Clyster Syringe - John Woodall
John Woodall was one of the first sea surgeons to write a text-book for sea surgeons. In his forward to a re-published version of Woodall's 1617 version of the book the surgions mate, surgeon and naval historian John Kirkup wrote that the book served "...to guide novice surgeons' mates who for the most part were articled apprentices, and inexperienced surgeons expected to treat medical and surgical emergencies peculiar to ships, far from land for prolonged periods and under tropical conditions." (John Kirkup, Forward to the surgions mate 1617 edition, p. xvi)
Source: John Woodall, the surgions mate, 1639 edition Woodall was particularly strident and repetitive in recommending the use of the Clyster Syringe for relieving seamen. From this I believe we can infer that the food and environment conspired to make regularity difficult for many of the men kept at sea for such long periods of time. One can see the importance of the Clyster Syringe in the drawing from the surgions mate below - not only is it centered; it has been given a lot of shading which makes it stand out. I don't know if this is intentional or merely subconscious, but taken with the large amount of text Woodall devotes to the device, it certain is suggestive. Below this drawing is the majority of the text on the use of the Clyster Syringe. As a bonus, he also talks about one of his few additions to the surgical armory: the spatula mundani. This was a tool with a cup-less spoon on one end and a paddle on the other that was used for removing hardened excrement and applying salves when a patient was badly constipated. Again, this points to the prevalence of this problem. I have only minimally altered the text by inserting paragraphs and changing some of the more obscure uses of letters (u for v, v for u, vv for w for example). I have preserved the spelling.
John Woodall Talking About the Clyster Syringe
Source: John Woodall,
the surgions mate
"Of the large Siringe conteyning one wine pinte, commonly called the Glister Siringe.
This worthy and well devised instrument so needful in the Surgeons Chest I wish each Surgeons Mate were perfect in the use thereof: for it is so necessary and so comfortable an instrument to him that hath neede thereof, and so ready, near, and easie for the workeman, as surely no instrument in the Surgeons Chest in my opinion is like to it: for there are two principall and capitall evils which chiefly hasten the ends of many of our loving Countreymen at Sea; note onely in the East Indies, but also in all hote Countries: the first and principall is extreame loosenesse and weaknesse of the stomach, and interalls causing a flux of the belly; the other is extreame costivenesse, in both which this instrument is most necessary: provide therefore that you bee sure to have one at hand, and that it be alwaies ready: also that you have severall pipes thereto; that you arme it well with good towe [cloth]; that when you have used it you wipe it cleane, and hange it up in your Cabine in two parts being drawne out, namely the staffe and the barrel ech by it selfe, for if it bee kept close it will be mustie and the towe rotten. There is also to be had in readinesse a crooked neck much like an elbow, belonging to the same instrument, that how crooked soever the Patient lye, the medicine may be administred to him: & therewith also any man may give himself a Glister very easily without the helpe of another.
The principall things to be observed in fitting the instrument is that the towe, within the staffe mentioned, be even and full and close put on, that no drop of liquor can come out behind at the staff end, which is as esie to do as in a finall Sirring. And you must also have a glyster pot of pewter, but one of brasse were better for feare of melting. Your glister pot should be made with a snout or lipp, and containing one pinte and a halfe, the better to deliver in the liquor at the narrow hole of the firing without a funnel. When you would put in your medicine, you must draw downe your staffe as low as you can, that there may be the whole roome to containe the substance which you have ready, namely your Glyster, which put in, have ready a corke to stop the hole you put it in by: then may you
Source: Mission's Collection lay downe your instrument till you be ready to use it. There is no other thing in the delivering it into the body to be observed, save that you put on the pipe: annoint the end of it with some fat thing; or dip it into the oyle swimming in the firing. And when you are ready, having some towe about the head of the said pipe, wringing it hard in, and thrust it to the head, laying the firing in an even position if it may be, and then put it from you till all be in the gut: then let the party turne himselfe on his backe, forcing himselfe by all possible meanes to reteine the medicine given him for one howre if he can.
Sometimes also it falleth out that by meanes of the hardnesse of the excrement in the gutt, the holes of the firring pipe is like to be choaked and hindered from the delivering of the medicine; in such a case the said excrement being onely clammie and not fully hardned, put upon the end of your firing pipe that first entreth the gutt over the holes of the save – a thin oily clout that may cover all the holes, & so put it in clout & all, thrusting the same up to the head or thick part of the pipe; then a very little as it were draw backe your hand, & deliver your glister with some reasonable good force, thrusting the pipe in the delivery close up to the body that nothing come backe, the firing being drawne out let it be washed, wiped, and drawne out of the barrel, as I have said, and so in two parts hung up to be ready for the next occasion.
But if you finde such resistance in the gutt that your medicine by the aforesaid meanes will not enter, then with the afore mentioned Spatulum mundani draw out part of the hard exrements which hinder, and then proceed as beforesaid to five a Glyster. Moreover many are so weake and unfit to hold in their bodies any such medicine, except you with some towe, clout, or the like, will hold it in they can take no benefit by a Glyster: wherefore in such a case you must be full of humanitie and Christian commiseration, not to be fine fingered, squeamish, or disdainefull, but consider your brother by your selfe.
Concerning the substance of a Glyster, the quantitie to be given, and other necessary observations of that kinde in the Chapters of the cure of the Flixe [Flux] and Scurvie I have written to which place I referre the well disposed Surgeons Mate: and looke what for brevities sake I have omitted, the young practitioner must as I have done before him, either by reading, inquiring, or practicing, and sometimes even by erring finde it out: and if he know more then my selfe, thanke God for it, and let him impart some to others, and not scorne this; for to such I write it not, but to the young and willing learner. Some may marvaile I multiply so many words concerning the Glyster sering, and forget to mention the Glyster bagg and pipe, so good and auncient a worke, and so long in use before the other. To which I answer; this worke is cleanlier for the Surgeon, easier for the Patient, and may bee delivered with greater or lesser force, as the Artist please; and this instrument will last, when the other will stinke and putrifie: and yet I deny not the other to be good, but not to be trusted to at Sea.
Thus much of the Glyster Sirring." (Woodall, p. 18-20)