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 ...

THE SECOND BOOK OF THE PRACTICE OF PHYSICK. Of the Diseases of the Eyes. (Book 2)

The PREFACE.

THE Diseases of the Eyes are so divers, that it is very hard to lay them down cleerly and plainly, and to distinguish one from the other: which that we may endeavor as much as may be, and cleer up our Treatise for Practice, we will so divide them, the Diseases by which the sight is immediately hurt, may first be expounded, and after∣wards the rest which happen to the Parts of which the Eyes are Compounded, or which are neer unto them, without any, or very little hurt to the sight. The sight is hurt when it is diminished, abolished, or depraved. Sight abolished is called 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉 in Greek: in Latine Caecitas. But sight dimished hath divers Names according to the degree and manner of the diminution: of which the chief are Amblyopia, Myopia, Nyctalopia, and Acies Vespertina.

Caecitas blindness, comes either from an absotute Obstruction of the Optick Nerves (and then it is called Amaurosis) or from a total Suffusion, or from some great fault in the Tunicles and Hu∣mors.

Amblyopia, in Latin Obscuritas, Hebetudo, or Caligo, dark or dim sight, when the Object is not cleerly seen at what distance soever placed; comes from the same Causes, but more light and im∣perfect, as an imperfect Obstruction of the Optick Nerves, a light suffusion, want of spirits or gross∣ness of the same, and the like.

Myopia, in Latin Lusciositas, or Pur-blindness in which the Objects are not perceived, except they be very nigh, and close to the Eyes, but not at all a far off, or very little; and imperfectly: so that they perceive not their known Friends passing by: And according to the Opinion of Galen, and all Modern Physitians, from the thinness and smalness of the visour spirits which stand not in need of a medium, much enlightned to make a perfect sight, but is thereby dissipated. On the con∣trary, they which have gross and thick spirits, see things best at a distance, because that gross spi∣rits needs more enlightning which is brought by the larger illumination of the medium: But this Doctrine is demonstrated to be false, and to spring from ignorance in Opticks whose Principles de∣clare, that these diversities of sight proceed from the diversity of the scituation of the Crystalline hu∣mor. For when the species of the Objects are received into the Crystalline humor by a Pyramis or sharp Point thereof called Conus; if the Crystalline humor be too much inward towards the pupil

of the Eye, the remote Objects are better seen, because it is necessary that the Objects should be at a farther distance, that the Conus, or point of the Pyramis may come to the Crystalline bumor, and there be terminated: But if the Objects come neerer the Eye, the Conus goeth by the Crystalline, and they are seen more obscurely: Again, If the Crystalline lie too low and too far from the Tunicle called Uuea, the Objects must be neerer to the Eyes, that the Conus or point of the Pyramid may come to it: whence it appears that Myopia comes no other wayes then from the Crystall me lying too low; and so this Disease becometh connatural, and not to be cured. But the affect of Myopia is contrary in which the Object is better seen at a distance; and this happens for the most part in Old Men, in whom some of the portion of the watery Hamor is spent, so that the Crystalline goes to the Pupil of the Eye: Farther, By long holding down of the Head either with Reading, Wri∣ting, or otherwise, the Crystalline Humor comes by degrees forward: This is demonstrated by the use of Spectacles; because that they who have Myopia, or are Pur-blind, see best with hollow or concave spectacles, by which the rayes or beams of the visible species are dispersed, whereby it comes to pass, that the Conus of the Pyramis is more long, and so that thing which by reason of the great distance could not be seen, is now plainly perceived; because the Conus of the Pyramis is extended as far as the Crystalline, which before ended in the Pupilla, or in the watery Humor, or in the white Humor: On the contrary, Old Men are helped with Convex Spectacles, by which the beams are united, and the Conus of the Pyramis is made shorter, and so things are better perceived whose Conus before passed by the Crystalline, which was too neer to the Pupilla.

Nyctalopia, or Nocturna Caecitas, is when men see well enough at day time; at Sun-set worse; and at Night not at all: and it comes from the over thickness of the spirits, or Humors, or Tunicles; or the straightness of the Pupilla. For in these Cases a greater light is necessary for true sight, which being wanting, at Sun-setting, or at Night by a Candle, they see little, or not at all.

Vespertina Acies, is when men see worse by day, and better by night; and this somtimes is called Nyctalopia, as we see in Hippocrates, 2. Prorrhet. but the Modern Greeks have from long Custom used the word Nyctalopia only for Night blindness: it comes from the thinness of the spirits which are spread abroad by too much light: or from the enlarging of the Pupilla, by which too much light goes into the Eye, and hurts the sight, for a little light at night doth more illustrate and shine to them, than to those who have the Pupilla enlarged.

After what manner the sight is hurt by diminishing, abolishing, and depraving, we shall lay down more plain when we explain the Diseases of all parts of the Eyes by themselves. For when all the parts of the Eye do conduce to the action of it, namely Sight, when any part is distempered, the sight must also suffer.

The Eye is compounded of Tunicles, Humors, and the Optick Nerve, for the action of which parts, the Animal Spirit doth concur as a principal and universal Agent.

And therefore that we may run through the Diseases of those parts, we will begin from the di∣stemper of the constitution of the optick Nerve; next we will proceed to the Disease of the Humors and Tunicles. But the faults of the Spirits either depend upon the distemper of the Brain, and then other Sences are also hurt; or from the distemper of the Eye it self, which being cured the spi∣rits receive their ancient and due constitution, so that we need not make a particular tractate of them. But in curing Diseases of the Eyes, when sight is hurt, we must alwaies mingle those things which comfort the visive spirits with other Medicines.

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.

CHAP. II. Of the Disease of the Vitrous, or Glassy Humor.

THe Vitrous Humor is next under the Crystalline, and therefore it is made by Nature trans∣parent, that the Species carried to the optick Nerve may be pure and clean. If therefore the cleerness of that humor be hindered by the mixture of another, and so made dusky: according to the degree of that duskiness or foulness, the sight is either diminished or abolished.

Moreover, This humor may be out of order in respect of its scituation; namely, when any part of it by a blow or contusion shall be brought before the Crystalline; for then the sight will be dar∣kened, in regard the vitrous Humor is more thick than the watery, and therefore the species of the objects cannot be carried pure and cleer unto the Crystalline.

The first affect, namely the Mixion of a Humor with it, cannot be perceived by any signs, but only it is judged probable by reason, for the vitrous Humor cannot be seen, or its condition known; and therefore Practitioners are constrained to confound it, and to make it one with Gutta serena, because no fault appears in the Eye, and this they do without offence to the Patient, in regard any humors that are mixed with the vitrous, are to be discussed with the same Remedies that a Gutta serena is cured.

But you may know that this vitrous humor is disordered in respect of its Scituation, when it ap∣peareth white under the Pupilla, yet it is not easily distinguished from Suffusion, except the ante∣cedent and first cause be diligently observed. For a Suffusion is caused by a simple defluxion of an humor; but this transposition or displacing of the vitrous humor useth to come of a Wound or Con∣tusion.

This last Disease is incurable, for the vitrous humor being displaced can by no art be reduced to its former condition. But this by Nature hath sometimes been done, and therefore the whol business is to be committed unto her.

CHAP. III. Of the Diseases in the Crystalline Humor.

THe Crystalline Humor is the chief instrument of Sight, and therefore ought to be kept more pure and perspicuous than the rest, that that Sence may more freely be exercised. And if it be soiled in the least measure, the sence of Seeing is much hindered.

The chief Disease whereby the purity thereof is infected, is called Glaucoma (or the changing of the Crystalline Humor into a fiery redness) and this happens when the Crystalline Humor is made thick by dryness, as in old people, from some drying and condensing cause it is often seen.

This Disease is known, by a plain appearance of a thick white about the Pupilla, and when all objects are apprehended by the Patient as through a cloud or smoak. But it is hard to distinguish this Disease from a Suffusion which representeth such a whiteness about the Pupilla: hence it▪ is that many Authors do not distinguish between a Glaucoma and a Suffusion. But they which dili∣gently observe may distinguish them thus: In a Suffusion there is a white in the very Pupilla, and very neer the Membrane called Cornea; but in a Glaucoma it lieth deeper.

This Disease is incurable; especially in old folk in whom the driness of the part cannot be amen∣ded; but if it be not manifest that the fault is in the Crystalline, and there is a suspition of a su••••u∣sion; you may use the remedies prescribed for it.

Moreover, the Crystalline may be out of place, namely when the broader part of it which is flat like a Fetch or Lentil is not directly against the hole of the Pupilla, but either is too high or too low, and then objects appear double when one Eye only suffereth; because the p••…••… 〈◊〉〈◊〉 ••••eight line is lost which ought to be one and the same in both Eyes, that whatsoever 〈◊〉〈◊〉 is 〈◊〉〈◊〉 both Eyes may appear but one and the same. And if they be not in that order, things 〈…〉〈…〉; which you may prove by depressing or lifting up one of your Eyes with your ••••••nger: for then the paralel is lost, and things appear double: But this Depravation of sight by whi••h objects appear double, comes not only of the Cause now mentioned, but also from vapors, or water which hurt the Cry∣stalline; by which the visive Spirits are divided, whence it comes to pass that the species of the same thing is received into two places, which Drunkards usually per••••ive when they see double.

Secondly, The scituation of the Crystalline is altered, when it declineth backward or cometh forward, if it comes forward to the Pupilla, then things neer at hand are not so rightly perceived as those which are more remote, as in old men often. But if it decline backward towards the Optick Nerve, things neer are truly seen, but not afar off, and then is the Disease called 〈…〉〈…〉 which was mentioned in the Preface; where we shewed, That these Diseases are only Cured by Spe∣ctacles.

Thirdly, The Crystalline is out of its place when it tendeth either to the right or left side, which is called Strabismus, or Squinting; when the Pupilla is not directly but oblique upon the Object, and appeareth not in the middle of the Eye, but in one side: so that there appeareth more white in one part of the Eye, than in the other.

This Disease comes not only from the displacing of the Crystalline, but also from the Evil Dis∣position of the Muscles which move the Eyes: which is either natural, or else proceeds from a Pal∣sey or Convulsion of the said Muscles.

Of what Cause soever it c••meth, if it be connatural, it is incurable: but, if it come from Pal∣sey or Convulsion of the aforesaid Muscles, you may find out a way of Cure, in my Treatise of head Diseases.

Finally, Other Depravations of sight may come from the inversion of the Crystalline be it grea∣ter or less; as when streight things appear crooked, or when the Objects seem to be ••oulded: which happened to a certain Physitian (as Sennertus reports) who going up a Ladder to take a Book from a shelf, and turning his Eyes violently upwards, saw al things afterwards turned upwards as though men walked upon their Heads, which ca••e by the attraction and displacing of the Crystalline. For a quarter of a yeer after when again he turned up his Eyes violently, his natural sight returned, and al things appeared in right order.

Hence it appears that by a violent motion of the Eye that the Crystalline may be displaced, and again by the same motion be set right. I suppose that the displacing of the Crystalline was thus, It was so inverted that the fore-part of it (which is more depressed than the other) was not right against the Pupilla; but rather its side which being more round and convex might represent the species of the Objects inverted, as we may observe in round Glasses, which discover the Object inverted; and this is true from the principles of the Optick art: for in a Medium that is Convex and thick, the spe∣cies are so broken, and as it were cross-cut, That they which come from the upper part of the Ob∣ject, do represent the lower part; and so contrarily, but if the inversion of the Crystalline be less, so as both the depressed part of the Crystalline and also the Convex part thereof, be right again••▪ the Pupilla, the Objects may seem crooked. Although that Depravation of sight whereby Objects seem crooked, may come by other means: namely when any part of the Crystalline is mixed with the watery humor then by reason of inequality of the Crystalline in regard of thickness, the refractions are divers, which are the Cause of Depravation of sight whereby things appear crooked. This may be demonstrated by a clear Example: A staffe put half into the water, appears crooked for this Cause, namely, The species of that part in the water, when it is carried out of the water into the air, from a thicker to a thinner Medium, is broken by the perpendicular; but that part which is in the air is not broken, because it doth not pass through divers Mediums as that which is in the water: Hence it comes that the stick seems crooked. After the same manner the species of the object which is car∣ried into the thicker part of the Crystalline is more broken, than that which is carried to the thin∣ner, which is in its natural state, and not mixed underneath with the watery humor; and so by rea∣son of the divers refractions the objects appear crooked.

But since Medicines are to no purpose, we shal prescribe none for these Diseases.

CHAP. IV. Of the Diseases of the Watery Humor, and especially of a Suffusion.

THe Watery Humor is out of its Natural Condition, when it is distempered in quantity or quality. When the Distemper is in quantity; it is enlarged or diminished, and makes the Pupilla be dilated or contracted, which Diseases shall be mentioned in their places. When the distemper is in quality, it becomes thicker, and that comes from another Humor mixed with it, and that is called Suffusion, which we here speak of. For although Galen 1. de Symp. caus. cap. 2. sheweth that a Suffusion may come from the condensation of the watery humor without the access of an excrementitious Humor: yet because it happens seldom, and is known rather by imagination than art, and is altogether incurable: omitting that, we shall speak of that Suffusion only which cometh from the afflux of another excrement or humor. This is called in Greek 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, in Latin Suffusio, by the Arabians, Water, vulgarly a Cataract. Some Authors would distinguish these names, and make them signifie divers sorts of this Disease: They call it in the beginning (when the sight is only a little darkened) a Suffusion; but when it is grown older, and somthing gathered into the Pupil appears like water, then they call it only Aqua, Water: but when the matter is grown thick in the Pupilla, and the sight almost gone, then they call it a Cataract. A Suffusion comes from a serous Watery Humor spread in the space between the Cornea and the Crystalline: and since a Watery Humor is contained in that space, it may well be reckoned among the Diseases of the Watery Humor.

This is the Cause of a true Suffusion: There is another Bastard Suffusion which comes from va∣pors sent from the Stomach and other parts into the Eyes. Galen 4. de loc. aff. cap. 2. taught that vapors may be sent from the Head to the Eyes, and make a bastard Suffusion; but although Au∣thors speak of two sorts of Suffusions, yet they are for the most part united, and a spurious or false pleuresie is complicated or joyned with a true one; because vapors sent from the lower parts to the Brain, are easily carried to those parts of the Head which are weakened with any Disease, and this appears in that all troubled with Suffusions are less troubled, and see better in the morning than at noon or night, because after dinner or supper many vapors are sent up from the Stomach to the Eyes which disturb the sight. And Experience teacheth, That men so diseased have their sight more dull and dark presently after meat, than a few hours after. Moreover, all that have a Suffusion relate that they see in the Air little bodies, as Gnats, Flyes, Hairs, Cobwebs, and the like; which could not be but by the gross vapors which are sent to the Eye, and there move: for although Authors suppose that these representations depend upon some thick Humors contained in the Eye, which make a Suf∣fusion: yet this is not credible, Because then it should alwaies move in the Eye, to represent those little Bodies which fly in the ayr, which is contrary to reason. But rather without question, the vapors are in perpetual motion, and so can represent those flying fancies.

A Watery Humor is the chief and most ordinary cause of a Suffusion, yet other Humors at least in a smal quantity may be mixed therewith: and if Choller be mixed, then it is citrine or yellowish; if Melancholly, then it is a black Suffusion.

And those Humors use to slow to the Eyes when they are weak, either Naturally, or by Acci∣dent.

From a Natural debility comes a thrusting forth of the Eyes, for they who have such Eyes, are very subject to a Suffusion; for such Eyes use to be great, and therefore the vertue spread abroad is less in them: as also by reason of their largeness they do more easily receive humors and vapors. External causes make an accidental or adventitious debility, as a stroak, contusion, baths, a Southern and rainy habitation or season, heat of the Sun, smoak, continual reading, especially by candle light, and the like: All which may also cause a flux of humors to the Eyes.

Now the Humors flow from the Brain to the Eyes by the Veins, by the Tunicle called Ʋvea, and by the Optick Nerve. The Veins by which they flow are divers: either those which come from the Pericranium to the Conjunctiva, thence to the Cornea and Ʋvea: or those which come from the Men••nges, from which some branches come to the Membranes of the Eye, from which Membranes, especially from the Ʋvea, the excrementitious humors may easily fall into the watery humor being so neer.

Finally, Humors may easily be carried by the Optick from the Brain; by the Tunica Retifor∣mis and Aranea, to the Crystalline; and then the matter of the Suffusion sticks upon the superfi∣cies of the Crystalline. Although a Suffusion for the most part comes by a defluxion, yet somtimes

it may come by congestion or gathering, when that nourishment of the Eye is not well changed, and the expulsive Faculty is so weak that it cannot expel sufficiently the remaining excrements, so that they are by degrees gathered together about the Pupilla, and so make a Suffusion, in which case o∣ther humors are ordinarily disturbed, and difficult diseases are produced.

The Differences of a Suffusion are taken from the thickness and quantity of the humor causing it, and from the place in which the humor resideth.

In regard of thickness more or less, the sight is more or less offended, for if the humor be thin and serous, of which the Suffusion is made, which is cured by pricking, as Galen taught 14. Meth. cap. ult. The sight is little worse, and it is called a Suffusion only begun, if it be somwhat thic∣ker the sight is darker; if very thick blindness followeth.

In respect of the quantity and the place, Either the humor possesseth the whol Eye, and the sight is equally hindered which way soever it be directed; or it possesseth one part of the Pupil more than another, and so the objects are not seen wholly at one direct view, nor can many objects be seen at one time: but if the humor be very little, and possess the middle of the Pupilla, the objects appear with holes through them. But if the matter be divided into divers parts, possessing divers parts of the Pupilla, the forms of Gnats shall seem to be before the eyes: All these differences are exactly di∣stinguished by Galen, 1. de symp. causis, c. 2.

Moreover, In respect of the place or Scituation of the matter, other differences may be made, as somtimes the matter is in the very hole or cavity of the Ʋvea about the Cornea; somtimes about the Ʋvea, and between that and the watery humor; sometimes it is mixed with the Watery Humor; and finally, somtimes it is between the Crystalline and Watery Humor.▪

Some Differences may be taken from the figure or shape of the matter, which Galen relates 1. de sympt. causis cap. 2. and 4. de loc. affect. cap. 2. for as the figure of the humor adjacent to the Pupil∣la is various, so divers objects are present thereunto, as Gnats, Hairs, Cobwebs, Circles about Can∣dles, and other things.

The knowledg of this Disease, is first in distinguishing a true from a bastard Suffusion, and then in the discovery of the differences of true and right Suffusions.

A true Suffusion doth for the most part affect only one Eye; but if both be affected, they are not at one time, or alike affected, as in a spurious Suffusion.

Secondly, In a true Suffusion, some dark matter appeareth in the Pupilla, which doth not in a Spurious or Bastard Suffusion. But this is not alwaies a true sign; for if the Suffusion cometh of a thin and serous humor, because it is no thicker than the Watery humor, there appeareth no change in the Eye, by which Physitians are somtimes deceived, not knowing that kind of Suffusion, take it▪ for Gutta serena, perceiving no change in the Pupilla: but this kind is easily distinguished from Gutta serena. First, in Gutta serena the sight is quite gone, or much diminished, no hurt appea∣ring in the Eye: On the contrary, In a Suffusion which we cannot see, there is only a smal decay of sight, because the serous humor from whence it proceeds, is thin, and transparent, so that it may be pierced by the species of objects like Glass. Secondly, They differ in this, For the most part in a Suffusion, the Sight is not equally hindered in all parts of the Pupilla; but the objects somtimes are seen better when they are direct before the Eye, somtimes when they are opposite to the corner of the Eye, because the humor is thicker or thinner in one part of the Pupilla than the other.

Thirdly, In a true Suffusion the Symptomes are continual, and have no intermission: in a bastard Suffusion, they are somtimes encreased and remitted, as the vapors are more or less which are sent un∣to the Brain. So they are fewer when the Stomach is empty, than when it is full, especially present∣ly after meat, for then a greater company of vapors do ascend, which sent to the Eyes, represent to the sight, Flies, Gnats, Cobwebs, and such like smal bodies, not alwaies, but at some times only. Which little bodies represented in the Air, depend upon the Vapors as aforesaid: but in regard the Eyes are weakned by a true Suffusion there is almost a continual sending up of vapors unto them, and therfore there is a continual appearance of these little bodies flying in the Air. Moreover, there is a constant darkness of sight in a true Suffusion, being alwaies after the same manner, as if all the objects were seen through a cloud or thick glass, which is the proper sign of this Disease: but in a bastard Suffu∣sion, there is somtimes a greater, somtimes a less, and somtimes almost no dimness at al of the Sight, even as the vapors are many, or few, or none that are sent to the Eyes.

Lastly, A true Suffusion grows in a short time, and is confirmed for the most part in six Months, and somtimes it encreaseth in a few daies: and Fernelius saith, 5. Pathol. cap. 5. that a Suffusion was perfect in one day, which we also have often seen: but a bastard Suffusion continueth many yeers without encrease.

The Differences among true Suffusions are these:

In a Suffusion beginning certain smal Bodies, as Hairs, Gnats, Flyes, pieces of Wool and Cob∣webs, fly before the Eyes.

But when it is far gone, the Air appears cloudy, and the objects are seen thicker, as through a

glass; the colour of the Pupilla is changed, and it appears either troubled or cloudy, or like filthy Glass, or of a sky colour when a suffusion is perfect, the sight totally perisheth: the Pupilla is ei∣ther white, or of some other colour is mixed with white.

Some signes are taken from the Colour: for when it is like a Pearl in colour, it signifies that the flegm is still fluid and transparent: when it is white as Chalk, then it signifies a thick and compacted matter: when yellow, then flegm and choller are mixed: when black, it shews Melan∣cholly.

The Place in which the Suffusion grows, is thus known; For if the matter be placed between the Uuea and Cornea, the Pupil appeareth more dark, because the matter is neerer to the beholder▪ Moreover the Pupilla is dilated by the Humor contained therein; and when the Disease is confir∣med, white or red veins, or swellings are perceived to be about the Iris, or circle of the Eye; or cer∣tain white spots appear about the Pupilla.

If the Matter be contained between the Crystalline and the Uuea, contrary symptoms wil appear▪ as also the Pupilla wil be contracted if the matter lie deep, and enlarged if the matter lie higher.

The Prognostick of this Disease, is to be diversly made, according to divers seasons: For when a Suffusion is only begun, when the Patient can perceive an object as through a cloud, it is curable as Galen saith, 14. Meth. Cap. ult. and Celsus lib. 6. cap. 6. which Opinion wants a restriction: Namely, if the Patient be yong, but in old it is incurable: and if the eyes be not naturally of a weak constitution. We also have seen some that have been cured in fifteen dayes space, of a Suffusion new∣ly began; who have been above fifty years of age, only by universal Purging, sweating Diet, and a Vesicatory, without any other application of Topicks.

This Cure is better wrought in a warm air and in summer time, because the Pores are then open, the matter of the Di••ea••e •••• more moveable and obedient; so that oftentimes it dischargeth it self by seege; which, is very much to the Cure of this Disease: as Hippocrates sheweth, Aph. 16. Sect. 6. in these words, It is a good sign, when men with sore Eyes, have a loose 〈◊〉〈◊〉

If a Suffusion come from an acute Feaver, a Peripneumonia, a Phrenzy, or from a violent pain of the Head, it is hard to be Cured.

A Cataract or Suffusion confirmed when the matter is grown thick, cannot be discussed with Me∣dicines, but must be couched with a Needle.

This Operation is not safe; and often hath ill success: For either the Tunicle Uuea is torn, or by the pain and inflamation, a new flux of Humors is brought to the Eye, which hath been long before weak: and many other inconveniences by which the sight is for ever lost. But since this Operation hath been sometime succesful, it may be tryed by those who have no other hopes of Cure; For it is better, as Celsus saith, to try a Doubtful Medicine, or Remedy, than None at all.

In a confirmed Cataract, if when the other Eye is shut the Pupilla appeareth larger in the Eye affected, there is hope of Cure by Couching; but if it be no larger, it is uncurable; as Galen tea∣cheth, 1. desymp. caus. cap. 2. because the optick Nerve is obstructed, and the spirits cannot come to the Pupilla, though it be open.

But if the Patient perceive no light when the Pupilla is enlarged by the shutting of the other Eye, he cannot be recovered by the Needle, because the visive spirit is troubled and obscure, and therefore unfit for sight.

A black Cataract, free from al brightness, can neither be Cured by Physick, nor Chirurgery; because the Visive Spirits are destroyed; but a cleer Cataract that hath some splendor, is Cure∣able.

These also are uncurable for the most part, a green, dark, very yellow, and hard Cataract; and that which moveth and is colored like quicksilver.

A Cataract which representeth objects ful of holes, is not to be tampered with: For since the matter is in the Center of the Pupilla, it is to be feared, lest when the Needle is thrust in, the whol Pupilla be filled with the matter, and so the fight be utterly lost.

The Operation of the Needle, is more succesful, in a ful Eye; and that which keeps its natural greatness: But if the Eye be smal and decayed, it is less succesful.

In Old men, this Operation is not to be tryed; nor in Children, in them the Disease is incurable; in these the Humor is too soft being not ripe; there is most hope of success in yong persons.

If this Operation be, when some part of the Suffusion floweth down (if the eye be compressed) and appeareth more large, and after returneth to its former station and figure, it is not succesful; be∣cause the Cataract is not yet ripe, but thin and crude: But if by a compressing with the finger there is no change of the shape and figure of it; it is then ripe, and may be couched with a Needle. But we must take notice, That the ripeness or thickness of the Cataract ought to be moderate and not too much compacted, that it may be easily couched: for it ought to be like a thin skin which may be row∣led about the Needle and so couched down; for if it be too thick and solid, it cannot be couched,

which you may perceive when it is like Chalk or Hail. Contrarily that which is fit for couching u∣seth to be Sky-colored, and Sea-green, of the color of Iron or Lead not black.

The Cure of a Cataract must be directed not only to the Conjunct, but to the Antecedent cause. And therefore you must purge the whol Body, and especially the Brain very exactly. After you must discuss that humor which obstructeth the Pupilla, and some way soften it.

Which intentions, when they are almost the same which were propounded in the Cure of Gutta serena, we may use the same Remedies for Diet, evacuation or purging of the whol Body, for revul∣sion of the humor offending, and for the strengthening of the Head and the Eyes, so we shall not in vain repeat them.

Having therefore first used all that Method which was laid down for the Cure of Gutta serena, we will declare unto you those Medicines, which belong properly to the taking away of the matter about the Pupilla. And though Topical Medicines are counted little worth according to Galens Opinion, 2. 〈 in non-Latin alphabet 〉〈 in non-Latin alphabet 〉, who saith that they promise more than they can perform: yet their Lawful use is not to be rejected: and Experience hath taught, by very good Authors confirmed, that Cataracts in their beginning, after universal Medicines used, have been cured with Topicks, that is, Medicines applied to the Eye.

First therefore begin with mild dissolvers, and such as dry not overmuch lest the matter grow hard, and be made unfit to be dissolved: then use mollifiers with your dissolvers, that induration may be hin∣dered, and it may more easily be dissolved. For this purpose the following Fornentation may be first used.

Take of the Leaves of Rue, Fennel, Eyebright, the greater Celondine▪ of each one handful: Foenugreek seeds one ounce: Chamomel and Melilot flowers, of each one pugil: Boyl them in three parts of spring Water, and one part of white Wine added towards the end of the Decoction. Foment the Eyes with a soft spunge dipt in the strained Liquor, morning and evening.

Of the same Decoction you may make a Fumigation, covering the head that it may be received in∣to the Eyes.

In the beginning of the Disease, while the defluxion is new, and that revelling Medicines are used, it is good to wash the Eyes with only red Wine, which by its astriction hinders the defluxion, and by its spirits discusseth and dissolveth it.

In the progress of the Disease, a Fomentation of white Wine, in which Crocus Metallorum hath been infused, is most profitable.

It is no less profitable to let a child eat sweet Fennel Seeds in a morning, and afterwards breath in∣to the Eyes.

As also to let him lick them, or to let a Dog lick them.

Also Bread hot from the Oven, in which is sweet Fennel seed cut in the middle, may be so placed to the Eyes that they may behold it when they are wet with the vapor.

These Medicines are to be used in the morning.

At night you may apply this Cataplasm:

Take of Fenugreek seed beaten one ounce: Aloes half an ounce: Saffron one dram: Make them into fine pouder, put it into white Wine wherein Crocus Metallorum hath been infused, and make a Cataplasm to be applied to the Eyes at night.

Many commend Pidgeons blood, put hot into the Eyes, for with the Natural heat of that Creature the part will be much strengthened, and the excrementitious matter dissolved: but because the heat will quickly depart from the blood, it is better to take a yong callow Pidgeon, and slit it in the back, and apply it to the Eye.

With these Medicines you may discuss the matter if it be possible.

Topical Medicines called Collyria, which are dropped into the Eyes, are of little force, and those are they which Galen said did promise more than they perform; for all their vertue is spent in the Cornea; neither can they reach to the internal parts, except they be made very sharp, by which, pain would be caused, and a greater defluxion: hence many that have used them immoderately, have from a light infirmity become stark blind. But because many of those Collyriaes are found in Au∣thors which have good report by them, lest we should seem defective, we will shew some of the choy∣cest, that they who please may try them.

Take of the best Honey two pints: Fennel Roots, and the Roots of long and round Birthwort, of each one pound: the leaves of Rue, Eyebright, Celondine the greater, and the tops of Fennel, of each six handfuls: Centaury the less three handfuls: Roses four pugils: the Ʋrine of a Boy two pints. Mix them all in a glass Vessel and distill them in Balneo Mariae. Drop this Water often into the Eyes.

Or you may make Bread with the Bran in it, with the Pouder of Rue, Celondine, Eyebright, Betto∣ny, and Fennel with a little Honey, which as soon as it is drawn and cut in pieces, must be put between two Pewter or Silver Dishes; from whence will come a Water, which Zechius affirmeth, dropped

into the Eyes, doth wonders. Also this following is highly commended.

Take of white Violet Leaves, one handful: Radish seed, one dram: Amoniacum, half a dram: mix them, and pouder them; then steep them twenty four hours in one pint of Fennel water: then let them boyl a little space: ad to the straining one ounce of the clarified juyce of Fennel: the Bal∣som of Peru, two drams: make a Collyrium: which Zechius saith, Dropt into the Eyes morning and evening, after the Body is sufficiently Purged, doth so clense the Eyes, that it takes away a Cataract wonderfully, without Couching.

Hollerius Describes a Water, that he saith, Cured one that was Nine yeers blind: Which is this.

Take of the juyce of Smallage, Vervain, Germander, Burnet, Avens, Sage, Celondine, Rue, Knot-grass, Chickweed, the pouder of Cloves, of each one ounce: gross Pepper, Nutmeg, Lignum Aloes, of each three drams: steep them all in the Ʋrin of a Boy, and the sixth part of Sack: Let them boyl a little, then strain them, and press them, put it in a Glass close stopt; drop e∣very night some of it into each Eye.

The juyce of Brooklime only, being often dropt into the eyes, hath somtimes Cured a yong Suf∣fusion, when a Cautery also hath been applied to the Coronal Suture.

The Juyce of Celondine and Calcitrap mixed together, are as good.

Quercetan, in his Dispensatory doth much commend▪ Water in which Crocus Metallorum hath been infused, which is thus made.

Take of the Water of the greater Celondine, six ounces: Crocus Metallorum, one dram: in∣fuse them, and drop three or four drops of this Water warmed into the Eyes for three or four times a day for a long continuance.

Fonseca saith, That he knew one Cured by this Water, who was very dim sighted many months: This is the excellency of it, which few other Medicines have; It clenseth very powerfully without a∣ny sharpness.

The same Fonseca sayes the Water following is admirable.

Take many Swallows, beat them with their feathers in a Morter: put to every pound of them four ounces of bread crums: of white wine, four pints: infuse them six dayes, and distil them in Balneo till they are dry: then set that Water in a Glass in the Sun for twenty dayes, and drop it into the eyes morning and evening.

There is a Water made of Rosemary flowers, which discusseth Films in the Eyes after this man∣ner.

Take of Rosemary-flowers as many as are sufficient to fill a Glass which must be well stopt, and set it in the Wall against the South Sun, thence will an Oyl come, which with a feather anoint the Eyes with.

Some Authors commend the Galls of Beasts because they clense and discuss strongly, but they cause pain with their sharpness, and therefore are seldom used.

Forrestus, Obs. 35. Lib. 1••. commends a certain Fish in his Country, out of whose Liver there comes a moisture, by which he saith Cataracts are presently, as by a miracle, Cured. See in the place cited the use of it. William Lozellus saith, That he hath Cured many stark blind, after universal Medicines have been used, with this Water.

Take of the Liver of a sound Goat, two pound: Calamus Aromaticus, and Honey, of each half an ounce: the juyce of Rue, three drams: the Waters of Celondine, Vervain, Fennet, Eye¦bright, of each three ounces: Long Pepper, Nutmeg, and Cloves, of each two drams: Saffron, one scruple: Rosemary-flowers bruised, half an handful: Sarcocol, and Aloes, of each three drams: the Gall of Ravenous Birds, Capons, or Partridges, one ounce: let those that are to be sliced be sliced, and that are to be bruised be bruised; then mixed altogether, with two ounces of white Sugar and six drams of Honey of Roses, cast them into an Alembick of Glass, and distil them in Balneo Mariae with a gentle fire, keep this Water in a Glass close stopt, for precious; which you may drop twice or thrice in a day into the eye affected.

Zacutus Lusitanus commends the Water following, in these words, For an old Disease in the Eyes, called Ophtalmia, or any other which cometh of overmuch moisture, and gross humors and mists; as in thickness, whiteness, the Haw, and Suffusion; this Water is the best in his Experi∣ence; if after sufficient Purging, you drop six drops cold every night three hours after meat into the Eyes, then about two hours after you shall have Water flow out of them in abun∣dance.

Take of Aloes, three drams: Rue, Fennel, and Pettony, of each two handfuls: Vervain and Tormentil, of each one handful: Sarcocol, three drams: the froth of Nitre, two drams and a half: Sugar Candy, three ounces: syrup of Roses, four ounces: the Ʋrin of a yong Boy, half a pint: Lizzards dung, three drams: Horehound, three handfuls: Eyebright, one handful and a half: Ginger, Spicknard, long Pepper, Cloves, and Tutty, of each two drams; Balsom, three

drams: Honey of Roses, two ounces: Verdegreese, one dram: Licium, two scruples▪ Radish leaves, one handful: powder those which are to be powdered, mix them, and infuse them in the best white wine, in a Still, putting to a fourth part of the best Honey, for ten dayes, and stir them daily, then Distill them, and keep the Water.

The same Zacutus commends the Oyntment following, in these words: For the drying up of moisture flowing from the Head into the Eyes, and for Purging them by the Corners very strongly; this Magistral Oyntment is excellent; being applied after universal Evacuations from the Head and the whole Body; let the upper Eye-brows be anointed lightly therewith morning and evening twice in a day three hours after meat: one hour after there will slow plentiful Water from the cor∣ners of the Eye, especially from the great corner.

Take of the Oyl of Roses, three ounces: Rose-water, nine ounces: Camphire, one dram: Tut∣ty, one scruple: Honey, two ounces: the Gall of a Goat, half an ounce: Lupin meal, half a dram: Aloes, Succotrine, one dram: Sugar candy, half a dram: the juyce of Horebound, Fennel, and Rue, of each half an ounce: Mirrh, one scruple: Ammoniacum, half a dram: Sarcocol one dram and a half: Pouder them that may, mix them, and boyl them a little with a gentle fire▪ and the grease of a Goat or Sheep, and a little wax: make an Oyntment according to art.

Finally, when al Medicines fail, when the Disease is almost desperate, it were good to try an ex∣perience with the Oyntment of Quicksilver; which Fonseca saith was his invention, yet seldom used; for in his 19. Consultat. lib. 1. he thus saith: I have thought sometimes that the Ʋnction used for the Cure of the French Pox, hath power to take away Cataracts in their beginning and in∣crease; by the same reason that it takes away the Humors remaining in the Eyes from the French Pox; for by it the Head may be so Purged, that a Cataract may be Cured; and I have determined to make tryal of it. Fonseca had much commended his Judgment if he had seen Skenkius his Obser∣vation, 309. Lib. 1. which is taken out of the 5. Book of Alexander Trajanus Petronus, of the French Pox, Cap. 1. One (saith he) before he had the French Pox was blind of one Eye with a Cataract or thick Suffusion; by the Ʋnction with Quick-silver was freed wonderfully from his Pox and Cataract both at once: Neither is it without reason that Cataracts may be dissolved with that Ʋnction, when we see by Experience that very hard Tumors of thick and gross Flegm are po∣werfully dissolved by the Ʋnction of Quick-silver.

When a Cataract can be dissolved with no other Medicines, the last Remedy is the Chirurgical Operation, which with a Needle put into the Eye, after the matter of the Cataract being thick, and turned to a little skin, thrusteth it to the lower part of the Eye, so that the sight is restored as if a window were opened. This Operation is successful sometimes; but often not: But when the case is so that no hope remains of other wayes, it is better according to the Opinion of Celsus, formerly Commended, to try an uncertain Medicine than none: But it useth not to be tryed by reason of its uncertainty by ordinary Chirurgions; but of Quacksalvers, who go to and fro practising, and there∣fore the time and manner of the Operation is to be left only to them.

But because those things ought not to be hid from a Physitian, you may find them exactly treated on in divers Practical Authors, when the Cataract is Cured.

Whether it be with dissolving Medicines or manual Operation you must use a course of Physick long after, because there is a great fear of a Relapse. For the Eyes having been much weakned by a long Disease, are very ready to receive any Defluxion again from the brain. Therefore you must fol∣low the usual Purging; you must have Issues continually for diversion; and use often strengtheners of the Eyes, such as are prescribed in Gutta serena: to which you may ad a washing of the Eyes, which must be done every day thus:

In the morning first chew sweet Fennel seeds some space of time, then fill the mouth with Wine, and after it is warm in the mouth, wash the Eyes therewith till they begin to smart, which wil cease when you leave washing.

Moreover Spectacles are very good to preserve sight which do make the Objects neither bigger nor less than they naturally are. And it is profitable to refresh the sight with green or sky coloured Spectales.

And Lastly, You must avoid al things which hurt the sight, and use those things which help it, as is declared in the Diet for the Cure of Gutta serena.

CHAP. V. Of the Enlarging, or Dilatation of the Pupilla.

THe Tunicle called Ʋvea, out of Galen, 1. de sympt. caus. cap. 2. is obnoxious to divers dis∣eases, and especially to Ruption, Distortion, Dilatation, and Constriction.

A Ruption may come both of an external Cause, as stroak or contusion; and of an in∣ward, when much humor distendeth and breaketh the Tunicle: But this being incurable concerneth not us.

A Distortion of the Ʋvea cannot be but in the first constitution of it, because it adhaereth to the Cornea. Therefore Galen in the place quoted doth only reckon it among the different symptomes of the Ʋvea: and doth not stand to explain it, because it is of no concernment in the practice of Physick. We therefore omitting the first two differences, wil only insist upon the explaining of the Dilatation, and constriction of the Pupilla.

The Dilatation of the Pupilla, which is a hole in the Uvea Tunicle, by which the Species of Objects pass into the Eye, is called in Greek Mydryasis; this hurts the sight because too much light goeth into the Eye; hence it is that they which have this disease, see better in a darkish place than in a light. Which appears by Natural and ordinary change in the Pupilla in bright and obscure places; for when the Sight is exercised in a cleer light place, the Pupilla is contracted that the light may go less into the Eye, and not hurt it with too much, by dissipating and dispersing the Spirits; and hence it is that they which go out of a very light place into a dark, see almost nothing at their first entry: be∣cause the Pupilla being formerly contracted, doth not in an obscure place receive light enough to make a perfect Sight. After, when they have continued a while in an obscure place, the Pupilla is by de∣grees dilated, to receive more light, for the cleering of Sight, and then those things which at first en∣trance were not seen, are cleerly perceived. On the contrary, they which go out of a dark, into a ve∣ry light place, cannot at first endure the light, and their Eyes are much dazled, because the Pupilla being much dilated before in the dark place for to get light enough into the Eye, when it comes sud∣denly thus enlarged into a great light, too much light gets into the Eye, and so makes it dazle and di∣sturbs the Sight. Whence it appears, that light necessary to sight ought to pass into the Eye in a moderate quantity, and for the receiving thereof, it is necessary that the Pupilla be moderately large.

Now the Preternatural Dilation of the Pupilla is either in the first original, which is not to be tampered with; or comes of Preternatural causes which are internal or external.

The nearest and immediate of the internal causes, is the stretching of the Ʋvea, which comes ei∣ther of driness or repletion.

Driness doth stretch the Ʋvea, and makes the form of the Pupilla larger, as when leather pierced through, when it is dried hath the hole larger: And this dry distemper comes from long watching, Feavers, and other drying causes.

The repletion of the Ʋvea when it distendeth it on every side, makes the Pupilla larger, and this is produced either of vapors, and wind sent into the Eye, or of humors flowing thither, or from the extraordinary encrease of the watery humor of the Eye, or lastly from the swelling of the Tunicle Uvea it self. To these Causes we may ad, the Convulsion of the Uvea, which appeareth chiefly in Epileptical fits; for then all the Nervous and Membranous parts are distended, and so is also the Uvea; and this appears chiefly most manifest in Epileptick Children, in whom the dilation of the Pupilla is so great, that it is over all the Circle called Iris, and therefore the sight is abolished.

The internal Causes are, a stroak, or a fall, or a retention of the Spirits, as in Women in Child∣birth, and Trumpeters. A stroak or fall make a defluxion to the Eyes, hence comes extending of the Pupilla: retention of Spirits makes wind and humors, from whence comes distention.

The knowledg of this Disease is not difficult, because it may be seen with your Eyes, especially if the Physitian knew before it became infirm how large naturally the Pupilla was; as also if there be a hinderance of the sight by reason of the over largeness of it.

Moreover, The natural largeness of the Pupilla is known by this, If when you shut one Eye, the Pupilla of the other is larger, which will not be in a Preternatural dilatation, because then the Uvea cannot be further extended.

Lastly, If this dil••aation of the Pupilla be only in one Eye, it is Preternatural, and signifieth one Eye only is affected.

As to the Prognostick, The Dilatation of the Pupilla from the original so, is incurable; but that which cometh after is hardly cured, especially that which comes of driness, but that which comes of other

••inuance, is curable; because yong diseases of the Eyes, according to Galens Doctrine may be cured, out old may not but with very much difficulty be cured.

The Cure is to be varied according to the variety of the Cause; and if it come from driness, which can scarce come from an internal cause, but also the whol Body must be so afflicted; therefore we must refresh the whol body with moist Remedies, and nourishments, and such as are restaurative, such we use in Hectick Feavers: but more peculiarly the Body is to be moistened with a bath of warm wa∣ter, and new milk, which also must be often put into the Eyes, especially womans Milk.

If it comes from a humor which filleth the Eye, because it floweth from the Head you must purge the Head and the whol Body also, and then you must discuss the humor that is fixed in the Eye. Which when they may be sufficiently performed by the Remedies propounded for the cure of a Ca∣taract or Suffusion, we shall not in vain repeat them here, but send you to the asoresaid Trearite for them, where you shall find all things necessary for the discussing and dissipating humors contained in the Eyes. Yet you may after use some astringents which may make the Pupilla which is too much enlarged more narrow: for this end you may make use of this following Collyrium, o•• Water for the Eyes.

Take of red Roses dried two scruples: Saffron, Spicknard, the Bark of the Frankinsence Tree, of each half a scruple: Tutty prepared, burnt lvory, and Acacia, of each one scruple: Bring them into a Pouder, and put them in a thin linnen cloth, and tie it; then hang it in three ounces of Rose Water, and wash the Eyes often with the Water, dropping into them, squeezing the cloth as often as you use the Water.

If it comes from wind (after universal Evacuations) those Medicines are to be used which dis∣cuss wind in the whol Body, and especially in the Eyes, and so they may be fomented with the De∣coction of Fennel, Rue, Dill, red Roses, Myrtles, made in Rose Water with the fourth part of white Wine.

Finally, If it come with a stroak, you must alter the manner of Cure, according to the greatness of the Contusion; and if there be an Inflamation, you must cure it as an Opfithalmy: But if there be no Inflamation, you shall at the first apply a Cataplasm of Bean flower, Plantane Leaves, and red Roses made up with Rose Water. After that, you shall often drop therein the blood of a Pid∣geon, which is a most excellent Remedy in all Wounds and Contusions of the Eyes.

CHAP. VI. Of the straitness, or Contraction of the Pupilla.

THe Pupilla being too straight, hindereth the sight, as the being of it too large, as was shew∣ed in the former Chapter, because a moderate largeness of the Pupilla is necessary for recei∣ving perfectly the visible Species. So when the Eye is in its Natural condition, and is in a light place, the Pupilla is contracted lest it should take in too much light, if suddenly it be in a dark room, the things therein contained are little or scarcely seen at the first entrance, by reason of the aforesaid contraction. Afterwards when the Pupil is dilated, al things are seen rightly, there∣fore in a place moderately light, the breadth of the Pupilla ought to be moderate, that it may receive moderate light, not too much, nor too little, for making a perfect sight. But if the Pupilla be too narrow, it receiveth not light enough, therefore they who are so affected, the sight is diminished, yet they see well in a very light place, because at that time light sufficient will pass through a narrow hole, if no other Disease of the Eyes be joyned with it.

Now the narrowness of the Pupilla, cometh either from the original, or first constitution, and then it little hindereth; for if they who are so affected see less in a dark or dusky place than they who have a Pupilla of its moderate natural breath, yet in a clear light place they see better. Hence Galen said in 1. de symp. caus. cap. 2. that they who are born with smal Pupilla's see best.

Or the straightness of the Pupilla comes from preternatural causes, namely, overmuch moisture, driness, or defect of the Watery Humor, and want of Spirits.

The Pupil is contracted by humidity, when the Uvea is relaxed, and so makes the hole less or nar∣rower: For although the dilatation of the Pupilla come of the same humidity, yet contrary effects come not of the same cause, because if the cause may be called the same, it ought to have the same re∣••ation to its effects, but humidity is not in the same manner when it makes a Dilatation, for it makes ••hat by filling and distending the Membrane, but it makes the angustia or narrowness by relaxing it: 〈◊〉〈◊〉 relaxeth when it is united to its substance.

Concerning dryness there is the same difficulty, since it is mentioned among the causes of dilating ••he Pupilla. But this is the difference: When the Uvea is dryed, and the humors of the Eye re∣main

in their due quantity, then it makes a dilatation of the Pupilla, because it looseth not the extention which it formerly had, as was said in the precedent Chapter, concerning Skins extended when dryed, make their holes larger; but if the Tunicle Uvea when it is dryed, wrinckled, falls to∣gether, and loose its former extension, from the defect or diminishing of the humors of the eye, then is the hole of the Pupilla made straighter.

And so the constriction of the Pupilla by driness wil be almost the same with that which happen∣eth from a defect of the watery humor in the eye; although it may come without driness, when by the powring forth of the watery humor the Uvea falls down.

Lastly, she narrowness of the Pupilla comes from the defect of Spirits, or from the fewness of them, when by reason of the obstruction of the optick Nerve or some other cause, the visive spirit cannot come to the eyes, which when it is filled with spirit keeps its Tunicles extended; but when it wanteth spirits they grow lax and fal together: Hence the constriction of the Pupilla usually co∣meth. This appeareth in very Old men, in whom the Pupilla is made narrow by reason of the want of spirits.

This Disease is known easily being open to the sense, for if one eye alone suffer, by comparing it with the other you may perceive the straightness of the Pupilla; but if both suffer, by looking upon the eyes of another man who is sound sighted, you find it out.

As to the Prognostick, a straightness in the Pupilla which cometh from the loss of the watery hu∣mor in the eye, is incurable, because when that is once lost it cannot be recruited; especially in old folk: in yong people somtimes the watery humor of the eye hath been let forth by a wound, and hath been repaired again: A Constriction of the Pupilla from driness, can scarse, and very hardly be cured: But that which comes from moisture, in the beginning, and being yong, may be easily Cured: but an old one very hardly.

The Cure of this Disease differeth not from the former, for they come both from the same Causes, namely, Driness, or Moisture; which distempers, although they produce contrary effects, after the manner before Explained; yet are they to be Cured by the same Remedies.

CHAP. VII. Of Albugo, or the white Spot called Pin and Web, and of other Colours of the Cornea changed.

THe Natural Constitution of the Cornea Tunicle is destroyed when it looseth its brightness and transparentness; or when its infected with another colour.

It looseth brightness when it is grown thicker; now the Cornea doth grow thick by driness, as in old men, which is incurable; or by gross humors fastened upon it, which happeneth often in an Oph∣thalmy; when either by too much use of Resolving Medicines the thinner parts of the humor are dissolved, and the thick remain: Or when by an extraordinary use of cold Medicines the humors are thickned: and the Cornea doth not only become thicker in that part unto which the humor is fasten∣ed, but it also contracteth a white Colour, which is called Leucoma, or Albugo; somtimes this al∣so comes from a scar after an Ulcer, whereby the Cornea is made thicker in that part, and looseth its transparentness.

The Differences are divers, as they are more or lessthick; one doth possess only the superficies of the Cornea: another lies more deep, and pierceth the whol Cornea: another is greater, and pos∣sesseth the whol Pupilla, or the greatest part thereof: another is less, and comprehendeth but a little space of the Pupilla, and then it is properly called Macula, or Pin and Web.

The Cornea is altered in Colour when it is blood-shot, which Disease is called Sugillatio, and then al Objects appear red: Or when Choller is got into it, as in those who have the yellow Jaundice; and then the Objects use to appear yellow according to Galens Doctrine, which is to be understood of a great effusion of Choller upon the Cornea, for if it be only lightly died therewith, which often happeneth (for the Tunicle Adnata receiveth more Choller than the Cornea) then the Objects wil not seem yellow, but as they naturally are.

These Diseases need their peculiar Diagnosis for the knowledge of them; because they are appa∣rent to the Senses, but especially Albugo, which is thicker and more white; and more hindereth the ••••ght: So also that which is more superficial is more white; but that which is deeper declineth un∣to black because it is neerer to the Uvea, which being its self black, communicates its Colour unto that.

The Causes which produce these, are easily known by what hath been said; namely, if an Oph∣thalmy,

or Wound, or Ulcer went before.

As to the Prognostick: An Albugo which comes of Flegm, or a thick humor remaining after an Ophthalmy, it is easily Cured, especially if it be not inveterate: but that which cometh after a Wound or Ulcer, and is a scar, is very hardly cured; because in a part which hath exquisite sense, sharp Medicines, such as are proper to wear away a Cicatrize or Scar, c••nnot be endu∣red.

The Cure of an Albugo congealed or gathered in the Cornea from Flegm, is done by Emolients attenuating and discussing Medicines, but by alwayes using universal Medicines first, wh••ch may take a∣way the antecedent Cause, and hinder a new defluxion from the eyes, which would be caused by Medicines to the place; especially if they be sharp, or hot, except the matter be first remo∣ved.

Therefore first make universal Evacuations, then revulsions, then Derivations, as it is set down in the Cure of Gutta serena, and Cataract.

Afterwards apply a Fomentation to soften the hard matter (with soft spunges) made of the De∣coction of Foenugreek, Melilot, Celondine, and Fennel.

Or, Let the Vapor of it be taken into the eyes; and to this purpose you may make this that fol∣loweth.

Take of Marsh-mallow Roots one ounce: the Leaves of Mallows, Eyebright, Celondine the great, of each one handful: Linseed and Foenugreek of each three drams: Melilot flowers one pugil: make a Decoction of these in springwater, and let the steem or vapor of it be taken into the Eyes, morning and evening.

Afterwards use Discussives, such as are prescribed in the Cure of a Cataract or Suffusion; for they also wil do wel here. And so Collyria Eye waters which do attenuate and resolve the Humor fasten∣ed in the eye, may be taken from thence, and especially those which are made of Honey and things that quicken the sight. For the Water of Honey distilled used alone, is very good to take away al blemishes in the Eye if you continue the use of it any time.

Sugar Candy is good for the same, Dissolved in the Water of Eyebright, Celondine, or Fen∣nel.

As also it would be very good to let a Child that hath chewed Fennel-Seed to lick the Eye of∣ten.

Amatus Lusitanus reports that he Cured thick clouds in the Eye of a Girle of twelve yeers of age after he had given the Decoction of Sarsa twenty dayes, with this Medicine.

Take of Honey from the Hive two pints: the tops of Fennel, the flowers of Elder and Eye∣bright, of each two pugils: Sugar Candy four ounces: distil them in Balneo Mariae; and let the water be dropped into the Eyes.

The Seed of Clary put into the Eye at bed time, purgeth the Eye from Filth, and fo clenseth it, that it conduceth to the Cure of Albugo.

The juyce of Fennel doth potently discuss an Albugo if newly made, and mixed with a drop of the Balsom of Peru.

The same doth an Oyl made of burnt Rags mixed with the spittle of Child, and laid on with a Feather: It is made by burning of a Linnen Rag, and quenching it betwen two dishes; when it is cold you shal find the Oyl in drops upon the dish.

But Albugo coming of a Scar, is cured with Remedies that are good to mollifie, attenuate, and dis∣solve Scars; but since such are alwaies sharp, you must be more careful in applying, first universal Medicines, and revulsives, lest a flux of humors be brought to the part. Having therfore used them as aforesaid, first it is good to apply emollient Fomentations or Fumigations above prescribed. Then use abstergent & discussing Remedies: First those that are gentle, such as are above mentioned, especi∣ally the compound Water of Honey: After you may come to stronger, such as are the Galls of Fi∣shes, of the Uranoscopus, or one-eyed Fish; of the Pastinaca, or fish like the Ray; or of the Pike; as also of other Creatures, as of a Partridg, Cock, Goose, Ox, and others. After the same manner may be used the juyce of great Celondine, of the lesser Centaury, of Brooklime, and the like, which must be mixed with Honey both because Honey hath a clensing and discussing quality, as also because Liquors that are put into the Eye, flow to the corners, and stay not in the Pupilla in which their ope∣ration is required; but being thickened with Honey, they cleave wel to the Eye: But if their sharp∣ness cannot be endured, the said Juyces or Galls may be thickened, with that Mucilage or slime of Gum Traganth, of Fleabane, or of Quinces, being drawn with the Water of Fennel, Eye-bright, or other proper to the Eyes.

The form of a Collyrium made of Juyces, is thus:

Take of the Juyce of Fennel, Celondine, and Brooklime, of each three drams: the juyce of the lesser Centaury, ha••f an ounce: white Honey one ounce: 'Mix them like a Liniment. If with the Albugo there be redness of the Eyes, the Collyrium made of Salt, white Wine, and Wheat prescribed

in the Ophthalmia, is very good. Or this,

Take of Aloes and Agarick, of each one scruple: Pouder them, and tie them in a clout; which steep in the Water of Eyebright or Fennel, and wipe the Eyes therewith morning and evening. Aloes doth clense, strengthen, and stop the defluxion; Agarick doth powerfully clense.

Sugillatio or blood-shot, or that red color in the Eye which cometh of blood sent thither, if it be yong, is easily cured with Pidgeons blood dropped in: but in the want thereof you may use Wo∣mens Milk with a little Frankinsence and Saffron. Or you may apply the Yolk of an Egg with Wine; which is commended of Galen, 4. de comp. Med. sec. loc. cap. 8. But if the disease be stub∣born, you must foment the Eye with the Decoction of Foenugreek, Marsh-mallows, Fennel, Rue, Celondine; or let the fume of the same be received into it. And finally, all Medicines prescribed in the Cure of a Cataract may be very proper for the cure of this. But more especially, when the dis∣ease is old, and the redness turneth black, Galen commends dried Hysop tied in a rag, and put into hot water, and applied to the Eye: and Experience teacheth that this Medicine is of such force that the blood is drawn away by it sticking to the clout.

And lastly, The yellow color of the Jaundice, which most appears in the Eyes, when the Jaundice is cured is easily discussed: if you would hasten the Cure, take the fume of Vinegar into the Eyes.

CHAP. VIII. Of Ophthalmia, or Inflamation of the Eyes.

THe Tunicle called Adnata is so joyn'd to the Cornea, that many diseases are in both; as the Inflamation of the Eyes, though it is proper to the Adnata, yet it is often extended to the Cornea, and produceth divers Diseases in it, namely, Ulcers, Hypopyon, when matter is underneath, Albugo or Pin and Web, and others. So also Pustals, and other Tumors, Wounds, and Ulcers are common to both Tunicles. Therefore because all the Diseases of these Tu∣nicles cannot be spoken of severally, we will only speak of the Diseases of the Adnata before we speak more of the Cornea.

Beginning with an Ophthalmy; We say that it is, as the word in Greek sheweth, only an Infla∣mation of the Eye, and by all Authors it is used for the inflamation of the Adnata, or Conjunctiva. It is called by the Latines Lippitudo or blood-shotness since Cornelius Celsus.

This Inflamation, as it is greater or less, hath a three-fold difference. The first is called in Greek Taraxis, in Latin Conturbatio, which according to Paulus cometh from an external cause, name∣ly, the Sun, smoak, dust, oyl, and the like: but it may also come of an internal, namely, by fault of the stomach after drinking of Wine, or other Distempers; and this is a light Inflamation called Phlogosis, with a smal pain and redness, yet it somtimes turneth into a true Ophthalmy, and is the original of it.

But a true Ophthalmy comes alwaies from an internal cause, and it is a true inflamation with which tumor, redness, and pain, it is called by Celsus, Lippitudo or blood-shotness, because there cleaveth a thick excrement, which the Latins call Lippa.

The third is called Chemosis in Greek; in Latin Chemosis also, and it is when an inflamation groweth so high that it is very great with vehement pain, and both the Eyebrows are inverted so, that the Eyes can scarce be covered therewith; and the white of the Eye stands higher, and the red doth cover most part of the Iris or Circle. In Children, and such as have great Eyes, this hath often hap∣pened, and it comes from a great repletion, and from flegmy humors.

There is another Difference of the Ophthalmy taken out of Hippocrates, Aph. 14. Sect. 3. by which it is divided unto a moist and a dry Ophthalmy: The moist Ophthalmy is that which is al∣ready described, and hath a weeping. But the dry Ophthalmy called by Hippocrates, Xerophthal∣mia, which cometh in dry weather, is made of Choller, or burnt or adust Melancholly, and is such as wanteth humidity in part, and therefore there is no weeping. There are other subdivisions from the adjuncts; for if there be an itching joyned with it, it is called Psorophthalmia; but if it come with hardness of the Eye-lids, it is called Sclerophthalmia.

There is also another Difference of Ophthalmies, taken out of Galen, 2. de diff. febrium, cap. 11. where he saith That some are Periodical, or such as cometh by fits, to those which have a very hot and moist head, and weak Eyes, fit to receive a defluxion. These after many yeers have a consumption of their Eyes, and lose their sight; hence it is called Tabida Ophthalmia, or a consuming Ophthal∣my, or an Ophthalmy which ends in a consumption of the Eye.

There is also another difference taken from the immediate cause, which is defluxion or congesti∣on,

that is, gathering of humors. It comes for the most part by defluxion; but by congestion only, when there is either a distemper or weakness of the Conjunctiva, by which there is no equality, or Omoiosis in the part, but many excrements are gathered together, from whence through the weak∣ness of the part cometh an inflamation.

The Conjunct cause of an Odhthalmy is Chollerick, or Waterish, or Melanchollick Blood flowing into the Eyes, or gathered into them. The Causes of defluxion are manifold, both external and in∣ternal ordinarily known. But the causes of Congestion or Cumulation are all such as distemper or weaken the Eyes; so that an Ophthalmy which at the first came only by defluxion, in time by wea∣kening of the part may spoil its concoction, and so it may be said to be an Ophthalmy partly from de∣fluxion, and partly from Congestion, which is often seen in old Ophthalmies.

But when an Ophthalmy comes only by way of defluxion, it is certain that it comes for the most part from the head, and almost all Authors acknowledg this. Notwithstanding Experience teacheth that many violent Ophthalmies come from the Liver, and the humors that come from thence to the Eyes; insomuch that Cauteries applied to the hinder part of the head, e••crease the Disease, which o∣therwise are good Remedies when the defluxion is from the head, for they draw up the humors: and we have often seen that old Ophthalmies which were accounted incurable, have suddenly gone a∣way of their own accord, by stopping of an issue which hath long been kept open, namely, when the motion of the humors from the inferior to the superior parts hath ceased, which before was caused by the Cautery or Issue in the Neck, by Nature sending part of the humors to the weakened Eyes, not far distant from the Issue.

That defluxion which cometh from the head, either is carried by internal Veins, which are under the Skull, into the Eyes; or by the external Vessels, which is most frequent, namely, by the Veins, and Arteries which come from the Pericranium by the Forehead and Temples, to the Conjunctiva.

An Ophthalmy is easily known, because the blood diffused upon the Conjunctiva may be easily seen, and if redness appear without a tumor coming of an external, it is called Taraxis, or Conturba∣tion. But if besides the redness there be swelling and heat with weeping, it is a true Ophthalmy, and at length if it so encrease that it cover the black of the Eye, and the Eyelids be inverted, then is it cal∣led Chemosis.

Hence we fetch the signs of the Causes: for if it comes from repletion, and of blood alone, not only the Tunicle Adnata, but also the whol face will be red; as also there will be a swelling of the Veins, drouziness of the Sences and whol Body, and a manifest swelling.

If it come from Chollerick Blood, there will be sharpness of tears, and not only the corners of the Eyes, but also the very cheeks will be corroded, there will be a pricking and intollerable pain, a little swelling with redness inclined to yellow; and the patient hath formerly used immoderate exercise been inflamed by the Sun, subject to anger, and eating of sharp things, his complexion is Chollerick, or he is yong, and the disease cometh in hot weather.

If it come from flegm, there will be a heavy pain, little heat, not much redness, little shooting, no sharp tears, but many, and slimy and glutinatious.

If it come of Melancholly, the Tumor will be smal, the redness will be dusky, few tears, little clam∣miness, but very thick, a Melanchollick constitution, and the like signs of Melancholly.

If the defluxion come from the inner parts of the Head, there will be a pain in the Head internally coming to the Roots of the Eyes. But if the defluxion come into the Eyes by the exterior Vessels, the pain of the Head will be more external, the Veins of the Forehead will be distended, and also there will be perceived a great beating in the Temples.

The Prognostick is either in respect of an Ophthalmy coming, or already begun.

An imminent Lippitudo is known by an itching and pricking in the Eyes, with heat also, and the disposition of the Eyes to receive defluxions, doth give advantage to the prognostick of it; where∣fore they who have great Eyes are more subject to this disease: Moreover, the season doth much conduce to the breeding of it, as Hippocrates teacheth, Aph. 11. Sect. 3. If the Winter be dry and full of North winds, and the Spring rainy, and with South winds, in Summer you shall have sore Eyes very common, especially in women, and men of moist constitutions.

A flux of the Belly coming upon an Ophthalmy is good, according to Hippocrates, Aph. 17. Sect. ••6. because the superfluity of humors is discharged, and carried downwards.

An old pain in the Eyes is very dangerous, for it signifies the cause to be violent, and it is to be feared lest Imposthume, Suppuration, or Ulcer do follow.

An Ophthalmy beginning in one Eye useth ordinarily to pass to the other.

For the Cure of an Ophthalmy, the external causes must be first removed, as also the antecedent causes are to be evacuated, revelled, and repelled; the conjunct cause is to be derived and discussed, and the part affected strengthened. For the performing of which Indications there are these usual means to be applied.

First, Let his Diet be cooling and moistening, of Meats that breed good nourishment, boyled ra∣ther

than roasted; of suppings rather than solid things; because the Eyes are moved in chewing: let him avoid sharp things, Salt and Pepper. As also things that Fume, and wil fill the Head with va∣pors: As also such as quickly turn into Choller, as Milk, Sugar, Honey, and al sweet things; Wine especially is not good; but instead thereof use Barly water, with Liquoris and cooling things.

Sleep is very profitable, because then the Eyes rest from motion which is apt to stir up pain and de∣fluxion; besides pain is asswaged by sleep, and the matter causing the Disease is concocted: Let the Patient sleep with his Head high, and more inclined to that side which is least affe∣cted.

Let him avoid almotion of his Body, for rest is so profitable that Celsus commands that the first day of Cure they speak not, lest by that motion matter be carried to the head.

The Belly must be kept Solluble, for Hippocrates saith it is good for him that hath sore eyes to fal into a looseness.

Let him avoid Passions, especially Anger.

Let the Air be temperate and pure, without Smoak, Dust, and Winds, and somwhat dark; of the light by moving the Spirits causeth defluxion: Let him have a black, green, or sky colored cloth before his eyes; and keep not only his sore but his sound eye shut or covered; for while the sound eye is moved towards the Objects the sore is moved also, whence the pain encreaseth; and this is the reason why men have greater pain when one eye is affected, than when both.

The Diet being thus ordered, let us lay down the Cure of the Disease; and since it comes for the most part of external Causes: first let them be removed lest they nourish it: next make a Collyri∣um, or Eye-water, or Rose and Plantane Water, with the white of an egg, and Womans milk, and let that be instilled into the Eye often in a day; as also let a linnen clout be dipped therein and ap∣plied.

At the same time let him sleep as much as he can; for sleep is very profitable to concoct and discuss the matter causing the Disease. If it yield not to these, you must use the Remedies proper for a true Ophthalmy, in this Order.

First open a Vein (having given a Clyster) on the contrary Arm, and do it often, till you have made sufficient Evacuation and Revulsion: For Avicen teacheth, That in a true Ophthalmy you may let blood till they faint. But Galen, lib. de curat. per sangu. miss. cap. 17. tells a story of a Steward which was freed of a great Ophthalmy by blood letting: first three pound; and four hours after one pound: And in his 16. cap. of the same Book he affirmeth, That Ophthalmies are often cu∣red in an hours space only by Phlebotomy: which could not be but by loosing of a great quantity, as they did in those times in that case.

Phlebotomy must be regulated and moderated according to the temper, age, sex, strength, and kind of the Disease; for in a Plethorick body, and when it comes from blood, you must take a grea∣ter quantity: but in a Chollerick body, or Melancholly, or Flegmatick, and other Circumstances which prohibit blood-letting, you must take less.

If the whol body be ful of blood, first open the Liver or Median vein, after the Head vein; but if you intend to loose but little blood, begin with the Head vein.

But in them who have a stoppage of any ordinary accustomed Evacuation by the Terms or He∣morrhoids, you must open the veins beneath, or apply Leeches to the Hemorrhoid veins.

After you have bled enough, you must labor to make Revulsion by applying of Cupping glasses to the shoulders and the back, both dry and with scarrification.

Frictions also are good for the same; and Ligatures in the lower parts.

To the aforesaid Revulsions you must ad means to derive, which are by the opening of the veins of the Forehead and Temples; to which some ad the opening of the veins in the corners of the Eyes: others apply Horsleeches to the Temples, others behind the Ears; al which derivations are very pro∣fitable after sufficient Evacuation.

Galen 13. Meth. Cap. 22. Commended the opening of an Artery in the Temples, when the Dis∣ease comes of very hot blood: And though this way of Practice is not used in our times, yet it is ve∣ry excellent and profitable, without any danger; for in those lesser Arteries the blood is stanched by good Ligature and bondage only; nor is the Plaister mentioned by Galen in the same place necessa∣ry, which is made of Bole, Frankinsence, Mastick, and the Hair of an Hare, with the white of an Egg: yet for the better security, they who are afraid of the opening of an Artery, may make use of it; you may see what we have said concerning the opening of Arteries in the Cure of the Head∣ach.

Vesicatories also are very profitable in this Disease, both applied to the Neck and behind the Ears.

When you have bled sufficiently you must purge, that the Chollerick Humors, especially such as make the blood hot, may be evacuated: And Hippocrates saith it is very requisite, Aphor. 17.

Sect. 6. For it is good for him that hath an Ophthalmy to fall into a flux. And Galen, 13. Meth. Cap. 11. saith, That he hath seen some who began to have sore Eyes to be cured in one day only by a Purge. But it must be made of gentle ingredients, and such as do allay the heat of the blood, taking heed of al Medicines that have Scammony in them, and they be made thus.

Take of Tamarinds half an ounce: clean Senna three drams: Annisseeds half a dram: En∣dive, Succory, and Fumatory, of each half a handful: boyl them to four ounces; and when it is strained infuse in the liquor of the best Rhubarb and yellow Myrobalans rubbed with the Oyl of sweet Almonds, of each one dram: yellow Saunders half a scruple: after strain it again, and dissolve of Manna and syrup of Roses of each one ounce. Make a Potion.

Or in Form of Bolus, thus.

Take of Cassia newly drawn six drams: Diacatholicon three drams: Pouder of Rhubarb one dram: make a Bolus with Sugar.

So many times we prescribe Pills in an Ophthalmy which comes of Flegm, namely, Lucis majo∣ris, of Agarick, and the like: which though they are very good in the state of the Disease, yet it is better to abstain from in the beginning, lest the Humors moved with too violent a Medicine should fal more upon the part.

Nor is one Purge sufficient, but you must repel it a distance, if the Disease be old; first giving good preparatives by Apozemes or Juleps proper for the Humor offending: therefore in the begin∣ning allay the heat of the Humors with cooling Juleps, and such as thicken; or with Emulsions made of the greater Cold Seeds, Lettice and white Poppy seeds, in some cooling Decoction, with a little Rose water.

After universal Revulsions and Evacuations come to Topical Medicines with that part, which from the beginning must be repelling; yet the soundest Practicioners do warn us not to use repelling Me∣dicines to the Eyes at first, because for the most part they stop the Humor and retain it in the Eye, and so increase the grief and inflamation: For Galen Comment. Aphor. 31. Sect. 6. reproves a cer∣tain Oculist which used these kind of Medicines in the beginning of the inflamation; for they may be suspected in the beginning not to stay violent defluxions, but rather to keep them from coming forth: Hence it cometh to pass that when the humors are sharp the Cornea is somtimes ulcerated, but when they are many it is streaked and somtimes broken: But Avicenna, fen. 3. lib. 3. tract. 1. cap. 9. saith, That it is fit, that if possible, we abstain from Collyriums the first three dayes. And a little af∣ter, he saith, That we ought not in the beginning to apply strong Astringents and thickners: because they thicken the Tunicles or coats, and hinder resolution and increase pain.

Yet we need be so exact in the time and number of dayes, because the Disease is in some older, and in some yonger: But we may with profit apply Astringents at the beginning to the Forehead and Temples; for by those, the veins by whith the humors flow to the Eyes are stopt, and they driven back.

The Form of this is as followeth.

Take of Bole-Armonick, sanguis Draconis, Frankinsence, Mastich, of each one dram: red Roses, Balasts, or Pomegranat flowers, & the pouder of Lentils, of each two scruples: mix them with the white of an Egg and Vinegar of Roses, and make a Cataplasm for the Forehead, and Temples.

Moreover, A Cataplasm made of the Juyce of Nettles and Wheat flower, applied to the Fore∣head and Temples, is excellent to stay a defluxion by reason the Juyce of Nettles hath a special Vertue for the stopping of al sorts of Bleedings, as it doth the bleeding at the Nose or Mouth.

But if the pain be very great, which useth to encrease the defluxion upon the Eyes, you must apply Anodines or Medicines asswaging pains upon them. Among which new milk, especially if it be that which a sound woman giveth is best, if it be often milked fresh into the Eyes from the breast▪ and not be used stale, for then it wil grow sowr and be offensive to them: instead thereof you may use fresh Cheese made of Sheeps milk, which you must often change, lest it turn like Butter, and so inflame the Eye.

The white of an Egg wel beaten til it turn to water, is commended of Galen, for it asswageth pain, and gently stayes the Flux.

Also an Apple roasted in the Embers doth much asswage the pain of the Eyes.

The Mucilages, or slime of the seeds of Fleabane, Quinces, Foenugreek, drawn with Rose∣water, do take away pain; but they must be renewed every day or they wil grow sowr.

Of these things you may make divers kinds of Medicines. As for Example.

Take of the pap of a sweet Apple roasted in the embers, an ounce: the Mucilage of the seeds of Fleabane and Quinces drawn with Rose Water, of each six drams: the white of a new laid Eg beaten into water, and womans Milk, of each one dram: Make a Cataplasm and apply it to the Eyes. Or,

Take of the pap of a roasted Apple one ounce: Crums of white Bread half an ounce: one Egg mixed with Breast milk: Make of these a Cataplasm.

Thin slices of Goats Flesh, Veal, or Mutton, often applied to the Eyes, do very much asswage pain.

A Cataplasm may be made more easily with crums of white Bread, and Womans Milk mixed with Rose Water.

If the pain be intollerable, you must fly to Narcotick or stupifying Medicines, which you must use sparingly, and with good advice, because they do thicken the visive Spirits, and make the Humors and Tunicles gross, by which the Sight will become dim.

Among Narcoticks for the Eyes, the white Troches of Rhasis are principal; made with Opium thus:

Take of Rose water two ounces: the Water of an Eg well beaten one ounce: the white Troches of Rhasis with Opium, one dram: Make a Collyrium, or Water for the Eyes.

When the pain is aslwaged, you must come to repelling Medicines, which must be gentle and mix∣ed with Anodines continually: for this end make this Collyrium following:

Take of Plantane and Rose water, of each one ounce and an half: the Water of the white of an Egg beaten, one ounce: the white Troches of Rhasis with Opium, one dram: Make a Collyrium, and drop it often into the Eyes.

If the pain be very great, you may put to it Womans Milk, and the Mucilages aforesaid.

This following Medicine doth powerfully resist inflamation, and stay the flux.

Take of the white of an Eg, beat it in a pewter dish with a piece of Allum very well, till it come to the consistence of an Oyntment, which you must spread upon a linnen cloth, and apply it warm to the Eyes: After two or three hours take it away, left by its long continuance having an extraordi∣nary astringent quality from the Allum, it retain the humors in the Eyes.

Also the Water of Allum distilled in an Alembick, laid to the Eye with a linnen clout, doth allay the inflamation thereof.

The Salt of Lead dissolved in Rose Water, or Wine Vinegar, or mixed with Pomatum, doth po∣werfully cool the inflamation.

In the encrease of the Disease you must mix digestives with Repelling Medicines, and therfore you must put the Water of Eyebright, Fennel, Celondine, and the Mucilage of Linseeds, Althaeae, o•• Marsh-mallows, and Foenugreek, Gal. 13. Meth. commends especially the Decoction of Fenugreek, because it digesteth, concocteth, and moderately repelleth: but you must sift the Fenugreek to take out the dust, and after wash it often in warm Water, before you boyl it, or make the Mucilage of it. You may thus make a Collyrium.

Take of the Mucilage of the seed of Foenugreek, and Quinces drawn with Rose, and Eyebright Water, of each one ounce and an half: the white Troches of Rhasis with Opium, one dram: Tut∣ty prepared half a dram: Make a Collyrium.

When the Disease is at the height, you may put Sarcocol to it, which is of a more digestive quality; but since it is apt to hurt the Eyes by its over dryness and sharpness, it must first be steeped some few daies in Milk, often changed, and you must prepare but a little at one time, for if it be long kept it wil grow sowr, and hurt the Eyes. You may use it thus:

Take of the flowers of Chamomel, Melilot, and red Roses, of each one pugil: the seeds of Foenu∣greek clensed one dram: boyl them in Plantane Water. Dissolve in four ounces of the straining, Sarcocol one dram: Tutty prepared, and of the white Troches of Rhasis without Opium, of each half a dram: Make a Collyrium.

Authors do commend some Waters to be very powerful.

Quercetan commends the infusion of Crocus Metallorum made in Eyebright and Fennel Water, which is strong enough, and is no waies too sharrp for the Eyes as others are.

Crollius and the rest of the Chymicks, do highly commend the Salt of Lead dissolved in Rose Wa∣ter, to which they put a few grains of Sul Armonick. The manner is thus:

Take of the Salt of Lead twelve grains: Sal Armonick three grains: Rose Water three ounces: Mix them, and drop some into the Eye morning and evening.

There is also a Water made of calcined or burnt Lead, or Litharge, or Menium infused in Vinegar, which laid to the Eye with a linnen clout presently cureth their inflamation.

The Water of white Vitriol is most common, being dissolved in Rose or Plantane Water; this mitigateth inflamations, discusseth, and hindereth defluxions. Thus they are proportioned:

Take of white Vitriol one scruple: Rose or Plantane Water four ounces: Dissolve the Vitriol in it at the fire: Strain the Water and drop it into the Eyes. If it be too sharp, you may qualifie it as you please with more Rose or Plantane Water.

This following Medicine is not so sharp, and more dissolving.

Take of Flower-de-luce Roots, and red Roses, of each one scruple: Rose and Plantane Water,

of each three ounces: Boyl them to the third part with a gentle fire. Ad to the straining white Vi∣triol poundered eight grains: Make a Collyrium.

Many Oyntments also are used for the Eyes, of which, these three following are the best, and som∣times do wonders. The first is in Renodaeus his Dispensatory, called Ʋnguentum Ophthalmium, made thus:

Take of Bole-Armenick washed in Rose Water, one ounce: Lapis Calaminaris wash'd in Eye∣bright Water, and Tutty prepared, of each two drams: Pearl finely poudered half a dram: Cam∣phire half a scruple: Opium five grains: Butter as much as will be sufficient to make an Oyntment according to art, for to be applied to the corners of the Eyes, and the Eye-lids.

The second is John Cratoes, which is set down in his Physical Counsels gathered by Laurence Scholzius, Cons. 6. thus:

Take Butter made in May, if you can get it, or other that is fresh and well worked, or the marrow of an Ox or Deers Shank, and mix therewith as much of the fine pouder of Lapis Calaminar is as it will receive, make an Oyntment.

The third is from Paenotus in denario, thus made:

Take of Tutty prepared one ounce and an half: Camphire one dram: Verdegreece twelve grains Beat the Tutty with the Camphire together in a Mortar, the Verdegreece by its self, all very sine: Then take of fresh Butter one ounce: Rose water, one dram: boyl them gently together, and then take them from the fire, and first put in your Camphire with your Tutty, then your Ver∣degreece by degrees; stir them very well, and reserve them in a glass. Make an Oyntment and strain it through a Sarsenet; anoint the inside of the Eye-lids, especially about the corners, and the Pati∣ent will soon recover. This is a most approved Medicine against Inflamations both with matter and dry, against itching of the Eyelids, and weeping.

There is another very good, though sharp, and therefore must be only applied to the Eye-lids; it is thus made: (And when al have failed, this hath cured the most desperate Ophthalmy) namely, Of May Butter, and Juyce of Tobacco boyled to an Oyntment, which must be applied, the Eye∣lids being closed, and in a darkroom; as soon as the Patient opens his Eyes, it will begin to bite, and will certainly cure.

In the height of the disease, you must apply more resolving than repelling Medicines, therefore they which were prescribed in the encrease of it are good in the height or state of it, if you encrease the quantity of the Resolvers, and diminish the Repellers. But especially these two following Oyntments may be used not only in the state and height, but in the declination, to the perfect cure of the Disease.

First Fomentations to discuss the matter, are good in the height of the Disease, made thus:

Take of the flowers of Chamomel, Melilot, and Roses, of each one pugil: Foenugreek seeds pre∣pared as before shewed, two drams: Make a Decoction, with which foment the Eyes with four∣double clouts. This is good in the end, of the encrease, and the beginning of the state of the Disease; and in Winter you must use it hot, in Summer only warm.

In the end of the state and declination, you must make a more resolving Fomentation, which is done by adding to the former Ingredients, the Leaves of Eyebright, Marjoram, Bettony, and a little white Wine.

The best and rarest Secret fro the Cure of an Ophthalmy, is made of the Oyl which cometh from Linnen burnt between two close dishes; one drop of which mixed with the spittle of a Child must be dropped into the Eye with a Feather.

In the declination, not only the Remedies afore mentioned, but also Waters more resolving are to be used, as thus:

Take of Frankinsence and Aloes, of each half a dram: Sarcocol washed with Breast-milk, one dram and an half: Saffron half a scruple: the Mucilage of Foenugreek half an ounce: Fen∣nel and Eyebright Water, of each one ounce and an half. Make a Collyrium.

But if you wil, dry more, and also digest.

Take of Sarcocol one dram and an half: Tutty prepared one dram: Aloes one scruple: Mirrh half a scruple: the Mucilage of Foenugreek half an ounce: Vervain and Celondine Water, of each one ounce. Make a Collyrium.

In a defluxion which comes of flegm, you may use strong Resolvers, not only in the declination, but also in the state and encrease of the Disease very confidently.

Moreover, In the declination Authors do set down two special Remedies, namely, The use of Wine, and Baths: which first were delivered by Hippocrates, Aph. 31. Sect. 6. in these words; Drinking of Wine, or Baths, or a Fomentation, or Blood-letting, or a Potion, do take away pains in the Eyes.

Galen in his Commentary thereon, distinguisheth the Case and the Time in which these Remedies are good, which we have explained as to Blood-letting, Fomentations, and Purging: But Galen

in the place cited, cap. 22. lib. 13. meth. teacheth that Baths are then good, when an Ophthalmy 〈…〉〈…〉 of sharp humors, and when the body is sufficiently clensed by purging and bleeding: because they qualifie the sharpness of humors, and stayes their motion and defluxion; the chiefest part 〈◊〉〈◊〉 them being sent forth by insensible transpiration, and that which remaineth of the Chollerick hu••mor is easilier overcome by nature.

Galen also commends a Bath in a Flegmatick Ophthalmy, alwayes using before Evacuations ne∣cessary, because the thick humors fastened in the Eyes are extenuated by Baths, and so are easily dis∣cussed.

So Galen in the same place saith, That the drinking of pure Wine is good for those who have thick blood in the veins of their eyes, and have not gross or phlegmatick bodies; because Wine doth dis∣solve, diffuse, and discuss the thick blood, and also openeth obstructions.

For the taking away of the remainder of Redness and Inflamation, make this Fomentation fol∣lowing.

Take of the Leaves of Eyebright and Pennyroyal of each one handful: the Flowers of Cha∣momel, Melilot, and red Roses; and of Oaten chaff, of each one pugil: Foenugreek-seed three drams: Fennel-seed one dram: make a Decoction, adding in the end a little white Wine, foment the Eye with this, dipping therein linnen Cloaths, or with bags being half filled with the afore∣said ingredients.

Fennel watter alone mixed with astringent wine is a good Fomentation to discuss the reliques, and to strengthen the eyes.

An Egg boyled hard, and the shel taken off, and cut in the middle, laid hot to the eye, takes away the remainder of redness.

So doth a Fomentation made only of the Decoction of Hysop.

An old Ophthalmy requires another and longer way of Cure, and is somtimes very troublesom to a Physitian; because he can hardly hinder a delicate and noble part from receiving a defluxion by which it hath been long weakned.

Moreover, This Disease is not only nourished by defluxion, but by congestion whereby there is destemper brought into the part, which also is hard to cure.

But for the Cure of it you must first observe whether the Disease come not from a hot Distemper of the Liver, as often it doth: and then you must first administer such things as amend that. And chiefly after convenient Purging and Bleeding, Baths are good, Whey, and Mineral waters of Vi∣triol, as also Horsleeches applyed to the Hemorrhoids.

But if the matter of the Disease come only from the distemper of the Brain through which watery Humors flow to the eyes being mixed with some blood: then you must fal to purging the head with ordinary Pills, twice, thrice, or four times in a month, after you have given universal Medicines, as Apozemes or the like; which you may make according to our description in the cure of cold Disea∣ses of the Head.

If the aforesaid Purges with other Medicines now prescribed do not prevail, you must use Mercu∣rial Purges as the most excellent, by way of intermission.

Moreover a Cautery applied to the hinder part of the head is very profitable, to divert the humor flowing.

Instead whereof you may apply a Seton to the Neck behind, with better success, to them who can endure it.

A Vesicatory applied to the fore-part of the Head, as Forestus reports, Obs. 11. lib. 11. did a won∣derful cure upon an Old Woman with sore eyes.

But Rondoletius sayes, That a Cautery applied to the Coronal Suture, is better than to any other part.

Masticatories are profitable for the deriving of the Defluxion, but not Errhins because they are applied so neer the part affected that they may draw humors to it.

But if the Brain doth seem to want drying, you must have recourse to your sweating diet drink of China, Saria, and the like.

To these you may ad Topicks, which resolve and strengthen the eyes; such as are Fomentations and Unguents before mentioned for the state and declination of the Disease, which also are excellent for old Ophthalmies: nor must you forget the washing of the eyes as above mentioned with Fennel∣water and red Wine, to take away the remainder of the redness, and to strengthen the eyes every mor∣ning.

For which purpose also,

Take of the best Aloes, and of Tutty prepared, of each six drams: white Sugar one ounce: Rose-water, and mild white wine, of each six ounces: set them in the Sun fourty dayes in a glass well stopt: put some drops of this water not strained, into the Eyes. Or,

Take of white Wine three pints: Rose-water half a pint: Tutty prepared three drams: pou∣dered

Cloves one dram: Camphire half a dram: mix them in a glass close stopt, and shake them for two hours, and set in the Sun one whole month; remembering every day a little before Sun∣setting to take it out of the air, and never bring it forth till the Sun is risen: two or three drops of this water strained by filtration, must be put into the Eye before he go to sleep, or in the morning one or two hours before he rise.

This takes away the oldest redness; it dryes up weeping, and Fistulaes; it consumes al super∣fluous moistures upon the outward membranes and quickens the sight. This also following is ex∣cellent.

Take of Wheat two handful: poudered Salt one handful: put them in a Copper Vessel, and put white Wine to them two fingers breadth above them; cover the Vessel, and let them stand in the shade six or seven dayes till the liquor turneth green, stirring them often with a wooden Spatula, after pour off the liquor by inclination without the dregs, and if need be, filter it. One drop in∣to the Eye, takes away redness, and defluxion, and all spots or blemishes thereon, and quickeneth the sight.

Solenander, commends highly the Decoction of Quince Leaves, which are to be gathered without breaking in the beginning of the spring, and kept diligently that they neither be dusty, nor musty; nor otherwise defiled: and when you use them, boyl one handful of them in pure water, and let the Eyes be often washed therewith: It is a wonder (saith he) to see how it doth preserve, clense, and stop Rhewms in the Eyes.

Sometimes in a•• inveterate Ophthalmy much filth like matter is gathered in the eyes, which can scarcely be cured with Collyriums, or other remedies: but in this case fine Cotton dried at the fire and laid like a smal pillow upon the eye and rowled down, is very good; for the next morning you may take much filth away with it. And with this Remedy used many nights together many eyes have been cured which could not otherwise; and this kind of Medicine prevailes chiefly among Children that have sore eyes.

For a Conclusion of this Chapter, it wil not be amiss to set down the experimental Medicines of Sacutus Lusitanus who cured an old Ophthalmy w^ch would no otherwise be removed in a whol yeer with a Mercurial Unguent, although there was no sign of the French Pox: being perswaded by Mercurialis, who in his Book of the French Pox saith, When you see any Disease that will not be Cured by ordinary means, imagine it to be the French Pox. He asked the Patient if ever he had the French Disease, or ever lay with a foul bodied Woman? He denied al but only confessed that he lay with one Man once in the bed, whom he suspected to be Frenchified: Upon this conjecture, the Physitian prescribed a sudori••••ck diet of Sar••a for twenty dayes, but to no end. And though the Disease was chiefly in the upper parts, so that it was to be feared, least if he fluxed him at the mouth with Mercury that the humors should fal more into the eyes, but in regard it was old, and the force of the defluxion was attained, he prescribed the Unguent of Mercury after his body was wel Purged, and by it in seven dayes space after plentiful Salivation or Spitting, his pains ceased, that inflamation was gone, the itching abated which was before in his eye-lids, with much acrimony: And so leaving him only an issue in his Arm to breath the Brain; and prescribing a good diet, which he kept; the Patient returned to his former health.

The same Zacutus Lusitanus in his Praxis ad Hist. commends that Water and Oyntment which we mentioned in the Cure of Suffusion, for an old Ophthalmy.

Chap. 9. Of Hypopyo, or Matter under the CORNEA.

WHen the Inflamations of the Eyes are great, and swelling; somtimes they cannot be resol∣ved, but they wil be suppurated; which is much to be feared, and to be prevented by al means: For from thence Ulcers wil come; and somtimes Matter is gathered under the Cornea, which Disease is called Ʋpopuon; and this comes often from a stroak or con∣tusion, & blood-shotness: somtimes it covereth al the Pupilla, and hinders the sight: somtimes it compasseth the circle of the Iris, and is like the pairing of a nail, and thence it is called Onux, or Ʋnguis.

This Disease is known not only by the whiteness which is like Matter, but also from the Inflamati∣on and Blood-shot that went before; for when the Eye is moved, there appears a motion of the Pus or Matter urder the Cornea. There is a redness in the Eye, and Pulsation; or at least went before it.

For the Cure, first using universal Medicines, if there remain any reliques of Inflamation, you must take them away by the Remedies prescribed in the Ophthalmy: then you must apply gently Discu∣tients mixed with Emollients, lest when the thin part is resolved, the matter become thicker, and less fit to be dissolved. Therefore make your Fomentations of the Decoction of the flowers of Chamo∣mel, Melilot, the seeds of Fleabane and Fenugreek, to be used with Linnen, or Bags. You may ad the Leaves of Eye-bright, Celandine, and Fennel seed: or use this following Collyrium.

Take of the Water of Vervain, Rue, Celandine, Roses, and Fennel, of each half an ounce: the best Aloes and Tuity prepared, of each half a dram: Sugar-candy one dram. Pouder and mix them; with a little Breast-milk make a Collyrium, of which drop some into the Eyes twice or thrice in the day.

This following is excellent:

Take of Saffron, Aloes, and Mirrh, of each one dram: Wine three drams: Honey six drams: Dissolve the Saffron in the Wine; then mix them with the Aloes and Marrh, then put them to the Honey, and anoint the Eyes.

Lastly, Those Medicines which were prescribed in the declination of an Ophthalmy, in the spots or Maculae of the Eyes, and in Suffusion, or Cataract are good here.

If the Matter cannot be discussed with Resolving Medicines, you must seek others. Gal. in 14 Meth. reports, That there was one Justus an Oculist in his time, that cured many of this Disease by shaking their heads; for setting them straight upon a seat, and taking hold on both sides of their head, he shaked them till he perceived the matter to descend.

But if the matter which hindereth the sight cannot be thus cured neither, Galen in the place cited flies to Manual Operation, or Chyrurgery; whom Aetius and others do follow, which is done by pricking of the Eye, which is used also in a Cataract. Which operation, as it is little used in our times, so it requireth the hand of a most skilful Chyrurgion; and it is much to be feared, lest when the Cornea is opened, the Watery Humor come forth with the matter.

Chap. 10. Of Phlyctaenae, or Blisters in the Eyes.

IN the Cornea and the Adnata Tunica, as in other parts of the Body, there breed somtimes little blisters full with water, like bubbles, or bladders, which come from the heat of the Humor Phlyctainai in Greek, and called in Arabick Bothor: and they are little tumors like Gromwel seeds, coming from a sharp watery humor.

They are easily known. They in the Adnata are red: in the Cornea, blackish, if they be outward; but white if they be in the inner part of it.

As to the Prognostick P••lyctaenae which grow in the Adnata, are less dangerous than they in the Cornea. The more superficial these Pustles are, the le••s dangerous they are; the more inward, the more danger; for it is to be feared lest the whol thickness of the Cornea be eroded, and so either the watery humor wil flow forth, or else the Uvea wil start out.

The Cure consisteth wholly in the resolving of the matter conjoyned, and the averting of the ante∣cedent cause. And we must take heed lest we bring these Pustles to suppuration, lest they turn into Ulcers.

Therefore those Universal Evacuations, Revulsions, and Derivations, which were declared in the Cure of the Ophthalmy, must here be used.

Afterwards, we must apply Topicks, or Medicines to the part, which at the first must gently re∣pel, and discuss; such as were laid down for them in the treaty of the encrease of Ophthalmy, which are most proper when there is an Inflamation also, as it often falleth out.

Afterwards you may u••e more drying and dissolving Medicines, such as are described for the state and declination of Ophthalmy; and especially the Oyntments there set down, which are very proper to discuis and dry up Pustles.

Chap. 11. Of the Vlcers in the Cornea and Adnata.

AFter an Ophthalmy, there followeth often Ulcers in the Tunicles called Cornea and Adnata, when it comes to suppuration. They follow also the Phlyctaenae or Pustles, which bred in the Cornea, but not till they break. They also use to come from sharp corroding humors flowing into the Eyes.

There are divers sorts of these Ulcers mentioned in Authors, taken from their divers circumstan∣ces, as they are superncial or profound, broad or narrow, and according as they differ in shape and figure, and the like. So a hollow, narrow, and hard Ulcer is called Bothrion, or Fossula like a little

trench: A broad and not so deep an Ulcer, is called Coil oma: That which cometh in the Circle Iris, is called Argemon, or Vlcus Coronale: Finally, that which is deep and hard, is called Epicayma, and Egcayma.

The knowledg of Ulcers is easie, for they may be seen: If the Ulcer be in the Cornea, there will be a smal white blemish in the black of the Eye; if in the Adnata, there wil be a smal white blemish in the white of the Eye, because the Veins of the Tunicle Adnata are ful of blood.

The Ulcer of the Eyes are dangerous, and hard to be cured; but more in the Cornea than in the Adnata. An Ulcer in the Pupilla is more dangerous, because after it is cured, it wil leave a Scar, which wil hinder the perspicuity of the Cornea, and so the sight wil be hurt; and if the whol Tuni∣cle be corroded, the Watery Humor wil flow out, and the Uvea start forth.

The Cure of this Disease, as of other Ulcers, is, By clensing and drying means; but they must be very gentle by reason of the tenderness of the part, and exquisitness of the sence. But you must first use such things as revel and hinder the flux or humors from the Eyes; as in Ophthalmy either old or new, were declared. And if there be an Inflamation with it, you mix must things that are proper for that. With which also you may use things that asswage pain, if there be any.

These things do moderately dry and clense: Sugar, Honey, Saffron, Mirrh, Frankinsence, Aloes, Sarcocol, Tutty, and Ceruss; of which you may make these following Medicines:

Take of Barley and Foenugreek Water boyled, four ounces: the best Honey half an ounce: or of the Syrup of dried Roses, one ounce: Make a Collyrium to wash the Eyes often.

Take of Vervain and Plantane Water, of each two ounces: Sugar candy half an ounce. Mix them for a Collyrium.

Take of the Water of Honey distilled in Balneo, and of Rose water, of each equal parts. Or,

Take a hard Egg peel'd, cut it in two pieces, and taking out the Yolk fill the hollow with the pouder of Sugar candy; tie it fast, and hang it in a Wine Celler, and you shall have a Water drop from it, which is excellent to clense the Eyes without pain.

But if you wil have it stronger mix the Pouder of Mirch with your Sugar candy.

Montanus highly commends this Pouder following:

Take Twenty Whites of new laid Eggs, put them in a pewter dish in the Sun till they are dry: then pouder them finely with as much Sugar; and this pouder put into the Eyes, doth much good without causing pain.

In the Progress of this Disease, if you will clense and dry more, put to the former Medicines the white Troches of Rhasis, Frankinsence, Aloes, Mirrh, Sarcocol, or the like, but in a smal quantity lest it be too sharp, and also mix them with Milk, white of an Eg, some Mucilages, and other Ano∣dines, or things that mitigate and asswage pain.

Tutty is the best, for it causeth no pain, and dryeth and healeth; therefore Collyriums, or Un∣guents are good that are made thereof. And chiefly the Oyntment prescribed in the cure of Oph∣thalmy, which hath in it a great quantity of Tutty.

This following is very clensing, drying, and healing.

Take of Sarcocol steep'd in Rose Water, Ceruss and washed Aloes, Mirrh, and Tutty prepared, of each half a dram: Sugar candy one dram: With the Mucilage of Gum Traganth drawn with Rose Water, make a Collyrium, with which anoint the Eye-lids.

Chap. 12. Of a Cancer in the Cornea.

AS a Cancer may come in other parts, so somtimes it breeds in the Eyes. And though the knowledg and Cure of a Cancer is in the Treatise of external Diseases, yet we wil speak briefly here of those things which properly belong to a Cancer in the Eye.

A Cancer is either occult, or hidden, or ulcerated. The occult is reckoned among Tumors, and it is called a Cancerous Tumor, or Cancer of the Eye: But the ulcerated is called a Cancerous Ulcer in the Eye.

But in both there is an unequal hardness, a blew Lead color, a strong pricking pain, especially a∣bout the Head and Temples: the Veins adjoyning are blew, and very full. Somtimes adust and sharp blood floweth from the part affected, when the Cancer is ulcerated. And this pain is encreased by any warm Medicines.

This Disease is incurable, as wel in the Eye as in any other part, when it is fixed; except it be ta∣ken away by manual operation.

Authors propound two waies of Cure, namely a True, and a Palliative. A true Cure (as was said) cannot be wrought but by Chyrurgery when the Cancer is fixed: but when it is new in the be∣ginning, it may be cured by often evacuation of the Chollerick humor, first having let blood; as Galen teacheth 2. ad Glauconem, cap. 10. where he boasteth that he hath often cured this disease, adjoyning a convenient Diet with the aforesaid Physick.

A Palliative Cure, which tends only to the mitigation of Symptoms, is done not only by the afore∣said Evacuations' but also by convenient Topicks.

First then you must appoint a convenient Diet, such as is good against burnt Cholle••; and it must be cooling and moistning.

Then draw Blood on the same side, and apply Horsleeches behind the Ears, and also to the He∣morrhoids if they do appear, applying Cupping Glasses to the Shoulders, and use other kinds of Revulsions.

You must also prepare and Purge Melancholly by Potions, Apozemes, opening Broaths, by Magi∣stral Syrups, and the like: But above al for the purging of Melancholly black Hellebor wel pre∣pared is the best; and by giving the Extract thereof twice or thrice, we have somtimes cured a Can∣cer in the beginning.

These Remedies do exceedingly diminish the Humors that flow to the Eyes, and take away pains and other Symptoms: for which purpose also Topicks are good, such as are prescribed in Ophthal∣my, for asswaging of pain: especially the Collyria made of Mucilages, the white Troches of Rha∣sis, and prepared Tutty, with the water of Roses, Nightshade, and Plantane.

This following Water is a good Collyrium to wash the Eye with.

Take of the Roots of Pilewort, and herb Robert, of each two handfuls: Ribwort, Nightshade, Borrage, Bugloss, Purslain, Eyebright, and Bettony, of each one handful: green Frogs, and whites of Eggs, of each twelve in number: the seeds of Foenugreek and Quinces, of each one ounce: let the Roots and Seeds be bruised, and the Leaves Cut: then pour upon them of Eyebright and Rosewater of each one pint: mix them and Distil them in a pewter Still.

The flesh of Chickins is very powerful to alswage pain: and some say that the Disease it self hath been Cured by it alone. So Maritius Cordaeus, Comment. 7. in lib. 1. Hipp. of Womens Diseases, relates a history of a noble Woman, who had the right side of her face a long time infected with a Cancer ulcerated, and having tryed al means she could from Italian, French, German, and Spanish Physitians, was at length Cured with this vulgar Medicine by a Barber: He took Chickins and cut them in thin broad pieces, which he often applied to the Cancer: Others apply the flesh of yong Pigeons so cut, while it is warm.

Finally, The true Cure of a fixed Cancer is only by taking it out by the roots, and is by a taking out of the Eye; which Fabricius Hildanus saith may be done very safely; and he sheweth the manner and Circumstances thereof at large, Observ. 1. Cent. 1. so that we shal not here Repea•• them.

Chap. 13. Of the Rupture of the Cornea.

SOmtimes the Cornea Tunicle is so divided, that the watery Humor, and somtimes the Ʋvea al∣so cometh forth; and this is called the Rupture of the Cornea.

The Cause of this is an Ulcer, or Wound in the Membrane, or a great afflux of Humors, by which the said Membrane is so distended, that it cracks in the middle, and the Humors conteined are let ou••: As Paraeus reports it happened to a certain Woman in Paris, lib. 16. cap. 13.

This Disease is for the most part incurable, and takes away sight, because the Humors of the eye cast forth cannot be repaired: but if the Wound be smal, so that only a portion of the watery Hu∣mor is only lost, it may be Cured; for the watery humor may somtimes be renewed: as Galen taught 4. de ••ymp. caus. cap. 2.

You must use Astringent and Glutinating Medicines; having first Bled and Purged if necessary, as the white of an Egg, with the white Troches of Rhasis dropt into the Eye.

Let the part be Fomented with a Decoction of red Roses of Solomons Seal, Bramble buds, shep∣heards-purse, and Plantane boyled in red Wine if there be no inflamation; but if there be, in spring water.

Take of Quinces half a pound: red Roses three pugils: Acacia two drams: Saffron one scruple: boyl these in red Wine, and make a Cataplasm to be applied to the part.

For the perfect Consolidation and Cure, use this Collyrium.

Take of washed Aloes, Tutty prepared, and Sarcocol steept in breast Milk, of each half a scruple: Saffron five grains: with the Mucilage of Gum Traganth, make a Collyrium.

Chap. 14. Of the Coming forth of the Uvea.

UPon the Rupture of the Cornea, often comes the shooting forth of the Ʋvea, which is called in Greek, Propto sis Ragoidous: there are four kinds mentioned by Authors, especially by Paulus; of which the first is called Mu••cephalon, because it is like the head of a Fly: and this is when a smal portion of the Ʋvea comes forth. The second is called Staphuloma, and this is when a great part of the Ʋvea comes forth so that it is like the stone of a Raison. The third is called Melos, when there is so great eruption of the Ʋvea, that it seems like an Apple. The fourth is called Elos, or Clavus, when the Ʋvea being come forth groweth hard.

The Cure of this Disease is Difficult, and the more when the Ʋvea comes most forth: but when it is smal, as in Muocephalon it is Curable by moderate astringents, such as we prescribed in the Rup∣ture of the Cornea.

The Antients as Paulus Aetius, and Celsus, do labor to Cure them when old and not moveable by Medicines, with Chirurgery; but this is now out of fashion, by reason of its great difficulty and doubtful success: but if any wil try it, he shal find the way exactly set down in Jerom. Fabricius, ab Aquapendente, cap. destaphylomate.

Chap. 15. Of Aegylops, and Fistula Lacrymalis.

HItherto we have spoken of the Diseases of the Eyes which happen in the humors and upon the Tunicles; it remaineth that we speak of the Diseases of the Corners of the Eyes and Eye∣lids.

And first of the Tumor in the great Corner of the Eye, by the Root of the Nose, called Aegylops, and Anchylops if not broken.

This little Tumor, is either with, or without Inflamation.

When it is inflamed, it is like a smal Phlegmon: or Bile, red about, with a shooting pain. And it comes of thin and chollerick blood that flows into the part by the veins of the Temples, Fore-head, and Face, and so impostumateth; which being open produceth an Ulcer, which speedily turns hol∣low, and then it is called Fistula Lachrymalis. And if this continueth one yeer, there is a Caries or foulness of the Bone, as Hippocrates saith, 45. Sect. 6. In Ulcers of a yeer old, the Bone is foul: And this Caries is known by the Cavity, which is known by the finger: and by the stinking Matter flowing from it.

Somtimes it comes without Inflamation, and then it is bred of a thick slimy Humor, like Pulse or Hony: As the Tumors called Atheromata, Stea••omata, Meliceris, which are without pain.

The Cure of an Aegylops is very hard, both in regard Medicines are ill to be applied to it, by reason the sight is so nigh; and because an Impostume wil quickly Ulcerate in such a tender part (as afore∣said) But it is most difficult when the Impostume breaks out at the Nose, and the Matter flows through the Nostrils; because thereby the Bones wil be putrified.

Somtimes Aegylops turns to a Cancer, which comes with a pricking pain; extension of the veins, hardness and blewness of the skin, and then it is better to let it alone, because Medicines wil enlarge it, and encrease pain.

A Lachrymal Fistula that is newly begun, and which hath an external orifice to be seen, is cure∣able by Medicines; but that which is deep and old, and hath fouled the Bone, is scarcely Cured with∣out burning.

The divers times of these Diseases require divers Medicines.

And First in the beginning of an Aegylops you must revel the defluxion from the part by bleeding and purging; and use repelling Medicines to the Forehead, by which somtimes the Progress is stopt before it come to suppuration.

For this end, use the following Ceratum.

Take of Pomegranate-peels, Acacia, Pomegranate flowers, Galls, Cypress-nuts, Roch-A∣lum, Bole-Armenick, of each one dram: white Wax four ounces: Turpentine three drams: Make a Cerate.

After the use of Repercussives, you must apply Resolvers to the part affected, as this Decocti∣on.

Take of pure Honey and Aloes, of each two ounces: Mirrh one ounce: Saffron one dram

and an half: Water two pints: Boyl them gently to the consumption of half: dip a piece of soft Spunge therein, squeeze it a little, and apply it hot to the part, bind it on; and do thus often.

Amatus Lucitanus, Curatione 68. Cent. 5. prescribes a Cerat against Aegylops, which he highly commends, which is this:

Take of the Pouder of Cockle shels, two drams: Mirrh, washed Aloes, and Frankinsence, of each half an ounce: Sarcocol, Dragons blood, and Ceruss, of each three drams: Opopanax dissol∣ved in Wine, Vinegar and Blood-stone, of each one dram and an half: Saffron two scruples▪ Wax and Rozin, of each three ounces: Mix them according to art at the fire, and make a Cerate to be applied to the corner of the Eye.

If the Tumor wil not be resolved with the former Medicines, but wil come to suppuration, you must help it forward with a Plaister of Simple Diachylon; or if there be pain or inflamation, you may apply a Cataplasm of Crums of Bread. If it wil not break▪ open it with a Lancet, and delay not least the matter contained do corrode the parts, and make an incurable Fistula. Many open it with a hot Iron, but the cold is best.

After the imposthume is opened, you must clense the Ulcer, and heal it as others. But if it fistu∣late, cure it thus:

First make a general Evacuation by bleeding and purging. You must divert the defluxion from the Head by Cupping-glasses, Vesicatories, and Causticks applied to their proper places; and then use the decoction of China, or Sarsaparilla, for many daies. And at the same time dry the Brain with Fumes and Head Pouders, as in a Catarrh.

Instead of a Cautery you may apply a Seton to the Neck; for Fabricius Hildanus reports Obs. 41. Cent. 1. that it hath done it alone without other means.

If the distemper of the Liver be the Cause of the defluxion (as it often is) you must have a spe∣cial care to administer Medicines proper for that.

When you use Topicks, open the orifice of the Ulcer, and dilate it by degrees, with a Tent made of an Elder pith, a spunge made fit, or a Gentian Root. When it is large enough, apply this following Medicine, commended by Forestus, Obs. 17. Lib. 11.

Take of Honey two ounces: Verdegreece one dram: Water of Rue four ounces: Pouder the Verdegreece very fine, and boyl it with the rest at a gentle fire till the third part be consumed, and make a warm injection of the strained Liquor with a Syringe: if this be too sharp, wash the Ʋlcer every day with the Water of Rue, and after apply a little Unguentum Apostolorum. Continue this course for three weeks, laying on some convenient Plaister, and defending the Eye with Rose Water.

When the Ulcer is sufficiently purged, use this following Collyrium to incarnate and cica∣trize:

Take of Frankinsence, Aloes, Dragons blood, Pomegranate flowers, Allum, and Antimony, of each one dram: Verdegreece five grains: Pouder them fine, and with Rue Water make a Col∣lyrium to be dropt in with a stalk of Rue, thrice in a day, and put in a tent wet therewith, laying upon it a Diapalma Plaister: Lessen your Tent by degrees, and at length take it quite out, only washing the part with the aforesaid Collyrium, and laying on Diapalma.

Forestus in the place cited saith, that new fistulaes have been cured thus by a famous Chyrurgeon of his time.

If it appear that the bone be foul, it must only be cured by an actual Cautery; the manner of which is exactly described in Paraeus, Fallopius, and Aquapendente in their Works: But Fa∣bricus Hildanus Obs. 22. Cent. 5. boasteth that he cured a Fistula lachrymalis with foulness at the Bone, that was four yeers old, and counted desperate, in a child of thirteen yeers of age, with Medi∣cines alone, dilating of it with prepared Spunges, and after sprinkling Euphorbium into it, and that very much and often; and after applying only an Emplaister of Gum Elemi. Having used these things diligently for the space of divers weeks, he perceived a scale of the Bone, which he drew forth; and then with half a drop of Tolutan Balsom upon a little Lint, once in a day conveyed into the Ul∣cer, he perfectly consolidated the Fistula in a short time.

Chap. 16. Of Rhyas and Encanthis.

ANother Disease often followeth the Fistula Lachrymalis called Rhyas; and this is the consu∣ming or diminishing of the smal flesh in the great corner of the Eye, from whence it is enlarged: This comes also of other Causes, as sharp humors falling upon the part, or from clensing Medicines formerly misapplyed.

Encanthis is contrary to Rhyas, which is the immoderate encrease and swelling of the Caruncle,

or little flesh in the great corner of the Eye; and this comes from much blood flowing to the part, and the not orderly curing and drying up of the Ulcer.

The Cure of Rhyas is by Incarnatives, such as follow:

Take of red Roses, one pugil: Cypress Nuts, and Myrtles, of each two drams: Aloes one dram and an half: old Wine one pint: Boyl them till the fourth part be consumed: wash the part often with this Decoction. Or,

Take of Aloes and Frankinsence, of each one dram: Dragons blood half a dram: red Roses and seeds of Sumach, of each one scruple: Rose Water one pint: boyl them to the consumption of the fourth part. Make a Collyrium.

Encanthis is cured by taking away of the superfluous flesh growing in the corner of the Eye; this is done with eating Medicines, beginning with the mildest first, therfore first use burnt Allum; after proceed to Apostolorum Aegyptiacum, or burnt Vitriol. But if these will not do, cut it out, or burn it with an Iron. But before you do these things you must prepare the Body with con∣venient Evacuations least you cause a new defluxion: but in the cutting, burning, or consuming of this Caruncle with Medicines, you must take heed that you take it not wholly away, but only that which is superfluous, otherwise it wil turn to Rhyas.

Chap: 17: Of Epiphora.

THe word Epiphora signifieth any Defluxion into any part. But through custom it is used espe∣cially for the defluxion of a thin Rhewm from the Eyes; hence it is called involuntary wee∣ping, which flows dayly from the corners of the Eyes.

For the producing of which Humor flowing preternaturally there is an evil disposition in the part from whence it cometh, and in the part receiving it: the part that sends this humor is the Brain, which when it is too hot, or too cold gathereth a watery Humor, and so sends it to the inferior parts, which are fit to receive it: The part receiving is the Glandle or Kernel by the great corner of the Eye, and the Caruncle upon the corner; the thinness, or thickness, or other weakness of which parts causeth that they easily entertain the humors that flow thither. Therefore an Epiphora happeneth often in an Egylops, a Lachrymal Fistula, a Rhyas, and Encanthis, because the superfluous humors use to be easily received into the parts affected.

This humor is carried from the Brain into the corners of the Eyes, somtimes by the internal Veins, somtimes by the external, as we shal shew you hereafter by their proper signs.

But the Humor which maketh an Epiphora, is somtimes cold, and brings no other inconvenience, but only defluxion, somtimes it is salt and sharp, and causeth pain, heat, and redness, and exulcera∣tion of the Eyebrows.

There need no signs to be given of Tears, they are visible. It wil appear by what hath been said whe∣ther they are cold or hot, and sharp. But we must distinguish whether they come by the internal or external Vessels. When by the internal, there is pain in the inside of the head, and somtimes violent neesing. But if they come by the external without the Skul. The Vessels of the Forehead and Tem∣ples are stretched, and the head seems to be bound about and astringent means, outwardly applyed do help.

As to the Prognostick; New Epiphora's coming from outward causes are easily cured, especially in youth: but old, and in old men very hardly. They which proceed from other diseases, as Aegy∣lops, Fistula Lachrymalis and the like, have their Cure with the diseases whence they came.

The Cure of this Disease consists in taking away the defluxion, and strengthening the part recei∣ving.

You must take away the defluxion with Evacuation of the humor offending, revulsion, derivation, and strengthening the part from whence it cometh.

The Peccant humor which is a Water superfluous in the Brain, must be evacuated with bleeding and purging.

Blood-letting is not good in a cold distemper of the Brain, except there be manifest signs of ple∣thory or fulness; but in a hot distemper, when the humors are very sharp, it is very good, and you may use it twice or thrice if need be.

You may purge by Potions, Apozemes, Pills, and the like, which you may proportion to the condition of the Patient.

Make a revulsion of the humors flowing by Cupping-glasses often applied to the shoulders, by Ve∣sicatories to rai••e blisters behind in the Neck, or with Cauteries to the hinder part of the Head, and Issues in the Arms.

In a stubborn Epiphora, a Vesicatory applyed to the fore-part of the Head doth wonders; as Forestus sheweth, Obs. 11. lib. 11. concerning an Old Woman who had sore Eyes, weeping and mat∣tery,

with great pain and itching, and could by no means be Cured, that with applying a Plaister of Cantharides with Honey and Leaven to her head being shaven, he perfectly Cured her.

Rondeletius saith, That a Cautery applyed to the Commissura, doth more good than when it is used to any other part.

For Derivation, use Leeches behind the Ears; and Masticatories every morning.

But least the Humors once evacuated should breed again, the Brain must be strengthened and dri∣ed; and if it be too cold, you may use al our Remedies prescribed in the Cure of the cold Distemper of the Brain. But if it be too hot, those things which we prescribed in the Cure of a hot Catarrh; especially such as respect the Brain most, are here to be used.

While the former Medicines are used, you must apply Topicks to the part receiving; and first if the Humor comes through the external veins, apply Astringents to the Forehead and Temples: and if the Defluxion come from a sharp hot Humor, use the following Cataplasm.

Take Bole-Armenick, Dragons Blood, Pomegranat Flowers, and Mirtles, of each one dram and an half: Accacia and Hipocistis of each one dram: Frankinsence and Mastich of each two scruples: Red Roses one pugil: Pouder them and mix them with the white of an Egg and a little Vinegar, make a Cataplasm, which spread upon a Cloth and apply to the Fore-head and Temples, and renew it as fast as it groweth dry.

If it come of a Cold Humor, apply this following Cerat.

Take of Frankinsence and Mastich of each one dram and an half: Gum Anime, Tacama∣hacca, and Blood-stone, of each one dram: Gum of Juniper two scruples: Turpentine and Wax as much as will serve turn: make a Cerat.

But you must apply Astringent and Drying Medicines to the part affected: which are thus made.

Take of Tutty prepared one dram: Sarcocol half a dram: Frankinsence and Mastich of each a scruple: Spicknard six grains: make Troches, which being mixed with the white of an Egg, or the juyce of Quinces may be applyed to the corner of the Eye. Or,

Take Tutty prepared in a fine Rag, and tye it with a string, and put it in sharp Wine, and with this often wash the Eyes. Or,

Take Tutty prepared, Egg shells poudered, the best Aloes, of each one dram: tye them in a Rag and make a little Ball which steep in Fennel-water, and squeez the Ball often into the Eyes.

Only Aloes poudered and made into a Ball (as above) and put into Rose-water, is very good. Or,

Take Aloes, Cypress Nuts, Frankinsence, Mastich, Myrrh, of each two drams: Tutty pre∣pared, and Sarcocol, of each one dram and an half: Sanguis Dragonis, Barberries, Sumach, red Roses, of each one scruple: Pouder them finely, and with Fennel-water make a Colly∣rium.

In a Hot Defluxion this is excellent.

Take of white Troches of Rhasis without Opium, Sarcocol, Lycium or Box-thorn, Acacia, Olibanum, of each one dram: the stones of Myrobalans calcined, of white and red Coral, of each half a dram: Pearlhalf a scruple: as much of the juyce of Pomegranats boyled to half, as will make a Collyrium.

If Redness be joyned with it, this following is profitable.

Take of the seeds of Sumach bruised one scruple: hot Plantane Water one ounce: macerate them a while, then press them strongly, and put of Rose, Eyebright, and the Waters of the white of an Egg well beaten, of each half an ounce: Sugar Candy finely poudered and strained with a little water, one scruple: Make a Collyrium.

Lastly, Those Medicines which were prescribed for an Old Ophthalmy, are good in this Disease.

CHAP. XVIII. Of Pterygium, or Haw in the Eyes, called Unguis.

THis is a Hard and Nervous little Membrane, which coming out of the great Corner of the Eye, first covereth the white, and after by continuance, the black; and covering the Pupilla, hindereth the light.

Somtimes it is thin and white; somtimes it is fleshly with many red veins, and it is called a Pannicle, and Sebel, by Avicen; although some distinguish a Pannicle from a Haw, or Ʋngula; because Ʋngula is a Nervous Tunicle without repletion of veins, and is only in the Ad∣nata: But Sebel, or Pannicle, Covereth the whole Eye, and is very Red, and full of Veins.

This Disease comes from Ulceration of the flesh in the Corner of the Eye; or, of the Adnata, whence there comes a roughness or inequality in the part, which while the Nourishing Faculty la∣bors to make equal, it fills with blood, and begets a preternatural encrease, or covereth it with a Skin.

And because many Excrements do use to flow to an Eye disordered, therefore the Haw is not bred of pure Blood, but of many Excrements also, whence arise many sorts of Haws: Be∣cause,

Some are Hard, others Soft, some White, some Red, some Yellow, some Brown, others are easily separated from the Adnata and Cornea, others stick fast; some are simple and without Ma∣lignity, others are Cancerous and filthy.

The Diagnosis, or Knowledge of this Disease, is known by what is said; also the Causes, name∣ly, The Humors of which it is made, may be known by their Colour; for a Red Haw comes of pure Blood: a Yellow, of Choller: a White, of Flegm: a Dark and Black one, of Melan∣cholly.

As to the Prognostick, This Disease is scarcely to be Cured, and that in a long time; because sharp Medicines which are proper for to eate it away, cannot be used but by degrees, by reason of the exquisite sense of the Eyes.

If the Eye Affected grow smaller, it is an evil sign; for it argueth the Debility of the part.

A new Haw and smal, may be Cured with Medicines; but an over-grown, old, and one covering the black of the Eye, cannot, but by Chirurgery.

A Haw which is thick, turn'd out, stretcht forth, hard and black, cannot be Cured; for it is of a Cancerous nature.

The Cure is to be by the Antecedent and Conjunct Cause.

In respect of the Antecedent, first good Diet is to be enjoyned, such as is mentioned in other Di∣seases of the Eyes from Fluxes.

Also the afore-mentioned Evacuations and Revulsions may here be used, namely, Purgations, Bleeding, Cupping, Vesicatories, and the like.

And when the Body is sufficiently Purged, we must come to Topicks, which may Consume the Haw.

Beginning first with Mild, such as were they which we spake of in Curing of the Spots in the Eye, called Phlyctaenae: which not prevailing, we must use stronger, which are frequent in Authors.

Forestus commends this following.

Take of the juyce of Fennel four ounces: the juyce of Celandine three ounces: the juyce of Rue two ounces: the juyce of Mallows two ounces and an half: Aloes one dram: Vitriol two scruples: Verdugreese one scruple: Ginger and Cinamon, of each half a scruple: the Gall of an Eel half an ounce: the Gall of an Ox, or Hog two drams: Sugar Candy two scruples: Let the juyces boyl with the rest, and then clarifie it and make a Collyrium.

This also is by him Commended.

Take of Blood-stone two drams: white Vitriol and Verdegreece calcined, of each three drams: Myrrh and Saffron, of each one dram: Long Pepper half a dram: Sugar Candy half an ounce: Pouder them very fine, and mix with one dram of this Pouder two drams of Radish-water, and apply twice or thrice in a day, as the Patient can endure it.

Before you use these Remedies, you must Foment the part with an Emollient Decoction, which you must do also afterwards to asswage the pain.

Among the Mildest, this following is best.

Take of Cuttle Bone, one scruple: Sugar Candy, one dram: Vitriol, half a scruple: Tutty Prepared, half a Dram: Mix them, and make a fine Pouder, to lay upon the Haw.

If it cannot be taken off with these Topicks, you must fall to Chirurgery, and taking up the Ʋngula with a Hook at the bottom or root; draw a double Thred through it with a Needle, then laying it down close on both sides beneath, cut it off with your Cissours; as is more at large shewed by Celsus, Paulus, Aetius, Jerom ab Aquapendente, in their Chirurgery, and by o∣thers.

Having made Incision, lay on a little Lint dipped in Rose-water and the white of an Egg, to as∣swage pain, and hinder Inflamation.

And Lastly, you may Heal it up with drying Medicines, as Collyriums of Tutty, Frankinsence, Aloes, the white Troches of Rhasis, and the like.

The End of the Second Book.