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FIFTH EDITION
 C
The Art and Science of Advanced Practice Nursing
-An lnterprofessional Approach

BUILDING Class
CONFIDENCE & • Exams
KNOWLEDGE for • Board Certification

--
======-
·- -·- --

LEARNING APPLYING ASSESSING

Your text provides the foundational Online Case Studies hone your Davis Edge's online Q& A
knowledge you need t o know about clinical decision-making skills. review platform evaluates your
everything Primary Care. mastery of key content.

Your journey to success begins here!

Your text works together with real-world Case Studies and Davis Edge to help prepare
you for your role as an Advanced Practice Nurse in the Primary Care setting.
Don't miss everything that's waiting online to enrich your learning experience!

Follow the in structions on the inside front cover.

UNLOCK YOUR RESOURCES TODAY!
STEP#1 Build a solid foundation.

New color-coded icons help to categorize and emphasize

An integrated eBook
three major areas for Advanced Practice Nurses.
version of your text lets you

,,~
study anytime, anywhere.

•••
••••••
•••••••
••••••
•••
Nursing A ssessment Nursing Therapies Nursing Perspectives

mff-~ Differential Diagnosis 12.2:

Pediculosis
eJ Drugs Commonly Prescribed 12.2: Pedirnlosis

ADVERSE REACTIONS AND PRESCRIBING

Rash present Atop~ dermatitis (eczema) DRUG INDICATION CONSIDERATIONS
Bullous pemphigoid
Burrowing insects/larvae (scabies) Topj..l
Contact dermatitis Permethrin 1% lotion Presence of lice/nits; may May need to reapply in 7- t4 days.
Dandruff or 5% cream use on children older Use nit-remover products before application of
Dermatitis herpetiformis OTC(Nix) than 2 months permethrin
Oermatographism (Darier's disease) Apply to towel-dried. affected area; leave on
Drug eruptions to minutes. then wash off.
Ecthyma
Erythroderma Pyrethrin O.3o/, with piperonyl Presence of lice/nits May need to reapply in 7- t4 days.
Folliculitis butoxide shampoo or gel Use shampoo for head or pubic lice. gel for body lice.
Impetigo OTC(RID. R&C shampoo) Contraindicated in persons sensitive to ragweed.
Insect bites Apply to dry hair until wet leave on 10 minutes, then
Lichen planus wash off.
Malignancy (cutaneous T-cell lymphoma)
Miliaria (heat rash)
Neurotic excoriation
Pityriasis rosea I Drugs Commonly Prescribed
Pregnancy induced {Dlffmotlal Olagoosls bo,es help
Prurigo nodularis you reach the specific diagnosis charts summarize the key drugs
Pyoderma (impetigo) used to treat a particular condition.
Psoriasis
to determine the best treatment.
Scabies
Seborrheic dermatitis
Tinea !ca□itis corooris Dedis crurisl
JJ,11,. 11,e Patient's Voice I O. I : Pos therpetic Neuralgia
My mother died of postherpetic neuralgia (PHN) bed. Nothing helped the pain I'm convinced it was because
No rash pn My mother was 80 years old and had recently won the golf preventive treatment wasn't started early. As she became more
championship at her d ub. She had been a widO'N for 25 years depressed and stayed in bed, she got weaker and weaker and The Patient's Voice highlights
and decided that she wanted to move in with me, her daughter, just gave up. She complained of shooting pain over half of her the important role of the
and her only granddaughter (age 3). We lived 4 hours 3Way. At head that was worse at night, so she'd be awake all night, and
first she was very independent, driving around by herself and sleep all day. Nobody could help---not her primary-care provider, Advanced Practice Nurse as a
going shopping while I worked. That only lasted a few months neurologist, ophthalmologist, psychologist, orme. She died in her
Then the decline began. First, she broke a wrist, which inca- sleep, and I'm convinced it was the result of PHN.
holistic practitioner through

- pacitated her, and then she got pneumonia, which v,,,eakened her.
Then she got '"shingles'" (herpes zoster), which did her in. She
I've learned three things from this experience. First, if older
persons are optimally functioning, don't move them out of their
stories that illustrate how a
disorder can affect patients
was diagnosed at the earliest onset of pain, yet treatment wasn't familiar supportive environment. Second, treat all cases of
started until the vesicles erupted. She had ophthalmic herpes, so herpes aggressively, as you don't know who is going to develop and their families.
her vision was affected. She developed PHN very early, and due PHN. As ITT/ mom used to say, '"An ounce of prevention is worth
to the persistent pain, she became reclusive. She stopped going a pound of cure.'" This leads to the third, probably most important
out, retreating to her room, and eventually wouldn't get out of lesson: get every older adult vaccinatedl
 -
-- -
-
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--('TIAI. --.
- ·---
T hyroid disordef
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--
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Nutritional disorder
_
Heat-related illnesses
-
-- OINlllal-
- ICVAJ,

-ea.-,..,.,.......
(-
brain abace• )
.......
Urinary traa infection (UTI)
Septicemia
Release of vasotoxins
(-)
..
carbon monoxide
po;son;ng
Delirium
Dernenna (Alzheimer's disease)
Psycho... {
Diagnostic Reasoning Algorithms
help you narrow down the possible
differentials to arrive at a diagnosis.

(anaphylaxis) Toxic shock syndrome

-(MQ.
PsychOSis

--
a,ngestiveheart
tailufe(CHF],

--
corona,y ane,y

--
<isease(CAOJ,
arrhythrmas),
oohostatic S18p5

-
hYPQ!ension Step4
Mldl'erllalent S18p3
~ Step2
S tep 1

Controller
Daly Medications
None needed
P- Daly
Medications
Low-dose ICS
-Daly-
i.-dose JCS PM LABA
or
Med1ulTHlose JCS
-DIiiy-
Medium-dosalCS
plJs lABA
Alternative Daily
- Da l l y _ , .
High-dose ICS p...
LABA
Ahemative meds
noa<m•o• Flow,hart,} Altematrve Daily
Medications A•ernative Daily Medications
Low-dose ICS plJs e~her
Medications
Medium-dose
Consider omalizumab for
patients who have
walk you step-by-step LTRA, cromo)yn,
LTRA, theophyll ne, allergies
nedocromil, or ICS plus either LTRA ,
through standard theophylline or zileuton theophyl ne, or zileu1on
treatment protocols.

Reliever SABA PRN less than

twice per week
SABA PRN, not ID
exceed thraa to four
times per day
SABA PRN, not ID exceed
three to four times per day
SABA PRN. not ID -
thraalD!ow-
per day
Consider short
course of oral systemic
corticosteroids
·--
SABA.W.-1-
tlmes3ffMOdad
Consider short couraa ol
oral systemic
corticosteroids

APPLYING
Topics include...
Practice in a Ears, Eyes, Nose & Throat Problems
STEP#2 safe environment. Cardiovascular Problems
Neurological Problems
Respiratory Problems
Endocrine and Metabolic Problems
Ch apte r 10 Neurological Problems
Online Case Studies a se study
Skin Problems
hone your clinical A 35-vear-old woman presents t o the \\'illk-ifl d inic with a n l!f'{themic rash along he r left lat eral rib a rea, Health Promotion
somewhn under her bru st, which she de:Saibes i s "very p;i,infuL" You note it has a fewvesides
decision-making de'Rlopin:g. The woman has a &-mont h-old infant w ho is breastfeeding and t tll'e eother chiklren aver 3 Care of Older Adults
y,e<1n of a,ge, all o f whom t he porents ha ve c:hosM not toViKat\ilt e against common childhood illnesses.
skil Is wit h r ea I- The wom•n desaibes recent m ess re~ted to pro.-id[ng 24--hollf ca.re in her home to her mot her, who is
seriously ill. The womiln is seekin g treatment fo r the painful r.ish. Palliative/Chronic Pain
world scenarios that caseQue-stiom Sports Assessment
challenge you to L Which co nditions should be considered ,n possible dia,no:i.es?
Human Trafficking
diagnose and treat 2. What additional nfoonation shadd be gathered to make the diagnosis?
Genetic and Genomic Assessments
patients successfully. 3. Which condition is the woman l ikely experiencing?

4. What othoer informat ion shou!<lyou ob~in from t he p,ilttel'lt?

Suicide Risk Assessment
Opioid Addiction
 DAVIS

STEP#3
Study smarter, not harder.
Davis Edge is the interactive, online Q&A review platform that provides the practice
you need to master Primary Care content and to improve your scores on classroom
exams. Access it from a laptop, tablet, or mobile device for review and study on the go.

QU I/

Assignment 1

Questions 1. A 21-year-old man who has ingested " herbal ecstasy"

containing ephedrine is agitated and tremulous. Blood pressure 230/128
mm Hg; pulse 152/min; and respirations 24/min. Sinus tachycardia is Assignments are made by your
noted on cardiac monitoring. Intravenous administration of which of t he instructor. Or, create your own
following is the preferred initial therapy to reduce the blood pressure? practice quizzes as a study tool
{ to review before an exam.
v Acetazolamide
Adenosine

"' Nifedipine
Phentolamine

Q'1Htlon "· A 21-year-old man who has iniested "herbal ecstasy" containint ephedrine is aertated and tremulous, Blood pressure
2:10/128 mm Hg; pulse 152/mln; and rup1rations 24/mln. Sinus tachycardia IS l'H)t@d on cardiac monltorlng. lntrtv@l'IOUS
adm1nt.J;tration l'.lf whleh of the foUowll'lg Is thl!! ~hi~d Initial th@rapy to reduce the blood pru~ure?

1. Acetazo!amide

Comprehensive rationales explain

why your responses are correct or .; •· Ph@ntolam/ne

incorrect. Page-specific references RatJonales

direct you to the relevant content op&., 1, ACet.llOl.lmlde 1s ,1 urt,ook anhydr<1se ,nhibitor diuretic lh.lt rs us.e.:I to prevent .100 tre.1t .iwte h~ h roooot.1ln sac:kntss
in Primary Care. It t..D no !>ymp,atholytic effect.

Opdof, z, Meno5ine Is .10mlnlst("fe<f to p,;)t1t'tlts who h.lYf:" p..rOl(ysm..11 SUpt,l'llt'ntliCIJI.Jr t.1chyQ,rd1,1, How'e'ller, thi s ,1gent ~"-1 not be giVen to
patients who h;,...e asthma or chronic: obstructive lur18 disease because adenD!.ine can precipitate acute bronchospasm

op&o, , , Nifedipine is a d ihydropyrione c.1kium ch.lnnet blocker. It has no anti-arrhythmic effect. tt is a potent vasodilalor Iha! e4ici~ a stroog
reflr:-x bet.I adre-ne1gk r ~ resvltlng ~ t.1chy,::.1rdl,1 Thts hm,ts its effic,1cy ln tte.ittnffit of ~ng1N peetom vnie-.s.s the ~tiffit Is ;ilso
taking a bet.i adrenergic b locker. Lon11-acting nifedipine is commonly used lo Ueat the patient who h.ls isolated sr.,IDIK hypertem ioo.

Op&o, t · Eph,2-dr h'le ,l(ld coc,1,ne c,11.m! stir'l'lul.ltion of the Syr'l'lp;itht-ti( ~ s SY!-tem In~ br,11n and l)t'ripnttally P.atients h..M" ~pe-rt.en<,ion,
tad"lycardia, agitation, p5YChosis, and seizurn. lntravenoos administratiori ol phentolamine (an alp ha-adrenergic blockl!r) l!i indicated lo
lowe-rb4oo(lprM.SUre
 My Assignments D
Pn,ctk• Quiz lffpon Sucu :n ~ I

Pr.1ctic~ Quiz Report

00

The Success Center is where you can

access your quizzing assignments from latest Practice Quiz Progress
your instructor, as well as receive a U.TUfPIIACltaQUIZ: $COU: A'i'GSCOltl: 5TU!l(;TN$:

snapshot of your progress to identify ''"u· ·ePt ··ao--~•. :O_...:..,,.. tj 1: Beginner 71%
, ~ u .....,•.
Skin Problems Respiratory Problems

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The Art and Science of Advanced Practice Nursing
-An lnterprofessional Approach
FIFTH EDITION

Lynne M. Dunphy, PhD, APRN, FNP-BC, FAAN, FAANP

Research Professor
Christine E. Lynn College of Nursing
Flo rida Atlantic University
Boca Raron, Florida

Jill E. Winland-Brown, EdD, APRN, FNP-BC

Professor Emeritus
Christine E. Lynn College of Nursing
Florida Atlantic University
Boca Raton, Florida
Family Nurse Practitioner
VIM/Hands Clinic
Fr. Pierce, Florida

Brian Oscar Porter, MD, PhD, MPH, MBA

Clinical Drug Developmenr Physician-Scientist
Private Biopharmaceutical Industry
and
Medical House Officer
Veterans Affairs New Je rsey H ealrl1 Care System-Lyons Campus
Lyons, New Jersey

Debera J. Thomas, DNS, RN, FNP/ANP

Dean a nd Professor
Orvis School of N ursing
Universiry of Nevada-Reno
Professor Emeritus
Northern Arizona University
Flagsraff, Arizona

F.A. DAVIS
Philadelphia
F. A. Davis Company
1915 Arch Street
Philadelphia, PA 19103
www.fadavis.com
Copyright © 2019 by F. A. Davis Company
Copyright © 2019 by F. A. Davis Company. All rights reserved. This book is protected by copyright. No part of it may be reproduced, stored in a retrieval
system, or transmitted in any form or by any means, electronic, mechanical, photocopying, recording, or otherwise, without written permission from the
publisher.
Printed in the United States of America
Last digit indicates print number: 10 9 8 7 6 5 4 3 2
Publisher: Susan Rhyner
Developmental Editor: Kathleen Scogna
Manager of Project and eProject Management: Catherine Carroll
Content Project Manager: Amanda Minutola
Design & Illustration Manager: Carolyn O’Brien
As new scientific information becomes available through basic and clinical research, recommended treatments and drug therapies undergo changes. The
author(s) and publisher have done everything possible to make this book accurate, up-to-date, and in accord with accepted standards at the time of
publication. The author(s), editors, and publisher are not responsible for errors or omissions or for consequences from application of the book, and make
no warranty, expressed or implied, in regard to the contents of the book. Any practice described in this book should be applied by the reader in accordance
with professional standards of care used in regard to the unique circumstances that may apply in each situation. The reader is advised always to check
product information (package inserts) for changes and new information regarding dose and contraindications before administering any drug. Caution is
especially urged when using new or infrequently ordered drugs.
Library of Congress Cataloging-in-Publication Data
Names: Dunphy, Lynne M. Hektor, editor. | Winland-Brown, Jill E., 1948- editor. | Porter, Brian Oscar, editor. | Thomas, Debera J., editor.
Title: Primary care : the art and science of advanced practice nursing / [edited by] Lynne M. Dunphy, Jill E. Winland-Brown, Brian Oscar Porter, Debera J.
Thomas.
Other titles: Primary care (Dunphy)
Description: Fifth edition. | Philadelphia, PA : F.A. Davis Company, [2019] | Includes bibliographical references and index.
Identifiers: LCCN 2018039369 (print) | LCCN 2018039940 (ebook) | ISBN 9780803695290 | ISBN 9780803667181 (hard cover)
Subjects: | MESH: Advanced Practice Nursing | Primary Care Nursing
Classification: LCC RT82.8 (ebook) | LCC RT82.8 (print) | NLM WY 128 | DDC 610.73—dc23
LC record available at https://lccn.loc.gov/2018039369
Authorization to photocopy items for internal or personal use, or the internal or personal use of specific clients, is granted by F. A. Davis Company for
users registered with the Copyright Clearance Center (CCC) Transactional Reporting Service, provided that the fee of $.25 per copy is paid directly to
CCC, 222 Rosewood Drive, Danvers, MA 01923. For those organizations that have been granted a photocopy license by CCC, a separate system of
payment has been arranged. The fee code for users of the Transactional Reporting Service is: 978-0-8036-6718-1/19 0 + $.25.
The contents of this textbook and the independent contributions of Dr. Porter do not represent official views of Novartis, the VA, the FDA, the NIH, or
any other U.S. federal government agency.
 To Our Families:
To my husband, Jim, for his patience, support, and affection, which have been
ENDLESS …
To my parents, Joan and Arthur, for their immense love, and to my brother, Jim, for his good humor, steadfastness, and vacation
planning!
Lynne M. Dunphy

To my husband, Harvey, who is my soulmate.

To my parents, who instilled a sense of purpose in me and never let me give up on myself.
To my children: my sons, who have grown into wonderful friends—Ken, Nathan, Eddie, and Mason—and my daughter, Cydney, for
all that we’ve shared in the past and look forward to in the future.
Jill E. Winland-Brown

As with all my professional endeavors, this work is ultimately for my family—my beautiful and endlessly supportive wife, Carolyn;
our.pngted and talented sons, Mitchel and MJ; our creative and loving daughter, Cheyanne; and our brilliant yet goofy youngest
son, Brennan. I also dedicate this work to my mother and professional inspiration, Dr. Luz Sobong Porter, and my dear aunt, Dr.
Loreto Calibo Sobong, both pioneers in their fields, as well as the physician role models in my family—Uncle Boy, Auntie Espie,
Uncle En, and Auntie Esther.
Brian Oscar Porter

To my husband, Bob Coan, who is learning to be a rancher on our new property outside of Reno and who keeps me grounded.
To my parents, who inspired me to believe that I could do anything.
To my dog, Miller, who makes sure I get my exercise, and my cat, Neffer Kitty, for never failing to wake me up at 4:00 a.m. for
breakfast and start the day early!
Debera J. Thomas
Preface
We are very excited and proud to present this fifth edition of our primary care textbook, Primary Care: The Art and Science of Advanced
Practice Nursing. Maintaining the commitment to a holistic, caring-based approach to primary care practice, our Circle of Caring model keeps
the patient and family—and in some cases, the community—at the center of care, surrounded by a team of care providers.
Unit I, Caring-Based Nursing: The Art,contains five chapters that continue to provide a caring-based interprofessional approach to primary
care, conceptualized by a Circle of Caring, presented in Chapter 1, which is further operationalized in the remainder of the text. Chapter 2 in Unit
I lays out an ontological base for caring-in-practice and extends this across disciplines, Chapter 3 grounds caring-based primary care in the context
of community and health promotion, and Chapter 4 reviews the basis for a caring-based, interprofessional approach to diagnosis and treatment
that includes precision medicine. Chapter 5 discusses evidence-based practice, critical to providing value-based care.
Unit II, Caring-Based Nursing: The Science, uses the traditional system-based approach to provide the essential information necessary to
provide safe and effective primary care to patients. Each body system section has chapters that begin with “Common Complaints,” a symptom-
based approach to clinical phenomena that lays out the associated differential diagnoses of each complaint with which a patient may present, as
well as emphasizing the correct questions that a new practitioner needs to ask.
Following “Common Complaints,” each section then provides chapters on the most frequently encountered of these differential diagnoses under
“Common Problems.” Each problem is defined, and the associated epidemiology and causes are outlined, as well as the pathophysiological
processes. Dr. Brian Porter has again provided a thoughtful and in-depth update on the pathophysiology of the disorders developed within these
chapters, as well as a thorough review of diagnostic processes and management plans. The addition of more of our medical and physician assistant
colleagues as content experts and authors has provided a true team-based approach, new insights, and depth to the information provided.
Within each disorders-based chapter, the subjective and objective manifestations of each problem are elaborated, as well as the associated
diagnostic testing that might typically be used in a comprehensive work-up. A review of potential differential diagnoses for the disorder is provided,
including the underlying reasoning and critical thinking involved in reaching a specific diagnosis. This helps shape team-based treatment decisions,
made in concert with patient and family preferences. Consistent with our caring model, a holistic database is established and built on the patient’s
voice and experience. Management strategies, including pharmacological therapy and surgical interventions, when indicated, are described, as well
as complementary therapies and behavioral health interventions to provide a holistic plan of care. Follow-up and referral practices are included,
along with patient education—the all-important teaching–learning component of caring-based primary care practice.
Unit III, Caring-Based Nursing: The Practice,includes content on palliative care and the management of chronic pain, ethical and legal issues
affecting advanced practice nursing, and a substantive chapter on the business of practice. We include an update of a practical approach to
psychotherapy for primary care, known as the “15-minute hour.” This is especially important in an age of rising behavioral health issues and the
need for integrated mind–body approaches. Finally, we include an important message for all advanced practice nurses: a chapter on caring for self.

Expanded Contributorship and Team-Based Practice

In this fifth edition, we have expanded our contributorship to include physician and physician assistant colleagues in addition to nurse practitioners,
and we are pleased to embrace a truly interprofessional approach to primary care, which leads to sound, team-based practice. We have never
believed that caring is the domain of any one discipline; rather we embrace caring as a mode of relating, accessible to all, and lived out between the
care provider and the person seeking care.

Organizational Changes and Design Enhancements

Importantly, we made major organizational changes to both the structure and content of the text in this edition, to increase ease of readability as
well as to optimize learning. Body systems in Unit II are now denoted by sections, with smaller chapters devoted to common complaints and
conditions, making it easier for students to read and digest information.
Wanting to enhance the pedagogical value of all key features, color-coding has also been introduced in three major box categories: Nursing
Assessments (red), Advanced Practice Nursing Therapies (yellow), and Advanced Practice Nursing Perspectives (blue), which should aid
students in making connections and retaining information. As in past editions, tables, figures, and recurring displays are provided throughout the
text, including drugs commonly prescribed, therapeutic procedures that a primary care clinician might be called on to perform, screening guidelines,
diagnostic reasoning algorithms, treatment standards and guidelines, advanced assessment techniques, as well as sidebars for history and risk
factors. Also included are “Nursing Situations” (essential case studies), along with abstracts of current nursing-based research, and anecdotes from
patients drawn directly from practice experience in “The Patient’s Voice.” This variety of information will assist any primary care provider,
regardless of discipline or training background, in establishing and implementing a holistic, caring practice base. These changes were made based
on reader feedback and our own assessments, with much encouragement and concrete support from the FA Davis team.

NEW FACULTY AND STUDENT RESOURCES

With each edition of this text, we have added numerous resources to enhance student learning and provide faculty and preceptor support. We are
particularly excited about the addition of the Davis Edge online quizzing system to this edition’s resource package. Davis Edge is an adaptive
platform that affords faculty and students access to more than 1,000 board-style questions, with complete and detailed rationales for all correct
answers and incorrect distractors. Davis Edge provides faculty with a powerful assessment tool that seamlessly integrates with learning
management systems and gradebooks. As students take quizzes in Davis Edge, the system provides data back to faculty as well, tracking student
progress and reporting on areas of student strength and weakness (as individuals and at the cohort level) to assist with remediation. All questions in
Davis Edge are completely different from those in the faculty test bank, so that quizzing and exams are separate experiences.
For students, the Davis Edge platform offers nearly endless opportunities to ensure that they comprehend and retain the information presented in
chapters. The program also provides integrated access to the e-book version of the text, so students can quickly look up and refresh their
knowledge base as a part of their quizzing experience.
 In addition to Davis Edge, faculty resources in this edition include 48 new case studies with rationales, updated PowerPoints to support faculty
lectures and course packs, and an expanded and updated test bank for faculty.

Conclusion
As long-time nurse practitioner faculty and practicing clinicians, we remain committed to providing an in-depth book with a comprehensive and
holistic approach that can be used across the nurse practitioner curriculum, as well as in a variety of other primary care curricula—and that includes
participation by practitioners from other disciplines, such as medicine, pharmacy, and social work. This text provides a high-level
pathophysiological foundation, evidence-based diagnostic and management strategies, and a holistic plan of care that is consistent with this
advanced level of practice. Although we realize that health professional students will always need supplementary information to provide the
currency and occasionally depth of information required for clinical practice, the reader will be able to find a large amount of information in this
comprehensive and complete text, complemented by an ever-expanding collection of ancillaries.
It is a most exciting time for primary care and advanced practice nursing. The professional nursing doctorate—the Doctor of Nursing Practice or
DNP—is providing primary care practitioners of nursing with a well-grounded base of pathophysiology, diagnosis, management, and follow-up,
situated in a caring-based model. With the advent of readily accessible health information—both accurate and inaccurate—within arm’s reach of a
smart phone, an app, or a personal computer, consumers are more informed and empowered than ever. In turn, now it is time for primary care
practitioners to provide consumers with healthcare driven by an equally powerful framework—primary care practice within a Circle of Caring.
Caring-based relationships—and the team-based, patient-centered care encapsulated in this model—are the necessary foundation to create
healing environments so essential for effective primary care practice today.
Acknowledgments
There are numerous people to thank for helping this book become a reality: Susan Rhyner, Publisher—our wonderful, patient, always supportive,
always optimistic editor, whom we have come to know well, and who is, most of all, our friend.
Amanda Minutola, our new Content Project Manager, who has had to workvery hard to keep us all in line—and always managed to do this with
professionalism and humor.
Kathleen Scogna, our Developmental Editor from afar, who was efficient, enthusiastic, and patient. Kathleen worked tirelessly to “pull it all
together” and maintained her composure at all times, even the most trying!
The entire F. A. Davis production team—all of whom were always patient, flexible, and terrific!
All of our students, past and present, who continue to teach us as much, if not more, than we teach them!
We also acknowledge the following chapter authors of the fourth edition of this book, without whom this new edition would not have been
possible:
Susan K. Chase, EdD, APRN, FNP-BC
Lauren Gallagher, MS, APRN, FNP-BC
Bette K. Idemoto, PhD, RN, ACNS-BC, CCRN
Ruth McCaffrey, DNP, APRN, FNP-BC, GNP, FAAN, FAANP
Jacqueline Rhoads, PhD, RN, CCRN, ACNP-CS
Edwin W. Schaefer, ND, APRN, FNP-BC
Terry South, MSN, APRN, NP-C
Michael Zycowicz, DNP, APRN, FNP-BC, FAANP, FAAN
And most of all, we acknowledge all our patients over the years, who taught us to “hear” their voices.
About the Authors

Lynne M. Dunphy, PhD, APRN, FNP-BC, FAAN, FAANP Dr. Lynne Dunphy is Research Professor at the Christine E. Lynn College of
Nursing, Florida Atlantic University, Boca Raton, Florida. Dr. Dunphy was the Inaugural Routhier Chair for Practice from 2006–2016 at the
College of Nursing at the University of Rhode Island, Kingston, Rhode Island. She also served as Associate Dean for External Affairs during
2012–2014. She was a Robert Wood Johnson Executive Nurse Fellow and was the founding nursing lead of the Rhode Island Action Coalition,
dedicated to the implementation of the Institute of Medicine’s recommendations for the Future of Nursing. Dr. Dunphy served for 4 years on the
Board of the National Organization of Nurse Practitioner Faculties (NONPF) and as Co-Chair and Lead Co-chair of the American Academy of
Nursing’s Primary Care Expert Panel.

Jill E. Winland-Brown, EdD, APRN, FNP-BCDr. Winland-Brown was born in Boston but raised in Pennsylvania. After high school, she went
to Newport Hospital School of Nursing, Salve Regina College, Newport, Rhode Island, for her BSN; Boston College for her MS; and Florida
Atlantic University for her EdD and post master’s FNP. Her first teaching position was at the University of Rhode Island, after which she moved to
Florida. She taught in the undergraduate and graduate programs at FAU and was Assistant Dean and then moved to the Northern Campus as
Director. Children include his, mine, and ours, although after 37 years, all five are ours. In whatever little free time is left, her loves are the beach
and tennis. Dr. Winland-Brown was also on the ANA Center for Ethics and Human Rights Advisory Board. She currently volunteers 8 hours per
week as a nurse practitioner at a Volunteers in Medicine Clinic and precepts NP students.

Brian Oscar Porter, MD, PhD, MPH, MBADr. Porter is a triple board–certified and licensed immunologist/allergist, internist, and
pediatrician. After completing both his MD and PhD in immunology and microbiology at the University of Miami School of Medicine (Miami,
Florida), as well as his MPH at the Harvard School of Public Health (Boston, Massachusetts), Dr. Porter completed combined residency training
in Internal Medicine and Pediatrics at the Virginia Commonwealth University Medical Center (Richmond, Virginia), followed by fellowship training
in Allergy and Immunology at the National Institutes of Health (Bethesda, Maryland), where he also served as an Adjunct Intramural Investigator in
the Laboratory of Immunoregulation and Principal Investigator on two National Institutes of Health–based clinical and translational research
protocols in primary and acquired immunodeficiency. Dr. Porter then joined the U.S. Food and Drug Administration’s Center for Drug Evaluation
and Research (Silver Spring, Maryland) as a Primary Reviewer and Medical Officer, before transitioning into the private pharmaceutical industry
as a clinical drug development physician-scientist focusing on biological immunotherapies and global product development strategy. To
complement this work, most recently Dr. Porter earned an MBA from the Northwestern University–Kellogg School of Management (Miami,
Florida). Dr. Porter has held leadership roles in several biopharmaceutical companies, including Human Genome Sciences, GlaxoSmithKline, and
most recently Novartis Pharmaceuticals, where he currently serves as Vice-President and Therapeutic Area Head for Autoimmunity and Skeletal
Diseases* (East Hanover, New Jersey). He also continues to work actively as a clinician in the Veterans Affairs New Jersey Health Care System
as a Medical House Officer* (Lyons, New Jersey). Dr. Porter credits his multidisciplinary approach to human health largely to the influence and
encouragement of his mother, Dr. Luz Sobong Porter, a nurse clinician, educator, and researcher, who always involved him in her work and was
one of his primary research collaborators.

Debera J. Thomas, DNS, RN, FNP/ANPDr. Thomas is Professor and Dean of Nursing at the Orvis School of Nursing at the University of
Nevada, Reno, and a Professor Emeritus at Northern Arizona University in Flagstaff, Arizona. Her teaching career began in 1978 at Augustana
Hospital School of Nursing in Chicago, Illinois. She has held numerous faculty and administrative positions at institutions including Kent State
University, Case Western Reserve University, Florida Atlantic University, University of Connecticut, and Northern Arizona University. In her free
time, Debera is a potter. She prefers wheel throwing and functional ceramics and works in high fire clay. On most weekends, you can find her
caring for her 10 acres of gardens, vineyard, and house outside of Reno, NV.

*The contents of this textbook and the independent contributions of Dr. Porter fall outside of his current employment and do not
represent official views of Novartis Pharmaceuticals, the U.S. Department of Veterans Affairs, or any other U.S. federal government
agency.
Another random document with
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their Victuals: Yet some of them yield sweet water very fit for
domestick affairs. These Nitrous Fountains are of no use, nor do
they effect ought, save that they drive some Mills, and run through
the Village a particular way afore they fall into the Mhene.
And forasmuch as the aforesaid Earls have known that the chief
part (or most part) of the said Fountains are wholesome by reason
of the plenty of Salt-petre in them; they have therefore taken care to
have a great House built, that so the place may be rendred
commodious for those that by reason of some disease should come
unto this place for the sake of washing their sick bodies; and there
are abundance known to come, that are ill, in the Summer time,
from places far remote; several of them too by a due using this Bath
are restored to their former health.
They know not any other use of these nitrous Fountains than what
is aforesaid; whereas if they did but know how to add some Virtues
to the said waters by the benefit of the Juice of the wood, of which
there is great store in that place, they would find by the use of them
then, many wonderful effects in the curing of Diseases.
Being therefore earnestly intent upon the search hereof, viz. from
whence these nitrous Waters should chiefly proceed, I found that
the Mountain nigh that place, extending it self for some miles, was
every where full of Salt-petre, and that it stuck in the Rocks
themselves, out of which whatsoever is on the Mountain grew. I did
therefore diligently search out, what condition those Stones were of,
which the workmen dig’d out in these places, and I knew that there
was a great quantity of Salt petre contained in them, insomuch, that
as many Mountains as here (abouts) seem to be replenished with
the same: Nay more, if you shall break one or two of those Stones
with which the Houses of the Village of Cossel are built, you shall
find every where in them abundance of Salt-petre. I went to visit the
place it self where those Stones are digged out, but found not any
Salt-petre among the digging, because the Air had not as yet
displaied its Virtues thereupon: But I observed that in those stones
exposed a while to the Air, there was plenty of Salt-petre. He that
would see it with his own Eyes, let him go into any House of the
Cossel Village, whose Walls are of ancient standing, and he shall find
that there is abundance of Salt-petre in those stones, and withal,
that the Pillars belonging to the Bath-house do yearly wax less, for
as much as scalings of the thickness of the back of a Knife do still
fall off, by the power of the separated Salt-petre, as I have often
very accurately and curiously observed. If the Earls or Counts did
but know the true use of this excellent and o cult Treasure, they
would get far greater riches out of that bare Mountain only than by
all the County. I doubt not but that seeing I have in this place
detected this Treasure, there will some be found that will labour for
their own profits sake to find it out.
Not far off from the said Mountain the whole Earth abounds with
Iron, not in the form of Veins but of Reins, insomuch that the Metal
of Iron offers it self in various particles or pieces of diverse
magnitudes; for in some places it is found as big as an Hazle-nut, or
an Acorn; in other places as big as an Egg, or ones Fist, yea and as
big sometimes as ones Head, which by the force of the Fire is made
facile and yields abundance of Iron; nor did I ever yet meet with any
Metal of that sort more excellent than that is, but no body knows it,
though it may be commodiously prepared or fitted for the use of
Man, because there is in this place plenty enough of Wood and
Water to be had [for such a purpose.]
This Mountain stretcheth out it self some miles, reaching as far as
Iphovia, and the jurisdiction of the City of Wurtzburg; so that the
chiefest and greatest part thereof is seated in the Bishoprick of
Wurtzburg: And therefore might immense and vast Treasures be
gotten, were there but such as were lovers of Art and would make
themselves skill’d in the Operation.
Besides, this Mountain yields abundance of white and red
Gypsum, which may be reduced to an exceeding whiteness by the
force of the Fire.
Besides this too, we have known Marble and Alabaster digg’d out
hence, and yet it has not been very durable, for it becomes nitrous
after it hath lain exposed a while to the Air, and falls to powder, and
yields plenty of Salt-petre, were it but rightly managed, for there’s
no want of Wood here.
There is yet moreover found in the said Mountain another Castle
which is called Swansburg, and belongs to the Bishoprick of
Wurtzburg, where the Soldiers did heretofore use the Metallick Rods,
to search after, and to see if they could find (by the using them)
some Treasures; and they tried whether or no (the Castle being
burnt by the occasion of the War) any such Treasures lay any where
hidden. What they found I do not yet know: But this I know, that
the said Rods did shew good Metal to be every where (thereabouts)
The which thing gave occasion of explaining or unfolding the said
matter in its proper places. Besides this, they digged up nothing else
but such nitrous stones for some fathoms depth. I once viewed this
place, and found that the stones extracted some years afore out of
this Mountain were altogether brittle, and is a manifest token that
the whole Mountain is fill’d with Salt-petre.
There is besides this Mountain, another nitrous one that I know of,
of the like condition in the mid-way ’twixt Kitzing and Wernfeld (and
is about a miles distance from Carlstadt) but that which is here had,
differs from the former in this, viz. that the stones which it exhibits
are of a red colour, nor are they so much impregnated with Salt-
petre, as those of Kitzing aforesaid, for they are richer in Petre, and
are of a more ashy colour.
There are likewise such kind of stones also that they cut or dig
forth at the Mhene near the City Rotenfeldt, but they have not in
them so much Salt-petre as those have that are found in the Cossel
and Swansburg Mountain.
There’s abundance of such stones in several places in France, but
my purpose is not to mention them all, for I was minded to mention
such only as my self have seen, and that are near bordering upon
the Mhene.
 They that have a mind to deal with them may make their search,
and they will find in all Countrys of the Earth fit stones for their
purpose, the which we may hereby know, if being kept a while in the
Air, they wax soft, and scale off in most thin leaves, and there sticks
to your Fingers in rubbing them off, a reddish Meal.
Besides this too, you may have a most certain sign of such Petry
places by those Spiders that have a small body and round, and long
feet, for they stick to those stones in abundant measure: For such
Spiders do not feed upon hearbs, grass, flies or other insects, but on
old Walls, and they seat themselves chiefest of all on those aforesaid
stones. They are not all venemous as the common house Spiders
are, and therefore the Children do gather them, and are much
delighted with them. Now they sticking on to the softer sandish
stones do most certainly demonstrate that Salt-petre is contained in
them; for tis that which they are nourished with, and conserve their
life by, and this I was willing to signify unto you. But put case that
no such nitrous stones were to be found, yet however there is not
the opportunity denied us of making Salt-petre of the common Lime-
making stones, and of them there is every where plenty enough, if
they are calcined by the benefit of Wood, and made nitrous with the
juice of wood.
What shall I say of the Calcined fæces of Tartar which are yearly
gathered up and thrown away in vast quantities, in all that tract
which lies on the River Mhene, between Bamberg and Franckfort,
whereas notwithstanding some hundreds of hundreds weight of Salt-
petre might be extracted thence-from, did they but mind it. For
whatsoever Tartar is therein contained, is all of it Salt-petre when ’tis
duly boiled with a Lixivium of Lime, and being hence strained, and a
sufficient evaporation made, it be set by to Chrystallize. For it
attracts the soul after a magnetick manner, which Operation if rightly
instituted, there may be prepared thence from a most inflammable
nitre in three days space, the which is likewise of far greater profit
than the getting out the Tartar by the help of a Press, and with a
great deal of labour; or else than the making Potashes, as we see
usually done.
 Besides too, there are found other stones that being burnt do yield
abundance of Salt-petre, such as are the Tophi (or soft sandy
stones) which may be abundantly gathered near Triefelstein, which
is a Monastery situate on the Mhene, in other places of Germany
they make even whole Mountains: So that it is evident that there is
no where any want of convenient matter to gather Salt-petre from, if
Men would but set their hands to the work. These stones are
obvious unto all; and who knows what Treasures the Woods (which
we do not at all search into) abound withal? Would time permit me I
could shew that various kinds of Metals are conserved in the
Mountains situate between Kitzing and Franckfort, and especially in
the Speshardensine (Mountain,) the disclosing of which, some other
more commodious place will admit of.
 Now follows what we mentioned of the
aforesaid
L A Z A R US ER C K ER.

Of the manner of Boiling Salt-petre.

AND FIRST
By what means a Lixivium is to be made out of a Nitrous Earth.

I
f you are minded to make a Lixivium of such an Earth, dig it as
deep as you shall find by proving it to be either good or
naught, especially if you intend to make it in great quantity,
and keep it in a dry place. Then take care to have some great
wooden Tubs, or Vessels made, so large, that each of them may
hold about some ten Wheel-barrows full of the Earth, and whereby
you may be able to prepare Lixivium enough, answerable to the
work you have proposed to your self to do, and to the bigness of
your Copper. Now there are commonly required for such a work, to
one Copper Pan that weighs two hundred weight, eight Wooden
Vessels which are to be placed in such order, that on each side there
may stand four in a row, opposite to each other. These same Tubs
are to be so far distant from the next Collateral Vessels, as is
requisite for the Wheel-Barrow wherein the Earth is brought to come
between: Yea, and it is necessary that there be half an Ell’s space
betwixt the said Tubs and the Earth, or Ground, it self, whereon they
are placed. Likewise, each of the Vessels, or Tubs, must have a hole
in the fore-part, and towards the bottom thereof, fit to put in a Plug
(or Tap) at: Then finally, there must be put under those Plugs, a long
Vessel like a Channel-pipe, which may receive in it the Lixivium
running out of the Tubs, and may guide it along into a peculiar
Wooden Vessel, as into a common Store-house set in the Earth
hollowed for that purpose, to receive the said Lee in.
All your Tubs being thus rightly ordered, put in upon every Tubs
bottom another (false) wooden bottom, perforated with many Holes,
and let it lie two Fingers breadth distant from the true bottom: Upon
this (false) bottom lay yet another made of Bull-rushes, or your
small sort of Reeds which grow plentifully in Ditches about the
thickness of a quarter of an Ell: In want of these Reeds throw in
upon the aforementioned perforated bottom, the quantity of a Span
(thick) of Chopt Hay, or Straw, laying some very thin boards thereon,
that so it may not be scattered (or float) abroad. And your Vessels
are made compleatly ready.
Now then, put of the Earth you have already tried and gathered,
as much into each of your Tubs, as they can hold, yet with this
Caution, That the top part of your Vessel be empty a Spans heighth.
And observe this, that if you can get some old ashes of the Curriers,
or Soap-boilers, as much of it as two or three Wheel-barrows will
carry, it must be put in upon the topmost (made) bottom of the Tub,
afore the Earth, but now spoken of, be put in. At the top of the
earth, lay a Cover made of Twigs, (or Withes) and fasten it with a
wooden stick at the top of the earth. This done, pour common water
upon the earth contained in the Vessel, an Hands breadth in
heighth, so as that it may rather touch (or be poured) on the Twigs,
than the Earth it self, least the said earth become unequal thereby,
and hollowed in several places. Let it stand thus for eight hours,
which time being overpast, draw your Plug out, and let the water
you poured on, run out at the hole beneath, which as long as it is
muddy, you must always pour in again into the Vessel, repeating this
so often, till it comes out clear, then keep it, and this water is called
a weak Lee or Lixivium.
This done, pour common water again upon the earth from which
the Lee hath been already, once separated, that so it may extract
the residue of the Lixivium out of the earth; and this Lee is of no
use, save that it may be poured on upon new earth, instead of
simple water; for it oftentimes doth even yet contain a great deal of
Nitre, insomuch, that you may sometimes extract out of an hundred
weight thereof, three or four pound of Nitre.
This Extraction being finished, take out the unprofitable earth out
of the Vessel, and put in new; and continue the Operation, after the
aforesaid manner, reiterating it so long, and so often, until you have
gotten store enough of the Lixivium, that the work of boiling be not
intermitted for want of Lixivium.
Besides, there must be some Wooden Vessel placed at the upper
part of the Copper which this Lixivium is boiled in, out of which may
run so much Lixivium into the Copper as is wasted away by boiling,
that so there may be still kept the same order of boiling, and the
same quantity of Lixivium in the Copper. This boiling is to be on this
wise continued, until a Centenary, or hundred weight of Lixivium in
the Copper, yields according to the less assay (or weight) twenty five
pounds of Nitre; and this may be done in two Days, and one Night.
This being thus done, you must have ready yet two Tubs, or
Vessels (more) of Wood, made after the afore prescribed manner,
and furnished with a (false) perforated wooden bottom, besides its
own bottom, and likewise with such a bottom as is made of Reeds
(or Bull rushes); only you are to observe this here; That there must
be put yet another perforated wooden bottom upon this topmost
bottom of Reeds, upon which there must be first cast in some chop’d
Straw, then some Ashes of Firr, Beach, or any other Tree, so much in
quantity as may overtop the Straw an Ell or Cubit, [Ulna] high; or
rather (if it may be had for a very mean price) as much as may fill
the Tubs, or Vessels. But yet, these Ashes are not to be just simply
thrown in (as they are) upon the Straw, but afore this is done, they
must be first well mixt together, then moistened with some of the
best hot Lixivium, that there may be made a Mass. Then when the
Ashes are on this wise prepared, and put in the Vessel, the Lixivium
boil’d to its heighth, and which yields in the proof twenty five pound,
must be poured thereon, as hot as possibly it may, and is to be often
drawn off by the lower hole, until (if troubled or muddy) it becomes
clear.
After that all the Lee hath thus passed through the Ashes of both
Tubs (the which is done upon this account, That all its fatness may
pass into (or be left with) the Ashes, which Ashes are hereby
rendred stronger to wash withal) keep it in a peculiar Vessel.
Then pour the common Lee or Lixivium upon the Ashes remaining
in the Tubs, which when it hath passed through the Ashes, is called
the second stronger Lixivium: Then again pour on yet a third time,
hot Lixivium, and when ’tis drawn off, it is called the second weaker
Lixivium: Lastly, the common Lee, or Lixivium, may be poured on
cold upon the Ashes, that so all the virtue of the same may be
wholly extracted.

The Figure before going (Numb. 1.) will shew you the way of
placing the Tubs, of preparing the Lixivium, and ordering the boiling.
A Are the eight Wooden Tubs, wherein the earth is put.
B Channels, or Conveyances, by which the water runs into the
said Tubs.
C Channels, or Gutters, by which the Lixivium is conveyed into a
Vessel set thereunder.
D The Vessel in which the Lixivium is gathered, or received.
E The little Vessel out of which the Lixivium runs into the Copper.
F The Furnace.
G The Copper.
H The door of the Furnace whereby Wood is put in under the
Copper.
I The Lower Wind-draught (or Ash-hole) of the Furnace.
K The inward shape of the Furnace.
L An Iron Grate, which the Wood is put upon.
The manner of preparing the Liquor, out of which Salt-petre may be
made by Boiling.

F irst of all, pour your second weaker Lixivium into your Copper,
and set it a boiling, then let your second stronger Lixivium run
thereinto by little and little; and then lastly, the first Lixivium it self,
and which is the chiefest of all, until the Copper be almost filled, and
the Lixivium be boil’d enough to shoot.
And now when you perceive that your Liquor is made strong
enough by boiling, put in a Brass Ladle perforated (or full of holes)
several times, even to the bottom of the Copper, and if the Lixivium
lets fall out of it any Salt, you will find it at the bottom, the which
you may take up with your Ladle.
Note also, That the Scum which at the end of this Boiling is
plentifully gathered, must be carefully taken away: Now then try the
readiness of your Lixiviums Crystallization, on this wise: Put either
two or three drops on a cold Iron, or on a Polish’d Plate of Iron, and
if it stands, or grows hard; that is, if when you turn the Iron up and
down, it does not run (or flow) down, these are signs of the fitness
of your Liquors Crystallization. Or else, you may put some of the
Lixivium in a Brass Vessel, and set it in cold water, and so you shall
see whether the Liquor be fitted enough to Crystallize; for assoon as
ever the Lixivium shall be cold, there will be plenty of Salt-petre
generated: Nay, even the very Brass Spoon it self denotes the
goodness of the Liquor, it being put into the Liquor, and again taken
out, it will show it sticking on it, as if it were Oil.
Out of a Centenary, or hundred weight of Liquor thus perfectly
prepared, there will proceed more than seventy pound of Salt-petre.

The way of rightly using the Liquor for the Generating of a more
Crude Salt-petre.

P our your Liquor prepared after the afore-shown manner, out of

the Copper into a narrow Tub, or Vessel, made of Firr, or Pine-
tree wood; wherein let it remain quiet, till it be a little refrigerated,
and the muddiness, or slimyness [Limus] appear, and you find that
the salt sticks on in Granes to the sides of the Vessel; now when you
perceive your Lixivium so cooled, as that you can put your finger
thereinto without burning, pull out the Plug, wherewith an hole
made in this long Vessel, about a span’s heighth from the bottom,
was shut, or stopt, and so let the Liquor run forth, into very great
Wooden Vessels, and deep, purposely made for such a business; or
else into Copper Pans, buried almost (up to their Necks) in the earth,
(for the cooler the place is, which they stand in, so much the better,
and the more plenty of Salt-petre is gathered, and Crystallizeth) and
you will find that your crude Salt-petre will shoot therein, the
thickness of almost two fingers breadth, partly of a whitish colour,
partly yellow, and partly blackish.
After that this boil’d Liquor hath stood for two days, and so many
nights in the Vessel, the Lixivium of the Salt-petre which swims at
top, must be taken away, which you may mix with the strong
Lixivium, and pour a second time upon Ashes, for else the Lixivium
will contract too much fatness, and there will be no Salt generated.
Sometimes it happens, that when the Ashes are not good, there’s
no salt at all gathered in the Liquor, in which case there is no
presenter Remedy, than to mix such a Lixivium stronger than is fit,
with another, and so pour it again upon new, and good Ashes, and
then let the boiling be again perfected after the afore-prescribed
manner.
Likewise, when in the boiling you find the Lixivium very muddy,
whereby the Collection of the Salt is oft-times hindred, it must be
taken away, and let the Washer-Women, or Lawndresses have it,
and other must be substituted in its room, and be farther purified by
the help of Ashes.

The Figure signed (Numb. 2.) shews the manner of preparing the
Liquor by boiling, and of extracting and gathering the Salt thereout
of.
 A Long narrow Tubs, or Vessels, in which the decocted Liquor of
the Lixivium is cooled.
B The Furnace wherein the Copper stands.
C The Man that manageth the boiling, and extracts, or draws out
the salt with a Ladle, the which he lays in a Withy Basket placed on
the Copper, that so the Lixivium (in it) may again run down into the
Copper.
D The little Basket.
E The little Tub out of which the strong Lixivium runs (by little
and little) into the Copper.
F Coolers, or Vessels, in which the Crude Salt-petre shoots.
G Four Brass Pans put in the Earth, hollowed for the purpose, in
which likewise the Salt-petre is generated (or shoots.)
H A strong Vessel whereinto the Lixivium remaining after the
generating (or shooting) of the Salt-petre, is put.

The way to purifie the Crude Salt-petre.

W hen all these things are thus done, and the Lixivium that
swims at the top of the Salt-petre is taken away, lift up those
Vessels, or Brass Pans, containing that salt, and turn them up and
down in some convenient place, that so the residue of the Lixivium,
that lies as yet in them may flow, or run clearly out, into another
Vessel set thereunder.
This done, take the Salt-petre out of the Coolers, or out of the
Coppers (or Brass Pans) with an Iron Spatula, or rather with such an
Instrument as your Plasterers use (eine telle, a Truel) and put it in a
Tub that has a hole in the bottom thereof, that so the Lixivium may
be perfectly separated therefrom. They that sell that crude Salt-
petre, and not at all purified, for the Salt-petre Boilers, do pour
thereon pure (or clear) Well-water, by the means of which, it is made
more white, that which is thencefrom separated they do again mix
with other stronger Lixivium and so boil it up for the following use.
 But if you have a mind to purifie this crude Nitre from its salt, and
all its Impurities, that it may be rendred fair, and white, you are to
proceed this following way:
Take almost as much Well-water as is sufficient for the dissolution
of the Salt-petre, put it in the purifying Copper Vessel, first cleaned
with water, and dried with a cloth, and put the fire under it, and
make it most exceeding hot, then throw in your Salt-petre by little
and little, and in pieces, continually stirring the Salt-petre that sticks
at the bottom with a spoon, that it may be the easier, and sooner
dissolved; this only is to be observed, that there is required a more
gentle fire, while the Salt-petre is cast into the Copper, so as the
water may be kept always hot. When all the Salt-petre is almost
dissolved in the water, promote the boiling thereof, by augmenting
the fire, then try if there be any salt in a (biggish) gross form,
residing in the bottom of the Copper Vessel, which if you find to be,
(for indeed, the Salt-petre it self is not so very easily dissolved, nor
doth its being admixt in a more copious manner, at all benefit the
Lixivium) take it forth with a Spoon, (or Ladle.)
This done, separate the Scum swimming at top of the boiling
water, then have ready a Brass Vessel that will hold about ℥j.ss. of
Liquor, fill it half full with the Lixivium, set the Vessel in cold water to
cool, and you shall find your Nitre presently to Crystallize, or shoot
therein.
Hereby may you try whether your Purgative water be strong
enough, or not; for if it be stronger than is fit, you will find a little
skin spread it self over the matter contained in the Vessel, and when
it comes to be so, add thereunto more hot water, keeping the fire in
that degree of heat, as may suffice to keep the water contained in
the Copper, gently boiling.
Now when you have kept it thus boiling for some season, try the
goodness of your water again, after the aforesaid manner; and if
you shall find a Crystallization therein, and no Concretion, or
heaping-together, leaving a gaping, or chap in the midst, the
business is well done; but if it be otherwise (than thus well done) so
that it be wholly shut in (or gathers a skin all over) at top, pour on
hot water, until your Matters come to succeed after the manner
aforesaid.
Then after all this, take of the best Wine Vinegar, about one
pound thereof, and pour it into the said water, and you will presently
see a blackish spume, or filth arise in plenty at the top thereof, and
when you have left it so a while, it may be easily taken off, because
of the thickness it contracts.
The boiling being yet a while longer continued, pour in the same
quantity of Vinegar again, and diligently separate the Scum as afore:
This pouring on of Vinegar, and separating of the Scum, may be
repeated yet a third time, and oftner, whereby the purgatory water
may be made altogether pure, and that there appears not any more
spume.
When all this is done, cast in upon this water two or three Ounces
of Burnt-Alum, most finely powdered, stir all well with a Spatula,
whereby the Salt-petre may shoot into longer Crystals.
Then after this, pour out the purgatory water into the
aforementioned deep Vessels, and cover them over with Linen
Cloths, that the Liquor cool not. Let it stand thus one hour or two at
most, and a yellow slime will settle to the bottom: Then let the
water while it is yet warm flow out hence, into other Vessels made
of wood, and especially of Elm, and which are large enough; or else,
you may let it run into Copper Pans set deep in the Earth, for the
better coolings sake, which cover over very neatly with Cloths, that
so the Crystallization may begin from the bottom, and not at the
upper part, as we see it wont to happen, where it is not kept by
Coverings from the External cold: And we also observe therein too,
that the Crystals shoot not into that length, as when the
Crystallization begins from the bottom.
Let them stand thus for two or three days, until you see no more
Crystals generated, which you may on this wise try.
 Put some of the Lixivium in your (little) probatory Vessel, wherein,
if you find that there are no more Crystals generated, you may take
out the rest of the Lixivium: Then take out the Petre with an Iron
Spatula (or Truel) and put it into a Vessel that is full of holes in the
bottom, that so all the Lixivium may be the better separated
therefrom. And you shall have your Salt-petre pure and white, and
freed from its Salt.
Forasmuch as the Lixivium here separated hath as yet some
saltness in it, it may be mixed with other strong Lixivium to be
(agen) boil’d up, for the production of the Crude Salt-petre is usually
holpen forward there-withal.
Some there are that for the better purifying the Petre, do put Calx
vive in together (with it) whereby the water becomes most white like
Milk, and the Salt-petre gets a greater fairness.
You must withal observe that during the time that the purifying
water is contained in the Copper, your fire must be most gentle,
least by overmuch boiling you get some damage, for a little fire is
able easily to cause (a too vehement) ebullition, and when it has got
strength (or the start of you) it is hardly allayed again. The scum
which you take off from it you may pour upon ashes as if it were a
Lixivium, that so nothing (from whence any profit can be hoped for)
may be lost.
There is sometimes seen to stick to the bottom of the Copper
(especially when it is used about many boilings) a certain stony and
hard substance like Tartar, which unless it be taken away, your
Copper will easily suffer damage under that same matter and be
burnt.
The earth and ashes left, after the weak Lixivium (hath past
through them) are to be laid up in some convenient place, and there
kept for four years or more, that so they may be again apt to yield
a-new more Lixivium by extraction; which, that it may be the better
and easier done, there must be made in them (many weeks afore
they are wrought upon) by digging some Pits or Gutters, that so
they may be freed by the heat of the Sun from that moisture
wherewith they as yet abound. Nor do the ancients so much wander
from the Truth in that they suppose it much better and more
profitable to keep all the earth under a roof or shed, and that it will
be far sooner reduced unto a fitting goodness, than to lie open to
the weather, for much of the Salt-petre is corrupted (or spoiled) with
an abundance of moisture, especially with the Rain it self: For it
needs only a little wetting whereby it may be generated, and
extreamly shuns, or is injured by too much moisture.
Besides these ways, there are many that mix with this earth that
is yet contained in the Tub the Saw-dust of Firr, or some other Wood
(the height of) a Fingers length (on it): And they perswade that Salt-
petre is also generated and multiplied from that fatness which is
mixed with the Saw-dust, and that the earth prepared on this wise
can be so changed in a years space (so it be kept in a dry place)
that it may be again made use of as afore. Yea and they suppose
too that they can do much here, if they pour upon such a barren (or
lean) earth, thus lying in a dry place, the reliques or remains of the
dyes, which the Dyers are otherwise wont to throw away, and
evident it is that they are aluminous, but yet not so frequently.
Besides such waters of the Dyers they are wont also to mix soot
with their earth, (yea and the ashes too of which Lawndresses do
commonly make their Lee;) that so it may be made the more fruitful
and may be the sooner brought to use.
This only is to be noted, that there are sometimes found earths
that give a thick black Lee, which being used by it self is too fat, to
which is to be added a leaner and dryer earth, that so the Salt-petre
may be the better and more plentifully generated.
The way therefore how, and the instruments by which crude Salt-
petre is purifyed, is shown by the 6 and 8 Figure (in Lazarus Ercker’s
Book I think he means.)
The manner of purifying the gross and blackish Salt that comes out
of the Salt petre.

T hat black or rather ashy colour Salt, which is found in the

Copper while the nitre is prepared by boiling, and likewise in
the narrow Tub or Vessel, may be reduced into very good Salt, and
very convenient for daily use, and no ways at all hurtful to Man, if it
be but duly purified; which said purification is to be thus ordered.
The Copper being well cleaned fill it with most clear Well-water,
put fire under it and make it boil, throw in the said Salt by times (not
all at once) into the boiling water, that so it may be dissolved; which,
that it may be the sooner and better done, stir it continually with a
Spatula, when you think that it is all dissolved pour out the Lixivium
into some Vessel or Tub, & you shall see the grosser part will settle
to the bottom, and the Lixivium will clear up: When you perceive
this, pour this clear Lixivium again into the cleansed Copper, and boil
it so long till the Salt settles to the bottom, which take out of the
said Copper with a perforated Ladle, and put it in a Basket that is
placed over the Copper, that so all the superfluous Lee or moisture
may again run down into the Copper, and yields (or leaves) the Salt
perfect and dry.
Some there are who afore they use this Salt about domestick
affairs, do decrepitate it first, and perswade themselves that it
becomes thereby the more virtuous (or strong.)
What remains behind of the Lixivium in the Copper, you may boil it
up like as you would any other Lixivium appointed to be Crystallized,
then pour it out into the Vessels destinated to that purpose, and you
shall see Salt-petre to be generated in them; for seeing the said Salt
proceedeth out of the Salt-petre, this Lixivium cannot be wholly void
of Salt-petre, and therefore may it be separated from that Salt by
the aforesaid way, and be purified.
But you are to note here, that where there is too great a quantity
of Salt-petre permixt with the said Salt, or that the Salt it self is too
black and impure, that Salt cannot get its due lustre and whiteness
by barely one such a purifying Operation, and therefore there is
requisite a reiteration of this Operation, so that it be again dissolved
in new water, and be purifyed, whereby it may become altogether
white.
However, such a black and impure Salt, may be purified even by
this way (following.) Pour the solution it self, while ’tis yet hot, (the
water I mean in which the Salt is dissolved) upon the ashes which a
Lixivium hath been already poured on before, and you shall see the
Salt Lixivium to be wholly purified: But yet all the Salt which is
extracted thence, is not sufficiently white, but that which is gathered
last of all is yellowish, and therefore must be yet once again purified.
Note also here, that when such a Lixivium of Salt is poured on the
ashes, they must be well edulcorated (after the operation is finished)
least the Salt sticking in the Reedy or Bull-rush-bottom should give
an unfitting saltness to the Lixivium that is next poured thereupon.
And thus have you the common method of boiling and preparing
Salt-petre, in which you meet with what may be well disallowed or
rejected, viz. it is extreamly tedious, nor is it at all gainful, for out of
a centenary of Lixivium, we have no more than three or four pound
of Petre; to get which too, all the rest of the water must be done off
by evaporation, which is a long time doing, and requires no small
costs. Yet I will shew in what follows, by what means this
inconvenience may be prevented, which I have proved by mine own
experience.

The way of augmenting the Crude Lixivium afore its boiling.

T he Salt-petre boilers have hitherto variously sought after the

way of augmenting (or fortifying) the Lixivium of Salt-petre,
that is, of causing a more plentiful provenue of Salt-petre, in the
Water remaining of the extraction of Salt-petre, but in vain, because
they were ignorant of the lesser proof which all things here are tried
by. Its augmentation is done on this wise.
 Take of a Lixivium, a Centenary of which contains iiij. ℔. of Nitre,
pour so much of it as a Tub or Vessel will hold, upon new earth, let it
stand for twelve hours; then draw off the Lixivium, and as much as
you find wanting of what you poured on (which may easily be known
by the emptiness of the measure which it was in, afore you poured it
on, and in which it is now gathered or received again) pour so much
simple water on the Earth, which draw off in like manner, and mix it
with the Lixivium, and you will then have the same quantity that you
had in your Vessel afore. This done try the Lixivium by the lesser
experiment or proof and you will find it to contain vj. ℔. of Nitre.
Pour this Lixivium that contains in it vj. ℔. of Nitre upon other new
earth, and proceed on the manner aforesaid, and you shall have
your Lixivium to contain ix. ℔. of Nitre. You may pour this a third
time upon other new earth & proceed on with it after the aforesaid
manner, and you shall yet have more Nitre out of a Centenary of
Lixivium. But you must be always wary in this Operation, that you
draw off, neither more nor less Lixivium from the earth than you had
before in the Vessel. These things it pleased me to add, concerning
the second pouring on of water, meerly for the experiments or
proofs sake, whereby we may be made certain of the augmentation
thereof (forasmuch as the Lixivium doth by this means hold in it
more Nitre) and that we may be forced to acknowledge its
augmentation even in that way. Then after this is done, you may use
the weaker Lixivium instead of water, to fill up the first measure, and
so the Lixivium will be the easier, and more augmented; and we may
in a short time have sufficient quantity hereof for to boil. And
although this augmentation of the Lixivium requires a great deal of
labour, yet are all the (pains, &c.) recompensed, because we hereby
get in one Weeks space, and with less expence of Wood, far more
Nitre than by the other common ways: But yet there are requisite
more Vessels for this kind of working, wherein the separated
Lixivium may be kept.
I will also give the Reader a manuduction here, by what way the
boiling of the Lixivium is to be ordered, or contrived: First of all, this
is well to be regarded, that forasmuch as a great boiling requires a
great quantity of earth, and yet there does not at all times, earth of
a like goodness offer it self (especially seeing a Man cannot make
proof of it all) upon which the costs and labours (necessary about it)
may be well (or at the best hand) bestowed: It seems wholly
expedient, not to make such a great Coction (or boiling-trade) but to
do it with only three or four Tubs, that so we may choose only the
best convenient earth, which we may dig in the Cities (or Towns) out
of Houses of long standing, and out of Stables, but yet not too deep:
Such a Lixivium as contains in an hundred weight of it eight pounds
of Nitre, may be increased to eighteen or twenty pounds, if we
proceed according to the aforesaid method. And therefore such Nitre
boilers as inhabit those regions where there is scarcity of Wood may
give hereunto good heed.
Now the Lixivium augmented on this wise, doth not attract all the
nitre out of the earth it self, but there doth yet some always remain
behind: And therefore you need not presently throw it away, but
pour thereupon some simple Waters, which after it hath stood
thereon for some hours, draw off again, and you shall have a weak
Lixivium, which you may try by the proof, and proceed on therewith
in the method of augmenting it, and so you will have a continual
labour.
This likewise is to be observed in an especial manner, let the
Work-house in which this boiling up of your Salt-petre is done, be
very low, and covered with thatch, that so the heat may be the
better kept about the Tubs, and this Operation may be done as well
in the Winter as in the Summer, and that the weak Lixivium may not
at all congeal.
And now, even as Salt-petre is made by boiling, out of the
Lixivium which is made of Earth, even so is it of that Lixivium which
is gotten out of Stones or the Lime (and Dung) Arches (afore-spoken
of;) only there is this difference, That this last way of my contrivance
(with stones &c.) is easier, and yields more Nitre. Such as are
pleased with this kind of work may set about it, nor will they bestow
their Labours in vain; there may be abundance of things, and those
wonderful ones too, effected with Salt-petre, as I have abundantly
demonstrated in my foregoing Writings, and shall in my following
ones too, more clearly demonstrate if God vouchsafe strength and
abilities.
But before I come to the practice it self, and to describe the
benefits of Salt-petre in specie (or in particular) it is wholly
necessary to shew how wonderful, yea how incomparable a subject,
that Salt-petre is. And this thing I have already handled at large in
the Second Part of the Philosophical Furnaces, in the Second Part of
the Pharmacopœia Spagyrica, but especially in my Miraculum Mundi,
and in the Explication, and Continuation, and Defence of the same.

Here the Author runs out into a large digression in his own
vindication, upon the occasion of certain Letters sent him by one I.
H. S. who Stiled himself the Son of Sendivogius; in which Letters he
highly extols the Hermetick learning of the Author, but blames him
for Writing so plainly of great secrets, and exhorts him to be more
sparing and obscure for the future. Withal offering his service (and
begging the Authors leave) to defend his Person and Writings
against Farnner and others. The Author not taking his advice nor yet
accepting of his service (suspecting him to be a self designer) this I.
H. S. afterwards published a Book entituled Lucerna Salis
Philosophorum. In which he offers to teach the making of the
Philosophers-stone at a price or reward; and reproacheth Glauber
whom he before had so highly magnified in several Letters, advising
People to avoid his writings as Sophistical. In this Treatise he
mentions a Prediction or, Prophecy of three Monarchs that were to
appear in the World: The first of Paracelsus, concerning Elias the
Artist. Secondly, That of Cosmopolita of the coming of the Northern
Monarch. Thirdly, That of Jacob Behmen, That a Lily shall bring forth
Flowers from the North. He intimates that himself is the Elias of Arts.
Secondly, That some Northern Monarch shall do mighty things in the
World: And Thirdly, that the Writings of Jacob Behmen should be
again Printed a new. After the Author hath shewed the ill dealing of
this I. H. S. with him, and vindicated himself, then he proceeds
briefly to Comment upon these three Predictions or Prophecies.

By what hath been said, may the Candid and well-minded Reader
judge what judgment is to be had of this Monarch of Arts I. H. S.
Every one that reads them will find whether or no such a Monarchy
is to be expected from such a ones Writings. But now that I my self
may likewise here produce my opinion, concerning Paracelsus his
meaning where he writeth, I say that the most eminent Secrets will
not be known afore Elias the Artist shall come and teach them: (But
I pray) what hath the holy Man Elias to do with Arts? verily no thing
at all. Paracelsus minded or pointed at some other thing, he well
knew, that no body comes unto such knowledge, unless by
Revelation from God, by godly Prayers, and by searching: This is the
true Elias which Paracelsus speaketh of, if (viz.) the word Elias be
read backwards, and E changed into A: For then ’tis the same with
Salia (that is, Salts) such as these (viz. salts) are known unto, to
them is Elias a master or teacher. And where the said Paracelsus
speaketh of Salts he adds Alchimy finds it (to be) in Nitre: Hereby
shewing and pointing at Salia, Salts, which word being read
backward is Elias? And this is my opinion as touching the coming of
Elias the Artist, and I do yet (again) say, that to him to whom Salts
are known, hath Elias appeared. And let this be sufficient to have
spoken of the first Monarchy of I. H. S. and what is to be judged
thereof.

Now follows the Second Monarchy.

A s for the second Monarchy, he alledgeth the Prophecy of

Paracelsus, which runs thus: A Lion shall come from the North,
and become the Monarch of the World: Which Prediction is not at all
to be understood according to the Letter. What has Paracelsus to do
with the Northern Lion? What business has he with the Monarch of
the World. Some there are that endeavour to attribute that Prophecy
to one or other of the Northern Kings, but yet that was not in the
least Paracelsus’s meaning, he drove at a far other-guess business,
and by that Lion he meant Salt-nitre, which is wont to be brought
unto us by the Northern Winds, Rain and Snow, and that several
times yearly as is well known unto all; hereupon many amongst the
Philosophers, and some of them the latter Philosophers, have filled
great Vessels with the Rain and Snow that comes out of the North,
and aimed at the preparation of a Tincture thereout of, but they
found nothing else but Salt-petre, which to get, I have shown a
much shorter way.
Paracelsus, Basilius, and others have Written many things of the
green and red Lion, all which are to be understood of Salt-nitre,
which may most easily be transmuted into the green or red Lion,
concerning which thing I my self have made mention in many
places.
But some or other may reply, How can it be said that the Lion
shall be expected out of the North, if Paracelsus did by it understand
or mean Salt-petre, for that cannot be said to be expected (or
waited for) which hath always been? Surely the approach of this
Northern Lion is not to be supposed or thought to be as to the
outside aspect and known use, but only according to the internal
virtue, & the Treasure therein hidden; concerning which, the
Philosophers have written many things enigmatically, and kept up all
things most secretly. Verily he to whom the inside of Salt-petre is
known will be able to report wonderful things, for ’tis that only that
is the true Monarch, and is able to institute a good governance for
those that possess and know it. This Monarch will not be to any one
a stirrer up to kill others, and to take from others their Goods and
Kingdoms, and to disquiet the whole World, as we see other
Monarchs do, but he will bring Peace and Concord, and will
perswade the Soldiers to stay at home and to get their food by the
labour of their hands, and not to shed the blood of the innocent; he
will injoin the greedy Usurers to be beneficial to the poor & to put an
end to their immoderate usury; he will shew to the Divines, that all
their contentions are vain, and that they cause nothing but
inquietude, dissention and discord amongst Men, and will require at
their hands to Preach concerning friendship to, and love of ones
Neighbour, which under this unprofitable contending is wholly lost,
and to banish away all hatred; and contrary-wise to strive after
patience and Christian humility. These kind of Doctrines and
governance the inward or inside knowledge of the Northern Lion will
bring with him, and not any War or shedding of Blood. But afore the
said Lion is tamed and made gentle, he is very ravenous, and the
venomous Basilisk, and devouring Dragon, preying both upon Men
and Beasts, demolishing Cities and Castles, and destroying Goods
and Men together. Thus have I in brief expounded my opinion of the
coming of the Lion from the North, let everyone believe it as he
listeth. And thus much shall suffice for the Second Monarchy, and
how it is to be understood.

Now follows the third Monarchical Prophecy.

A s for what concerns the third Prophecy which I.H.S. doth also
make mention of, (& will have it) to concern a certain Writer,
whose name is Jacob Behmen, who exercised the Shooe-makers
Craft, and published many Theological and also Chymical things,
which John Beth doth again Print: As far as I know by his writings,
he was an honest Man, but I do not know what he understood in
Alchimy; but however this is evident, that he never exercised or
practised Chymical Operations, and that his Chymical writings are
most difficult to be understood, but his Theological writings are read
by many. My opinion concerning the business is this, that this same
I. H. S. was minded to quarrel with me, that so there being a
brawling bred between us he might make his Books the more
saleable. I have therefore thus plainly answered him, but if he
proceed on in contrarying and opposing me, I shall be constrained
Nolens Volens to meet with him another kind of way, for I am even
wearied and glutted with contention. If he will needs brawl and scold
let him do it with those that have no work to do, such as he himself
& his associates are, who have no Family to rule and look after, I can
for my own part bestow my time better than in those contentions,
which bring no profit, but only to the Bookseller, whose Books before
they are known sell well.
But to conclude, I will in a few words open the ill affected mind of
J. H. S. to the Candid Reader. When I had lookt into his Treatise, and
perceived that he had ranked me amongst the Sophisters, I showed
to some of my faithful Friends, the Letters which he had written unto
me, that so I might hear their Judgment concerning them; verily,
there was not one amongst them all, but wondered at the wicked
mind and falseness of this Man: Yea, one of them did afterwards
inform him by his Letters, what way I had purposed to take, viz.
again to wipe off that undeserved Title he had put upon me, and to
defend my self against such Monstrous Impiety; To which he
received from the said J. H. S. an Answer, which he likewise shewed
me, wherein (’mongst other things) he pretends, that the cause of
his hatred [against me] was, because I had in some places written
so very clearly of the Universal Medicine: Yea, and he farther adds,
that it is no such great despising one, or Contempt to call one a
Sophister; for Geber was accounted for a Sophister, and yet was he
a King. And that if I wrote against him, he would do the same
against me, and endamage not only me, but my Children too; which
Epistle is yet kept safe. Now let any Honest Man consider whether
this be a Human, or Diabolical action.
Some, when they heard this, perswaded me to pass over all in
silence, and that there would come of it such another brawling
business as was with Farnner, whose Exhortation I yielded to, that I
would not so much as once answer him, how great Lies soever he
told, but rather purposed by referring all till the next Spring, to get
me Friends by the benefit of my very eminent Inventions (God
willing) which should not only intercede, or stand up for me, but also
for my Children too, after my Decease: I doubt not, but that there
maybe some principal persons found, which are capable of
overturning such Inhuman Perverseness.
These few things was I constrained to add (in a Parenthesis) for
the defence of my Writings, thereby to paint out the deceitfulness of
Men, and to discover what is to be opinionated concerning such
turn-coated Foxes: The which I entreat the Reader not to take in evil
part, but to accept of the Secrets laid open in this Treatise, as a
Reward for his pains in reading this Apology.

Now follows the Most Potent Lion, and

Monarch of the North; to whom none in the
World may be compared, nor did ever any
excel him in Glory and Power, or shall be like
unto him.

B ut before I begin to write any thing of that Omnipotent Monarch,

I have thought it profitable to add here in this place, for the
better knowledge of the same, Paracelsus his Prophesie, as I met
with it, whereby any one that is skill’d in nature, may sufficiently
see, that Paracelsus did not mean a King, but the great Philosophical
Mistery, and would point that out unto us: His Words therefore are
as follows.

The Prophesie of Dr. Philip Theophrastus Paracelsus

of the Northern Lion.

T hey will not leave me in my Sepulchre, but will hale me out

thence, and lay me down towards the East: And I do foretell
unto you, that there are three great Treasures hidden.
1. The First is at Weyda, at the Alps of Julia.
2. The Second is between Suevia, and Bavaria: The place I do not
poine at, because of avoiding the being the original of many evils,
and because of the shedding of Bloud.
3. The Third is between Spain and France.
He now that shall find these, will be carried in Triumph, and be
admired by all: Likewise between Suevia (or Scawben) and Bavaria,
there are Books which contain no mean and common Artifices, that
will offer themselves together with precious Stones and a Carbuncle.
I will here likewise declare the Age of such as shall find them.
The First will be 31 years old.
The Second 50 years old.
The Third 28 years old.
And these shall be found not long after the exit (or ruine) of the
Austrian Empire, and it shall happen, that in this very same time, a
Yellow Lion shall come out of the North, which shall be Persecutor of
the Eagle, and at length its Conquerour: He shall subject under this
Empire all Europe, and a part of Asia and Affrica, and shall profess
the good and Christian Religion, and shall have many Followers
thereof. It shall first of all be a most troublesom work for him to
chase away the Claws of the Eagle out of the Empire; but afore this
comes to pass, there will arise extreamly great Dissentions, and
various Grudges amongst all Men in all Countries; the Inferior will
rise against the Superior, so that there will be a great tumult, but yet
notwithstanding the Members shall suffer the punishments of their
wickedness, and the head abide safe.
Nor shall here be an end, but there shall be kindled a great fire,
which shall turn all into ashes, but the Omnipotent God will be at
hand to help his own people, for there shall yet remain a small
sparkle of Piety, which will take rooting, and encrease by little and
little, and strike a terrour into the plundering Robbers, and make
that alive, which seems to be dead. The Enemies and Persecutors of
Christ, will call themselves powerful, and every where bring in great
Devastations, insomuch that there will seem to be an end of our
Actions.
Now whilst the Enemy is placed in the very topmost pitch of
fortune, the most Just God, will (by the help of a small company)
destroy, and utterly root out the Northern Lion, accompanying him,
together with all his Clerks; yet abundance shall be Converted, and
believe on his Omnipotence, and in the most Holy Name of God.
 When therefore this Lion hath gotten the Eagles Scepter, every
body will reverence, and run after his Majesty: He shall be powerful
in Deeds and Counsels, and the Subjects that now refuse him, shall
receive him with the greatest joy, and acknowledg him their
Superior.
Then must the aforesaid Treasure ’twixt Suevia and Bavaria be
found, which is equivalent to the Riches of twelve Kingdoms, where
also lies hid, a Carbuncle, as big as an Egg, richer than any price.
The other Treasure that lies between Spain and France, is indeed
great and potent, but yet it gives place to the former, it shall be
manifested at the entrance of the Lion that comes from the North,
and, which shall take the Eagle, and then at length shall men
consider well what I Theophrastus have been.
Now when the praised Northern Lion hath finished his Course, and
hath broken the edge of the Eagles Claws, then shall Peace and
Concord every where speedily and vehemently fly thereunto, but yet
he will send afore, some signs and tokens by which it shall appear
unto us, that the Messengers sent forth shall declare the coming of
the Lord. There is yet one only thing that I Theophrastus do beg at
your hands, that ye do not any of you impute unto me the things
which I now lay open; forasmuch as I cannot be against the Will of
God, which I must put in execution in the Nature of things.
These are those Secrets of Secrets that I was willing to open unto
you. This Treasure far exceeds other Treasures; my Arts are hidden
in that place betwixt Suevia and Bavaria, and they are these, viz.
The true Transmutation of Metals of a short way: The Universal,
more than perfect: The so much talk’d of Aurum Potabile, and
Philosophers stone: But he that by the guidance of God has an
entrance opened to the finding of them, shall there find (besides
other stones) a precious Carbuncle, which lies hidden in a little Box
cunningly made by Men, and covered over with Gems; the Key of
the little Box is in a Golden Coffin, the Golden is put in a Silver one;
the Silver one in a Tin one; and it lies in such a place as God hath
chosen, or appointed.
 The Omnipotent God will bestow upon him that finds them his
Divine Benediction in all his Affairs, and will give him power to
oppress all evil, and to draw out good; whereby things necessary
may likewise be obtained from God who is able again to reduce the
world he made of nothing, into a nothing: Let the Son and Holy
Spirit be also with us, the Blessed Trinity, for ever and ever. Amen.

First of all, Paracelsus saith in this his Prophesie, that Men shall
draw him out of his Grave, and place him towards the East; who is
so simple as to think that this is to be understood according to the
Letter? What Profit and Honour would thence arise to Paracelsus, if
his Bones were digg’d forth, and translated into another place?
Whereas if he were even now living, he could not desire a better and
more excellent Tomb, than that he lies in. Whilst he was living, he
was not so proud; he very well knew that the Honours of this World
are fading and vain. Nor did he ever require, that any Epitaph should
be erected to his Honour: Although (when his Friends had taken
care to lay him in a decent place.) The Magistrate commanded a
very notable Epitaph to be engraven on his Tomb-stone for a
Testimonial of his Deeds, the which Epitaph will bring him Praise
enough while the World lasts. The said Epitaph runs thus.

The Epitaph of Theophrastus Paracelsus; which is to be seen

Engraved on a Stone at Saltzburg, in the Hospital of St.
Sebastian, erected against the Wall of the Church.

H ere lies Buried Philippus Theophrastus,

an Eminent Doctor of Physick: Who by
a Wonderful Art, took away those Dire
Maladies, the Leprosie, Gout, Dropsie, and
other the Incurable Diseases of the Body;
and Honourably Distributed, and gave his
 Goods unto the Poor. He Died the 24th. Day
of September, Anno 1541.
How could he be possibly more praised after his Death, than I see
to be done by this Epitaph. But yet I would not have you think that I
desire you to account of my Opinion as if it were Gospel. It pleased
me here to put it for this end, to shew, what my thoughts are, as
concerning this thing, every one may believe as listeth him, but as
for my part I will in no case believe, that the Prediction is to be
explained according to the Words or Letter: But whereas it is said,
that he shall be taken out of his Sepulchre, and put in another
towards the East, I do thus interpret it: That if any shall understand
his Writings, they shall thencefrom perceive what, and how great a
one he was, and so will make his Cause their own, and will defend
his Writings against Inimicitious Zoilists (or Carpers) and Ignorants,
who as well since his Death, as whilst he was alive, entreated him
very inhumanly, and as it were, oppressed him with Lies, and
Infamous Libels, and so do they take him as it were out of his
obscure Tomb, and place him towards the East, by which it may
appear to every one what an incomparable Man he was; to the
performance of which, I will not refuse to lend my poor help, though
small, (God permitting.)
He doth afterwards add, that there are three great Treasures
hidden, which whoever shall find, shall triumph very nobly; the
places which Paracelsus points at, and where those Treasures are
hidden, are, where the Metals are digged; and indeed such places
they are, as in which there lies hidden the highest Tincture, and
which otherwise is not to be found neither in Gold, nor Silver, nor in
all the other Metals, or Minerals.
I do think that Paracelsus knew these Minerals, and made a
Tincture of them, and thereupon was willing thus obscurely to
describe such Treasures.
He that shall find, that is dig it forth, and shall know the way of
preparing a Tincture thencefrom shall doubtlesly be magnified,