Pharmaceutice rationalis: or, The operations of medicines in humane bodies. The second part. With copper plates describing the several parts treated of in this volume. By Tho. Willis, M.D. and Sedley Professor in the University of Oxford.

SECT. II. Of Splanchnick remedies, or those which respect the bowels of the lower Belly.

CHAP. I. Of the Jaundies and the remedies thereof, and the manner and reason of their operations.

HItherto we have largely enough unfolded the Pathologie and curatory me∣thod of the Thorax; now it follows next to finish our task in like manner a∣bout the lower Belly. But we have in our former tract for the most part described already the medicines belonging to this region, and the manner and rea∣sons of their working, together with the Anatomy of the Stomach and Intestines: we have treated of remedies stomachical, dysenterical, and others belonging to the in∣testines, as also diureticks together with the reasons of them: Moreover we have sus∣sicently elsewhere handled the aetioligie of Hypochondriack, and Hysterical reme∣dies. What therefore remains, of Hepatical distempers as well proper, as of those vulgarly ascrib'd thereunto, and of their remedies we will discourse in this Section; notwithstanding in each of these, we will bestow more labour, about the curatory, than pathological part.

The chief diseases by which the Liver and the appendix thereof,* 1.1 are wont to be incumbred, are the Jaundies, and a Tumour, and under this latter many other affects, viz. obstruction, inflammation, induration, and schirrus are numbred; to all which are vulgarly appointed remedies commonly called Hepaticks, and which make up a great part of the Dispensatory.

The Jaundies is either a disease by it self, primarily beginning, which is here pro∣perly treated of: or it is an effect or product of another disease; as when it arises upon an intermitting Feaver, which oftentimes it puts an end to, of which also we will presently treat by the by.

An Icterical distemper by the common consent of most is judged to arise in as much as the yellow choler, not at all, or not enough received,* 1.2 from the ends of vena porta, into the passages of the cholerick pore, overflows into the mass of blood and pollutes it with its greenness, whereby also the very skin is discolour'd.

That obstruction is wont to happen after many manners and in various places.* 1.3 For sometimes it happens near the extream ends of either kind of vessels, viz. the end of the vena porta, and the porus bilarius; the interspaces whereof happen frequently to be compressed, and stopt by reason of the Parenchyma of the Liver being tume∣fied, or otherwise vitiated; wherefore the humour of the gall not being transferred out of the separating vessels of the porta into the other receiving vessels, turns back upon the blood. Secondly, the passage of the humour of the gall is sometimes intercept∣ed in the middle passages of the cholerick pore; for that the cavities of these are filled either with a viscous, or sandy, and sometimes with a stony matter; as is plainly discerned in the Livers of beasts in the winter senson, while they are fed with hay and straw. Thirdly, it is also manifest by Anatomical observation, some∣times an obstruction in the very bladder or the gall, or in the cystic passage is the cause of the Jaundies; for if at any time, it being filled with stones, receive not the choler, or being here shut up, or grown together, it restrains the descent of the choler towards the guts, that humour although well separated from the blood, is constrained to flow black into the mass thereof, and so propagates the Jundies.

Against this most received opinion, by which it is judged,* 1.4 that the cause of the Jaundies for the most part consists on this side the vesica fellis or about it towards the Liver: the most Renowned Sylvius altogether places it without this, viz. in the

Cystic or common passage. For supposing the choler not to be separated from the blood, within the passages of the Liver, but in the very bladder of the Gall to be pro∣pagated of a humour brought thither by the Arteries; He judged the greatest part, being carried upwards by the passage of the pori bilarii, to be poured into the blood for some notable uses, and also another part to descend beneath to the Intestines, also for necessary uses: wherefore if this latter sluce be shut, all the choler is carried upwards into the blood, and filling it too much with this humour, perverts it from its genuine temper, into an Icterical.

But truly lest the stopping of the passage of the bladder, or of the common passage, (neither of which easily happens, or from any light occasion) may seem less effica∣cious to excite any Jaundies; therefore, whether such an obstruction hath place, or no, the most Renowned man ingeniously supposes besides, The choler while it is generated in the bladder does undergo sometimes a notable change, by which it is moved, and is born about more plentifully and impetuously, towards the blood, with which yet it is less mingled than is was wont to be, but only confounded together with it, and so more easily departs from it and infects and tinges the solid parts with its colour.

But that the choler in the Jaundies may be rendred unfit a mix with the other humours, or to be nearly united; he determines it to be done, by a spirit too valatile, mixed plentifully with it, and so making it more spirituous and immiscible with others. He confirms this assertion by two instances, viz. in as much as the most spirituous poison from the biting of a Viper, and the too much use of the more generous drinks, viz. Wine and Strong-waters, causes sometimes the Jaundies. Moreover he endeavours to procure credit to this Hypothesis, for that this disease is wont to be cured, not only by medicines opening obstructioins, but by them which blunt the force of a ra∣ging volatile salt (of which sort are the decoction of Hemp-seeds, also Venice soape with many other things of the same sort.)

It belongs not to this place, neither is it to our purpose to descend to end this con∣tention, nor dare I now rashly determine it (since it hath tired so many Renowned Wits of the Moderns) whether really the choler be made in the bladder of the Gall, or whether it be only separated from the blood in the Liver, the great organ of separation; I confess this latter opinion best pleases me.* 1.5 And weighing these things seriously I am induced to think the cause of the Jaundies to consist chiefly in this, that the choler be∣ing sever'd in the Liver, is not, by reason of the ways being obstructed, at all, or not enough conveyed to the bladder of the Gall, but that it must of necessity regurgi∣tate into the mass of blood; notwithstanding in the mean while we deny not, but this affect may sometime arise (although more rarely) from the Cystic passage or common pipe being obstructed. But also we think the fault of the blood to preceed in part and perhaps sometimes wholly for the morbific cause; when to wit from its sulphurous and fixt Saline Particles above measure exalted, the choler is more plenti∣fully, or quicklier generated in the mass of blood, than can be separated or discharged forth by the ordinary ways; wherefore this, separating every where from the blood with the Serum,* 1.6 is affixed to the solid parts, and impresses its tincture upon them. And without doubt it is for this reason that some poisons, and chiefly the biting of Vipers, and the dayly use of more generous drinks, induces the Jaundies in bodies be∣fore sound, for whose cure sometime Phlebotomie, and medicines reducing the blood to a right temper, are wont to profit more than those opening obstructions. More∣over it seems for this reason, that a tertian intermiting Feaver so frequently termi∣nates in the Jaundies; for we may not suspect the passages of the Liver can be by any means obstucted, since in all fits, so great an agitation of the blood and humours, by cold, and heat, and such an-evacuation of them happens either by vomit or sweat: and truly even as feaverish fits are caused, inasmuch as the sulphurous part of the blood being too much advanced, in the first place perverts the nutritious juice into a morbific matter, and afterwards being inflam'd consumes and exterminates it; so when the fixt salt is at last exalted together with the sulphur in the blood, and for that cause meer choler is abundantly engendered, the feaversh enkindling of the blood ceases, by reason of the restrictive force of the fixt salt, and in place thereof the distemper of the Jaundies doth succeed. But as the blood being too much advanced to a sulphureo∣saline distemperature causes the Jaundies in any, though least predispos'd to it; so in others very much disposed thereto, having the ways of choler obstructed & the sulphur of the blood being too much depressed, it produces a freedome from that disease; for I have known many cachectick and phlegmatick persons, to have been free from the Jaun∣dies

though they have suffered under obstructions and indurations of the Liver, as to most of its passages.

It is not worth our labour to make more ample disquisition about the aetiologie of this disease; as to what respects the cure, there will be three primary indications,* 1.7 all which (for what may be the chiefest of them, and first to be exhibited, for the most part is concealed) we shall prosecute together; wherefore the intentions of healing shall be, 1. That the obstructions of the passages or choler-bearing vessels be opened, if perhaps any shall be either in the porus bilarius, in the Cystic passage, or in any place about the Liver. 2. That the blood be reduced to its due temperament and mixture, lest it ingender choler above measure, or render it unapt to be voided. 3. That the strength may be sustain'd, and the symptomes chiefly hurting them may be with∣stood.

1. That we may satisfie the first indication, cathartic evacuations notably con∣duce,* 1.8 as well by vomit, as siege, whereby the choler's descending towards the inte∣stines may be furthered, and vessels obstructed, by the great snaking of them, freed from their obstruction. 2. Sharp, bitter, salt medicines and others indued with a cer∣tain briskness ought also to be given, which provoke the motion of choler gathered in the Liver, and stagnating; hither also ought to be referred, what by similitude of substance, and as it were signature, in as much as they are indued with a yellow juice, have the report to help against the Jaundies; notwithstanding many of these may fitly be numbred under the same classis of evacuators, as the former, because they move urine or sweats.

The second indication altogether requires alteratives,* 1.9 viz. medicines which may depress the exaltations, or ragings of the Sulphur and fixt salt, and in the mean time provoke the restitution of the volatile salt depressed; for these ends remedies endued with an acid or volatile salt, besides chalybeats do principally bring help; from hence spirit of salt, of vitriol, juice of Lemons, also spirit of Harts-horn, also dung of Sheep, and Geese, crocus Martis and diverse other preparations thereof, are fre∣quently used with success in the Jaundies.

The third indication vital suggests more and sundry intentions of cure,* 1.10 procuring the strength to be restored, and the removing the symptomes whereby it is prejudiced, all or the chief particularly to enumerate, and prescribe would be a vast and tedi∣ous work; wherefore we will annex only certain general rules about diet, and some cordials and anodynes appropriate in this condition.

The curatory indications being appointed after this manner,* 1.11 it next lies upon us to acommodate the most select medicines, viz. as well the simple as the compound, to these now proposed intentions of curing, and to unfold the manner and reason of the operating of remedies which are accounted of special note in this disease. There∣fore first we propound the forms of evacuating medicines appropriate in the Jaun∣dies.

1. Vomits.

Vomiting medicines are frequently wont to help in the recent Jaundies,* 1.12 while the tone and strength of the bowels are firm; in as much as they alleviate the stomach always oppressed in this disease with an unprofitable burden of viscous phlegm; and moreover do free their infarctions by irritating the vasa choledocha, and by much shaking all the passages of the Liver, and make easie the passage of the cholet by the former accustomed ways.

Take of the infusion of Crocus Metallorum half an ounce to six drams, Wine of Squils an ounce, Oxymel simple half an ounce, make a vomit to be taken with government.

Sometimes it is convenient to exhibite, the evening before, the following preparatory medicine for the easier vomiting.

Take of the powder of Asarum roots, faeculae Aronis of each a scruple, of Tartar vitrio∣lated half a scruple, of Oxymel of Squils an ounce, mix them.

Take of Sulphur of Antimony seven grains, Scammony sulphurated eight grains, cream of Tartar half a scruple, make a powder, give it in a spoonful of panada.

Take nine Asarabacca leaves, cut and bruised put them into three ounces of white wine, press out the liquor, let it be taken in the morning with regiment.

Take of Gambugia prepared eight grains, Tartar vitriolated seven grains, make a powder.

2. Catharticks.

Purgers take place in this disease,* 1.13 be it recent or inveterate, viz. that as well a more plentifull store of Excrements may be now and then withdrawn from the first passages, as that the vasa choledocha may be excited to Excretions.

Take of Electuary of juice of Roses three drams,* 1.14 Rhubarb a dram, Salt of Wormwood, Cream of Tartar, of each half a Scruple, Syrup of Rhubarb, make a Bolus.

Take of the roots of sharp-pointed Dock prepared one ounce,* 1.15 the tops of Roman Worm∣wood, of Centaury the less, of each P. ij. Gentian and Turmerick roots an. two drams, yellow Saunders one dram, boyl them in a pinte and a half of Spring-water to a pinte, ad∣ding towards the end Senna six drams, the best Rhubarb three drams, Agarick a dram and half, Coriander-seeds two drams, White-wine two ounces, let them boyl close two hours, after strain it and clarifie it by settling; the Dose from four ounces to six, with one ounce of Syrup of Rhubarb, the water of Earth-worms three drams; make a potion to be repeated every or every other day, for three or four dayes.

In a weaker Constitution.

Take choice Rhubarb two drams,* 1.16 Agarick trochiscated, half a dram, Cinnamon half a scruple, Ginger half a scruple, make an infusion in White-wine and Cichory-water, of each three ounces, for three hours, in it strained dissolve one ounce of Syrup of Rhubarb, water of Earthworms two drams. Or Rhubarb from half a dram to a whole one, Salt of Worm∣wood a scruple, make a powder.

Take pil. Ruffi a scruple,* 1.17 Extr. Rudii half a scruple, make 4 Pills, take them in a morn∣ing with government, after 4 or 5 dayes repeat them.

In the third place follow Deoppilatives,* 1.18 which are also Diureticks, or Diaphoreticks, some whereof are accounted specifick, by reason of similitude of substance; Medicines of this sort, both promote the separation of choler from the blood, and urge the passage of it, being separated, through the passages and pores in the Liver open but little. Moreover, in the mean time, by dissolving the blood, they carry off the serosities and cholerick recrements thereof, sometimes by sweats and urine.

Take of Elixir Proprietatis one ounce,* 1.19 take 20 drops in the morning, and at Five in the afternoon, with a convenient vehicle: after the same manner are taken, Tincture of Antimony, or of Salt of Tartar, and the simple mixture in a greater Dose: for vehicles, Apo∣zemes, distilled Waters, and Juleps for this Intention of curing are convenient.

Take of the roots of Celandine the greater,* 1.20 stinging Nettles, Madder, of each one ounce, tops of Roman Wormwood, white Horehound, Agrimony, Germander, of each one hand∣full, Worm-seeds two drams, Shavings of Ivory and Harts-horn, of each two drams, yellow Sanders a dram and a half, Coriander-seeds two drams, boyl them in three pound of Spring∣water to two pound, adding of White-wine four ounces, strain it, and adde Syrup of Chi∣chory with Rhubarb two ounces, water of Earth-worms, an ounce and a half, make an Apozeme, the Dose four or six ounces twice in a day.

Take of white Horehound dryed, Centaury, of each one handful, Gentian and Turme∣rick-roots, of each three drams, Cinamon one dram, Saffron half a dram, being sliced put them into a Glass with two pound of White-wine or Rhenish-wine; make an infusion, the dose three ounces.

To this we will adde Gesners famous Antictericum.

Take of the roots of stinging Nettles a pound, Saffron one scruple, bruise them well, and draw off the tincture with White-wine, the dose three ounces 4 or 5 dayes.

Like to the former is that of Fr. Joel. Take the Roots of Celandine the greater,* 1.21 two handfuls, Juniper-berries a handfull, bruise them and pour on them a pound of Rhenish∣wine, and draw out the juice, the dose sour ounces twice a day.

The juice of white Horehound is mightily commended by Dioscorides, and the Syrup of the same by Forestus, for curing the yellow Jaundice.

In lieu of an Elixir, and other chymical liquors, which to avoid nauseousness are to be taken in very small quantity; to others endued with a stronger Constitution, Electua∣ries, Powder and Pills may be administred with better success.

Take of Conserve of Roman Wormwood, of the yellow Rinds of Oranges and Limons,* 1.22 of each two ounces, Species Diacurcumae one dram and half, powder of Ivory, yellow Saun∣ders, of Lignum-Aloes, of each half a dram, Troches of Capers one dram, of Rhubarb half a dram, Salt of Wormwood two drams, with Syrup of Cichory with Rhubarb, make an Electuary, the dose the quantity of a Chesnut twice a day, drinking after it three ounces of the following Julep.

Take of the greater Celandine-water, Fumitory, Wormwood,* 1.23 Elder-flowers of each five ounces, Snail-water, water of Earth worms, compound, of each two ounces, Sugar half an ounce, mingle them and make a Julep. Or,

Take of the roots of stinging Nettles, Angelica, Gentian, of each four ounces, the greater Celandine leaves and roots, six handfuls, Wormwood, Tansie, Southern-wood of each four handfuls, the outer rinds of twelve Oranges and four Limons, prepared Worms and Snails of each one pound, Cloves bruised two ounces, being all cut and bruised pour upon them eight pound of White-wine, let them be distill'd in a cold still, and the whole water mixt. Or,

Take of filings of Steel one pound, fresh Strawberries six pound, put them into a gla∣zed pot, stirring them together, and let them stand a day, afterwards adde of English Rhubarb sliced one pound, the rinds of four Oranges sliced, pour upon them of White wine six pound, and distill them according to Art; let all the liquor be mixt together. The dose of this and of the former is three ounces twice in a day after the Electuary or any other medicine.

Take of Turmerick-roots, Rhubarb, of each one dram and a half, the Bark of Caper-roots, of Asarum-roots, of each half a dram, Extract of Gentian, and Centaury, of each one dram and a half, Salt of Wormwood four scruples, Water-cress-seeds half a dram, of Rocket half a scruple, Elixir Proprietatis one dram, gum Ammoniacum dissolved in the water of Earth-worms what will suffice to make a mass, form it into small Pills, the dose is half a dram evening and morning, drinking after it three ounces of the distilled water.

Sylvius doth much magnifie for cure of the Jaundies,* 1.24 the Decoction of Hemp-seed in milk, and the solution of Sope, and from thence endeavours to establish his own Hypothesis (as we have above intimated) whereby he endeavours to deduce the Aetiolo∣gie of the Jaundies, rather from an alienation of the choler, than from the obstructi∣on of its passages.

2. The Second Indication respecting the altering or tempering of the blood,* 1.25 by which it may breed but moderately, and duly separate the choler, requires Medicines of that sort, which depress the Sulphur and fixt salt too much advanced. For these ends, I know not by what chance or conduct Medicines endowed with a volatile salt, as Worms, Snails, Millepedes, yea Lice, Dungs of fourfooted Beasts, and Fowl, are brought into practice for curing the Jaundies, and not only prescribed by Empiricks, but the more famous Physicians: These sometimes by themselves, but oftener joyn'd with Purgers and Deoppilatives, become the chief Ingredients in Compositions against the Jaun∣dies.

Fonseca prescribes Goose-dung gathered in the Spring-time and dryed, as also the white excrement of Pullets, of both which let the Powder be given in a convenient vehicle from half a dram to a whole one.

Take powder of Earth-worms prepared, of Goose-dung, of each three drams, Ivory,* 1.26 yellow Sanders, of each half a dram, Saffron one scruple, make a powder, divide it into six parts. One to be taken every morning with some appropriate liquor. To the Apozeme, or Anticterical Tincture prescribed above, Earth-worms, Goose-dung, and also Sheeps∣dung are profitably added.

Take Millepedes fresh and alive from 50 to 100. Saffron half a Scruple, Nutmeg a scruple, bruise them together, and infuse them in Water of Celandine four ounces, of Earth worms two ounces, express them strongly, and drink it: after this manner take it first once, then twice in a day for a week.

The vulgar and Empirical remedy with us is, that Nine quick Lice be taken in a morning for five or six dayes, by which remedy they report to me many to be cu∣red (whenas other remedies effected little) which truly can help by no other means than by restoring the volatile Salt depressed in the blood.

Upon the same account of succour even in this disease the flowers of Sal Armoniac,* 1.27 the volatile Salts of Amber, Harts-horn, Soot, in like manner their Spirits are fre∣quently administred with great success.

Take powder of Earth-worms prepared two drams, Species Diacurcumae one dram, flower of Sal Armoniac half a dram, Salt of Amber a scruple, Extract of Gentian one dram, Saffron one scruple, Gum Ammoniacum dissolved in water of Earth-worms what suffices, make a mass, and form it into small Pills; the Dose is three or four, morning and evening, drinking after it three ounces of the Julep before prescribed.

Take Spirit of Harts-horn tinctured with Saffron three drams; Dose from 15 drops to 20. with the distilled water prescribed above.

In this Class of Medicines by which the icterical distempers of the blood are to be corrected,* 1.28 steel'd remedies do also challenge their place by right; for these afford notable help, not so much by unlocking the obstructions of the bowels, as by de∣pressing the rage of the Sulphur, and fixt Salt, and by volatilizing the blood, in the Jaun∣dies, no less than in other cachectical distempers.

Wherefore, to the Decoction, or Tincture, or Infusion above prescribed, is pro∣perly added the filings of Iron, or the prepared powder thereof (its mineral con∣sistence being some wayes opened) or the vitriolic Salt extracted; from hence it is, that Medicinal waters heal even to a miracle those sick of the Jaundies, that had been de∣spaired of; although these drunk in a very large quantity, inasmuch as they pass through all the vessels, do also open the passages of the Liver, however shut up.

Therefore also even Preparations of Steel are added to the Electuary, Pills and Powders above recited, one while this, another while that, in due proportion. More∣over the Syrup thereof given twice a day to one spoonfull, in three ounces of Apozeme or water against the Jaundies; also tincture of Steel to twelve or fifteen drops may be administred in the same manner.

In the last place we may annex to this classis of altering Medicines those things which not taken inwardly,* 1.29 but outwardly applyed, and by contact, used to the very urine of the Patient are held to cure this disease.

As to the former, a remedy often tryed by the vulgar, is a living Tench-fish, whose Scales and outer superficies do resemble a yellow colour, applyed to the right Hypochondria, or Stomach according to some, (to the soles of the feet, according to others) whence a sudden flight of this disease is expected; hence although many pro∣mise themselves a sure cure, it hath often deceived me.

Another cure of the Jaundies at a distance is said to be done by I know not what sympathy or secret manner of working.

Take the fresh Ʋrine of the Patient made at one time, of the ashes of the Ash-tree searced, as much as suffices to reduce it into Paste, which may be formed into three equal balls, to be placed in a place shut, near the hearth or Stove; as these dry and harden, the Jaundies will vanish; after this course, I have known this inveter ate disease happily cured, although resisting many other remedies; the practice thereof is very familiar with the Vulgar.

If of a certain it could be made manifest that this effect doth for the most part happen,* 1.30 and the reason of it be inquired into; in the first place we ought to sup∣pose a consent or sympathy of the spirits and other particles in the animated blood, with other symbols inmates of the fresh urine; and that they immediately are af∣fected in the like manner with these. Notwithstanding it is evident enough that a lixivial Salt mingled with urine, doth presently set free the volatile salt formerly sub∣dued or enwrapt in other particles; as is plainly seen in distillation of Urine, which if you urge by it self with a sand-heat, nothing but phlegm will arise; but adde the calx of Tartar, or Ashes, immediately the Spirit and volatile Salt will come forth: wherefore, that Empirical administration being administred, at the same time, both in the Icterical urine, and also in the blood of the Patient, the volatile Salt escapes out of the power of the fixt Salt and the Sulphur, and for that cause the icte∣rical

distemper of the Blood is put to flight. Also upon the same reason is built ano∣ther sympathetical cure of the Jaundies, whereof Phil. Grulingius and Felix Platerus do make mention, viz. the sick party pissing upon Horse-dung while it is hot, hath cured many of the Jaundies; inasmuch as the fixt Salt of the Urine, and thereby the fixt Salt of the icterical blood of the patient, is altered by the volatile Salt of the fresh dung, and reduced into its due temperature.

3. The third Curatory indication vital institutes a convenient course of Diet,* 1.31 and moreover Cordials and Anodynes, of both which there is frequent need.

As to what relates to the former, Food in this disease, more than in any other ought to be medicinal. For Vegetables and their parts, styled commonly Hepatick remedies, are boyled in the broths of these Patients. And these also are wont to be made instead of other flesh, of Worms, or Snails, (which are accounted Antidotes against the Jaundies.) Moreover Ale, and other ordinary drinks are impregnated with infusion of Medicaments.

Take of the roots of stinging Nettles, of Strawberries, of each an ounce and half, Eriygo-roots candied one ounce, Ivory and Harts-horn, of each two drams, Earthworms cleansed twenty, a Crust of White-bread, Mace two drams, boyled in two pound of water to one pound, strain it through Hippocrates sleeve, to which adde Diasantalon half a dram, make broath, whereof take from four ounces to six, twice in a day: for ordinary drink, fill a Tub of four Gallons with Beer, after it hath wrought, put in the follow∣ing Bag.

Take the tops of Roman Wormwood, white Horehound dryed, of each two handfuls, the roots of sharp pointed Docks six ounces, of the Bark of Ash, of Barberries, of each 3 ounces, the outer Rinds of eight Oranges, and of four Limons, being sliced and bruised, let them be prepared according to Art.

Since many sick of the Jaundies are usually affected with a great languishing,* 1.32 and frequent faintings of the Spirits, they have also need of cordial Remedies.

Take of small Aqua Mirabilis eight ounces, water of Earth-worms four ounces, Syrup of Orange-peels two ounces, mingle them, the dose two or three ounces.

Moreover, they who are troubled with this disease, do very much suffer with pain sometimes very troublesome in the night, and are often obnoxious to waking; where∣fore also Anodynes come into use for administration.

Take of Aqua Mirabilis, water of Earth-worms, of each one ounce, Diacodium six drams, Tincture of Saffron half an ounce, the dose one or two spoonfuls late at night, if sleep be wanting.

Take of Laudanum tartarizated two drams, Aqua Mirabilis two ounces, Syrup of Clove-gilly-flowers one ounce, mix them, the dose is one spoonfull after the same man∣ner.

SECT. II. CHAP. II. Of other Hepatick Remedies.

THe Liver is seldom or never found obnoxious to an Atrophie or extenuation, since truly it performs the office of a strainer, and according to some, of a mingling bowel; but on the contrary by reason of many causes and occasions, it runs the hazard of being encreased as to its bulk, and to be stufft and swell'd with divers things gathered therein, and with concretions. Hence no small account of health consists in this, that the Liver having right conformation may freely convey the blood every where, without keeping back too much Custome or provision for it self.

Truly many faults,* 1.33 and indeed not altogether undeservedly, are imputed to this Bowel, as also unto the Spleen; the chief Kinds of which we shall touch upon. The Liver frequently and chiefly is wont to be faulty in one of these two, viz. Frist that in∣tercepting the nutritious juice appointed for other parts, it bestows it to its own pro∣per use; this is plainly discerned in Children affected with the Rickets, and more∣over in many others that lead a sloathful and idle life. Anciently there was an art with the Romans so to feed a Goose that the Liver prodigiously encreased might weigh more than the whole body. Secondly, the other fault of the Liver is, that it too easi∣ly receives all the excrements and feculencies whatsoever of the depraved Blood, brought into its inward recess, and by retaining them there, doth not only grow large, but is obstructed in its passages, whence frequently comes the Jaundies, or a Dropsie; it contracts also tumours and preternatural Concretions of divers kinds of matter.

Many and divers distempers of the Liver ought to be referred to these two heads:* 1.34 of each of which it is not our purpose to institute particular pathologies. As to what appertains to the general pharmacie of this bowel, there will be one principal scope of curing, that its income be diminished as much as may be, or altogether cut off. Wherefore it will behove us to procure these two things, viz. That the Liver augment not above measure, by taking the nutritious juice too much unto it self; and that it retain not the feculencies of the Blood, whereby it may be affected with obstructions and preternatural Tumours.

It will be much easier to prevent than cure either of these faults of this bow∣el. For truly the former may be done, respect being had only that the blood be well vonstituted in its Temperament, and enjoying a free Circulation, it may both dispense its nutritious juice to the parts, and especially its outward parts, and driving forth all its excrements to the particular Emissaries, it may put them away there. And surely, the Medicines vulgarly called Hepaticks, do first and more immediately exert their power by purging the blood, rather than by correcting of the Liver: those namely consist of particles of such a kind, which entering into the blood, and not mixing with it, do so stirre up the mass thereof, and break it into pieces, that all the Coagulations and Concretions being taken away, all its dregs and impurities may easily depart, and being carryed to their proper Emunctories may be cast out of doors.

For truly all remedies which are called Splanchnick,* 1.35 first work upon the blood, and incite its constitutive parts into a kind of effervescency, and so toss, divide, and move them rapidly to and fro, that the vaporous effluviums being sent into the habit of the body, the serous excrements into the Kidneys, the cholerick into the Liver, the melancholy into the Spleen, and others to other Emissaries for which they are fitted, may be shut out, without impediment or adhesion.

Wherefore the same Remedies which help the Liver,* 1.36 help also the Spleen, the Reins, the Lungs, and other the Bowels in their separations; and for the most part move sweating and urine. If any be found to respect one part before the rest by any specifick power, it is therefore because their particles being more ally'd unto the excrements to be separated within that bowel, and from thence associated to them are conveyed thither together with them. For this reason Rhubarb, Turmerick, the greater Ce∣landine, with many others adjoyned to the bilious humour, do the more easily reach the passages of the Gall, and are wont to succour in the Jaundies. We have observed

before, the energies and manners of operating of Medicines of this kind. As to what appertains to the other, vulgarly called Hepaticks, first we will annex briefly certain forms of those which are reported either to prevent or remove the unnatural aug∣mentation of the Liver, and then those which are held to provide against or take away the obstruction and preternatural Tumours thereof.

1. Against the too much encrease, or improportionate nutriment of the Liver, first a more sparing and thin diet, short sleeps, and moderate and frequent exercises are convenient: wherefore we prescribe for Infants, and Children, when they are disco∣vered obnoxious to this distemper, as in the Rickets, that they suck thin and serous milk, that they be shaken or tossed in their Nurses arms, and tumbled quickly to and fro, or be carried swiftly in a Chair or Coach, and as soon as may be, learned to go and to use their feet.

Take of the water of Snails, of Earth worms, of each three ounces,* 1.37 Syrup of Chicory with Rhubarb two ounces, spirit of Sal Armoniac with Gum Ammoniacum one scruple, mix them, and take a spoonfull evening and first in the morning.

Take of the roots of Maleferne, Chervil, candied Eringoes, of each one ounce, the leaves of Agrimony, Harts-tongue, male Speed-wel, of each one handful, Shavings of Ivory, Harts-horn, of each two drams, white and yellow Sanders, of each one dram, Raisins stoned one ounce and a half, Barly three drams, boyl them in three pounds of Spring∣water to two, to it strained adde of Snail and Earth-worm water, of each one ounce and half, Syrup of Chicory two ounces, make an Apozeme, take two or three ounces in a day.

Take Powder of white and yellow Sanders, Crabs-eyes, Lignum-Aloes, of each half a dram, Salt of Wormwood one Scruple, make a powder, the dose half a Scruple to a whole one twice a day.

Take Empl. Diasaponis, Cerate of Sanders, of each what will suffice, make a Plaister to be applyed to the Hypochondrion.

Take Ʋnguentum Splanchnicum two ounces, Oyl of Wormwood one ounce, mixe them, and make a Liniment for the region of the Liver.

Hither many other methodical as well as Empirical Medicines being used for the Rickets may be referred, but we hasten to other things.

2.* 1.38 Remedies ordained for most other distempers of the Liver are either simple or compound. Very many of the former sort are reckoned by Authors, as if they were procreated for this particular use. Heurnius says, That God Almighty hath offered to the World the greater plenty of Remedies of this kind, by reason of their notable necessity. And to this Rank may be referred in the first place all kinds of Chichories, the Sor∣rels,* 1.39 the sharp pointed-Docks, and almost all Vegetables endowed with bitterness and something of sharpness, (wherein the deoppilative vertue is reported to consist) as Wormwood, Germander, Ground-pine, Fumitory, Tanzy, Agrimony, Liverwort, Lignum Aloes, all the Sanders, Tamarisk-bark, and Ash-bark, the roots of Capers, with many others, which commonly make up the greatest part of Herbals; so that whilst the Liver like a certain Goddess ruled sanguification, very many Medicines were used to be ascribed fot its safeguard and succour.

The fixt Salts of herbs, the acid Spirits of Minerals drawn by distillation, belong by right to this number, as they do chiefly exagitate the masse of blood, dissolve the Con∣cretions thereof, dispatch their obstructions, and cause it every where to be passable, as to all the parts thereof.

If I here omit Chalybeates, most Chymists will censure me very unjust to the Liver;* 1.40 for truly as the Prerogative of Venus is vulgarly attributed to this bowel, so as to con∣strain to Love, we may hence expect that Mars will be perpetually kinde unto it. And really it is manifest by Reason, as well as Experience, that Preparations of Steel are convenient in hepatical affects, as chiefly in the Jaundies, and oftner in the Drop∣sie; wherefore these are put into the Receipts of the Ancients and modern, and a∣mong curatory Compositions. For what reason the Preparations of Steel as in like manner the medicinal waters from Iron, as well natural as artificial, do purifie the masse of blood, and by consequence do relieve many distempers commonly call'd He∣patical, is shewn by us largely enough in another place, so that here is no need for repetition.

Medicines that are appointed by Physicians for the Liver are divided into vari∣ous

forms, but first into hot and cold, and also into moist and dry; accordingly as the temper of this bowel is supposed to consist after divers manners: when in truth it is only a dyscrasie of the blood, which being so diversly faulty, desires so various an energy of medicines. Neither is it a less vulgar error, that in the estimating of mens constitu∣tions, the various temperament of every one due to the blood, is ascribed chiefly to the Liver, as hot or cold, or otherwise disposed.

In the Antidotaries of the Ancients there are many Shop-compositions extant,* 1.41 which seem to be besigned for the Livers sake only, of which sort are Rhasis his Electuarie of the dross of Iron, Crocus ferri of Balchusis, which being mixt with Treacle is commend∣ed for hepatical affects; the species Diatrion santalon, Diarrhodon Abbatis, Trochiscs of Rhubarb, of Agrimony, of Capers, Diacurcuma, Dialacca, Syrup of Wormwood, Chico∣rie, of the five roots, Byzantinus, with many others, unto all whose forms, a vast Catalogue is annext for curing all the diseases of the Liver. But these passed over, it pleases me now to propound some Kinds and Examples of Medicines which are count∣ed deoppilative according to the practice of the Moderns.

Therefore for an opening Decoction, Take of the roots of Ferne,* 1.42 Chervil, stinging Nettles, Dandelyon, of each one ounce, the leaves of Agrimony, Harts-tongue, Speed-well, Oak of Jerusalem, Liver-wort, of each a handfull, white and yellow Sanders, of each three drams, Ivory half an ounce, red Cicers an ounce, Coriander-seeds three drams, Raisins two ounces, boyl themin four pound of water to two pound, adding towards the end White-wine four ounces, stram it through Hippocrates Sleeve, to which adde Species Diarrhodon Abbatis one dram, of our prepared Steel two drams, Syrup of Chicory with Rhubarb two ounces, the Water of Snails and Earth-worms, of each one ounce, the dose six ounces twice in a day after ae dose of the following Electuary.

Take of Conserve of the yellow of Oranges and Limons,* 1.43 of each two ounces, of Worm∣wood and Fumitory, of each one ounce, simple Powder of Aron-roots, yellow Sanders, Lignum Aloes, of Caper-roots of each one dram and a half, Crabs-eyes one dram, Salt of Wormwood two drams, syrup of Fumitory what suffices, make an Electuary, the dose the quantity of a Walunt twice in a day, drink after it a draught of the Apozeme now prescribed, or of the following distilled water.

Take the leaves of Wormwood,* 1.44 Centaury, Tansie, both sorts of Southern-wood, Tama∣riske, of each four handfuls, of green Walnuts four pound, of Ashen keyes green two pound, the Rinds of ten Oranges and four Limons, Snails and Earth-worms prepared, of each one pound, all being sliced, pour on them of White-wine eight pound, distill it in a cold Still, let all the liquor be mixt together, the dose three ounces, sweetning it with Sugar or a fit Syrup.

If a form of Pills will please better, the ensuing Extract called in the Shops Ex∣tractum Ecphracticum, seems profitable.

Take of white and clear Tartar,* 1.45 and of fresh Filings of Iron, of each 4 ounces, let them be ground together into powder, after boyl them in Fountain-water from four pound to two (some use White-wine) to the strained liquor adde the tops of Centaury, of Roman Wormwood, or Carduus, of each one handfull, Gentian-root half an ounce, Species Dia∣curcumae an ounce and half, let them boyl shut close for three or four hours, strain it, and evaporate by the heat of a Bath to the consistence of Pills, adding roots of Rhubarb or Species of Hiera Picra two drams; the dose is from one scruple to half a dram made into Pills, in the evening, with an appropriate vehicle.

For the same intention, viz. to prevent or to remove the obstructions of the Liver, a medicated purging Ale, to be taken many dayes in Spring and Autumn, is by some very much magnified, and exactly observed every year during their lives.

Take of the roots of sharp pointed Docks prepared, Polypodie of the Oak, of each 3 ounces, Madder-roots two ounces, English Rhubarb two ounces, of leaves of Senna four ounces, Epithymum two ounces, yellow Sanders one ounce, Carthamus and Coriander-seeds, of each one ounce and a half, slice them and bruise them according to Art, make a bag for 4 gallons of Ale, after six dayes let him take to 12 ounces more or less in the morning, expect∣ing four or five Stools without regiment.

SECT. II. CHAP. III. Of Remedies for the Dropsie called Ascites.

AFter the Jaundies and the Remedies thereof, our method leads us to treat of a Dropsie; not because of the Vulgar opinion, that it always arises from the fault of the same bowel; but because that former disease having long continued, for the most part concludes in this: which happens so, not so much from the fault of the Liver, as from the whole Blood, for this and not that perform san∣guification. Wherefore, when the masse hereof hath for a long time been filled with cholerick excrements, and at length degenerating from its temper, accumulates also watery humours, then doth a Dropsical Disposition come upon the Jaundies.

But whereas three sorts of Dropsies are vulgarly supposed, viz Ascites, Tympanites,* 1.46 and Anasarca, we will at present handle only the two former, appertaining to the Splanchnick or Pathologie of the nether Belly. And first what relates to an Ascites, this disease as to its matter and formal reason is manifestly known by the sign of even many senses together, viz. it is a Tumour of the Abdomen,* 1.47 from a waterish tu∣mour contained within the cavity thereof. The water making this tumour, some∣times encreases to a huge inundation, and scarce credible quantity. I have once seen a Tub would hold 15 gallons filled with water taken out of the Abdomen of a wo∣man dead of a Dropsie. But whence that humour proceeds, also by what manner, and from what causes it gathers together in the belly first, and afterwards is sensibly augmented; and lastly by what passages, and by what vertue and operations of Hy∣dragogue Remedies, it may again be taken from thence, and evacuated, seems most difficult to be unfolded.

As to the former, viz. the encrease of water,* 1.48 some have thought it to descend from the Liver, and others from the Spleen distempered, into the cavity of the Ab∣domen; and so this bowel or that being vitiated, always to be the cause of an Ascites. But that this is otherwise, Anatomies of many dead of this disease, do manifestly declare: when after the inundation of the belly, the Liver and Spleen and found often without fault. And truly these bowels do not seem the Springs of any such illu∣vies, being endowed with no cavityes, wherein waters might be accumulated toge∣ther: wherefore the origine of an Ascites, as of a standing Pool or Lake, is to be de∣rived from a River, or at least a glutt or inundation of some Humour.

The humours that flow within the passages, or Vessels as Brooks,* 1.49 are chiefly these three, viz. the Blood, the milkie Humour, and the Lympha. The showering or distilling of water may come to pass from the nervous Liquor which sometimes slowly and insensiby sweats out of the fibres and membranes, and from vapours condensed within the hollowness, or some Cavity of the Body. Whether by these wayes an Ascites doth rather, and oftener proceed, we will now search.

And in the first place as to what relates to the blood, it is without doubt,* 1.50 the Se∣rum falling from the masse thereof, too much dissolved, as it doth excite Fluxions and Catarrhs of various kindes, so it sometimes stirs up the greater illuvies of waters, viz. Dropsical: wherefore when an Anasarca proceeds altogether from this cause, and when oftentimes an Ascites comes upon that disease not immediately heald, we may well enough inferr that either distemper is induced from a watery humour, every where poured out from the little mouths of the Arteries. Moreover, it is not much improbable, that the Serum of the dissolved Blood is first and solitarily poured out of some end of the Coeliac and Mesenteric Arterie being open into the Cavity of the Abdomen, and so brings on an Ascites without an Anasarca going before; and so especially if perhaps it happen, that scirrhous Tumours, Ganglion's, little swell∣ings, or preternatural Concretions of another manner, are first raised about the Me∣sentery, the Spleen, the Liver, the Womb, or any of the other bowels of the nether belly: for, because the Circulation of the blood is hindred in those places, that the blood being carryed through the arteries, may be some way brought back, the serous part being thrust out from its company, falls into the cavity. For truly it is most evi∣dently manifested, that it so comes to pass, by this Experiment mentioned by us in another place, viz. If in a living animal, the jugular veins being taken up and bound

with a thred, the reduction of the blood be stopt, the whole Region of the head swells in a short space, with a water between the skin, and clearly hydropical. And truly I have more frequently observed that an Ascites hath followed upon secret tumours gathered and raised in some place in the lower belly: which certainly happens for the reason above recited. When the course of blood being obstructed, the watery part is extravasated in a short space, that humour is not meerly serous, but besides, the nutritious Liquor, ordained to nourish all the solid parts, is emptyed into the belly: wherefore, while this Region swells up, the members are extenuated, and the Lym∣pha taken out from an Ascites, with heat thickens and grows white, like the white of an Egge.

It is also very probable,* 1.51 that the milkie Vessels being burst asunder, pour out their humour into the cavity of the abdomen. Truly the most renowned Sylvius thought this disease most frequently engendred from such a cause. And truly as out of the milkie or watery Vessels, viz. one of them or both together, being divided, or opened, we may well suspect the illuvies of water or chyle sometimes to overflow the bowels of the nether belly; so the following observation seems to confirm the same thing. Of late one that had been long sick of the Jaundies, and in the mean time temperate and abstemious of drink (to which he was not prompted by thirst) contracted an Ascites, increased in a short time hugely. After that medicines were administred in vain, a Paracantesis is attempted according to the manner of Sylvius, with a hollow Needle; out of the orifice, not icterical water, but limpid and thin flowed out abun∣dantly; from whence we may inferre, that hydropic humour flowed not out of the mass of blood, for then it had been coloured, but distill'd out of the lymphic or milkie vessels into the cavity of the abdomen. We have joyn'd together as akin the ways of the milkie and lymphic Vessels in propagating an Ascites, because both ves∣sels do convey the chyle, or what is analogous to it, to the common Receptacle; and many branches or leading Pipes of either kind, are distributed about the bowels of the nether belly; in the mean time, it is not improbable but that a solitary fault of either vessel may sometimes produce an Ascites.

As to the other wamys of generating an Ascites, proposed in the beginning, I am scarce induced to think, such an inundation of the belly can easily arise from the distilling of a nervous humour, or by reason of vapours there condensed: although perhaps in a Tym∣pany where the cavity of the abdomen is enlarged, and transpiration hindred, the efflu∣via that were wont to exhale, being forced inwards, are changed into Lympha or wa∣ter, wherefore for the most part an Ascites is ever conjoyn'd with that disease.

The immediate or conjunct causes of an Ascites being design'd after this manner,* 1.52 which indeed seem to be, either a watery humour poured out of the Vessels bringing Blood, or Lympha or Chyle poured out of the proper passages of them both; not we must in the next place inquire about the more remote causes of this disease, viz. for what occasions, and after what manner, the vessels affected of either sort deposite their burdens into the cavity of the belly.

First therefore,* 1.53 that the watery part of the blood sweats out into the Aqualiculum or belly, either the very Blood, or Vessels containing it, or both together, are in fault. The Blood is in fault, when being depraved in its Crasis it doth not rightly contain within its consistence the constitutive parts, but being apt to be dissoved, it every where rejects its serosities from the mixture; which either it drives out by Urine or Sweat, or permitting them to reside within, pours them out into the pores of the flesh,* 1.54 or the cavity of the bowels. The vessels bringing blood grow faulty for a second reason, for that their extremities or little mouths either are too much loose, or altogether shut up. In the former state the clew of Circu∣lation of blood is not entirely and firmly continued; but the thinner and more crude part of the blood being apt to depart, is suffered to flow out near to the inter∣spaces or inosculations of the Arteries and Veins; likewise on the other side, when the course of blood is hindred, by reason of a tumour or obstruction of some vessels, their little mouths being throughly closed; to this being so straitned that a passage may be made open by some means, that which is thin and watery is extravasated, and sent away into the neighbouring places, as we have shewed above.

2,* 1.55 & 3. But an Ascites beginning alone, doth often arise, by reason of the milkie or lymphatic vessels being depraved; wherefore seeing we suppose the cause of this kind of disease to be oftentimes conjunct, we must enquire, by what means, and for what occasions, these vessels are wont to be so opened or burst asunder, that they pour out thei liquor into the cavity of the belly.

First therefore as to what belongs to the Lymphaducts, these vessels may be in fault after a diverse manner, but chiefly, either that being obstructed or compressed near their origine, they do not receive the humour, or being burst about the middle or extream parts, do pour it out into the belly. There are many causes and rea∣sons of effecting of either of these, for it may be a viscous matter obstructs their be∣ginnings, or glandulous, scirrhous, and other preternatural Tumours compress them, as also a vast inundation of Lympha flowing out, moreover vehement motions of the Body, or passions of the mind, may burst them asunder.

2. The milkie Vessels, no less than Lymphatick, are in danger to be broke,* 1.56 and so by pouring out their liquor into the cavity of the Belly, do excite the Dropsie called Ascites; and truly they are wont to be hurt for the like reason, in regard their middle passages, or their ends, either are obstructed by a more viscous chyle brought into them, or by Phlegme from the intestines, or they are compressed by Tumours bred in the Mesenterie: for forthwith the chyle entering into the beginnings of the vessels, and not finding a passage, first very much distends them, and afterwards breaks them. There are many causes and occasions, for which the thicker and obstructing humours are driven forwards into the milkie Vessels; for besides an irregular Diet, and for the most part from meats hard to be digested, this evil is frequently caused by too much drink, or immoderate exercise immediately after Food, also from cold drink while the Bowels are very hot; for so the passages of the Vessels before gaping are suddenly shut, and afterwards more narrowly closed, wherefore the chyle sticking within their straitned chanels, doth throughly fill and obstruct them in a short space.

As to what belongs to the differences of this Disease, besides them already cited,* 1.57 viz. that it comes after an Anasarca, or comes solitary; that this also is manifold and after a diverse manner, according as the Vessels bringing blood, or water, or milk, are found in the fault; Moreover we observe, that the Dropsie called Ascites sometimes proceeds from a meer watery humour filling and distending the parts of the nether belly; but sometimes there happens to this deluge an extension of the mem∣branes, or inflations made by the irregularities of the inmate spirits, and so they do encrease the swelling of the Abdomen; and in this case a certain Tympanites comes upon an Ascites, even as more frequently on the contrary, this is the offspring of that.

Moreover, in an Ascites meerly watery, sometimes the Lympha only fluctuates within the Cavity of the Abdomen, so that in the mean time the bowels being soakt in it, continue still entire, and little or nothing encreased in their bulk; but sometimes besides the inundation of the Lympha in the hollow of the belly, the blood being slowly circulated there, and almost stagnating it is much diluted with water; Moreover the Parenchyma of the bowels, and the sides of the Vessels and of the membranes, and chiefly the Glandules every where numerous, being moisten'd, do swell with the flowing water, and so the tumour of the belly consisting as it were of many pools of water and moorish Contents, rises into a vast bulk.

The Prognostick of this Disease, is always suspected and accounted of an ill omen:* 1.58 for none of the vulgar but will pronounce the obstinate tumour of the belly to be very dangerous and difficult to cure: If any seem to be affected with a Dropsie, or a Consum∣ption, with them presently the next question is, Who shall be his heir.

An Ascites beginning after an Anasarca (which proceeds commonly from the whole mass of blood being pour'd forth into serosities, and sweating them out of the little mouths of the Arteries into the cavity of the Abdomen) is accounted of easier cure, or at least of more promising hope, than that solitary disease coming from tumours about the bowels, or from the Lymphatick or lacteal Vessels being burst asunder; for as well the conjunct as procatarctick cause of the former Disease, oftentimes is used to be removed wholly, or in part; but in the other case, both for the most part exist incurable. A reddish Urine, lixivial, and little, in an Ascites is of ill signification, for 'tis a sign that the mass of blood, being repleated with a scorbutick Salt and Sulphur boyled together, is too much bound up in its substance; insomuch that it doth not well separate the feculencies, nor discharge them by fit and convenient Sinks, which notwithstanding it doth evilly dispose by constraint into the Cavity of the Belly, for∣asmuch as it is hindred in its Circulation in the very same place. For in an Ascites the blood is not always dissolved as in an Anasarca, but sometimes appears too much com∣pacted in its temper, yet so, that the salt Serum being denyed to the pores of the skin,

and to the Urnary passages, by reason of the Obstructions of the bowels is forced to break out within the abdomen.

If in an Ascites, by a Purge taken, the waters are evacuated with ease plente∣fully by stool, and from thence the swelling of the belly is somewhat diminished, we are not to despair of the Cure; but if Purgers bring out little or nothing of the Serum, or Lympha, and thence by reason of the Nervous fibres being irritated, and driven into extensions or inflations of the bowels and membranes (as it uses frequent∣ly to be) the belly swells the more, and grows like a Drum, we may expect only a fatal event of the Disease.

About the curing of the Dropsie called Ascites it behoves us chiefly to consider by what ways the waters heaped within the abdomen,* 1.59 may be thence brought out, and evacuated, for such an evacuation ought to be attempted only by possible ways. And here presently is to be observ'd, that the remedies used for Hydragogues according to the ordinary practice of Medicine, intend to accomplish that end by purging, by Urine,* 1.60 by Sweating, and by insensible transpiration: In some cases of the Sick you ought to proceed by this way, and in other cases rather by that way, or another, and if none of these seem feasible, or succeed well, let mature consultation be had for a Paracentesis. It will be worth our labour to weigh every of these kinds of Medicines, and the reasons of every one, and the manner of their operations, and with how much vertue Hydragogues are endowed.

First,* 1.61 therefore as to what relates to purging, we have in another place shewed that, from the irritation of the Physick made in the belly and guts, as well the Contents and winde of these bowels, as moreover the humours driven into their Coats and Glandules, and which are heaped up in the Vessels and Pipes of the neighbouring parts, are disquieted, and partly streined into the passages of the guts, and partly returned in∣to the mass of blood; insomuch that the tumour of the abdomen arising from the stoppage, and as it were a waterish affection of those kind of Parts, is often abated by Purgatives seasonably administred, and sometimes wholly removed; but it doth not so succeed when it proceeds from a Lympha fluctuating within the cavity of the abdomen, or from an inflammation of the membranes, or from a tympanitic exten∣sion: because Hydragogues do little or nothing bring out those waters, and if they be of the stronger sot, they encrease this passion and exasperate it by inflaming the part.

Catharticks used for Hydragogues,* 1.62 are either Vomits, or Purges; they exert their power in the stomace, and these rather in the Intestines; insomuch that they power∣fully provoke and twitch the Nervous fibres; and together pour forth the blood and nervous liquor by a certain septick force, and do cause the serous humours wherever impacted to be stirr'd, and do cause them plentifully to be sent away by the passage granted. Either are reckon'd of a various kinde, viz. either simple or compound, gen∣tle or strong, by the Ancients as well as by the Moderns; some of which that are most chielfy noted, we will here briefly observe.

1. Emetick Hydragogues, chiefly famous, are Gambugia, Esula, Spurge, and their se∣veral Preparations, as also the Hercules of Bovim, and the Pilulae Lunares.

2.* 1.63 Purgers are Elder, and Dwarf-Elder, Soldanella, Gratiola or Hedge-hyssop, the Juice of Orris, and Elaterium. We will briefly prescribe some methods either of prepa∣ring or compounding or administring each of these.

1.* 1.64 Gambugia, first an Indian Medicine, being from thence brought by our Coun∣trey-men, from the Painters Shops coming to the Apothecaryes, began to be in use, and is much magnified for purging out serous humours. But sorasmuch as taken by it slef it vehemently disturbs the Stomach, and often weakens it, therefore, that its outragious and violent vomiting force may be somewhat abated, there are divers ways of its Preparation invented; but truly it is best corrected with an acid Spi∣rit, or with an alcalizate Salt, or by throughly mixing and correcting it with aro∣maticks.

Adrian à Mynsicht,* 1.65 extolls the magistery thereof, which is made by a dissolution in Spirit of Wine, and after drawing it off, and precipitating it with Spring-water; also dissolving it with Spirit of Wine vitriolated, and with Tincture of Roses, and red Sanders, and after by evaporating it: others prepare it with the fume of Sulphur after the manner of Scammonie sulphurated; others grinde it on a Marble, moistening it with Oyl of Cinnamon, or Cloves, or other chymical Aromaticks. I use most the Solution thereof made with a tincture of Salt of Tartar, the dose from 15 drops to 20 or 30.

Take of Gum-gutta, gr. 6. Mercurius dulcis gr. xv. Conserve of Violets,* 1.66 a dram and a half, make a Bolus.

Take of Gambugia twelve grains, Salt of Wormwood fifteen grains, Oyl of Mace one drop, Conserve of Damask Roses one dram, make a Bolus: and it is wont to be given with Tartar vitriolate, or Cream of Tartar, and powder of Rhubarb.

Take of Gum-gutta sulphurated, or vitriolated, fifteen grains, Cream of Tartar half a scruple, Extract of Rhubarb one scruple, Oyl of Cinnamon, gut. 2. make 4 Pills.

Lately, a woman afflicted with a most painfull Ascites, and most desperate, as it seemed to me, the ensuing Medicine being taken for 6 days successively, she began to be much better, and in a short time afterwards recovered her health entirely.

Take of powder of Gum-gutta twelve grains, Oyl of Cinnamon one drop, with syrup of Buck-thorn, make a Bolus, the dose daily to be augmented, ascending from twelve grains to twenty.

Take of our Tincture of Gum-gutta one scruple, water of Earth worms one ounce, Sy∣rup of Rhubarb half an ounce, mix them, and let it be taken with government.

2. Whereas there are several species of Spurge, or Tithymalus,* 1.67 and all of them work more violently either by Vomit or Stool, by reason of the notable provocation they make in the bowels; and for that cause do abundantly bring out serous humours; yet by reason of the too outragious force of many of them, the lesser Spurge for the most part only is now in use, and the preparations thereof most of all magnified are, the powder of the bark of the Roots, and the Extract, and we think fit to adde the tincture inferiour to none of the rest.

Take of Spurge with the Roots cleansed four handfuls, Lignum-Aloes, and Cloves, of each one dram, bruise them and boyl them in four pound of Spring-water, to half, the strained Liquor clarifie by separation or settling in a long glass afterwards evaporate the clear liquor in a Bath heat, to the consistence of an Extract, the dose one scruple.

Take of this Extract half an ounce,* 1.68 pour upon it into a matrass of the Tincture of Salt of Tartar 6 ounces, digest them in a Sand-hath to the Extraction of a Tincture, the dose from 20 drops to 30 in a convenient vehicle.

Take of the Powder of Spurge from seven grains to ten, Cinamon half a scruple, Salt of Tartar eight grains, mix them together in a glass mortar, give it by it self or mixed with a fit Conserve, or Syrup, make a Bolus or Pills.

2. Precipitate of Mercury with Gold,* 1.69 or the Hercules of Bovius which is much extolled by the Author for curing Dropsies; it is described in a former Treatise in the Chapter of Vomits, and the manner of preparing, and the working thereof, and the Reasons are there delivered. This Medicine, inasmuch as it twitches the sto∣machical fibres by its acrimony, and pours out the blood by reason of the mercurial and salt particles, causes or stirs up a fierce Vomit, and thereby causes the serous hu∣mours, violently strained into the Cavities of the bowels, to be ejected.

3. The Pills called Lunares produce the same effect in like manner,* 1.70 by reason of the vitriolate particles of Silver sharpened with other saline menstruums, viz. by wrink∣ling of the fibres of the Bowels very much, they force the serous humours to be strongly strained into their passages, and so to be evacuated.

A Solation of Silver made in Stygian water, and well cleansed, and by a little evaporation is reduced into pleasant Crystals, which by themselves (or with an addition of Salt Nitre to abate the fierceness of the Lunar Vitriol) are made into Pills with crums of bread: the dose is one Pill, sometimes two or three, respecting the ability of strength and working. Medicines of this kinde are exhibited sometimes with success in a strong constitution, and bow∣els strong, and a good habit; but they are scarce ever conveniently or rarely without prejudice taken by tender and cachectical persons.

Hydragogues meerly or chiefly purging, are either of a more mild sort, as Elder,* 1.71 Dwarf-Elder, Soldanella, and juice of English Orris, which seldom being administred by themselves, do want the stirring up of sharper Medicines, and on the other side they blunt their too much fierceness; or they are of a stronger sort, as Gratiola or Hedge hyssop, Jallap, and Elaterium.

The seeds or grains of Elder and Dwarf-Elder being dryed,* 1.72 are reduced into a powder, which being taken to the weight of one dram, doth gently bring forth se∣rous humours by siege; Water and Spirits are distill'd of the juice of either sorts of Berries fermented, also Robs and Syrups are made of them; which with many other Preparations of those Vegetables, are much magnified for all hydropical Distem∣pers.

Soldanella and Gratiola,* 1.73 are rarely used by themselves in our age, neither are any neat and very efficacious Medicines prepared out of those Simples, they are frequent∣ly mixt with certain other Hydragogues, and chiefly are ingredients in compounding Apozems.

The Juice of English Orris is a very profitable Medicine,* 1.74 and because to be easily provured for the poor, is the more to be esteemed: It is given grom six drams to an ounce and a half, or two ounces, either by it self in a fit vehicle, or with other things appropriated thereunto. Jalap is a most known Medicine against every Dropsie, and common enough. Any one of the common people suffering under that disease, pre∣sently takes of the powder of the root of Jalap a Pennyworth, mixt with Ginger and White-wine, and the desired effect doth frequently follow this remedy used with in∣termission.

Elaterium, is rightly esteemed the most powerful Hydragogue,* 1.75 for that it most pain∣fully provoking the splanchnick fibres and together melting the blood and humours by a certain corrosive force, compells whatsoever serosities the Coats of the Bowels, Membranes, Vessels, also the Glandules, and flesh do contain in themselves, to be poured out into the cavities of the Stomach and guts: by which Medicine happily working, the asswaging of the Abdomen doth sometimes succeed. Truly this is the chief weapon of the Empirical Magazine against any Ascites; which they notwith∣standing using in all cases, do oftener administer to the hurt than benefit of the Pa∣tient: the dose is from three grains to ten or fifteen, taken either by it self, only with correcting spices added, or it is given with other hydragogues in form of a Powder, Pills, or Electuary. The tincture and essence of it are extracted with Spirit of Wine, or with tincture of Salt of Tartar.

These are the chief simple Hydragogues,* 1.76 from which being prepared with the ad∣dition of others, many compounded ones as well Magistral as common in Shops are made, adn are every where in use; moreover, very many more might be prescribed extemporarily, as occasion serves. Of these we will here annex a few more select forms, and chiefly those that are taken in the form of Potions, Powders, Electuary and Pills.

Take of Dwarf-Elder,* 1.77 English Orris, of each an ounce and half, leaves of Soldanella and Gratiola, i.e. Hedge-hyssop of each one handful, Asarum, and Asse Cucumber-roots of each two ounces, roots of lesser Galangal six drams, choice Jalap half an ounce, Ela∣terium three drams, Cubebs two drams, shred and bruise them, and pour upon them three pound of small Spirit of Wine tartarizated, digest it stopt close in Sand for two days, strain it clear and depurate it by settling. The dose from two spoon-fuls to three, in a convenient vehicle.

Take of Elaterium,* 1.78 Soldanella, Ginger, of each one scruple, Galangal, Cloves, Cina∣mon, of each half a scruple, Salt of Tartar fifteen grains, make a powder for two doses.

Take powder of Jalap one dram, Ginger one scruple, Cream of Tarar 15 gr. make a powder to be given in a draught of White-wine.

Take of Rhubarb one scruple,* 1.79 Elaterium 5 grains, Tartar vitriolated half a scruple, Spick∣nard three grains, with Syrup of Buckthorn make four Pills.

Take of pill Aloephanginae half a dram, Elaterium half a scruple, Oyl of Cloves gut. 3. make four Pills.

Bontius hydropick Pills are given from half a scruple to half a dram, prepared thus:

Take of Aloes two drams and a half, the preparation of Gum-gutta one dram and a half, Diagridium corrected one dram, Gum Ammoniacum dissolved, one dram and a half, Tartar vitriolated half a dram, make a mass, and form it into Pills.

Certain hydragogue Electuaries re now every where in use and celebrated by practi∣sers.* 1.80 Of which sort are, 1. One described by the renowned Sylvius, and the other by Zwelfer. This following pleases us.

Take of Resine of Jalap two drams, Tartar Vitriolate one dram, Extract of Rhubarb two drams, of Spurge a dram and a half, lesser Galangal one dram, beat them in a mor∣tar, and lastly adde of Conserve of the flower of English Orris, four ounces, and with Syrup of Peach-flowers make an Electuary, the dose from half a dram to a dram and a half, or two drams.

I might here set down or describe many other purging Hydragogues,* 1.81 but Cathar∣ticks do not always cure an Ascites, yea often-times exasperate it, and (if they be long continued) render it incurable; hence it is necessary to have recourse to other Reme∣dyes for the Cure of this disease. Wherefore, let us next enquire whether Diureticks do here profit or not?

And truly any one may easily think that Remedies moving Urine conduce very much for draining waters out of every place or cavity of the body. In truth it is ma∣nifest by frequent experience, these do often cure an Anasarca before any other Re∣medy; let us see what they may effect for the emptying the Cavity of the Abdo∣men.

As to this it first appears,* 1.82 that there is no passage immediately open from an Ascitick pool to the Reins, although contiguous; but that whatsoever waters are transferred from hence thither, must of necessity first be drunk up into the mass of blood, and from thence be poured out of its bosom into the sink of Urine; and truly it is but a little which the gaping little mouths of the veins about the superficies of the bowels can receive (if perhaps they are open at all) and Diureticks can but effect this one thing, that by pouring forth the blood, and forcing its serosities more plen∣tifully to the Kidnies, they cause the waters fluctuating in the belly to be allured to it being so emptyed; in the mean time there is no less danger, lest Diureticks be∣ing unseasonably administred, while they dissolve the blood too much, they constrain the serum to depart into the seat of the Ascites, more than into the Reins, and so rather augment than remove the inundation of the belly. For that it sometimes so happens, I have often found by experience; wherefore when Diureticks are prescur∣bed to cure an Ascites, we must chielfy provide against such a contrary effect. For this reason indeed Astringents and Corroboratives are always mixt in Remedies for the Dropsie (founded on experience, and the Authority and Practice of the An∣cients) not that such (as is commonly said) do confirm the Tone of the Liver, but conserve the temperature, and mixture of the blood, lest it be wholly dissolved by too great a fusion. Wherefore in an Ascites which chiefly or in part happens by rea∣son of the frame of the bowels and vessels, and chiefly the Coats, Glandules, and their little strings, and their interspaces being stuffed by a serous humour, and there∣fore very much swell'd up, as Catharticks so also Diureticks profit, and are fre∣quently taken with success; forasmuch as by the use of these the masse of blood be∣ing emptyed (the serum being more plentifully derived to the kidneys) doth easily reveive unto it self those waters every where stagnating about their little mouths, and conveys it towards the urinary sink: but on the contrary, in a meer Ascites where the heap of waters do overflow the Cavity of the Belly, the Textures of the bowels being free from the serous stuffing; Diureticks are given in vain, or incommodiously; inasmuch as they express nothing from this Lake of the belly, and most frequently by dissolving the blood more impetuously drive together the waters apt to be instill'd there.

Not all Diureticks of every kinde are equally convenient in an Ascites,* 1.83 neither ought they indifferently to be administred; for we must observe, the affected in this disease for the most part make a little, reddish Urine, and as it were lixivial; which truly is an indication that the temperature of he blood is too much bound in them, by reason of the fixt and sulphureous Salt exalted and combined together: and therefore that the Serum is not duely separated within the reins; which notwithstand∣ing is shook off about the windings of the obstructed bowels, and so is depisited in the Cavity of the Belly. Wherefore in this Case it will be convenient to drink only those things to excite Urine, which so restore and amend the Constitution of the blood, that the enormities of the fixed Salt and Sulphur being taken away, the serous part might be separated within the reins, and more plentifully discharged; for which purpose, not acid or lixivial things, but those endowed with a volatile Salt are appointed. For I have often observed in Patients of that kind, when the Spirit

of Salt, and other acid drops of Minerals, and when the dissolutions and Deliqui∣ums of Salt of Tartar, Broom and other things, have done more hurt than good, that the Juice of Plantane, Brooklime, and other Herbs abounding with a volatile Salt, have much helped, as also the expressions of Millepedes: for the same reason Salt of Nitre throughly purified or Crystal Mineral doth often profit. Forms of Medicines more accommodate for this use are extant in our former Treatise, where, viz. ex∣amples of Diureticks are described, in which both volatile and nitrous Salts are the Basis. Moreover, hither ought to be referred the notable experiment, by which Joannes Anglus affirms himself often to have cured the Ascites from a hot cause,* 1.84 which Medicine also that expert Physitian Dr. Theodore Mayern was wont to magnifie and prescribe in the like case.

Take of the juice of Plantane and Liverwort, and fill an Earthen pot to the top, which being stopt close, put in a hot Oven after the Bread is drawn, and make a little fire on the sides of the pot to continue the heat of the Oven; after it is so boyl'd strain it, and being sweetened with Sugar, drink of it Morning and Evening, and it cures. In imita∣tion of this I have often with success prescribed as followeth.

Take of green Plantane-leaves four handfuls, Liverwort, Brooklime, of each two hand∣fuls, bruise them together, and pour upon them half a pound of small compound Radish∣water, or other appropriate Aagistral, express it strongly, the dose three ounces three times in a day.

Although Diaphoreticks are most efficacious in an Anasarca,* 1.85 yet in an Ascites they are rarely or not at all used: for being unseasonably offered, they impress oft-times great hurt on the Patient without any avail; forasmuch indeed as by heating the blood, they cause the fluctuating waters to grow hot, and as it were to boyl in the hollowness of the belly; so that the spirits and humours are disturbed by vapours raised from thence; and so a disorder of all the functions follows, and the very bow∣els being as it were boyled, are much prejuciced. Moreover from sweating unadvi∣sedly instituted, the blood being forced into a fusion and precipitation of the Serum, throws it off the more into the nest of the Ascites. Wherefore when some prescribe fomentations, and liniments, adn bathing, to be applyed to the swelling Paunch of the Belly, for the most part it turns to the worse in such Patients; for besides a little Feaver, a Vertigoe, fainting of the spirits, and other ill symptomes of the brain and heart, being most frequently so raised, even the belly also doth from thenc swell the more: forasmuch as the Blood being agitated and poured out, deposits in that place more largely the Serum; and for that cause the mouths of the Vessels are more loose∣ned and opened, so that they may more readily let fall water prone to depart from the mass of blood. But the Remedies which are chiefly wont to be administred with success near the places affected (when a Cure is intended without a Paracentesis) are Clysters and Plaisters.

The former draw the Serum out of the Vessels and Glandules of the Guts and Me∣sentery without fusion of the whole mass of blood,* 1.86 (which the stronger purging Me∣dicines do excite,) which being so emptyed do imbibe a little the extravasated Lym∣pha. For this purpose the ensuing Clyster, wont to be prescribed by us in this case, is most fit, in regard it contracts the intestinal fibres together, and draws the Serum imbibed by the blood, or contained formerly therein, towards the Reins.

Take a pint of Ʋrine of a sound man that drinks Wine,* 1.87 Venice Turpentine dissolved with the Yolk of an Egge, an ounce and a half, Sal Prunella one dram and a half, make a Clyster, which repeat daily. Sometimes Plaisters yield help in an Ascites, yet let them be such, as by a certain restringent and comfortable virtue strengthen the bowels and bind together the moughs of the Vessels, lest they too much spue out their serosi∣ties: for this purpose, I use to apply the Plaister Diasaponis with successe. Or,

Take of the Plaister of Minium, Paracelsus Plaister, of each what suffices, make a Plaister to be applyed to the Abdomen. If this disease is accompanyed with a Tympanie, Epi∣themes of another manner are fit, as we shall hereafter declare.

The great and most present remedy of an Ascites, is, that the waters may be drawn out by a Paracentesis being made; which administration however doth not oftner cure the disease, than kill the Patient; wherefore there is need of exact caution

to whom, and at what time of the disease it ought to be administred: to persons of an ill habit, who have been long ill, in whom the conformation and temper of the bowels is wholly depraved, it will be in vain to have the Lympha drawn out by the Paunch being pierced; for thereupon immediately the Spirits faint and the strength is dissoved, and after a while a new illuvies of the morbific humour succeeds.* 1.88 But those who being formerly of sound bowels, and healthful enough, as to other parts, when they fell into an Ascites from some great and evident cause, as we are not at first presently to make a Paracentesis, so neither if it be needfull ought we to deferre it too long: for an incorrigible depravity of the Bowels is contracted by a longer delay, while they remain a long while drowned, and as it were boyled in water.

It is beside our purpose to describe here the administration of a Paracentesis, whe∣ther it be done after the ordinary manner, or by a hollow Needle according to Sylvius; this part of Chirurgery, as dangerous, when Physitians seldom prescribe, yet Quacks and Empiricks rashly and unluckily essay it, Artists not being consulted: we will re∣late here for conclusion the History of a true and huge Ascites, lately cured without and Paracentesis.

A young Woman wise to a Merchant, being slender and proper,* 1.89 while she gave suck to her Child, to encrease her milk day and night did immoderately guzzle one while plain Ale, another while Posset-drink. After having used this kind of dyet for a fortnight, she contracted a vast Ascites in a short time, the beginning whereof she was not in the least sensible of; for her Abdomen being great with water fluctuating within, did much swell up, and its bulk when she turned from one side to the other, fell without the Ileon and borders of the rest of the body: when in the mean while the flesh of all her Members was very much consumed, that she seemed no less in a consumption than a Dropsie.

The Child being weaned, and a better course of Diet being appointed, she be∣took her self to Medicines, and took in the first place the more mild Hydragogues, as well purgative as diuretical, but without any advantage; also she was worse after every purge; but being committed to our care, and almost desperate, I handled her after the ensuing method.

I prescribed these Medicines, for the most part forbidding Ale, and any potulent liquor (medicined excepted.)

Take of the leaves of Plantane, Brooklime, Clivers, of each 4 handfuls bruised, and pour upon them of water of Earth-worms and Rhadish compound of each three ounces, press them, take it twice a day, viz. at Eight in the Morning, and at Five in the After∣noon. She continued long in the use of this Medicine, but did sometimes vary the Compo∣sition, sometimes changing the herbs, sometimes the Liquor poured on them.

Take of the reddest Tincture of Salt of Tartar an ounce and a half, she took 20 drops at night, and early in the morning, in two spoonfuls of the following Julep, drinking seven spoonfuls after it.

Take water of Elder-flowers, Saxifrage, of each six ounces, water of Snails, Earth∣worms, and Rhadish-compound, of each two ounces.

She wore a Plaister of Minium and Oxycroceum upon her Belly.

The following Clyster was given first daily, afterwards every two or three days.

Take Ʋrine of a healthy man one pound, Turpentine dissolved with the Yolk of an Egg an ounce and a half, Sugar an ounce, Sal Prunella one dram, make a Clyster.

By the constant use of these things her Belly asswaged within a fortnight, but her flesh daily wasting, a Consumption was threatned. Wherefore, going into the Coun∣trey to avoid this, she drank Asses milk; by the benefit of which Nutriment and of purer Air, continually taking the above-mentioned Medicines, she recovered her en∣tire health within three or four weeks, and lives yet in health.

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

ATypany vulgarly,* 1.90 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.* 1.91 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.* 1.92 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,* 1.93 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,* 1.94 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,* 1.95 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,* 1.96 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,* 1.97 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,* 1.98 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,* 1.99 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,* 1.100 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,* 1.101 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.* 1.102 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,* 1.103 (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

of every humour within contained, being rarified into vapours, forthwith turns into wind, wandring about those empty spaces.

Truly,* 1.104 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;* 1.105 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,* 1.106 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,* 1.107 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,* 1.108 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

all 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,* 1.109 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,* 1.110 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,* 1.111 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

certain description of this disease, viz. That it is a fixt and constant Tumour of the Ab∣domen, equal,* 1.112 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,* 1.113 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;* 1.114 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,* 1.115 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,* 1.116 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,* 1.117 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,* 1.118 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

wont 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,* 1.119 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,* 1.120 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,* 1.121 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.* 1.122 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,* 1.123 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,

also 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,* 1.124 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,* 1.125 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,* 1.126 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.* 1.127 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,* 1.128 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,* 1.129 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,* 1.130 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,* 1.131 Chervil and Clivers-leaves, of each four handfuls, bruise them, and

pour 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,* 1.132 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,* 1.133 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,* 1.134 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,* 1.135 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,* 1.136 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:* 1.137 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,* 1.138 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,* 1.139 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,* 1.140 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,* 1.141 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,* 1.142 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,* 1.143 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.* 1.144 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.

1. Cardiacks.

Take of the water of Napha,* 1.145 Marygolds, Camomile, of each three ounces, of Dr. Stephan's water two ounces, Tincture of Saffron two drams, Sugar one ounce, Pearls one dram, make a Julep, the dose four or five spoonfuls three times a day or oftner in faintings.

Take Conserve of Marygolds two ounces, Confection of Alchermes, and de Hyacin∣tho, of each two drams, prepared Pearl one ounce, Syrup of the juice of Citrons, enough to make a Confection, take the quantity of a Nutmeg evening and morning, drinking after it a draught of the Julep.

2. Hypnoticks.

Take of Aqua Hysterica six drams,* 1.146 Syrup de Meconio half an ounce, mix them, and take late at night. Or,

Take of small Cinnamon-water one ounce, Diacodium three ounces, Tincture of Saf∣fron two drams. Mix them, and take one spoonfull at night, if sleep be wanting. Or,

Take Syrup of Cowslip-flowers three spoonfuls, compound Poeony-water one spoonful, Lauda∣num tartarized one dram, take one spoonful, if Watchings require it.

3. Extinguishers of Thirst, in this Disease being very thirsty,* 1.147 ought frequently and in small quantities to be administred, that that troublesom symptom may be restrained without much drink, which is perpetually pernicious. For which pur∣pose,

Take of Conserve of Wood-sorrel passed through a Sieve three ounces, Pulp of Tamarinds two ounces, Sal Prunella one dram, with a sufficient quantity of Syrup of the juice of Wood sorrel, make a Lohoch, of which let him lick often.

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.* 1.148 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,* 1.149 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,* 1.150 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,* 1.151 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,* 1.152 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,* 1.153 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

straiter 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;* 1.154 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,* 1.155 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,* 1.156 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,* 1.157 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

every 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,* 1.158 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,* 1.159 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,* 1.160 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,* 1.161 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,* 1.162 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

other 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,* 1.163 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,* 1.164 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,* 1.165 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,* 1.166 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.* 1.167 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,* 1.168 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

the 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,* 1.169 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,* 1.170 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,* 1.171 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,* 1.172 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,* 1.173 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,* 1.174 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

that 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.* 1.175 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,* 1.176 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,* 1.177 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.* 1.178 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,* 1.179 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,

not 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,* 1.180 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.* 1.181 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;* 1.182 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,* 1.183 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,* 1.184 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,

and 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,* 1.185 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.* 1.186 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.* 1.187 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.* 1.188 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.* 1.189 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.* 1.190 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

stream, 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,* 1.191 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.* 1.192 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,* 1.193 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,* 1.194 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,* 1.195 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,* 1.196 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,* 1.197 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

watery 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.* 1.198 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.* 1.199 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.* 1.200 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.* 1.201 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.* 1.202 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,* 1.203 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,* 1.204 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,* 1.205 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

weeks 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,* 1.206 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.

Notes

• * 1.1

  Diseases of the Liver.
• * 1.2

  The Jaundies.
• * 1.3

  The cause of it.
• * 1.4

  The opinion of Sylvius of the cause of the Jaundies.
• * 1.5

  The Authors opinion.
• * 1.6

  The cause of this disease some∣times in the blood.
• * 1.7

  The cure of the Jaundies.
• * 1.8

  The 1. Indica∣tion.
• * 1.9

  The 2. Indica∣tion.
• * 1.10

  The 3. Indica∣tion.
• * 1.11

  Forms of Reme∣dies.
• * 1.12

  Vomits.
• * 1.13

  Purgers.
• * 1.14

  A Bolus.
• * 1.15

  Apozems.
• * 1.16

  A Potion.
• * 1.17

  Pills.
• * 1.18

  Deoppilative Medicines.
• * 1.19

  Elixir.
• * 1.20

  Apozems.
• * 1.21

  Empirick Re∣medies.
• * 1.22

  An Electuary.
• * 1.23

  Distilled Wa∣ters.
• * 1.24

  Sylvius his Em∣pirical Reme∣dies.
• * 1.25

  The second Indi∣cation. Remedies a∣gainst the Jaundies en∣dowed with an animal vo∣latile Salt.
• * 1.26

  Varlous forms of them.
• * 1.27

  Also such as are endued with a mineral vola∣tile Salt.
• * 1.28

  Steel remedies of several kinds.
• * 1.29

  Outward and Sympathetick remedies a∣gainst the Jaundies.
• * 1.30

  The reasons of some of them.
• * 1.31

  The Third Indi∣cation vital.
• * 1.32

  Forms of Cor∣dials.
• * 1.33

  The Kinds of Remedies as∣signed to the Liver.
• * 1.34

  Two general in∣tentions of cu∣ring this bowel.
• * 1.35

  Medicines vul∣garly called Splanchnick, first and chiefly operate upon the blood.
• * 1.36

  What such they are which more especially respect the Liver.
• * 1.37

  Some forms of Hepaticks.
• * 1.38

  Their numbers enumerated.
• * 1.39

  First Simples.
• * 1.40

  Chalybrater.
• * 1.41

  The Shop-com∣positions of He∣paticks.
• * 1.42

  Magistral Compositions.
• * 1.43

  Electuary.
• * 1.44

  A distilled Wa∣ter.
• * 1.45

  Pills.
• * 1.46

  The more remote causes of an Ascites.
• * 1.47

  First in respect of blood.
• * 1.48

  It doth not al∣ways proceed from the Liver & Spleen.
• * 1.49

  The humours by which it is pro∣duced are,
• * 1.50

  First the Blood.
• * 1.51

  2, & 3. The milkie and wa∣tery humour.
• * 1.52

  An Ascites often the product of the Jaundies.
• * 1.53

  The kinds of a Dropsie.
• * 1.54

  The Description of an Ascites.
• * 1.55

  2. In respect of the Lympha∣ducts.
• * 1.56

  3. In respect of the milkie ves∣sels.
• * 1.57

  The differences of this disease.
• * 1.58

  The Prognostick.
• * 1.59

  The Cure of an Ascites.
• * 1.60

  By what and how many re∣medies the e∣duction of the water is to be endeavoured.
• * 1.61

  First by purg∣ing.
• * 1.62

  Catharticks are either Vomits or Purges.
• * 1.63

  The chief medi∣cines of either kinde.
• * 1.64

  1. Gummi gut∣tae.
• * 1.65

  Its various Pre∣parations.
• * 1.66

  The forms of Hy∣dragogues pre∣pared thereof.
• * 1.67

  2. Spurge. The Preparati∣ons thereof.
• * 1.68

  Forms.
• * 1.69

  The Hercules of Bovius.
• * 1.70

  Pilulae Lunares.
• * 1.71

  Purging Hydra∣gogues.
• * 1.72

  Elder and Dwars-Elder.
• * 1.73

  Soldanella.
• * 1.74

  The juice of Orris.
• * 1.75

  Elaterium.
• * 1.76

  The forms of Hydragogues.
• * 1.77

  A Tincture.
• * 1.78

  Powders.
• * 1.79

  Pills.
• * 1.80

  Electuaries.
• * 1.81

  2. Diuretick Hydragogues.
• * 1.82

  What Profit they bring in an Ascites.
• * 1.83

  With what choice and dif∣ference they ought to be ad∣ministred.
• * 1.84

  John English his Empyrical remedy.
• * 1.85

  How beneficial Diaphoreticks are in an Asci∣tes.
• * 1.86

  Glysters and Plaisters.
• * 1.87

  Forms thereof.
• * 1.88

  When and to whom a Para∣centesis is con∣venient in an Ascites.
• * 1.89

  A history of a cure.
• * 1.90

  A Tympany not properly a kind of Dropsie.
• * 1.91

  Wherefore its cause is occult.
• * 1.92

  Commonly ascri∣bed to Winde.
• * 1.93

  Authors do not agree about the seat of the Windes.
• * 1.94

  Not without the guts in the ca∣vity of the Ab∣domen.
• * 1.95

  Nor within their passages.
• * 1.96

  Not between the coats of the bowels.
• * 1.97

  By what and how wany cau∣ses the Belly swells.
• * 1.98

  1. From tu∣mours of the Bowels in that place.
• * 1.99

  2. From wa∣ters gathered as in an Ascites.
• * 1.100

  3. From winds.
• * 1.101

  4. From the in∣flation of the Fibres, by rea∣son of the Spi∣rits being di∣sturbed.
• * 1.102

  An Affection of what sort a Tympany is.
• * 1.103

  Its cause and formal reason explicated.
• * 1.104

  And proved by arguments and instances.
• * 1.105

  An universal Tympanie.
• * 1.106

  The Cause of an universal Tym∣panie enquired into.
• * 1.107

  The true cause assigned.
• * 1.108

  Why the belly swells in the dead.
• * 1.109

  The Animal Spirits and not winde the cause of the Tympanie.
• * 1.110

  This happens by the fault of the Nervous juice.
• * 1.111

  By the obstructi∣on whereof the Spirits whthin the fibres are detained and made immo∣vable.
• * 1.112

  A description of the disease.
• * 1.113

  Its procuring causes.
• * 1.114

  Other previous convulsive af∣fections.
• * 1.115

  The case of an Asthma ending in a Tympanie.
• * 1.116

  The evident causes of this disease.
• * 1.117

  The Prognosticks thereof.
• * 1.118

  The Cure.
• * 1.119

  Remedies de∣signed against Wind profit not.
• * 1.120

  3. Curatory In∣dications.
• * 1.121

  The first Indi∣cation hardest.
• * 1.122

  What, and what sort of Medi∣cines are good or hurtful in this Disease.
• * 1.123

  Only mild Pur∣gers and Cly∣sters are conve∣nient.
• * 1.124

  Forms of Medi∣cines.
• * 1.125

  A solutive li∣quor.
• * 1.126

  Clysters.
• * 1.127

  Diureticks.
• * 1.128

  Distilled Wa∣ters.
• * 1.129

  Pills.
• * 1.130

  Spirits.
• * 1.131

  An Expression.
• * 1.132

  Apozems.
• * 1.133

  Topicks.
• * 1.134

  A somentation.
• * 1.135

  A Plaister.
• * 1.136

  The second In∣dication.
• * 1.137

  Of Chalybeate Medicines.
• * 1.138

  What preparati∣ons of Iron are not convenient.
• * 1.139

  What sort may be admitted.
• * 1.140

  Forms of Cha∣lybeates.
• * 1.141

  A liquor of the flowers of Tap∣sus Barbatus.
• * 1.142

  An Electuary.
• * 1.143

  A Julep.
• * 1.144

  Third Indica∣tion.
• * 1.145

  Cordials.
• * 1.146

  Hypnoticks.
• * 1.147

  Things mitiga∣ting Thirst.
• * 1.148

  The description of an Anasarca.
• * 1.149

  How it differs from an Ascites.
• * 1.150

  The Original from the blood.
• * 1.151

  The material and efficient cause.
• * 1.152

  The Blood its efficient cause in a double respect.
• * 1.153

  First that it doth not right∣ly sanguifie.
• * 1.154

  The reason whereof enqui∣red into.
• * 1.155

  The reason and manner of san∣guification ex∣plained.
• * 1.156

  An Hydropick temper of the blood springs from a double respect.
• * 1.157

  Viz. First from the desect or fault of its Fer∣mentation;
• * 1.158

  Secondly, from defect of Ac∣cension.
• * 1.159

  Reduced to three heads.
• * 1.160

  First, because the active par∣ticles of the blood, are too much consumed.
• * 1.161

  Secondly, be∣cause they are not enough re∣paired.
• * 1.162

  Thirdly, because they are buryed in duller par∣ticles.
• * 1.163

  Whereof there are three causes.
• * 1.164

  First from Non∣naturals immo∣derately ingest∣ed.
• * 1.165

  Secondly, From Naturals un∣duely retained.
• * 1.166

  Thirdly, From Preternaturals generated in the Body.
• * 1.167

  Different man∣ners hereof are reckoned.
• * 1.168

  The material cause of an Ana∣sarca is partly the Serum of the Blood, and partly the nu∣tritious Juice.
• * 1.169

  Why the hydro∣pick humour is limpid and not milkis nor bloody.
• * 1.170

  The Differences of the Disease.
• * 1.171

  The Progno∣sticks of it.
• * 1.172

  The Cure of it. Two Indicati∣ons.
• * 1.173

  The first intends the evacuation fo the morbific matter.
• * 1.174

  By Purgers.
• * 1.175

  Strong Purgers are couvenient but not to all.
• * 1.176

  The manner of their working.
• * 1.177

  Secondly, By Diureticks.
• * 1.178

  And chiefly Lixivials.
• * 1.179

  The reason and manner of their operation en∣quired into.
• * 1.180

  Forms of lixi∣vial Diureticks.
• * 1.181

  Diaphoreticks.
• * 1.182

  Diaphoreticks profit which are taken in a targer dose.
• * 1.183

  Forms thereof.
• * 1.184

  External Hy∣dragogues.
• * 1.185

  The chief Kinds of them, and the manner of their Administrati∣on.
• * 1.186

  1. Frictions.
• * 1.187

  2. Liniments, and, 3. Fomentati∣ons.
• * 1.188

  4. Baths.
• * 1.189

  5. Vesicatories.
• * 1.190

  6. Escharoticks.
• * 1.191

  The empirical manner of Es∣charoticks.
• * 1.192

  7. Pricking with a Needle.
• * 1.193

  The second In∣dication pre∣servatory what kind of Reme∣dies it suggests.
• * 1.194

  Forms of them.
• * 1.195

  1. Electuary.
• * 1.196

  Chalybeates profit much in this Disease.
• * 1.197

  But only those endued with Sulphur.
• * 1.198

  2. Powders.
• * 1.199

  3. Pills.
• * 1.200

  4. Julep.
• * 1.201

  5. Distilled water.
• * 1.202

  6, 7. Decoction.
• * 1.203

  Dirt-drink.
• * 1.204

  An Example of the Cure of an Anasarca Drop∣sie.
• * 1.205

  The Prognostick and Cure of the Disease.
• * 1.206

  The 〈◊〉〈◊〉 of 〈◊◊〉〈◊◊〉.