Nine books of physick and chirurgery written by that great and learned physitian, Dr Sennertus. The first five being his Institutions of the whole body of physick: the other four of fevers and agues: with their differences, signs, and cures.

CHAP. IX Of the place by which purgation ought to 〈◊〉〈◊〉 made.

LAstly the place, * 1.1 by which purgation ought to be made the residence, or as I may say the in••lination of the hu∣mours shew, for a humour is to be evacuated through that place, through which, both in respect of the place wherein it resides, and of its owne nature, it is fit to be evacuated so that the strength will permit it, which Hippo. also admo∣nisheth 1. Apho 21. we ought to lead out humours that way which they are most inclined to goe, thither they are to be led through convenient places.

But the convenient places are those through which nature at other times rightly acting, evacuates what is offensive, and indeed there are two wayes by which purga∣tion is to be appointed, the one is that by which we vomit, the other through the paunch, * 1.2 but by vomit those humours are conveniently evacuated which are apt both in regard of the place where they reside, and in respect of their own nature to be carried to the stomach, or such as tend upward,

namely such as are generated, and reside in the stomach, as those also which are contained in the Spleen, Cavities of the Liver, and Pancreas, as also thin humours, hot and cholerick; but by the paunch those which remaine in the inferior parts and tend downwards, as also thick and cold humours, * 1.3 hence Hippo. writes 4. Apho. 6. those that are leane, and easie to vomit are to be evacuated upwards, being carefull of the Winter. As for example, those which abound with choler which tends upwards; but on the contrary those which are hard to vomit, and are somewhat thicker, and of an indif∣ferent habit of body are to be purged downward being cau∣tious in the Summer, because they more abound with phlegme.

Moreover the time of the yeare shews the humour, * 1.4 and from thence also the place of purgation, hence Hippo. 4. Apho. 4. in the Summer the superior ventricles, in the Winter the inferior are to be purged, for in the Summer yellow choler and hot humours abound, and by reason of the heate all things in our bodyes seeme to tend upwards, in Winter, phlegme rather abounds which is heavy, and by nature tends downwards.

Symptomes also shew the nature of humours, * 1.5 and whither they incline, as Hippo. teacheth 4. Apho. 17. the loathing of meat by one that is not in a feaver, the griping of the mouth of the stomach, a Vertigo with Apparitions of shadowes, and bitternesse of the mouth shew that there is need of purging upwards, all which Symptomes signifie that choler is willing to ascend to the mouth of the stomach, and the same Apho. 18. paines above the Middriffe, whoever wants purging, they signify they are to be purged upwards, but those which are beneath, downward, and the same Hippo. Apho. 20. if there be gripings, and frettings in the guts in feavers, and heavi∣nesse of the knees, and paine of the Loynes, they shew that you are to purge downward.

Yet in provoking vomit we must consider whether the sick be easie to vomit, or not, and whether the stomach or any of those parts, which may be moved by vomit and to which the humours, or at least the vapours stird by vomit may flow, be weake, and affected, for then you must ab∣staine from giving a vomit.

Notes

• * 1.1

  What shew the part to be purged.
• * 1.2

  By vomit.
• * 1.3

  By the paunch.
• * 1.4

  Time of the yeare.
• * 1.5

  Symp∣tomes.