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. XII. Of the Imposthume, and Spacelus, or Mortifica∣tion of the Brain.

THe Imposthume and Mortification of the Brain is described by few Authors, although it was observed by Hippocrates in his 3. Book of Diseases, and happeneth somtimes in Pra∣ctice, and deluding those Physitians who are not well grounded, making them conceive it to be another Disease.

Now a Spacelus, or Mortification of the Brain, is a suppuration, or corruption, or matter of the substance of the Brain, which is called a Gangrene, Syderation, or blasting of the Brain.

The Immediate cause whereof, is an Inflamation of the substance of the Brain, which is distingui∣shed from a Phrenzy, in this: In a Phrenzy the Membranes are chiefly inflamed, and they do commu∣nicate an inflamation to the external part adjoyning; but in this Disease, the inward parts of the Brain are inflamed, and the whol substance thereof is putrified; for so great an inflamation in a most tender part and moist, will quickly produce a Spacelus, or Mortification.

The Cause of this Inflamation is Blood over-heated, or over chollerick, running into the Body and internal parts of the Brain.

The Primary Causes, are, all such things as produce hot and much Blood in the whol Body which is sent to the Brain; as violent Exercise, the heat of the Sun, heat of the head by Fire, Wrath, and the like: But great Wounds do more usually produce this Disease, as also Contusions. But a Spacelus or Imposthume coming from a Wound or Contusion, is different from the former in this: An Imposthume made by a Fall or Contusion, doth n•• possess so many parts of the Brain, but for the most part adhaereth to one. Hence the Symptomes are higher, especially in the beginning, and the Di••e••••e continueth longer.

The S••gns of an Imposthume or Spacelus, which cometh without a Wound, or Contusion, are these:

In the beginning there is a great Head-ach, which is communicated by the hinder part of the head to the neck and all the back; after which comes a general decay of all the Sences both internal and external, as in an Apoplexy, from which it is distinguished by the Signs hereafter mentio∣ned▪

The Patient is tossed to and fro, and cannot remain in the same place; he layeth hold with his hands upon his head, and desires to tear and scratch his face, plucking his hair: but as the Disease en••reaseth, his Body groweth faint, and cannot use such violence.

A most sharp and strong Feaver alwaies accompanyeth this Disease, which comes from the great Inflamation of the brain.

Lastly, In this Disease, the Patient never takes meat or drink, neither can you take any course to give them any thing, and therefore their strength soon faileth.

An Imposthume by a Wound or Contusion, is known by these signs following:

After the Wound or Contusion is received, there is a kind of numbness and sadness in the Body, the Animal Spirits beginning to be weakened by the matter which is got out of its Vessel. When the Disease encreaseth, there ariseth a kind of Feaver, when the matter begins to putrifie, thence comes head-ach and drouziness: after, when putrefaction is encreased, al the symptomes grow stron∣ger, the Feaver sharper; the Patient rising from sleep suddenly roareth out, and then presently lyeth down again; he often brings his hand to his head: Hence it is, that many before they die do send forth filthy green matter out of their mouth and nose.

As to the Prognostick part thus:

This Disease is most dangerous, and commonly deadly, even in three daies space, as Hippocrates sheweth in his 51. Aphorism, Sect. 7. saying, That they who have a mortified and putrified brain, die in three daies; but if they live longer, they recover. Galen in his Comments teacheth that we are not to understand here by a Spacelus, a compleat corruption of the Brain because that is uncura∣ble, but such as is at hand by reason of the great Inflamation.

In those which recover, who are very few, there is no remembrance of things past: they can neither remember their Disease, nor any thing concerning it.

We must make great hast for the Cure of this Disease, for if we do not apply Remedies in the be∣ginning, there is no time for Cure.

Therefore in the first beginning of this Disease we must let blood in great plenty, and very often twice, or thrice, or four times in the same day, as strength will permit: for al the hope of the Cure lyeth in this only Remedy; for when a great quantity of blood possesseth the substance of the Brain, which is large, soft, and moist, we cannot make so great a revulsion from thence, except we

draw almost all the blood in the veins: and here that common saying of Celsus is to be observed; Many things are done well in time of sudden danger, which at other times may be omitted.

You must also give sharp Clysters every day, that the humors which tend upwards may be brought down.

At the same time apply those Medicines of Rose Vinegar pre••cribed in the Chapter of Phrenzy.

For the greater revulsion and derivation, apply Cupping-glasses to the Shoulders and Back, with deep scarification; use Frictions and Ligatures to the extream parts: first open the Ankle Veins, then the Forehead, and the Arteries in the Temples; apply Hors-leeches behind the Ears, and to the Hemorrhoids; Vesicatories to the Neck and Arms, and other Medicines which we prescribed in the cure of the Phrenzy.

At last, if the Disease decline, you must apply to the head things that gently resolve; among which, the best is, the hot Lungs of a Sheep newly slain.