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. 1. Of the Stone in the Kidneyes, and Pain in the Reins, called Dolor Nephriticus.

THat is called Dolor Nephriticus which doth afflict the Ureters or Reins; the common people call it the Stone-Chollick, because of the great affinity it hath with the Chollick, so that it is hard to distinguish them, as you shall see in the Diagnostick, or Signs.

The Cause of this Pain in manifold, but chiefly the stone or thick flegm. A stone continuing in the Reins, causeth either little or no pain, because the substance of the Reins hath little Sence: but if it fall upon the Head of the Ureters, or get into the passage, and distend it, and cannot be brought to the Bladder by reason of its greatness, then it causeth grievous pain. But gross flegm fastened upon the Ureters, doth distend them, and causeth the Nephritical pain.

The less ordinary Causes are, thick blood fixed in the Ureters, or thick Matter coming from the Kidneyes, or other parts; somtimes wind gets into the Cavity, and causeth great pain.

There are many Controversies in Authors about the stone, which is the chief and usual cause of the pain of the Reins, which we shall not accurately declare, but only touch those things which are ne∣cessary to declare its Nature and Causes.

And first, they doubt under what kind of Disease they should reckon the stone; Galen placeth it among the Diseases in number, of those things which are wholly besides Nature, as also the Worms. For though a Disease in number properly doth respect living parts, whose number being encreased or diminished, maketh an organical Disease; yet those things which are preternaturally added to the number of those things of which the Body is compounded, ought to be referred to the Diseases in number, so that somtimes the bare qualities are somtimes referred to Diseases in number; when they do immediately hurt the actions, as yellowness in the Eye of one that hath the Jaundice, a noise in the Ears, and a bitter tast upon the Tongue.

Oftentimes the stone is reckoned among Causes of Diseases, as it breeds Obstruction or Disten∣tion.

It may also be placed among the Symptomes, those that are voided or retained: for if it be retai∣ned in the Kidneys, Reins, or Bladder, when it should be voided, it is to be reckoned among those things that are preternaturally retained: but when it is voided, it is to be reckoned among those that are voided wholly against Nature.

But there is more difficulty about the cause of the stone, both material and efficient. Galen and his posterity, thought that flegm was the material cause of the stone, which is thick and slimy, fit to be hardened, and (as they say of late) faeculent, slimy, and Tartarous, and heat the efficient, which drieth and hardeneth that matter, and at length turneth it into a stone Which Doctrine is opposed with strong Reasons.

First, If it should come of a slimy and thick flegm, then it would often be bred in the Brain and the Stomach, in which such flegm doth chiefly abound. Neither will it suffice to say that there is not sufficient heat in those parts to harden it; because according to the Doctrine of Hippocrates and Galen, a gentle heat by a continual action is sufficint to congeal; and hence is the reason why old men do more often breed the stone, when yong men have hotter Kidneys; because the matter of the stone lies longer in old mens Reins, by reason of the weakness of the expulsive Faculty, and so it's longer concocted by the heat, and at length hardened.

Secondly, From Aristotle, 2. meteor. cap. 4. they which grow together by heat, are melted by moisture, as Clay. But the stone is never dissolved with water. Neither doth it hinder to say that a strong heat makes such a Concretion or growing together, that it cannot be dissolved by moisture, as in Bricks. For first, in Man there is not so great a heat; then the not dissolving of Bricks with Water is not because of the strong heat they had, but rather from the disposition of the Clay; for Clay made of common Earth, although it be baked in a Furnace, wil never be hard as a Brick, but alwaies be dissolved with moisture.

Thirdly, From Aristotle in the place mentioned, the heat that makes concretion must be dry. But there is a continual flowing of moisture into the Reins and Bladder, therefore such a drying and har∣dening cannot be in those parts.

Fourthly, Stones bred in Rivers and Fountains, in which there is no heat, and in some Dens and Holes that are very cold, the water that fals turns into a stone; from whence strange shapes do arise. Therefore we must find another cause besides heat, and another Matter besides clammy and glutinous Flegm.

Fifthly, Flegm made hard is like Chalk, and is brittle, as you may see in the knots of the Joynts. But some stones are like flints, which they cannot be from Flegm: nor is there so much heat in mans Body to make it so.

This slimy flegm hath deceived the Physitians of all Ages, which is found in the Urine of many Pa∣tients, and they thought it to be the immediate Cause: But they were out. For first, In the stone of the Kidneys such Urines are seldom made, but often in the stone of the Bladder. But if this were the matter of the stone it would be alike in both. Therefore this Matter depends especially upon the proper Disease of the Bladder, for it is an Excrement of it distempered. The disease of the Bladder is this: we have seen in the Bodies of them who have died of the Stone in the Bladder, and who voi∣ded much of that matter, that the bladder grew fleshy, as thick as ones finger or thumb, so that it fil∣led the whol Cavity, and lay next to the stone till by stopping the Urine it killed the Patient. But in those who made thin cleer Urine, their bladder was not altered. The Reason of these accidents are taken out of Hipp. Aph. 66. Sect. 5. If there be no Tumor in great and evil wounds, it is evil. And Galen gives the Reason because there is a suspition that the Humors which should come by reason of pain to the wound, are gone to some noble part. Moreover, it is Natural to all parts; as Galen, lib. de diff. febr. cap. 11. that they which are stronger, send that which hurteth them to the weaker, nor do they cease so doing till it come to the weakest. So when the part wounded is very weak, and therefore fit to receive Humors, if they come not thither, it is a sign that other parts are very weak,

which cannot send, and that others are weaker than the wounded, to which the humors are carried. Not only the bad Humors are carried to the wound, but also good blood, which Nature sends to re∣fresh it. All these things are in the bladder that hath the stone. A great uneven stone, or sharp, hurts the Tunicle of the Bladder; hence comes pain and weakness. And Nature to help it sends more than usual blood, and the stronger parts send their superfluiteis. These the bladder concocteth as much as may be into its self, and so groweth thicker. But when it cannot take in all, especially the evil Humors, hence come many foul Excrements, which from the Nature of the part turn so fleg∣matick. But in them who have clear Urine, either the stone hurteth not, which causeth the attra∣ction, or some other parts are weaker than the bladder, to which the humors flow.

But because this Doctrine doth destroy an old Opinion, we will confirm it by a cleer Example of the Womb. The Womb is Membranous, as the bladder: but in Women with Child it is rleshy and thick; so that in the last months it is two fingers thick; because Nature all the time sends much blood to it to nourish the Child; which when the Child doth not wholly consume, some part of it is taken into the Womb: and so it encreaseth. The same is in the Bladder, though Preternaturally (which in the Womb is Natural) that when much blood comes to it, it coverts it into its self, and grows thicker. But if without being with Child, the Womb be distempered and made weak, then Humors superfluous from other parts come to it, which when they cannot be taken into its substance, turns to the Whites. And that flux is a proper Excrement of the Womb, as the flegm is of the blad∣der. The same thing is in the Reins, though not so often; as when by a stone in them there is pain and weakness, Nature sends much blood and humors to them, which when they cannot be turned into the substance of the part, they are turned into a slimy Excrement, which is voided in abundance; and this vulgar Physitians take for Matter or Pus, which is only flegm, or mixed with a little Pus, as when by the grating of the stone there is an Ulcer.

Some Modern Writers being converted with the aforesaid Reasons, have made a Juyce, which will turn into a stone to be the material cause of the stone called Succus Lapidescens; and the efficient to be Spiritus Lapidescens. They call the former a certain Humor naturally proper to turn into a stone: And this they desire to prove by the breeding of stones in the Earth, which are by many Au∣thors said to come of Waters and things cast there into to be hardened presently; some Waters in Caves to be made Stones, and some part of the Wine groweth to the Vessel, called Tartar; and U∣rines that are cleer, when they are cold grow to the glass. And although the peculiar fitness of the Matter to be thus turned, is not sufficiently known; yet some say they have found it out, saying that it is of Salt mixed with Earth. Some Salts do grow hard in the Sun, and are easily dissolved in Water; and if they be joyned with Earth like themselves, by the force of the efficient cause they may be stones. So we see in Wines turned to Tartar: but Tartar calcined goes all into Salt, which shews that it is chiefly made of Salt. So in Urines that have much Salt, especially in those which have slimy matter, we see a tartarous Matter cleaving to the glass. This Salt Matter, which is mix∣ed with the Urine, comes from Meat and Drink so affected, and they are cast forth in a sound Body, nor are they retained in the Reins when the efficient Cause is absent.

We have called the efficient Cause, Spiritum Lapidisicum, or a Spirit that makes a stone: Fer∣nelius calls it a stony disposition, which is in the Reins commonly Haereditarily. But we like the foremost Title best. For first, some have stones which have them not Haereditarily if they eat or drink things that breed them, because in them there is both the Material and Efficient Cause; there∣fore the Hermets impute the Efficient Cause of stones to their proper seeds, which in a Matter right∣ly disposed, produce their form.

Moreover, Many Histories shew that Stones come from a Stone making Spirit, of Men, Beasts, and other things turned into Stones by a Breath or Spirit out of the Earth. So in Aventinus, lib. 7. Annal. Bavar. an. 1343. that more than fifty Country men and their Cows, were turned into Stones. And so saies Ortellius in his Description of Russia, of whol Heards of Cattel. So also Camerarius reports of a South wind that bloweth some times of the yeer, in the Province of Chilo, in Armenia, by the blasts whereof, whol Troops of Horses are suddenly turned into Statues of Stone, and stand in the same rank and file in which they were.

This Stone making Spirit, is not only in the Reins of those which have this Disease, but also in the Juyce of those things that are eaten and drunk separated from them; so that somtimes both come together: Hence it is that some that eat but any Meats that incline to the breeding of the stone, do presently produce it, because there is a Stone-breeding disposition, or Stone-making Spirit in their Reins. But if their Reins be free from this Spirit, such meat will not breed stones, because their stone-making force is not strong enough without the assistance of the Reins to convert that matter in∣to stone. On the Contrary, if the stone-making power be greater in the meats that are taken, and they are often eaten, stones will be bred, although the Kidneys have no such disposition or stone∣making Spirit. So we see in divers places, where the Water or Wine are full of stone-making juyce,

the greatest part of the Inhabitants are subject to the stone; as we may see in Ovid concerning the Thracians, in these Verses:

The Thracian Waters, all things Marble make, Their Guts turn Stone that inwardly them take.

And contrary, If there be that stone-making vertue in the Kidneys, it makes stones of any nourish∣ment, though never so wholsom. So about three yeers since, I saw one who for three or four months voided more than twelve little stones every day by Urine, when all that while he kept his bed, very sick, and fed only upon Broth and Panadoes.

The Antecedent and Primary Causes, either respect the supply of Matter for the stone, or the constitution of the Reins, by reason whereof the stones do more easily grow.

The Stomach, Liver, Spleen, and Reins, do much cause the breeding and heaping up of Matter for the stone; chiefly the Stomach, if it do not wel concoct, there is a crude Chyle brought to the Liver; and from thence impure and Earthy Juyces are sent with the Serum or Water into the Reins. A hot liver doth bake the Chylous Matter, and makes it fit to breed a stone; as also being too cold it makes crude blood most fit for the same purpose. A Spleen weak or stopped, or otherwise disturbed, doth not sufficiently purge the drossie part of the blood, but sends part of it to the Reins, which will more easily be turned into a stone. And lastly, the Reins besides their conjunct cause, which is a stony disposition, are an Antecedent Cause in two respects; namely, in respect of their Temper, and of their Form. In regard of their hot Temper, they more violently draw the Stone-making Matter, and thicken it more: but in respect of their Form, they are an Antecedent Cause, if the Emulgent Veins are more loose, so that that thick and Tartarous Matter may be more easily received into the Reins; or if the Ureters, and those Vessels that send the serous Matter to them, be too narrow, so that the thick Matter hath not a free passage, but is retained in the Reins.

Thick and slimy Nourishment doth chiefly afford Matter for the Stone, such as are full of Salt, as Beef, Pork, Hairs, Geese, or things dried in the Smoak, or poudered, as Salt-fish, Shel-fish, Eeles, Pulse, Chees, and all Milk meats, hard Eggs, Chesnuts, Pears, Quinces, Medlars, unleavened Bread, and Rice; thick Wine, sharp or black, or new Wine not purged, standing Waters, and such as are full of stone-breeding Juyce.

To these add very hot Meats, as Pepper, Ginger, Garlick, Onions, old strong Wine, which makes the Liver and Reins too hot, too strong Diureticks, which carry the Matter that will cause the Dis∣ease too violently to the Reins; thick Garments, Down Beds, Baths, inordinate Lechery, which is a great Enemy to the Reins, violent Exercue, especially after meat, too much feeding, or long fa∣sting, great anger, and other passions.

The Signs of the Stone taken by themselves, are equivocal, and common to other Diseases: but if you consider them all together, you may have certain Knowledg by them.

The First Sign, is a fixed pain about the Loyns, somtimes heavy when the Stone is fastened to the substance; which being of a dull sence, hath a weighty pain; but as often as the Stone gets into the Head of the Ureters, then it causeth a sharp and pricking pain, and this is called the Nephritical pain, or pain of the Reins, and it continueth while the stone is there; neither will it cease to torment the Patient till the stone get into the Cavity of the Bladder, or turn back into the hollow of the Kid∣neyes.

The Second Sign, is bloody Urine, which comes from the opening or corrosion of the Veins which are dispersed into the substance of the Reins, which comes from the rubbing of the Stone that sticks in the substance; but if there be but little blood voided, being mixed with Urine it looseth its color, so that the Urine looks like a Lye. This Sign is not alwaies, but somtimes depends upon other causes. But when it doth appear, it is one of the chief, which distinguisheth the Stone from the Chollick. It useth to be caused by riding, much walking, and other violent exercise; for then the stone if it be rough and snaggy, being removed from its place, doth cut and tear the tender Flesh of the Kid∣neyes.

The Third Sign, is thin Urine, water-like, and little, in the beginning of the fit; after which som∣times followeth a total stoppage, if both Ureters are stopped: but when the fit is past, and the stone that was fixed in the Ureters is fallen into the bladder, there comes forth much thick troubled Urine, with a sandy Sediment.

The Fourth Sign, is often voiding of sand and stones. Concerning voiding of a stone, it is evi∣dent, That if the Patient voided any formerly, though never so smal, when he had a fit, it is most certain that the Disease is the Stone. But concerning Sand we cannot speak so infallible; for we may see many all their lives time void Gravel, and never be troubled with the stone; for sand comes often from adustion of Humors in the Liver and Veins, and it sticks to the sides of the Urinal, and goes not to the bottom, as that which comes from the Reins. Besides, if you rub it between your fingers, it dissolveth, and is like Salt, when the other will not yeeld to the fingers, and will not dis∣solve. And finally, because this Sand is salt, it is dissolved in hot Urine, nor will it appear while the

Urine is so; but when it is cold it grows together to the sides of the Urinal, not unlike the Crystal of Tartar; which being dissolved in warm water, when it grows cold, congealeth and sticks to the sides of the Glass; so the Nature of them both is very like.

The Fifth Sign, is a stone voided, and this is most certain: For if any former Sign, though equi∣vocal do appear, and a stone be voided, you may be certain of the Disease.

The Sixth Sign, is a numbness of the Thigh on the same side that the Back is pained of: for the stone being great, doth oppress the Nerve which is in erted into the Muscles of the Loyns, under the Reins, called by the Anatomists Psenas, and those Muscles go to the Hip for its motion such a numb∣ness is perc••ived by sitting upon the Thigh, through the compression; or in the Arm by long leaning thereon.

The Seventh Sign, is the drawing in of one stone, on that side where the pain is: For the Kidneys and Ureters being provoked with the greatness of the pain, do vehemently contract themselves, and then the Spermatical Vessels and all the parts adjacent are also contracted, and these Vessels do raise up the stone which is joyned to them, so that it seems somtimes to be fixed to the Groyn. And this retraction or drawing in of parts reacheth to the bladder and Guts: For in great pain the belly is bound, and Urine stopped; so that then Purges will not work by reason they are hindered by that Contraction.

The Eighth Sign is, loathing and vomiting by the connexion of the Kidneys with the Stomach, by the Membrane that comes from the Peritonaeum, and by the Nerve of the sixth Conjugation, two branches whereof reach from the Stomach to the inward Tunicle of the Kidneys. Therefore when those sensible parts in the Kidneys are pulled, the Stomach consenting, is stirred up to exclude that which hurteth; and first it sends out Flegm, then yellow Choller, after green, if the evil continue, because through long pain and watching the blood is altered in the Veins, and that part which is most disposed for it, is turned into green Choller.

Finally, The Nephritical pain is so like the Chollick, that Galen himself was deceived in the di∣stinguishing of them, as we shewed in the Diagnosis or Knowldg of the Chollick: where also we laid down signs by which we may distinguish them, which we shall not need to repeat.

The Signs afore mentioned are equivocal, and one of them can scarce give a certain knowledg. Some Authors mention others, which are more equivocal and uncertain, but joyned with others they help the knowledg of the Disease, therefore it will not be amiss to mention them.

Hipp. Aph. 34. Sect. 7. saith, They who have bubbles in their Ʋrine, have an old Disease in the Reins. For these bubbles come from thick Humors full of gross vapors, which are either bred in the Reins, or sent from other parts to them, that matter is proper to breed the stone, and can∣not be presently cured, therefore the Disease is long. Galen in his Comment upon this Aporism, saith that the mouthes of the Arteries which come to the Reins, are opened by the sharpness of the Urine, and thence comes a Spirit which being mixed with the Urine, maketh bubbles. But it is not probable that such a gross Spirit that will remain so long, should come from the Arteries, and Urine being cold may long time so continue, as we see many bubbles many hours swimming thereupon. And also when the Arteries are opened by the sharpness of the Urine, blood will also come forth. And the mouthes of the Veins having thin Skins, would be more easily opened, and so there would be al∣so blood mixed with the bubbles.

Hippocrates also Aph. 76. Sect. 4. saith, They who void little bits of flesh, and things like hairs, with a thick Ʋrine, do it from the Reins. The bits of flesh come from the Ulcer of the Reins, of which we shall speak hereafter: but these thrids or hairs are said by Galen, in his Commentaries, to come from thick and crude flegm, made long and round by the extraordinary heat of the Reins. Yet Galen confesseth, 6. loc. aff. cap. 3. that after a long search he was ignorant of the cause of their length. Avicen saith that these thrids grow long in the vessels of the Reins, or others; for in regard these are taken away by Diureticks, and the Patients acknowledg pain in the Reins, it is credible that they receive their form from thence. Actuarius doth directly say they come from the Ureters: For when the Reins abound with flegm, it goes with the Urine into the Ureters, and sticking to them and growing thick by heat, it gets a long shape like a thrid or hair. But Fernelius writes that those hairs come from the Parastatis or kernels, from his Observation, in which they grow long like hairs from the matter of the seed, which by force of the Disease flowing down by degrees, grows thick by heat, and that they appear much in those who have lately had a filthy Gonorrhoea, and in those wo∣men who have the Whites, or a foul Womb, and in that Urine which they make next after they have known a man. Others suppose, that those thick Humors of which those filaments or hairs are made, are first bred in the Veins, but take their form in the narrow passages of the Reins, through which, as through a sieve, they turn smal, and after they descend into the Ureters, in which they grow dryer, till they are sent into the bladder, neither can they be broken by reason of their toughness. What∣soever the cause is, since the best Authors do agree that these hairs breed of thick flegm in the Kidneys,

or come to them from other parts, it is certain that they may turn into a stone, if there be an efficient cause fit to produce it. And therefore this may be a probable sign of the stone.

As for the Prognostick. The stone of the Kidneys is very dangerous, for it useth to bring great evils; as Inflamation, Exulceration, great Pains, Watchings, dejection of strength, Feavers, stop∣pings of Urine, and the like dangerous Symptomes.

If this Disease be Haereditary coming from the Parents, it is incurable.

And because Hippocrates saith that the Diseases of the Reins are hard to be cured in oldmen, Aph. 6. Sect. 6. The Stone of the Kidneyes in old men is difficult, if not incurable.

If the pain of the Kidneys continue many daies, and cannot be cured with any Medicines, there is danger of death, and it is neer at hand when they are cold externally, and have a cold sweat in the face. Urines that are first thin, and after thick, and have sand at the bottom, do signifie that the fit is towards an end.

A Stone joyned with an Ulcer in the Kidneys, is incurable: for those things which break the Stone, do exasperate the Ulcer.

The Cure of the pain of the Kidneys, and stone sticking in them, or in the Ureters, is by enlarging of the passages, and relaxing them by throwing forth the stone, and any other thing that hurts them, by removing or taking away the antecedent cause, and by taking away the pain. Which you may do with these Medicines.

Take of Marsh-mallow and Lilly Roots, of each one ounce: Mallows, Violets, Pellitory, Bear∣foot, of each one handful: Lin-seed and Fenugreek seed, of each half an ounce: fat Figgs, six: Chamomel and Melilot Flowers, of each one pugil: boyl them to a pint. Dissolve in the strai∣ning, Cassia, and Diacatholicon, of each six drams: Oyl of Lillies and Violets, of each one ounce and an half: fresh Oyl two ounces: make a Clyster to be given presently.

Afterwards open the Liver Vein of the right or left Arm, and take away eight or nine ounces of blood, according to the strength and fulness of the Patient. Phlebotomy is very necessary to prevent Inslamation, which useth to come from continuance of pain.

After blood-letting, give this Clyster.

Take of the flowers of Chamomel and Melilot, the tops of Dill, Pellitory of the wall and Rue, of each half a bandful: Annis, Fennel, and Cummin seeds, of each half an ounce: Make a de∣cootion to one pint; in which dissolve Diaphoenicon half an ounce: Turpentine dissolved with the Yolk of an Egg one ounce: Oyl of Dill and Scorpions, of each three ounces. Make a Clyster.

To mollifie more, and asswage the pain after your Laxative, you may make one of Oyl thus:

Take of Oyl of Dill and of Chamomel, of each half a pound: Oyl of sweet Almonds two ounces: Oyl of Rue one ounce: mix them for a Clyster.

At the same time appply a Fomentation to the part pained, made of the Decoction of the first Cly∣ster, with Annis seeds and Fennel seeds, Oyl and Water, with Spunges.

Take of Oyl of Scorpions compounded two ounces: fresh Butter, Hens Grease, Oyl of Lillies, and of sweet Almonds, of each one ounce. Make a Liniment to be used after the Fomenta∣tion.

Or this Cataplasin:

Take of Mallows and Pellitory, of each two handfuls: Parsley with the Roots one handful: Rhadish Roots two ounces: boyl them soft and beat them: then add of Onions roasted, two: Oyl of Lillies, bitter Almonds, and sweet Butter, of each two ounces. Make a Cataplasin, which you must put between two thin linnen cloaths, and apply warm to the Belly, according to the length of the Ʋreters, and heat it as often as it grows cold.

You may also apply one either made of Pellitory alone, or with Eggs fryed in a Pan with Oyl of Chamomel, bitter Almonds, Scorpions in a cloth.

Or make it of Onions shred and fryed with Hogs Grease, or the Oyls aforesaid, with five or six warm Eggs applied.

And because in this Disease, there is abundance of crude Humors, after Clysters (which must still be repeated as the pain cometh) you may give a purging Medicine, especially in form of a Bolus, lest it be easily vomited up, because these Patients are commonly squeazy stomached.

Take of Cassia new drawn with Oyl of sweet Almonds one ounce: Diaphoenicon three drams: Pouder of Rhubarb one dram: with the pouder of Liquorin and Tragacanth, make a Bolus.

If the Patient cannot swallow a Bolus, dissolve purging things in the Decoction of Mallows.

But you must diligently observe that you must not give a Purging Medicine before the pain be al∣layed. For when the pain is great, a strong Purge seldom works, because then all the parts contract themselves, and refuse to help the Medicine.

But at that time you may give a Vomit, by which the plenty of Humors may be abated, and a re∣vulsion is made from the part affected; and often Nature of the self, when the pain is urgent, doth endeavor the same, and after it finds ease.

A gentle Vomit which will also asswage pain, may be made thus:

Take of warm Water four ounces: Sallet Oyl one ounce: simple Syrup of Vinegar one ounce and an half: Make a Vomit.

If you will have a stronger, you must use Salt of Vitriol, or Mercurius vitae, with which Angelus Sala saith, that he hath often cured this disease.

Before and after purging, you must give at the mouth, those things which open the passages, and abate the pain: for which purpose the Syrup of Marsh-mallows proscribed by Fernelius often given, is excellent. But because it is not alwaies ready in the Shops, you may make it simply thus:

Take of Marsh-mallows three ounces; boyl them to a pint: dissolve in the straining half a pound of Sugar. Let him take it often.

This following Julep given often, is good to mollifie the Passages.

Take of Barley one pugil: gray Pease half a pugil: Mallow and Marsh-mallow seeds, of each two drams: the four great cold seeds, of each one dram: fat Figs, eight: Scbestens, six: Liquo∣ris half an ounce: boyl them to a pint and an half. Dissolve in the straining, Syrup of Maiden∣hair four ounces. Give it at four draughts, twice or thrice in a day.

Give for his ordinary drink, a decoction of Marsh-mallow Roots, one ounce and an half: Barley two pugils: Liquoris six drams, in sive pints of water to a pint.

Or make Broths of Mallows, Marsh-mallows, and gray Pease, with much butter, and a little salt: or boyl the same in fat broth.

Or give Emulsions made of the four great cold seeds.

But Oyl of sweet Almonds above all Medicines, doth mollifie and relax the Passages, and asswa∣geth pain, if it be new drawn: give three or four ounces by its self, or with white Wine, or a De∣coction of Marsh-mallows, Liquoris, and gray Pease; or make Potion of equal parts of Oyl of sweet and bitter Almonds, because bitter Almonds are good also to expel the Stone.

The day after you have opened the Arm, you may open the Ham or Ancle Vein on the same side, for that will derive the Humor, and the Patients find much ease thereby. Which Rule is given us by Hippocrates, 6. Epid. Part. I. Aph. 6. and by Aetius, lib. 11. cap. 5.

And if the Disease last long, you may open the Hemorroids; according to Hipp. Aph. 11. Sect. 6. who saith, That it is good for Melanchollick men, and such as have the stone, to have their Hemor∣rhoids bleed. From the same branch of the Spleen there are Veins which go to the Reins, bladder, and Hemorrhoids.

If the pain be not asswaged by Fomentations, Liniments, and Cataplasms aforesaid, put him into a Bath made of the Emollent Decoction, with white Wine added, for it asswageth pain, at least while the Patient sits therein; but you must not use it much least it take away strength.

And lastly, When the pain is very great with watching and weakness, you must give Narcoticks, and put two drams of Philonium Romanum, or five or six grains of Laudanum in a Clyster, or three or four grains at the mouth, or one ounce of Syrup of Poppies in a convenient Julep.

After these Topicks have been used, in a long pain, it is good to apply a Plaister of Melilot, malax∣ed with Oyl of Chamomel and Dill.

This pain useth to be bred with some of these Medicines, and with repeating Purges (if they be needful) or giving Cassia often. But if after the use of them it continue, it is most certain that they are great stones which stop the Ureters, which must be sent out by Diureticks, which wil break them. But you must first begin with the mildest, lest by strong and sharp you inflame the Blood and the Reins. And you must consider the habit of the Body: For a full Body will endure things that do more pierce and make thin; but a slender, less.

There are abundance of this kind in Authors, that diminish, break, and expel the stone, but we wil give you only the most choyce.

Take of Smallage, Parsley, Butchers Broom, Couch-grass, and Sparagus Roots, of each one ounce: Mallow and Marsh-mallow Roots, of each half an ounce: Pellitory of the wall two band∣fuls: Annis, Fennel, Dill, Caraway, Carrot, Amye, Carthamus, Cummin, Rue seeds, and Bay-ber∣ries, of each two drams: Chamomel, Melilot, Dill, and French Lavender, of each one pugil: boyl them in white Wine to the consumption of half. Dissolve in the straining, being one pint, fresh Butter four ounces; Honey of Roses two ounces; red Sugar one ounce; Benedicta Laxativa half an ounce; one Yolk of an Egg; Oyl of Nuts, Lin-seed, and Dill, of each three ounces: mix them for a Clyster, which let him keep two hours, if he can.

Take of Strawberry Water, and Saxifrage Water, of each two ounces: the best white Wine six ounces: Oyl of sweet Almonds two ounces: Spirit of Vitriol one dram: mix them for three doses. Give the first as hot as may be endured; after six hours give the second as the former, and if this will not do (as it seldom misseth) let him take the third.

You may sooner make a Julep of Saxifrage Water, and Syrup of Violets, with fifteen or twenty drops of Spirit of Vitriol.

Take of the Juyce of Pellitory drawn without fire three ounces: Juyce of Lemmons, and Oyl of sweet Almonds drawn without fire, of each one ounce and an half. Mix them for a Julep to be given three or four times morning and evening. Or,

Take of the Juyce of Lemmons and white Wine, of each two ounces: Sugar candy half a dram. Take it instead of the Julep.

Concerning Juyce of Lemmons you must note, That it must be used warily, for being given of∣ten and much, it maketh Exulcerations in the Stomach, from whence cometh the Flux called Lienteria.

These Pills following are excellent:

Take of Sal prunella, Crystal of Tartar, Salt of Ivy Berries, and of Water-cresses, of each equal parts: with some proper Syrup or Turpentine, make a Mass of Pills; of which give one dram eve∣ry morning.

This following pouder of Quercetan is much commended.

Take of the inward skin of Hens Gizzards, and their white Dung, of each half an ounce: the inward skins of Egg-shels poudered, two ounces and an half: Rupture and Cinnamon, of each four scruples: Medlar stones two drams: Annis and Fennel seeds, of each one ounce: make them into very fine pouder, and give half a dram or a dram thereof in white Wine.

The Ashes of burnt Egg-shels from half a dram to an ounce given in white Wine, doth powerfully expel the Stone that sticks in the passages of the Ureters.

Goats blood prepared is commended of all Authors, old and modern, as the best Medicine to dis∣solve the stone. The Dose is from half a dram to a dram.

The Water of Goats Blood distilled in a Glass in Balneo Mariae, doth wonders. But you must feed the Goat one month with Saxifrage, burnt Juniper berries, Parsley, and other Diureticks, with∣out Drink.

Hartman commends the Urine of a Goat in these words as a wonderful Remedy: In the stoppage of the Reins by a greatstone, or when the Ʋreters and Bladder are stopped by stones sent thither, so that one drop cannot be voided, it is excellent if you take the Ʋrine of a Goat taken out with his Bladder while he is yet alive, and drink and apply his Paunch and Guts to the Belly and Privities, for so the stone will be presently consumed without hurt to the Vessels, and the Patient cured.

The Pouder of Millepedum, or Sows, is excellent to dissolve the stone, and we will teach the use thereof in the stone of the Bladder.

Also the infusion of the same in white Wine, and continued

There is a Wine of Winter Cherries commended of Arnoldus Villanovanus, and they say it doth so bring forth the matter of the stone that you may take it up in your hand. And this is done by bea∣ting the Winter Cherries in white Wine, and giving the strained Liquor.

These also following are good:

Take of Lapis Judaicus, or Jews stone, Pulvis Lithontribi Justini, of each one dram: Peach Kernels, Gum Tragacanth, and Cherry-stone Kernels, of each half a dram: bring them to Pou∣der, and with Turpentine make a Bolus, which give in three Doses morning and evening.

Take of Hors-Rhadish scraped two ounces: white Wine four ounces: steep them a few hours; then strain them strongly. Let the Patient take the straining twice or thrice, at convenient hours.

Savin Water given to an ounce or two, doth purge stones and gravel.

Take of Mallow Roots clensed in white Wine, six ounces: Burdock and Couch-grass Roots, of each four ounces: Asarum, Pa••sley, Valerian, and Fennel Roots bruised, of each two ounces: Maiden-hair, Saxifrage, Burnet, Golden rod, and Betony, of each four handfuls: Bazil, Bur∣dock, Carduus, Mountain Osier seeds, Medlar stones, and Peach stones, of each one ounce: Grom∣wel seeds two ounces: Lapidis Lyncis, and Judaici, of each one ounce and an half: Turpentine three ounces: Goats Blood prepared two ounces and an half: Saffron two drams: white Wine four pints: bruise them that must, and mix them all; distil them in Balneo Mariae. Take two oun∣ces of this Water three hours before Supper, drinking after four ounces of white Wine.

Take of the bark of the Roots of Carduus Asininus one ounce: Liquoris two drams: boyl them to six ounces: let him take the straining many daies. It doth wonderfully clense Stone and Gravel.

Take four pounds of shred Onions that are white; two pound of Sugar; one pint and an half of white Wine: distil them in Balneo Mariae till they are dry. Give every morning two or three ounces for many daies together.

The Ashes of a Scorpion is commended by Practitioners, if you take one scruple at a time, with Wa••er of Couch-grass, Pellitory, or white Wine; but it is seldom used.

Mathiolus his Oyl of Scorpions is more in use; a dram taken at the Mouth with the aforesaid Li∣quors.

The Chymists brag much of their Salts: among which the best is, Salt of Bean Cods, or Stalks, half a dram whereof, with white Wine works very well. And also Tartar vitriolate in the same quanti∣ty, They commend also Spirit of Salt, Vitriol, Mercurius dulcis, with their proper Vehicles or Li∣quors.

Outwardly you may help the Stone, if you continually chafe the Reins and Ureters with warm hands anointed with Oyl of Scorpions.

Also many Cupping-glasses from the Kidney affected downwards, applyed without Scar∣rification.

Then anoint the Part with Mathiolus his Oyl os Scorpions; to which add a little pouder os Can∣tharides. Or make a Liniment of Oyl of Wax, Bricks, and Scorpions, of each equal parts; it is ve∣ry piercing and good, if you fear no inflamation of the Reins.

You must observe in the use of Medicines to break and expel the stone, That they must not be used twice or thrice, but often, till the passages stopt are open; and while you give them, you must cherish the Reins and Bladder with Baths, Fomentations, Oyntments, and Cataplasms, that the other may work the better. And you must give thin Liquor, as white Wine, often; and use inward E∣mollients, Looseners, and Openers, to enlarge the Passages, and temper the sharpness of other Medi∣cines.

By these Remedies the pain of the Reins is cured, and stone dissolved and expelled. But because they who are diposed to this Disease, and cured, do often relapse: therefore we must appoint some Preservatives that we may hinder it as much as may be.

And first, if there be a Plethora or fulness, or the Reins and Liver hot, it is good to open a Vein, Spring and Fall, a Clyster or gentle Purge being first given: And then to purge the Matter away which is proper to breed the stone before it come to the Kidneys, which you may do by a Vomit twice or thrice in a month, to those which easily vomit.

Or you may give a Purge by a Bolus of Cassia, Diaphoenicon, and Rhubarb, prescribed in the Cure, or some other convenient Medicine every month; or two or three, according to the habit of the Pa∣tient, and the plenty of Humors, and that in the last quarter of the Moon.

Or if there be evil Humors, they must be purged Spring and Fall with a convenient Apozeme: for by that, not only the Antecedent and remote cause wil be taken away; but also some part of the con∣junct cause; as also the Obstructions of the Bowels, which usually accompany this disease, wil be ta∣ken away, if you mix therein clensing and cutting Medicines.

Or instead of the Apozeme, you may use the Decoction of an old Cock made thus:

Take of Polypody of the Oak, Carthamus seeds, of each one ounce and an half: Thyme and E∣pithimum, of each one pugil: Cummin, Annis, Dill, Fennel, Caraway, and Carduus seeds, of each two drams: Senna one ounce and an half: Gummy Turbith half an ounce: Cinnamon one dram: Crystal of Tartar two drams: beat them and mix them together, and put them into the belly of an old Cock; and then boyl them till the flesh come from his bones. Let him take the Broth being strained, at four mornings draughts.

Or you may give this following Pouder commended of Solenander, by the use whereof he testi∣fieth, that he cured many of the pain of the Reins, giving it in the fit.

Take of Senna two ounces: the best Rhubarb half a dram: Turbith one dram and an half: Hermodacts two scruples: Polypody half a dram: Cinnamon, Ginger, Gromwel seeds, Saxi∣frage, Broom seeds, of each one dram; pouder them finely. Give one dram, or a dram and an half in white or thin red Wine, once in a month.

Carolus Piso doth extol this following Pouder:

Take of Annis, Fennel, Caraway, and Cummin seeds, of each one dram: Coriander prepared half a dram: Liquoris and Burdock seeds, of each one dram and an half: Cinnamon and Ga∣langal, of each one scruple: Gromwel and Broom seeds, of each half a dram: Diatragacanth fri∣gid two drams: Diagridium one scruple: Senna as much as all the rest: make a Pouder. The Dose is one dram, with the Broth of gray Pease.

Or you may make a Magistral Syrup thus:

Take of Sparagus, Couch-grass, Marsh-mallow, Knee-holm, and Parsley Roots, of each one ounce: Bettony, Burnet, Saxifrage, and Pellitory of the Wall, Maiden-hair, of each one hand∣ful: Bazil, Parsley, Gromwel, Broom, and Burdock, and Mountain Ofier seeds, of each two drams: Liquoris, Raisons, and Polypody of the Oak, of each one ounce: Make a Decoction to one pint and an half. Infuse in the straining, four ounces of Senna: white Agarick two ounces: Ginger two scruples: boyl them a little, and strain them: after dissolve in it one pound of white Sugar. Boyl it up to a Syrup, and give thereof two ounces once or twice in a month, with the De∣coction of Barley, Couch-grass, and Gray Pease.

Or if the Body be very foul, make Pils of Aloes and Agarick, and give two or three of them every other day before Dinner.

After Purging, give Diureticks, to bring forth the slimy Matter, and Sand that is about the Ure∣ters.

For this end, make Decoctions of the Diureticks mentioned in the Magistral Syrup, with Sugar, into the form of a Julep, or Apozeme. Or Chicken, Goat, or Mutton Broth, to be taken many daies together after general Evacuations.

Also after every Purge, take some of these following, once or twice in a week.

Take of the stalks and flowers of Beans three pound: Calcitrah one pound: beat them, and add one pound of Sugar candy; the Juyce of Lemmons one pint and an half: the Juyce of Oranges half a pound: the Decoction of Mallows, and Marsh-mallows wel strained two pound: Honey one pint: Distil them with a gentle fire, and let them not be burnt, nor the Liquor wholly consumed. Let the Patient take four ounces of this Water every morning.

Take of the stones of Medlars, and the pouder of Diatragacanth frigid, of each one ounce: dried Rest-harrow Roots, Liquoris, Melone and Gromwel seeds, of each two drams: Saxifrage, Broom, Rhadish, Knee-holly, Calcitrap seeds, of each one dram: Marsh-mallow and Sparagus seeds, of each one scruple: Sugar candy two ounces: make a Pouder. Of this let him take one spoonful thrice in a month in the morning, about New moon, Fullmoon, and Wain, drinking after a little white Wine, or red Pease broth, Sea-holly, and Liquoris, exercising after it.

Carolus Piso highly commends this following Pouder, which he gave with his purging Pouder be∣fore mentioned, and took away many boxes of smal stones from a President of Lorrain.

Take of Marsh-mallow and Violet seeds, of each half a scruple: Gromwel seeds, and Liquoris, of each one scruple: the Jews stone, and Spunge stone, of each six grains: the pouder of Dates, Medlar, and Cherry stones, of each two scruples: Melone Seeds three drams: make a Pouder. Give one dram with unleavened bread dipt in white Wine three daies together of the New moon, and let him drink red Pease broth after it, wherein the Roots of Marsh-mallows, Fennel, Sea-holly, Rest-harrow, and Parsley, and Juniper berries bruised have been boyled, adding a little white Wine, Honey, Butter, and Juyce of Lemmons.

This following Electuary prescribed by Zappata, is excellent.

Take of the Seeds of St. Johns-wort dried, and finely poudered, three ounces: Conserve of Roses of Violets one pound: mix them into an Electuary, of which let the Patient take half an ounce e∣very morning three hours before meat the first two weeks two daies together; and after for fifteen daies once in a week; and after that once in a month, or oftener, according as the Disease re∣quireth.

Conserve of Roses, is better than Violets, because it correcteth the scent of the Turpentine which comes forth of the Seeds of St. Johns wort beaten. But Violets agrees best with the Reins.

These following Lozenges are very safe, and most excellent.

Take of the four great cold seeds, and of Liquoris, all clensed one scruple: Burnet, Bazil, Par∣sley seeds, and Nutmeg, of each half a dram: Aromaticum Rosatum two scruples: Sugar dissol∣ved in Winter Cherry Water, four ounces: make Lozenges of three drams in weight. Let him take one in the morning three hours before meat, drinking after it four ounces of Rest-harrow, or Rupture-wort Water, with two ounces of white Wine.

The Wine of Winter Cherries described in the Cure, if it be drunk somtimes, doth take away the Matter that breeds the Stone, saith Villanovanus.

In the use of all Diureticks observe this, They must not be used too often because they draw to the part affected; there once or twice in a month, or somtimes seldomer, is sufficient, purging before, lest the Humors of other parts should be carried to the Reins.

Turpentine may be used oftener: for Amatus Lusitanus in Curat. 68. Cent. 2. reports of a Monk that had the Joynt-gout, and the Stone both, and could find help by nothing; at length by the use of Turpentine he was cured within six months of them both. Every morning he swallowed the quan∣tity of a smal Nut with Sugar. And the reason why Turpentine often used doth not hurt as other Diureticks, in my Judgment is this; Because it looseneth the Belly withal; so that those gross Hu∣mors, which by other Medicines would be carried to the Reins, are sent out by stool.

But commonly Turpentine is used seldom, as other Diureticks, either alone, or with other Medi∣cines, thus:

Take of Turpentine ten times washed in Saxifrage or Pellitory Water, half an ounce: With Su∣gar make a Bolus. Or,

Take of Cassia newly drawn six drams: Turpentine half an ounce: Pouder of Liquoris two drams: mix them for a Bolus. Or,

Take half an ounce of Turpentine, and one dram of poudered Rhubarb: mix them for a Bolus. Or,

Take Four ounces of Turpentine, burn it upon a hot Iron that it may pouder, and give two drams with convenient Liquor. Or,

Take Turpentine half an ounce: Pouder against the Stone, called Pulvis Lithontribus, t••o drams: mix it for a Bolus.

Zacutus Lusitanus, Obser. 58. lib. 2. Praxis admir. doth much commend Natural Balsom for ex∣pelling stones, and that a man of three score yeers of age that had his Water stopped eighteen daies with stones, was cured thereby. First he took some drops of it with Oyl of sweet Almonds, encrea∣sing the quantity of both till he came to half an ounce of Balsom, and three ounces of Oyl of sweet Al∣monds, within ten daies he voided six stones; and afterwards he was preserved by the same Medi∣cine, by taking in a morning half an ounce of Oyl of sweet Almonds, and six drops of Balsom, by which means he made a Sandy Urine, and lived long. If you want Eastern Balsom, you may take that of Peru.

The same Zacutus in the same Observation, doth commend Tobacco Water, in these words: I remember (saith he) that I took away many great stones fastened in the hollow of the Reins, with distilled green Tobacco Water. If you want that, then use the Decoction.

Most wi••e Varandaeus, my Master, commends the Waters of some Baths, Balervacan or Bitume∣nous for Preservatives against the Stone, of which we have seen rare effects. We 〈◊〉〈◊〉 his words: There is (saith he) no better Medicine after Purging, than the drinking of Balervacan Waters; for by the heat which comes from the Bitumen, they dissolve gross humors and stones, and by their Nitrous quality they clense, and by their great quantity, do not only clense the Guts, but Reins; so that it is incredible to tel what abundance of thick Water some have made after it. But when we fear the Inflamation of the Guts, we ordered them to abstain from Wine, and gave them Chicken Broth with cold Herbs and Juleps. Therefore we put fat Flegmatick men into them once a day in the morning, having first anointed their Reins and Liver with some proper Oyntment, and bound them with doubled linnen cloaths, that the Excrements might be received from the Pores o∣pened. And if their Bewels grow hot, they may after use sweet Water Baths that cool and moisten.

Sharp Mineral Waters, or Vitriol, are also good to prevent, for they do not only dissolve the sli∣my Tartarous Matter that breeds the Stone, but correct the hot distemper of the Liver and Reins, and therefore in hot distempers these are best.

And because hot Bodies are hurt by hot things, we will prescribe more temperate; as Bean and Rupture-wort Water, and Lemmon Water distilled. Slice them and distil them in Balneo Mariae. And for their better cooling, still them with Milk.

The Conserve of Hipps, is Diuretick and cooling, and is commended by Crato in this case also.

The Conserve of Marsh-mallow and Mallow flowers, which by mollifying and moistening helps the stones to come forth.

The inspissate Juyce of Purslain made into Pills, and given one dram at a time, doth powerfully clense the Reins.

The dried Flowers of Pomegranates in one dram, doth purge the Matter causing the Stone.

And the like Quantity of the Dryed Spunge of white Thistle, given in like quantity, is excellent.

Fresh Butter with as much Sugar candy taken every morning fasting, doth clense the Passages of the Urine, and hinder the breeding of the Stone.

Bitter Almonds taken ten or twelve in a morning, do the same.

Filberts also taken before meat, are commended by Crato, who saies that he found by Experience, that many long affected with the pain of the Reins, were cured by them. Which Amatus Lusitanus Curat. 78. Cent. 7. wisely confirmeth, where he thus saith: A man that had the pain of his back, and pissed often red hairs, complained of his Loyns and Guts, for which he had took many things in vain; but contrary to all hope he was cured with eating of Filberts. For one counselled him that if he would be cured, he should eat Filberts with their inward Husks before Dinner and Sup∣per. But he considering the Innocency of the Medicine, eat them at meat, and after also: by which he was cured per••ectly, and his pain never returned. Amatus Lusitanus in his Notes, adds this: That not only that man, but many others have been cured thereby. These are those vulgar Nuts that Avicen reckons among the Medicines that consume the Stone. But the question is, by what fa∣culty they work? whether by the dryness of the inward skin? But some say that they work by their Oyly quality.

The Chymists commend the Spirit of Salt, and give some drops thereof in a morning with Broth, or other Liquor.

Zechius commends boyled Water given warm, the quantity of six or seven ounces, once or twice in a day, before meat. For it clenseth the Reins, and extinguisheth the heat, so that they cannot af∣ter breed stones.

Let his Drink be thin Wine, with the Decoction of Sea-holly. This Crato commends. And we have seen excellent effects thereby.

Sowr Wine called in French, Ʋnies, drunk often, doth so much good, that some have Vinyards of those Grapes on purpose.

To correct the hot distemper of the Reins, is the best Preservative, by such things as are mentioned in the hot distemper of the Liver. For they help the Reins and the Liver, from whence many times they are distempered.

Among the rest, Whey drunken in Summer, a whol month together, is the best. And sharp Mi∣neral and Vitriol Waters, to cool al the Bowels.

You may apply this following Epithem often to the Reins.

Take of Lettice, Water-lilly, and Rose Water, of each three ounces: Rose Vinegar two ounces: Apply them very warm morning and evening.

This following Liniment is good, especially in Winter.

Take of the Oyl of Roses, Water Lillies, and Violets, washed in Vinegar and Rose Water, of each one ounce: the Mucilage of Marsh-mallows drawn in Pellitory Water, six drams: Wax, a little. Make a Liniment for the Reins morning and evening.

The extraordinary heat of the Reins, is allayed with a plate of Lead, alwaies warm.

And lastly, Because the Crudities of the Stomach do breed the Stone, you must have an eye to that, and strengthen it with such things as are prescribed in the Chapter of the Weakness thereof.