Notes on the Ophthalmic Aspects of Philip Barrough’s Method of Physick.

Links:    Ophthalmic Texts in English from before 1800.        By Christopher T. Leffler, MD, MPH.

[cited: Leffler CT. Notes on the Ophthalmic Aspects of Philip Barrough’s Method of Physick. The Journal of Ophthalmic History. Sep 12, 2012. http://www.eyehistory.org/barroughmethod1652.]

Philip Barrough’s Method of Physick is of particular interest to ophthalmic historians. The first edition was published in 1583, and contained a lengthy section on the eyes, including cataract surgery. It was one of the first English works to extensively treat diseases of the eye. Additional editions were published in 1590, 1596, 1610, 1617, 1624, 1634, 1639, and 1652. The multiple editions make clear that it was a successful book.Eldredge (1999) has made the case that Barrough’s ophthalmic chapters are taken from the manuscripts of Benevenutus Grassus, who may have lived at the beginning of the twelth century (ADB 1930). Moreover, Eldredge also has stated that Barrough’s work was in turn borrowed by the authors who described cataract needling in several later works. For those who are interested, I have transcribed the ophthalmic chapters of the 1652 edition of Barrough’s work in the below appendix.By word frequency analysis, we see that the ophthalmic chapters in Method of Physick describe eye medicines as a powder, a plaister (an adhesive emollient for dressings), an electuary (a medical paste), or an ointment. The most common medicine ingredients are saffron, aloe, and egge (egg). Eye ailments are understood according to the classic theory as an imbalance of the humours (humors), starting with the most commonly mentioned: bloud (blood), melancholy (elsewhere described as black bile), fleam (phlegm), and choler (elsewhere described as yellow bile). The specific eye ailments are cataract and pannicle. The cataract is treated by “the art of the needle.” The term “couching” was not actually used. The book was originally published in 1583, and the term “couching” (in an ophthalmic context) has not been identified in the English language prior to 1587 (Leffler 2013).
REFERENCES:

A D B. Benevenutus Grassus of Jerusalem. Can Med Assoc J. 1930 Jun;22(6):850-1.

Eldredge LM. The English vernacular afterlife of Benvenutus Grassus, ophthalmologist. Early Science and Medicine vol. 4 (1999) p. 149-163.

Leffler CT, Schwartz SG, Stackhouse R, Davenport B, Spetzler K. Evolution and impact of eye and vision terms in written English. Archives of Ophthalmology 2013 [in press].

Appendix 1

[transcription by Christopher T. Leffler, MD, MPH]

The Method of Physick,

Containing,

The Causes, Signes and Cures of inward Diseases in Mans Body from the Head to the Foot.

Whereunto is added,

The Form and Rule of making Remedies and Medicines, which our Physicians commonly use at this day, with the proportion, quantity, and names of each Medicine.

By Philip Barrough.

London.

Printed by Abraham Miller, and are to be sold by John Blague and Samuel Howes, 1652.

[p. 49-61].

Chap. XXX.

Of the Eyes.

I thought good in respect of the worthinesse of the Member, and the manifold Diseases to the which it is subject, to subnect the discourses of the Eye, with the remedies of the infirmities which by experience I have found incident unto it: and the multiplicity of it is so great, that the treatise thereof stretcheth beyond the bounds of other ordinary Chapters. But (as I hope) the Reader will not account it tedious, because of the pleasantnesse and necessity of the discourse, though it be somewhat long: for God hath (as it were) packed and bestowed an infinite variety of marvels in one little round subject, which if it be consumed and distributed into his parts, and according to the dignity of every one sufficiently treated of, (I suppose) it would fill a great Volume, and require both an exquisite Philosopher to conceive aright of it, and an excellent Orator might seem also necessary to lay abroad at length such secret and wonderfull notions. But the eye is wont with curious inspection to pry into all other things, and to finde out the nature and order of them, hath been unable to unfold his own wonderfull constitution, and hath been alway blinde in judging of it self, and in seeing the discommodities which attend upon it, or in curing them when they have laid hold of it.  For mine own part, I will not promise any absolute work, but as Learned Physitions have thought of it, (and as I my self have by experience learned ) so will I frame and fashion my Treatise. An eye therefore is a member, round, whole and hard, as the ball of a foot, or as the scowred new bason full of clean water, set in the Well of the Head to minister light to the body, by the influence of the visible spirits, sent from the fantasticall Cell by a sinew that is called Nervus opticus, with the help of a greater light ministred from without. And very fitly is the place where the eye is set called, The Well of the Head, or the abundance of watery humours and tears which often dissolve out thereof, sometime of sorrow and heaviness of the Heart, sometime of joy and gladnessr, and sometime of the abundance of watery humours cause of frigidity and coldnesse: and thus have the Physitions described the eye. It shall not be unnecessary also to distribute it into his parts, and therefore (as Johannicus [difficult to read name] saith) the eye hath seaven coates, which they call tunicae, four colours, and three humours. But his opinion concerning the tunicles, by sundry Anatomists hath been evicted, making but only six; yea, and some there be, that (swarving from the most received opinion) have made room for a conjecture of their own, as they think by reason, excluding all those overcurious divisions, (namely Iris, Cornea, Aranea, Uvea, and the residue,) and imagin but only two coates, the one whereof they name Salvatrix, because it saveth and keepeth the humours: and the other they terme Discolorata, that is, having no colour: and they maintain, that in the eye it self there is no colour, but that which is caused of the Crystalline humor, which if it be planted very near to the tunicles, then the eye seemeth of no colour: if it lye deep within, it deferreth three visible colours unto the beholder, and (as they say) the diverse placing of this crystalline humor begetteth the variety of colours in sundry eyes; which gave our Anatomists matter to devise their distrubitions, while they referred the colour to the nature of the tunicle, which (indeed) is to be imputed to the humours. For mine own judgement, if it be lawfull to judge in so intricate a cause, (I think) I could very well maintain, that the humours be the causers of the diversity of the colours, though our blind Anatomists do impugn it in their common books. But I have taken upon me rather to cure the malady of the eye, then to define the nature of it, although this little Praludium will not seem altogether unnecessary.

CHAP. XXXI.

Of a Cataract.

A Cataract is a corrupt water, congealed like a curd, ingendred of the homours in the eye, distempered betwixt the tunicles, and sest before the sight of the eye and the Crystalline humour. Of these manner of Cataract there be seven divers spices or kinds, whereof four be curable, and three be uncurable. The first kind of the curable Cataract is light, very bright, like white chalk, or as alabaster well polishe : and it is caused by a stroke in the eye, either with a stick or a stone, or any other outward violence. The second kinde is somewhat white, and much like unto a celestiall colour; and this proceedeth from the stomack, and is commonly caused of unwholsome meats, and unkinde nourishment, whereof a grosse fumosity resolveth, and ascendeth up into the brain, and from thence falleth down into the eyes. The third kind is also whitish, but it turneth into the colour of ashes, and is commonly engendred of pain in the head, as of the Migrime, or such like diseases; and it is caused sometime of great sorrow and heavinesse, whereof cometh immoderate weeping, and sometime of much cold, and much watching, and such other like. The fourth species is of a Cytrin colour, and is commonly engendred of excessive meat and rink indigest, and also of great labour, and sometime of the humour melancholy. These are the four curable kindes, but they be never healed till they be grown and confirmed: and the sign or token of their full perfection is, when the patient seeth nothing, unlesse it be the brightnesse of the Sunne by day light, or the light of the Moon by night.  Many ignorant persons, neither knowing the cause nor the properties of these manner of Cataracts, have assayed to cure them with purgations, powders, and plaisters, but they have been deceived. For neither inward medicines nor outward remedies can any whit prevail, unlesse you joyn to them artem ocuariam, the art of the needle; which because it is unknown to many of our Practitioners, I will insert a discourse of it in this Treatise. Neverthelesse, before you use the needle, it is requisite that the brain should be purged with Pilulae Hierosolymitanae, which you shall make thus: Rx. Turbith, j. Aloes, hepatick, . . Maces, Quibibes, Mastick and Saffron, ana. j. beat them to powder altogether, and confect them with the juyce of Roses, and make pils thereof: and this purgation must be ministred the day before you try with the needle. And on the next day, while the diseased party is fasting, about nine of the clock, cause him to sit overthrwart a stool in riding fashion, and plant your self likewise on the same stool face to face against him, and bid him hold his sound eye close shut. Encourage him also, and exhort him to be patient; for the tractability of him maketh much to the convenient dispatch of your labour. Then with your left hand lift up the over-eye-lid, and with your other hand put in the needle made therefore, and on the side farthest off from the nose: and subtilly thirle the tunicle salvatrice, writing alwaies your fingers to and fro, till you touch the corrupt water (which is the Cataract) with the point of the needle; and then begin by little and little to remove that water from before the sight to the corner of the eye, and there keep it with the point of your needle the space of three minutes of an hour, and then remove your needle easily from it. And if it happen that it rise up again, bring it back the second time. But this caution you must be sure to have, that when the needle hath touched the Cataract, you do not writh it about with your fingers to and fro, till it be set in his place before named, but that you gently draw it thither: and when you have brouhgt it thither, thirle the needle about till it have gathered the water about it, and then pull it out. This done, cause him to shut his eye, and apply thereto a plaister of flaxe and the white of an egge, and cause him to lye in his bed nine dayes together, removing the plaister three times on the day, and three times on the night, without any other stirring of it. Provided that he lye in a very dark place, and let his diet be thinne, as rere eggs, and white bread. And if he be young and lusty, let his drink be water, but if his body be weak, let him drink wine well lymphate or small Ale; for truly much nourishment would prejudice the cure, by engendring much bloud in the eye, which is very hurtfull now in the beginning of the healing of it. The nineth day being passed, let him rise and wash his eye well with fair cold water, and he shall enjoy his sight by the help of God, even as he did before; although some of the Cataracts be fairer healed then the other, as namely the second and the fourth kinds, but that which is caused by a stripe, ( though the water be with more ease extracted ) yet the eye never recovreth his clearnes of sight again, because it is greatly bruised and troubled by the force of the stroke. And the third kind also, though it be soon restored to his old perfection, yet it abideth not long therein, unlesse it be continued as well by good diet, as also by this electuary, which is called Diaolibanum Solarimitanum, which is thus confected, Rx Cloves ij. Nutmegs of India, and Saffron, ana. j. and of good castoreum, j. Let all these be beaten into Powder and searced, and confect that powder with clarified hony, and let the patient receive of this Electuary in the morning fasting the quantity of a Chestnut or Walnut, and at evening to bedwards as much. And let him use digestive nourishing meats, which ingender good bloud; but let him beware of bief and Goats flesh, and Eeles, and raw Onions, for they are oftentimes used to ripen the Cataract, which must be done before you strive with it. In winter, let the patient drink hot wines, in the which let him infuse Sage and Rew. Let him also abstain from the company of women, neither let him frequent common baths; for every strong fume hurteth him greatly. The aforesaid Electuary of Diaolibamum, is good to dry tears: it availeth also against all manner of pain of the Migrime which proceedeth of fleam. After this sort are all the curable Cataracts healed, (I mean) by the needle, which must be made of gold, silver, or of clean Spanish latten: for iron and steel are very brittle and frangible. And if the Cataract should prove hard in drawing down, the point may easily break, which if it should abide in the eye, it would in time consume the eye through abundance of tears and greatnesse of pain.

Chap. XXXII.

Of the three kindes of Cataracts uncurable.

The first kinde of Cataracts uncurable, the Physitions call Gutta Serena, and the sign of the knowing thereof is this: when the pupill of the eye is black and clear, as though it had no spot, and the eyes are alwaies moving, and the eye-lids do tremble as if they were full of quicksilver. This kinde of Cataract is caused of a corruption in the mothers womb, and therefore they that have them are for the most part born blinde, and therefore they bestow their labour in vain that assay to cure them; for the nerves optick be oppilate and mortified, so that no medicines can prevail, although many that have this kinde do see the light of the Sun, and the stature of a man even to their lives end. We call it Gutta Serena, because it is engendred of a water that falleth from the brain, of which truly one little drop corrupteth & dissolveth all the humours of the eyes, and stoppeth the hollow nerves and sinews, so that the visible spirits may no more passe thorow them. The second Cataract incurable, is that which appeareth in the eye of a green colour, like water standing in moist places, not much moved nor removed ; this is the most dangerous kinde of all, if there be any degrees in them, and it is procured by the overmuch coldnesse of the brain, and by great buffeting and beating about the head, by great fasting and such other like. The third uncurable Cataract is, when the pupill of the eye is dilated and spread so farre, that no circle may be seen within the tunicles of the eyes, and the eye seemeth all black, or else all white.  And thus are the three kindes of Cataracts uncurable distinguished and known: which will forbid the practitioners to deal with them.

Chap. XXXIII.

Of Diseases which chance to the Eyes, by Bloud, Choler, Fleame or Melancholy, and of their Cures.

Now after the description of Cataracts, and the number of them, which be curable, and which be not, and the curing and knowledge of the curable and the causes of the uncurable, I will speak of other maladies of the eyes caused and occasioned of the four humours, as bloud, fleam, choler, and melancholy.  But first I will treat of bloud, through the abundance whereof oftentimes there groweth a rednesse in the eyes, with great burning, and afterward it turneth to great itch: and this disease maketh the hair of the eye-lids to fall away, and of many it leaveth not one hair: and if this malady be not cured within one year, it will make the eye-lids to turn up, and make the Patient blear-eyed.  But before it cometh to that extremity, it may be cured by this Colliry, which they call Collirium Jeresolymitanum, which is made in this wise. Rx Tutty of Alexander, j.and beat it into small powder, and temper it well with two pounds of white wine (that is) a quart, and put thereto, j. of dry Roses, and boil it with a soking fire, till the wine be half wasted, and then cleanse it through a linnen cloth, to keep it in a violl glasse, and morning and evening put some of it into the eye: and if it be taken betimes, the Patient shall be cured within a week or two at the most.  Neverthelesse before you apply this Colliry, it shall be good (if the Patient be young) to let him bloud on the vein that is in the midst of the forehead: or if he be aged, to purge the brain with these pills: Rx of the best Aloes, red Sanders, Esula, and Rewbarb, ana. . . Turbith, Cataputia minor and Agarick, ana. ij. contect them with the juyce of Mugwort, and minister to the Patient according to his strength. And truly these pils are not only good for the itch of the eyes, but also for all manner of itch or scab, of what humour soever it be caused. There be other diseases also of the eye ingendred of bloud, as the Opthalmy and Pannicles: and these kinds of infirmities are tied to the season of the year, for they commonly happen about the end of August, and so forth to the end of September; and the rather then, because they proceed of the eating of variety of fruits.  The Ophthalmy is thus described.  An Opthalmy is a corrupt bloud ingendred of hot humours, and commonly it standeth and appeareth in the white of the eyes, and round about the tunicles and blacknesse of the eye, and it proceedeth of immoderate sorrow and burning, and of the abundance of tears, which causeth the eyes to swell, and make them to boln, that from that time forth that Patient make take no rest nor sleep: for it ever seemeth to him that his eyes are full of gravell or of thorns, or of smoak. In this kinde of infirmity it is good to use this powder, which many (in respect of the notable vertue thereof) do call Pulvis benedictus, which is thus made: Rx white Sarcocoll, and beat it to very fine powder, and fill the Patients eye with it, and let him lie with it wide open till the powder be consumed: and in the mean time make a plaister of flaxen herds, and wash it well in cold water, which when you have drained out with your hand, lay it on the Patient his eye, which he shall still keep open, and it will procure him to take his rest very well. Many ignorant practitioners, while they have endeavoured to cure this infirmity with many impertinent medicines, have added sorrow to sorrow, and have brought the eye without his lids, and so made it uncurable, which by the foresaid powder might easily have been healed. And note, that there be some, which by the occasion of the Ophthalmy, are greatly troubled in their eyes, and have them fumous and musty: which proceedeth of evil keeping, or because they eat contrary meats. Now if such happen, the brain must be purged with these piles: Rx. Polipody, sula, Myrobutlani Citriui, and Rewbarbe, ana. . j.Mastick, Quibibes, Saffron, Spiknard Nux Indiae, Cynamon, ana. .j. confect them with Milk or juyce of Quinces, and minister to the sick according to his strength, and after this purgation minister morning and evening of the Electuary of Diaolibanum Solarimitanum, as before. And moreover put into his eye a powder called Pulvis Nabetus, the making whereof we will shew in the cure of the third pannicle. But this must be done only in the morning and evening; put in his eye the powder called Pulvis Alexandrinus as before, and this do till the Patient hath recovered his health, keeping him in the mean time from hurtful meats.

Chap. XXXIV.

Of Pannicles.

The Pannicles have the same cause that the Ophthalmy hath, that is to say, superfluicy of bloud. Sometime they are ingendred of evil keeping, and sometimes by great pains in the head, as the Migrim, where the extremity of pain ascending into the temples, and so into the brows, maketh the veins to beat, by which painfull beating the eyes are troubled. There be four kindes of Pannicles: the first is, when upon the tunicle salvatrice there groweth a little pearl like the seed or grain of a Corn, called in Latine Ostillium. The second is when it appeareth in the aforesaid tunicle in the likenesse of a spot or a freckle of the face, or like the scale of a fish. The third appeareth on the one side of the eye, like as it were a flake of snow when it snoweth. The fourth is when all the eye appeareth white, and no blacknesse, neither of the tunicle, neither of the light appeareth. The first pannicle is neither cured with laxatives nor powders, nor Colliries, nor Electuaries, nor yet with Cauteries; for any of these (if they be ministred) do annoy rather than help. But you shall make this precious ointment for the cure of it, which of many practitioners is proved to be of great credit. Rx fourty render crops of the Bramble, and stamp them small, and a good handfull of Rew, powder of Alabaster, lb j. , powder of Fenel seed, . , oyl of Roses, j. all these incorporate well together, put into a new earthen pot with a quart of new white-wine, and to all these put iiij. of dry flowers of Cammomil, and of Wax, j. and then set the pot on the fire, and let it boil with an easie fire till the wine be consumed, so far forth that it seemeth to fry in, and then put thereto the whites of six Eggs, and alwaies stirre it well, till it be incorporated together, and then strain it through a fair linnen cloth; with this ointment thus made, annoint the temples of the Patient, and the forehead, down to the brows, and it will cure this kinde of Pannicle. This ointment is not only tied to this cure, but it hath many vertues: some of the which I will expresse, though it be impertinent to this discourse. It is very good against a green wound, for it both purgeth and cleanseth it. It is good against the tooth-ach or pain in the matrice, if it be beaten like an Electuary. It is good for them also who are molested in excess, if their stomack be annointed, and their feet together with their hands. It availeth against the Migrime, and generally for every pain of the eyes, if the Patient be annointed therewith upon the temples, as before. The second pannicle must be cured at the very beginning, for if it be incarnate and hardned upon the tunicle, it may not by any suttelty be removed (the tunicle saved,) and therefore it is not safe to adventure to cure it, when by continuance of time it hath united it self with the salvatrice. But at the first you shall cure it thus: first make a cautery in the temples with a round cautery (as shall be shewed afterward when I speak of Cauteries) for fire dissolveth and consumeth the pannicle; and so keepeth it from uniting and incarnating with the tunicle, and maketh the eye fit to be clarified with this medicine following. When the eye is cauterized, put into the eye some of the Powder called Pulvis Nabetus, which I will teach afterward; and while he lieth with this powder in his eye, take four Crabs, and rost them under the embers very well, and then take them, and being pilled and cored, incorporate them with the white of an egge, in manner of an ointment, and lay it upon a clean flaxen herd, and bind it to the eye with a linnen band, and so renew this plaister morning and evening till you have absolved your cure. [sidenote: Maladies coming of fleam.]  Like as bloud begetteth many infirmities of the eye, as namely Ophthalmies and Pannicles: so likewise many maladies are ingendred of fleam, but the most notable are four: The first is procured by over-abundance of tears, whereby the over-eye-lids are so softened and mollified, that within them grow hairs, which prick the ballof the eye continually, as though there were Hogs brissles : which hairs, though many bold Chyrurgions have plucked out, and so for a time ensed them, yet afterward ( the hairs being hardned with plucking out ) do gall them farre worse than before, and so in the end the Patient being destitute of any other aid, leeseth his sight ( the hairs fretting and consuming the substance of his eye.) But indeed the best way, which, as yet, experience hath found out to cure that malady, is this : Take two needles of the length of the little finger, and put a thred through the eyes of both of them, and binde them well together at both the ends, then with your fingers lift up the over-eye-lid, and with these needles take off the leather where the hairs grow, that the Patient may shut and open his eye, and let the needles hang till they fall away, together with the leather which was between them : which done, you shall put no medicine in the wound, for it will heal of it self: but if any Pannicle be ingendred in the eye by reason of the vehemencie of the pain, it shall be cured by Pulvis Naberus put into the eye twice a day, till such time as they be clarified and healed.  And this powder is made of Sugar Candy of Alexandria, which powder is very available against many sicknesses of the eye.  The second infirmity which happeneth to they eye by fleam, is when the eyes appear troubled and full of veins, so closed with a Pannicle, that the Patients cannot well see, nor discern any thing, and this sickness is called Pannicum vitreum, which is thus cured: first cause his head to be shaven, and then cauterize him with a round cautery in the soft of the head, and with a long cautery in his temples, which so done, put into his eyes the powder of Candy once in the day, till that he hath received again his full sight, and twice in the moneth purge him with the pils called Pillulae Ferosolymitanae, and at his going to bed let him receive of the Electuary called Diaolibanum Solarimitanum till he be whole. The third infirmity caused by fleam, is when the eye appeareth carnous or fleshy, the which carnosity (if it be waxen hard by the space of a year or two ) giveth place to no medicine. But in the beginning, cauteries (in that manner that I prescribed them before) will heal it, so that after cauterizing you very warice, let it stand all night, and in the morning cleanse it, and cut away all the carnosity with a sharp razor, without offending the tunicle Salvatrice; which when you have done, fill the eye full of powder of Candy, and then cause the Patient to shut his eye, and then lay to it a plaister of flax of the white of an Egg, and change the plaister twice on the day, xv.daies: and after xv.daies make this plaister: Rx a handfull of Cardus Benedict and stamp it well, and mingle it with the half the white of an Egg, and so make a plaister with flaxen herds, and lay it upon the eye, removing it twice on the day, and after three daies leave all plaisters, and let the Patient lie with his eye open, and every day in the morning put into his eye the powder called Pulvis Benedictus, and at evening the powder of Candy, till he be perfectly whole: in the mean time let him abstain from Eels, Onions, Bief, and all such meats. The fourth malady caused of fleam, is when the eye appeareth all boln, and alwaies sheddeth tears, so that the Patient may not open his eyes by reason of the heaviness of the eye-lids, for there is a fatness on the upper eye-lid, which troubleth the eye very much, and this disease is called the scab of the eye, and it proceedeth from superabundance of salt fleam: the cure of it is this: you shall first purge the stomack and brain of the Patient with this receipt: Rx Turbith, of the best Aloes and Rewbarb, ana. j. then take of the juyce of the root of Walwort j. and the aforesaid things being beaten and dissolved in the said juyce, let it stand all night, and in the morning cleanse it, and let the Patient take thereof a good quantity, and the next day subtilly with your Razor pare away the aforesaid fatnesse, even from the one lachrymall to the other: which done, lay on a plaister of herds and the white of an Egg nine daies after, (every day changing the plaister twice) and then let the Patient lie with his eye open, and put into it of the Colliry called Collirium Alexandrium, which is taught before in the cure of the third Pannicle, and that will heal it very well. I have heard that women did rub away that fatnesse with Sugar, but it returned again afterward, though for a time they were eased.  There is an Electuary very available against these tears, which is thus made: Rx Olibanum, Castoreum, Nutmegs, Nux India, Cloves, Quibibes, ana. j. leaves of Lawrell, Spikenard, Saffron, and Cardemomum, apa. ij. seeds of Dill, Smallage, Basilicon, Alisander, Annise, Fennell, four seeds of Henbane, white Poppy, Musk, and Campher, ana. j. all these must be beaten together to powder, saving the Olibanum, which must be boiled with clarified Hony till it be molten, and then powre it into a fair large woodden platter together with the powder before made, and incorporate them together by often stirring, and let it abide in the platter still, and when you will minister it, give as much as a Chestnut at the Patients going to bed. It destroyeth the tears together with the fleam, it warmeth the brain, it driveth away the pain of the Migrime, it openeth the eyes, relieveth the eye-lids, and clarifeth the sight. It is good for them that have the gout and the palsie, and for them that have an impediment in their speech.

CHAP. XXXV.

Of the maladies in the Eye, proceeding of Choler.

Two kindes of griefs are incident to the Eyes by Choler, the first whereof is that which is caused by abundance of Choler in the stomack, from whence ariseth a corrupt fumosity into the brain, which annoyeth the brain, and troubleth the visible spirits, so that the party thus affected, shall imagine an object planted between him and the light in manner of a dark shadow. We cannot outwardly judge of this malady, for it hath no evident mark either in the eye, or without the eye, but the cause of it abideth in the stomack, which mustbe taken away by an Electuary mitigative and preparative, which will asswage the pain, and open the oppilat nerves and sinews, whereby the visible spirits may have free passage: you shall make it thus: Rx Rewbarb, Esula minoris, red Sanders, Mirobalani citrini, ana. iiij. the roots of Fennell, Spinage, Bansci, Parsly, Apij, Sicacella, Simory, and Maiden hair, ana. M. j. Polipody of the Oke, ij. boil all these roots in fair water till half the water be wasted, and then cleanse it, and take the aforesaid spices well beaten, and put them into the aforesaid liquor with two pounds of good Sugar, and make thereof a Tyrupe laxative. But you shall boil it but little the second time, for the spices will soon lose their vertue, and then cleanse it again the second time, and let the Patient take of this twice in the week. The second infirmity arising of choler, is when there appeareth before the tunicle, as it were a thin cloud in a clear air, and this is brought by an evil diet, but it happeneth only to those that be cholerick. For the cure you shall take a Saphire, and break it in a mortar, and keep the powder in a vessel of gold, and once in the day put this powder into the Patients eye, and he shall be whole in short time.  The same effect hath the gall of a Hare dried, and beaten into powder, and so put into the eye.

CHAP. XXXVI.

Of the infirmities of the Eye caused of Melancholy.

Of the humor of melancholy be ingendred in sundry folks many and divers sicknesses, by reason of the oppilation of the spirits visible, which cometh by the distemperature of the brain which is disquieted by the abundance of melancholy.  In these Diseases therefore it seemeth to the Patient, that there are flies flying in the air; and that there are three or four moons, and three or four faces, when he beholdeth but one: but these infirmities happen most commonly to aged persons which are melacholick, superfluity of melancholy dimming their eye sight. There must not therefore any medicines be put into the eye of the Patient, but make this Electuary mitigative and apparative, which will open the oppilations of the nerves which did before foreclose the way to the visible spirits. The Electuary is thus confected: Rx the juyce of Liquorice, Eyebright, Sileris montani, ana. . the seeds of Rew, Basilicon, Nettles that come from beyond the seas, or Cecilian, or Fennel, of Alisander, of Apium, of Caraway seed, ana. ij. Mastick, Cloves, Nutmegs, Cinamon, Quibibes, Gummi, Almonds, Cerache pomi gummorum, Aragunton, and saffron, ana. kernels of quince apples, all these must be beaten together into small powder well searced, and then you must confect them with good Sugar, and make an Electuary of it, and of this let him receive morning and evening till it be healed. It availeth also against that dimnesse of the eyes which cometh by thought, and of much heavinesse, and maketh them to see more clearly, and of that effect it hath his name (that is) Clarificativum oculortum. There is also another infirmary which cometh of melancholy, [p. 58] and that is when the painsuddenly ascendeth into the eyes, and grieveth so extreamly, that it seemeth to the Patient that his eyes would start out: they appear also most commony very bolne.  Many which are troubled with this kind of malady do lose their sight altogether, and many (though there be some) which do see notwithstanding but very feebly. But the seasonable applying of remedies, preventeth either discommodity. After this sort then you shall encounter with this evil. You shall first purge the stomack and the brain with these pils: Rx Aloes, M. robalani Citrini, Turbith, Sanders, Citrine and Rewbarbe, ana. Seammony, Myrrhe, Saffron, Balsamum, Mastick, Lignum Aloes, Olibanum, white Agarick, Nux Indie, juyce of Liquorice, seed of Apium, Lettuce, Succory, Basilicon, ana. j.  Beat all these to powder, and confect them with the juyce of Roses, and make pils of them, and give the Patient after his powder.  The stomack and the brain thus purged, lay upon the eye this plaister: Rx four Apples or Crabs, and rose them under the embers till they be soft, then core them and pare them, and bruise them well in a mortar; and to four of them put half the white of an Egge, and so bray them together till they be well incorporate, and so lay them upon flaxen herds, and morning and evening apply it to the eye, and you shall find that it will do much good; for it both asswageth the swelling, lesseneth the pain, refresheth the sight, and with all these fixeth also the eye in his place.  There is another infirmity also which proceedeth by the abundance of melancholy, and that they call Ungule, for it is much like the nail of a finger, sometime it breedeth in the corner of the eye to the ear-ward, and so spreadeth over the eye if it be not hindred and resisted betime: sometime it also happeneth that another ungle ariseth in the other corner: and if they meet, it maketh the cure more uncertain; yet by heedfull skill and discretion, it may be healed by the hand. Take therefore a twitch of silver, and therewith lift up subtilly the ungle from the tunicle, proceeding to the lachrimall where it grew, and there cut it away, and then lay the white of an egge and flax upon it ten daies together, removing it twice on the day, and at the end of ten daies wash his eye with hot water, and put into it Pulvis Nabetum before named, till the eye be sufficiently cleared. Let him abstain from such meats as do feed melancholy. It happeneth also sometime that the superfluous abundance of melancholy seated in the brain, begetteth a driness in the eye-lids, which aferward turneth to itching and burning. But this disease is cured by letting the Patient bloud on the middle vein in the forehead, and after with using this Colliry: Rx fourty tender drops of the Bramble, and stamp them small, then put them in a new earthen vessel together with a quart of good white-wine, and so boyl them till half be consumed, and then cleanse it and preserve it in a glasse to your use, and twice in the day put some of it into your Patients eye, till it be whole. Of the like superfluity of melancholy groweth sometime a corrupt humour without the eye upon the lid, the which holneth all the one side of the face with extream pain, but with no offence to the sight of the eye. The signs of this disease are these: it maketh the eye-lids hard and red, and keepeth the eye so shut, that the Patient may not open it. For the cure of it, you shall take fine flour of old wheat, and yolks of egs, ana. j. of Saffron, j. and stamp them well together with womans milk till it be as an ointment: then make a plaister of it, and apply it so that non enter into the eye. You may also use this: Rx a Lilly root and Crabs; and rost them in the cinbers till they be soft, then taking away the core and the pils of the Crabs, stamp them both of like quantity with the whites of egs, and so use it. On the step of the wound where the sore was, lay this ointment, that it may draw the flesh together, so that no scarre do appear: Rx Aloes, Hens grease, oyl of bitter Almonds, and white Wax, and incorporate them together into an ointment, and apply it. It is very good in all the diseases of the eyes to annoint the temples of the Patient, and the forehead with Unguention Alabastrum before named, for it asswageth the pain, and helpeth the other medicines in their operation. It happeneth many times in this infirmity, that the Patient his eye lids, for want of provident skill do reverse, which is a great blemish. In this case you must subtilly with the Raxour divide the eye-lid from the wound, and part them with a little roul made of fine linnen cloth, dipped in the white of an Egge, which you shall lay betwixt the lid and the sore xv. daies together, changing it daily, and then make the ointment of Hens grease and white Wax, and lay of it upon the roul, and it will consume the wound, so that there shall appear no cicatrice. The like cure you shall use when the reversment of the eye-lids is caused of superfluity of bloud. Of the melancholick humour there is also ingendred in many men a sicknesse, which groweth between the nose and the eye, and it appeareth like a piece of a lung or light. It is gravelly, and avoideth our alwaies filth. This sore is called Vulgalpus. For the cure of it, you shall only take a twitch, and lift the sore up subtilly, and with the point of a Raxour cut up the sore by the root and cauterize it with a hot iron, and use the ointment before rehearsed, which they call Unguentum Subtile, that is, Hense grease and white Wax, and anoint the place with it till it be whole.

CHAP. XXXVII.

Of diseases happening to the Eye by outward Causes, as by blows with Sticks, Staves or Stones.

The only thing generally that you shall use when the eye is smitten, is the white of an Eg and flaxen herds, to which God hath given three especial properties: the first is to asswage the pain: the second to purifie and clear the sight: the third is to let and keep away all superfluous humours, which otherwise would fall into the eye. You shall remove it four times in the day, and twice in the night, by the space of xv.daies together, anointing in the mean time the temples of the Patient with ointment of Alabaster, which as I told you before, was an adjuvant and aid to all medicines. Now after the fifteen daies be expired, if you shall perceive the tunicle salvatrice to be hurt and broken, you shall then take xij. streins of the new laid eggs of white Hens, and put them in a mortar, labouring them with a pestil till they be united in a manner of an ointment, and so reserve it in a glass, & twice in the day and once in the night put a little of it into the eye, and it will knit together, and make sound again the tunicle if it be broken or hurt: after this manner I have cured many wounds in the eye, which have seemed dangerous, and uncurable to the ignorant beholder. But sometime it will happen, that through the force of the blow, there will grow a Cataract, and then in the beginning the tunicle must be saved by this forenamed prescript, and the Cataract must grow without let to his full perfection, and so be healed by the needle. Some unskilfull practitioners use to lay a plaister of Wax and Comin to the eye, if it be smitten, and other some use Olibamum and Wormwood: but both those, and all such like hot ointments are passing evil, because they consume and waste the substance of the eye. It followeth now that I speak of watery eyes, and of corrupt humours like tears, which Physitians call fistules, to discern between the fistula and the watery profluence of tears. You shall therefore use this skill: lay your forefinger between the nose and the corner of the eye, and straining the place a little, if it be a fistula, you shall see the matter of it run out at the points of the eye-lids: but if none appear, then judge it to be a watery humour. Many boisterous fellows ( seeing the place of the issue of the fistula ) have used to cauterize it with a hot iron, thinking by that means to have dried up the matter : which indeed they have done, but they have destroyed the sight, and deformed also the place. This therefore is the surest way or course that you can take to cure the fistula. First purge the Patient his stomack with pills of Jerusalem, and then with the point of a razour you shall make a little incision betwixt the neather eye-lid and the nose, so directly, that the lid be not touched : and this incision shall be sh out the skinne in a long wise, and into the same put in the grain of a Fitch, binding it on with a little pillow of linnen, and so let it lie till the next day : then removing the Fitch, you shall in the whole where it lay, put in a little of some powder corrasive.  After the powder is put in, lay a plaister of flaxen herds, and the white of an egge (the patient alwaies shutting his eye for fear of the powder.) In the morning after, you shall apply nothing but clean Swines grease, till the mortified flesh be raised: and when it is raised and removed, put in a place of a sponge, as much as a Fitch, in the hole which the powder made, and it will purge the drinesse of the wound: and when you shall perceive it throughly dried, leave the sponge, and binde nothing to it else but fair dry lint of linnen till the Patient be whole. Now concerning the tears, they issue out of the eye-lids both the upper and the neather : but there is difference between the causes of their issuing from both places: for they which proceed from the neather eye-lid, come from the heart, by reason of sorrow, dred, or smart, or they be caused by some manner of violence: but the tears which flow out of the hole of the upper eye-lid, proceed from the brain, by reason of corruption and abundance of humors, and their course ceaseth not, unlesse the matter be purged with Electuaries and Cauteries, as I have shewed before.

CHAP. XXXVIII.

Of the Diseases which come by skipping in of Stones or Chips (by chance) into the Eyes.

These Diseases happen specially to Masons, Millers, Carpenters, Wrights and Smiths: for if any chive, chip, or dust skip into the eye, and through negligence be left behinde, it will incarnate upon the tunicle Salvatrice, and then can you not cure the eye, but by removing and drawing the said chive, which you shall do with your needle, dividing it cunningly from the tunicle. And if it happen that there be any pit in the place where it lay, by reason that it abode long therein, then put into the eye the streins of egs, ordered as I declared before, twice in the day, and once in the night; and upon the eye lay a plaister of flax and the white of an egg, and within three daies it will heal the party diseased. And after this sort you shall also remove the haw in the eye. But you shall in drawing out the haw, binde two needles fast together at the top, and so take the haw between the two points, and so easily rowling the needles, bring it away. Sometime it happeneth that the eye is stung with a Bee or Wasp, or some other venimous thing, or blasted with an infected air: and if any of these happen, the eye is much disquieted and grieved, so that the Patient may take no rest, and it bolneth up that he may not see.  The only cure for such and the like accident is this, as I have by experience often tried, Take a handfull of Cardus benedictum, stamp it small, and temper it well with half the white of an egg, and therewith make a plasiter laying it on flaxen herds, binding it hard to the eye, where it shall lye till it be dried, and then apply another: and so consequently use it till your patient be thoroughly whole. These qualities this herb hath, it asswageth swelling, and easeth the pain, destroyeth the venime, and putteth away bloud from the eyes. This is also a present remedy for the eyes that are bloudshed, when they burn as though there were gravel in them. And thus much for the especial discourse of sundry Diseases which do most commonly bend to that little member, the Eye, together with their particular Cures.

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