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. I. Of Gutta Serena, or Amaurosis,

WHen the sight is gone, and no fault appears in the Eyes, it is called Gutta serena, or Amau∣rosis. And it comes to pass, when the Animal Spirits cannot pass from the Brain to the Eyes; for when the Animal Spirits come into the Eyes from the Brain by the Optick Nerves, we must find out the stoppage of their influx in the Optick Nerves. The Optick Nerves are many waies affected, but chiefly by obstruction or stoppage, astriction or binding, and by solution of continuity.

Obstruction is the most common and most ordinary cause of Gutta serena, which comes of a wa∣tery humor flowing down from the Brain upon the Nerves, even as other Nerves are obstructed in a Palsey by the same humor; so that the Diseases may be said to be alike by reason of that Obstructi∣on.

But it is most certain that this Disease is also begot by adstriction and compression of the Optick Nerves; which compression may come both or a moist humor gathered about the optick Nerves, and pressing upon them: as also of blood, filth, or matter: Whence somtimes certain tumors rising in those parts, produce the like Disease. For Experience teacheth, That somtimes blindness in one Eye, somtimes in both, comes upon inflamation of the Brain, and from Phrenzy in malignant Fea∣vers. And Platerus reports lib. 1. Observation, That he saw a blindness which came from a round tumor growing in the Brain, and compressing the optick Nerves, which appeared by opening of the Head after the Patient was deceased.

Finally, Wounds in the Head, in which the Optick Nerves are divided, without controversie do cause that the Animal Spirits can no more come to the Eyes.

This Disease is known, in that the Eyes seem to be in their natural condition, and there is no fault apparent in them, only the Pupilla seems blacker and larger. But in distinguishing the differences of Causes, there is great difficulty; for although the Disease coming of blood or matter is known by inflamation, aposthume, or wound going before, yet no certain sign can be given by which we can di∣stinguish a compression made with flegm from an obstruction: but we may in some part conjecture, for in the obstruction only of the optick Nerve, the Eye is only affected; but if a compression be made of the same Nerve by flegm gathered about the roots of the Eyes and Mamillar Passages, that matter possesseth other parts of the Brain, and then all or some of the other Sences are hurt; but if it seize only upon the Optick Nerves, there is more plenty of humor sent forth at the Nostrils, and the Patient perceives a heaviness in the fore part of the Head, especially about the Eye-brows.

As to the Prognostick part; If this Disease be absolute, that is, if there be a total loss of sight, e∣specially if it come from obstruction of the optick Nerves, it is for the most part incurable; as we see in Palseys also, that they are scarce or never cured which come from the obstruction of the Nerves, e∣specially if the Patient be old. But if the obstruction be imperfect, which only causeth a diminution of sight, but not blindness, there is more hope of recovery, although it cannot be brought about with∣out much pains, and long use of Medicines.

But if this Disease come of humors gathered in the fore part of the head, which compress the Nerves, it may be more easily cured. So saith Fabricius Hildanus, observ. 19. cent. 5. That a cer∣tain man after a strong vomit lost his sight, and that he cured him with giving him the same Medicine again; for as the humors being too much stirred by a violent vomit, and cast upon the Optick Nerves, compressing them, did hinder the passage of the Spirits to the Eyes: so the same humors being carried away by the same Medicine, the disease became cured. Almost the like story is mentioned by Sen∣nertus of a certain Student, who taking too strong a Purge became suddenly blind. He also affir∣meth, That certain women after they had conceived with child, became blind through the straightness of the optick Nerves, and that this Disease went away after four or five months, or in the time of their Delivery.

We also have seen some which fell suddenly into extream diminution of sight, who within fifteen daies, were cured by universal Evacuations, and some revulsions, and by the easiness of the Cure we supposed that the humor was not fastened within the substance of the nerve, but only gathered toge∣ther in the Brain about the original of those Nerves.

For the Cure of this Disease, The matter fastened upon the Nerves, or cleaving thereto, and ma∣keth the obstruction or adstriction, is to be evacuated; which cannot be done, except first the whol body be clensed, as Galen saith 4. meth. The Eye is not to be cured before the whol Head, nor the Head before the whol Body.

And that Remedies may be set down in a convenient Method, we will first set down a Course of Diet, which must be attenuating and moderately drying.

And first, The Air must incline to hot and dry, and a thick, cold, cloudy, and moist Air, must be altogether avoided. Let him cat meats of good and laudable Juyce, avoiding them which beget gross Juyce, as Pork, and all Swines flesh, Geese, Fish, Pulse, Cheese, and the like; as those which are windy, and fill the head, as Milk-meats, and hot Spices, viz. Pepper and Ginger, &c. Let his Bread be made with Fennel Water, or with the Seeds thereof; being careful that the Wheat of which it is made, be not mixt with Darnel, which all the Ancients beleeved to be very naught for the Sight: hence in the Comedy, he that derideth another for defect in his sight; I think (saith he) thou hast sed upon Darnel. In the sawce to his Meat, and in his Broths, let him use things extenuating, as Hysop, Fennel, Marjoram, Bettony, Sage, Eye-bright, and especially Nutmeg, which strengtheneth the Brain, and clears the Sight. He must eat Turneps often, which are thought to quicken the Sight: So do Sparrows, Pidgeons, often eaten. Cold Herbs must be forborn, and especially Let∣tice, which hurts the Eyes.

Let him take but a smal quantity of Meat at a time, and let the sick man never fill himself immo∣derately: Let his Supper be less than his Dinner: and to abstain from a Supper twice or thrice in a week is very good. At his Meat, instead of Salt let him use this Pouder following:

Take of common Salt two ounces: Eyebright dried two drams: Nutmeg one dram: Cinna∣mon two scruples: Mix them into a Pouder.

After every Meal, let him take one spoonful of the Pouder following:

Take of Coriander seed prepared half an ounce: Annis seeds, and Fennel seeds, of each two drams: Cinnamon and Nutmeg, of each one dram: Eyebright dried three drams: Sugar of Roses, a double weight to all the rest. Make a Pouder.

Wine in this Disease is not good, because it is too full of vapors, and fills the Head, and is apt to cause defluxions: therefore a Deoction of Sarsaparilla, sweetened with Liquoris, and aromatized with Coriander, will be very profitable. But because the Disease is of a long continuance, and all cannot abstain so long from Wine; if we must permit Wine, let that be chosen that is weakest, and less vaporing; and it would be more beneficial if Eye-bright dried were first steeped therein: and that he may make Eyebright Wine for a long time, in the Vintage let him put Eyebright into a vessel filled with new Wine, and let the Patient use that for his ordinary Drink.

Let his sleep be less and shorter than usual, and let him he upon his back with his face upwards as much as may be: Let him avoid sleeping at noon, because it is very hurtful. Let his Exercise be moderate, and instead of exercise let him use frictions or rubbing of the inferior parts. Let his Belly be alwaies kept loose, and let him avoid disturbance of mind.

The course of Diet being thus ordered, you must begin your Cure from Universal Evacuation And first you must purge with the following Medicine:

Take of clean Senna half an ounce: Fennel seeds one dram: the Leaves of Bettony, Eyebright and Vervain, of each half a handful: Liquoris three drams: Boyl them to three ounces. Dis∣solve in the straining three drams of Diaphaenicon; Syrup of Roses one ounce. Make a Potion and give it in the morning with orderly Government.

After this first Purge, let the Physitian consider seriously with himself, whether he may bleed or not. For it is disallowed in this case by almost all Practitioners, because it is a Chronical Disease of long continuance, coming of a cold distemper and of a flegmy humor. Hence they fear least by blood-letting, the Brain should be made more cold, and so beget more flegm, and least the conjunct cause of the Disease should be more incressated or thickened, and so become more difficult to be dis∣cussed and dissipated. But although their Opinion may take place as to old men, and such as are of a Phlegmatick Constitution, yet it is not to be admitted to them that are yong, or of a hot Constitu∣tion, especially if there be manifest signs that blood doth predominate; for then there is no doubt but seasonable blood-letting may much profit. Nay, where the aforesaid signs of blood do appear, it is profitable in the judgment of Paulus and Aetius after the Vein in the Arm is opened, to open the particular Veins of the Head, and those which are neerest the Eyes, namely, the Frontal and Temple Veins, and those which are in the corners of the Eyes neer the root of the Nose. But you may bet∣ter apply Hors-leeches to the Forehead, as also behind the Ears. Some Practitioners do relate, that some by a wound in the Forehead have been cured of blindness. In which it is most probable that the cause of their blindness was the compression of the optick Nerves by the Veins and Arteries adjoy∣ning, and swelling with too much blood, which the Wounds aforesaid emptied forth. Whence Spi∣gelius (as Plempius reports in his Book of the Eyes) was wont in Gutta serena with good success to open the middle Vein in the Forehead, and let it bleed while it stop of it self.

But if the suppression of the terms went before this Disease, you must draw blood from the lower veins, or apply Leeches to the Hemorrhoids: if the Patient had formerly a flux thereof, which then is stopped, or if he have a very hot Liver, or be of a melancholly temper.

Afterwards the whole body is to be more exactly purged by this following Apozeme.

Take of Fennel Roots, and Sarsaparilla, and Flower-de-luce-roots, and Elicampane roots, of each one ounce: the Leaves of Bettony, Marjoram, Balm, Eyebright, Fennel, Vervain and Celendine the great, of each one handful: Liquoris sliced, and Raisons of the Sun stoned, of each one ounce: Annis-seed, and Fennel-seed of each three drams: clensed Senna two ounces: Gum∣my Turbith and Agerick newly made into Troches, of each two drams: Ginger and Cloves of each one scruple: flowers of Stoechas, Rosemary, and Lavender, of each one small handful: Boyl them in five quarters; that is a pint and a quarter of water; dissolve in the straigning four ounces of white sugar: make an Apozeme, clarifie it and perfume it with two drams of the best cinnamon, for four mornings draughts: After the Apozeme is done, let him take these Pills.

Take of the mass of Pill, Lucis major, and Cochia the less, of each half a dram: malax them with Bettony water, make six guilded Pills thereof, which let him take early in the mor∣ning.

After this general Evacuation the antecedent Cause is to be revelled; and the conjunct Cause is to be derived and discussed. For this Frictions of the extream parts, especially beneath, are to be used every morning.

Cupping-Glasses must be applied to the shoulders and back without sacrification; especially to

the hinder part of the Head with scarification; for they do so powerfully draw the humors from the fore-parts and the principle of the Nerves, that some presently after the application thereof have re∣covered their sight: At the same time apply a Vesicatory to the hinder part of the neck, and let the Blysters that are raised be kept long open, with Beet or Colewort Leaves often applied.

When the Vesicatory is dried up, apply a Caustick to the hinder part of the head or neck between the second or third Vertebra; or (as it is now most usual) apply two Causticks to the Neck behind upon the fourth and fifth Vertebra; so that the back bone may lie untouched between them, and both may be Cured with one Playster.

Instead of Cauteries a Seton applied to the same part is most efficacious; but the tenderness of our Country men hath almost abolished the use thereof.

If the aforesaid Cauteries avail not, you may lay a potential Cautery to the Coronal Suture, which sometimes hath done the work when other Remedies have failed.

When these things are doing, presently after universal Evacuation by seege, you must order a sweating Diet of the Decoction of Guajacum Sassaphras, and the Roots of Sarsa, according to the method prescribed by us in the Cure of the Cold distemper of the Brain. Observing this; That to∣wards the end of the Sudorifick Decoction, you and those things which peculiarly respect the Eyes; as Vervain, Fennel, Eyebright, and Celondine the greater.

And for the better drying of the Brain; let the Bags prescribed in the Chapter above mentioned be applied to the Temples if you fear not an inflamation.

Also after the Sudorifick Diet it is very convenient to use Sulpherous and Bituminous Baths and washings of the head; because they are very proper for the correcting of a Cold and Moist Distem∣per, for the consuming of Flegm, and strengthening the brain.

Besides the universal Evacuation of the body and Head, particular may be ordered; as Medicines that cause spitting; called Apophlegmatisin; by which the Rhewm is brought out of the Brain by the Pallate; which may be made either in the ••orm of a Gargarism or Masticatory; according to the forms prescribed in the Cure of the cold distemper of the brain.

Errhins and Sternutatories or Neesings are condemned by almost al Practitioners in this Disease; because they draw humors to the eyes: but yet if some of the milder and gentler sort be used (after an exact purging of the whose body and head) for some few dayes they may be profitable in regard they may by degrees draw forth and derive the humor which causeth the Disease, and is fastned in the Optick Nerves; nor can they fetch any thing from the profound part of the brain to the fore-parts: Otherwise in every derivation which is an evacuation by the part affected, or that which is neer unto it; we should alwayes fear lest there should be an attraction to the part affected, which is easily hindered by universal Evacuations which ought to precede; and those Errhins may be made of the juyce of Beets and Marjoram with white Wine in which Manna hath been dissolved.

But a stronger and yet safe Errhine may be made of the powder of Tobacco corrected with Cepha∣licks, and Oxydorcicks; or Medicines that help the sight; for by that the Rhewm is drawn forth ra∣ther by the Palate than the Nostrils; and the brain is so fortified, that it wil not so easily receive the defluxion of humors from other parts. The Composition whereof is as followeth.

Take of dryed Tobacco one ounce: the leaves of Sage, Marjoram, Bettony, Eyebright, the Flowers of Clove-gilli-flowers, and Red Roses, of each one dram: make a pouder to be snufft into the Nostrils for some few dayes.

Neither is it sufficient once to clense the Body of Excrementitious Humors with universal Purg∣ing; but you must keep it in that condition all the time of the Cure; therefore with Purges inter∣mixed, the Excrements which daily encrease must be brought forth; which may be done with usual Pills made after this manner;

Take of the best Aloes half an ounce: clean Senna, Turbith, Hermodacts, and Agarick new∣ly trochiscated, of each two drams: Diagridium, one dram: Mace, Cloves, and Eastern-Saffron, of each seven grains: sprinkle them with the juyces of Marjoram and the greater Celon∣dine: then dry them again in the shade. And with the Oxymel of Squills make a mass of Pills of which let him take half a dram or two scruples twice or thrice in a month.

While these things are used, you must continually labor to strengthen the brain and the eyes: and the Patient must take diversity of Medicines, lest by taking the same a long time, it prove Nauseous unto him; and lest Nature be too much enured to a Medicine, and so it loose its Operation. Old Physitians say, Treacle is reputed to be of excellent vertue to this purpose, which may be taken by a dram every night with Fennel, Eyebright, or Celondine water twice or thrice in a week. Nut∣meg eaten every morning fasting, is much commended if it be long chewed that the vapor may be car∣ried to the Eyes; if you fear that the swallowing down thereof should offend by reason of the heat: it may be spit forth after it is chewed. Candid Myrabolans taken in the morning are thought to clear the sight exceedingly.

The usual Opiate is thus made:

Take of Conserve of Bettony, and Rosemary flowers, of each two ounces: Candied Myrobalans two: old Treacle two drams: the Leaves of Eyebright poudered, three drams: Fennelseed two drams: Nutmeg, Cinnamon, and Cloves, of each one scruple: With the Syrup of the Juyce of Fennel, Rue, and Celondine made up with Honey, make an Opiate.

Let him take thereof the bigness of a Chesnut, drinking after it a little Wine mixed with Fennel Water.

Nor must you omit external Medicines which strengthen, warm, and dry the Head; of which sort is the Cephalick Pouder for the Hair, a Cap and Fumigation, mentioned by us in the Cure of the cold distemper of the Brain.

Finally, You may apply Topical Medicines to the Eyes to strengthen them: these are usual in Authors; but they are of little force which cannot reach to the optick Nerves; but if any desire to try some of them, they may find enough of them in my Treatise of the Cure of a Suffusion.

In a desperate case when all other Medicines have been used in vain, a Vesicatory applied over the whol Head (being shaven) in form of a Cap, hath many times been very successful: if it be twice or thrice used after the drying up of the former Blisters, it is more advantagious.