Platerus golden practice of physick: fully and plainly discovering, I. All the kinds. II. The several causes of every disease. III. Their most proper cures, in respect to the kinds, and several causes, from whence they come. After a new, easie, and plain method; of knowing, foretelling, preventing, and curing, all diseases incident to the body of man. Full of proper observations and remedies: both of ancient and modern physitians. In three books, and five tomes, or parts. Being the fruits of one and thirty years travel: and fifty years practice of physick. By Felix Plater, chief physitian and professor in ordinary at Basil. Abdiah Cole, doctor of physick, and the liberal arts. Nich. Culpeper, gent. student in physick, and astrology.

The Causes.

The Cause of the comming forth of the Guts, Cawle, Womb, Fundament, Eye, or Tongue is either from some o∣pening, and the Rimme of the Belly, or weakness, and dis∣solving of the Neck of the womb, or the turning of the Fundament, or strait Gut outward: or the loofening of the knitting of the Eye, or Tongue; or a wound of the Codds.

By the opening of the Rimme of the Belly which keep∣eth the Guts and Cawle in the same, if the Guts or Cawle fall through the opening, then there is a Rupture or Fal∣ling out, of which we spake in Tumors. And this ope∣ning of the Rimme, is either when it is broken or dilated.

The Falling forth of the Guts and Cawle is from the breaking of the Rimme of the Belly, * 1.1 that causeth the Swelling called Hernia or Rupture, of which there are divers sorts accord∣ing to the Diversity of Parts where they fall; for if it be in the Groin, and in the male-kind, so that the Rim be open which covereth the Stones and seminary Vessels, the Guts get through the opening, and so lye under the skm, which is called Entero∣cele; and sometimes into the Codds, and cause a great Swelling when much falleth down, or when they are stret∣ched with wind, or with Excrements. And if they be hard, it is selt, and if there be wind, they make a noise be∣ing pressed. And if the Guts stay there and cannot be put up, because they are stretched and rouled together, because the Passage of the Excrements is stopped, they are thrown up again. But if part of the Cawle fall into the Groin by the aforesaid, it is called Epiplocele, and the Tumor re∣mains

there, not going lower because the Cawle being short and scarce, reaching beyond the Bone of the Privi∣ties, cannot fall so low as the Guts, except some part of it be broken, when the Rimme is broken, and then it may fal into the Codd, which cannot be put up again. We saw one in the Groin very big, which we knew was the Cawle by feeling of it to be unequal with Knobs of hard Fat; which we knew was broken by the quantity or relaxed as we shall shew, but being without pain it was neglected, and the Patient lived not long after.

If the Rimme be broken in the groin of a Woman, * 1.2 where a certain Vessel passeth by it outwardly in the Groine, then there is the Rupture called Ente∣rocele or Gut-rupture in Women, which is sometimes very great. And if the Cawle fall there which is longer in Women then in Men, the Tumor is larget then in Men, and is called Epiplocele or Cawle-rupture.

But if the Rimme be broken in ano∣ther part of the Belly and the Guts, * 1.3 or the Cawle get there under the skin, if it be in the Navel, it is called Omphalocele Navel-rupture, or Exomphalocele, or Rupture about the Navel, if in any other part it is called Hernia or Rupture, which you may know by touching, whether it be the Guts, for then they will make a noise, but the cawle will not, and the Guts make a larger Tumor then the Cawle.

The Rimme is broken, either by a Stroak or Fall, or ve∣hement Leaping, or Vaulting into a Saddle, as I have ob∣served. Also by great straining when the Belly is pressed by the Muscles in Labour or Travail with Child, or going to stool, also in Children by crying. Also by a cut, when the skin is healed, and the Membrane left open, or the like.

A Portion of the Guts or Cawle may fall down, * 1.4 only by the enlarging or di∣lating of the Rimme of the Belly, by which the Seed Vessels descend into the Codds. This comes not speedily but by degrees, with often straining; for when the Guts are carried to the enterance of the Rimme of the belly, they work themselves through or break through, when the force is great. And that this may be so, and that the enterance of the Rimme of the Belly may be so dilated and opened without breaking, it appears, in that more narrow and thick parts, may be so enlarged as the Ureters, through which a Stone falls down, as we shewed. And this we have seen to be by degrees. And in a Rupture-dropsie, when after Death we opened him, we found a round hole not cut or broken, by which the Guts fell into the Codds, by which that thin part of the Gut which is above the blind Gut, was carried to the bottom of the Codd which was full of Water, and it grew firmly to the Rimme in the whol Passage; and the Patient while he lived and was in Health otherwise, voided his Excrements orderly, and complained of no pain. Fernelius who distinguisheth this Passage of the Rimme into that which is internal, and that which is external, faith that in the Gut-rupture, and cawle Rupture, the inward Rimm or Skin must needs be broken, and the outward only enlarged. It may be he meant that it was so in Women, that these Ruptures came from the Relaxation of the Rimme of the Belly in the Groin where they have as we shewed a peculiar Vessel.

For he saith that there is a Tendon sent from the Groine to the Rimme of the Belly which strengthneth it, and so al∣so the Guts and cawle.

But in regard that Vessel is not so membranous and thin as the enterance of the Rimme, but is nervous and hard, and therefore is not so easily enlarged, the Guts or Cawle cannot fall into the Groin by the relaxing thereof, except it be broken.

When the Rim of the Belly is enlar∣ged without being broken, * 1.5 there may be a Navel-rupture also: and this ap∣pears, because in great straightness, es∣pecially of Woman in travail, the Na∣vel often swells, by the Guts through straining, sent chiefly to that part of the Rim, where there is a short Passage in the Navel, which appeared at the birth in the Navel string and after grew together, and there di∣stending or stretching the Rim, and when the straining is over, and the stretching, the swelling goes clean away and returns no more, which would not be, if it came from the breaking of the Passage: for which cause, as we perceive plainly that the Navel-rupture continues not, so we may collect, that the Rupture which remains, comes from the Rim of the Belly, so stretched by the Causes aforesaid, that it cannot return, which cannot be in other parts of the rim of the Belly, but that in the Groine, without a breaking thereof.

From the Dissolving or Division of the Neck of the Womb, * 1.6 from the parts unto which it is knit, comes the Falling out thereof. For the Womb being chiefly held up by its Neck, upon which it resteth, and unto which it grows firmly, and in other parts being free from all connexion or joyning, that it may better di∣late and enlarge it self in Conception, (except on each side a little, and that loosely to the Rimme of the Belly) it cannot be that it should fall all to the Privities, except the Neck thereof which is so fastned thereto, that it can∣not be separated, do also follow. And because this can∣not be without the rending of the fibrous Connexion which is made by the Neck and Parts adjacent. The im∣mediate cause of the Falling of the Womb, must be the dis∣solving of the Connexion of the Neck thereof. And if this dissolving be in some part onely near the womb, the womb will hang down in the Privities, with some part on∣ly of the Neck turned, but if the Neck of the Womb be wholly separated from the parts under it, then the Womb will all hang forth, with the Neck turned inside, outward, and the womb will not be so turned in the bottom, but as it was when in the Belly, the Orifice onely being open, drawing with it the Membranes and the Rimme which is joyned to them with the Vessels and Stones. And this may be without a Rupture; only from the Looseness of the Membranes which can stretch much, (as we see in Dropsies, when the Belly is swollen, how the Rim thereof is stretched) although the womb hath been long down, as appears in that when it is put up again, Women may con∣ceive, which could not be, if the Vessels were divided from it.

The womb it self causeth chiefly this Separation of the Neck of it from the Fibers or small Veins by which it is joyned to the parts adjacent though not strongly, and ther∣fore it may be without great hurt or bleeding; when it is forcibly so drawn down, that it brings the Neck with it, either suddenly or by degrees, when there is less force, first tearing the Veins next to it, and then turning out the neck downward, which hanging forth, makes it fall more down by degrees through the weight thereof.

The womb is thus driven down by great and often straining, * 1.7 by blowing the wind, or otherwise which presseth downward the Guts and Womb, es∣pecially in a womans throws in child∣birth; when the travail is hard, and the womb gets too much downward with the Child, and the rather when the Child getting through with difficulty, thrusts the Neck of the Womb down, and so untieth it from the Veins. Or if the Secundine or after Birth, stick∣ing still to the womb, be so driven by the Midwife, that the womb is driven down also with the Neck thereof. For these Causes after Child-bearing the womb falls down;

and those Women which have often brought forth, and en∣dured such Midwives, are presently troubled therewith, or when they grow old.

The same may come from Leaping, or the like Shak∣ing of the Body; and the Womb may hang out thereby.

Also from the Neck of the Womb it self besides, when it is pull'd away by the Womb, there may be a Falling out of the same, when it is separated by Force from the parts beneath, by violent and frequent Copulation, as in Har∣lots which are continually rubbed; or from some Cor∣ruption in the Neck, by which we once saw the womb fal∣len out.

Also from other Causes, this Falling down of the womb can scarce proceed. As for the looseness of the Ligaments (or of Muscles by which some thought the Womb did hang) which they say comes from the Force mentioned (and by which the womb is driven down,) or from the plenty of Humors that wet the Membranes. We, (since there are no such Muscles, because as we shewed the womb must be free, and Membranes so loosned, that they may follow the womb, nor so fast tyed as they ought to be, if the womb hang by them) cannot grant the Falling out of the womb to be from the looseness thereof. For although the womb be loosned, and the Vessels stretcht beyond their bounds, yet can it not fall through the Privities, except the Neck be separated, also which only holds it in.

Nor can the breaking of the Membranes be the Cause, as some say, because, we found in the Anatomy of a Wo∣man whose Membranes were putrified and consumed, long before her death, as appeared by a Flux of stinking matter, that the womb moved not out of its place, but was firm.

As for the watery Humor which they say causeth the Falling out of the Womb, we shewed that it could not do it by moistning the Ligaments, and now declare, that in Women that have the Dropsie, in whom the womb and its Membranes swimms in water, the womb falls not out; yet it may come to pass in the Whites, that the neck of the womb being continually moist, and therefore too loose, that the womb being compelled by other Causes, may easier slip down, and the neck may yeeld more easily, and be inver∣ted.

Some teach that besides this Falling down, that the womb while in the Belly may be moved on one side, and get also up to the Stomach. But being it grows to the neck, and is compessed every where with the guts, abiding commonly in the middle, it will not easily get into other parts, and will rather go downwards then upwards. Except perhaps it grow so that it take up more room then formerly, as we see in Women with Child: and then also it rather goes down∣wards by its weight, and the Belly is more swollen and harder beneath. For which reasons, and the other acci∣dents in the Mother-fits, we declared in the Cure of them, that they come rather from Vapors that arise from the womb, then from the ascending of the womb it self.

The Falling out of the Fundament is from the Inversion or straight Gut, * 1.8 for then it swells, as when going to stool, the Fundament sticks out with straining to let out the Excrements, till it be drawn in again; so that if by great force and straining with hard Excrements, it be so brought down, that it brings a part of the straight Gut with it, it is the cause of its staying out. The same may be from other causes that bear down, as in Child-birth, when the Deli∣very is hard, the Fundament also falls out, also from for∣cing about the Fundament, as in the Tenesmus, or needing or in the Flux called Dysentery. And we have seen in an Incision made in the Rimme or Peritonaeum near the Fun∣dament for taking a stone out of the Bladder, that through pain, the Fundament hath been by straining thrust out, and the Yard also though in an Infant and little, hath been swollen and stood. And I have observed in some Chil∣dren troubled with the Stone, that they had not only this coming forth of the Fundament alwayes when they strain∣ed to make water, but an Extension of the Yard, especial∣ly in the Head and Fore-skin, from their often handling of it through pain, which were the undoubted signs of the Stone in the Kidneys.

And if the Fundament be so thrust out by straining, that the straight Gut be drawn from the Mesentery or middle Membrane by which the Guts are held, then they cannot be put up or kept in; although the Muscles be right a∣gainst the Fundament to draw it in again gently, yet if it be far forth and tied with no Ligaments, the Muscles alone cannot do it, because if the Fundament be far out, they will fall out also.

It may come from the weakness of the Muscles which draw in the Fun∣dament after stool, * 1.9 and constrain it up, that the Fundament may be so far forth, that it cannot be drawn in, by which means the Fundament may be said to be forth, but not to fall out except Force or Strain∣ing perceeded; because it is not so retained by these smal Muscles, that when they cease to act, it should presently fall out of the Body in which it was included without any Force. These weakness which makes the Muscles unable to draw back the Fundament, that falls out by stool, bofals them, which have often had the Falling of it out; or it comes from too much cold of the part which is very sensi∣ble, by sitting upon a cold stone or the like, or by staying in the cold Air or Water, which touch the Fundament.

Many suppose that Falling of the Fundament, * 1.10 and that which is called the Palsey of the Fundament, comes from Loosness of the Muscles through a Defluxion upon the Nerves. But it is improbable, that a particular Palsie of this part should be alone, without any other part affected from the Defluxion. Nor is it pro∣bable that a Defluxion which must needs fall in abundance to cause a Palsey, should fall only into the lowest part of the os sacrum, where these slender Nerves are accompanied with these Muscles, and not rather sill the whol Cavity of the os sacrum, by which means the Nerves might be dissol∣ved. Therefore if there be a Palsie in the Muscles of the Fundament, it would be in the whol Body, or in the inse∣rior parts, as well as there. And though there be a great Resolution of parts in an Apoplexy, we find none there, nor doth the Fundament fall forth, nor in any other Palsie, when all the lower parts are resolved, yet the Patient can go to stool and draw in the Fundament, and though it be weaker for the Disease, yet it falls out. For which cause, if difficulty of drawing back of the Fundament be from the Nerves, which comes soldom, it comes from a Palsie caused by a Defluxion, and we suppose that it comes from com∣pression of the Nerves, or contusion by Fall or Stroak about the Crupper, or from some great Coldness of the part which is not only upon the Muscles but Nerves.

When the Connexion of the Eye with its hollow roundness is loosned, * 1.11 it falleth out, and this comes by fome violent Cause, because it is so fixed to the place, that when it is brought to the Table boyled it can scarce be got out.

Yet the Eyes fall out by a great Contusion of the head, by a Fall or Stroak.

And scarce by another means, except they start out a little by straining, as in Child-birth, crying or roaring and so seem bigger, yet they fall not out by that means but on∣ly stick out, of which we spake in Deformity: because by straining they cannot be much dissended, but a little for∣ced by the Muscles.

Some think that the Eye may fall out by the stretching of the Globe with Wind and Moisture gathered before it, but since we find no Cavity in the Eye, but it is full every where, and there is no way for these to get in, or can they

be bred in the Eye, or come from other parts, we cannot yeeld to them. As we shewed in the Causes of pains of the Eyes, from Wind and Filmes, which they suppose to come from Defluxion of Water.

The Falling out of the Tongue may be from the loosning of its Connexi∣on, * 1.12 it is so strong bound by Muscles, a Coate and Ligaments, that it must be done by great Force. But it hap∣pens from a Contusion of the Neck or Breast, as when theeves are racked, their Tongue sticks out, and it may also come by other means.

I saw one whose Stones hung out by a wound which was given upon his Codd. * 1.13 And I observed the same in one which was shot with a Bullet and lost half his Codd, that his right Stone, with the Seed-vessels hung forth bare.

Notes

• * 1.1

  The Cause of the rupture of the guts called Enterocele, and of the Cawle called Epiplocele.
• * 1.2

  The breaking of the Rimme is the Cause of the Rup∣ture in the Groins of Women.
• * 1.3

  The Cause of Navel-rupture.
• * 1.4

  The Dilatation of the Rimme is the Cause of ruptures.
• * 1.5

  The cause of Na∣vel-rupture is the enlarging of the Rim of the Belly, there.
• * 1.6

  The cause of the falling out of the Womb, is the dis∣solving of the connexion of the Neck thereof.
• * 1.7

  The forcible unty∣ing of the Neck of the Womb, is the cause of the wombs Falling down.
• * 1.8

  The cause of the falling out of the Fundament is straining.
• * 1.9

  The Loosness of the Muscles of the fun∣dament is the cause why it cannot be drawn in.
• * 1.10

  The Loosness of the muscles is the cause why the fundament cannot be drawn back.
• * 1.11

  The Connexlon or Fasting of the Eye being loosned by a Contusion is the cause of its coming forth.
• * 1.12

  The loosning of the Connexion of the tongue from a con∣tusion, is the cause of its coming forth.
• * 1.13

  The cutting of the Cod causeth the fal∣ling out of the stones