Ebrietas, or Drunkenness.

I. ACcording to the rule of Schola Salernitana,

If you be bitten by a dog over night, a hair of his tail will cure you the next morning. And although this remedy may seem to contradict the common fundamental of Medical Cure, that Contraries must be the cure of Contraries; and that of Hippocrates 1 Aphor. 3. That fulness is cured by emptiness: Yet we must distin∣guish between things that are done by accident, and things that come of themselves. Repletion is not truely the remedy of repletion; but it does good, inasmuch as it excites the faculty and the innate heat; hence a consumption of the morbifick mat∣ter happens from it: For Nature, upon the ac∣cession of new Aliment attempts concoction, which before it was not able to perform. Crude matter indeed over-heaped does harm, if the quantity ex∣ceed the strength of the stomach, but a little puts Nature in mind of her duty, and solicites her to perfect concoction. Hollerius de morb. int. lib. 1. cap. 3. affirms, that the hurt of Wine is removed by re∣peated drinking, inasmuch as Wine by its heating and drying power consumes the hurt of Wine; In the same manner as Hippocrates says, that pains in the eyes, arising from thick vapours, are cured by drink∣ing mere Wine. A. Villanovanus, in his Comment up∣on the aforesaid Verses, adds a caution, namely, that the rule holds not good when Drunkenness has heated the body: because then the repeated drink∣ing of Wine, would be onely adding fewel to the fire.

II. One that had drank plentifully of Spanish Wine, fell from his seat and lay for dead; when his Scrotum,* and all his Privities were wrapt up in the Juice of Housleek, mixt with sharp Vinegar and Nitre, his drunkenness was presently discussed; yet a heaviness remained in his head.

III. Galen, for the concoction of crudity, orders them that are drunk to bathe the next day, and after ba∣thing to go to sleep. Yet he advises not this in e∣very head-ach, but when the head is hot without a Fever, then he prescribes a Bath, and after ba∣thing to eat Lettuce, and sup Ptisan:* But when fla∣tulent vapours exhale to the head from putrid hu∣mours in the stomach, and cause giddiness, then he utterly disswades the use of the Bath.

Ecchymoma, or a Bruise, or Blackness and Blewness.

I. BAth-keepers apply to the contusion of the parts a middling Medicine, between a Pla∣ster and a Cataplasm, made of astringents, disper∣sers, driers, and strengthners of the tendons and nerves, as Bean-flower, dust of the Mill, Bole-Armenick, Comfrey, mixt with the White of an Egg. Horstius says, It is no absurdity, if we apply such things as soon as the part is bruised, though it want articulation, while the matter is yet upon motion thither: For then the affluent matter is wasted more powerfully by drying, and hindred by repelling. But if we use Unguents or Oils, the Skin and Pores are stopt, so that what ought to exhale, cannot. Otherwise, if the Contusion be small, nothing is better in the beginning for mo∣derate repelling and discussing, than a linen-cloth dipt in Rose-water and Whites of Eggs beaten,* ap∣plied warm: Or if the Skin onely be bruised, it may be anointed immediately with Hog's-grease; It will be quickly cured without any spot.

II. If we can by no means obtain discussion, and there be marks of Suppuration, it must be promo∣ted: Yet we must use caution in the application of Suppuraters, and we must not use any but such as are moderate: for if we mistake but a little in this case, a fordid Ulcer and Putrefaction may easily be raised in the part.

III. And because Modern Chirurgeons have ob∣served this, they advise, when we observe a Con∣tusion run into an Imposthume, that we should not wait for perfect Suppuration: For if Pus, which is bred of concrete bloud, be kept long in the part affected, it may cause much mischief, as Fevers, Pains and high Putrefaction, and corrupt the ad∣joyning parts, Nerves and Bones; whence after∣wards malignant Ulcers, and oftentimes Fistulaes, de∣rive their original. Nor also do they admit of e∣mollient and suppurating Plasters and Cataplasms, because Putrefaction may easily be caused by them.

*IV. A Man of Threescore, of a full constitution, complained of defluxions from his head; the night following he observes a sudden remission of his Head-ach. His left arm was all on a sudden of a deep bloud red colour, without any pain or in∣flammation, and so was the upper part of the same side. When I was called, I judged it to be an Ec∣chymosis, from an internal cause, Nature driving the abundance of bloud, which threatned an Apoplexy from fulness, to the out parts: and I declared that this afflux must be dissipated by things that di∣gest gradually, and not at all by repellents: By which means the red colour became a little blew, and then yellow; just as we see Ecchymo•• left after bloud-letting are also dissipated by Nature. For this reason I ordered Ry-flower, mixt with pow∣der of Chamaemil flowers, Savine and Melilot, &c. to be applied twice a day: Making use in the mean time of such things as plenitude requires. ¶ A boy six months old had several fits, at length when his Fits were returning, he was on a sudden taken with such another Ecchymosis about his left Eyelid and Cheek, whereby he was relieved, and seemed better in other respects. Here I told them they must abstain from liquid things, as being endued with a repelling faculty,* by reason of their actual coldness, which they quickly fall into; and that they should undertake the business with dry digesting fo∣mentations, by which also gradually a dissipation was obtained, as in the former.

V. This Caution is necessary before application of a Cat••lasm, that, if the Skin be not whole, a thin lin•••ag, spread with Ʋnguentum rosatum,*popu∣lem, or •e tatia, be first applied, and then the Cata∣plasm.

VI. A Woman about 50 years old got a contu∣sed wound in her head by a fall, so that there a∣rose a Tumour from the extravasated bloud, as big as a Hen's Egg. When all was done that should be done, I thought of opening it, or suppurating it ac∣cording to Aphor. 5.20. To this there did concur, the abundance of matter, her age, the hardness of her Skin, the Winter-season. Because she was a∣gainst opening it, and that I might avoid the pain and other troubles of Suppuration, I tried dissipati∣on. First I fomented the part with warm water for half an hour, then I shaved the part against the hair, that the pores might be better opened, and the filth sticking to the part might be better got off:* Then I applied of Oil of Lilies and Chamaemil equal parts, applying upon that warm Cotton fumed with Spi∣ces, and so the Tumour dissolved beyond all ex∣pectation.

VII. They think this must especially be observed, if the contusion be in the sides, belly or back. For then we must take especial notice, whether in 3, 4, or 5 days, there arise upon the place, where the Contusion was, a Swelling with pain, whether it in∣crease daily, and there be a throbbing pain, and the Patient cannot indure the part to be touched, if an unusual redness appear round it, if he breathe short, and there be any heat in the body: For when these things appear, although no blewness appear in the outer parts, it is a sign that matter is gather∣ing, and an Imposthume breeding. Wherefore, lest the matter turn inwards, eat holes, and corrode the inward parts, and by these means cause death, or tedious diseases in the Patient, the place must be timely opened; for when the place is opened, the matter runs out with ease.* They think that Emol∣lients and Suppuraters doe little good.

VIII. We must take notice also of what Paraeus tells us, how in a Contusion of the Muscles, especi∣ally about the ribs, the flesh swells, and becomes as it were mucous; so that if it be prest, it makes the air flatulent, with a small hissing, and the prints of one's fingers remain in it. Then in the space, which the flesh parting from the bones has left, a purulent matter is left, which causes the ribs to perish. If this happen, we must timely prevent the mischief, and the part must be bound very strait, and then Oxycroceum Diachylum, ••iatum, or the like digesters must be used.

Page  139IX. Some Noblemen in the River threw Water one at another; one of them that had stirred him∣self most violently, had a great pain in his left groin, and at length an Ecchymosis in the same place, a span long, and five inches broad, which was a certain argument that some Vessels must be broken. There∣fore the cure of broken Vessels was entred upon by Ʋnguentum herbaceum inwardly and outwardly,*Pulvis ad casum, Pimpinellae and Oxycroceum, presently the pain ceased, and the concrete bloud exhaled.

X. You may often see, upon a Contusion of the fleshy parts of the body, abundance of bloud extra∣vasated in their interstices, which you may find to fluctuate by the touch of your fingers, and you may sever it, as in abscesses; but you must consider, that to treat this as an Abscess is not always successfull. To go to work by Discutients were tedious, and by driers would be more difficult; but to efficacious and expeditions Chirurgery it is easie. That is, if you thrust a Penknife, or sometimes a broad point∣ed Lancet into the Skin: for so, and by squeezing it a little, the grumous bloud will start out wonder∣fully. Which was verified in a Carman, that was kicked by a Mule,* and had his Arm bruised, swelled and pained, who came to me, and was this way suc∣cessfully cured.

XI. A Man of about 36 years of Age, of a lean constitution, by accident of a fall, near two stories high, into the Street, was sorely bruised, especial∣ly on his left-side, hip and arm. I immediately let him bloud largely, and embrocated the parts bruis∣ed, cum oleo ros. myrt. & aceto, and applied astringent Emplasters. A Clyster was also prescribed, and I∣rish Slate, &c. was given him, whereby he was dis∣posed to a breathing sweat: and at the hour of sleep an Anodyne draught was prescribed, to in∣cline him to rest. By this method the fluxion was checked, during which the parts diseased were fo∣mented with a decoct. summitat. abfinth. anethi, majoranae, flor. cham. sambuci, sem. anisi & cumini, to which was ad∣ded Spir. vini.* Embrocations were also made ex oleis aneth. rutae & terebinth. and the Cerote above proposed was applied over them: and in progress of time he was cured.

XII. To them that are employed in the cure of outward Ails, there often occur Ulcers, which lie hid under the Skin, a little discoloured, and some∣thing exasperated, unity being broke; which in cacochymick or cachectick bodies gives a painfull suspicion of it self, and which may either pass in∣to some cavity, if any such place be there, or of besetting and putrefying the bones; or the Muscles and Nerves, or if these or any joint be underneath, there is fear of loss or lameness, or of a perpetual feebleness. Which it is a prudent Man's part to pre∣vent; because the force of corruption is admira∣ble, if it remain there any time. For I have seen, where the Skin has been whole, and where it has not been touched by the abscess, pieces of flesh, ill cured, have withered, and likewise whole torous Muscles, and long tendons, &c. Yea, and solid bones have lost their rigour, and natural splendour. I have had eminent examples of this matter. Which, indeed, as it is wonderfull in exactly putrid Ails, so it is much more admirable in Contusions and Ec∣chymomas, which if indeed they fall upon the nervous parts, and be not at the first exhausted and dried up by Medicines, when the flesh, and vessels, and fi∣bres of other parts, do both languish with the bruise, and are a little poisoned with their own juice ex∣travasated, the bones which are fenced round, be∣ing not sufficiently defended by their own small heat and slender vigour, and being deprived by de∣grees of their temperament, wax black, which is the last sign of absolute mortification. This was the case of N. whose hand was bruised with a stick, and when the Ecchymoma had been ill cured by others, and was just turning to an Abscess, I opened it, and found it putrefied a great way; and after the ri∣sing of a great Swelling, it created me no small trouble in the cure,* till the ossa phalangis were laid bare, and appeared black. And he was cured of the Abscess of the Bones with much adoe.

Empyema, or a gathering of corrupted Matter in the Chest.

I. WHat can be expected from giving a Purge, when the peccant matter can onely be discharged by spitting? But, Hippocrates, lib. de int. affect. Purges by Mare's-milk, and sometimes by Asse's. And Trallianus beside these, in some cases, allows of Goat's and Cow's Milk; and justly indeed, because from Milk we have the cleansing of the Page  140 Body, and the cooling and tempering of the Hu∣mours, all which things are desired in suppurated persons; for the cleaner Bodies are, the less sick they are, tempered humours doe less harm, and when the habit is cooled, Fevers are less afflictive. Where∣fore, I commend such a kind of Purge; but for this a great quantity of Milk, that is, three or four pounds must be given: And what Hippocrates did every day, that we must doe at several turns. But if the use of Milk do not please,* or the Patient re∣fuse it, for this same Purging we must make use of Manna, Cassia, Solutive Syrup of Violets, and the like, which are proper to evacuate, cool and tem∣per.

II. Urinary Medicines are usually powerfull re∣medies; for that Catarrh, which falls down on the Lungs, and there putrefies, does not take its rise from the head onely; but sometimes it is cast off by the whole venous kind, upon some weak part. Therefore Sweat and Urine is a present re∣medy for it: And a decoction of China-root with Scabious, and other things proper for the Breast and Urine,* will doe good.

III. If the Abscess break not, Practitioners bid us give such things as may break it. But they do not reach to the part affected. It were better to apply Medicines to the side, which might draw out∣wards, and afterwards open it with an Instrument, or Cautery, that the matter may purge outward, and not break inward: for breaking inward would be dangerous for fear of choaking, and when it was broke, the matter could not conveniently be eva∣cuated.* And when the Lungs are exulcerated, Men become consumptive and die.

IV. In the choice of Medicines we must have respect to the matter which must be expectorated. For if the Pus be bilious, sharp and corroding, we must chuse such as mitigate and allay acrimony; as Barley, Jujubes, Raisins, and the like: If the Pus be not sharp, but thick, then attenuating and inciding Medicines must be made use of,* as Hyssop, Colts-foot, Elecampane-root, &c.

V. The insensible drying and consumption of the purulent matter is usually attempted by dry∣ing and resolving Decoctions; from which, seeing more hurt may be feared, through increase of the leanness and Fever, than good, by consuming a small portion of the matter; therefore we deservedly omit this sort of remedy in this case.

VI. Instead whereof I should more willingly give Sulphureous Waters, both Purgative and Diuretick, if they were at hand, for several days, to dry up the Lungs, and carry off the matter both ways. But in defect of them use may be made of a decoc∣tion of the Root of Elecampane, Liquorice, and China also, if you can have good, made in distilled-Water of Coltsfoot, Lungwort and Maiden-hair, a∣bout half a scruple of Spirit of Tartar, and Spirit of Turpentine being added for one time; where∣to may be premised a Bolus made of Salt of Urine,* Butter of Sulphur and Turpentine.

VII. External Expectoraters must not be neg∣lected, and the Muscles of the Breast must be freed from tension and hardness by anointing• and fo∣mentations; Yet we must not insist long upon them, lest the strength of the Muscles, which is here very necessary, be spent; and by reason of laxity the chest be again made liable to fluxions.*

VIII. Tapping is more dangerous, than is com∣monly believed, for seeing the Lungs always play on the inner superficies of the Breast, and in expira∣tion is but a very little way from it, they can scarce avoid the edge of the Knife: And then the matter cannot well get out. At last, if the matter get out, to me it is probable, that it proceeds from the very Lungs,* after their Coat is wounded; which is the reason, why the Physician rarely obtains his desired end, and the Patient, for the most part, dies quickly after.

IX. Unless the strength of the Patient be very good, or indifferent, tapping must be omitted, lest when the Patient dies, a remedy, otherwise the most noble and safe, be defamed. And Physicians measure for the most part the strength by Pulses, which yet may deceive the Physicians in this case, since the matter in the Breast of a Patient, that is yet strong enough, may cause Pulses, that argue lowness of strength, namely, a little, swift, frequent and inor∣dinate one. But it is a most certain sign,* the strength is good, when a Patient can sit or walk, and that either by the benefit of a strong nature, or by the help of some Staff.

X. The matter of an Empyema must be let out by little and little, and at several times, that is, every day six ounces once or twice, as the strength of the Patient can bear it: for if they who let out all the matter together at one time, do not die spent, yet because of the sudden change of nature, they must certainly expect a greater Empyema than the former; for Nature, if the matter she was accustomed to, be evacuated all at once, transmits many humours from the rest of the Body,* to correct the Vacuum that was so suddenly made, so that a greater and worse Empyema than the former must arise.

XI. This must in the first place be considered, whether the signs that the Disease is made be cer∣tain or dubious: In the former case there is no great need of Pharmacy, but onely of a prepared body, and you may streight proceed to the opening of the side. Therefore, if after a Pleurisie, or Pe∣ripneumony, or bloud run inwards after a wound, there be any fluctuation of Pus, or purulent matter, or bloud within the cavity of the Thorax perceived, with no spitting, or diminished, there is no necessity for our tarrying any longer upon ripening, or ex∣pectorating Medicines; but we must proceed to tapping: In tender and timorous people a caustick may be first applied between the sixth and seventh rib. But if the signs of this disease be not so very certain, and altogether dubious, we must not fall too soon and rashly upon tapping: For in some that spit out purulent matter, with great difficulty of breathing, and straitness of Breast, I have known Tapping celebrated, not onely to no purpose, but to hurt. Therefore when expectoraters,* and gen∣tle diureticks and sudorificks have been used in vain, we may proceed to Tapping.

XII. Hippocrates used burning to all that were sup∣purated, when they had gathered Pus in the Thorax, or in the region of the belly: and when burning is not sufficient, he proceeded to penetrating section. And truely I perswade my self, this cure would be very beneficial to many, were it but administred in time. But, now it gives help to few or none, be∣cause either it is not done at all, or much later than it should be done; partly because Physicians themselves are afraid, as if it were some great mat∣ter; partly because Patients will not obey them, except they plainly see they must die, and then they give way when it is too late:* But the sea∣sonable use of such things, is, while the Patient has yet strength to bear them.

XIII. Hippocrates, 6. aphor. 27. commends Tapping; and Galen gives it his Vote, nor without reason; for wounds of the Breast are not mortal of them∣selves, and there is not a more convenient passage open for the purulent matter: So that the several attempts for evacuation of the matter, by Vesicato∣ries; or, as Paul will have it, by several Burnings made in the skin, that the matter may be drawn to the external Muscles, are fruitless, because of loss of time, which is attended by loss of strength. The experience of both the ancient and modern make it clear, that several have been saved this way. Marchetti, in sylloge observat. 44. has an illustrious example. A Nobleman of Padua, saith he, after a Pleurisie that was not well purged, fell into an Empyema: So much Pus was contained in the cavity of Page  141 the Thorax, that twice or thrice a-day he fell into a Lipothymy, next to a Syncope: I propounded cut¦ting between the fifth and sixth Rib, commended by all Authours, and by my own experience often ad∣ministred with good success, which the next mor∣ning I performed between the fifth and sixth Rib (some condemning it for fear of hurting the inter∣costal vessels) and put in a Tent thick enough, which might keep the hole open: I drew it out a∣bout evening, and with it above three pounds of Pus; after which N. was well of his Lipothymy: Which I afterwards cured, as other wounds of the Breast, that is, every day drawing out the purulent mat∣ter, and a few days after putting in a Leaden pipe, through which all the matter was wholly drawn out. Which at last, being drawn out, I brought the wound to a Cicatrice, at length, in the space of twenty eight days.

XIV. There is a great disagreement in opinions about the place of Cutting, some chusing the space between the fourth and fifth Rib, others that be∣tween the third and fourth: And the latter opini∣on evidently preponderates, as to getting out most conveniently what is troublesome to the diaphragm: But the case in a live and a dead man is far different; because in the living the diaphragm is lifted up much higher than in the dead: but in a suppuration of long continuance the expulsive faculty so lan∣guishes, or rather is so dead, that it delivers its burthen much more easily down hill than up. A publick Hospital sometime saw this in an unfortu∣nate man, from whom cutting above brought out no Pus,* but cutting below, after he was dead, brought away much. ¶ Moreover it is necessary to find the distance of Latitude: For if Section be made towards the Back, the thickness of the Mus∣cles of the Back, the multitude of Tendons, and the passage of the Nerves from the Spine shew dan∣ger: If you cut forward toward the Breast, it is to be feared you may hurt the diaphragm; or, if you miss that, you may not be able (because of the ac∣tivity of the diaphragm) conveniently to purge out what will be apt to fall backwards. That you may shun these Rocks, take a thread, and measure from the tip of the Breast bone to the top of the Verte∣bra's of the Spine. Then divide this into three parts, and at that place whither the two third parts of the thread reach (beginning from the Breast-bone) there will be the very place for Tapping.* ¶ Paulus, l. 6. c. 44. opens the Breast between the fifth and sixth Rib, reckoning from above: But Hippocrates, l. 2. de morbis, opens between the seventh and eighth Rib, reckoning also from above. In the place cited in∣deed he names the Interstice of the third and fourth Rib for Tapping, reckoning from the last below up∣wards: Yet, because he reckons not the twelfth Rib, as being difficult to find, and begins his ac∣count from the eleventh exclusively, this place jumps with the Interstice, which is between the seventh and the eighth. This place of Paulus in some does usually make a right perpendicular line with the Nipple of the Breast. Hippocrates chuses the emi∣nence or bending of the Ribs; yet, to avoid the nervous Muscles, he makes not his incision upon it, nor behind, towards the Back; but a little for∣ward, toward the Sternum. Indeed in this place of Hippocrates the diaphragm seems to be in danger, but is in none, because, being depressed by the quanti∣ty of matter, where it sticks to the Ribs, it comes not so high as to be hurt by the Knife. In the same side, where matter is perceived gathered, the Tap∣ping must be made. If therefore it be felt on the right side, tap on the right; if on the left, tap on the left; if on both sides, tap on both. Of the re∣counted places, that of Hippocrates is certainly the best, because Pus, or any other matter gathered in the Breast, may this way better run out, because of the more declivous site of the opening, than in that of Paulus. Yet that of Paulus is not wholly to be de∣spised, since, the matter a little more narrowly considered, in the right side Paulus his place seems preferable to that of Hippocrates, because the Liver, by its gibbous side, drives the diaphragm upwards. In the left side, if the Chest must be opened on that, because the diaphragm, by reason of the lower site of the Spleen, rises not so high, and is depres∣sed by the store of matter, either Hippocrates his place must be made choice of (wherefore Hippocra∣tes, l. 2. de morbis, says, It were to be wished, that the mat∣ter to be evacuated always settled on the left side) or the middle one between it and that of Paulus.* ¶ Two things should be taken care of in the choice of the place; First, that nothing (which may any way endanger the Patient) may be hurt in the Chest, that is, the Pericardium, Lungs, Diaphragm, Veins, Arteries or Nerves. Secondly,* that Pus may con∣veniently be evacuated by the place, where the sec∣tion is made. ¶ I saw one, who going about to cut the Muscle of the Thorax between the fourth and fifth Ribs (though I had ever rather doe it, being taught by long experience, between the fifth and sixth, or rather below the membrane which clothes the sixth underneath) cut through the very Pericar∣dium, whereupon he fell in a Swound; and, when the Chirurgeon came the next day, he found him dead. I saw another make a hole on the right side, so wide, that I could easily have put three of my fingers into it, whereby both the Vena ajuga and o∣ther Veins were cut, so that the poor man expi∣red under the Chirurgeon's hand. There lives now at Liege a Tailor, who by my advice, when he was almost choaked with the quantity of matter, was cut by a skillfull Chirurgeon between the fourth and fifth Ribs; and twenty days after he was cut, as he should, below the sixth,* and he quickly re∣covered.

XV. As to what concerns the place where this Section should be made, the Learned are at no small variance among themselves; and the reason of this thing may easily be imagined: for sometime the diaphragm lies higher in one Man than in ano∣ther, so that this is the reason, why the humours, that fall upon the diaphragm, are found higher in one Man than in another. 2. Some have a pro∣tuberant Breast, others a flat one, which also cau∣ses a great alteration. Besides, the Lungs often stick so fast to the Pleura, that the Pus cannot easily fall down upon the diaphragm, wherefore you do not doe well, if you cut the lowest place about the dia∣phragm. And although both in this and other Tu∣mours the highest place be reckoned the fittest for opening, it is not impossible, if the Disease put the Chirurgeon upon it, to chuse sometimes one place, sometimes another for the most convenient. Upon this score Hippocrates, Guid•, &c. open the Breast between the third and fourth Rib, reckoning from below; Flenus, Riverius, &c. between the fourth and fifth; Vidius, Aquapendens, &c. between the fifth and sixth; which place seems to them and to us the safest of all: for if you cut higher, you endanger the Pericardium; and if lower, you will hurt the Di∣aphragm, as very sad examples of this matter have made it evident to us. But in this troubled water of Discord among Writers,* the Signs now propo∣sed will conduct you safe to harbor.

XVI. In the inner part, on the under side, the Ribs are a little hollowed by a Sinus, where they receive an intercostal Nerve, Artery and Vein. This Sinus is especially considerable in tapping Empyick persons; for we must have a great care that we hurt not the said intercostal Vessels. Bartholinus writes, that this may be avoided, if Section be made from above downwards: For so Ottho Heurni∣us did of old teach us, who for this Section re∣quired a Knife on one side sharp and cutting, on the other blunt, and he would have it so thrust in, that the blunt part should be towards the lower part of the upper Rib, that is, towards the aforesaid Si∣nus,Page  142 and the lower sharp part should be forced downwards to the top of the lower Rib. But practice and experience teach, that all this Do∣ctrine is more theorical than practical, for in a li∣ving Man the Ribs are not so far distant one from an∣other, that a Knife can conveniently be thrust in a∣thwart from the lower part of the upper Rib to the top of the nether. And therefore, that the said hurt of the Vessels may be avoided, I use to order the Chirurgeon to make his Section in the upper part of the Rib, lengthways of it, and not going up∣wards toward the Rib next above it. Some say, that by this way the transverse Fibres of the intercostal Muscles are too much cut, as if they remained un∣hurt in the former Section. All the Fibres of these Muscles are oblique, and the inner lye cross the ou∣ter, so that whatever way Section be made, the hurting of the Fibres can no way be avoided; which also need not greatly be feared, since in this case no great wound is inflicted, and experience shews,* it may be healed again with small trouble: for in this manner I have several times administred this piece of Chirurgery with good success.

XVII. If the Ribs be strong and broad, and not small, and the Patient elderly, then I would bore a hole in a Rib with a Gimlet, and this operation would be safer than any other, for the Vessels that arise from the lower part would suffer nothing, be∣cause the hole should be in the middle of the Rib, and the matter might go out freely; and there would be no danger of a Fistula, though the matter should run for a whole year; and then the Lungs and Chest would suffer less from the external Air. Hippocrates, lib. de int. affect. intimates, that this o∣peration is very safe,* because no flux of bloud can be feared.

XVIII. The Readers must take notice, that this operation is often performed according to art, and yet no egress of Pus perceived,* because it sticks, not floting upon the diaphragm, but enclosed in a bag, made by the connexion of the Lungs with the suc∣cingent membrane. ¶ One had been long ill of an Empyema, at length sagacious nature seeking an out-let for the Pus, produced a Tumour on the side, which once perceived, the Physician ordered the opening of it, nothing run, contrary to expectation; wherefore the Patient was left, to regain strength, he slept upon his sore side (because they cannot lye upon their sound side, by reason of the abundance of Pus that lies upon the Mediastinum) but in his sleep all the Pus ran out: And when he was asser∣ting that he was cured,* because he could breath better, he died suddenly. Here Chirurgeons may be admonished, never to leave abscesses open, with∣out a Tent; because although nothing burst out of them in the operation; yet, because they reach not the matter, the Pus, seeking a passage for it self, finds the next hole, and so, for want of a Tent, runs all out, and sudden death follows. ¶ If the wound be narrower than you would have had it, or the matter be thicker, then it must either be suffici∣ently dilated, with a crooked incision Knife, that has a Silver button at the end of it; or the matter must be attenuated by injection of Honey and Wine with a Syringe, and drawn out. Yet in extreme danger of suffocation I should prefer dilatation of the Wound, which is done quickly and safely, far be∣fore injection of Wine and Honey, which must needs increase straitness of Breast,* the matter not be∣ing diminished before.

XIX. When nothing would doe good, and I was thinking of opening the Breast, and when the thirti∣eth day was over since the breaking of the Impo∣sthume, I proceeded to smoaking of Tobacco, af∣ter the usual manner, in a Pipe, and to take the decoction of it hot, with Sugar, upon which there followed a wonderfull excretion of Pus by cough, and in great quantity, and it was onely used twice; Take of Leaves of Tobacco 1 ounce; boil them in 2 pound of sweet water, till half be consumed; add in the end some Leaves of Mallow,* Branc ursin and Violets. Strain it, and give it often.

XX. The Mediastinum in Man has not so great a cavity as in Dogs and other Creatures. It happens sometimes that purulent matter is gathered within its two membranes, after an Inflammation, which cannot be cast out by the Lungs. Therefore we are forced to pierce the Sternum with a Trepan, that so when a hole is made, the Pus may be got out by the help of Tents, Sponges, and other Instruments.*

XXI. Here also we must observe, that sometimes an Empyema is contained in its proper coat, and so it comes to pass, that it bewrays it self outwardly by its Swelling; and then it is called by the Latines, Vomica pulmonis, i. e. an Imposthume of the Lungs. In which case, do not expect, the coat should break of it self, for afterwards the Pus, running all about, is drawn with more difficulty out of the Breast; but the first opportunity you have, open it, and chuse no other place, than the most prominent part of the Tu∣mour.*

XXII. Although this that I propose be a hazar∣dous Remedy, yet, if we would leave talking, it is a most excellent one. The intercostal Muscles of the Thorax must have a potential Cautery applied to them upon the diaphragm, between the fourth and fifth Rib, till an Eschar large enough do arise, which will be in about three hours time; then it must be opened with a wound wide enough, and this is therefore needfull, lest if Incision should be made without such a Cautery, the wound should close sooner than it ought: for it is necessary the lips of the wound should be a good distance one from ano∣ther (which in a round wound is most certainly true) that the outlet for the Pus and filth may be the freer. But care must be taken that the Pus run not all out at once, with respect to the Patient's strength. I have seen some cured this way,* to a wonder.

Epilepsia, or, The Falling-sickness.

I. PEtrus Salius Diversus, l. de affectib. partic. c. 3. proves clearly that the Epilepsie is caused by Bloud, from Hippocrates, 4. acut. tom. 23. He jud∣ges the cause to be an Irruption of the bloud into the upper parts, and a Repletion of the vessels of the brain made on a sudden, which being of a hea∣vy nature, and it may be also of a molesting quali∣ty, causes the Epilepsie, while nature rises to the expulsion and discussion of it. Hippocrates in the same place calls that Oppression of Bloud, 〈 in non-Latin alphabet 〉, in Epidemiis,〈 in non-Latin alphabet 〉. Foësius, in his Oeconomia, translates it, the stopping of the Bloud flowing with violence and swelling. By which words Hippocrates intimates, the interrupted Circulation of the bloud was known to himself; as is clear from his Book 〈 in non-Latin alphabet 〉. Nourishment passes to the Hair, and Nails, and to the outmost superficies of the Body, from things with∣in; and from things without, nourishment passes from the out∣most superficies to the inner parts. And since the in∣nate heat goes in danger of being extinguished by this Repletion of the vessels, through the abun∣dance that threatens Suffocation, no other Reme∣dy to prevent so great a danger seems to be indica∣ted, than plentifull Bloud-letting. Salius, in the said place, does therefore assign the very same Cure to an Epilepsie, when it is bred, as to an Apoplexy, which arises from the same cause, that is, plenti∣full Bloud-letting in the inner Vein of the right Arm, according to Hippocrates his opinion, in the forequoted place. ¶ Yet, at this day, saith Sen∣nertus, scarce any one would advise or attempt any such thing in the very Paroxysm, seeing at that in∣stant neither Bloud can conveniently be let, nor, if it could, were it (in his Judgment) either safe or beneficial; by reason of the violent contest be∣tween Nature, which is then highly oppressed, and the morbifick cause, as the hurt in respiration and other actions, by reason the influx of animal spi∣rits is interrupted. The Physician therefore might incur the censure of rashness, and pay for it with disgrace, if the Patient should dye, upon letting bloud while he was in a Fit. ¶ It is the part of an experienced Doctor (saith Paul Barbette, in his Praxis) to distinguish a-right about letting-bloud in a Fit. ¶ I, and other Physicians with me have observed, that, taking away a little bloud in the fit has sometimes done good, namely, to get motion in the Bloud, which is as it were coagulated •y an austere Acid: otherwise Bloud-letting, both in the Fit and out of it, does, in a manner, always so much harm, that the fits grow more violent every day after Bleeding, saith Deckers in his Notes upon the place.

II. In the year 1675. a Noble Boy of Berne was upon a Fright taken with a cruel Epilepsie, his face was red and swollen, and when his Fit had held him already three hours, by my advice and Dr. Cramer's, the Cephalick Vein in his left Arm, was opened, whence the Bloud sprang with such violence, that one might have taken it all away in the twentieth part of an hour. The Fit was then presently over, and the next day he was well, with∣out any Relapse. A red hod Iron had been appli∣ed to him a little before. ¶ Hippocrates, 2. Epidem. sect. 5. bids us open the inner Veins, if the Disease be very violent. ¶ A Girl about twelve years old was fre∣quently taken with an Epilepsie, and when she was taken with a Pleurisie she was several times let bloud, and from that time was never troubled with her Epilepsie.* Hence you may gather the efficacy of Bleeding in this Disease. ¶ A Boy eight years old was taken with an Epilepsie from Plenitude, and when all other Remedies had been tried in vain, he was let bloud in the Arm several times once a month, and recovered, through the great altera∣tion of his Body, by this Remedy: which never∣theless should scarce be allowed, except in a Dis∣ease by consent with the venous kind,* and excee∣ding hot Bloud.

III. Ben. Sylvaticus cured a middle aged Nobleman of an Epilepsie,* by opening the haemorrhoid Veins once a month.

IV. A young Man about twenty five years old was troubled with the Falling-sickness once a month, I opened one of his temporal Arteries, and when he had been free from it four months, and there was hopes he would be well, he brought it upon him∣self again by drinking strong Wine, which was his custome. ¶ A Man about forty three years old had frequent Fits, a Wind running up from his Hand to his Brow upon the same side: From whom I (gues∣sing it came from some halituons cause) took three ounces of Bloud. But the bandage being loosed, much Bloud ran out, after which fortuitous evacua∣tion, notwithstanding he was well a long time af∣ter, so that he seemed cured. ¶ Alphonsus N. a ve∣ry melancholick person, who from a child had been troubled with this Disease 9, 10, 15, 20 or 30 days together, in nature of a certain light vapour, ascen∣ding gently from his Arm to the upper parts, was very much relieved by Bleeding in the temporal Arteries.*

V. P. Merenda writes, that in a very violent one, that comes often in a small interval, and will not yield to Remedies; he has, by applying Blisters to their Neck and Shoulders, brought several to the former use of their Reason in a short time, and freed them of their Fits, who afterwards by orderly cure were restored to perfect health. But observe, that they, as also Issues and Setons, should be used onely when the Disease is essential to the Brain; and after Purging,* except the Disease be very ur∣gent.

VI. By a Seton, according to the opinion of that most Learned Physician, Hollerius, I cured a young Man about twenty years old of the Falling-sickness, who had frequent Fits of it before; the ichorous matter, as it may justly be believed, which fed the Disease, being by this means derived.* ¶ An Epi∣lepsie succeeded the Cure of a Ring-worm from a hot humour in a Gardiner,* which by Spigelius his advice was cured by putting Hellebore root into a Seton in his Arm. ¶ Yet it is not always safe to put Hellebore root in a wound; for while Page  144 pain encreases by attraction of the humours, the strength sometimes wasts,* according to my own and others observation.

VII. I resolved to open another Issue in the left Arm, because I understood, a Disease of so long standing must now be in the Brain, for it is certain the brain abounds with these juices, for which pur∣ging by the Belly seems not sufficient. Which re∣medy was of that power, that from thence forward he fell more rarely into fits, and they were milder, so that those who were by,* accounted him perfect∣ly cured.

VIII. Adr. Spigelius tells of a Nobleman who had often struggled with an Epilepsie for twenty one years, and when Aquapendent had trepanned his Skull for a grievous fall, he had got down a pair of stairs, he was never after troubled with a fit. Therefore Rondeletius does not without reason approve of this remedy for a confirmed Melancholy in the Brain,* though Forestus think it dangerous.

IX. Erastus disapproves of rubbings in the fit, be∣cause the draw nothing from they place affected, and because the numbness of the Limbs admits not of their virtue: But the reason they are made use of is, that the drowzy senses may be recalled to their office, which thing violent rubbing in the Shoul∣ders, Arms, Back and Thighs, with a course cloth, doth perform effectually. Moreover this advantage accrews, that the parts are thereby heated, and the humours and Spirits drawn thither, whereby there is a retraction made of the vapours, that are cree∣ping upwards, to the lower parts, because of the rubbing, upon which restitution of the senses fol∣lows.

X. Whereas some set up the Sick, keep their Arms and Thighs wholly from the Convulsive moti∣on, or strain them into this or that posture: Farther, whereas they blow sneezing up their Noses, and pour strong Cordials into their mouths, or use cup∣ping and scarifying, and by other modes of ad∣ministration treat the caducous but roughly, and disturb the manner of the Paroxysm; this course, I say, is often followed amiss, because by this means Nature has a double trouble, one from the disease, and another no whit less from the by-standers and attendants; when it had been far better, that, the fit being suffered to take its own course, the Pati∣ent had been onely one way afflicted.*

XI. We must take notice that the usual Purges must be made use of frequently, that is, once or twice in a week, and the course must be continued for several months; yea, sometimes we must go to the stronger Purgatives, according to Massarias his rule, who says, that the Epilepsie is seldom cured, because Physicians are always upon gentle means. For this reason Chymists are wont to give the usual Purgers, which draw the humours from the most remote parts. If a happy event may be expected from such Medicines, it depends especially upon Mercury, calcined either with Gold, or by it self in a sand Fornace, with a long regiment of fire, taking especial care, that no part of it remain crude and volatile, which would give a great violence to the Medicine, which would otherwise purge gently enough it four or five grains of it be given with Pil. Coch. or rather with some phlegmagogick Ex∣tract.*

XII. Septalius says, he never saw any relieved by a Vomit, but that he observed, they were all made heavy headed. Reason tells one as much, because a Vomit disturbs the head more, which is ill alrea∣dy. And this is very true, where the Brain is pri∣marily affected, or when the matter lies in some part in the habit of the Body, because this reme∣dy gets nothing thence. And Experience confirms it, which has ever had ill success upon giving Pur∣ges, whether upwards or downwards. But if the Epilepsie hath had its first rise in the Stomach, and the adjoining places, and the humour, that is the cause, can easily be derived thither: If the Pati∣ent can bear a Vomit, the worst that can follow will be some small disturbance of the head, which will quickly be at an end.

XIII. The success of Vomits in an epileptick Pa∣roxysm is dubious; Septalius l. 6. n. 5. utterly dis∣approves it. Nor is it good, though it by consent with the Stomach, for it is one thing to cure an Epi∣lepsie before the fit; another thing in the very fit; in this we deny it, for the reasons alledged by Septa∣lius, in the other we have no reason to scruple it. Whether in diseases above the Throat a Vomit be of any use, although the humours seem to be carried to the head? Santorellus, l. 22. Antepr. c. 4. answers af∣firmatively. Fridericus Hosmannus m. m. l. 1. c. 5. It is another case, when Poison, for example, Hemlock, taken into the Stomach, produces an Epilepsie: For Vomits, according to Septalius his opinion, would not be safe: These are his words: Have a care you do not give a Vomit in a fit of an Epilepsie, I have seen some that have tried this in a fit, induced thereto by the Authority of some Writers, who have killed their Patients outright: For the Head being more filled by the violent motion, and the matter residing in the Brain being stirred, they bring them to a per∣fect obstruction, whereupon an Apoplexy usually follows. The most excellent Frider. Hosmannus also, l. 1. c. 9. disap∣proves of Vomits, though the Epilepsie be caused by consent of the Stomach, and although he seems to grant them out of the fit; yet in their opinion they can scarcely be given, when either the Paroxysms are continual, or invade at very short intervals. But these things are not of such moment, as to forbid Vomits; for Septalius seems to respect any periodical Epilepsie, even that whose cause lies hid within the Brain: and then it seems to be grounded on an opi∣nion, that is false and now exploded by most, i. e. that the Epilepsie arises from the obstruction of the ven∣tricles of the Brain, and in the stirring of the hu∣mours by some violent agitation caused by Vomits, even in the head, the ventricles of the Brain may easily be wholly obstructed, and an Apoplexy caused. Besides, when Vomits are given to get Hemlock out of the Stomach, they are not opposed to an invete∣rate Epilepsie, or one that is otherwise deep rooted, and has tired out the Patients with many fits, but to a new one. Finally, they cast out the proximate and primary cause from the Stomach, which being removed, the Epileptick fits forthwith, or within a little time, abate, and shortly altogether cease. And reason does not onely persuade the necessity and benefit of Vomits in this case, but experience also proves the same: for a Vomit immediately cu∣red six little Girls, who at one and the same time had eaten Hemlock, and thereupon had been taken with most violent and tedious Epileptick fits; while two Boys that had eaten it at the same time, who could not be made to vomit, though they were provoked to it, died of the violence and tedious∣ness of their Epileptick fits, who undoubtedly might have been delivered from death, if the excretion of the Hemlock roots, which Nature endeavoured, had been timely facilitated with Vomits by some skilfull Physician. Santorellus Antipr. l. 21. c. 10. fa∣vours this opinion, and advises to vomit, upon ta∣king poison at the mouth, and says, the use of them is both safe and proper, because they immediately cast out the Poison. Seasonable Vomits did two Girls and two Boys good, who had swallowed Arse∣nick. Also from Faber Lyncaeus, Hist. 12. to a young man who had swallowed Mercury sublimate. And there is not a Practitioner, who, making little reckoning of the Convulsions, commends not Vomits, and if the case will allow it, who gives them not upon ta∣king Poison. And use has taught, that the sooner they are given, the more speedy and firm health is restored, but if they hastened to Alexipharmacks, death was hastened,* or the Disease with its Symp∣tomes prolonged, as it happened to one in Timaeus, l. 7. casu 4.

Page  145XIV. If by reason of an Epilepsie caused by Hem∣lock (or Poison) continuing a long time, or having many fits in short intervals, we cannot endeavour the evacuation or expulsion of it out of the Sto∣mach, the President of the nervous systeme must be averted from those tumults, and as he wanders must be reduced into the way, by such things as are u∣sually given in fits of the Falling-sickness, and of the Mother, such as are things that awaken the drowzy Senses. Let things be held to the Nose that breathe some acrimony, made of Savory, Penny-royal, Rue, Marjoram, Flowers of Lavender, Rue, Seeds of Angelico, Rue, Lovage, Mustard, Berries of Lau∣rel, Juniper, Pepper, Cloves, Assa foetida, Castor, and the like, tied in a knot, and steeped in Vinegar or Wine, Balsam, and Oil of Amber, of Rue. The urinous Spirit of Sal Ammoniack is excellent for this awakening, which, they say, the most excellent Dr. Sylvius always carried about him, that it might be at hand in sudden cases of this Nature. Indeed I hold such topicks near to the Nose, but by no means anoint the Nostrils with them, or put them deep in, because when they are anointed or thrust in, I have known them very troublesome a long time after, let Matches of Sulphur be held to the Nose, let the contracted fingers be opened by a strong man,* let sharp Suppositories and Clysters be given, let the teeth be opened, &c.

XV. In an Epilepsie, (and the Vertigo) especially if matter be supplied from the whole, when this is first diminished. Diureticks do conveniently carry off the reliques of the humours by way of Urine, chiefly if it be sympathick, and not inveterate, which at once open obstructions, dissolve the mat∣ter,* and carry it off, such as Hartman's Antepileptick Spirit, volatile Spirit of Vitriol, which is contrary to it by a peculiar faculty.

XVI. A Maid was often taken with Epileptick Convulsions. One who thought there was fraud in the case, and that she counterfeited the Disease, that he might detect the cheat, put live Coals into her hand: She perceiving nothing, endures all the burning of the coals. Hereupon so great a wound was made by the fire in the Palm of her hand, that a Chirurgeon could scarce heal it in some months time. In the mean time a Fever invaded her, which as soon as it was kindled, all her convulsive motion ceased afterwards. For Hippocrates in Coacis, & 2. A∣phor. 26. judged aright, that it was better for a Fe∣ver to come upon a Convulsion,* because it attenu∣ates and discusses cold and tough humours stuffed in the Nerves, as Galen comments upon it.

XVII. Sternutatories may both cause and keep off an Epilepsie. The first is evident from instances of those, that by the continued use of sneezing pow∣ders (in dimness of sight, thickness of hearing, &c.) have brought Epileptick motions upon themselves: The other is evident from their efficacy, because they relieve the head, and discuss what is trouble∣some in it. In this place, and upon this occasion, I will relate what I have very often observed in Epi∣leptick persons, namely, that sneezing sometimes precedes, sometimes follows an Epilepsie: For I have seen in some people, before the fit took them, several sneezings, and those frequent enough, twen∣ty, thirty, or forty often precede, and that for a day or two, every hour, so that they have been forced to stop the sneezing by applying warm milk, and afterward this ingrate and hated Disease has fol∣lowed, in as much namely as it darts its acrimony inwardly upon the meninges, and then shakes the Co∣ver of the Brain, by consent also it passes to the out parts, and the very Nerves of the Nostrils, and is as it were shaken off by Nature, that it may free it self of this unhappy Disease. In others I have seen the Paroxysm end with this very explosion and ex∣cretion, attempted at least, in as much as the rest, which nature can subdue, and cast outwards, is dis∣missed and exploded another way, without any great Vellication. Since therefore if two things doe the same, it is not the same thing; truly it behoves the Physician to help Nature, yet so as not to hurt her, and therefore he should be very carefull h w he uses them. 1. They must be mild, for Nature abhors strong ones, and if she be forced violently upon what she would doe of her self, she does it forced, and as it were against her will. 2. They must be Cephalicks, which may also strengthen the head by their sweet smell: Or things good for the Nerves, as powder of the Flowers of Lily Conv•l, Castor, Amber. 3. If the Patient abound with hu∣mours, and be not so very sensible, in which case the Disease may very easily be brought upon one by any irritating thing. 4. If the fit be very strong, and there be a want of sense, or a detention of the principal faculties, more than the Convulsive moti∣on. 5.* And therefore they must be given to raise one out of the fit, or in the declension of it. Hence it is that Aurelianus denies Sternutatories to be good for Epileptick persons.

XVIII. I do not permit the use of stinking smells but upon urgent necessity; for it is better, that the fit should be lengthened out, and spent by de∣grees, than to fill and make heavy the head with stinking smells, and defile the substance of the Brain and Spirits: Therefore do not use them, unless the fit have held some hours,* and other more gen∣tle means have been first tried in vain. ¶ The main controversie is about the Agate Stone: for Dioscorides says, the Fume of it brings the Fal∣ling Sickness: Trallianus, Aetius, Pliny, Caelius, and others, affirm the same. Avicen and Mesae are of the contrary judgment, that it is good for an epileptick person to be fumed with Agate, and that the Oil of it is good for the same. ¶ C. Piso commends it highly; The smell of it, saith he, is a most present remedy, as I have experienced in several, and in that famous French Virago, Maturina, who being given over for dead by her Physicians, upon her first smelling of this Stone was raised from her Bed, and beyond all expectation ran immediately with great chearfulness to the Table and Dice. The controversie is decided by distinguishing Epilepsies, for this fume is good in that, which vapours ascending from the womb do cause, for the virtue of strong smells is such, that they discuss hysterick Fits, if they be held to the nose: But stinking smells bring an Epilepsie, that comes of any other cause.

XIX. Stupefiers of the Nerves, because by dul∣ling their sense, they render them less affected with trouble, when they are irritated, and there∣fore less convulsed, if the gentler sort of them be given in grievous and dangerous Convulsions, I have often found them doe much good: In which respect I think Treacle, &c. may be proper, both because it infringes the venomous power of the Epilepsie, and because it dulls the exquisite sense of the nerves,* and that it is given rather for that reason, than be∣cause it strengthens the nervous kind.

XX. If it have its rise from the Womb, we must take notice, not to give sweet smelling Medicines, for they both make the head heavy,* and cause the fit.

XXI. Things that add strength to the nervous kind, are appropriate remedies, which are made of capital and arthritick simples, which since they sup∣ply the nervous kind with new strength as it were, that it may be the better able to resist, what is troublesome to it, use not improperly to be added to other Medicines, which we use in the Epilepsie. However not with the same mind or intention; but because they believed, the Epilepsie was cau∣sed by Phlegm stopping up the Brain, not onely these things appropriate to the Nerves, are hot; but in the cure of the Epilepsie they used for the most part things that mig•t cut and attenuate thick Phlegm, and the hottest remedies. Which notwith∣standing, if the Epilepsie come from the irritation of the nervous kind, because they heat the Body Page  146 more, I observe they cure not at all; so I know by experience, they rather irritate, and promote, and exasperate the fits: And because I either found, or had it from credible persons, that they doe more good than hurt with their heat, except in a cold and moist constitution of body, or when they have moreover some other property, whereby they re∣sist poison,* or this disease; I think they should not otherwise lightly be used.

XXII. We affirm with Jacchinus and others, that a Decoction of Guaiacum is proper for those that are subject to the Epilepsie, because we must especially have respect to the antecedent cause, whereby the proximate is fomented and sustained. And it often consists in gross impurities gathered in the whole Body, or Brain, Womb, Stomach, &c. which do indicate Incision, Attenuation, Solution, Purging by Urine, Stool, Sweat, &c. and therefore the consumption of themselves. For these, as they are the subjects and antecedent causes, being removed, the noxious faculty existing in them is also remo∣ved, that is, the malignant Vapour, which being exalted, or raised by evaporation, does otherwise produce an Epilepsie. And a Decoction of Guaiacum is of great service in respect of the present indica∣tion, as by inciding and attenuating it dissolves this antecedent cause, by cleansing it evacuates, and by provoking sweat it renders the mass of bloud defoe∣cate, not without strengthening of the Bowels, through its amicable, astrictive faculty connate to it. Nor is the decoction of Guaiacum onely usefull in rooting out the Cause, but its acid Spirit and Oil also is very good to allay and conquer a fit. We must take notice concerning Hydroticks, that they are proper, generals premised. 2. That the decocti∣on it self of Guaiacum, according to the different na∣ture of the Subject, must be prepared with things appropriate to the morbifick cause; taking care es∣pecially,* that in boiling it the Spirits do not ex∣hale.

XXIII. There are some that take Guaiacum for Lignum Heracleum Rulandi, induced thereto both by the similitude of the name, and because he often uses a decoction of this wood in the same diseases, in curing of which he glories, that the Oil has done good. Quercetan on the contrary thinks it is drawn by distillation off Box wood: Others think rather from the Pine: Others from the Larch-tree, for this reason especially, because Oleum ERACLIƲM makes by transposition of the very same Letters LARICE∣ƲM. We, saith Clossaeus, although we are not ignorant that the Oleum Heracleum Rulandi is made of Hazle wood per descensum, and that his Antepileptick Conserve is made of it, not onely because Hazle nuts were cal∣led by the Ancients Heracleoticae, but especially be∣cause Valentinus Rulandus writing to Fabricius Hildanus, Obs. 84. cent. 3. plainly calls the Spirit and Oil of Hazle Wood per descensum, Heraclinum: Although, saith he, the thing be so, yet I constantly affirm, that Oil of Guaiacum may very fitly be used in its stead. For the acid Liquor of Guaiacum hath the same virtues and faculties, and shews the very same ef∣fects, which he attributes to his Oleum Corylinum. Moreover, as experience testifies, the specifick pro∣perties of Liquors perish in descensory distillation; which being consumed by the fire, a more fixt vi∣triolick Spirit is elevated, together with a stinking Oil and Gum, or Resine, which as they are in great plenty in all Wood, so in their power of acting and virtue,* they differ not much one from ano∣ther.

XXIV. Let Candidates in Physick observe this, that the seed of Poeony is more gratefull than the root, wherefore the seed may be put in Childrens victuals; on the contrary, the root is more conve∣nient for Clysters. It is better to use the powder of the root than the faecula; for in preparing the fae∣culae of simples, their virtue is washed away with the menstruum that is put to them, yea, just like Ma∣gisteries, they are made like an useless Calx, or the menstruum gives them some ascititious qualities.

XXV. Candidates in Physick must also be told, that if, by God's Blessing, they would cure an Epi∣lepsie according to their desire, they must account among Vegetables the Male Poeony, rare to be found; among Animals, Castor or Swallows; among Minerals, Vitriol, to be recommended to them as Specificks. Some indeed will highly commend the use of Cinnabar of Antimony; but it should onely be, where the Epilepsie is caused by Worms,* other∣wise in my opinion it is no convenient Medicine for Epileptick persons.

XXVI. While it was my custom to use Oil of Am∣ber, in people troubled with Epilepsies, Convulsi∣ons, Imposthumes in the Lungs, for those that were made purulent by a Catarrh falling on the Lungs, when I observed it was odious not onely to the Pa∣tients, but to the by-standers also; and that it was distastefull to most, by reason of its too much foetid∣ness, whether they used it by anointing outwardly, or in Lozenges or Pills inwardly, or any way else; I have now for some years used Balsam of Peru in its stead, to the advantage of my Patients. I know, Chymists do now correct it, and take away the of∣fensiveness of the smell by repeated distillation after washing it: But I have found that after washing it is much weakned, and does but little good, where∣fore I think we should rather use Balsam of Peru, or the natural Balsam brought from Syria,* till we are taught how to distill an Oil of Amber without stink.

XXVII. A Boy fell into an Epileptick fit once a day for fifteen days together. The best Physicians thought it came from some disorder in his Head: But the more Medicines they gave, the worse the Disease grew; so that in twenty four hours he had above one hundred and fifty fits; yet they were small ones, for he had onely a little commotion of his Head, with a buble at his Lips. Whereby not∣withstanding they knew the Disease was not from any disorder in the head, but by consent with the Stomach.* Wherefore when they left off to trou∣ble him with Physick, and strengthened him, the Child grew very well.

XXVIII. I observed wonderfull shapes of Worms in an Epileptick Woman: as she was athirst she drank greedily and frequently in her journey, com∣ing from Italy, of any Water she met withall. Her Epilepsie was very grievous, with a swelling and an ill colour all her body over. She was not relieved by Antepilepticks. At length, upon the repeated use of my Mercurial Pills, she voided a great quantity of multiform Worms. As soon as they were displaced, her Epileptick-fits likewise ceased. Bartholinus, hist. 7. cent. 4. He also, Cent. 6. Hist. 20. produces the example of a young Man often troubled with Convulsions, whose cure succeed∣ed much better, after his voiding of Ascarides.

XXIX. A Youth about fifteen years old had a pain in his Pubes, afterwards, as his pain shifted to the left-side, his Spleen grew presently ill, and from Sympathy with it, the Brain; for he fell in∣to most violent Fits of the Falling-sickness, which came upon him onely by pressing the region of the Spleen with ones finger. Among several Reme∣dies nothing was better than Chalybeate-wine, or black Hellebore,* upon taking of which he void∣ed so much black Choler, that at last he came to himself.

XXX. An Epileptick Maid was cured by the use of Vinegar and Water, she took a glass of it eve∣ry day in the morning, and before the time of her Fit pure Vinegar. When this disease was cured,* she was troubled with a pain in her Limbs, which also was cured by the use of the Bath.

XXXI. I have known some young Men, who might easily have been cured of this disease: but because they would not abstain from Wine, they became incurable. All Men know, that the Epi∣lepsie Page  147 affects the Nerves especially. And because Wine turns sowre in all, who have an infirm Sto∣mach and a weak Brain, and Vinegar is an open ene∣my to the Nerves; hence Epileptick persons may easily gather how much they ought to avoid Wine and Venus. Besides, according to Aristotle and Aver∣roes, the Epilepsie is caused like sleep, that is, by a vapour,* wherefore all vaporous things, especially strong Wines should be avoided.

XXXII. It is disputed by many, Whether Api∣um be hurtfull for Epileptick persons? That by Api∣um, Parsly must be understood, no Man will question who reads a passage in Pliny, l. 20. c. 11. and Galen 2. de alim. facult. for this is the true garden or do∣mestick Apium of the Ancients; and ours is the Pa∣ludapium, or Apium Palustre. Pliny, in the cited place, says, That if a Lying-in-woman eat Parsly, the Child that sucks her will have the Falling-sickness. Avi∣cenna rejects Parsly, especially from among Meats, because, by an innate property, it causes the Fal∣ling-sickness. And others, following their steps, forbid it. Jacchinus is of another judgment, oppo∣sing Galen, and in a Counsel for an Epileptick Child, allows of Parsly. But an opinion that is held by so many learned Men, must not be esteemed a fig∣ment, it being, without doubt, founded on Expe∣rience, which must be consulted. They, to whom it did no hurt, were either not inclined to an Epi∣lepsie, or they used it onely as a Sauce, and not as Meat: So Galen, in his advice, allows one to taste it at least; as he does Alexanders also, by which not∣withstanding the head is filled, as he writes. But, the Ancients that are quoted, speak of it taken as Meat.*

XXXIII. In the cure of this Disease we are for∣ced to leave the common method: For the prescrip∣tions of the Dogmatists, in which they usually en∣deavour to carry off, and totally eradicate the mor∣bifick cause onely by Purges, doe little or no good in the Falling-sickness, yea, they use often to doe harm. I have known some eminent Practitioners, who totally omitting the train of therapeutick in∣tentions, have betaken themselves to certain Empi∣rical Medicines, without any provision for the whole.

This sort of Practice, though sometimes it suc∣ceeded well; yet it would much more certainly have attained the proposed cure, if by other Me∣dicines also, when the body had been rightly pre∣pared, all impediments had been removed. Where∣fore the Indications about the cure of the Falling-sickness, will be either Curatory, which respect the fit, or Prophylactick, which respect the cause of the disease. As to the first, general Evacuaters are scarce of use: But the thing of most importance, is, to fix the animal Spirits, that are too fierce and vo∣latile, and to suppress their explosions already be∣gun. To which ends, two sorts of Remedies espe∣cially conduce, that is, 1. Things that give a check to the animal spirits, when they are apt to be unru∣ly and disorderly, and that repell them as it were with a smell ingratefull to them, and bring them into order, which thing, Medicines endued with a Volatile and Ammoniack Salt, or with a Vitriolick Sulphur, effect; Such as are Salt and Oil of Am∣ber, Spirit of Bloud, Hartshorn, Soot, Tincture of Castor, &c. for these taken inwards, or applied to the nostrils, often give relief, and are thought to drive away the evil Spirits of this disease, just as the fume of a Fishes-gall burnt drave away the Devil in Tobias. 2. The Animal Spirits are either divert∣ed or hindred from making their explosions, when they are enticed and kept employed in some work familiar to them. Wherefore, when a fit is violent, rubbing all the body over, and continued, often does good. But the most of a Physician's care lies in preservation, that the cause of the disease being re∣moved, or the root cut away, all the fruits may wi∣ther. The Medicines requisite to this intention may be reduced to these two heads chiefly. 1. That the fewel of the Disease, supplied immediately, from bad bloud, or the nervous juice, and more medi∣ately, from the bowels and first ways; Then 2. That the evil disposition of the brain, and of its in∣habitants, the Spirits, which is peculiar to the Epi∣lepsie, may be removed. As to the first thing in∣dicated, in this case, Vomits, Purges, Alteratives, Bleeding, Issues, &c. are proper, in as much as the impurities are withdrawn from the bowels and hu∣mours, and their dyscrasies amended; And although they cure not the Epilepsie, yet they remove im∣pediments, they raise nature, and excite her to en∣counter the enemy; also they prepare the ways, so that Specificks may more certainly exert their Vir∣tues. As for Specifick Medicines, onely which in∣deed, though not always, are reckoned to reach the cause of the Epilepsie, it is wonderfull by what power of acting they use to doe good in this di∣sease, seeing they are taken without any sensible eva∣cuation, or even perturbation in the bowels or hu∣mours, following thereupon. If we may guess, since we hold that the procatarctick cause of the Epilepsie consists in a heterogeneous conjunction, arising in the Spirits, those inhabitants of the brain, and inciting them to preternatural explosions; it will follow, that what things resist or remove such a cause, must be of such a nature, as that by strength∣ening the Brain, and contracting its pores, they ex∣clude that conjunction, and so fix the Spirits, which are up and down the middle of the brain, by dissolv∣ing their conjunction, that they will not any more be apt and inclined to those irregular explosions: Not unlike, it may be, to Aurum fulminans, which, if it be ground with Sulphur, or be sprinkled with Spirit of Vitriol, it loses its fulminant virtue. And indeed we may discover such properties, either one or both in most Antepilepticks: for Poeony, Misletoe of the Oak, Rue, Lily Conval, with many others, have a manifest astriction in them, so that it is very likely, their particles taken inwards, and so carried in the vehicle of the bloud, or nervous juice, to the Brain, do so contract, and shut up its pores, which are too lax and open, that for the future they do not at all lie open for any passage of the morbifick matter. Moreover, because these concretes do breathe out, as it were, an Armoniack, or dissipative scent, there∣fore they are said to depurate the animal Spirits, and to fix and strengthen them, when they are de∣prived of their heterogeneous conjunction. This virtue, depurative of the Spirits, proceeding from the Sal Ammoniack, is apparent in remedies, which are fetcht from the animal and mineral families, such as are preparations of Man's Skull, Bloud, Amber and Coral; as the other astringent virtue is more powerfull in the parts and preparations of Vege∣tables.*

Epiphora, or involuntary Tears.

I. WE must not use stopping Medicines, while there is a great and plentifull flux of humours; for then the abundance of humour, be∣ing intercepted by virtue of the Medicine, and stuffed as it were, it either, through its acrimony, causes greater pain, or exulceration. They must therefore be used, when either the humour is in a great measure evacuated, or the Flux of it is not great; otherwise they will doe what Galen 4. 〈 in non-Latin alphabet 〉. writes, Washt Pompholyx,*as also Spodium and Starch may both moderately dry up the humours, and also hinder the superfluous moisture, which is contained in the Veins, from being evacuated through the tunicles.

II. Collyries must have no roughness in them; for things that are of this nature, although they be ground never so finely, cannot lose their nature, for they are never diluted like a Juice, but when they are even brought to their highest fineness, they must of necessity continue a kind of Powder, which as it were pierce the parts of the Eyes, and raise a more troublesome Epiphora, if they be used at the beginning. But when one has been vext se∣veral days, and there has been a perseverance of the humour, and the Phlegm is rendred more glu∣tinous by the heat of the Eyes, then Collyries of metallick things will doe good,* for the Eyes will then bear them more easily, so they be void of ex∣ulceration.

III. In a stubborn Disease a Vesicatory applied to the forehead does good. Forestus, obs. 11. l. 11. tells of an old Woman, whose Eyes were blea∣red, weeping, full of water, painfull and itching, and was cured onely by application of a Vesicato∣ry made of Spanish Flies, Leven and Honey. I had a Matron of about sixty under cure, who had had sore Eyes for six months, and when no Remedies would doe good, she was cured in twenty four hours, by applying Schroderus his chephalick Pla∣ster to her Forehead: But she would not abstain from Wine through the whole course of her Dis∣ease.

IV. Fernelius derives the original of the Flux of Tears from the Forehead and Crown of the Head, in which he reckons the humour is gathered with∣out the Skull, and under the Skin, which he will have to fall from the Peritranium upon the adhering Membrane, and so break out at the Eyes from without. But we must believe, that the Flux of the Eyes often derives its original from within, which Paulus has expressed; and Rhases says, that this Flux may easily be cured, if it be fed by the ou∣ter Veins, but very difficultly,* if the Tears come by the inner Veins.

V. In Defluxions and Weepings of the Eyes, all men agree, there is no Remedy more powerfull than a Seton in the Neck. Now Hildanus would have it made between the second and third, or even between the fourth and fifth Vertebra of the Neck. I think, the custome of Aquapendent and the Italians should be followed, who make it between the se∣cond and first Vertebra. For that which is made low∣er Page  150 puts one to pain, because of the rubbing upon it by the Band and the Doublet.

VI. One upon the unseasonable stopping of a la∣chrymal Flux by the Oil of Vitriol, had so luxu∣riant a Gland upon the corner of his Eye next his Nose, that the excrescence of it did not onely co∣ver his whole Cheek, but it degenerated also into a most pernicious Carcinoma, which a Chirurgeon tried indeed to take hold on by a thred, and to cut it off conveniently with a Knife; but then the tu∣mour had acquired that malignity, that it could scarce be touched, but it would immediately gush out with Bloud, and therefore there was a neces∣sity onely to use Lenients, by which the destruc∣tion of the Patient was deferred, rather than remo∣ved. Let them therefore consider, that so frequent∣ly use sharp Medicines, how easily an errour may be committed,* which by no Art can ever after be rectified.

Erysipelas, or, St. Anthony's-Fire.

I. IT is commonly believed it has its rise from yellow Choler; but some of the Moderns rather derive it from thin bloud: for, 1. The Co∣lour is a token rather of bloud than bile, which is red, when it ought to be pale or yellow, as is ma∣nifest in the Jaundice. 2. Although the Colour be vehement enough, yet it is not so sharp, as in Dis∣eases arising from yellow Choler, wherefore it is not so frequently exulcerated, as Ring-worms and other Tumours caused by bile; and when it is ex∣ulcerated, it is not so much from its own nature, as from the alteration of it. 3. They are seldom ob∣noxious to it that are of a hot and dry constituti∣on, lean, brown or black, which is most suitable to breed yellow Choler; but they rather that are san∣guine, fat, fleshy and red. 4. The fleshy parts, the Thighs, Legs, Face, Neck, Breasts, and the like, are oftner affected than others. 5. This Dis∣ease comes most between thirty and forty years of age, about which time there is most bloud in the body. But yet the cause must not be ascribed simply to fulness, but rather to a depraved and pe∣culiar quality of the bloud, which proceeds from the putrefaction and corruption of its thinner part: for Nature being stimulated by that malignant qua∣lity, drives the vitious humour to the outside of the body. A sign whereof is, that this Disease sei∣zes one like the Pestilence, so that they, who ne∣ver had it before, think they are taken with the Plague, till the Disease shew it self in some part. Hence it is the common practice, when the Par∣oxysm comes, and the Rose appears, to take Medi∣cines which help Nature's motion, and drive the matter from the inner parts to the outer, as Trea∣cle, Mithridate, Water or Rob of Elder. These Medicines taken in the beginning are approved on, where plenty of humours is not urgent,* otherwise it is safer to remove the antecedent cause.

II. Celsus especially commends Bloud-letting, whom Paulus, lib. 4. follows. Galen, 14. meth. & 2. ad Glauconem seems averse to it. But I follow Reason rather than Authority: for it is an acute Disease, which must quickly be opposed, a kind of Inflammation, from the thinner Bloud, or at least its Ichor, and the hottest of it; But in such a Heat who dare omit Bleeding, or fly to other Remedies, and neglect it, since it draws from the Page  151 part where the fluxion is, evacuates, helps tran∣spiration, and readily draws out the bilious bloud, as it lies in the Veins. If a sincere Erysipelas occur, arising from Bile alone, such as Galen supposes, and if a bilious Cacochymie redound in the habit of bo∣dy, then Bleeding may be let alone, for fear of the ebullition of cholerick humours.

III. Although Galen, 13. m. m. seem to approve of Purging; yet we must proceed to it with great caution, and not till the declension, lest the hu∣mours, being stirred, run to the part affected: Wherefore, after the seventh day, Electuary of Juice of Roses with Cassia may be given, and after it some pounds of Whey.*

IV. The Ancients, and most Writers of Chirur∣gery do very much use Coolers, even Water it self, the coldest of all; yea, they also mix with them Astringents and Stupefiers, as Henbane, Mandrake, Opium, Hemlock. But the Modern reprehend this common Cure, not without the suffrage of reason and experience: for since the sharp matter exciting the Rose is not without malignity, if its going out be hindred by these very cooling, binding and re∣pellent things; it returns inwards, and seizes the nobler and inner parts, to the hazard of life, hence a Phrenzy comes from an Erysipelas in the Head struck in. Finally, by these things the matter is shut up in the part affected, whence putrefaction and suppuration, which is often attended by a Gangrene. Which thing since it often happens from the cure of the Greeks and Arabians, they admo∣nish us, that the part may be so far cooled, as that the heat may remit, and the Patient confess himself not to feel so great a heat, with the turning of the red colour into a livid: But it may easily fall out, that before sufficient caution can be used in this case, such dangers may already be at hand. Wherefore the case seems not to differ much from that of Burns: For if a burnt part be dipt in cold water, it does but inclose the heat, with danger of pain and making it worse. Hot things are more proper∣ly applied, which make the skin lax, open the pores, and dissolve the serous humours, that would break out into pustules. The intemperature of the part is removed after the same manner in both cases, not so much by opposing it with a contrary,* as by ta∣king away the cause. ¶ In this case the use of moist things is prohibited; for they presently cool actually, although they may heat potentially; and therefore they obtain the force of a repellent. Therefore dry and digesting fomentations are best. Hence it is, that if a Patient, through carelesness, wash in the beginning of an Erysipelas,* not knowing the Disease, it will be exasperated, swelled, and the pain doubled. ¶ We must have a care of things that are unctuous and have an emplastick virtue, e∣specially of Narcoticks; for the sharp vapours ex∣hale,* which if they be kept in, sometimes cor∣rupt the part. ¶ It is a custome among our coun∣try people, if they be taken with an Erysipelas, to anoint the part affected with Oil of Bayes, mixt with a little Quicksilver, with which Medicine they prolong the Disease; for while the Oil makes lax the Skin, the Erysipelas spreads farther and far∣ther, so that you may see it overrun the whole Body on a sudden, except you prevent the mischief thus, i. e. unless you apply all round it a linen cloth wet in warm water, which may defend the other parts. If the humours that stick in the flesh be plainly extravasated, they cannot flow for their thickness: let the Physician therefore make them fluid with hot Medicines. So an Erysipelas in the be∣ginning is taken away by applying Spirit of Wine.*

V. I have seen an Erysipelas in the right cheek, that was treated with suppurating Emplasticks, turn to a Gangrene. Again, I saw a Chirurgeon with such Emplasticks who was taken with an Erysipelas in ano. The reason is, 1. Because the Cheeks, Breasts, Nose, &c. because of their softness, are easily de∣prived of their innate heat. When therefore strength is good and the humours are hot, let Di∣gesters, not Suppuraters, be made use of.*

VI. This is a rule concerning Sleep; When an Erysipelas is in the Legs or Thighs, moderate Sleep is good: But when it is in the Face, we must re∣frain from Sleep as much as may be.*

VII. Green Coriander and Barley-flower applied is a very good Medicine, but not in the beginning, because it is hot, which its bitterness shews, al∣though it partake of moisture.*

VIII. By the use of Linimentum simplex, not yet rank and often changed, I have cured innumerable Erysipelas's with success, not neglecting universals and inward coolers. In defect of this nothing is better than Oil of sweet Almonds nine times washt in a glass-bottle with Night-shade-water, with which cold anoint the place till the violent heat be diminished. Others commend Balsamus Saturni made with Linseed-oil, and often anointed with a Feather. This is the Description of Linimentum sim∣plex. Take of Juice of Night-shade fresh made, Oil of Roses, each 20 ounces. Boil them to the consumption of the Juice. Strain it, and add to it Litharge of Gold, Ceruss, each 1 pound. Mix them; make an ointment according to art.*

IX. A Leech did a melancholick Woman a great deal of good, who had an eating Erysipelas in her Leg: for it drew out of the Veins thereabout the hot and adust bloud, which had all along supplied the stubborn Ulcer with matter: which being suck∣ed out, the rest of the trouble was easily over, onely by applying Bread soaked in Water.*

X. The famous Veslingius cured a certain person of an ulcerated Erysipelas in his Leg, when he had first purged the Body, by touching it sometimes with a Feather dipt in Spirit of Vitriol. He said, that these sharp chymical Liquours, were therefore applied to malignant and spreading Ul∣cers, that the corroding humours may after a man∣ner be mitigated, and their violence broken, af∣ter the example of Salt of Tartar, and Spirit of Vitriol, both which were very sharp, and by their mutual acting one upon the other, their mixture produces a far more gentle Medicine.*

XI. In the Blisters of an Erysipelas, which by force of sharp and hot ichorous Juices use to break out, Fallopius advises to prick them in the beginning, adding this moreover, that the place subject to the Fluxion should be prickt. Which operation also pleases me; yet I had rather doe it with a golden or silver Needle. But you must also know this, that they must not be prickt slightly, but also clipt with Scissers, that nothing of the Ichor may be left, which being kept in a Bladder might by its contact spoil the part.*

XII. I knew a man about thirty five years old, of the Senatory order, whose Face was often inva∣ded with bilious bloud, and then was continually disfigured with an oedematous swelling, the thinner parts of the humour being discussed. By the ad∣vice of Physicians several remedies were tried, al∣tering Broths, Whey, Waters; but all in vain. I advised an Issue in the Arm, (it was made in the right Leg, but to no purpose,) which by the per∣suasion of the Chirurgeon (whose Wife had found the benefit of it in the like case) he admitted. And he has not been troubled with this Disease ever since the year 1673. to 1679. his Face falling, and all signs of the Oedema being gone.

XIII. A Countrey fellow had an inflammato∣ry Erysipelas in his left Hand, he anointed his Hand and Arm for some days with Oil of Roses, upon which his Pain, Inflammation, &c. grew worse, so that his Hand was all over gangrened: From whence it is clear, that Oil is a great enemy to In∣flammations, as Galen 15. de simpl. intimates.* ¶ In the year 1668. a Butcher's Wife of Geneva, called Bourdillat, anointed her Face, that had an ErysipelasPage  152 in it, with the same Oil, then she had a most filthy thick scab, as white as milk, which almost caused a Gangrene. Therefore Fortis, Consult. 95. cent. 1. bids us wholly abstain from oily and fat things; because being heated by the heat of the part, they may in∣flame it farther.

XIV. I happily cured an ulcerated Erysipelas by the method prescribed of Rulandus, cent. 1. cur. 43. One about sixty three years old was taken with an ulcerated Erysipelas in his feet, with great pain and swelling. 1. I thus purged the Body: Take of Syrup of Roses, Mont. 1 ounce, extract of Spurge half a drachm, Pectoral Decoction 1 ounce and an half. Mix them. A wash for the feet: Take of Roses 4 handfulls, Plantain 3 handfulls, let them boil a little in a sufficient quantity of water. When you take out your feet, and have wiped and dried them with a soft Towel, anoint them twice every day with the following Ointment. Take of Litharge 3 ounces, Ʋnguentum Populeon, washt Ceruss, Infrigidans Galeni, each half an ounce, oil of Roses complete, 1 ounce. Let them all be mixt in a mortar, till it be made an Unguent.* Water-Cresses is a singular thing in an Erysipelas.

XV. It is usual with some men to quench St. An∣thony's fire with Frog spawn-water, but often with ill success: for it is too cold, because it has in it a Mercury joined with a certain saturnine property. Therefore indeed it is repelling; but a manifest cause of a Gangrene, and other grievous symptomes. And it is best to mix with a decoction of Myrrh and Oli∣banum in Wine and Vinegar.*

Exanthemata, or, Spots, Wheals or Pustules.

I. GAlen 2. in 6. Epid. 30. considering Simon's hi∣story, who had broad Pustules appear, said that purging and bleeding were proper in this case: Not indeed to evacuate the matter transmitted to the Skin; but to take away the superfluity of humour residing in the venous kind, before the matter trans∣mitted to the Skin,* is evacuated by topical Medi∣cines.

II. It is no small difficulty to determine, whether in Diseases, wherein something breaks out in the Skin, we may use a purging Medicine, at the first breaking out, and in the beginning of the motion, or at any time else? Some being affrighted with the plenty of bad humours in malignant Fevers, do rashly run to purging, when spots begin to appear. For when they find that taking away bloud is not sufficient, but that the accidents do yet increase, (and often because bloud enough is not let, which would doe more good) they fall on purging, that they may be thought to oppose great Remedies to great Diseases: thinking they may avoid so urgent a danger, little regarding the retrocess of the dead∣ly matter to the bowels, and expecting greater be∣nefit from purging, that is, when the load of hu∣mours is taken away, which will not tarry for coc∣tion. These men are seduced by Galen's judgment, who denied not, that in the cure of Simon's Pustules we might use a Purge. That the truth may ap∣pear, we must know, there is a threefold difference of Efflorescences in the skin. For some are caused, while Nature by the malice of the humours is much irritated, and before the time; which being com∣pelled, and taking care that the humours fall not on some principal part, changing her accustomed or∣der, and before coction, drives the deadly humour from her self; Of this rank are the Small-pox, Mea∣sles, Erysipelas and Spots in malignant Fevers. Again, some are indeed made by Nature driving them out, but then the matter is more kindly, and such as Page  153 causes not a Fever inwardly: of which nature are pocky Pustules, and the scabby Eminences of Simon and all others, which break out at the Skin, while the faculty of the Veins unburthens it self. There are others also, that bud out at the skin, from some fault in the flesh or the third Region, through the depraved nourishment, as in the Leprosie, several sorts of Scab and Itch. From which difference it follows, that what is driven to the Skin, is either caused by the pernicious condition of the humour, which causes a deadly Fever; or by reason of abundance of ill humour, unfit for nourishment, whether it be in the veins or in the flesh. Also that which breaks through the Skin, is either fastened in the flesh and skin, and so causes Pustules and Tu∣mours; or it onely defaces the skin with its colour and thinness, and raises a very diseased affection in the skin, while it prevents a greater in the bowels. Which things premised, it is resolved, that a purge must not be given in any defoedation of the skin, as it begins, and in the very breaking of it out, whe∣ther the matter be malignant or not. And this should be observed especially in spots of malignant Fevers, Small-pox and Measles, nor yet after the complete time of apparition of the Small-pox and Measles. But sometimes upon the score of some most urgent danger, in Malignant-fevers (because while they are yet appearing, there is abundance of pernicious humour, and the Fever encreases,) after the violence of the eruption, and while the motion is continued outward by nature, sometimes it may be lawfull to purge by friction and cupping; although this must be done but seldom, and with premeditation. But in other spots of the skin, which degenerate into the Small-pox and Measles, we must neither purge in the beginning, nor after the time of eruption is complete, nor at any time: because the humours, that caused the Fever, are they which de∣generate into the Small-pox or Measles, and for that Reason the Fever presently ceases, which is discolou∣red, though there follow another from suppurati∣on: In an Erysipelas very slowly, because in these Di∣seases the matter is very moveable. But if that which has appeared in the skin (whether Erysipelas, Measles, Small-pox, or Malignant-spots) do suddenly fall back, disappear, and turn inwards, we must purge forthwith, before it fall on any principal part, as the manner is in turgent humours. But in some scabious eruptions, such as Hippocrates observed in Si∣mon, and in others of the same stamp because they are settled in the flesh and skin, and come of a thick matter, and are moved slowly, you may give a Purge when you think fit; yet not in the beginning and very height of the eruption. For we must permit Nature to finish the motion she has begun, and af∣terwards we may purge at any time; because what remains within, as it breeds dayly more and more, so also it desires to be evacuated: for the matter is neither all together, nor expelled, but remains to be expelled, without any Inflammation or Fever, which can require coction, or it must be expelled because of urgency; yet by no means in the violence of its motion. For it is determined among the Prudent, to permit as yet the violence of the irritation and commotion in erring Nature, before we stop it, in evacuations which we must of necessity stop: Nor must we doe it in those evacuations, which Nature moves from the principal parts to the ignoble, for the bet∣ter, because of the deadly humour. In which mat∣ter the wiser, guided by reason and experience, fear to divert Nature from the work of expulsion, she has begun, by giving a Purge; which motion it were a thousand times safer to help by cupping, scarify∣ing, &c. Because Nature would sink very much, and be wearied in the contest, by the violence which is done her by the Medicine drawing to the Bowels, contrary to her own motion outwards. Besides, up∣on its turning back we must fear it will settle on some principal part: for the turgescency is not more mortal, than the foresaid retrocess inwards and from the skin, contrary to the motion of Nature from within outwards. Nor also is it in the power of Me∣dicine necessarily to force the humour,* when it is moved, to the Guts.

II. A Nun, without any precedent Fever, or de∣cay of strength, or any other usual signs appearing, was suddenly seized with Pustules all her body over, and she was then sensible of no other ail besides. She recovered onely by Diet without the help of Phy∣sick. I judged, because the Disease came in the wane of the Moon, that Nature helped by the monthly motion, rather drove the excrements, which were few, to the circumference; as if she had endeavoured insensible transpiration: Since the Pus∣tules appeared not all red, as in others,* but were somewhat black and greenish.