flowers, Fumitory, and Sorrel, of each half a handful: Liquoris three drams: boyl them to three ounces. Dissolve in the straining, Rhubarb infused in Lavender Water one dram and an half: double Catholicon three drams: Compound Syrup of Succory one ounce. Make a Potion; to which you may well add in a strong Melancholly, one dram of Confectio Alkermes.

The day following, let Blood from the left side chiefly, or as the Liver or Spleen are most affected.

Then give these Broths:

Take of Sparagus, Dog-tooth, and Succory Roots, of each half an ounce: Agrimony, Ceterach, Maiden-hair, Bugloss, and Succory, of each half a handful: Cream of Tartar one dram: boyl them with a Chicken, and make Broth ten or twelve daies, adding four drops of Spirit of Vitriol to cool and open more.

In old Obstructions, you may add to the former, China Roots, Sassaphras, white Sanders, Smal∣lage Roots, and ••••le Fern Roots, Bettony, Scabious, Coriander prepared, Raisons, and the like.

If the Belly be bound, or the Body very foul, give in every third draught of Broth, half an ounce of Senna, with Annis seeds.

Or this Apozeme instead of the Broth:

Take of Bugloss, Sparagus, Succory, and Sorrel Roots, of each one ounce: the middle rind of Tamarisk and Ash, of each half an ounce: Agrimony, Ceterach, Maiden-hair, Dodder, Succory, Fumitory, Hops, Bugloss, and Borrage, of each one handful: the four cold seeds, Annis and Fennel seeds, of each two drams: Currance one ounce: Senna and Polipody of the Oak, of each two ounces: Dodder of Time one ounce: the best Agarick and Rhubarb infused by themselves in Cinnamon Water, of each two drams: Mace and Cloves, of each one dram: the three Cordial Flowers, of each one pugil: Boyl them to a pint, and dissolve in the straining, Syrup of Succory with Rhubarb, and of Roses solutive, of each two ounces. Make an Apozeme clarified and aro∣matized with two drams of yellow Sanders, for four morning draughts.

Or give Cock Broth thus made:

Take of Roots of Asparagus, Bruscus, and the bark of Capar Roots and Tamarisk, of each half an ounce: Agrimony, Ceterach, and Maiden-hair, of each one handful: Annis, Citron, and Carduus seeds, of each one dram: Senna half an ounce: Polipody of the Oak, and Epithimum,

or Dodder of Time, of each three drams: Cinnamon one scruple: Crystal of Tartar one dram. Boyl them all with half a Cock, which let him take four mornings.

After you have sufficiently purged, a Bath of warm Water is most convenient, used many ••••ie••, in which cool Herbs have been boyled, and sweet Apples. Somtimes it is made of Barley and Almo•••••• beaten, and put into a Bagg and boyled in Water. It must be often repeated, if the season will permit; for Galen, 8. de loc. aff. cap. 6. saith that he cured many melancholhck men, only with the use of hot baths, without any other Medicine. And if the Patient cannot endure a whol bath, let him have one for half the body.

And least often washing should hurt the Stomach, when he enters into the Bath, let it be per•••••••• with Oyl of Nutmegs by Expression, or the like.

When he goes forth of the bath, let the Region of his Liver be anointed with the Cerat of Sanders, or Oyntment of Roses washed in Oxycrate.

After his last bath, let the Hemorrhoids be provoked with sharp Suppositories, or with rubbing the Anus with Fig Leaves, or with a rough linnen Cloth; and with two or three Hors-leeches apphed to the most apparant places, take away five or six ounces of blood. And this must be done every Spring and Fall, and somtimes once a Month.

They who are used to have the Flux of the Hemorrhoids, if it hath been long stopped, so that they wil not appear, must have a Cupping Glass applied.

If after the Leeches are fallen off, they bleed stil, as somtimes they wil, stop them with Clay, or Pouder of Coal, or with Spiders Webs, or with Pouder of Lime, or with astringent Pouders taken up with the white of an Egg and Pledgets.

And if you cannot conveniently open them, it is good to draw blood from the inferior Veins, that the most impure may be voided.

An Issue burnt in the left Legg doth purge the Spleen and other Bowels from superfluous Humors, and therefore forget it not.

But because this Disease useth to be very stubborn, and after Purging, new Humors return, you must purge by sits, that the Body may be freed from them by degrees: which may be wel done by a Magistral Syrup, made thus:

Take of new drawn purified Juyces, of the Flowers of Borrage, Bugloss, Endive, Succory, Fumi∣tory, and Sorrel three pints: the Juyce of sweet Apples newly drawn and clensed two pints: fresh Po∣lipody of the Oak half a pound: clean Senna eight ounces: Dodder of Time three ounces: Agarick newly made into Troches one ounce: Ginger and Cloves, of each one dram. Infuse them and strain them according to art, till there remain five pints and a quarter of the Liquor, in which dis∣solve the straining of an ounce of Rhubarb dissolved in the said Juyces by themselves with a little Cinnamon, and one pound of Sugar. Make of these a well boyled Syrup; clarifie it, and a••••ma∣tize it with two drams of the Pounder of the three Sanders, keep it in a Glass, and let him take into ounces thereof, twice or thrice in a month, with a little Chicken Broth, boyled with Endive, Sorrel, Borrage, and Burnet.

Or instead of the Syrup, you may give Pils, especially in Winter, such as were mentioned in the Obstruction of the Liver; or if you fear they are too hot, you may make these following:

Take of Polypody of the Oak half an ounce: Asarabacca Roots, and Broom buds, of each one dram: Currance three drams: Crystal of Tartar one dram and an half: Bugloss and Borrage flowers, of each half a pugil: Boyl them in Spring Water. Take half a pint of the straining being well clarified, and six ounces of the Juyce of sweet Apples also well clarified; and infuse therein one ounce of clean Senna: Turbith and Agarick, of each three drams: Mace, Cloves, Cinna∣mon, and Dodder of Time, of each one dram: digest them four daies in Balneo Marioe: then strain them, and add to the straining, one ounce of the Extract of Aloes made in Endive and Sor∣rel Water; Myrrh dissolved in Wine and strained, two drams: Salt of Tartar one dram. Eva∣porate them all, and inspissate and thicken them at a gentle fire, adding towards the end when the matter is almost evaporated, Diarrhodon Abbatis Loetisicans Galeni, and the Troches of Dialac∣ca, of each half a scruple: bring them into a mass for Pills; and let the Patient take half a dram once in a week, two hours before meat.

Pereda witnesseth, that the hath cured many Melanchollick men with this following Pouder; and he cals it Blessed, and Divine.

Take of Dodder of Time half an ounce: Lapis Lazuli, and Agarick in new made Troches, of each two drams: Scammony one dram: Cloves twenty: mix them into a Pouder, and give two drams twice or thrice in a month with, Whey or Borrage Water.

If you cannot conveniently give often Purges, it is good every other day to give a Clyster to revel vapors, and draw forth some part of the Humor: for if they go deep into the Guts, they take away the greatest part of the filth from the Meseraicks. We knew a Noble Man, who being long troubled with this Disease, was cured by often Clysters, when other Medicines did nothing.

While you give intermitting Purges, let the Body at other times be moistened with Baths, or half Baths, or Fomentations, by which both the violence of the Humor is restrained, and the Body made moister.

Also at those times, you must use strengtheners, which will also open Obstructions, and they use to be made often like Opiates, or a hard Electuary, or Lozenges, thus:

Take of Conserve of Bugloss Roots half an ounce: Conserve of Borrage Flowers, and Violets, of each one ounce: Conserve of Roses, and candied Citron peels, of each half an ounce: one can∣died Myrobalan: Confection Alkermes three drams: Pouder of Ivory, Harts-horn, and Bezoar stone, of each one dram: Loetisicans Galeni, and Diarrhodon Abbatis, of each two scruples: Coral and Pearl prepared, of each half a dram: Amber-greece half a scruple: the best Musk five grains: Gold three Leaves: with Syrup of Apples, and of candied Citrons, make an Opiate, of which give the quantity of a Chesnut two hours before meat, every day drinking after it a little white Wine.

A plainer and better tasted Opiate, is made of one part of Confection Alkermes, and four parts of Conserve of Borrage Flowers. And to open more powerfully, if you fear no hurt by hot things, add Conserve of Tamarisk flowers, Elicampane Roots, Wormwood, Maiden-hair, and the Salts of Wormwood and Tamarisk, &c.

You may make Lozenges thus:

Take of Diambra, Diamoschi dulce, and Loetisicans Galeni, of each one scruple: Confectio Al∣kermes three drams: Sugar dissolved in Borrage and Rose Water, four ounces: make Lozenges of two drams in weight, gilded. Let him take one every day two hours before meat.

Or you may make them more pleasant thus:

Take of Confectio Alkermes two drams: Amber-greece one scruple: Sugar dissolved in Rose Water four ounces. Make Lozenges.

Amber-greece alone, given five or six grains at a time every day with Wine or Rose Water, doth cheer the Spirits and the Natural Heat, and much rejoyce the Heart.

Some Authors do much commend the use of Bezoar stone against all Melanchollick Disease, be∣cause it doth much strengthen the Heart, and you may give five or six grains in Rose Water, or other Liquor.

After the Body is well purged, if it be Spring or Summer, you may give Whey for fifteen or twen∣ty daies, which will open the Obstructions of the Bowels, and amend the hot distemper. Make it by boyling and clarifying it, and putting into it every night two drams, or half an ounce of Epithi∣mum.

You must proportion the quantity according to the strength of the Stomach. For if it can easily pass through the Veins, being somwhat open, and be sent forth by stool and urine, it is good to give it in great quantities, as Mineral Waters prescribed in the hot distemper of the Liver, with this Caution, That you strengthen the Stomach with Baggs, and other things hereafter mentioned, and give every day at evening a Cordial strengthening Opiate. Instead of Epithimum, you may mix with the Whey, the juyce of Succory, Borrage, or of any other proper cool Herb, thus:

Take of Goat Whey four or five pints: the juyce of fresh Lemmons four ounces: the new juyce of sweet Apples six ounces: Conserve of Roses or Violets, or white Sugar, one ounce. Clarifie these with whites of Eggs. Let him take every morning three or four more Cups thereof, if his Stomach will bear it.

In Bodies that are very lean, after the Obstructions are a little opened, you may give Asses Milk with Sugar of Roses; and if there be rumbling in the Hypochondria, a little Aromaticum Rosatum, or Diarrhodon Abbatis wil do very wel.

But your sharp and Vitriol Mineral Waters, are beyond all Medicines, which by correcting the distemper of the bowels, do powerfully open Obstructions, especially the warmest, which do make the Humor thin, and clense it.

There is great dispute among Authors concerning drinking those Waters. Some (with Sennertus) do allow it, because they receive Vertue from their Minerals, and do thereby both clense the passages, and send forth the filthy Humors which stick to them by stool and Urine: they warm the Stomach, and strengthen the Liver and Spleen: And we may rather fear that these Waters wil hurt by the use of them external than internal, by heating and drying. Others (with Claudinus) do altogether de∣ny them, by reason of their drying quality. Others (with Montanus) do neither altogether re∣ject them, nor wholly approve of them; they say they are good, by reason of the coldness of the Stomach, which is alwaies in this Disease, and by reason of Obstructions. But in regard the Liver and Spleen are hot, they wil have them defended with the cool Oyntment of Galen. And also the Loyns, for then (saith he) the water will not hurt, because it staies longer in the Stomach, and cold places, but only passeth through other parts. We suppose that the use of them is convenient, if the Stomach being cold have much thick and clammy flegm in it, and if the heat of the Liver be not very

great. Which part is not like to suffer, if the aforesaid Oyntment be not only given, but also cool Broths after the Waters; and after they have been used enough, cold and moistening baths for some daies.

Medicines made of Steel, use to be of great Vertue to open these Obstructions, such as are mentio∣ned in the Obstruction of the Liver, and of the Spleen, avoiding those which do heat and dry much. In hot bodies you may give Steel prepared with Brimstone or Vinegar, with Conserve of Borrage and Succory, made in the form of an Opiate.

For dainty folk, the Syrup of Steel afore mentioned in the Obstruction of the Liver and Spleen, is excellent; or the Froth which remains in the Glass after the Evaporation of the Wine which hath been often steeled, mixed with the aforesaid Conserves.

But Salt or Vitriol of sron goes beyond all Medicines, because it opens Obstructions, strengthens the Bowels, and qualifies their heat. The Dose is from twelve to twenty grains, with a fit Liquor, Syrup, or Conserve. But because it is displeasing to the taste, I use to make it into Pils with the Mucilage of Gum Tragacanth. You must use it long, and therefore get a great quantity, which is not easie to be got after the way that Beguinus and others make it. We will shew you the easie way of making it, which few men know.

Take of the Oyl of Vitriol, or of Sulphur, half a pint: the Spirit of Wine one pint: Put them in a new Iron Pan that is clean, and cover them well; within fifteen daies of them there will be a Salt∣like gathering, which you must set in the Sun to dry it throughly, somtimes stirring it with an Iron Spatula: In Winter you may dry it upon a gentle fire, or in a Hot-house. Let the Salt being well dried, be kept in a close Glass; for if it be exposed to the Air, it easily turneth moist. Also the Pills that are made thereof, of Tragacanth, must be hardened with the Pouder of Tragacanth, and after put in a Glass, otherwise they will grow moist. You may continue this Medicine for a month or two, not only without hurt, but with great profit.

Fonseca commends these Pils following, which he cals Diatartarum, for opening Obstructions by degrees, and purging Melancholly gently, and for allaying it.

Take of the Pouder of Senna, and Salt of Tartar, of each one dram: Pouder of Cinnamon half a scruple: with Syrup of Lemmons make a Mass, of which give three Pills made of half a dram one hour before Supper, to give him two or three stools, for Salt of Tartar hath great Vertue to allay black melanchollick Humors; for it draweth to it self by certain propriety sowr things, as you may perceive when it is mixed with Vinegar, or Spirit of Vitriol, whose sowrness it taketh away: For we must know, that Fonseca by Salt of Tartar, meaneth Crystal of Tartar. Yet you may as well infuse your Senna with the Salt of Tartar, and some drops of Spirit of Vitriol in some conveni∣ent Liquor.

To open the same Obstructions, some commend the Decoction of China, as we said in the Obstru∣ction of the Spleen; which a wise Physitian may do with good success.

Some commend the Juyce of VVormwood thickened into the form of a Pill, given either by its self, or with Gum Ammoniacum; and after that presently, Oxymel made of the Decoction of Asa∣rum Roots and Liquoris.

Others say, That Hypochondriack Melancholly hath been cured with the Decoction or Wine of Wormwood taken thirty or forty daies together.

The Juyce of Bugloss is excellent, not to open Obstructions as Wormwood, but to qualifie the Melanchollick Humor. Therefore they give two ounces thereof with two drams of Sugar, and as much Wine as of both, for ten or twelve daies every morning.

The principal thing for this Cure, is to keep the Body alwaies soluble: Therfore the Patient must have some familiar Medicines, which he may often use before meat, somtimes one, somtimes another, lest he grow weary of them. For this he may take the Magisterial Syrup, and the aforesaid Pils, and those which were pre••cribed for a costive Belly. To which he may add (out of Montanus) Venice Turpentine, which he orders to be swallowed in the quantity of an Acron, three hours before dinner, once, twice, or thrice in a week: for besides that it looseneth the belly, it also clenseth the Stomach, opens Obstructions, provokes Urine, warms the Stomach, and doth not heat the Liver, but doth it good by opening and clensing it.

For his ordinary Drink let him use Water wherein Gold hath been quenched, or the infusion of Tamarisk, Agrimony, Burnet in thin Wine, either alone, or made Physical in Vintage time with the Roots of Bugloss, Borrage, with a little white Sanders and Rosemary Flowers.

The Decoction of the Sweet Bryar Root, is commended for ordinary Drink; for it openeth and strengtheneth all natural parts.

The Decoction of Lignum Nephriticum doth open the Obstructions of the Bowels without any manifest alteration. But steeled Water is more usual. All which Waters and Decoctions, you may also mix with Wine.

While in the internal Medicines mentioned or any of them are used, you must apply External, as Fomentations, and Oyntments to the Hypochondria, such as are prescribed for the Obstructions of the Liver and Spleen, making Choice of the Coolest.

You must also apply strengthners to the Stomach, because that part doth alwaies suffer in this Disease; therefore you may use those Fomentations, Oyntments, and Emplaisters mentioned in the Diseases of the Stomach: Also those Internal which wil not inflame the Liver; and especially the Digestive Pouder to be taken after meat: in a Fit when the Vapors arising from the Hypochondria do trouble the Heart, Brain, and other parts, and produce great Symptomes, as Swoonings, Palpita∣tions, Tremblings, Convulsions, Head-ach, and the like; you may use those things which are given in Swooning, or the Mother; but among the rest Laudanum used wisely, doth wonders.

Chap. 6. Of the Scurvy.

THe Scurvy is usual in the North, in most places thereof Common, but almost unknown in the South; so that al Writers that have Practiced in these Parts, have never mentioned it: and we may wel leave it out, because in our Preface to this Book we promised to meddle only with the usual Diseases of the Spleen; but Experience hath taught us, That our Country is not altogether without it, for though it be not in every Symptom the same with that of the North, yet it hath enough to confirm it to be the same: for the aforesaid Authors say that one Symptome is sufficient to discover it; we have seen many Symptomes of it in many people, but because it is not familiar here, and al our Physitians say we have it not, we would not absolutely cal it a Scurvy, but we thought it better to cal it a Scorbutical Disease, such an one as comes next to it, though it be not a true Scurvy.

For the Scurvy is nothing else but an Hypochondriack Disease, having a peculiar degree of Malig∣nity from which more Symptomes arise than in the Hypochondriack Disease: this malignity comes from the putrefaction of Melancholly, not of every kind of melancholly, for it is often corrupted, from which other Diseases arise and not the Scurvy, as a Quartan Ague •••• Imposthume in the Mesen∣tery, and other parts; but of a peculiar and proper Melancholly which is a••••••••able to that Malignity. This is known by the Infection which is found in this Disease, because author•• hold it to be infe∣ctious. And because al the degrees of malignity which lie in the Humors and produce divers Diseases are unknown unto us and 〈◊〉〈◊〉, therefore is this of the Scurvy obscure 〈◊〉〈◊〉 hidden; and it is won∣derful that so many Diseases should arise from the variety of malignity which is in the Humors, as malignant Pestilential Feavers, 〈◊◊◊〉〈◊◊◊〉 Measels, Cancers and Elephantiasis, the Pox, and ma∣ny others. And especially Elephantiasis comes from a peculiar malignity in a Melanchollick Humor, and so doth the Scurvy, and yet these two Diseares differ so much, that none can tel their divers de∣grees of malignity.

Divers Symptomes common to both, do shew a great likeness of the Scurvy and Hypochondriack Melancholly: for al they which were mentioned in the former Chapter, are found in this Disease, as crudities and want of Concoction in the stomach, often spitting, flegmatick, sharp, and stinking vo∣mitings, noise in the Hypochondria, belchings, breaking of Wind downwards, vomiting of blood, and purging of blood, pains from wind under the ribs and in the stomach, somtimes Costiveness, and somtimes Looseness, heat in the Hypochondria, beating of the Left side, Urine now thin, than thick, heart beating, thirst, drought of the mouth, short breath, head-ach, noise in the ears, dimness of sight, giddiness, sorrow and sadness, and divers dolings, convulsions, falling-sicknes, numbness, coma, wat∣chings, troubled sleep, and terrible dreams: The Reasons of al which were shewed in the Chapter above, and they may agree with this of the Scurvy.

But if any Symptomes appear besides these, which are not found in that, nor mentioned by Au∣thors, nor belong to another Disease; you may conjecture that it is the Scurvy: The Chief are these, which are not al sound in one Patient; but one of them is sufficient to shew that the Disease is such.

The First most remarkable Sign is in the Gums, Mouth, and Teeth, in the Gums redness, itching, and putrefaction, and somtimes bleeding and stink, which are somtimes in the Palate, Jaws, and Teeth, which are loose and black.

The Second, which is an evident Sign also, is Spots in the Legs which at first are Red, and after Purple, blue, and black: Somtimes there are in the Legs broad spots, black or blue, or both; these come from the serous filthy part of the blood which is unfit to nourish the body, and therefore is sent by nature out of the Veins to the Skin, by the Nausiosis of the Veins, as Hippocrates saies of Fra∣ctures, and this happens often in the Shins and Legs, because nature useth to send the worst Humors

to the most ignoble and remotest parts; somtimes when there is more plenty of matter you shal find them in the back, arms, neck, and face.

The third sign is shortness of Breath, and straightness of the Breast, which comes commonly from thick vapors, arising from the Hypochondria, that get to the Midriff, as also from Tumors and swel∣lings by wind of those parts that press upon the Midriff, especially from the Twelling of the Sweet∣bread, which commonly in this Disease is fulled with gross Melancholly: Hence the Patients com∣plain not of their Breast, but of the part affected, whereby they feel the weight, and by reason where∣of the Breath is short, as Eugalenus noted well, who was much acquainted with this Disease, and ma∣ny Observations therein: yet he knew not the cause of this weight, namely, the swelling of the Sweet-bread; nor doth any that write hereof make mention of it. Yet we observed it in My Lord Audeyer, President of the Senate of Gratianopolis, whom we thought had the Scurvy, as you may reade in his History, at length, in our Observations, Cent. 3. Obs. 85. For being very lean, we did easily perceive with our fingers, a hardness in the Sweet-bread; and by handling of the part, he con∣fessed that all his shortness of Breath and straightness came from thence.

The fourth sign, is Laziness, and heavine••s of Body, especially in the Legs, which comes from wa∣tery and foul Humors, which come through the Veins to the Muscles, and the whol Body.

The fifth sign is in the Urine, which is divers, as in Hypochondriack Melancholly; but in this they somtimes differ, because they are cleer and red like a Lye, from the plenty of salt Humors. The redness is higher and inclining to black, by how much the more salt humor there is. As in a Lixivium somtimes the Urine is very thick, with a red thick sediment, like the Pouder of Bricks, and somtimes this Humor is so much, that it causeth burning and pissing by drops, especially in them who have this Disease from stoppage of the Hemorrhoids; and after it is setled, the third or fourth part of the U∣rinal is filled with thick and black filth, which makes some think it to be the Stone or Ulcer of the Bladder.

Somtimes the Urine varieth without manifest cause; to day thick, to morrow thin; now pale, then yellow, or red.

The sixth sign is from the Pulse, which is now weak and unequal, leaping, or formicans, that you would wonder he should live with it; anon it is great and hard, without Inflamation. And this is to be observed, That in time of fainting and swooning, with which he is often troubled, his Pulse is greatest and strongest. Which comes from the Heart contending to cast out those vapors with which it is oppressed.

The seventh sign, is pain in divers parts: in the Thighs heavy, and somtimes stretching; somtimes Ostokopos, or at the bone; somtimes in the Shins, Ankles, Soals of the Feet, in the taps of the Fin∣gers, in the Hips, Knees, and other Joynts, or parts to which the Salt Humors flow; somtimes in the Belly, like the Chollerick Chollick; and it comes from these Humors flowing upon the Caul: these in the Arms, Thighs, and Legs, are like those of the Pox, and may wel deceive a Physitian in France, where the Scurvy is rare, and the Pox common.

But they may be thus distinguished; The pains in the Pox are between the Joynts and if they stay long, make knots, and there are, or have been then also other Symptomes of it, as running of the Reins, Ulcer of the Yard, Bubo, and the like, or Uncleanness with Women. But the Scurvy pains seize up∣on al parts indifferently; and then there are other signs of it, or at least a Melanchollick Constituti∣on; and the Matter is certainly known, if the Patient wil truly say that he hath not been with un∣clean Women. Which caused our suspicion in a Magistrate, who had a long time great pain in his Feet, Shins, and Thighs, and was brought very lean, ••o that you would have thought that he had the Marasmus, or Consumption: And when no Medicines for a long time would do him good, we from his Melanchollick Complexion, and other signs, especially because he le•• a ••ost chast life, and because for many yeers his Gums did bleed at certain times, conjectured that it was the Scurvy, and by using of things against that Disease for some time, he was cured.

Somtimes those pains remain in the Hypochondria, somtimes in the Loyns, so that they are weak, and can scarcego. Hence this Disease is called Lumbago.

Somtimes the pains are like the Stone, and the Urine is very red or black; and if you do not dili∣gently observe, you will think they are bloody, and that it comes from the Reins wounded by the Stone, when it is from a scurvy salt Matter in the Spleen, and parts adjacent, sent into the Urine.

Some have Head-ach, and heat at nights, if they caught this Disease from stoppage of the Hemor∣rhoids, by reason of the vapors which ascend, and all the night after they are as in a Feaver all over their Bodies, which the next morning vanisheth by sweating.

They have often the Tooth-ach, without any evident reason or cause; and it is not in one place, but movable from one Tooth to another, making them loose, and they again fix of their own accord, the pain and tumor being discussed.

Somtimes the pain of the Scurvy is in the sides, imitating the Pleurisie; from which it is easily di∣stinguished, because it is without a Feaver, at least a strong one; the breath is not hindered, there is no Cough, no spitting, nor is the pain constant, but coming by fits.

Also it will be in the Joynts; and we must declare how it is distinguished from a true Arthritis, or Joynt-gout. The pain of the Joynts in the Scurvy, is not fixed and constant in the same place, but runs from one Joynt to another, either on the same, or on the contrary side; somtimes it vanisheth, and then returns; so that he which now seems free, and in perfect health, is suddenly taken with pain, somtimes with swelling, somtimes without. But a true Joynt-gout seldom changeth the place.

The Joynt Scurvy hath this peculiar distinction: It is for the most part joyned with a smal Palsey, by reason whereof the Patient can hardly move the part affected; and when the Passey seizeth or returneth, the pain doth so also.

The eighth sign is from the divers hinderances of Motion, they have a bastard Palsey; the Exam∣ples whereof we laid down in our Observations: and it is distinguished from a true Palsey, because this is constant; but in the Palsey from the Scurvy, he that yesterday could scarce set one foot be∣fore another, can now stand, and walk with a little help, and it may be presently after he cannot move at all: and somtimes the motion is trembling, and with Convulsion, which doth not happen in a true Palsey. And this kind of Palsey cometh from a filthy kind of Matter or vapor, which gets in∣to the Nerves and Muscles. And if the Matter be sharp, it causeth trembling and Convulsion by pul∣ling the Nervous parts.

And Convulsions are not only in some peculiar part, but somtimes in the whol Body like an E∣pilepsie, by a windy or watery matter full of sharpness, and malignity, which is sent to the Brain, which being discussed doth give ease, and gathered again, maketh new Convulsions.

Also in this Disease there is a Contraction of the Members, somtimes of all; so that the Patient cannot move one Joynt; somtimes of one, and that principally in the Leg, when the Tendons which are made to move the Leg grow hard and stiff in the Hams. This contraction comes by reason of the salt Humor that flows with much moisture to the Nerves and Tendons; and when the thin and wa∣tery part, through continuance of time is consumed, the thick is dried and made hard; from whence come these contractions of Nerves and Tendons.

Somtimes there is a contraction in the Gullet, so that the Patient can scarce swallow, and is in fear of strangling. And this comes from astringent vapors, which contract the Oesophagus, or Gullet.

The ninth sign, is the Flux of the Belly, either with, or without blood. The simple Flux which is without blood, is distinguished from others, in that the Excrements are thicker, and more than the quantity of meat that is taken; when a common Flux is more thin, and of Humors only.

The Flux of blood in this Disease is distinguished from a Dysentery, because it is without pain of the belly, and it is thick blood which is sent into the Guts by the Meseraick Veins. Somtimes the Hemorrhoid Veins do receive that filthy blood, and send it forth: but if this flux of the belly conti∣nues long, the Vein••swell, and send forth not only much blood, but also other salt and slimy Humors.

The tenth sign, is a stinking Breath, which is common to all in the Scurvy, as Eugalenus witnes∣seth, so that they which stand by cannot endure it, but must turn aside their Nose.

The eleventh sign, is often shivering, with none or little heat following it.

The twelfth sign, is an intermitting Feaver, which somtimes they have, which are unlike the o∣ther ordinary Agues of Feavers: for in them the Pulse is weak, slow, and unequal, especially in the declination; but in the height it is commonly great and hard. Besides, at the first coming there is such a twitching in divers parts, especially the Legs, that they suppose their flesh to be torn; and somtimes they have convulsive motions therewith. And though somtimes this Ague is a Quotidian, Tertian, or Quartan, yet somtimes the fits are disorderly, coming once it may be, or twice in a month, without certainty.

The Thirteenth Sign is Tumors in divers parts; somtimes hard, somtimes soft like bladders, and somtimes like an Erysipelas, or red Tumor.

The Fourteenth Sign is Atrophy or Consumption; which is so great in this Disease somtimes that they are nothing but skin and bones like a Sceleton or Anatomy; especially after long sickness, which comes from the evil blood; so changed from its natural Condition that it cannot be made like unto the parts which should nourish.

Eugalenus propounds many other Signs of the Scurvy, and Sennertus with others: some whereof are Common to many other Diseases, which we will Conceal, least they breed Confusion.

And though (as we said before) the Scurvy is not ordinary in France, as in Poland and other Northren parts, and almost unknown; yet if any in Practising Physick shal observe al the Symp∣tomes of Melancholly he shal find some inclining to the Scurvy, in whom some of the former Symp∣tomes proper to the Scurvy wil appear.

As to the Prognostick: This Disease is hard to be Cured, as al other that come of Melancholly, and here much more hard, because of the malignity in the Melancholly which doth more cruelly o∣verthrow the body, and wil not obey the greatest part of Medicines.

It is also dangerous because it many times brings a Consumption or Dropsie, and destroyes others by sudden death, by an Apoplexy, Swooning, and other acute Diseases.

Yet somtimes they who have seemed desperate have been Cured, and oftener in this Disease than in any other: And we have seen some brought to a Consumption by long pain, and bloody Flux (which by many circumstances we conclude to be from the Scurvy) to have been perfectly Cured.

Moreover, The Pulse is deceitful, especially in the Fits; it wil be so quick, smal, and unequal somtimes that the Patient seems to be at deaths door; yet after his Fit he wil rise from his bed, and is as formerly; As we peculiarly observed in a Dutch Schollar, unto whom we being sent for in the time of his Fit, thought that he would presently die; but the next day we saw him seemingly in ve∣ry good health; and when we had examined the Circumstances of the Disease, we Concluded that he had the Scurvy, which he brought out of his own Country where it is very usual.

The same Cure is to be used in this Disease as in Hypochondriack Melancholly: because as we said at the first it comes from the same Humor more differing from its natural state; therfore for the most part it needs stronger Medicines.

But because this is a general Rule in Physick, That we alwaies begin with the weakest Medicines, and so proceed to stronger, if the former will not cure: It will be good in this Disease to appoint the whol course of Cure for Hypochondriack Melancholly, because a stubborn disease requires a long course; and if that will not root out the Disease, let us then use the Medicines more specifically proper: Aud it will not be amiss to mix some such with the other at the beginning.

These Specifical Medicines are called Antiscorbutica, or Medicin•••• proper for the Scurvy, and there are many of them in Authors that have written of this Disease; whose strength chiefly de∣pends upon a Volatile or flying Salt, of which they are very full, by which means they make thin and fluid, that thick, earthy, and salt humor, and at length discuss it. Moreover, they have a cer∣tain preservative and opposing Vertue against the poyson of the Scurvy which is in the Melanchollick Humor. Among these, the chief is Dutch Scurvy-grass, which is not in France. Another is, Cres∣ses of both sorts (but the Water-cress is best) Brooklime, Hors-Rhadish, the lesser Celandine, Wo••mwood, and Fumitory. To which may be added many others, but of less vertue, and all they are such which can prepare, correct, and tame the Melanchollick Humor. Hence it is that we directed the Cure against Hypochondriack Melancholly to be used here: Those are, Carduus, Ceterach, all the Capillar Herbs, Hysop, Germander, Bettony, Agrimony, Borrage, Bugloss, Elicampane, Asarum, Ditch Dock, Polypody of the Oak, Capar, Ash, and Tamarisk barks, Flowers of Elder, Tamarisk, and Dodder of Time.

In the choyce of these Plants, you must alwaies observe this, That you give the least quantity of hot things, and that you alwaies mix with them cold or moderate things, and in a greater quantity, espe∣cially in hot Countries, in which Melancholly is burnt. And besides the Capillar Herbs with Bor∣rage, Bugloss▪ and Agrimony before mentioned, when there is a Feaver, or we fear heat, you may ad Endive, Succory, Sorrel, Juyce of Citrons, Lemmons, Orrenges, and also Spirit of Sulphur, or Vi∣triol, or whey.

Of these former Plants you may make many sorts of Medicines, which are all gathered by Senner∣tus out of all Authors, which every man may imitate as he pleaseth. Yet this we must mark, which all Authors mention, That the aforesaid Plants work more powerfully if you ••ake their Juyce, or make them into Conserves; because the flying salt wherein all their vertue remaineth is gone by de∣coction, as also if the Plant be dried.

We have used these following forms with good success.

Take of c••eer Juyces, of Water-cresses, and Brook-lime, of each one ounce: the Juyce of Fumi∣tory two ounces: white Sugar two drams. Make a Potion.

Or,

Take of the Juyce of Fumitory, and Water-cresses, of each two ounces: mix them.

Or,

Take of the Juyces of Sorrel, Fumitory, and Water-cresses, of each two ounces. Mi•• them.

You may give more Juyce of Sorrel, if you desire to cool more, or Juyce of Lemmons▪ o•• th•• like.

The power of the Medicines, will be more to dissolve that sticking clammy Tartar, if you add one dram of Salt of Tartar with Spirit of Sulphur, or Vitriol, one scruple or half a dram; and because in the use of these Medicines, we purge often, it is good to infuse one dram or two of Senna all night in the said Juyces, and give it every other day, or every third day.

It is worth your while to give somtimes also some steeled Medicines, such as we prescribed in Hy∣pochondriack Melancholly; as also the strengthening and opening Opiates, and others, as in wisdom you shall think fit.

And last, Mineral Waters that are sharp, and of Vitriol, used in due season, are very beneficial for the Cure of this Disease.

The End of the Twelfth Book.