Section III. Of the propriety or operation of Medicines

CHAPTER I. Of Emolient Medicines.

The various mixtures of heat, cold, dryness, and moisture in simples, must of necessity produce variety of faculties, and operations in them, which now we come to treat of, beginning first at emolients.

What is hard, and what is soft, most men know, but few are able to express. Phylosophers define that to be hard which yields not to touching, and soft to be the contrary. An emolient, or softening medicine is one which reduceth a hard substance to its proper temperature.

But to leave phylosophy, and keep to physic: physicians describe hardness to be two-fold.

1. A distention or stretching of a part by too much fulness.

2. Thick humours which are destitute of heat, growing hard in that part of the body into which they flow.

So many properties then ought emolient medicines to have, viz. To moisten what is dry, to discuss what is stretched, to warm what is congealed by cold; yet properly, that only is said to mollify which reduceth a hard substance to its proper temperature.

Dryness and thickness of humours being the cause of hardness, emolient medicines must of necessity be hot and moist; and although you may peradventure find some of them dry in the second or third degrees, yet must this dryness be tempered and qualified with heat and moisture, for reason will tell you that dry medicines make hard parts harder.

Mollifying medicines are known, 1. by their taste, 2. by their feeling.

1. In taste, they are near unto sweat, but fat and oily; they are neither sharp, nor austere, nor sour, nor salt, neither do they manifest either binding, or vehement heat, or cold to be in them.

2. In feeling you can perceive no roughness, neither do they stick to your fingers like Birdlime, for they ought to penetrate the parts to be mollified, and therefore many times if occasion be, are cutting medicines mixed with them.

CHAPTER II. Of hardening Medicines.

Galen in Lib. 5. de Simple, Med. Facult. Cap. 10. determines hardening medicines to be cold and moist, and he brings some arguments to prove it, against which other physicians contest.

I shall not here stand to quote the dispute, only take notice, that if softening medicines be hot and moist (as we shewed even now) then hardening medicines must needs be cold and dry, because they are contrary to them.

The universal course of nature will prove it, for dryness and moisture are passive qualities, neither can extremeties consist in moisture as you may know, if you do but consider that dryness is not attributed to the air, nor water, but to the fire, and earth.

2. The thing to be congealed must needs be moist, therefore the medicine congealing must of necessity be dry, for if cold be joined with dryness, it contracts the pores, that so the humours cannot be scattered.

Yet you must observe a difference between medicines drying, making thick, hardening, and congealing, of which differences, a few words will not do amiss.

1. Such medicines are said to dry, which draw out, or drink up the moisture, as a spunge drinks up water.

2. Such medicines are said to make thick, as do not consume the moisture, but add dryness to it, as you make syrups into a thick electuary by adding powders to them.

3. Such as congeal, neither draw out the moisture, nor make it thick by adding dryness to it, but contract it by vehement cold, as water is frozen into ice.

4. Hardness differs from all these, for the parts of the body swell, and are filled with flegmatic humours, or melancholy blood, which at last grows hard.

That you may clearly understand this, observe but these two things.

• 1. What it is which worketh.
• 2. What it worketh upon.

That which worketh is outwardly cold. That which is wrought upon, is a certain thickness and dryness, of humours, for if the humour were fluid as water is, it might properly be said to be congealed by cold, but not so properly hardened. Thus you see cold and dryness to be the cause of hardening. This hardening being so far from being useful, that it is obnoxious to the body of man. I pass it without more words. I suppose when Galen wrote of hardening medicines, he intended such as make thick, and therefore amongst them he reckons up Fleawort, Purslain, Houseleek, and the like, which assuage the heat of the humours in swellings, and stops subtil and sharp defluxions upon the lungs; but of these more anon.

CHAPTER III. Of Loosening Medicines.

By loosening here, I do not mean purging, nor that which is opposite to astringency; but that which is opposite to stretching: I knew not suddenly what fitter English name to give it, than loosening or laxation, which latter is scarce English.

The members are distended or stretched divers ways, and ought to be loosened by as many, for they are stretched sometimes by dryness, sometimes by cold, sometimes by repletion or fullness, sometimes by swellings, and sometimes by some of these joined together. I avoid terms of art as much as I can, because it would profit my country but little, to give them the rules of physic in such English as they understand not.

I confess the opinion of ancient physicians hath been various about these loosening medicines. Galen’s opinion was, that they might be referred either to moistening, or heating, or mollifying, or evacuating medicines, and therefore ought not to be referred to a chapter by themselves.

It is likely they may, and so may all other medicines be referred to heat, or coldness, or dryness, or moisture: but we speak not here of the particular properties of medicines, but of their joined properties, as they heat and moisten.

Others, they question how they can be distinguished from such as mollify, seeing such as are loosening, and such as are emolient, are both of them hot and moist.

To that, thus: stretching and loosening are ascribed to the moveable parts of the body, as to the muscles and their tendons, to the ligaments and Membranæ; but softness and hardness to such parts of the body as may be felt with the hand: I shall make clear by a similitude, Wax is softened, being hard, but Fiddle-strings are loosened being stretched. And if you say that the difference lying only in the parts of the body is no true difference, then take notice, that such medicines which loosen, are less hot, and more moistening, than such as soften, for they operate most by heat, these by moisture.

The truth is, I am of opinion the difference is not much, nay, scarce sensible, between emolient and loosening medicines; only I quoted this in a chapter by itself, not so much because some authors do, as because it conduceth to the increase of knowledge in physic, for want of which, this poor nation is almost spoiled.

The chief use of loosening medicines is in convulsions and cramps, and such like infirmities which cause distention or stretching.

They are known by the very same marks and tokens that emolient medicines are.

CHAPTER IV. Of drawing Medicines.

The opinion of physicians is, concerning these, as it is concerning other medicines, viz. Some draw by a manifest quality, some by a hidden, and so (quoth they) they draw to themselves both humours and thorns, or splinters that are gotten into the flesh; however this is certain, they are all of them hot, and of thin parts; hot because the nature of heat is to draw off thin parts that so they may penetrate to the humours that are to to be drawn out.

Their use is various, viz.

Use 1. That the bowels may be disburdened of corrupt humours.

2. Outwardly used, by them the offending humour (I should have said the peccant humour, had I written only to scholars,) is called from the internal parts of the body to the superfices.

3. By them the crisis of a disease is much helped forward.

4. They are exceedingly profitable to draw forth poison out of the body.

5. Parts of the body over cooled are cured by these medicines, viz. by applying them outwardly to the place, not only because they heat, but also because they draw the spirits by which life and heat are cherished, to the part of the body which is destitute of them: you cannot but know that many times parts of the body fall away in flesh, and their strength decays, as in some persons arms or legs, or the like, the usual reason is, because the vital spirit decays in those parts, to which use such plaisters or ointments as are attractive (which is the physical term for drawing medicines) for they do not only cherish the parts by their own proper heat, but draw the vital and natural spirits thither, whereby they are both quickened and nourished.

They are known almost by the same tokens that attenuating medicines are, seeing heat; and thinness of parts is in them both, they differ only in respect of quantity, thinness of parts being most proper to attenuating medicines, but attractive medicines are hotter.

CHAPTER V. Of discussive Medicines.

The nature of discussing (or sweating) medicines is almost the same with attractive, for there are no discussive medicines but are attractive, nor scarce any attractive medicine but is in some measure or other discussing. The difference then is only this; that discussive medicines are hotter than attractive, and therefore nothing else need be written of their nature.

Use. Their use may be known even from their very name; for diseases that come by repletion or fulness, are cured by evacuation or emptying; yet neither blood nor gross humours are to be expelled by sweating, or insensible transpiration (as they call it) but the one requires blood-letting, the other purgation, but scrosus or thin humours and filthy vapours, and such like superfluities, are to be expelled by sweat, and be wary in this too, for many of them work violently, and violent medicines are not rashly to be given.

Caution 2. Besides, swellings are sometimes made so hard by sweating medicines, that afterwards they can never be cured; for what is thin being by such medicines taken away, nothing but what is perfectly hard remains: If you fear such a thing, mix emolients with them.

Caut. 3. Again, sometimes by using discussives, the humours offending (which physicians usually call the peccant humours) is driven to some more noble part of the body, or else it draws more than it discusseth; in such cases, concoct and attenuate the matter offending before you go about to discuss it.

From hence may easily be gathered at what time of the disease discussive medicines are to be used, viz. about the declining of the disease, although in diseases arising from heat of blood, we sometimes use them in the encrease and state of them.

They are known by the same marks and tokens attenuating medicines are, viz. by their burning and biting quality, they being very hot, and of thin parts, void of any biting quality, therefore they contract not the tongue in tasting of them.

CHAPTER VI. Of repelling Medicines.

Repelling medicines are of contrary operation to these three last mentioned, viz. attenuating, drawing, and discussive medicines: It is true, there is but little difference between these three, some hold none at all; and if you will be so nice, you may oppose them thus. And so medicines making thick, correspond to attenuating medicines, or such as make thin, repelling medicines are opposed to such as draw, and such as retain the humours and make them tough, are opposite to such as discuss, some hold this niceness needless.

2. The sentence of authors about repulsive medicines is various.

For seeing an influxion may be caused many ways, a repulsive hath got as many definitions.

For such things as cool, bind, stop, and make thick, stay influxions, and therefore repulsives are by authors opposed, not only to attractives, but also to attenuating, and discussing medicines.

But properly such things are called repulsives, which do not only stay influxions, (for so do such medicines which stop and make thick) but such as drive the humours flowing to, or inherit in the place, to some other place.

The truth is, binding is inherent to repulsives, so is not coldness nor making thick: Yet such as are binding, cold and thin in operation, are most effectual.

Your taste will find repulsives to be, tart, or sharp, or austere, with a certain binding which contracts the tongue.

Use 1. Their use is manifold, as in hot tumours, head-aches, or the like.

Use 2. By these in fevers are the vapours driven from the head, Vinegar of Roses is notable.

Time of giving. They are most commodious in the beginning and encrease of a disease, for then influxions most prevail.

But seeing that in the cure of tumours there are two scopes, 1. That that which flows to it may be repelled. 2. That that which is already in it may be discussed; repulsives are most commodiously used in the beginning, discussives in the latter end.

In the middle you may mix them, with this proviso, that repulsives exceed in the beginning, discussives in the latter end.

Caution 1. If the matter offending be of a venomous quality, either abstain from repulsives altogether, or use purging first, lest the matter fly to the bowels and prove dangerous, especially if the bowels be weak.

2. Also forbear repulsives, if the pain be great.

3. Lastly, Have a care lest by repulsives you contract the pores so much, that the matter cannot be removed by discussives.

CHAPTER VII. Of cleansing Medicines.

Cleansing medicines can neither be defined by heat, nor coldness, because some of both sorts cleanse.

A cleansing medicine, then, is of a terrene quality, which takes away the filth with it, and carries it out.

Definition.] Here, to avoid confusion, a difference must be made between washing and cleansing.

A thing which washeth, carries away by fluxion, as a man washeth the dirt off from a thing.

A cleansing medicine by a certain roughness or nitrous quality, carries away the compacted filth with it.

This also is the difference between cleansing and discussing medicines, the one makes thick humours thin, and so scatters them, but a cleansing medicine takes the most tenacious humour along with it, without any alteration.

Besides, of cleansing medicines, some are of a gentler nature, some are more vehement.

These are not known one and the same way; for some are sweet, some salt, and some bitter.

The use of cleansing is external, as the use of purges are internal.

They are used to cleanse the sanies and other filth of ulcers, yea, and to consume and eat away the flesh itself, as burnt Alum, precipitate, &c.

When these must be used, not only the effects of the ulcers, but also the temperature of the body will tell you.

For if you see either a disease of fulness, which our physicians call [Plethora] or corrupted humours which they call [Cacochyma] you must empty the body of these, viz. fulness by bleeding, and corrupt humours, or evil state of the body, by purging before you use cleansing medicines to the ulcer, else your cure will never proceed prosperously.

CHAPTER VIII. Of Emplasters.

By Emplasters, here, I do mean things glutinative, and they are quite contrary to things cleansing.

They are of a far more glutinous and tenacious substance.

They differ from things stopping because they do not stop the pores so much, as stick to them like Birdlime.

They have a certain glutinous heat, tempered both with coldness and moisture.

From these plasters take their names.

Their taste is either none at all, or not discernable whether hot or cold, but fat, insipid, or without taste, or sweet, and viscous in feeling.

Their use is to stop flowing of blood, and other fluxes, to cause suppuration, to continue the heat, that so tumours may be ripened.

Also they are mixed with other medicines, that they may the better be brought into the form of an emplaster, and may stick the better to the members.

CHAPTER IX. Of suppuring Medicines.

These have a great affinity with emolients, like to them in temperature, only emolients are somewhat hotter.

Yet is there a difference as apparent as the sun when he is upon the meridian, and the use is manifest. For,

Emolients are to make hard things soft, but what suppures, rather makes a generation than an alteration of the humour.

Natural heat is the efficient cause of suppuration, neither can it be done by any external means.

Therefore such things are said to suppure, which by a gentle heat cherish the inbred heat of man.

This is done by such medicines which are not only temperate in heat, but also by a gentle viscosity, fill up or stop the pores, that so the heat of the part affected be not scattered.

For although such things as bind hinder the dissipation of the spirits, and internal heat, yet they retain not the moisture as suppuring medicines properly and especially do.

The heat then of suppuring medicines is like the internal heat of our bodies.

As things then very hot, are ingrateful either by biting, as Pepper, or bitterness: in suppuring medicines, no biting, no binding, no nitrous quality is perceived by the taste, (I shall give you better satisfaction both in this and others, by and by.)

For reason will tell a man, that such things hinder rather than help the work of nature in maturation.

Yet it follows not from hence, that all suppuring medicines are grateful to the taste, for many things grateful to the taste provokes vomiting, therefore why may not the contrary be?

The most frequent use of suppuration is, to ripen Phlegmonæ, a general term physicians give to all swellings proceeding of blood, because nature is very apt to help such cures, and physic is an art to help, not to hinder nature.

The time of use is usually in the height of the disease, when the flux is stayed, as also to ripen matter that it may be the easier purged away.

CHAPTER X. Of Medicines provoking urine.

The causes by which urine is suppressed are many.

1. By too much drying, or sweating, it may be consumed.

2. By heat or inflammation of the reins, or passages whereby it passes from the reins, it may be stopped by compression.

Urine is the thinnest part of blood, separated from the thickest part in the reins.

If then the blood be more thick and viscous than ordinary, it cannot easily be separated without cutting and cleansing medicines.

This is for certain, that blood can neither be separated nor distributed without heat.

Yet amongst diureticks are some cold things, as the four greater cold seeds, Winter-cherries, and the like.

Although this seem a wonder, yet it may be, and doth stand with truth.

For cool diureticks, though they further not the separation of the blood one jot, yet they cleanse and purge the passages of the urine.

Diureticks then are of two sorts:

1. Such as conduce to the separation of the blood.

2. Such as open the urinal passages.

The former are biting (and are known by their taste) very hot and cutting, whence they penetrate to the reins, and cut the gross humours there.

Bitter things, although they be very hot, and cut gross humours, yet are they of a more dry and terrene substance than is convenient to provoke urine.

Hence then we may safely gather, that bitter things are not so moist nor penetrating, as such as bite like Pepper.

CHAPTER XI. Of Medicines breeding flesh.

There are many things diligently to be observed in the cures of wounds and ulcers, which incur and hinder that the cure cannot be speedily done, nor the separated parts reduced to their natural state.

Viz. Fluxes of blood, inflammation, hardness, pain, and other things besides our present scope.

Our present scope is, to shew how the cavity of ulcers may be filled with flesh.

Such medicines are called Sarcoticks.

This, though it be the work of nature, yet it is helped forward with medicines, that the blood may be prepared, that it may the easier be turned into flesh.

These are not medicines which breed good blood, nor which correct the intemperature of the place afflicted, but which defend the blood and the ulcer itself from corruption in breeding flesh.

For nature in breeding flesh produceth two sorts of excrements, viz. scrosus humours, and purulent dross.

Those medicines then which cleanse and consume, these by drying are said to breed flesh, because by their helps nature performs that office.

Also take notice that these medicines are not so drying that they should consume the blood also as well as the sanies, nor so cleansing that they should consume the flesh with the dross.

Let them not then exceed the first degree unless the ulcer be very moist.

Their difference are various, according to the part wounded, which ought to be restored with the same flesh.

The softer then, and tenderer the place is, the gentler let the medicines be.

CHAPTER XII. Of glutinative Medicines.

That is the true cure of an ulcer which joins the mouth of it together.

That is a glutinative medicine, which couples together by drying and binding, the sides of an ulcer before brought together.

These require a greater drying faculty than the former, not only to consume what flows out, but what remains liquid in the flesh, for liquid flesh is more subject to flow abroad than stick to together.

The time of using them, any body may know without teaching, viz. when the ulcer is cleansed and filled with flesh, and such symptoms as hinder are taken away.

For many times ulcers must be kept open that the sanies, or fords that lie in them may be purged out, whereas of themselves they would heal before.

Only beware, lest by too much binding you cause pain in tender parts.

CHAPTER XIII. Of Medicines resisting poison.

Such medicines are called Alexiteria, and Alexipharmaca, which resist poison.

Some of these resist poison by astral influence, and some physicians (though but few) can give a reason for it.

These they have sorted into three ranks:

1. Such as strengthen nature, that so it may tame the poison the easier.

2. Such as oppose the poison by a contrary quality.

3. Such as violently thrust it out of doors.

Such as strengthen nature against poison, either do it to the body universally, or else strengthen some particular part thereof.

For many times one particular part of the body is most afflicted by the poison, suppose the stomach, liver, brain, or any other part: such as cherish and strengthen those parts, being weakened, may be said to resist poison.

Such as strengthen the spirits, strengthen all the body.

Sometimes poisons kill by their quality, and then are they to be corrected by their contraries.

They which kill by cooling are to be remedied by heating, and the contrary; they which kill by corroding, are to be cured by lenitives, such as temper their acrimony.

Those which kill by induration, or coagulation, require cutting medicines.

Also because all poisons are in motion, neither stay they in one till they have seized and oppressed the fountain of life, therefore they have invented another faculty to stay their motion, viz. terrene and emplastic.

For they judge, if the poison light upon these medicines, they embrace them round with a viscous quality.

Also they say the ways and passages are stopped by such means, to hinder their proceeding; take Terra Lemnia for one.

Truly if these reasons be good, which I leave to future time to determine, it may be done for little cost.

Some are of opinion that the safest way is to expel the poison out of the body, so soon as may be, and that is done by vomit, or purge, or sweat.

You need not question the time, but do it as soon as may be; for there is no parlying with poison.

Let vomiting be the first, purging the next, and sweating the last. This is general. But,

If thou dost but observe the nature and motion of the venom, that will be thy best instructor.

In the stomach it requires vomiting, in the blood and spirits, sweating, if the body be plethoric, bleeding, if full of evil humours, purging.

Lastly, The cure being ended, strengthen the parts afflicted.

CHAPTER XIV. Of purging Medicines.

Much jarring hath been amongst physicians about purging medicines, namely, whether they draw the humours to them by a hidden quality, which in plain English is, they know not how; or whether they perform their office by manifest quality, viz. by heat, dryness, coldness, or moisture: it is not my present scope to enter the lists of a dispute about the business, neither seem it such an hidden thing to me that every like should draw its like, only to make the matter as plain as I can, I sub-divide this chapter into these following parts.

• 1. Cautions concerning purging.
• 2. Of the choice of purging medicines.
• 3. Of the time of taking them.
• 4. Of the correcting of them.
• 5. Of the manner of purging.

Cautions concerning purging.

In this, first consider diligently, and be exceeding cautious in it too, what the matter offending is, what part of the body is afflicted by it, and which is the best way to bring it out.

Only here, by the way, first, have a care of giving vomits, for they usually work more violently, and afflict the body more than purges do, therefore are not fit for weak bodies; be sure the matter offending lie in the tunicle of the stomach, else is a vomit given in vain.

Vomits are more dangerous for women than men, especially such as are either with child, or subject to the fits of the mother.

What medicine is appropriated to the purging of such a humour, for seeing the offending matter is not alike in all, the purging medicine ought not to be the same to all. I shall speak more of this anon. As also of the divers ways whereby medicines draw out or cast out humours, viz. by lenifying, cleansing, provoking nature to expulsion, and (which is stranger than the doctor’s hidden quality) some purge by binding, but indeed, and in truth, such as are properly called purging medicines, which, besides these faculties, have gotten another, by which they draw or call out the humours from the most remote parts of the body, whether these do it by heat or by an hidden quality, physicians are scarce able to determine, it being very well known to modern physicians, though the ancients denied it, that many cold medicines purge.

There is this faculty in all the purges of Galen’s model, (because he gives the whole simple which must needs consist of divers qualities, because the creation is made up of and consists by an harmony of contraries) there is (I say) this faculty in all purges of that nature, that they contain in them a substance which is inimical both to the stomach and bowels, and some are of opinion this doth good, namely, provokes nature the more to expulsion; the reason might be good if the foundation of it were so, for by this reason nature herself should purge, not the medicine, and a physician should help nature in her business and not hinder her. But to forbear being critical, this substance which I told you was inimical to the stomach, must be corrected in every purge.