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. VII. Of the Epilepsie, or Falling-sickness.

THe Epilepsie, is a Convulsion of the whol Body, not continually, but by fits, with a hin∣derance both of the Mind and Sences.

The Word Convulsion, is not here taken properly and strictly for a true Convulsion; but improperly, for a Convulsive Motion: For an Epilepsy is a Convulsive Motion, not a true Convulsion. But we keep the name of Convulsion in imitation of Galen, who calls an Epilepsy alwaies a Convulsion.

This Definition is taken out of Galen, 3. de loc. aff. cap. 7. and lib. de diff. sympt. cap. 3. and de∣fines a perfect Epilepsie, in which all the Body is contracted, and all the Sences both internal and ex∣ternal are abolished. Yet there are imperfect Epilepsies, in which only the Head, or Arm, Leg, and Thigh, or half the Body is only contracted. There is also an Epilepsy in which the mind remains sound, and the external sences, and also the voluntary motion of some parts. I saw a Nun, which in her Epileptick fits had divers contractions, somtimes of the Arms, then of the Legs, somtimes of the Head, afterwards of the whol Body; yet she saw those that stood by and spake; nay, she also en∣deavored a voluntary motion against the Convulsive, so as she did in a manner diminish the involun∣tary motion: somtimes she was in a smal fit only, and walked about her Chamber, but with a disor∣derly motion, leaping and using strange antick postures, by which she caused the rest of the Nuns to be very merry, and she at that time laughed with them, and spake when she pleased.

Every convulsive motion (as I said in the former chapter) cometh of provocation, which procee∣deth from the quantity or quality of the matter. The quantity of matter which causeth the disease, burdening Nature, stirs her up to expel that which is troublesom to her. Whence the Opinion of Galen is confirmed, which is so disputed by late Physitians, That an Epilepsy comes of an imper∣fect obstruction of the Ventricles of the Brain; for if the humor obstructing or stopping is burden∣som to Nature, the Brain will labor to expel it. In the quality there is no difference, for all agree in this, That the expulsive faculty is stirred up by sharpness and acrimony, and by any quality which is offensive to Nature.

The Causes stirring up or provoking, are either contained in the Brain, and make a proper Epilep∣sy, or come from other parts, and so make an Epilepsy by consent or sympathy.

And that provoking or irritation makes an Epilepsy, when the Brain laboring to expel that which is offensive shakes its self, and by consequence all the Nerves which are adjoyned to it.

There is in Galen, and almost all Authors, a threefold Epilepsy. The first is that which hurts the Brain, in which the Disease is: The second is that which hurts the Brain by consent from the Sto∣mach: The third is when the disease is sent from other parts of the Body to the head: And these have their proper names; The first, as being chief, is called Epilepsia; the second Analepsia; the third, Catalepsia: But (by Galens leave) that division is superfluous, and in vain is that Epilepsy which comes from the Stomach separated from those which comes by sympathy from other parts; when all ought to be called Sympathicae, or Epilepsies by consent. Neither is it sufficient to say that an Epilepsy from the Stomach is distinct from others, because it is most frequent since that which comes from the Stomach and Spleen, is as usual and as frequent, if not more.

Therefore we divide an Epilepsy into a Proper one, and one by Consent. Again, we subdivide that which is by consent according to the divers parts from whence these sharp and malignant vapors are sent to the Brain, for there is almost no part in the Body from which a malignant vapor cannot be sent. Two Stories are related by Galen in the place quoted; the one of a Boy of thirteen yeers old, who at the first had the Epilepsy in his Leg, after that it ascended into his Thigh and Bowels, and by the sides into the neck til it came to the head, which at first touch made him not able to stand Another is of a Youth who in the beginning of his fit perceived as it were a cold air to ascend. But it is remarkable and well known, that an Epilepsy comes for the most part from the Guts, the mat∣ter that breeds worms, from the Matrix and other parts, and it is confirmed by many Authors.

Therefore it is manifest from what hath been said, how Galens Opinion may be defended, who af∣firms, That a proper Epilepsy comes of an imperfect obstruction of the ventricle of the Brain; which we cannot defend to be the constant cause, as Galen seems to grant who laies down no other: but we are rather forced to confess, that it is less usual than the rest.

Nor do the Arguments brought against Galen any way convince, the chief whereof are these:

First, As Fernelius saith, if an Epilepsy comes from plenty of Humors, it would come most in the sleep, at which time there is plenty of Humor. I answer▪ That the humor of which sleep is be∣got, is in the substance, not the Ventricles of the Brain, and therefore doth not stir up the expulsive faculty which resideth most in the Ventricles.

Secondly, Fernelius saith, That because an Epilepsy is quickly dissolved, it should turn into a Palsey, as an Apoplexy doth when the humor is cast into the nerves. I answer, That in an Apoplexy, by reason of the weakness of the expulsive faculty which is oppressed by many humors, they are cast into the parts adjoyning; but expulsion being stronger, and more free in an Epilepsy, they are sent to those parts which are ordained by Nature for their discharge. And it is false which Fernelius saith, That an Epilepsy never ends in a Palsey; for we have seen a Palsey come after it. And somtimes Apo∣plexies at their first coming are turned into Convulsions before there be a perfect obstruction of the Ventricles of the Brain; and also many Epileptick men die by an Apoplexy when a little obstructi∣on turns into a total stopping.

Thirdly, Against Galen some argue thus: As a compleat Obstruction of the Ventricles totally takes away the functions of the Brain in an Apoplexy: So an incompleat Obstruction would only diminish, not deprave the Functions, nor produce such convulsive motions as are somtimes more vio∣lent than sound motions. I answer, That Nature being wholly oppressed by a total obstruction doth not labor for expulsion; but she hath strength enough in a half obstruction to move and stir up the Brain to expulsion. This is confirmed by the Example of a defluxion falling upon the Lungs, which if it fill the whol Lungs, it makes great difficulty of breathing without a Cough, as cometh to pas in an Astma, or shortness of breathing: But if a smal quantity only of humor do fall, the Lungs are stirred up to expulsion, whence cometh a Cough.

The Signs of an Epilepsy are of three sorts: Either they are such as signifie an approaching Epi∣lepsy, or one that is present, or such as shew the difference of Epilepsyes.

The Signs of an Epilepsy approaching, are two-fold: Either they signifie the first coming of the Disease; or some Fit to be at hand. ••he same signs serve for both, but most surely in those who are actually possessed therewith, do they shew the condition of it in its return; for in those who ne∣ver had this disease formerly, these signs are doubtful for the most part, and may declare many head diseases; but all of them together may give some certainty.

Therefore al signs of an eminent Epilepsy are to be propounded with this admonition, That al signs do not meet in al; but some in one, some in another, as the causes and constitutions do differ. But that they may orderly be laid down, we must search the originals of these signs, which flow from Animal, Vital, and Natural actions, from excrements, qualities changed, and proper accidents.

In respect of the Animal Functions, and unaccustomed disturbance of the mind and Body, threat∣neth an Epilepsy, heaviness of head, head-ach, vertigo or giddiness, or much sleep, from whence the Body hath no refreshment; troublesom dreams, dulness of mind, or perplexity, forgetfulness, sorrow, fear, dread, sloth, graveness of actions, snatching and trembling of the parts, dulness of the sences, a down look, clouds and other things flying before the eyes, noise in the ears, a stink in the no∣strils,

a stiff tongue, and its inordinate Motion, yawning, and neezing.

In respect of the Vital Function, these with others are the signs: Anger, Beating or palpitation of the heart, straitness of Breast, and alteration in Breathing.

In respect of Natural Functions, these are forerunners of an Epilepsy; disdain of meat, or immo∣derate Appetite, Squeamishness, heart-burning.

In respect of Excrements, these are signs: Much spittle, thin and crude Urine, often Nocturnal Pollutions.

In regard of qualities and proper accidents changed; Paleness of Face, and swelling of the heart.

A present Epilepsy is easily known, if it be perfect; but it hath many differences which cause difficulty, as we shall shew.

In a compleat fit all the Sences both internal and external are hindred. The party suddenly falls, and the whol Body, or at least some parts are diversly moved: Moreover, there is a staring and thru∣sting forth of the eyes, gnashing of Teeth, a difficult breathing, as in those that are hanged; the seed, dung, and urine are sent forth involuntarily, and about the end of the fit, he foameth at the Mouth and Nose, which happen only in a vehement Epilepsy, and the fit being ended, he forgets all things he then acted.

Some of the Ancients make three kinds of Epilepsies: One which is like a deep sleep; another which doth shake the body after divers motions; a third which is made of both the former. The late Physitians deny the first kind, saying, That it is more like a Coma, or a Carus than an Epilepsy; and these two Diseases cannot be otherwise distinguished, but that in a Coma is a deep sleep without a Convulsion, and a Convulsion is a certain sign of an Epilepsie. But Avicen saith otherwise, namely, That an Epilepsy comes many times without an apparant Convulsion. And experience teacheth us, That many men in Epilepsies have fits like Coma: and it's known to be an Epilepsie, not a Coma, or a Carus by this; The sleep in an Epilepsie cometh and goeth by fits, when in a Co∣ma it comes all at once.

A true Epilepsy is distinguished from an Epilepsy by consent thus: In the true there appears many signs of the Brain affected; as heaviness of mind, and slowness, decay of memory, troublesom sleep with dreams, dulness of sences, slowness and idleness of Body, pain of the head, and other things. Moreover, the sick man doth not perceive the fit coming, but is suddenly taken therewith unawares, at the new Moon for the most part. The due proportion of the inferior parts being without blemish do confirm this sign.

But we may know whether it come from the right or left side of the head most: By this, either the sight of one eye is more obscured, or the hearing more thick with the noise of the head on that side; or if the right or left side be more dull.

But we may know from what humor, especially an Epilepsy cometh by those signs which declare when flegm, choller, or melancholly abound.

An Epilepsy by consent, is thus known: There appear no signs of a distempered Brain; the Pa∣tient perceives his Disease Coming, and a wind rising from the parts below: or some lower part is weakened, or else affected strongly in the time of the fit.

These things following do shew that the Cause of an Epilepsy is in the stomach: Disdain of meat, an inability to fast, loathing, vomiting, pain of the stomach, gnawing, pricking, and distention; somtimes beating of the heart, which ariseth from the Stomach.

That the disease comes from the Liver or Spleen, appears by often belching and breaking of wind, a swelling of the belly with rumbling and noise, sowr belchings, straitness of the Midrif, and pain som∣times reaching to the back, besides some distemper in inferior parts.

An Hysterick fit, or the Mother, mixt with Convulsions, if a retaining of the Courses or Seed went before, shews that it comes from the Womb.

If the Epilepsy comes from an external part, some wind is perceived to rise from that part, and the matter causing the Disease, somtimes tickleth and beateth in the part, which is a sign there is a fit at hand; and if that part be tied hard, the fit is hindred.

Lastly, The Signs of worms, shew that the disease come from them, as stinking sowr Breath, itch∣ing of the Nose, pain of the Belly, earthy Excrements, grating of the teeth, sleepiness, and the like, especially if somtimes worms are voided.

But the extraordinary Causes, as Imposthumation, foulness of a Bone, stopping of urine, and the like, may be taken from their proper signs.

As to the Prognostick, An Epilepsy is a Disease of long continuance, and very stubborn and dead∣ly in Infants.

An Epilepsy coming haereditary is incurable; but that which comes from external causes, and evil diet, is curable.

An Epilepsy coming before fourteen yeers of age in Boyes, and twelve in Girls, is curable: after twenty five yeers of age it is incurable; out of Hippocrates, Aph. 7. Sect. 5. For in the time of ripe∣ness

of Age, there is great store of Natural heat, which is powerful to discuss-Diseases. Moreover at that time women begin to have their terms, by which the uncleanness of the Body is purged. Yet although Hippocrates supposed an Epilepsy to be incurable after twenty five yeers of age; yet this is not alwaies true, for we find by experience that many have▪ been cured after, although but seldom seen; therefore we may say that the Aphorism is true for the most part, A strong Epilepsy often killeth the Patient in the fit, or it turns into an Apoplexy, or by reason of the strength of the symp∣tomes, and the violent shaking of the Brain, the Fabrick of the Body it is overthrown, and some parts thereof are broken, and it happens somtimes that pieces of the bones called Processus Mammil∣lares, come out of the Nose.

An Epilepsy coming of Melancholly turns somtimes into madness, when the humor is sent from the Ventricles of the Brain into the substance thereof.

The same humor when it is only in the Ventricles of the Brain, stopping them and paining them, causeth an Epilepsy: But when it offends the substance of the Brain which is the seat of the chief ••unctions, by defiling its Natural temper, and corrupting the Animal Spirits, and darkening them, it makes a M••lancholly doting. Hence Hippocrates, 6. epid. sect. 8. text 40 saith, that Me∣lancholly men turn for the most part Epileptick, and Epileptick to Melancholly. But these Disea∣ses thus change in a two-fold respect; either by the change of the matter causing the Disease from its proper seat▪ and so when one comes, another goes, or by the propagation of the matter, and then both remain.

An Epilepsy coming of flegm turns either into an Apoplexy, or a Palsey.

A Quartan Ague coming upon an Epilepsy, and continuing long, cureth it, by reason the matter of the Disea••e is by degrees co••••••••ned by the heat of the Feaver if it be of flegm; but if it come of Melancholly, it is sent from the part affected, to the place where the ground of the disease lieth, that it may supply matter to the new sits.

The ••ure of the Epilepsy is two-fold; the one in the fit, the other out of it.

Physitians are seldom called to the Cure of the fit, except it continue over long: in which cafe those Remedies which we laid down in the Cure of sleepy Diseases, especially the Apoplectick Wa∣ter, the Cinnamon Water, Aqua vitae, and other Spirits which are very proper to discuss the fit.

Out of your fit you must vary your Cure as the Cause requires.

And first we shal lay down the Cure of a proper Epilepsy, which consists in Evacuation of humors throughout the body, in the discussing of the matter of the Disease, and rectifying its evil qualities; as also in strengthning of the Brain. And since the matter offending in a true Epilepsy is for the most part Flegm, we will direct our general Cure in oppo••••tion to that; admonishing yong beginners that if Choller or Melancholly abound, they would prepare and purge them. But the specifical Re∣medies are alwaies the same, of what cause soever the Disease doth come.

For a perfect Cure we must thus proceed:

First, Give him a Potion to purge flegm, or some other Medicine to that purpose, which the Patient can best take, mentioned in the first Chapter. First giving a Clyster, if his body be bound.

After, if there be signs of Repletion, or if the party be Sangume he must be let blood; otherwise not.

Afterwards the Universal Cure, of the cold distemper of the Brain is to be followed, with this Cau∣tion, That to the Decoctions, Apozemes, Diets, Sweats, Syrups, Chewings, and head Pouders, you ad the Root and Seed of Peony, and Misleto of the Oak, which all ancient Authors hold to be most proper for the Cure of this disease.

For his D••et, Guajacum is the best Sweater: By the use of which Jachinus reports that he cured many, but let it be continued thirty or fourty daies.

To every Dose of the Sudorifick Decoction, put some drops of the Spirit of Vitriol, which is thought very proper for the Epileply.

You must often use the common purges, namely, the Pills, or Magistral Syrup once or twice a week if the Patients strength will suffer them, and continue purging for divers Months: and som∣times use stronger purg••s, as Massaria ordains, who saith it comes from hence that Epilepsies are not, or seldom cured, because the Physitians alwaies give weak Medicines.

For this cause, the Chymicks use Minerals, which draw the Humors from remotest parts, but not without much danger, especially if they be not well prepared. But if good success may be expected from these Chymical Medicines, it is to be found in Mercury or Quick-silver, either by its self, or with Gold calcined in a Furnace of Sand, with a long continuance of fire, watching narrowly lest any crude portion of him remain, which would make the Medicine very violent; otherwise it will work gently, if given in the quantity of four or five grains in Cochie Pills, or any Extract that purgeth flegm, or all humors.

A new Epilepsy is somtimes cured with Salt of Vitriol; as Angelus Sala saith, that he hath cured at thrice taking of it, an Epilepsy, giving it every fourth day. And after in his 77. Gurat. Gent. 2. he

boasts that he cured a Girl of eleven yeers of age, of an haereditary Epilepsy, with Stibium calcined, given only thrice.

Quercitan's Syrup of Tobacco, is very good for the Cure of the Epilepsy: But it is not to be used but by a wise Physitian, it is so vehement.

Instead of the Opiate before mentioned, this may be used, which is more Specifical.

Take of the conserve of Rosemary flowers, Peony, and Bugloss, of each half an ounce: Citron barks candied, two drams: of the pouder of Misleto of the Oak, Peony seeds, and Elks Claw, of each half a dram: Mans skull that was not buried calcined white one dram and an half: Coral, Pearl, and Harts-horn prepared, of each four scruples: right Bezoar stone, one scruple: Diamos∣cu dulce, Diatrion santalon, of each two scruples: old Treacle, and Confectio de hyacintho, of each one dram: Spirit of Vitriol fifteen drops: With the Syrup of candied Citron barks, make an Opi∣ate; of which take the quantity of an Acorn, or Filbert, drinking a little Cinnamon water after it.

But this following is most powerful for the rooting out of the Disease after the Body is well purged.

Take of Conserve of Bettony Flowers and Rosemary Flowers, of each two ounces and an half: Eringus Roots candied, and Mithridate, of each one ounce: the pouder of Sassaphras six drams: Castoreum three drams: Mans Skull not buried, and Elks hoof, of each two drams: of the roots and seeds of Peony, and Gith seeds, wild Rue, and Pellitory, of each one dram: Oxymel as much as is sufficient, make an Opiate, of which take two or three drams.

The Opiate of Montagnus goes beyond all, by which many have been cured: It is made thus:

Take of the Roots of male Peony, Stoechas, and Pepper-wort, of each ten drams: Agarick five drams: Pellitory, Carua seeds, Dill, Assafoetida, and Aristolochia or round Birthwort two drams and an half: of the juyce of Squils, and Honey, of each one pound and two ounces: Boyl the Squils and Honey gently to a good consistence; then ad the Pouders, and make an Electuary: of which, take two, three, or four drams, as age requires, continuing it twenty or thirty daies.

After the use of the Epispastick Plaister, you must apply a Vesicatory to the fore part of the head, and a Cautery to the neck.

But a Seton or Skein of Silk drawn through the neck, draws the Humors more strongly out of the Brain. And Fabricius Hildanus reports that he cured a Youth that had the Falling-sickness every day, and had used all means he could get, in vain; and a Girl of eighteen yeers of age, born so, only by the continuance of a Seton.

If you conjecture that the vapors rising from the parts below, and flying into the Brain, produce this disease, and nourish it; it is good to apply a Caustick to the fore part of the head, avoiding the Sutures: for Carolus Piso reports that he cured two by so doing. Also if the Disease come from the inferior parts, the Waters of Germany called Aquae Acidulae do work wonders, and somtimes root out the Disease, if first evacuations have been sufficiently made, and the veins inferior have been opened.

But an Epilepsy coming from the Matrix requires a special Cure.

The Pouder of Elder Berries described by Quercetanus, given three daies together, the quantity of a dram with some Hysterical Water, is good.

If al means fail, the last remedy is, to open the fore part of the Skul with a Trepan, at distance from the Sutures, that the evil air may breath out. By this means many times desperate Epilepsies have been cured, and it may be safely done if the Chyrurgeon be skilful.

Let the Patient drink ordinarily Hydromel, or a smal Decoction of Guajacum with Peony Roots.

Let him carry a Bag about his Neck made thus:

Take of Peony Roots and Misleto of the Oak, of each one ounce: Elks hoof two drams: Nut∣megs, Cloves, and Mace, of each two drams: Rue and Hysop, of each one dram and an half: Pouder them and put them in red Sarsnet to be bung about his neck that he may often smel to it.

After Universal Evacuations, among other Medicines you must use Specifical Medicines, which you may find in many Authors. We shal set down some of the best (besides those Opiates prescribed) which are of no smal Consideration in the Cure of this Disease.

Rondeletius commendeth much the Water of Swallows, which Quercetanus borrowed of him in his Dispensatory. Treacle Water is of no less value, and Aqua Cephalica, and Syrupus Antepi∣lepticus, mentioned by Quercetanus.

The Root of wild Valerian is much commended by Fabius Columna, that (once or twice taken) it cures the Epilepsy. And he reports he gave it to many of his friends, who affirmed that (under God) they were cured by it. The Dose is half a spoonful in Wine, Water, Milk, or any other

proper Liquor; but it is given to Children in a less quantity in Milk.

The Chymists commend the Spirital mixture, than which no better Medicine can be required (as they say.) The Composition whereof is as followeth:

Take of the spirit of Vitriol, one part; spirit of Tartar, three parts; Treacle Water with Cam∣phire, four parts: Mix them, and let them stand in a glass well stopped three or four weeks.

The Dose is one dram in any proper Liquor, or Vehiculum to swallow it down with.

Rulandus used much the Oleum ligni Heraclei (which the Chymists affirm to be of Coryline, or the Oyl of the Hazel-nut, or Filbert tree) And in his Centuries he relates some passages of them, which by the use of the Medicine were cured. The Dose is three or four drops in any proper Li∣quor for five daies together.

The Oyl of white Amber is inferior to none, if not the best, being drawn by a good Artificer, and smelling of no fire, but sending forth a most fragrant scent. The Dose is from half a scruple, to one scruple.

The Oyl of Box-tree taken by four drops at a time, in four ounces of the Water of the Tile-tree flowers with four drops of the Spirit of Sulphur for some certain daies together, is very powerful, and is thought by many to be the true Oyl of Lignum Heraclei.

Crato calls the Natural Cinnaber the Load-stone of the Epilepsy, and makes this Pouder of it.

Take of Natural Cinnaber, or Vermilion, which is cleer, and finely poudred half an ounce: red Coral, and Pearls prepared, of each two scruples: Saffron one scruple: the Leaves of Gold five: Grind them all very finely upon a stone. The Dose is from six grains to a scruple in the time of the fit, in some proper Liquor.

The Cinnaber or Vermilion or Antimony, which is taken after the extraction of Mercurius vitae, is thought by Chymists to be of no less vertue than the former: for if it be mixed with an equal weight of the Magistery of Pearl, Coral, and pouder of a dead Mans Skull, it is a specifical Medicine in an Epilepsy; though it be old, the Dose is from ten grains to fifteen in a proper Liquor.

The Cure of an Epilepsy by consent is first to begin with the part affected, and that part is to be clensed and strengthened by convenient Medicines taken out or those proper Chapters wherein they are mentioned: not omitting Specifical and Antepileptical Medicines, which are alwaies to be used in every Medicine. But if the Epilepsy come from any external part, besides the Universal Cure, we must have a special eye to that, and the malignant matter therein contained, is to be evacuated by Cupping-glasses with scarrification, Vesicatories, and Cauteries. And if the Disease continue after the Ephar or Scab is fallen off, you must apply the Cupping glasses again; and at last, when necessi∣ty urgeth, you must apply an actual Cautery. If the disease come from a foulness of the Skul, that is to be taken away with the Trepan and burning.