SECT. II. CHAP. IV. Of a Tympanie.

ATypany vulgarly,* although not properly, is esteemed a kind of Dropsie, from which rank, Prosper Martianus alleading the testimony of Hippocra∣tes, rejects as well this Disease, as an Anasarca. But the former infessting the region of the Abdomen, and raising it up into a bulk, now comes under conside∣ration next after an Ascites, (to which it is something a-kin): where first of all it is obvious, that this Disease as it is most difficult to cure, so also to be known; for although its outward form, viz. a somewhat hard swelling of the belly, very stiffe and yielding a sound like a Drum, upon touching it, is evidently perceived by many senses together; notwithstanding what may be the morbifick matter inducing that Tumour, or after what manner it is generated in the belly, or from what place it comes thither, is altogether unknown: therefore those who have a Tympanie, as though they were big with winde, are ignorant both of the manner and time of its conception.* Truly I therefore judge the nature and causes of this disease to lye concealed, because whereas its first beginnings are not observed, it suddenly aug∣ments prodigiously; so that they who are affected, do scarce sooner perceive them∣selves to be sick, than that they are become almost incurable. Moreover, a Tympa∣nie, its station being accomplished, degenerating into an Ascites, or rather procuring it to its self, seems to lose its own nature; and truly after death Anatomical inspecti∣on scarce discovers any thing more in bodies dying with a Tympany, than with an Ascites.* But that many Physical Authors do readily declare this Distemper to be raised by wind enclosed within the cavity of the abdomen, doth not at all satisfie a mind desirous of the truth; because it seems altogether improbable that winds should be produced so suddenly, and in so great plenty in that place; or admit they were, that so hard, unmovable and constant a tumour should be raised.

Moreover they do not easily agree concerning the seat of the disease,* where the wind is supposed to be included; for some affirm that this place is determinate in the concave of the Peritonaeum, and by the convex superficies of the Intestines, and other bowels of the lower part of the belly; but affer what manner such a heap of winds can be therein collected, in my opinion it cannot be manifested by any reason, exam∣ple, or parallel instance. Besides, if the case were such, it might be more easily cured by pricking, than an Ascites by a Paracentesis; which yet I never heard accomplisni∣ed. Helmont reports a stinking wind was vented by a Paracentesis,* in one esteemed Hydropick; that suddenly his abdomen sunk, and the man dyed immediately. But Platerius and Smetius, no less worthy of credit, do affirm, They discovered in some who wore thought to have the Tympaine, and dissected after death, that no wind broke forth out of the hollow of the belly, neither that it fell, but that especially the smaller guts being distended, and strutting with winde, burst out so, that they could not be put up again into the same belly.

But truly neither is this observation an argument to me,* that the cause of the disease (of which we treat) remains within the Cavities of the guts, and that the winds ac∣cumulated in that place, do often or most of all raise a Tympanitick swelling of the belly. For besides that, a disease taking rese from such an occasion, would not be of im∣movable, and frequently incurable; moreover, I am induced to think, that the In∣testines are not so greatly dilated by winds shut up in them, but that they often of their own accord swelling out, give occasion to those winds consequently and secon∣darily to be produced, by which the spaces enlarged might be filled, as we shall by and by more clearly demonstrate.

But what is asserted by others,* that the windes which are the cause of a Tympany, are engendered among the Coats of the Mesentery, and Guts, seems yet much more improbable; because when there is no cavity in that place preexistent, after what manner can the winds so tear those parts and separate them froom one and another so that from such formed Denns, the whole region of the Belly should grow into so vast a bulk by accumulated windes there laid up? Certainly so many and so great divulsions could not be made without continual torment and most sharp pains.

Wherefore, omitting these opinions already spoken of about a Tympanie,* let us proceed another way to the more assured searching out its Pathologie; viz. by tho∣rowly weighing by what means, and by what evident causes, the Abdomen is wont to swell up. Wherefore, we advertise there are four kinds of things contained, from which proceeds a tumour in the nether Belly of the living, (why the Abdomen swells in dead personns, the reasons follow hereaster) which kinds are, solid, humid, wind and Spirits.

First, It is obvious enough, that the inward tumours of the bowels,* viz. scirrhous, strumous, cancrous and glandulous, and some perhaps of another kinds, when they rise to any notable bulk, do swell the whole belly; yet in the mean time as long as they are simple, and new, they may be perceived and circumscribed by the touch; yet afterwards growing inveterate, they cause other evils to the neighbouring parts, yea over the whole Region of the Abdomen. Truly these as they are sometimes the procuring cause of an Ascites, so of a Tympany from the beginning, to which after∣wards for a complement of either disease, another conjunct cause gains access, viz. an illuvies of waters, or an irregularity of the Spirits.

Secondly, a watery humour gathered within the Cavity of the abdomen,* or being impacted in the membranous or glandulous parts thereof, frequently produces an Asci∣tes, the reasons whereof, and the manner of its coming to pass, are at large set domn before.

Thirdly, Winds within the bowels of Concoction being reised from crudities,* ill concoction, or fermentation of heter ogeneous humours, do frequently puff up the Cavity of the guts, and for the most part produce a short and transitory tumour of the belly. For the fermentation of the Juices ceasing, and eruption of wind being pro∣cured, immediately succeeds an asswaging of the Belly. To this cause, both the Colick and Tympanie, not only by the vulgar but by Physicians of great note are imputed; but in our judement, when it is solitary it produces neither of these distempers.

Fourthly, There yet remains another sudden, and vast swelling of the belly,* which the animal Spirits, (not for nothing styl'd by Hippocrates violent) seem to procure. For when these in heaps, and inordinately, rush into the nervous fibres belonging to the bowels of the lower belly, presently the parts that these weave together are caused to be puffed up, and extended every where round about. For truly, from this cause (as we have often shewed in another place) a swelling, and as it were a tympanitical puffing up of the whole abdomen, as well in the Colick as in Hysterical fits vulgarly so called, doth often happen. And truly these distempers are so allyed to a Tympany, that they sre∣quently end in it; for I have oft observed, that those who have been obnoxious to the Colick and hysterical passion long and grievously, unless they receive cure, do become Tympanitical. And then the greatest of the difference will be, that the swelling of the belly, which before was a wandring Symptom, and soon passing over, at length grows to be a fixt and permanent disease.

Wherefore, it seems material in this Case, to accommodate th Aetiologie of those passions delivered by us in another place, to unfold the Nature and Causes of this present maladie.

Which truly will not be of any great business or difficulty.* For supposing (what we have in another place more largely set down) the extensions and inflations of the membranes and hollow bowels, take their origine from the impetuous invasions of the Spirits into the nervous fibres (of which they are interwoven) it will be obvious enough to conceive cven a Tympaine to be produeed from such a cause, but being more sixt, and longer, or uncessantly in the act; into the reason of which difference, we will by and by inquire.

In the mean time I am induced to believe a Tympanie not the be stirred up from winds shut up within, or without the Cavity of the guts,* (for such an accumulation of winds in those places, is an effect, but not a cause of this disease) but that it does arise, inasmuch as the animal Spirits, in the bottom of the belly, belonging to the membranous bowels, being forced into disorder by something incongruous, do tu∣multuously rush every where into the nervous fibres, and puffe them up, neither do they immediately recede back from them: from hence the Peritonaeum swells, and the guts being blown up and enlarged, they are as it were inflated, the Mesentery, and other membranous bowels, being turgid with an impetuous Spirit, are as it were raised up into a bulk; moreover, while these come thus to pass, that the va∣cuities caused from the swelling of hollow bowels might be filled, a portion presently Page  116of every humour within contained, being rarified into vapours, forthwith turns into wind, wandring about those empty spaces.

Truly,* we have clearly enough shewn, by reasons and instances in our Pathologie of Convulsions, that the animal spirits puff up the membranous parts by their irre∣gularity, and so produce as it were this windie Distemper. Moreover the fame is demonstrated by Anatomical observation made in dissecting a living Creature; viz. inasmuch as the Trunk of the eighth pair of Nerves, descending on each side by the Neck, if it be taken out and bound with a thred, forthwith all the stomach swells up, as if it were puffed with winde;* which certainly can proceed from no other cause than that the animal Spirits of the fibres of that bowel, and others flowing through the nervous passages, (inasmuch as they being cut off from their origine, are driven into confusion) do tumultuously enter those part, and puss them up. Besides these, for the further illustrating of this Hypothesis, I will relate a History cited by the most re∣nowned Smetius, of an universal Tympany (as he calls it) in a certain young man of Liege: Who when he had received, in a conflict, under his right arm-pit, a wound, made by a prick, penetrating into the Cavity of his breast, next day and night being past, he ap∣peared in the morning after swell'd throughout his whole body, not only in his breast, but also in his back, belly, loins, and in the cods, besides both in his arms, shoulders, neck and face, that he could not open his eye-lids, also on the crown of his head, the skin being every where swolne and tumefied, the tumour was every where extended with great pain. The Author calls this wonderful affection, an Universal Tympanie. The most renowned Sennertus relates a Case like this from his own knowledge: Moreover, I remember I have heard or read of the like from a wound of the breast being reveived near the arm-pit.

Notwithstanding,* the reason of this Symptom, deliver'd by Smetius, and approved by Sennertus, doth not at all please me: for they ascribe the cause of the general Tympanie to the puffing up of the breast, by the axillary wound, made all that night under the skin, as we see a new and moist bladder to be blown up by boyes with a quill: which truly doth not only seem improbable, but also we think scarce possible, that the wind to be blown out of a wound of the Thorax, by reason of the hole one might stopt, can enter the skin, and from thence passing through the whole body, should make it become every where Tympanitical: For besides that the wind cannot so suddenly pass from thence into all parts, although it should be blown with a quill from the mouth, under the skin; besides, while the orifice of the wound is stopt, no wind can altogether be blown out from the Cavith of the breast, because none in the mean time enters. But assuredly the cause of that wonderful affection is this; (whence also the formal reason of a Tympanie is illustrated) In the Breast near the Arm-pits,* are many and eminent fold∣ing of Nerves, (as we have described in our Treatise of Nerves,) by which the nerves of the whole body communicate among themselves: viz. the Trunk of the eighth pair unites with the intercostal Nerve, and both with the nerves of the Spina Dorsi, by branches and sprigs sent here and there. Wherefore, this nervous, folding, perchance being pierced by the point of the Sword, first of all the spirits resi∣ding in that place being provok'd, run into disorders, afterwards a consent being im∣mediately made thorow so many notable Nerves, and transmitted to and fro every where, other Spirits, and then again others, are sensible of the like irregularities, and puffing up the membranous and nervous Fibres (which every where they en∣ter tumultuously) they induce as it were a tympanitical affection throug the whole body. By reason of the like fury or virulent madness imposed upon the Spirits, in any place, and from thence immediately diffused far and wide, certain Poysons be∣ing fdrunk, the strokes of weapons, or of wild Beasts, or a venemous bite, do fre∣quently induce a swelling together of many parts, or of the whole body; which swelling distemper of the Spirits, is styl'd by Helmont to be Indignatio Archaas. There are many other Cases and Instances, by which it is most clearly evinced, that the Animal Spirits being provok'd, and driven into angry inclinations, inasmuch as they do more impetuously enter into the nervous Fibres, are wont first to swell the membranous parts, and to excite many passions out of those, which are vulgarly but falsely ascribed to windes: so that in truth no other cause of a Tympanie can be assigned more like truth.

If it objected,* that the Paunches of the defunct after some time are raised by winde into a bulk, and swell like as in a Tympany: I pronounce this to proceed from the putrefaction of humours, and the extream dissolution of the mixture, wherein Page  117all the active particles depart, being freed one from the other, and flying about seek vent in every place, and distend greatly all obstacles, and chiefly the sides of the Ca∣vities, (which doth not at all happen in living bodies;) wherefore, as all Carkases do not putrifie alike, so their bellies swell sooner or later, more or less: But while life endures, no rottenness or dissolution of particles is made in an animated body, that can bring about a splanchnick fermentation or swelling. In the mean while we deny not, that winds are generated within the offices of concoction, fanguification, and separation, yea within all the particular cells and recesses of our whole body; notwithstanding from them all, unto the winds wheresoever engendred (whilest the Spirits have their due influence, and actuate the nervous as well as moving fibres, that the sides of the howels be not kept distended and rigid) and easie vent does every where lye open. And the truth is, in a Tympany, we allow the wind to fill up the empty spaces, but the spirits, inasmuch as they extend the bowels by their irregu∣larity, do first cause those vacuities, (wherein the winds secondarily and consequently are engendreed) and they (inasmuch as the same bowels are still kept strutted and di∣stended) do hinder those winds from being removed.

And now I judge it is plain enough by what we have said,* that the animal spirits ra∣ther than the wind do raise swellings of the belly in that fort; at least such short and transitory ones, as happen in Hysterical and Colick fits. Notwithstanding there yet remains a great difficulty, after what manner the Tympanitical swelling of the Abdo∣men, which is fixt and permanent, yea for the most part immpovable, can proceed from any such cause; especially, because the Animal Spirits being of their own nature active and very apt to motion, do for the most part so affect removal, that unless they be wearyed or become defunct, they scarce ever lie still.

That I may loosen this knot by reasoning, it becomes us to consider the Nervous Juice together with the substance of the Animal Spirits, which is every where a vehicle to them, and also a bridle: for the Spirits enjoying the most subtile stream thereof, do freely expatiate, and lest being dissipated from one another, they might fly away, they are contained in and entire series. When therefore theat Juice is faulty as to its temper or motion, immediately the animal spirits become diversly delinquent, or are perverted in the exercises of their functions, as we have at large expounded in our Treatise of Paslions. And lest by repeating them now I should make long Preambles, I will contract into a few words what belongs to the present pur∣pose.

Wherefore in the first place, it is to be observed,* that the contents of the nether belly (excepting only the Liver, Spleen, and Kidneys) are furnished with many mem∣branous bowels, (which the nervous fibres for the most part weave together) whence it follows that the nervous Juice (whose journey is longer, and the passages straiter in these parts) doth find here many remora's which also may be proved from the effect, forasmuch as the convulsive invasions, every where stirr'd up in the Hypochondriack, Colick, Nephritical and Hysterical Passions, do so grievously infest the Abdomen. When therefore that Juice watering the nervous fibres of these parts, shall be either viscid or tenacious of it self, or fill them with very many feculencies, for that cause it will come to pass, that all the animal spirits will not easily return from thence as oft as they are hurl'd into these fibres, in some part obstructed: and when in this manner there is a full incursion, and a small return of them, at length it will happen that great abundance of the spirits remain in these fibres every day more and more impacted, and hold them always distended and very much pufft up; and at length by reason of the ways of their ingress and regress in those fibres being obstructed, they become immovable in that place, and keep the affected parts always extended and stiffe: in the mean time because these Spirits there impacted within the nervous passages,* and cramm'd thick, have commerce whit others that flow to them in their dens, therefore the affected part although it be stiffe and almost immovable, yet how∣ever enjoys sense. This Pathologie although it may seem to some a Paradox, and un∣couth, I doubt not but it will deserve assent from many, if it be throughly weighed, that those who have been a long time obnoxious to Hypochondriack, Colick, and other convulsive distempers of the nether Belly, do at length become sick of a Tym∣pany.

The formal reason and conjunct cause of a Tympanie being delineated after this manner, before we proceed to trace out diligently the more remote causes thereof, it may be lawfull for us from what we have said to deliver a definition, of at least a Page  118certain description of this disease, viz. That it is a fixt and constant Tumour of the Ab∣domen, equal,* hard, stiff, and yielding a noise upon striking, taking its origine from a con∣vulsive inflation of the parts and membranous bowels, by reason of the Animal Spirits be∣ing driven into those fibres in too great abundance, and through the fault of the nervous juice obstructing, being hindred from their return back; to which disease consequently an ac∣cumulation of winds in the empty places, accrues as a complement.

As to what appertains to the procuring and evident causes of this disease, it very seldom happeneth that they are altogether observed,* but that insinuating it self by silent beginnings, it frequently is finished, or becomes deplorable before it is per∣ceived; insomuch that against this disease scarce any antidote can be appointed; for while the ordinary functions are not much prejudiced, the swelling of the belly is presumed only to have its origine from winde, and while it is expected to vanish spontaneously, it often grows into a Tympanie. Wherefore that we may have time∣ly notice of its beginning, we may take notice, that some previous affects dispose to it;* of this sort is first an Hypochondriack, Colical and Hysterical disposition, yea and sometimes an Asthmatical; whose fits when they are used to be frequently raised, if at length a tumour of the Abdomen follow it, though it be small in the beginning, a Tympany forthwith may be feared. Of the former of these affects cases every where are to be met with, and stand fair to common observation: of the later Scheri∣chius reports,* That a man of Sixty years of age was infested with this symptome some months before his Belly was swell'd into any manifest tumour, that as often as he sate at meat, beginning to eat, also when composing himself for sleep, he began to sleep soundly, he was surprized with such a difficulty of breathing, that the frequency of it threatned the dan∣ger of choaking; at which time also he perceived a certain palpitation about the Hypochon∣dria, as if some living Animal were underneath the midriff; this distemper afterwards ended in a Tumour of the Abdomen, by which he dyed. In this and other cases now cited the same reason holds, viz. that the animal spirits being used to make irregular ex∣cursions into the nervous Fibres of the lower belly, at length do not only more often and abundantly enter into them, but being impacted and hindered they abide in them, and so at length induce tympanitic inflations of the bowels. Truly this mor∣bific beginning happens sooner of later,* if thereupon do come the evident causes, which disturb the Spirits in the bottom of the belly, and compel them to frequent disorders, and also do either stop the motion or pervert the temperature of the ner∣vous Juice flowing within those Fibres; in which rank are accounted irregularities in the six Non-naturals, immoderate Passions, and chiefly of grief, and usual evacuations suppress'd, drinking of cold water after some great heat, or any sudden cold induced on the belly, either from air or water.

As to the Prognosticks,* this disease is always accounted of so bad an omen that commonly the name is abhorr'd, insomuch that frequently when there is no suspi∣cion of ill from the tumour of the belly, if perhaps that swelling be call'd by the Physitian, a Tympanie, forthwith it is concluded desperate. Notwithstanding this Disease rarely kills of it self, but being protracted a long space of time, that it may at length more certainly kill, it gains to it self an Ascites, as a Harbinger of Death. That we may search into the reason thereof, it will be obvious enough to conceive, while all the bowels are distended in the lower belly, and are held as it were stiffe, the passages of the blood, and nervous and lymphatic humours, being too much ex∣tended, or compressed are much straitened, and for that cause cannot freely and readily transmit its Juice; from whence it follows that every humour being strait∣ned in the passage, that at length it may pass by some means, it shakes off a certain serosity from its masse wherever way is given; and those droppings of the humours falling into the hollow of the Abdomen, excite an Ascitick Dropsie.

What relates to the Curatory part of this Disease,* the whole scope of healing is com∣monly bent against wind, viz. Indications inculcated by practical Authors suggest the matter to be evacuated, from whence the winds are raised, and to remove the cause that lifts them up, and the winds to be discuss'd and dissipated, which do already distend the belly.

For these ends Purgers appointed against the humour chiefly suspected are wont to be prescribed with great confidence, although with small or ill success; that is to say, Phlegmagogues so called, another while those that purge Melancholy, another while those that purge Choler, whereto also are joyn'd purgers of water (as weapons intended against every enemy.) For this disease (as is manifest by our observation) is Page  119wont for the most part to be exasperated with strong Purgers, and seldom alleviated; the reason whereof is evident enough, because the nervous fibres being provok't by a sharp Medicine, the animal Spirits renew their irregular excursions,* and do every where more and more stretch them out, rather than give any remission to them; where∣fore, although frequent and abundant watery and flatulent stools are procured, not∣withstanding the Belly swells the more. Moreover, to dispell, discusse, and bridle the winde, there is a more than Aeolian power prescribed; Medicines commonly call'd Carminatives, almost of every kind or form are sedulously administred, within and without, above and beneath, and upon the part affected; notwithstanding this dis∣ease for the most part is untamed by all these; whence we may suspect, that the true cause of the disease lyes as yet conceal'd, because Medicines profit not that are administred, indicated or suggested according to the ordinary Aetiologie or reason of it.

Although I cannot challenge a better successe in curing this disease, or a more cer∣tain method of healing, attested from experience, notwithstanding in the mean while we will here proffer another way of curing, accommodated to our Hypothesis, and established by reasons strong enough.

Wherefore in a Tympany, as in most other affections,* there will be three chief indications: Whereof the first, and chiefly insisted on, is the Curatory, that by recall∣ing the animal Spirits from their convulsive affection, and reducing them into order, endeavours the removal of the swelling of the Belly. The second Preservatory, which restrains those or other Spirits from their irregular excursions into the lower Belly, and together corrects the faults of the nervous liquor, watering it, both as to its tem∣per, or motion. The third Vital, by removing the Symptoms urging, doth succour and sustain all the functions oppressed or weakened, as much as possible may be.

I. The first Indication is of greatest moment,* on which the hinge of the whole Cure turns, but it is most difficultly performed, for it doth not easily appear by what re∣medies or wayes of administration it ought to be attempted, when most weapons or medicines do little or nothing prevail against this inviolable enemy.* Phlebotomie assumes no place here, but is declined for the most part as prejudicial; also Cathar∣ticks, insomuch as they provoke the affected fibres, and disturb the Spirits, and hurry them more impetuously, do increase rather than diminish or cure the Tumour of the Belly; in like manner Diaphoreticks impell the Spirits and the morbific particles deeper into them, whereas they ought to be allured, and call'd out of the Fibres. The chief order of healing seems to be placed in Diureticks and the use of Clysters; and also great things are expected from topical Applications, because they are more immediately exhibited to the disease, and as it were by contact, and because they do best discusse Tumours in other places. Yet not all Dissolvents are here fitting, nor those which profit most in other Tumours; for the more hot being given for discus∣sing, whether they are applyed by fomentation, Liniments, or in the form of a Ca∣taplasm or Plaister, oftner afford hurt than succour in a Tympanie; for the both open and dilate the passages of the fibres, that from thence they may lye more open to the incursion of the Spirits; and also rarifie the particles impacted, so that while they occupy a larger space, an inflation and intumescency of the Belly is augmented. Lastly, what appertains to Alteratives which succour against other affections of the nervous kinde, only a certain few are fit in a Tympanie; for where the morbific matter sticking within the straiter passages cannot be impell'd straight, or throughly, Elastick medicines render the stoppage greater and more fixt, by enfixing the matter deeper; wherefore Spirit of Harts horn, of Soot, of Sal Armoniack, yea also Tinctures, Elixirs, and other Medicines endowed with a volatile Salt, or active particles of another kind, do not only acquire heat, and a troublesome thirst in the sick person troubled with a Tympanie, but also cause the Abdomen to swell the more, inasmuch as they melt the blood and nervous Juice, and stirre the Spirits, insomuch that the particles de∣posited by each of these, are compell'd into the parts affected.

But truly although Medicine doth so little avail against this disease,* it is not alto∣gether to be neglected, (as if either it effected nothing, or what is ill,) but it behooves us to turn every stone, that by some means we may succour the Patient, and at length may obtain a cure for him, or at least an alleviation. Wherefore in the first place (because it is the custom to begin with Purgatives) although the stronger do ever hurt, and the gentler scarce ever prevail to discharge the conjunct cause, notwithstanding these latter, inasmuch as they do something substract the nourishment of the disease, Page  120also make a way by which other Medicines do exert their powers, they ought to have their turns in physical practice once in six or seven dayes; and at other times let Clysters (whose use is much better) be frequently administred. Hydroticks being prohibited, we must rest upon moderate Diureticks, whereto are adjoyned things respecting the alteration and reduction of the Spirits and Humours, which truly make up the Tympanitical pharmacy. Moreover in the mean time the use of Topicks is not to be neglected. We will annex certain select forms of Medicines appropriated for every of these purposes. For a Medicine mildly solutive, let the laxative Wine be used, prescribed by the renowned Greg. Horstius for a Tympanie, in his book of Observations, lib. iiij. Chap. xxx. or in its place let the following be pre∣scribed with greater ease.

Take the leaves of Peach-flowers,* of Damask-roses, of each two Pugils, Broom, Elder, Centaury the lesser, of each Pugil 1. the leaves of Agrimony, Roman Wormwood, of each one handful, Senna one ounce, Rhubarb six drams, Carthamus-seeds half an ounce, Dwarf-Elder two drams,* yellow Sanders three drams, Galangal two drams, slice them and bruise them, put them into a silk Bag in a Glass, with 2 pound of White-wine, Saxifrage-water one pound, Salt of Tartar one dram and a half, let them stand 48 hours, let the patient drink from four ounces to six, every third or fourth day.

In a hotter Constitution let the following form be taken, which I have proved with success in this disease.

Take of purging Mineral-waters eight pound, Salt of Wormwood two drams, let it eva∣porate in a gentle Bath to two pound. To this I use to adde four ounces of water distill'd from Purgers with Wine; the dose from four ounces to six.

Or to the two pound of evaporated water adde of Mechoacan, Turbith, of each half an ounce, Rhubarb six drams, yellow Sanders two drams, Cloves one dram, digest them close and warm for two hours: filtre it through Paper, the dose 3 or 4 ounces.

Clysters are of frequent use in this Disease, inasmuch as they loosen the Belly with∣out any great irritation of the fibres.

Take of the Infusion of Stone-horse dung with Cammomile-flowers a pound,* Mellis Mercurialis two ounces. After the same manner Decoctions and Infusions are prepa∣red, with Carminatives, from Dogs-dung.

Take of the Emollient Decoction one pound, Sal Prunella, or Sal Armoniack from one dram to a dram and a half; make a Clyster.

Take of sound Ʋrine one pound, Sal Prunella one dram, Venice Turpentine dissolved with the yolk of an Egge, an ounce and a half: make a Clyster.

2.* Diureticks if any other Remedies promise help in this Disease.

Take of Millepedes living and cleansed three ounces, one Nutmeg sliced, bruise them together, and pour upon them one pound of the Diuretick-water prescribed below: Press them strongly, the dose from three ounces to four twice a day.

Take of green Juniper-berries,* and Elder-berries, of each six pound, of Firre-tops four pound, green Walnuts two pound, Cortex Winterani four ounces, the outer Rinds of six Oranges and four Limons, Seeds of Ameos, Rockets, Cresses, of each an ounce and half, Dill∣seeds two ounces, slice them and bruise them, and adde of Posset-drink made with White∣wine 8 pound, distill it in common Organs, let the whole liquor be mixed.

Take of Crystal Mineral half an ounce,* Volatile Salt of Amber, two drams, the pow∣der of Carrot-seeds one dram, Turpentine of Venice what suffices to make small Pills, the dose Numb. 3. in the evening and morning, drinking after it three ounces of the distilled water.

Take of the sweet Spirit of Salt half an ounce,* take six drops to twelve, twice in a day, in a draught of the same water, with a spoonful of Syrup of Violets.

Take of spirit of Salt of Tartar one ounce, take one scruple to half a dram, twice a day, after the same manner; So also spirit of Nitre, and Tincture of Salt of Tartar may be taken.

Take of Plantane,* Chervil and Clivers-leaves, of each four handfuls, bruise them, and Page  121pour on them a pint of the former distilled water. Press them strongly, the dose three oun∣ces, twice or thrice in a day with other Medicines.

Take of Grass roots three ounces, of Butchers-broom two ounces,* Chervil and Eringo candied, of each one ounce, shavings of Hartshorn, Ivory, of each two drams, of burnt Hartshorn two drams and a half, Burdock Seeds three drams, boyl them in three pound of Spring-water to two pound, in it strained hot, infuse the leaves of Clivers, Water-cresses, bruised, of each one handful, adding of Rhenish wine six ounces, make an infusion close and warm for two hours, after strain it again, and adde of Magistral-water of Earth-worms two ounces, Syrup of the five opening Roots an ounce and a half. Make an Apozeme, the dose four ounces twice a day, with some other medicine.

While these are taken inwardly,* also Topicks and outward Applications may be carefully administred; not those which are hot and discussing, but those which are endowed with particles of a volatile Salt, and Nitrous, to wit, those which destroy the Combinations of other Salts, and dissolve the impactions of the Spirits, for which we propound the ensuing things. If Fomentations ought at all to be admitted into use, let them not be applyed too hot, also let them be prepared not of those that are usually call'd Carminative, but chiefly of Salts and Minerals. Cabrotius (cited by Helmont) says, That he cured one of 80 years of age, whose Belly he somented twice a day with a Lye, in which he boyled Salt, Alum and Sulphur, and after applyed Cow-dung for a Cataplasm. I use to prescribe these ensuing.

Take of flowers of Sal Armoniack one ounce, Crystal mineral two ounces,* Spirit Wine small and imbued with much Phlegme two pound, mixe and dissolve them in a glass.

Let a woollen Cloth dipt into this warm be applyed upon the whole Abdomen, and then let it be changed, wetting it again; let it be done for the space of half an hour twice a day, afterwards let there be applyed a Cataplasm of Cow-dung, with the powder of Dogs turd, or the following Plaister.

Take Empl. Diasaponis, that is, de Minio, with Venice Soap,* let it be spread thin upon limber Leather, and applyed to the whole Belly, to be renewed once in ten or twelve dayes.

II. The second Indication requires mostly alterative Remedies, to wit,* those which stop the fermentations of the humours in the bowels of the nether Belly, and the Or∣gasms and irregular excursions of the Spirits, also those which procure equal mixtions and due motions of the Chyle and nervous Juice:* for which end Chalybeates are chiefly in use. And truly it is wont not only in this, but in many other splanchnical Diseases, to have resort to the Medicines of Iron, as if from thence to fetch the sharpest weapons; whenas many Empiricks and Quacks, who prescribe these things confidently and dog∣matically, observe not by what way such a Medicine doth operate, or what alterations for the better may be lawfully expected from thence: wherefore, while Iron, changed into Medicine, although the Sword of Goliah, is snatcht and brandisht by a blind man, it is no marvel if it prove in vain, or if in the stead of the disease, which is an Enemy, Nature it self is sometimes hurt; and truly frequently it happens so, when Chalybeats, of which there is great variety, and diversity of operations, are administred without any choice or difference either of the temperament or constitution in the Patient, and respect to the state of the Disease.

Of Medicines prepared of Iron or Steel, and of their vertues and manner of work∣ing,* we have in another place treated, and there is no need here to repeat the same things. For this disease, if any of them, not all of them are fit; for those in which the frame of the mixture being opened, the Sulphur remains still, and being loosened predominates over the rest, they are altogether to be excluded from this number; for they do much ferment the Juices of the bowels with their notable fermentation, and do so exagitate the Blood and Spirits, that the whole Region of the nether Belly is lifted up into a greater bulk, as if by a certain Spirit thronging violently into it.

Neither here are they fit, from which the sulphureous particles together with the saline are chased away, as in Crocus Martis prepared by long and strong Calcination. For this Medicine as it is conducing to stop all fluxes, rather fixes any impaction of Humours and Spirits, and renders them more obstinate.

But there remains a Martial Remedy of a middle kind,* wherein the Sulphur being wholly or for the most part expell'd, a vitriolic Salt remains and predominates: as indeed it is in the solution of the filings of Iron, or in a simple Infusion, or in Mineral wa∣ter, in the Salt or Vitriol of Mars, in our preparation of Steel, with many others; out of which medicines, being prepared or compounded, we find by often Experience that in some cases, they contribute notable help. For these destroy the exotick ferments of the bowels, and restore the native ferments; they open their obstructions, they fix the blood, and restrain its consistence from too much dissolution; wherefore Cha∣lybeate remedies, after the same manner as certain other alteratives, do perhaps some∣thing profit against the procatarctick, and more remote causes of a Tympany; but as to the conjunct cause, they contribute little or no succour.

Take of our Steel finely prepared two drams,* the distilled water above prescribed two pound, Syrup of the five Roots two ounces, mix it in a glass, let it clarifie by settling, the dose three or four ounces, in the morning, and at five afternoon.

Take of the Powder of Aron-roots, Crabs-eyes, of each three drams, Crystal Mineral two drams, Vitriol of Mars a dram and a half, Sugar of Rosemary-flowers two drams, mix them, the dose half a dram twice in a day with a convenient vehicle.

Hartman doth wonderfully magnifie the liquor of the flowers of Tapsus Barbatus or Mullein,* as a specifick remedy in this disease, by putting the fresh flowers into a Vessel, being strongly press'd, and put into an Oven with bread being close stopt, after∣wards the Liquor being strained, let it be distill'd in Balneo, the dose one Scruple in the Decoction of Fennel-seeds and Roots. Surely this Medicine, if it doth effect any thing, ought to be given in a larger dose.

Johannes Anglus commends an Electuary of Rosata Novella with Diatrion Santalon, and Egges of Ants, which remedy seems to promise something probable enough. In imitation of this I here propound this ensuing.

Take Conserve of Chichory flowers,* of Indian Cresses, of each three drams, powder of Aron-roots, Lignum Aloes, yellow Sanders, of each one dram, Crabs-eyes one dram and a half, Salt of Wormwood one ounce, Ants Egges one ounce, the liquor of Tapsus Barba∣tus half a dram, with a sufficient quantity of Syrup of Citron-rinds make an Electuary, the dose two drams twice in a day, drinking after it of the former distilled water, or of the following Julep three ounces.

Take the water of the leaves of Aron,* of the Juice of Elder-berries, of the water of Juniper and Elder-flowers, of each six ounces, the magistral water of Snails, and of Earth worms, of each two ounces, Syrup of the Juice of Elder-berries two ounces, mix and make a Julep.

III.* The third Indication Vital prescribes Remedies against fainting of Spirits, and difficult breathing, and against Watching and Thirst. We will briefly annex certain forms of either kind.