SECT. II. CHAP. V. Of an Anasarca.

NOw two kinds of Dropsies, viz. Ascites and Tympanie (according to common reckoning) being finisht, although the third, to wit an Anasarca (for that it is an affection rather of the whole body, than of the nether Belly) ap∣pertains not properly to this place, notwithstanding the Pathologie thereof having some affiance with the former, we think sit to deliver here also its Cure in short.* An Anasarca is described after this manner, That it is a white soft Tumour of the whole out∣ward Body, or of some of its parts, yielding to the touch, and leaving a dent upon compression, proceeding from a watery humour extravasated, and accumulated as well within the interspaces of the Muscles, as within the pores of the flesh and skin, yea of the Glan∣dules and Membranes.

It differs from an Ascites as to its outward form and appearance,* yet not as to its morbific matter, which being the same in both distempers, as it is heaped within the greater or lesser hollownesses, it gains divers Appellations of the Dis∣ease.

The watery humour procuring an Anasarca,* doth proceed altogether or for the most part from the blood; for it being continually produced within the mass of blood by the fault and defect of sanguification, it is poured out in greater abundance from the extremities of the Arteries, than can be received, or brought back by the Veins, or the Lymphaducts, or can be discharged by the Reins or pores of the skin, and other vents of the serous Juice.

From these it follows, that the material cause of this Disease is a watery humour,* and the efficient is blood, which engenders waters and deposits them in the places affected. We will exactly weigh the reasons of either of them, and the manner of becoming and effecting it, and first we will treat of the efficient Cause of an Ana∣sarca.

1. The affection of the Blood, or rather the Hydropical brood,* consists in these two things, to wit, First by reason of a failure or fault of sanguification, it doth not rightly assimilate the nutritious Juice perpetually infused into its mass, but suffers it to degenerate into a watery humour: Then secondly by reason of the too loose mix∣ture thereof, it doth not retain that humour, so degenerated, so long within its consistence, untill it might be discharg'd through fit Emunctories or Emissaries, but lets it out every where near to the ends of the Arteries, into the inter-spaces of the Vessels, and there leaves it. Either of these vices of the Blood we will consider a little more.

In the first place as to the former, for the most part it is confessed by all,* that the Blood it self and not the Heart or Liver sanguifies, by what of late is plainly understood concerning the functions of these parts; yet by what means the Blood assimilates Chyle infused to it self, and converts it into fresh blood, to be bestowed to so many and diverse sorts of uses, doth not easily lie manifest to us. But what some affirm, that it is made only by the exact comminution and commixtion of particles, and for that cause the particles of either kinde being confused together, they think, that within the Page  124straiter passages of the Liver and Lungs they are kneaded and wrought together as it were with little pestils, seems little probable to me; but on the contrary, I think these bowels (as I have shewed already) are constituted the Organs rather of separation than of mixture;* but the reason of sanguification altogether consists in this, that the active particles of the old blood, to wit, the saline and sulphureous, being placed in vigour with the spirituous, immediately act upon the like particles of the infused Chyle as yet existing in an inferiour state, and do so stir them up and ferment them, that thereupon being extricated from the coverings of the thicker parts, they are carryed into a like degree of exaltation or perfection with the former, and being at length associated with them, and made also homogeneous, they put on the same nature of Blood; the more thick and heterogeneous particles being removed thence to another place, from those which they had deserted and gone away from. For tru∣ly Sanguification is altogether finisht by Fermentation, even as the maturation of the Must into Wine or Ale; but the reason of the difference is, that Wine being shut up in the Tub, still remaining entirely in the same Mass, is flowly fermented, as to its whole consistence, and is not accomplished but in a long space of time; but the Blood constituted in a perpetual flux by the loss of some parts and the reparation of others, is fermented by the parts still received fresh, and is generated anew.

The old Blood for the most part affords the same thing towards the fresh Chyle,* as Ferment from the flower or faeces of old Ale, being put into new Ale; notwith∣standing as it were by a contrary manner; because the huge mass of blood being for∣merly fermented, doth suddenly ferment and alter the small portions of the Chyle continually brought in; but the fermenting liquor in Ale in a very little quantity is put to the great mass of the other liquor to be fermented; which it brings not to maturi∣ty under a long space of time. After the rudiments of blood are so cast by fermen∣tation, the conclusion and perfect assimilation into blood, is acquired by accension; (for surely that it is so enkindled (as I think) I have formerly shewed by demonstration, which arguments chiefly taken from its proper passion, although many have cavil'd at, none have been yet able to overthrow.) Wherefore, while the whole mass of blood consists of Blood and Chyle confusedly mixt together, it is fermented while it is circulating; andbeing divided into most minute portions, is spread through the whole Lungs, that it might be kindled successively according to all its parts, by the nitrous air suckt in: for by that means both the vital flame is continued, and all the particles of Blood having as it were passed the fire, become more purified, and more agreeable among themselves; moreover, they are so disposed of whilest they are kindling, that while some go into Nourishment of the Spirits, of the Nervous Juice and the folid parts, and others less useful depart into the ferments or recrements of the bowels; mean while others being more fixt, abide longer in the mass of blood, and sustain its consistence, and by fermenting the Nutritious Juice, still engender new Blood, untill themselves being impoverished, are at length discarded, and give place to others that are fresh and Iustie.

Having shewed after this manner by what course Sanguification ought to be finish∣ed,* as well by fermentation as accension of the Blood; it will be easie to conceive wherein the fault confists producing an Hydropick dispdsition: To wit, this usually assumes its rise whensoever either or both those Conditions requisite to Sanguification, ether fail, or are perverted.

First therefore this bappens more frequently and rather,* for that the blood being depraved in its temperature, doth not rightly ferment the Nutritious Juice poured into it, that so it might be changed into laudable blood. For when the watery par∣ticles predominate with the earthy in the mass of Blood, the Salt and Sulphur being depressed with the Spirit, as all the functions, both Vital and Animal, from thence languish and waver; so especially Sanguification it self fails and is perver∣ted. For the Juice of the Chyle commixt with the Blood, when it cannot be dissol∣ved and fermented, with the particles thereof, (after the fashion of other liquors, as often as being mixt they want ferment,) it degenerates perhaps into a watery, acid, or ropy, or otherwise faulty humour, which being afterwards daily encreased, and at length rising to its fulness, lyes heavy on the blood, and oft-times almost stifles its heat; from whence there is a necessity that it be forthwith discharged by some means, and wheresoever it can get vent; but afterwards for that the offices of sepa∣ration fail in their sunctions (the stock of the animal Spirits Languishng by reason of the diminished provision from the influxe of Blood,) the abounding Serum is deposited Page  125every where into the pores, and next vacuities whether greater or lesser, out of the little moughts of the Arteries; from whose daily and great encrease, after all the pores are filled, arises that as it were fenny habit call'd Anasarca of the whole body out∣wardly, or of some of its members.

Secondly, not only the defect or fault of Fermentation,* but also of the accension of the Blood, induces sometimes an Hydropical disposition on the mass thereof: which is clearly discern'd, inasmuch as some persons inhabiting Maritime or moorish places, fall into the Dropsie without any other cause or occasion, than that they draw a thicker air endowed with heterogeneous vapours, by which the Nitre is either driven away or obscured. Therefore the blood becoming degenerate, and vitiated as to its temperature, because it is not duely kindled, nor perfected by efflagration within the precordia, doth not rightly dissolve and assimilate the Juice of the Chyle, but suffers it to be perverted into a watery liquor. But although in the first place, the blood being depraved for this reason, sometimes loses its fermenting vertue, and there∣fore the rather and more immediately procures a Dropsie; notwithstanding it is ma∣nifest, the first fault thereof assumes its origine from unwholsom air suckt in, and not duely enkindling the Blood; because such Hydropicks removing their resi∣dence into Sunny and Mountainous places, recover their health without any other Medicines.

Hitherto of the nearest Causes of an Anasarca and which are conjoyned to the Dis∣ease it self, which namely are the depravation or defect of the mass of blood, chiefly as to its fermentation, and in some measure as to the enkindling thereof; which latter is scarce wont to be effective but when if follows the former: But what remains as to the more remote and procuring causes of this Disease, to wit, from which the defer∣mentative affection arises (that I may say no more of the defect or depravation of its enkindling;) I say that these appear so diverse and many, that I judge it hardly pos∣sible to recite them all particularly; notwithstanding, very many or at least the chief may be reduced to these three heads: to wit,* For that the watery distemperament of the blood doth arise, inasmuch as its active Principles, viz. Spirit, Salt and Sulphur, are not invested with their fermenting and sanguifying force or vertue, I account this to come to pass, either First because those particles are too much wasted by their great expences; or Secondly because they are not repaired by convenient and propor∣tionate Refections; or Thirdly, for that they are overwhelmed or obscured by some other duller or heterogeneous Particles being too much accumulated in the mass of Blood: We will a little weigh the Reasons and ways of each of these their coming to passe.

In the first place, the former of these is evidently discerned in frequent and inor∣dinate Haemorrhages, whereby many men, although strong and formerly healthy,* are immediately enclined to a Dropsie, more than from any other accident or occasion; the reason whereof is, that the blood is so impoverished, through its more noble Par∣ticles issuing out in great abundance, that afterwards it can neither duely ferment nor enkindle the Juice of the Chyle brought into it. Moreover, sometimes the same effect fucceeds (although in a more slow degree) from Feavers and other long mala∣dies and languishings; to wit, inasmuch as the blood suffering under a long depressi∣on, is so extenuated and robb'd, that at length it becomes watery and defermenta∣tive.

Secondly, the Blood sometimes deferting its genuine disposition,* declines into an Hydropical one, for that the nourishment being more slender than it was wont, or ought to be bestowed upon it, its active and sanguifying Particles are not enough re∣paired within its masse; for so we have observed, that some who have used themselves to Wine and stronger Drink, after they have been reduced to homely Diet, and smal∣ler drink, of water of small beer, suddenly have become Hydropick. It is a com∣mon observation, and frequently true, although of ill omen, that Drunkards, and darly drinkers, if that wild Custom be left, at length becoming sober and abstemious, are much in hazard, lest by reason of the usual fermentation of the blood being denressed, they become obnoxious unto that Disease. I knew a notable Drunkard, who declared that a Priest very learned and Pious was guilty of his death, because he gave him admonition to Temperance, and to leave his Drunkenness,* and he complying therewith, incontinently fell into a mortal Dropsie.

But the third cause or occasion disposing to that Disease, the most common and no∣table, consists in this, that the active Particles of the Blood, being involved with Page  126other more dull or heterogeneous ones, or being dissipated from one the other, lose their fermentative power, or cannot enough exercise it. But such an affection of them, as it is wont to be raised from various causes and accidents, so chiefly from these, three,* one while solitary, another while united together; to wit, First from the Non-naturals immoderately received: Secondly from the Naturals unduely retain'd; or Thirdly, from the Preternaturals corruptly generated in the body.

The errors of Diet deservedly may be referred to the first rank of these (whereby the stock of that Disease is always most abundant) For it is a common Prognostick and in every bodies mouth,* that Gluttons and great Drunkards dye at length of a Dropsie: to which moreover, not only Surfeits and immoderate and daily Tiplings incline, but also frequent and unseasonable Treats; and moreover the continual pour∣ing in of absurd and hard to be digested Nourishment. For from the evil course of Diet of each kind used any while, whenas the Juice of the Chyle, oftentimes crude, in∣congruous, and above measure plentiful, is poured into the masse of blood, it of necessity follows, that it is first burdened, and afterwards its Consistence being loosened, the more noble Particles being forced asunder, it is so involved, or abated by the other heterogeneous ones, that being hindred, it desists from its fermentative or sangui∣sying virtue; insomuch that the bowels being in a short time hurt by its assaults, a Cachexia, and then a Dropsie sollowes, whereof that is alwayes a forerunner.

Secondly,* in this place are put all ordinary, accustomed and solemn Evacuations suppressed. It is observable enough, that a Cachexie, and often a Dropsie, doth arise from a menstruous or Hemorrhoidal flux dimmished or stopt, no less than from a too immoderate one, (by reason of the fermentation of blood impeded by the heterogeneity of Particles.) Moreover, the same is often wont to be effected from Issues suddenly stopt, or eruptions of the Skin suddenly repercuss'd. Lastly, suppressi∣on of Urine, and sweating much hindred, do render the blood more watery, by an immediate and necessary affection, and incline to the Dropsie. Also it is an observa∣tion frequent enough fo healthful Persons, who being compelled for some time to ab∣stain from going to Bed, that their feet have swoln.

Thirdly,* Preternatural things generated within the Body, but especially Tumours and Humours do hinder the motion of the blood, or pervert its temper, and so in∣duce an Hydropical disposition. Tumours stirred up in some place about the Bowels, inasmuch as they hinder or straiten the circuit of the Blood, do cause its Serum to be there extravasated, and poured out; by the accumulation whereof within some cavi∣ty, in the first place an Ascites (as we have shewn above) and at length an Anasarca a consequent of that doth frequently ensue.* Moreover, Humours of divers sorts be∣ing engendred in divers places within, and transferred into the blood, do first pollute the masse thereof, and defile it with heterogeneous Particles, whereby at length it is so depraved in its temperament, that it perverts the Juice of the Chyle brought in (when it cannot further ferment and assimilate it) into an hydropical liquor. For this reason, nothing is more usual than that Consumptive persons, and those that are affected with strumous and cancrous Ulcers, nay of any sort within the Reins, Mesen∣tery, Guts, or other Bowels of the lower Belly, after they have been long consuming, dye at length hydropical.

Hitherto concerning the next efficient cause of this Disease,* also of the chief re∣mote ones, as well procuring, as evident. But as to what appertains to the material cause, it is obvious unto the Sense, that it is a meer Lympha accumulated within the pores of the Skin, and of the other outward parts; which being deposited there by the blood (the liquor thereof being partly serous, and partly chylous Juice) but fail∣ing in Sanguification and Nourishment of the body, to which it was destinated, it is cast off like recrements into the vacuous spaces of every vessel. And though the matter of the Dropsie proceed from the Blood and Chyle, yet it is no wonder if it appear nei∣ther like blood, nor milkie, but only limpid; because the Urine even of healthful people, after more plentiful drinking, is rendred crude as well as watery; and there∣fore it is manifest, it is nothing changed by the blood, but leaves in that place, what∣soever of colour or thicker consistence it brings to its masse. And although a reason may be given in either case, that the Urine, inasmuch as it is streined through the Kidneys, and the hydropic matter thorough the pores of the solid parts, even so become limpid and watery; notwithstanding it is evident by observation, that the watery part of the Chyle, even while it is confounded with the blood, is not inti∣mately mixt with it, but being deprived of its colour and consistency, it remains under Page  127the form of Lympha, within the pores of the blood; the sure sign of which is, that the blood taken from any Animal by Phlebotomy, after being cold it is divided into parts,* exhibits a watery liquor (which consists of Serum and Nutritious Juice) plainly limpid, and separate from the other blood. It will be from our present purpose to enquire any further into the reasons hereof, and manner of being so, and where∣fore blood, which being poured into water doth presently tinge the same, and bloodies all solid bodies whensoever it is sprinkled thereon, yet dyes the Serum of no colour with which it is intimately confounded and a long time circulated.

From the AEtiologie of this disease now delivered,* the differences of it may easily be collected; to wit, first it is either universal, when the whole habit of the body and all the members swell up; or it is particular, wherein for the most part the in∣feriour members only suffer, in the mean time the rest of the body pining away for want of Nourishment, which kind of distemper, and not a Tympanie, Prosper Martianus will have Hippocrates style the dry Dropsie, in which what is reported of the Syren, the dry is joyned to the watery.

Secondly, an Anasarca whether universal or particular,is either simple of con∣plicated with an Ascites; and then either an Anasarca ensnes an Ascites, or this dis∣ease follows that. Moreover an Anasarca may be distinguished many ways in respect as well of the procatarctick as evident causes, as we have before intimated; and such differences thereof are found to be frequently fo great moment about duely institu∣ting the Prognostick and Cure.

Wherefore, what relates to the prognostick part, this disease while it is simple,* proves least dangerous among all the kinds of Diopsies; and a particular one seising only the inferiour members, so that the belly doth not together swell with them, in much safer than an universal one.

An Anasarca bringing on an Ascites, wherein for the most part the Urine is plenti∣ful enough, and the thirst not very intense, is far more safe than an Anasarca brought in by an Ascites, wherein the diseased do very much thirst, and make little, red, and thick, and for the most part a lixivial Urine. In like manner it is, or worse, when an Anasarca comes upon a Tympanie or a Phthisis (as sometimes 'tis wont.) Lastly, no slight Prognostick of this disease is taken from the complyance, or the ob∣stinateness of the Patient, about Diet and Medicine. For whatsoever the condition of the disease may be, if the hydropick person refusing medicine will indulge his fancy, we may not hope any good from thence.

About the Curatory part to be designed in order,* two chief Scopes of Healing do occurre, viz. First, that the water between the skin be consumed by some means; Secondly, then provision must be made, lest it be continually generated and accumu∣lated afresh; for which purpose a Physitian is to employ his labour, both that the bowels of Concoction being emptyed of their Superfluities, and free from obstructi∣ons, may always procure laudable Chyle, and supply the masse of blood in due plenty; as also that the blood (the principles thereof being restored to its sermenta∣tive power) may orderly ferment the Juice of the Chyle continually poured into it, and assimilate it into Blood. The vital Indication seems not at all necessary in this disease as in many others, for that very rarely in this appear swoonings of the Spi∣rits, or Watchings, for which Cordials and Hypnoticks are required; and there is little need of restoring Diets, because Fasting and Abstinence rather help, and oft∣times make up the greatest part of the Cure: the reason whereof is, that the Vessels being emptyed through want, do swallow up the waters between the skin, or stag∣nating in other places, and do discharge them forth partly by the Kidnies, by the pores of the skin and other Emunctories, and partly do adyantageously employ them being yet turgid with alimentary Juice, to the nourishing of the body.

First, That the first Indication being Curatory,* intending an Evacuation of th morbific matter, may be performed, there ought to be exhibited all Hydragogue medicins, as well simple as compound; and also the froms of medicines recounted and prescribed in the former Chapter of an Ascites. Moreover, hereto belong not only Catharticks and Diureticks, but also Diaphoreticks, which though in other sorts of Dropsies they are very much forbidden, often take place in curing of an Anasarca.

In a simple Anasarca we may lawfully administer strong Purgers,* and frequently they much profit. And truly this Disease being cured sometimes by means of a Ca∣thartick, Empiricks do much glory of their Cures, and certain of their medicines be∣come much cryed up for curing hydropical persons; for if at any time it happens Page  128that they have healed one or two labouring with an Anasarca, by their specifick Hy∣dragogues and Elateriums, it is enough wherewith they may always magnifie them∣selves and their Art, although by the same medicine they have murdered a hundred Ascitical persons.* Wherefore, although Preparations of Spurge, or Elaterium, Pilu∣lae Lunares, Hercules Bovii, and other Hydragogues, have sometimes profited in some cases; notwithstanding if they be indifferently exhibited to all Hydropicks, or at all to any endowed with a weak Constitution, and Bowels of a brittle tone, or of evil conformation, they oftener cause death than remedy: wherefore let it always be committed to the judgment of a prudent Physitian, the time when, how long, and what sort of Catharticks are to be used.

We have before described froms of Hydragogue Purgers of every sort, to wit, those that exercise their power upwards and downwards, and as well mild as strong∣er workers, so that they may be referred hither, and accommodated to the method of healing now proposed.

But if the reason be enquired,* after what manner Purgers do operate in this dis∣ease, and why they more happily, and much more efficaciously bring out waters than in any other sorts of Dropsie; I say, in an Anasarca the morbific matter (which is the Lympha) subsists partly in the mass of blood, partly in the habit of the body, within the pores and vacuities between the ends of the vessels; wherefore, a strong Cathartick being administred, presently troubles and dissolves the mass of blood, and stirres it up to the excretion of any superfluous or heterogeneous thing; and irritates also the little mouths of the Arteries gaping towards the Cavities of the Intestines, that the humour ejected from the blood may easier find vent through these Emunctories. From hence in the first place, the waters fluctuating within the blood are abundantly drained out, afterwards the vessels being emptyed, do pre∣sently swallow up again the waters between the skin, and presently discharge them forth partly by siege, and partly by Urine, or Sweat; in the mean time there is no fear lest, as in an Ascites, the morbific matter being driven and poured from the blood, by the Medicine, should be further forced into the places affected, whence not easily flowing back again, it should be more largely encreased; nor lest, as in a Tym∣pany, by reason of the Fibres of the Stomach and Guts being too much irritated by the Physick, those bowels might be provok'd into convulsive swellings. For as long as the bowels are firm and well constituted, the particles fo the Medicine inflict them with no hurt; but presently being brought into the blood, they do not only allure waters out of it, but by exagitating the mass thereof, they raise the active particles formerly overwhelmed, and dispose them towards their fermentative power.

Secondly,* Hydragogues working by Urine, as well simple as the compound, as also forms of Medicines prepared from either of them, and the manner of their ad∣ministration, we have also described above, which also may be transferr'd hither to save repetition.* But because not all Remedies of this kind do help alike in all the Distempers, it is here observable, that for curing an Anasarca Lixivials (as has been frequently manifest by our observation) do far excell other Diureticks. For indeed now it is a common and thredbare Remedy, for any one having swell'd members, after a previous Purge, to take twice or thrice in the day, from six to eight ounces of a Lye made of the Ashes of Wormwood or Broom, made in White-wine, and to con∣tinue the use of it for some dayes. This Medicine moves potently the Urine as I have observed in many, yea sometimes in such abundance, that pissing the quantity of half a gallon in a day and a night, the Patients have recovered their healths in a short time even to a miracle.

We have unfolded in a former Treatise,* by what manner and fashion Diurticks of several kinds do operate, and after what manner they affect the bowels, blood and other humours: But that in those that labour under an Anasarca, Medicines endow∣ed with a fixt and lixivial Salt, expell Urine more than those of an acid, alcali, or volatile Salt, the reason as I judge is this, viz. in those affected with this disease, after the fermentation and sanguisying vertue of the blood failing, the watery and crude humours heaped up as well in its mass as in the habit of the body, do there remain almost immovable for a long time, till at last they (as the manner is of watery Juices long stagnating) do wax soure; wherefore the lixivial particles of the Medicine spread abroad in the blood presently boyl up with the acids of the waters, which while they serment and move, they stirre up in the whole mass of Blood, a notable and excretive fermentation; insomuch that all the particles being put into motion, Page  129not only the watery and superfluous being thrust from the rest, are discharged by the Reins; but also the innate and active particles of the blood it self, unfold themselves from the more gross with which they were involved, and lastly rising up, they begin to resume their fetmenting power, and to sanguifie.

Take of the Ashes of Broom or Wormwood,* or of the twigs of a Vine calcined to white∣ness and sifted, sour ounces, put them into a glass bottle with a quart of White-wine, let them digest close stopt and warm for three or four hours, after strain it j the dose froms six to eight ounces twice a day.

Take of white Tartar calclned with Nitre, and after melted in a Crucible to blueness three ounces, small Spirit of Wine a pound and a half, water of Snails and Earth worms, of each four ounces, digest them in a Sand furnace for two days: the dose of the clear liquor from two to three ounces, with sour ounces of the decoction of Kneeholm and Burdock-roots in Ale.

For ordinary Drink:

Take of the white Ashes of Broom cleansed two pound, put them into a little Bag, with three ounces of Sassafras, one ounce of lesser Galangal, an ounce and a half of Juniper∣berries, and as much of Carrot-seeds, make a bag for four gallons of Ale, after seven or eight dayes begin to draw it.

3.* Diaphoreticks od often very hotably help in a Leucophlegmatia (which is the commencing or declination of an Anasarca) but in this disease confirmed, they are wont to be more convenient than in other kinds of Dropsies. And although from the beginning they cannot cause Sweats, by reason of the habit of body surround∣ed as it were with a more thick marsh, however while they exagitate the blood, they cause the innate active particles thereof, being before dormant, and half overwhelm∣ed, to be raised up and disposed towards fermentation, and also they cause all the excrementitious, and chiefly the watery, to be raised into motion, so that presently flowing out of their Receptacles, they may the more readily and easily find way by siege or Urine, and oftentimes in some part by transpiration. But truly after the waters being poured out by purgation, the morbific matter is diminished so much, that the bulk of the body and the swelling of the members begin to abate, the reliques of the humour are best consumed by a moderate transpiration and constant sweat∣ing.

We have described before the number and forms of Hydroticks;* as to the present purpose for curing an Anasarca, those chiefly are fit which are given in a larger dose; for they whose quantity is very small, their active particles being overwhelmed in the waters, are lost before being infused into the blood they can exert their strength. Wherefore, Spirits, whether armoniack or vinous, as also Tinctures and Elixirs, yea and powders, are more rarely used in this disease, because they effect little in a lesser dose, and if they be exhibited in a very large one, they often hurt the bowels by their outrage; But those things are rather chosen, which being taken hot, and in a full draught, are able to pass into the whole blood not weakned; of which sort, in the first place are Decoctions of Woods, and Roots, whose particles being agreeable enough to the Blood, and not to be tamed thereby, do pass through the whole mass thereof, and do exert their Elastic power by moving together all the humours.

Take of the Shavings of Lignum Vitae six ounces,* of each of the Sanders six drams, shavings of Ivory, Harts-horn, of each three drams, let them be infused and boyled in eight pound of Spring-water to half; adding of Calamus Aromati∣cus, lesser Galangal, Burdock and Butter-Bur-roots, of each one ounce, the leaves of Sage, Germander, dryed, of each two handfuls, let the strained liquor be kept for use; the dose from eight to ten ounces twice in a day warm; to every dose may be added 20 or 25 drops of Spirit of Sal Armoniack drawn with Amber, or of Spirit of Soot, or half a dram, or a dram, of Tincture of Salt of Tartar.

Hitherto of inward Hydragogue Medicines,* which cause the Lympha to be drawn forth, either by alluring it inwards towards the guts, or by driving it forth to the Reins or pores of the skin. Besides, there are certain outward administrations in use, by which the water accumulated within the habit of the body are moved toge∣ther, Page  132and so are either generally disposed to go forth by sweating, or Urine, or par∣ticularly are sent out forthwith, a vent being made in some private places.

In the first rank are placed Frictions,* Liniments, Fomentations and Baths as well dry as moist: Then those particular things that bring out waters are, Vesicatories, and things that bring the Skin to an Eschar, and pickings by a Needle. We will treat brief∣ly on each of these, or at least of the principal of them, as far as they have reference to this disease.

1.* Frictions do frequently afford advantagious success in a Leucophlegmatia and an Anasarca: for when the habit of the body is not only filled with a watery il∣luvies gathered there together, so that nothing can evaporate, but that the extern parts grow cold by reason of the approach of blood towards them being stopt, often and stong frictions do move together the stagnating waters, and dissipate them from thence in some measure, and also recall again the blood by opening the passages into those parts from whence it was banished; wherefore, not only the swoln members, but also the whole body once or twice in a day, is expedient to be rubbed with a course Cloth, or with a little Brush now ordinarily prepared for that purpose.

2.3.* With or after Frictions, Liniments and Fomentations are sometimes con∣venient. They are prepared either of Salts, and other Minerals dissolv'd, or from hot and discussing Vegetables, with the faeces of Wine boyl'd in water, the hot ap∣plication whereof opens the pores, moves together more amply the accumulated wa∣ters, and discusses them, and also enlarges the compass of the bloody Circuit, the watery heap being somewhat dissipated. Let the Liniments consist of Sulphur, and Salts of a diverse kind, or of Quick-lime, and other Minerals, which being powdered and mixed with the mucilaginous Extracts of sharp Herbs, are reduced into the form of an Unguent; to which let a fit quantity of Oyl of Scorpions be added, for the better consistency. Moreover this Oyl (so it be genuine) applyed by it self, doth frequently afford notable help. I knew a Boy much swell'd with an universal Ana∣sarca, who was cured by this Remedy alone: for his mother (I know not by whose advice) anointed his whole body morning and evening with Oyl of Scorpions, strong∣ly rubbing all the parts with her hot hand; by which act within three dayes he be∣gan to pour forth abundance of Urine, and when he had continued pissing so for some dayes, the swelling vanishing by little and little, he became sound.

4.* Baths are not convenient in any Dropsie but an Anasarca, and not for this un∣less in a Diathesis or Declination. For seeing the Blood from the heat thereof, en∣compassing the whole Body, being made boyling and stirr'd up, every where puts in motion the waters formerly stagnating, and swallowing them up into it self, con∣veys them variously away; the danger is, lest (as frequently it falls out) receiving them out of the habit of the body into its own mass, it should depose them presently into the Praecordia or the Brain: for there in noting more usural than an affection of those parts, viz. an Asthma or Apoplexie to come upon Hydropicks by unseason∣able bathing. But when the conjunct cause of the disease (viz. a Swelling) becomes moderate, or not much, a Bath of water impregnated with Salts and Sulphur, or a Hot-house, by which a gentle Sweat is promoted, is frequently administred with suc∣cess: As for the Stew it is more expedient, and oft-times notably helps, that the Patients be placed in fitting Seats in Salt-houses, near the Furnaces wherein Mineral Waters are boyled into Salt.

5.* Vesicatories send out abundantly the waters between the skin, and often too profusely. Touching the manner how they operate we will treat more specially here∣after; in the mean time we advise, that they are very cautiously to be exhibited to Hydropicks, for that Epispasticks of this kind, applyed to the swell'd places, do make the Emissarie too open, by which apertion the water in the first place burst∣ing out, draws oftentimes a great illuvies after it from the neighbouring parts, whence immediately ensues a great prostration of the Spirits. Moreover, some∣times the place is so suddenly emptyed, that being destitute of heat and spirits, it is in a short time sphacelated or mortified; wherefore this Medicine is seldom ap∣plyed to the Legs, or the Feet of Hydropical persons, where the heat is weak, and the humour greatest, but sometimes to the Things and Arms with security (as often as there shall be need.)

6.* Escharoticks are administred a little safer than Vesicatories, to the swell'd pla∣ces, because from this Emissary the flux of waters happens not so headlong and abun∣dant at first: but commencing moderately grows up by little and little to a great Page  131stream, which Nature (after that by degrees it is accustomed thereunt) endures the better. Moreover, there is less fear of a Gangrene from an Escharotick than from a Vesicatory, because in that application the part, whose union is dissolved, is defend∣ed by the Eschar against the loss of heat. I have known sometimes an illiterate and rude Empirick, who frequently by an Escharotick did evacuate with success the mem∣bers of hydropick persons, however swell'd, by the ensuing manner: to wit, he fo∣mented the legs evening and morning with the Decoction of Dwarf-Elder, Worm∣wood,* Cammomile and other hot herbs put into the Lees of Ale of Wine; and between the times of the Fomentations he applyed a Cataplasm prepared of the masse of that Decoction with Bran; after he had used these for three dayes, he co∣vered both legs and seet with a Plaister of Burgundy Pitch, leaving only a small hole on each Calf, about the bigness of a Nut, in which places he put an Escharo∣tick, on the bare skin, of the Ashes of Ashen-bark: which after twelve hours being removed, a small Eschar was left, from whose pores water was wont at first slowly to sweat out, afterwards day by day a little more plentifully to drop out, and after∣ward (the Eschar falling off) it used to flow out more abundantly as from an open Spring untill it had drein'd the whole leg both beneath and above.

7.* There remains another manner (not inferiour though less used than the former) of draining out the waters between the skin, viz. by the pricking of a Needle; which likewise ought cautiously, and minutely to be used, lest a headlong and too great efflux of waters be provok'd thereby. Take an ordinary Needle (such as Taylors use) and let it be thrust into the skin, pricking over the place chiefly swelled, only so far that blood follow not: and so at one time let six or seven little holes be made, a thumbs breadth distant from each other; from every little hole the water will issue forth by drops, and so it will contiually drop out untill all the swelling vanish about the place so pricked; afterwards, the next time after twelve hours, another while after 18 or 24 hours, let the same pricking be exercised in another part of the same thigh, or of the other; and afterwards once or twice a day in this or that member, or in both together, or in more places, let such Emissaries of the water between the skin be excited. For in truth after this manner the hydropick illuvies may be ex∣hausted more plentifully and safely than from any other outward Chirurgery; In the mean time if the new provision thereof be provided against by inward Physick, the disease will be the easier cured. Moreover in a desperate Dropsie life is best pro∣longed by such an administration, for that the waters being exhausted continually by those outward Emissaries, the inner inundation of life is longer protracted. Not long since an old man aged seventy years, overwhelmed with a Dropsie over his whole body, by the help of this Remedy only, remained living for many moneths beyond expectation, and raised his head above the waters.

Hitherto of the Kinds and Forms of Remedies suggested by the first Indication,* viz. the Curative; what belongs to the other, to wit the Preservatory, which respects the temperature and sanguisying power of the Blood to be restored, it offers Medicines of that sort which being endowed with more hot and Elastick particles, revive the active or depressed Principles of the mass of blood, or cause those consumed to be repaired, for which end Remedies commonly called Altering are wont to be prescri∣bed under the form of an Electuary, Powder, Pills, distilled Water, Julep,* Apozeme and Diet, to which also Spirits, Tinctures, Elixirs, are sometimes added, for the bet∣ter essicacy. We will propound one or two Examples of each of these.

1. Take of Conserve of Roman Wormwood, Scurvy-grass, the yellow Rindes of Oranges,* of each two ounces, Winters-bark two drams, Species Diacurcumae a dram and a half, of Steel prepared with Sulphur three drams, Syrup of Citron-peels what suffices to make an Electuary, the dose two drams morning and evening, drinking after a draught of the Julep, or three or four ounces of the distilled water.

Chalybeate Medicines notably help in this Disease, as in the green sickness of Virgins,* insomuch that frequently the whole or chief scope of curing depends upon this kind of Remedy; yet we are to observe, that not all Medicines of this kind are equally convenient in these cases: for those which are chiefly in use, viz. Salt of Steel,* or Vi∣triol of Mars, and others prepared with acids, and deprived totally of Sulphur, do not help, inasmuch as they do not promote the fermentation of the blood, but ra∣ther on the contrary fix it, being too wild or elastick. But for an Anasarca or any Page  132watery tumours, in a cachectick habit of the body, Chalybeates of that sort are given, wherein the sulphureous particles are left, and are predominant; as in the first place the Filings of Iron, and the Scales, reduced into a fine Powder, also Steel dissolved with Sulphur, and powdered. The powders of this being taken, are pre∣sently dissolved by the acid Salts within our body, whence the sulphureous metallick particles being set free, and brought into the blood, they ferment the whole mass thereof, and revive the like particles in the same, which before lay dormant, and being conjoyned therewith, they give vigour to the blood, and renew its sanguifying power being formerly depressed. Wherefore we may observe by using but a little Chalybeates of this sort, the green and yellow colour of the face is converted into a florid.

2.* Take of the compound Powder of Aron-roots, of Winters bark, of each three drams, lesser Galangals, Cubebs, of each a draw and a half, of Steel prepared with Sulphur half an ounce, Sugar of Rosomary flowers six drams, make a Powder, divide it into twenty parts. One part is the dose, morning and evening, with a draught of the sudoriferous De∣coction before prescribed.

3.* Take half an ounce of the gummous Extract residing after the distillation of the Elixir Vita of Quercetane, powder of Earth worms two drams, lesser Galangal, Winters∣bark, of each one dram and a half, Salt of Wormwood two drams, of Rust of Iron two drams and a half, Balsam of Peru one dram, Tincture of Salt of Tartar two drams, Balsamum Capivii what suffices to make a mass to be formed into small Pills, the dose half a dram evening and morning, drinking after it three ounces of the Julep or the distilled water following.

4.* Take of the water of Elder-flowers, of the juice of their Berryes fermented, of each one pound, water of Earth-worms magistral, of Rhadish compound, of Aqua Mirabilis, of each two ounces, Syrup o fthe juice of Elder-berries two ounces, mix them and make a Julep.

5.* Take the leaves of Carden Scurvy-grass, of Hedge-Mustard, of Pepper-wort, of each six handfuls, of the Roots of Calamus Aromaticus, Galangal, of Zedoaria, Orris of Florence, of Elder, Aron, of each six ounces, Winters-bark, Jamaica Pepper, of each three ounces, Juniper-berries four ounces, Cloves, Ginger and Nutmegs, of each one ounce, slice and bruise them, and pour upon them eight pound of old Rhenish-Wine; distill it in common Organs, let the whole Liquor be mixt.

6, 7.* An Anti-hydropick Decoction is described above, among the Diaphoreticks. A Diet-drink is to be taken instead of Ale, and is to be made according to the en∣suing form.

Take of Shavings of Guaiacum,* Sassafras, of each four ounces, Florence Orris-roots, Calamus Aromaticus, Galangal, Enula-campane, of each one ounce and a half, of Juni∣per and Bay-berries, of each two ounces, Anniseeds, Carue, Sweet-fennel, Coriander and Dill-seeds, of each one ounce, long Pepper and Cubebs, of each an ounce and a half, cloves, Nutmegs and Ginger, of each half an ounce, Jamaica Pepper two ounces, the dryed leaves of Sage, Wood-sage, Calamint, Agrimonie, of each one handful, Liquorish four ounces sliced and bruised, boyl it in four gallons of Spring-water to half, the strained liquor being cold, let it be kept in glass Bottles for use; with the constant use of this drink, I have known many laborring with a deplor able Anasarca to be made well. Among many Examples of Dropsies cured, I shall propound but one.

A certain strong man of a middle age,* after he had contracted an Epidemical Qnartan Feavour, and being evilly handled from its beginning, had laboured with it above a year, and in the mean while had used an ill course of Diet, fell into an Anasarca, which afterwards in a short space augmented hugely, by reason he in∣dulged himself more freely to drink for quenching his thirst (which was outragious) so that all his members being swollen from head to foot, and over the very Abdo∣men it self, he could not turn in his bed from side to side without help.

When I first visited this man,* and despairing of a Cure (as the Physitian in Celsus lib. 3. Chap. 21. who denyed that any intemper are Hydropick could possibly be cured) I immediately affirmed this Prognostick, That he would dye in a short time unless he abstained from drink. Whereunto he replying, profest he would not drink in a Page  133weeks space, provided he might be helped; and indeed did as he said, although be∣ing very thirsty, for six or seven dayes he scarce took any liquid thing in his mouth, but what was Medicine; and during that time, when in the mean while he took Hydragogues, Catharticks and Diureticks, and any other things prescribed care∣fully, he became much better, and afterwards the method (before described) some∣while being administred, he was restored to his entire health, and even now though five years since lives and continues sound.

There remain certain other splanchnical Affections,* touching the Remedies where∣of, according to the ensuing method, we should here have treated, notwithstanding I have performed this task already for the most part under other titles; for as is above intimated, Remedies which concern the Kidnies we have for the most part unfolded under the rank of Diureticks, and those which concern the Stomach and Guts, un∣der that of Vomits and Purges; what relates to the Spleen we have finished in the Hypochondriac Pathologie; and what to the Womb in the Hysterical. As to what ap∣pertains to the Genital parts and their Diseases, and help, I reserve for another time and place; it behoves me now next of all, after treating hitherto of the in∣ward Pharmacie, to discourse something of the outward, and of the Reason or Aetio∣logie of the administrations thereof, which shall be done inthe next Section, begin∣ning with Phlebotomie, that great Remedy.