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. IX. Of Giddiness, called Vertigo.

Avertigo is a false Imagination, in which all objects, and the head it self seem to turn round, so as the Patient often falls to the ground, unless he lay hold on some stay at hand.

It may be objected, That in a Vertigo, the Imagination is not hurt; for if it were so, the Patients would think the objects truly turned round; as men in Madness and Phrenzy do think what they imagine to be truly so. We answer, That in a Vertigo, the Reason is not hurt, which perceiveth the error of the Imagination; but in a Phrenzy, or Melancholly, the Reason is hurt as wel as the Imagination.

There are two sorts of Vertigoes; the one simple, called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in which the Sight re∣mains unhurt: the other is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, or 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, a dark Vertigo, in which the Eyes are both darkned as it were with smoak, or a cloud.

In both kinds the Sight is somwhat hurt, because the Spirits which use to go directly to the Eyes, are moved out of order by the visive Nerve, by reason whereof the Eye doth not so sitly enjoy them. But in a dark Vertigo there is a more violent Motion of the Spirits, so that they come less to the Eyes, from whence the sight is darkned or hindred.

The immediate Cause of a Vertigo, is the circumvolution of the Spirits coming of a vaporous matter or wind, which coming into the Ventricles of the Brain, and Plexus Choroides, disturbs the Spirits, and makes them run round; whence the species of the Objects brought by those spirits are moved in like manner; and so the objects themselves seem to be moved also the same way. But here we may doubt, since a Vertigo is a symptom of a hurt action, and every action hurt depends immediat∣ly upon a Disease, how the Circumvolution of the Spirits can be the immediate cause of a Vertigo, when it can be referred to no kind of Disease. To which we thus answer, A Circumvolution of the Spirits, is a Disease in respect of Scituation; for at that time the Spirits do not keep that place or po∣sition which they Naturally ought, but move preternaturally, and amiss. And this Answer hath a weighty instance: For a Disease is an affection of a true part, but spirits are not true parts. We answer, That Axiome is not alwaies, but sometimes true; according to Galen that which is principal and hinders the action of its self, is the true Disease: We say that the word Part ought to be taken in a larger sense, comprehending all those things which go to the making up of the Body, and whatso∣ever hinders the action of any part, is called a Disease. So a yellow color in the Eye, hurts the sight immediately, and therefore it is called a Disease in number; so a better savor in the tongue, and noise in the Ears, are Diseases in number, in regard there is something in those parts besides, which offendeth the actions. After the same manner is the Circumvolution of the Spirits, a Disease in Scituation or Position, for the Reason above mentioned.

But those Vapors are sent up from evil humors, not continually without intermission, but by com∣pass and going about, and at a distance, namely, as often as they are raised up by an external cause; and the humors are such as use to produce vapors, namely, Blood, Choller, Flegm, and Melancholly, and the watery Humor; because both a cold as well as a hot vapor, may cause a Vertigo; as Galen, 3. de loc. affect. chap. 8. and Comment. Aphor. 23. Sect. 3.

These evil humors are either contained in the Brain, or in the inferior parts. Hence a two-fold Vertigo ariseth, one Proper, the other by Consent.

Waterish and flegmy humors heaped up in the Brain, send wind and vapors to its ventricles, which stirring about there, do cause a Vertigo. And so a proper Vertigo comes to be a forerunner of an Epi∣lepsy, or Apoplexy.

But Humors contained in the inferior parts, especially the stomach and the spleen, do easily send up Vapors to the head, which if they touch the Ventricles, and the Arteries, cause a Vertigo.

The external Causes are all such things as will quickly dissolve the Humors, and turn them to Va∣pors, or make an inordinate motion in those Vapors. Among which are reckoned by Hippocrates, Aphor. 17. Sect. 3. a South wind, and sudden change of Air. To these ad the heat of the Sun, windy Meats, Garlick, Mustard, Radish, Pease and Beans, Drunkenness, Gluttony, immoderare Exercise, and unseasonable, the suppression of a wonted evacuation, Anger, Baths, Hunger, especially in those which are ful of bitter Choller, often turning of the Body round, long looking upon Wheels and

things that run round, and of Waters that run swift, looking down from a high place, a Fall, a stroak upon the Head, a Fracture, or depression of the Skull, compressing and lying upon the Brain.

We shall lay down no Diagnosis, or general signs to know this Disease by, because it is of it self manifest. Yet in particular we shal declare those signs which shew the part affected that containeth the mine or matter of the Disease; as also those which shew the humor offending.

Pain of the Head shews that a Vertigo cometh from a Disease of the Brain, which is a true or pro∣per Vertigo. Also Heaviness, and the loss of some Sence; as Dimness of sight, noise in the Ears, thickness of hearing, decay of smelling and tasting; the beating of the Arteries of the Head when o∣ther parts are free.

The signs that shew what the matter is that offendeth, are these: That abundance of flegm offen∣deth, is signified by a dulness of the internal and external Sences, heaviness of Head, slowness of mo∣tion, drouziness, much spitting, want of Appetite, want of Thirst, white Urine, and crude, with the other signs of abundance of flegm.

But watchings, wrath, nimbleness in actions, thirst, bitterness of mouth, quickness of pulse, a thin and yellow Urine, and the like, shew that the Chollerick matter offendeth.

The signs of a Melancholly matter are, Fear, sorrow, troublesom thoughts, much watching, fear∣ful dreams, sowr belchings, and the like.

The signs of Blood abounding, are, Stretching of the Veins with fulness, redness of face, and heat, beating of the Temples, heaviness and distention in the head, long sleep, dreams of red things, weari∣ness, reaching, thick and red Urine, somtimes thin and transparant by the ascention of the blood into the head.

A Vertigo by Consent is known by the want of those Symptomes, which come from the Head, when no disorder is found in the Brain, but rather some part beneath is sensibly hurt.

These things shew that a Vertigo comes from the stomach, want of appetite, loathing, sowr bel∣chings, pain of the stomach, or swelling with wind.

That a Vertigo comes from the Liver, Spleen, or Matrix by Consent, the same signs declare which were laid down in an Epilepsy by Consent coming from the same parts in the Chapter aforegoing.

The Prognostick, or foreknowledg of this Disease, is thus:

A new Vertigo that comes but seldom, and which comes only from external Causes, is more light and easier cured: On the contrary, that which is old, and comes often, turneth for the most part in∣to an Epilepsy, or Apoplexy.

A Vertigo in an old man is most dangerous, because his Brain is colder and weaker, and flegm doth more abound.

A Vert go in which not only external things, but also the Head and whol Body seem to be turned about, and which happens with hurt to the sight, is more dangerous, for it signifies greater force in the cause of it; and if the sick man falls to the ground, it foretels an Epilepsy, or Apoplexy.

A Vertigo coming of hot Humors, is sooner dissolved than that which comes of cold, because hot Humors are sooner dispersed.

The Cure of the Vertigo is much like that of the Epilepsy, because both Diseases come almost of the same Causes: whence it comes that a Vertigo often turns into an Epilepsy. But because a Ver∣tigo is a lighter Disease, it doth not need so many Medicines as an Epilepsy: but they will serve, which we will here lay down; and also we shal demonstrate in short what is that which this Disease most properly requireth for its Cure.

In the first place, Therefore if blood abound in the whol body, or in the head, you must open a Vein, and let the blood out by degrees, giving before a Clyster that is somwhat sharp.

After that, give the ordinary Purge which is prescribed in the Cure of the cold Distemper of the Brain.

Afterwards we must come to the particular Evacuations of the Brain, by Errhines, Sternutatories, and Gargarisms, or Apophlegmatisms, mentioned in the first Chapter.

Cupping glasses dry, and with Scarrification; Frictions of the extream parts, and opening of the Hemorrhoids are to be used for to cause revulsion.

Apply Vesicatories and Cauteries for derivation, and at last use those things which strengthen the Brain, and disperse Vapors and Humors as well externally as internally, as Opiates, Pouders, and Bags that are described in the first Chapter.

And you must not omit the digestive Pouder, because the weakness of the Stomach often causeth this Disease.

And lastly, You must use those Medicines which are esteemed by special quality to cure the Ver∣tigo; such as are those which were prescribed for the Cure of the Epilepsy; namely, Antepileptick▪ Waters, a Balsom to anoint the Nostrils, Temples, and Crown of the head, Oyl of Amber, Pouder of Cinnaber, and many other.

Moreover, Quercetanus in the twentieth Chapter of his Dispensatory, commends a Medicine

made of Peacocks dung, whose Preparation and manner of use, may be seen in the Author.

If the Disease do obstinately resist the propounded Remedies, you must fall to a Diet of the De∣coction of Guajacum.

A 〈◊〉〈◊〉 in the fore part of the Head, is much commended by Zacutus Lusitanus in his first Book of Admirable Practice, Obs. 38. in these words: A certain man was so troubled with a dark Vertigo, that his Brain did almost continually seem to run round: and when he had tried many Medicines, and there was fear of an Apoplexy to follow; with no other means (besides general and particular Evacuations, and Fontanels or Issues in divers parts, and a Seton in the nape of the Neck) could he be cured, but with a Cautery in the fore part of the ••ead; by which only (be∣yond the expectation of Physitians) I have cured many of the Falling-sickness, letting them run a long time.