'T is corrected by a large-mouth'd Cupping-glass outwardly applied upon the depressed Cartilage and being there fixt let it remain till breathing is hindred then suddenly remove and the Cartilage oftentimes at the first time returning again into its natural place which if it appears not to do the Chirurgeon must repeat this Operation once or twice then having embrocated the Part with Oyl of Roses and Myrtles apply this Plaister to the Part which must remain there several days Take Bistort-Roots Cypress-Nuts of each a dram Mastick Frankincense of each half a dram Balaustians a scruple Oyl of Nutmegs Exprest one dram and an half Naval-Pitch and Turpentine of each enough to make it into a Plaister CHAP. V. Of Ligaments A Ligament is a Similar Spermatick dry part adhering firmly to the Bones tying the parts of the Body mutually together Difference Some are Broad and Membranous some Round and Nervous 'T is here to be observed that the Names Membranous and Nervous are much used both by Writers and Practitioners and hath deceived many of them for 't is requisite to know that here it hath regard only to their external form not their internal essence for the Ligaments both the Membranous and the Nervous are void of Sense which they would not be if they were composed of their true substance of Nerve or Membrane There is no Ligament hollow if you except the slender Ligaments of the Womb and are all destitute likewise of Sense of Motion as from themselves Use is to connect the parts of the Body especially the Bones and preserveth them from continual Luxation Chirurgical Considerations 1. Ligaments hurt by reason of their want of sense seldom draw other parts into consent and by the use of drying Medicines are easily cured I cannot but again in this place taught by Experience commend the Restaurative Powder of which this is the Description Take Roots of Comfrey the greater Aloes Succotrine Calcis vivae of each two ounces Mastick Mirrhe Mummy of each two drams Precipitate two ounces Make it into a Powder Here diligently at the first time is the weak heat of the Ligaments to be considered seeing it may give occasion to a copious collection of Humors and other grievous Symptoms 2. The Ligaments also are not seldom Relaxt Yea although the Ignorant do contradict sometimes they are so much extended that they may give way to a Luxation which the Sciatick pain hath more than once given us example of in such a case external Bleeding and Purging profit much outwardly the Application of corroborating and discussing Topicks The following Plaister is excellent Take Stiptick Plaister of Crollius an ounce Oyl of Earth of Tiles of each a dram Make it into a Plaister to be spread upon Leather CHAP. VI. Of Membranes A Membrane is a Similar Spermatick Part broad soft dilatable white investing the Parts and carrying sense to them Difference Some are very thin others thick some fleshy but for the most part not The Parts which invest are properly call'd Membranes those which contain the Humors Tunicles and those which cover the Brain Meninges It is endued with sense from itself for all Membranes are sensible yea the Nerves themselves owe their sense to the Membranous substance of them Membranes therefore only are the true Organs of feeling they serving the Animal Spirits to this purpose Use is 1. To invest the Parts of the Body 2. To defend it from Injuries 3. To keep them united 4. To strengthen them 5. To give them sense 6. To close the Mouth of the Vessels that the Nutritious Blood be not carried too suddenly into the Part or out of it into the Vein it self 7. To separate the Parts Chirurgical Considerations The Membranes being so very sensible they cannot bear sharp Medicines they are not endowed with great quantity of Blood whence when they suffer a solution of continuity they are not easily united again But I have observed oft entimes that by the Muscles and the assistance of the Quittour they are joyned together as in the Bladder it self whose Wounds and Ulcers otherwise are esteemed incurable CHAP. VII Of Fibres A Fibre is a Similar Spermatick Part dispersed through the Skin Flesh and Membranes to make them the stronger and being naturally distended to contract again into the same manner Differences are right oblique and transverse and some round the right attract the oblique thrust forth transverse retain round constrain but this they do not so by their own singular virtue as by the common virtue of the Member which they serve and from whom they have their sense and nourishment for of themselves they are senseless Use is to strengthen the Membranes Skin and Muscles and when dilated to reduce them into their natural state Whether the Blood it self hath Fibres as many have delivered and as it seems very probable to us shall be explained in another place Chirurgical Consideration These offer nothing worthy consideration except that when they are wounded the consolidation of the Flesh and Skin is the longer and there is a greater stiffness of the Muscles about the place and makes them difficulter to contract and extend The Ductus of the Fibres is diligently to be observed by them which are to make any curious Incision CHAP. VIII Of Veins A Vein is a Similar Spermatick Membranous long hollow Part every where joined by Anastomoses to the Arteries receiving the Blood wanting further Concoction from them and carrying it to the Heart and Liver Difference Veins of a four-fold condition are found in the Body 1. Vena Cava 2. Vena Porta 3. Vena Pulmonalis 4. Vena Lacteae Of the last of which a more convenient occasion will be offered to treat of in the following The Venae Cava and Porta take their beginning from the Liver There are those which would have them come from the heart from a weak Argument taken from unborn Embrio's But where I find many Branches inserted in the Liver few or none in the Heart yea I have observed that it hath not entred into the Heart it self but only to be joined to its right Auricle I rather embrace the old Opinion willingly granting those honours to the Liver that I think belongs to it That the Roots of the Vena Cava and Porta were united by mutual Inosculations the old Anatomists perswaded themselves but the curious Inquisition of the Moderns hath both found out and clearly demonstrated that they mutually touch one another but not so united that the Blood can pass out of one into the other for the extremities of the foresaid Vessels by means of the Parenchyma of the Liver do so mutually consent that Milk or any liquid thing cast into the Vena Porta with a Syringe finds an easie passage into the Vena Cava without either an injury of the Veins or the Parenchyma Concerning which read Glisson Anatom of the Liver pag. 272. Veins have only one Tunicle with many Valves within especially in the external Joints They are nourished
with Blood from the little Arteries not that contained within themselves They are endowed with feeling both from themselves and sometimes from the Nerves Use is to receive the Blood not sufficiently elaborated from the Arteries and return it to the Heart and Liver there to be more perfectly concocted For the better Methods sake in the following we must be forced to describe all Veins here particularly and divide them into their Branches Vena Cava taking its beginning in the Liver as is before said is separated into the ascending Trunk and descending The Ascending which is the greater perforates the Diaphragm and is divided into four Branches of these 1. Phrenica which disperseth it self through the Diaphragma and Pericardium 2. Coronaria appropriated to the Basis of the Heart proceeds from the Trunk it self after it hath penetrated the Pericardium and inwardly united it self by a large fleshy Orifice to the right Auricle of the Heart 3. Azygos or sine pari coming from the right side of the same Trunk when ascending it hath passed the upper part of the Pericardium affording chief Branches to the eight lower Ribs then about the fleshy appendices of the Diaphragm it enters the Cavity of the lower Belly where on the left side 't is inserted into the Emulgent Vein on the right into the Trunk of the Cava 4. Subclavia from whom comes forth several Branches which go both upward and downward The Superiors are 1. Muscula Superior 2. Jugularis externa interna that on both sides sometimes single sometimes double goes to the Neck Head and Face this to the thick Meninx of the Brain to whose third Sinus its greater Branch is united The Inferiors are 1. Intercostalis serving the four upper Ribs and their Intercostal Muscles 2. Mammaria which is carried to the Breasts 3. Mediastina which goes to the Mediastine and Thyme 4. Cervicalis which goes to the Neck 5. Muscula inferior which goes to the Muscles of the Neck 6 7. Thoracica inferior and superior which goes to the Muscles of the Breast The Subclavials being come out of the Breast are called Axillares then go to the Arms where they are divided into 3 great branches which are 1. Cephalica in the hand between the little Finger and its next 't is named Salvatella Its Branches are variously mixt with the Branches of the Median 2. Basilica or Liver-Vein 3. Mediana which proceeds with other branches from the Basilica The descending Trunk which is the lesser and is undivided till it comes to the fourth Vertebra of the Loins then it communicates 1. Adipsosa to the Membranes of the Kidneys 2. Emulgens to the Kidneys themselves 3. Spermatica to the Testicles 4. Lumbares two three or four to the Loins and to their Vertebra's Nearer to the Os Sacrum it is separated into two Branches called Illiaci Before they go to the Feet the Trunk it self presents 1. Muscula Superior which goes to the Muscles of the Loins and Peritonaeum 2. Sacra sometimes single sometimes double to the Os sacrum 3. Muscula Media to the Buttocks 4. Hypogastria to the Bladder and its Neck to the Sphincter Ani to the Penis and to the neck of the Womb. 5. Epigastrica to the Muscles of the Abdomen and to the Peritonaeum 6. Pudenda to the privy Parts 7. Muscula Inferior to the joint of the Hips The Iliack Branches as soon as they have left the Cavity of the Belly are called Crurales From these proceed 1. Ischiatica minor which goes to the Skin and Muscles of the Hip. 2. Ischiatica major to the Hip then to all the Toes 3. Proplitea to the Ham. 4. Suralis to the Muscles of the Calf of the Leg. 5. Saphena To the Knee Ankle and to the upper part of the Foot and to the great Toe The Vena Cava where it comes out of the Heart receives three Valves called Tricuspidales looking internally for this purpose that the Blood may freely enter into the Heart but to hinder its return The Use of the Vena Cava is to receive the cruder Blood from the Arteries and remit it to the Heart Vena Porta much lesser and looser than the Vena Cava ariseth from the Umbilical Vein and with many Roots is inserted into the Liver without the Liver it is divided into Trunk and Branches all which are distributed into several Parts contain'd in the lower Belly From the Trunk proceeds 1. Gastroepiplois which goes to the Caul and Stomach 2. Intestinalis to the intestine Duodenum 3. Cysticae Gemellae to the Gall. 4. Gastrica minor to the left side of the Stomach Then this Trunk is divided into two great branches the Splenick and Mesenterick Ramus Splenicus sometimes joyning to the Sweet-bread sometimes passing through it divides into four little Branches as soon as it hath left it which are these 1. Vena Gastrica major which goes to the Spleen communicating from thence three or four small Veins to the Stomach These being blown up in living and dead Bodies manifestly declare nothing at all can enter into the Cavity of the Stomach so by consequence no Humor coming from the Spleen as long since Learned Men have imagined taught and writ seeing they terminate in the Coats of the Stomach and open not into the Cavity it self 2. Epiploica dextra 3. Coronaria stomachi 4. Epiploica sinistra Mesenterious ramus is also divided into four others of these the 1. Retains its old name and is distributed with fourteen or more Branches through the Mesentery 2. Vena Haemorrhoidalis and goes to the Spleen the Womb and the right Intestine 3. Vena Coecalis to the blind Intestine 4. Ramus Mesocolicus and goes to the Intestine call'd Colon. The Use of the Vena Porta is to take the Blood not sufficiently elaborated from the Arteries and carry it to the Liver for the perfecter concoction and for the separation of the Choler Venis pulmonalis which the Ancients corruptly call'd Arteria venosa seeing that it hath but only one Tunicle beats not of it self nor returns the Blood coming out of the left Ventricle of the Heart with a wide Orifice goes to the Lungs to receive the more imperfect Blood from the Pulmoniack Artery and carries it to the Heart About its egress from the Heart it hath two Miter-like Valves hindring the regress of the Blood to the Lungs It s Use is to carry the Blood received from the Pulmoniack Artery into the left Ventricle of the Heart Chirurgical Considerations 1. We have in another place treated of the Wounds of Veins we shall only add that if the Bandage by which you stay the bleednig be bound too hard it will easily induce a Gangrene 2. We have admitted only four general Indications of Bleeding to wit for the Refrigeration Imminution Revulsion and Derivation of the Blood but special Diseases requiring one Vein to be chosen before the other which are these following in a Delirium and great pain of the Head the Vein of the Forehead or
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
be purified and in some manner concocted in which its operation that the Blood may be rendred more perfect 't is carried to the Heart especially when by reason of its continual and necessary Pulsation the Blood cannot remain long in the Heart and for this reason I judge the whole Blood must needs be moved about with a circular motion The Blood made in the Liver as is declared but now in the eighth Chapter enters the Vena Cava and from thence into the Heart And thus the Royal Liver at the same time when Kings are taken away may yet use a limited power and may remain with honour in its own Kingdom But what shall we do with the Melancholick Spleen which makes many laugh It hath many accusers and not fewer excusers 1. It was never accounted by Hippocrates the Learned Greek a receptacle of the Excrements or is it any where to be found in him that he call'd the Spleen another Liver 2. The great number of Veins and Arteries and so by consequence the abundance of Vital Spirits do not permit the Excrements to be collected here 3. It hath not any convenient Cavity wherein the Melancholy Faeculent Juice can be received 4. And if you imagine that there is no necessity here of a Cavity its Parenchyma is too thick and not porous enough therefore unfit for the reception of so thick a Humor which also is never naturally found in it 5. It is too great a Bowel to perform so vile an Office 6. In dead men where Melancholiness hath been the cause of their death upon the examination of the Internal parts there none of them less recede from its natural state than the Spleen the Heart only excepted whom the Vital Spirits do so greatly defend that it is less affected than other parts which seldom happen to the Intestines Kidneys Gall and Bladder What is therefore its Use It elaborates the Acid Humor which is very necessary but not Excrementitious and mingles it as a Ferment with the Blood by which it becomes more perfect and fitter for Circulation In my judgment the Salt of the Blood affords matter to this Humor which it greatly requires that it may not be corrupted but this Salt which proceeds from the Meat and drink is never so pure but that it hath need to be brought to a more perfect state in our Body But this is my Opinion The Supremest of the Kings is the Heart to this are two others subject the Liver and Spleen I beseech you give me leave to make use of this Similitude in favour of the Ancients the Heart makes the Blood the Liver repeats the Concoction and separates the Choler the Spleen from its own Salt by an innate vigor produceth an Acid Humor which as a Ferment by the Venal Splenic Branch it mixeth with the Blood to render it the perfecter and the more fit for Circulation if any Excrementitious part should be there separated it is all by the Caeliack Artery and the Haemorrhodal Vessels sent to the Guts If it appears to any one to be a contradictory that by Salt a Humor should be made Acid we advise that person to taste some Spirit of Salt About sixteen years since the great Anatomist Franciscus Sylvius put forth some particular things concerning the use of the Spleen he was of opinion that the Blood was not made in the Ventricles of the Heart neither that it was carried from the Heart by the Arteries to all the parts of the Body for nourishment-sake alone but that it likewise underwent some other Mutation in the rest of the Viscera's particularly that the Spleen further concocts the Arterial Blood and brings it to a higher degree yea that it more then perfects it so that the Blood in a manner in this place assumes the nature of Ferment by whose means in a short time a great quantity of Mass may become acid in the same manner he affirms that the Blood more and more concocted in the Spleen there receives strength by which it restores the returned and weakned Blood and preparing together with it the Chile that it may the sooner be turned into Blood The Reasons which he produceth for it are these 1. The Spleen receives a much greater quantity of Blood from the Heart than is necessary for its nourishment 2. That it can be returned back again to the Heart by no other way than by the Branches of the Vena Cava and Porta for what hath hitherto been delivered of the short Vessel are to be accounted but ridiculous Fictions as may most evidently be made appear in dissected Bodies 3. Seeing this Blood is continually mix'd with the returned Blood and Chile in its passage to the Heart it ought not to be an Excrement for so the Noble Parts and the whole Body would not be purged but the more injured 4. Chymistry hath long since taught us that such mutations happen daily in Nature The Remaining Part of the Blood unuseful to the Body therefore Excrementious is thrown out through the Guts Ureters and Parts of the Skin c. concerning which it is not necessary to add more here but now we are forced to describe those new watry passages which the studious in Anatomy have long and diligently inquired into The watery passages the Lymphatick Vessels have their rise both from the Liver and from the Joints and receive the liquid Juice from the Arteries with which they correspond Those which come from the Liver embrace the Vena Porta and so pass to the Misaraick Glandules of the Chile as do those also that ascend from the Feet thence they discharge their Water into the great Lacteal Vein which as we have already declared carries the Chile to the Heart Those which proceed from the Arm both lie above and under the Veins until they come to the Subclavial Vein which they enter about the same place where the great Lacteal Vein doth being furnished with a particular Valve just at their entrance and so altogether they carry the Water to the Heart This Water is Sweet not being as Urine is Salt These Vessels consist of a very thin Tunicle whence they are soon broke Use of them in my opinion is to take the superfluous Water from the Arteries and carry it to the Glandules of the Chile and Lacteal Vein by which the Chile being made more Liquid may the more conveniently be conveyed through the narrower passages thence to return the same to the Arterial Blood making it fitting to serve to the nutrition of the moist parts and to the cooling and moistening of the hot But that it may the more clearly appear in what manner I conceive how what hath already been said is perform'd in our Body observe that the Meat is converted in the Stomach into Chile to which part of the Drink is mingled this mixture is carried through the Glandules of the Chile and the great Lacteal Vein into the Heart where it is changed into Blood which is by means of
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
the Os Petrosum to be removed a great distance from the Os Parietale so that in the place where the Bones did recede from each other was a motion observed beginning at the Os Petrosum and ending in the Os Parietale there where the Toothy unition in the Os Jugale in the inward part which is covered with a Callus as it ought to be in every Articulation to hinder bruising is observed And this being so it may be concluded that the Pericranium if it had invested the Bone under the temporal Muscles without all doubt it would have passed it self between the Os Petrosum whence from its moving and rubbing in eating speaking or any other Motion would haue always felt intollerable pain Thus have you Sir what I thought hoping to proceed further the reason to the Question propounded c. Farewel This Opinion is indeed judicious and very probable for in dead Mens Skuls the upper Bone of the Temple is movable as is the lower and in the Suture of the Zygomatick Bone is a Cartilage found which is necessary in every Joynt for I confess the motion is little but greater would not be required than what sufficeth to afford passage to the thick Humors either from External or from Internal Causes collected sometimes in the Cavity of the Ear by the which the Brain and Ears may be freed from many and various inconveniences I hope time and diligence will give us greater light in this thing Each Jaw is armed with necessary Weapons which are called Teeth In Men for the most part thirty two in Women twenty eight Four are called Fore teeth or Cutters Two Dog or Eye-Teeth All the rest are called Jaw-Teeth or Grinders After the 20 th 40 th 80 th year oftentimes comes forth with pain two Teeth in the very furthest part of the Jaw which some call the Teeth of Manners or Wisdom others the late Teeth Before we come to the other Muscles of the Head we deem it necessary to describe some parts which are not as yet mentioned that is the Eye Ear Nose Mouth The Eye with the Lids to wit the Membranous coverings before Cartilaginous and Hairy defend from External Injuries hath two Corners or Angles In each corner is a Glandule that which is in the lesser External Corner is great white hard that in the greater External Corner is lesser soft red and covers the Punctum Lachrymale Four Tunicles contain the three Humors One of them which comes from the Pericranium is likewise common to the Lids and is called Conjunctiva or Adnata The other three are proper and are thus reckoned 1. Cornea coming from the Dura Meninx 2. Uvea from the Pia Mater this sometimes dilating it self then again contracting it self constitutes the Pupil shewing the many coloured Oval Circle call'd the Iris. 3. Retina from the Brain it self or rather from the Optick Nerve which proceeding further is changed into the Aranea To these three may be added a fourth Vitrea which is ill omited by many The Humors of the Eyes are 1. The Aqueous 2. The Chrystalline 3. The Vitrecus The second pair of Nerves or the Optick Nerve brings the Spirits for sight the third pair or the Motorious for Motion Branches of the Internal and carotide-Carotide-Artery bring to it the Nutritious Blood and the superfluous is returned by the Internal and External Jugular Veins Fat and Muscles make up the rest of the Eye The Fat serving to the Calefaction Humectation and better motion is here in great quantity every where distributed between the Vessels and the Muscles The Eye-lid hath four Muscles One straight Muscle three orbicular The Eye it self hath six of which four are straight 1. Attollens or proud 2. Deprimens or the humble 3. Adducens or the Drinking or Reading Muscle 4. Abducens or disdainful Muscle Two oblique which are call'd the Lovers Muscles of these 1. Obliquus Externus or Troclearis because it passeth through a Pully 2. Obliquus Internus The outward Ear or the Cartilaginous Auricle is join'd to the Bone of the Temples It hath a very sensible Membrane and behind it also some Glandules to which the Head sends the superfluous humors Vessels it receives from the External and Internal Jugular and Carotide Nerves from the second pare of the Nerves of the Neck as also from the six pare of the Nerves of the Brain Here is but little Fat what little there is is below the Lap it receives four Muscles of which the three former are to it common with other parts the fourth proper to it self 1. Antrorsum ducens which moveth it forward 2. Retrorsum ducens which pulleth it backward 3. Quadratus deorsum trahens pulling it down 4. Tripartitus lifting it up The inward part of the Ear hath four Cavities for sound and for defence and strength as many Bones The Cavities are 1. Meatus Auditorius whose extremity a little and strong Membrane covers which is call'd the Tympanum and Membrane of the Drum 2. Tympanum 3. Labyrnthus 4. Cochlea The little Bones are of the same bigness in Children as in older People which are 1. Malleclus or the Hammer 2. Incus or the Anvil 3. Stapes or the Stirrop 4. Os Orbiculare or the Orbicular Bones The Noble Lewis de Bils the great Anatomist in a particular Treatise shews that the Os Petrosum which hitherto by reason of its great thickness and solidness was a vast hindrance to those that had a desire to view these Bones of the Hearing in their natural situation not to consist of one only Bone but to be made up of four joined together by Harmony which may very easily be separated by 〈…〉 Within are two Muscles the one joined to the Meatus auditorius the other to the Malleclus The Nose covered with a Scarf-skin Skin Muscles and the Periostium hath two Cavities separated by a Cartilaginous Septum each of these again is divided into that which ascends to the Os Ethmoides and into that which descends above the Palat into the further part of the Mouth The sides of it are called Pennae Alae or wings the lower fleshy part is called Columna or the fleshy Pillar In the inside they are invested with a thin Membrane which is very sensible arising from the Dura Mater which is as to the Nose likewise common to the Mouth Palat Tongue Larinx Gullet and to the Stomach it self The Bones of which it is compounded are many and spungy replete with Caruncles that the Snot might not voluntarily distil forth Arteries from the Carotide bring nourishment to it Veins from the Jugular return the Blood that is not perfectly concocted Nerves from the first pare according to our order serve for the smelling as do those from the fifth pare serve to the feeling It hath no Fat Its Bones we have already given you its Muscles are six 1 2. Deprimentes depressing the Nose 3 4. Dilatantes or dilating the Nostrils 5 6. Constringentes or pulling the Nostrils
the Internal Parts is the Peritonaeum comprehending all the others before and behind above and below It is a double Membrane its rise is rather deduced from the membranous quality of the Soul than from the Meninges of the Brain It is joyned to the Diaphragm and to the first and third Vertebra of the Loins It is thicker in Women from the Navel to the Privy Parts and therefore stronger terminating about the Os pubis In Men it is thicker from the Navel to the Diaphragm and after it hath received the Spermatick Vessels as in a Sheath it sends them through the outer Membrane to the Testicles where it constitutes their first Coat Between the foldings of this Peritonaeum lie four Vmbilical Vessels 1. The Vmbilical Vein 2 3. The two Vmbilical Arteries 4. Vrachus coming from the Navel which is nothing else but an indurated knot of the aforesaid Vessels In Infants these Vessels are open in old people altogether closed and turned into Ligaments Yet I could never by any means observe in Abortives of six seven or eight months the Vrachum pervious into the Bladder for neither Probe nor Wind would pass The Umbilical Vein goes to the Liver the Vrachus to the Bladder both the Umbilical Arteries to the Iliack Branches of the great Artery The Omentum or Caul keeping the Stomach and Intestines warm is very fat and double yet it consists of very thin Coats which are perforated with many little holes It takes its rise from the Peritonaeum under which it also lies for the most part extending it self as far as the Gut Colon and sometimes as far as to the Os Pubis The Stomach the Work-house of the Chyle is composed of three Tunicles the outwardmost is common from the Peritonaeum the innermost from the Dura Meninx the middlemost is proper to it self the first is the thickest the middlemost fleshy and the innermost wrinkled It hath Fibres of all sorts inwardly crusted over with spungy flesh It is situated in the middle of the Hypogastrium resting upon the Vertebra's of the Loins its left Orifice is called Os or Stomachus its right Orifice Pylorus The Guts are joyned to the Stomach which convey the Chyle and expel the Excrements they are almost of the same substance with the Stomach and are all divided very well into the thick and thin The thin Guts are 1. The Duodenum in which the Vesica Fellea with the Ductus Coledochus and the new Ductus Pancreaticus are inserted 2. Jejunum in which are more Lacteal Veins than in any of the rest 3. Ileon which is the longest of all The thick Guts are 1. Coecum with its worm-like appendix 2. Colon with two outward Ligaments and one internal Valve 3. Rectum with the two Muscles Ani levatores and with one Sphincter all these Guts are joyned together by the help of the Mesentery and also to the Vertebra's of the Loins The Mesentery consists of a double strong Membrane with many Glandules between each Membrane which are so very small that they can scarce be perceived by the Eye but commonly after a long sickness three excepted they shew themselves and are greater than their natural constitution long white and hard The greatest of them is seated in the midst of the Mesentery which being prest yields Milky juice sometimes thicker otherwhile thinner which is nothing but Chyle as likewise do the other two which for the most part are in the left side under the Emulgent Vein above the Muscle Psoas not far from the Vertebra's of the Loins As these Glandules receive many Lacteal Veins so each of them again produceth a Branch which forthwith being joyned together make the Thoracick Lacteal Vein which ascending as hath already been declared carries the Chyle to the Heart The Pancreas or Sweet-bread lies under the Stomach like a Pillow joyned to the Gut Duodenum into the which the late invented passage from the Author call'd Ductus Wyrsungianus penetrates in this is often Choler found but never Blood The Spleen which perfects the Blood contains an Acid humor which it sends not to the Stomach by the Vasa brevia but to the Liver by the Ramus Splenicus It consists of a rare substance covered with a proper Tunicle not proceeding from the Peritonaeum It is of a darkish red colour It joyns to the bottom of the Stomach by the means of the short vessels and to the Bastard Ribs and left Kidney to the Caul Peritonaeum and to the fleshy part of the Diaphragm by the assistance of Carnous Fibres There is no Bowel abounds with so many Arteries as the Spleen except the Brain The Nerves which it receives from our seventh pair are distributed through its Tunicle rather than through its Parenchyma It is not placed in the fore but back-part of the left side near the left Kedney lying upon the Bastard Ribs and Vertebra's which is to be well observed The Liver the Instrument of Blood Mother of the great Veins is situate in the right Hypocondrium and covers a great part of the Stomach It is divided as it were into two parts by the Umbilical Vein which after-birth serves it for a Ligament It is a great thick and hard Body of a red colour It is fastened to the Diaphragm by two Ligaments from the Peritonaeum and to the Muscles of the Abdomen by the Umbilicial Vein Some few Arteries it receives from Coeliaca and serveral Nerves from the Spinal Marrow and from our seventh pair In the right side of it underneath is inserted the Vesicula Fellis or Gall with the Porus Biliarius the branches of both together with the branches of the Vena Porta are comprehended in a certain common Bladder call'd by Glisson Capsula these branches of the Vesica Fellis Ductus Colydochus or Biliarius being detained in the Liver are dispersed through its whole Parenchyma every where included in the above-named Capsula which is red about the thickness of an Artery taking its Original as it appears from the Peritionaeum The External Branches being joyned perforate the Gut Duodenum taking two little Arteries from the Coeliaca and Veins from the Vena Porta call'd Gemelle together with the Bladder it self The Kidneys which depurate the Blood consist of a peculiar hard flesh invested with a proper Tunicle Outwardly they are encompassed with Fat and with a large loose Coat from the Peritonaeum They lie upon the Muscles of the Loins yet the left is higher than the right within the folding of the Peritonaeum And above the Kidneys are two hollowed Glandules called Renaes succenturiati or Capsulae atribilariae these are furnished with Branches from the Emulgent Veins and Arteries and with Nerves from the Par vagum The Kidney being opened appear the nine Carunculae pupillares through which the Serum distils into the Pelvis to be carried through the Ureters into the Bladder The Ureters or the Urinary passage whilst within the Kidneys themselves is very large but when come from them
is very narrow it is furnished all along with two Coats the innermost is proper the outer common from the Peritonaeum Within the duplicature of the Peritonaeum it descends downward upon the Muscles of the Loins to the Bladder into whose Neck it is inserted then it ascends upwards between the Membranes where it perforates the innermost Coat and through the same hole together with the Ureter of the other side enters the Bladder which is so very little so straightly closed that there needs not here any Valve to hinder the return back again of the Urine Vesicae Vrinaria or Bladder consists likewise of two Membranes the External is thick and fleshy the innermost not It is seated between the Duplicature of the Peritonaeum in the Cavity of the Hypogastrium which is commonly call'd Pelvis In Women it is joined before by its Neck to the Vagina uteri The Neck of the Bladder is very fleshy and by the assistance of the Fibra's like a Sphincter it opens and closeth the Bladder in men it is longer narrower and more crooked in Women shorter wider and straighter The Vessels that bring Blood to the Bladder are the branches of the Hypogastrick Vessels it receives many Nerves from the seventh pare and from the Os Sacrum The Spermatick Vessels yet remain which wonderfully vary according to the diversity of the Sex In Men the Spermatick Veins and Arteries first appear of each side one which serve for the bringing of the Blood to the Testicles for its preparation The right Spermatick Vein comes from the descending Trunk of the Vena Cava the left from the left Emulgent and both the Arteries from the great Artery These four Vessels being very crooked and covered by the Ureters pass to the Testicles but before they come to them near and in the process of the Peritonaeum are united by several inosculations and joining themselves with the Nerves make one Body which is call'd Pampiniforme The Testicle or Stones themselves the Organs of Seed have each a Muscle call'd Cremaster they have two common Tunicles and three proper The common are 1. That wrinkled Purse which is call'd the Scrotum to wit the Skin which is thinner and softer than in other parts 2. Dartos to wit the Carnosa Membrana which hath many Vessels The proper are 1. Elytroides arising from the process of the Peritonaeum 2. Erithroides from the Muscle Cremaster 3. Albuginea from the Spermatick Vessels The substance of the Testicles is white soft thin something like to the Glandules Upon them with a transverse situation lies the Corpus vermiforme which sensibly becoming narrower constitutes the Vas ejaculatorium which is Epididymis or Parastata Vas ejaculatorium is white and hollow like to the Ureters which carries the Seed about the neck of the Bladder into the Vesiculae seminales where it is kept till a convenient time Proceeding a little further before you shall find two great Glandules in which an Oily Liquor is contained to mitigate the acrimony of the Urine these are called Prostatae At last comes the Penis or Yard appointed for the evacuating of the Seed and Urine It s Substance is peculiar to it self the like being not in the whole Body It hath no Scarf-skin and is destitute of Fat even in the most fat Bodies It is covered with a loose Skin which is double and makes the Praeputium and covers the Glans to which it is tied by means of the Froenum or Bridle Under the Skin and fleshy Membrane lie the Vessels above described Near to these are the four Muscles which are the two Erectores and the two Ejaculatores under the Muscles are two Nervous Bodies which make the greatest part of the Yard By their fungousness rendring it either stiff or flacid In the lowest part of the Penis appears The Vrethra or passage for the Urine consisting of two Coats the innermost is very thin and sensible the outermost thick and fleshy In Women the Spermatick parts in this differ from Mens that they are shorter and less and by a wreathing and winding approach the Testicles likewise they communicate several Branches to the Uterine Tubes and to the Womb it self The softer Stones are placed on the sides of the Womb qualified to elaborate the Seed they are covered with only one Coat and that is proper They have no Parastats The Testicles inwardly are full of little Bladders which both contain the Seed and by means of the Tubes conveigh it to the Womb. These Tubes joyn to the Womb of each side and to the Testicles but only of one side These have a Cavity consisting of a double coat which also contains some little Bladders in which many will have the Seed to be further perfected The Womb the receptacle both of the Seed and Child is situate in the middle of the Hypogastrium call'd Pelvis between the straight Gut and the Bladder It hath two strong and thick Coats the first which comes from the Peritonaeum the other is proper and between both many fleshy Fibres It is conveniently divided into the Fundus or Botton the Orifice and the Neck The Fundus the Globous part of the Womb hath four Ligaments the two uppermost are broad and membranous which are joyned to the Os Ilium the two lowermost are red and round and pervious to the Clitoris thence like a Goose-foot destitute altogether of their hollowness they spread themselves upon the forepart of the Thigh The Orisice of the Womb which at one time can very straightly close it self together yet at another is very dilatable hath in its lower part a Tubercle or knotty substance as also many little holes The Cervix or Neck of the Womb appointed to receive the Penis is very much wrinkled within and almost eight inches long To the Dissector comes first in view the Meatus Vrinarius or the passage for the Urine which is short and straight then in this Cavity is the Clitoris seated which is something in softness or hardness resembling to a Mans Yard To this joyns the Hymen perforated in the midst for the passage of the Urine and Courses to which joyn four Caruncles call'd Myrtiformes then follows the Alae Nymphae or wings which defend it and the hairy Lips Chirurgical Considerations 1. The Coats of the Peritonaeum grow very thick in Hydropick persons nay in process of time they acquire a Cartilaginous hardness which is very necessary to be known in a Paracenthesis or opening of the Abdomen there oftentimes suddenly follows a watry swelling in the Cod. After a Paracenthesis made by the formerly described Instrument the reason of it and the passage are true that the Water by little and little sinks down above the process of the Peritonaeum in the space between the Peritonaeum and the right Muscles of the Abdomen 2. Sometimes between the fouldings of the Caul is Wind detained the cause of long continued pain which brings along with it fear also of a future abscess In this case
30 hours or more been troubled with the Spots at length after exceeding great pain accompanied with a Delirium he voided first Blood and after that a purulent matter through his Yard by which means he was restored to his health I conjectured that there was a Carbuncle in the case which seized not on the Membranous part of the Bladder but on the Neck thereof As to the Cure Blood-letting is very prejudicial to those that already have the Plague and dangerous to such that would prevent it The Poison oftentimes lies hid within the Bâ—dy for some dayes weeks or months before â—â— discovers it self by seizing on the conveyances of the Blood Wherefore I would advise you seriously to consider if by opening a Vein you invite it immediately to the Heart whether the diminution of Blood Spirits and Strength which is effected by this means be not the Cause why the Heart is suffocated and deprived of that vigour which it should make use of to repulse the Enemy I confess some Experienced Physitians of good credit have reported that in hot Countries there is no better means for restoring a Patient visited with the Plague unto his health than that of opening a Vein provided it be done cautiously and at the beginning of the Disease but whosoever have attempted it in colder Climates have quickly learnt by experience that it ought to be forborn Purging which is oftentimes very necessary in other gentle Diseases is excluded by the Malignity of this But every one is not quick-sighted enough to discern when it is requisite to be done and when to be forborn Moreover it is evident that in a Malignant Disease the Physick which is administred to a Patient ought to be more mild and gentle than at other times for besides that the Body cannot then bear strong purgations a Dysentery is oftentimes the consequence of them I have when I have been fully perswaded that there was no Malignity in the Disease oftentimes used this or some such like Potion with good success viz. Take Rhubarb a dram and half Senna two drams Cream of Tartar a dram Scorzonera-Roots half an ounce Aniseeds half a dram Boil them in Holy-Thistle-Water and to three ounces of the strained Liquor and Syrup of Succory with Rhubarb six drams Spirit of Salt a little Confection of Alkermes a scrupel Make it into a Potion I never adventured to prescribe any thing Purgative to such as have been taken with the Plague before the fourteenth day at which time the Fever and the other Symptoms of the Disease would be abated There are some who have attempted it while the Carbuncles remain purulent and before the Bubo is perfectly cured But I dare not advise any one to follow that Method whatsoever Remedies they administer at the same time which may be intended specifically against the Plague But if it happen that the Patient for several days be very costive and troubled with a pain at his heart and hopes to be relieved by Purgation It is to be considered that the Venom of the Disease and not the Costiveness is the cause of the pain at the Heart it is therefore most requisite to make use of Sudorificks to corroborate the Heart and not to concern your self for the costiveness of the Body but if you desire to open it a little it is better to make use of a Suppository than a Glyster which is not altogether so safe but hath been prejudicial to many on this occasion and to others it hath done but little good and not at all opposed the Malignity of the Disease But to such as will not take this advise which hath been very confirmed by experience and several good Reasons and will still persist to make use of Glysters it is fit however that they forbear to prescribe Scammony as an Ingredient especially to Women in the time of their Flowers Juleps are in this case very necessary but all persons may not make use of them nor any at all times I am never wont to prescribe them without joyning with them some Sudorificks which will appear hereafter and this I take to be the safest course for if the sick person should make use of such things only as refrigerate while he sweats freely the Sweat would oftentimes strike inward and the Venom would be conveyed to the Heart from whence would follow sudden Death There is no means more requisite than that of Diaphoreticks and Cordials especially those that are acid which produce such effects as are certain and therefore the more laudable for they rectifie the Mass of Blood and free it from the venom which infects it They dissolve the pituitous Matter which is lodged in the Stomach and the Entrails and correct the Choler which in this Disease is the cause of much mischief Nevertheless the several disguises of this Disease and the vanity of the Symptoms which attend it do require that they should be often changed since when the Disease is more gentle those things are not to be used which would do good service in an accute one Medicaments against the Plague Roots of Zedoary Butter-Bur Angelica Ditamny Galangal Vipers-grass Gentian Master-wort Lovage Burnet Orrise Florentine and ours China Sarsaparilla Leaves of Rue Scordium Sage Holy-Thistle Swallow-wort Wormwood Southern-wood Centuary the lesser Valerian Sorrel Fluellin Balm Marjoram Rosemary Thyme Mint Flowers of Borage Bugloss Violets Roses Marrigolds St. John worts Rosemary Indian-Spikenard Jesamy Seeds of Citrons Oranges Rue St. Johns wort Anise Coriander Lovage Fruits Citrons Oranges Walnuts Figs sharp Cherries Pippins Ribes sowre Pomegranates Barberries Spices Musk Ambergreece Civet Benjamin Storax Calamita Cinamon Mace Nutmegs Cardamums Camphire Animals or their parts Flesh of Vipers Mummy Serpents Quails Thrushes Harts-horn Unicorns-horn Bezoar Stone of an Indian Hog Ivory Castor Precious Stones and Earths the Jacinth Granate Emerald Ruby Carbuncle Pearls Coral Bolearmenick Earth of Lemnos and Seal'd Gold Silver Salts Common brought lately from the River Nile which moveth Sweat most powerfully of Scordium of Wormwood Rue Self-heal Holy-Thistle Vitriolated Tartar Bezoarticum Minerale Threacle of Andromacus's Diatesseron Mithridate of Damocratis Diascordium of Fracastorius Confection of Alkermes of Hyacinth Species Liberantis Electuaries of the Egg Rob. of Currans of Barberies Conserves of Balm Mint Rosemary-Flowers Borage Bugloss Marigold-Flowers Troches of the Juice of Barberries of Citrons Out of all which you may make choice of such as you judge most fit for the purpose The Writings of Authors who have treated of this Disease will give you an account of other Compounds out of which you may chuse such as please you best I shall here propound such only as I have found to be most efficacious and which I shall constantly make use of till by experience I shall discover some others whose nature is more excellent and that the use of them may the more plainly appear I shall premise some Medicaments that some years since were prescribed by my self and those Learned Men Dr. Francis Sylvius
Belly-ach that the membranes of the Pudenda were so far stretcht out that the unskilful have taken it for the Matrix it self and do so still For though many Authors have dared to write that the Womb may be cut out without danger of life seems altogether impossible to a skilful Anatomist To cure this Disease lay the Patient on her back with her Knees on high and Legs asunder then take a Wax-Candle of a competent thickness mix therewith some Castoreum or Assa Foetida and with it gently press the Womb inward and having sastened the Candle with a Bandage apply outwardly to the Belly the Emplastrum Barbarum or the following Take the Roots of Cyprus Bistort of each a dram Galls Acacia of each half a dram Cypress-Nuts Date-stones Myrtle-Berries of each one dram Pitch and Colophony as much as sufficeth to make it into a Plaister Then presently enjoyn the Patient to lie still with the Legs cross and to beware of speaking aloud of scolding and of whatever may occasion coughing or sneezing Here great care is to be had that your Wax-Candle be not too thick to the end that by its continual friction it may not cause Fluorem Album whereby the strength of the Body would certainly come to decay Yet because ev'n by the greatest care and circumspection this inconvenience will hardly be altogether or always prevented therefore those do very well and discreetly that long-ways perforat the Candle and thereby give a convenient passage for the humors flowing that way CHAP. IX Of the falling down of the Fundament IF the Gut be sunk down anoint it with Oyl of Rose and Myrtle mixing a little Powder of Galls amongst it and with your Fingers and a small Linnen-Rag put it in If an Inflamation hinder the reducing it then bathe the Anus with these Medicines Take Flowers of Elder Camomile and St. John's-wort of each a handful Red Roses rwo Pugils the tops of Wormwood and Melilot of each half a handful Boil therein Milk and Red Wine and bathe the part Here especially care is to be had that no external cold may come to the fallen-out Anus for then you may sooner than you are aware of be surprized with a Gangreen Wherefore do your utmost to put it in again with speed and in the mean time endeavor with the above prescrib'd Bathing and warm Linnen Rags to preserve its natural heat There is yet another though in appearance ridiculous yet in reality a good way of reducing the Gut With a strong hand strike five or six times the Patient's Buttocks and thereby the Muscles called Ani levatores will presently draw the Anus into its right place again But before the Patient be thus chastized take care that the Gut may first be anointed with Oyl of Roses or of Myrtle CHAP X. Of the second Operation called Diaeresis or the seperation of what was united together HItherto we have joined together again what had been disjoined now it follows that we separate what is united and treat of the second Manual Operation called Diaeresis which teacheth us the manner of Cutting and Burning and that both in the hard and soft parts of the Body In the soft the Cutting is called Incision In the hard it is performed four manner of ways By Terebration or Perforation by Rasion or Scraping by Limation or Filing by Serration or Sawing Burning is done either by an Iron which is the Actual Cautery or by Medicaments called the Potential Cautery as shall be declared particularly hereafter CHAP. XI Of opening a Vein BLeeding one of the greatest Remedies in the Art of Physick is sometimes highly necessary but sometimes so dangerous that it ought not to be used without very urgent Causes Here therefore I think it will be better somewhat to digress for fuller information than to leave the unskilful in their error The Blood is the darling of Nature by whose assistance she performeth all her Operations and which can hardly be drawn from her without dammage yet does Art require that those who meddle with it being neither venturous nor timorous but discreet and couragious and making out of necessity a virtue do sometimes proceed to the opening a Vein yet for no other than these four following causes 1. In a Plethora or super-abundance of blood that by this means Nature may be eased of her too heavy burden and the innate heat preserved from suffocation 2. For Revulsion-sake when the blood and the therein mingled humors by flowing too plentifully to this or that part hinder the Cure Here you are always to chuse a Vein of the opposite side and that sometimes the farthest distant sometimes the nearest 3. For the Derivation or conveyance of the Blood which is already got into the part but is not yet altogether setled there nor extravasated into another place in which case a Vein is to be opened the nearest to the Part. 4. For Refrigeration when the heat of the Blood is so excessive that it cannot be allayed by cooling Medicines or not time enough These limits are too narrow for some who will needs take into those a fifth cause which they make the Corruption of the Blood held by them to be as great an inducement for bleeding as any of the four by us recited to the end say they that Nature being rid of part of what is corrupt may be the better able to correct what remains But I much wish 1. That they could make this discharge without the loss of that strength which is so highly necessary 2. That they would be present when their Patient is to bleed and precisely tell to what degree of corruption his blood is come that so the Chirurgeon may know how much of it he is to take and how often forasmuch as they will not allow that Bleeding is good in all sorts of the Blood 's corruption but in that only which is not gone considerably far 3. That they would declare why they will have cur'd the greater corruption by Purging and the lesser by Bleeding since that they give to the one as well as to the other and that duly the name of Cacho-Chimia Let them shew that things differing only secundum Majus Minus do differ in specie and so require specifically different Remedies Others proceed yet further and shed innocent Blood in all sorts of Fevers without any consideration of spots of the Plague or of Poison it self thus freeing themselves from a great deal of labor and trouble otherwise caus'd to the Physitian from the variety of Fevers But because the nature of all Poyson and Malignant Humors is continually to assault the Heart and suddenly to prostrate the strength of the strongest Persons and since Bleeding doth likewise both not only diminishing strength but also drawing the malignity toward the Heart and driving in again for the oppression of Nature what she had thrown out for her relief I do intreat and warn all the Practisers of our Art That as they love the
when we spoke concerning a Phlegmon Erysipelas Oedema Schirrhus Then Care is to be had of the Blood seeing it affords assistance to the matter and serves to unite the Wound Where it is vitiated it requires purging But if it flow in too great quantity Intercipients Repellents Revellents and Derivation must be us'd If it flow in too small quantity Aliments that nourish are convenient as also Medicines that strengthen and that move Sweat Outwardly gentle Frictions and Embrocations moderately hot Then the Cure is to be perfected by External Medicines which shall be declared in the following Chapter when we speak of the removal of the Symptoms and the Cure of Wounds themselves CHAP. IV. Of the Symptoms of Wounds THe chief Symptoms of Wounds are 1. A Fever whose Cure we commend to the Physitian ' 2. A Flegmon or Inflamation 3. An Erysipelas Of the Cure of both which look in the second and third Chapter of the first Book 4. Hemorage which not only impedes the Cure but also deprives of strength and life it self therefore great Care is to be taken that it be stopped as soon as possible which in the greater Vessels especially the Arteries is very hard to do therefore those Wounds are for the most part Mortal For Medicines that stop Blood are too weak and hard Ligatures occasion a Gangrene the surest way therefore in my opinion is an actual Cautery the lesser Vessels may and will close Some close the Wound of the Vessels with their Fingers and so hold them there while the Blood is coagulated and the Flux stopt but this Operation seldom succeeds besides the long holding of the Finger in the Wound is hurtful Therefore let the Wound together with the Vessels be forthwith clos'd by the Fingers but if you cannot come to do this outwardly make a compress upon the Vessel which done wipe away the Blood with a Spunge then sprinkle some restringent Powder but not over the whole Wound which is used to be done by the ignorant but only upon the Vessels then bind up the Wound continuing the use of the Medicines stopping Bleeding while there appears no longer any Blood not neglecting in the mean time Generals viz. Scarification and Bleeding c. Medicines that stop a Flux of Blood Roots of Bistort Cinquefoil Tormentil Comfrey the greater Red Saunders Lignum Leutisci Pomegranate-rinds Mastick Talk Acacia Dragons-Blood Amber Sarcocols Frankincense the hairs of a Hare Os sepiae burnt-Crabs Whites of Eggs Mummy Cobwebs red Coral Chalk Bloodstone Bole-Armenick Aloes succotrine Frogs dried and powdered crude Vitriol burnt Vitriol Take fine Meal three ounces Dragons-Blood Frankincense of each an ounce and half Bole Sealed Earth of each two drams Talk six drams dried Frogs an ounce Hares hair cut very small a dram and a half Whites of Eggs dried in the Sun and powdered half an ounce New Spunges torrified an ounce white Vitriol a dram Mix them and make them into a fine Powder 5. Pain which must of necessity be eased because it creates watchings and dejects the Spirits and is cause of the Flux of Humors to the Party affected and of Inflamation Fever and Gangrene but the Causes are diligently to be considered For if either Medicines that are sharp or too hot occasion it they are presently to be altered 'T is better to confess the Error than pertinaciously to persevere in it If any foreign Body remains in the Wound it must be drawn forth If pain comes from the choaking in of the Matter you must allow it a free passage If an Inflamation be the cause of it its Remedies are set down in the second Chapter of the first Book You must apply to the Wound those things which ease pain and are anodine as Oyl of Roses Linseed Camomile Worms sweet Almonds Poppies c. Take Oyl of Roses of Poppy-seeds of Camomile of each an ounce the White of an Egg Saffron a scruple Mix them But if the pain cease not with these or the like Medicines it is a sign that some Nerve is wounded or affected by consent The Cure shall be set down in the following 6. Convulsion or Spasm this shews the Malignity of the Humor or the ill constitution of the Nerves neither of them promising any good Here must be used both Internal and External Medicines appropriated to the Disease the Internal by reason of the diversity of causes we commend to the Physitian External Medicines for a Convulsion Balsam of Peru the fat of Geese Castor Foxes Rams Mans Horse-dung Oyls of Juniper Lavender Ol. Philosophorum Amber Turpentine Rue Marjoram Worms Castor Orise Bays Petraeleum Ointments of Agrippa Martiatum Ung. Nervorum Spirit of Wine Take Oyl of Snails Worms Sesamin of each an ounce of the Grease of Rams and Foxes of each half an ounce fresh Butter six drams Spirit of Wine three ounces Let them boil till the Spirit be consumed then add Oyl of Spike distilled Rosemary Amber of each two drams Mix it into an Ointment Against a Convulsion there cannot a better Remedy be invented than distill'd Oyl of Lavender some few drops being given in some convenient Liquor and anointing well the convulsed part 7. Hypersarcosis or too great increase of flesh which if it happens from abundance of Blood the flesh is solid and otherwise well conditioned but if from the too weak quality of drying Medicines it is spungy of the same nature as when the Bone underneath is rotten In the former Case Bleeding is convenient and sometimes fasting and the use of strong drying Medicines In the latter the Medicines must be very strongly drying that are applied Detersive and Corroding Remedies are here good Medicines against too great increase of Flesh Burnt-Spunges Burnt-Allom Galls Aloes the Bark of Frankincense Tutty Verdigrease burnt Vitriol Praecipitate Arsenick A Green Corrosive Water Take crude Allom Verdigrease of each two drams boil them in eighteen ounces of white-Wine to a wasting of the fourth part strain them and add Camphire a dram Mix them A Powder very drying and somewhat corroding Take Galls Balaustions burnt-Allom Frankincense Myrrhe of each a dram Dragons-Blood Ceruse Verdigrease of each half a dram Make it into a Powder 8. A Gangrene and Sphacelus concerning which look in the fourteenth Chapter of the first Book of the second Part of Chirurgery CHAP. V. Of the drawing forth Extraneous Bodies out of the Wound NO Wound ought to be joined together as long as any Extraneous Body remains in it for otherwise after some little time it will break out into an Ulcer The Blood by which Nature unites the divided Parts if it flow in great quantity to the wounded Part and there coagulates 't is to be removed by Expression sucking it out or by any other way for so there will be less Matter generated and the Symptoms fewer but where an Haemorage is feared all the Blood is not to be cleansed away Where Hairs are about the Wound they are to be removed If Sand or any such like thing remain
of others if thou dilligently require of what parts the Fabrick of thy Body consists to this end first we will shew the simple parts and their use then after the division of the whole Body the compounded Parts The Chirurgical use Seeing 't is very necessary even at first sight that thou shouldst know the nature and temperaments of Men because they give the Rules of what is to be done in the curing of each Disease we have thought it convenient in the very beginning of this Treatise to describe their Signs The Sanguine abound with Hair but lank and yellowish in process of time declining into blackish handsom red cheek'd freshy strong When young addicted to Venery not enduring â—â—â—ours easily sweating phthisical affable in their Conversation and Discourse not suspicious equally prone to laughter and tears they sleep soundly their dreams are pleasant Pulse is great and strong Urine yellowish and in great quantity soluble They hate Women and except in their company seldom think of them They bear Bleeding provided it be at a fitting time and in a convenient quantity otherwise they easily fall into a Dropsie Strong Purges to wit Euphorbium Scammony Colloquintida and those that are compounded of them they cannot bear though gentle Medicines easily as Cream of Tartar Manna Tamarinds Pruines Syrup of Roses with Senna Syrup of Succory with Rhubarb Pulp of Cassia Electuaries of Diacatholicum Lenitive c. As they easily fall into a Disease so they quickly again recover The Cholerick have black Hair and for the most part curled lean but very strong Coition profitable they are judicious and swift in action avoiding idleness they trust neither the words or gestures of Men soon subject to Laughter if the thing require it otherwise grave When irritated addicted to strike more inclined to Drink and Watching than to Eating and Sleep their dreams are of Fire Thunder Quarrels Battels Pulse strong quick and great Urine high-coloured as also their Excrements Choler requires not Bleeding yet permits it if there be a quantity of Blood joined with it but it must neither be excessive nor oftner repeated than just necessity requires lest the Choler shews its Malignity gentle Purges relieve it but strong irritate it it produceth vehement and dangerous Diseases and for the most part short Phlegmatick have long Flaxen Hair which easily falls off and as easily grows again Pale-fac'd cold and weak Body long ere they desire Marriage and soon debilitated by it sloathful unfit for Conversation not sollicitous about publick Affairs difficulty brought to Laughter or Anger which then lasts not long They eat and drink little prone to sleep Dreams are of Fish of the Water and Rain Pulse small and slow Urine pale and sometimes thin but generally thick and darkish the Belly soluble they bear not Bleeding except upon necessity they endure strong Purging their Diseases are long but not dangerous The Melancholick are almost destitute of Hair which is lank and black of a grim Countenance the whole skin livid lean slow and addicted to Venery prudent morose in conversation readier to give counsel to others than to themselves not subject to Laughter or Anger but long before appeased they eat and sleep much Urine copious Excrements little grievous Dreams Pulse small slow and hard Bleeding is hurtful Purging profitable the Diseases which it begets are stubborn and tedious and oftentimes more dangerous in the end than in the beginning Let these general Signs suffice in this place But 't is to be observed that the Temperaments are mixt and then the Signs are also Yea many Mutations Vices and Dissimulations as also Virtues and Ingenuity may be attributed to them which is your part judiciously to distinguish but we assent not to Galen who held that the dispositions of the Mind relie upon the Temperaments CHAP. II. Of the Parts in general· A Part properly so call'd is a firm limited Body which is nourished by other living Parts but doth not nourish having a peculiar use and operation for the advantage of the whole It is distinguished 1. Into the Principal Parts or or those not so Principal are those that perform some Noble Operation common to the whole Body as the Heart Liver Brain Testicles Those not so are those that serve the Principal and whence they are call'd their Servants as the Eye Ear Hands c. This distinction pleased some Anatomists many years since whom I much esteem yet not me For if the Liver and Heart are numbred amongst the Principal Parts because they elaborate the Blood for the advantage of the whole Body why is not the Tongue accounted a Principal Part also which is not only an Instrument of Speech by which we are distinguished from Beasts but also of Tastes by whose assistance we chuse those Aliments which are best which if wanting how the Heart and Liver could supply the Body with good Nutriment I see not The Brain governs all but how I beseech you If the Intestines did not perform their Orifice aright what would it effect How should we be esteem'd if like an Oister we should want Eyes and Ears How despised are the Feet and Hands yet in how many conditions do they serve For those not stirring both Chilification would be impaired and the Blood and the Spirits rendred thicker and the Brain made unfit for all actions In how short a time would the Limpha of our Body be corrupted if besides its own motion it was not also moved with the whole Body All things in our Body are joyned together as in a Clock one cannot be without the other neither is the most despicable Wheel less necessary than the Hand of the Clock itself without which it cannot be accounted a Clock 2. Into similar Parts and dissimilar A similar which divided into many parts yet whose single parts be of the same Nature with the whole Dissimilar are made up of more or less similars as the Hand Fingers Feet There are ten Similars found in the Body a Bone Cartilage Ligament Membrane Fibre Nerve Vein Artery Flesh Skin the eight former are made of Seed Flesh of Blood alone the Skin of both This Division is subject to greater difficulties than the former but seeing it is not convenient to reject it without the greatest confusion in the practice of Physick let us consider the thing it self committing the Disputes concerning the Name to the Schools Chirurgical Considerations 1. A Principal Part being affected or wounded renders the whole Cure dangerous therefore Prognosticks are not to be given here but with limitation lest the sudden alteration be rather ascribed to thee than to the Disease 2. Wounds of the similar Parts are less dangerous than of the dissimilar yea oftentimes they are sooner cured by simple Medicines than by compound the consent of the Parts by reason of the Vital and Animal Spirits is so great that scarce a Joint of the Finger being hurt can be cured without regard had to the whole Body In deed by the
it remains for some time in the same condition 3. When it relaxeth so that it is restored into its former seat and quiet by its Antagonist The Glandulous flesh is white thick and spungy formed of seed from whence it cannot properly be call'd flesh to this purpose ordained 1. To prop up the Vessels 2. To receive the superfluous Humidities whence they are called the Emuâ—ctories of the noble Parts Some Anatomists make strange diversities of them but it will appear to any one that diligently enquires into all the Glandules that they differ not so much in substance as in their Use and Humor The Viscerous flesh or the Parenchemick is red hard convenient to prop the Vessels and to serve for many particular and various operations this is the flesh of the Lungs Heart Liver Spleen which shall be treated of in their places Chirurgical Considerations The Muscles are subject to many Diseases very many of which are of so little consequence that they shall not be numbred here some we have declared in another place the following require consideration oftentimes wonderfully exercising the patience and diligence of the Chirurgeon 1. An Atrophy of the whole Body oftentimes comes from an Internal Cause But if of the Finger Hand Arm Foot for the most part from an External Cause Thus a Fracture Luxation Contusion Tumor too hard Ligature and the like so vehemently compressing the Veins and Arteries that it hinders the free passage of the Blood to the Parts upon which happens an Emacitation for where the Vessels are wholly divided or stopt so that the least quantity of Blood cannot be carried to the Parts there follows not a Wasting of the Part but a Mortification in this Case the External Causes must be removed And care is to be taken that the Blood may again be carried to the Part Here chafing the Part and the use of Nettles as many will is good the Chymists commend much Alumen Plumosum all hot Oyls likewise are here good and this Oyntment is of excellent vertue Take fresh tops of Savin Juniper Lovage of each two handfuls Camomile Flowers Juniper-berries of each two handfuls Oyl of Bayes White-Lillies of each twelve ounces Hogs-grease three ounces Dogs-grease an ounce and half Aqua vitae two ounces Boil them to the consumption of the moisture then add to the express'd Liquor Oyl of Spike three drams Juniper a dram Mustard-seed in Powder half a an ounce Roots of Pellitory of Spain Long-Pepper powdred of each two draws Yellow wax as much as is sufficient to make it into an Ointment Or Take Pulvis Amianti three drams Roots of Pellitory of Spain a dram and half Castor Euphorbium Oyl of Earth of each two drams Gum Ammoniacum an ounce and half Laudanum and Wax as much as sufficeth to make it into a Plaister 2. The true reason of the generation of Wens in my opinion is this the mouths of the Arteries appointed to carry nourishment to the Muscles sometimes are more opened than they ought to be whether it be by Fall or Blow or from an internal Cause especially in Plethorick People and in Parts disorderly moved the native heat converts the extravasated Blood into Flesh But seeing the Member requires not so great a quantity of nourishment it increaseth into a preternatural Swelling and if this Blood be impure Choler produceth Pain Phlegm Viscousness Melancholy a Cartilaginous hardness and 't is to be attributed to these Humors that this preternatural flesh is more yellow white or livid 'T is seldom included in a proper Tunicle except where Phlegm is its greatest Cause and then those Tumors are generally in the Neck The Veins grow big according to the increase of the Tumor so that under the Skin they appear as thick as ones Thumb 'T is not in it self malignant yet by ill applications may be easily made so Air is very hurtful if the Tumor be exposed to it For the most part the best Remedies are here used to little purpose on the contrary the Tumor more and more increasing You cannot promise any Cure except you take it away by a Thred Knife or both In the beginning the Medicines that are to be applied ought to be very astringent and repelling the Part is gently to be rouled having applied to it either a Plate of Lead or a Diachalcitheos Plaister or of Frogs with Mercury or the following Take Pomegranate-rinds Bistort-roots of each one dram Scales of Iron Quick-silver Burnt-Lead of each two drams Bole-armenick Lapis Haematitis of each a dram and half Turpentine Wax as much as is sufficient to make it into a Plaister according to Art In the mean time Purging Bleeding Scarification and the Application of Leeches are not to be neglected Sweating also Watchings and Abstinence profit very much But if the Tumor yields not to these Remedies but daily increaseth Suppuratives are to be applied but if these within few days effect nothing and the Tumor continuing in the same state an actual Cautery may be used which let not the contrary Opinions either of Chirurgeons or standers-by hinder for by its use the increase of the Tumor will be stayed for a long time yea sometimes the Disease will be wholly eradicated But if the Flesh begins to repullulate again beyond expectation the Surgeon ought not to defer to endeavour either by a Thred or Knife its extirpation the Thred being small and strong must be twice wound about the neck of the Tumor and tied with a double knot which must be straightned the same day and so every day until the Tumor be deprived of its colour sense and life which is within seven or eight days then 't is to be taken off with a crooked Knife which is very easie to perform seeing neither any great pain or flux of Blood is to be feared If the Thred be wet in Mercurial or Arsenick-water it hastens the mortification of this Tumor But in this Operation a Phlegmatick Body is required for in other Bodies pain and inflamation do so much afflict the Patient that 't is seldom that the Thred in a short time should take them off yet the Chirurgeon may to lessen the Symptoms and to cool anoint with a Feather the part which the Thred toucheth with white camphorated Ointment of Roses or the like continually putting the Patients in mind how that others bear it more quietly But if you design to use a Knife only the whole Tumor must be endeavoured to be taken away except you will consume the remaining by Medicines which is very rarely effected besides the Chirurgeon must have a Care that he divides not the greater Vessels lest there follows a Flux of Blood not to be stopped 3. The Viscerous Flesh belongs rather to the Physicians care than the Chirurgeons 4. Of the Glandulous Flesh we have treated particularly in several places In general 't is to be noted 1. That the Glandules are of a cold temperament therefore require hot Medicines but very ill suffers cold 2.
The Tunicle investing them being eroded or divided the Skin cannot be consolidated before the whole Glandule together with its Tunicle be consumed with the Ulcer 3. If Corrosive Medicines cure not the Ulcers of the Glandules within the space of few weeks no hope remains of a sound Cure because of the continual Flux of Humors And this is the reason why we are for the most part compelled to take them away by Incision CHAP. XII Of the Skin THe Skin is a similar spermatick part having some Blood mixed with it reddish white loose investing the Body and serving for feeling 'T is covered by a Scarf-skin for the greater defence every where perforated with Pores to give vent to the useless Fumes and Vapors endued likewise with manifest Perforations as are the Mouth Nostrils Ears c. whose use is sufficiently known It hath Cutaneous Veins and Arteries as also Nerves It s Use is to cover the Body as moreover it is the Instrument of feeling Chirurgical Consideration 1. The Skin being discoloured by the Jaundies Freckles and other Spots this Water renders again smooth and fair Cosmetick Water of Minsicht Take white Frankincense Sugar-Candy of each two ounces white Hermodactils Florence-Orrise Venice-Borax of each an ounce Salt of Tartar Burnt Ivory Camphire of each half an ounce Flowers of white Lillies of the white Water-Lillies of the white Garden-Mallows of each three handfuls Virgin-Honey three ounces Goats-Milk two quarts Bean-flower-water and white Rose-water of each a pint and half white Lilly-water and Solomons Seal-water of each a pint being mixt let them be distilled in Balneo Mariae 2. Scars remaining after the Small Pox Wounds or Burns we take away by the following Medicines if deep and great first having used Exedents then Sarcoticks Take Venice-Borax three drams Camphire a scruple Oxes-Gall a dram Oyl of Mirrhe two drams Capons-grease half an ounce Make it into a Liniment Or. Take Powder of the Roots of Snake-weed of Orrise of each three dams Seeds of Melon blanch'd of Raddishes of each a dram Burnt Egg-shels half a dram Common white Chalk a dram and half Frankincense a dram Sugar-Candy three drams Gum Tragaganth dissolved in Rose-water an ounce Goose-grease as much as sufficeth to make it into a Liniment 3. Scabs blemishing the Skin are sometimes moist dry spreading eating crusty malignant this difference is of so small consideration that generals being well known 't is not difficult to one that well weighs every thing to proceed aright in particulars Seeing the Cause of this Disease is a sharp cholerick serous salt Humor mixt sometimes with Phlegm the often use of Purging Sweating and Vomiting of Bleeding Scarification Leeches Natural and Artificial Baths as also of cooling drying Medicines and those that temper the acrimony of the Blood Lotions and Unctions are here very profitable an Example of each I here give A Purging Decoction Take Roots of Asparagus Grass Polypody of each six drams Liquoras three drams Leaves of Fumitory Succory of each an handful Senna an ounce and half Rhubarb half an ounce Tamarinds an ounce Anifeeds two drams Cream of Tartar three drams let them infuse 24 hours in a sufficient quantity of Whey then boil them and to a pint and half of the strained Liquor add Syrup of Dianicum three ounces Make it into an Apozem Dose three ounces A Vomit Take Oxysaccharum Vomitivum Syrup of Roses solutive with Senna of each an ounce Fumitory-water as much as is sufficient Make it a draught A Sudorifick Take Flower of Brimstone Antimony Diaphoretick Salt of Holy-Thistle Sal Prunellae of each a dram Make it into a Powder to be divided into six equal Doses A Bath Take Roots of red Docks Briony of each six ounces Leaves of Fumitory six handfuls Camomile Flowers three handfuls Bran a pound Brimstone two ounces Nitre an ounce Alom an ounce and half common Salt two ounces Mix them In a grievous and rebellious Scab the Powder of Snakes is excellent this is the Preparation of it Take a Snake in March if possible before it hath laid its Eggs the Head and tail being cut off and the Skin stript off all the inward Bowels except Tongue Heart and Liver thrown away let it dry in an Oven moderately warm to a Powder The Dose from four grains to fifteen Vipers dried after the same manner excel Snakes and are commended in the Leprosie it self A Fomentation Take Burnt-Talk an ounce and half quick-Lime two ounces Litharge of Gold half an ounce Bole-armenick an ounce dry Tabacco-Leaves three ounces White-Wine a pint clear Water a quart Let them boil a little and keep the strained Liquor for use A Liniment Take Crude Brimstone two drams Venice-Sope a dram and half prepared Nitre half a dram Litharge of Gold two drams Mercurius dulcis a dram and an half White Camphorated Ointment an ounce Oyl of Rhodium eight drops Make it into an Ointment CHAP. XIII Of the Fat Nails and Hair IT hath been long disputed whether the Fat Hair and Nails ought to be accounted Parts of the Body or Excrements I neither think them Excrements nor Parts properly so call'd Not Excrements for they are Bodies enjoying with the rest Life and Nourishment but not nourishing others and are of singular use for the publick good They are not Parts properly so call'd being destitute of any certain bounds and have no particular operation Fat nourisheth in Famine the Hair and Nails without injury to the whole may be cut off Adeps or Fat is a similar soft white insensible part made to preserve the Natural Heat to help Chylification to facilitate Motion to moisten the Parts and to nourish the Body in Famine Hair is a similar Part produced by the worst part of the Blood covering some Parts and in some manner adorning them 'T is outwardly four-square inwardly hollow the variety of Colour it owes to the Temperament Age of Men to the Constitution of the Air or Country The Nail is a similar part sprung also from the impurest part of the Blood flexible hard defending the Fingers from external injuries as also adorning them It s Root is joyned to a Ligament and is very sensible by reason of the neighbouring Tendons Chirurgical Considerations 1. Blood wholly or in part destitute of Fat is not much to be commended for its abundance constitutes fleshy its unctiousness fat Bodies as where but little fat lean this fatness of the Blood dispersed into the parts of the Body changeth into natural Fat more copiously in the cold parts to wit in the lower Belly Breast c. than in the hot These Signs may confirm our Opinion as often as they are required from the Blood after the opening of a Vein for the upper part of the Blood which is erroneously taken by many to be the Phlegm of the Body and so the vitious part oftentimes is the very best of it This may be distinguished by the Fire for if it be fat it will flame if Phlegm it useth to crackle hence
the Oyl of Langius whose Virtues are very excellent not only in the Kings Evil but also in malignant and sordid Ulcers if it be carefully used Take Oyl of Philosophers or Brick half a pound Frankincense Mastick Gum Arabick Turpentine of each three drams pound them togather distil them in an Alembick then add to the distillation Salt of Holm-Oak two drams and distil it again and reserve the distillation in a Glass for use In the room of the Salt of Holm-Oak which grows not in Holland Sal Gemmae may serve instead of it 2. In a Hernia gutturis or Bronchocele seldom Medicaments effect any thing when for the most part the Cause of the Disease to wit preternatural Phlegm mixt with Wind is contained in a peculiar Bladder and the Tumor lies under the Muscles having its Original not from the Glandules but from the Aspera Arteria or Wind-pipe yet in the beginning the following do good Take Roots of Ireos Galangal of each a dram and half Penny-royal Savory Rupture-wort of each a dram Seeds of Fennel Annise of each a dram Parsly-seeds half a dram Long-Pepper Spikenard Nutmegs Cinamon of each two drams Mirrhe half a dram Burnt-Alom half an ounce White Sugar three ounces Make it into a fine Powder Let the Patient take of this Powder each Morning a dram and half in White Wine Take Gum Ammoniacum Galbanum Bdellium dissolved in Vinegar of each an ounce powder of Orrise-roots two drams Mustard and Nettle-seeds of each a dram Pulp of Coloquintida Eastern Saffron of each a scruple Sal Gemmae Alom of each a dram Naval-Pitch six drams Rosin of the Pine an ounce Make it into a Plaister These Medicines effecting nothing after this manner the Tumor may be taken away First Take up the Skin and divide it long-ways then it being separate of each side to the bottom from the Tumor take out the Bladder whole if possible for if any part of it be left behind the little Artery which brings nourishment to the Tumor must be divided lest it increase a new Then let the Part affected be washed with Vinegar wherein a little Salt and Nitre hath been dissolved for the Flux of Blood is not in this case at all considerable Lastly Bring the Lips of the Wound together with a stitching Plaster it being not necessary to use a Needle here Of the Angina and luxation of the Vertebra's of the Neck we have spoken of in their places The End of the second Book of the third Part. The THIRD BOOK Of the Thorax or Breast CHAP. I. Of the External Parts of the Breast THe middle Region of the Body whose upper part is call'd the Shoulders fore-part the Breast hinder-part the Back under proper and common Teguments hath proper and common Muscles The common are those of the lower Belly and Scapula's those we have shewn already these are four 1. Serratus Anticus minor which brings the Scapula forward 2. Trapesius or Cucullaris which moves it upward and obliquely backward 3. Romboides which moves it obliquely downwards 4. Levator The proper Muscles of the Thorax are twelve 1. Subclavius or Extensor 2. Serratus Anticus major or the inferior raiser up the Ribs 3. Serratus posticus superior or the superior riser up of the Ribs 4. Serratus posticus inferior or the depressor of the Ribs 5. Sacrolumbus which draws the Breast together 6. Triangularis which likewise draws the Breast together Under these Muscles lie the Breasts in both Sexes abounding with quantity of Fat and in the Female with many Glandules The Back and Loins whose Muscles in this place we are forced to describe have four pair of Muscles 1. Quadratus or the flexor of the Vertebra's 2. Longissimus or first extender of the Vertebra's 3. Sacrum or the second extender 4. Semispinatum or the raiser up of the Back After the Musclers follow the Collar-bones the Shoulder-blades the Breast-bone the Ribs and the Vertebra's of the Veins Arteries and Nerves we have formerly treated The Clavicles or Collar-Bones being spungy bones are joyned to the upper process of the Shoulder-blade by strong Ligaments and movable Cartilages The Scapula or Shoulder-Blade is a broad and thin Bone lying upon the outside of the Ribs furnished with two Ligaments three processes and five appendices The Sternum or Breast Bone being distinguished in Infants by seven or eight lines and by three or four in old people is very spungy and hath in its lower part a Cartilage call'd Cartilago ensiformis or mucronata The Ribs in each Sex are twelve the seven uppermost which are the true are joyned with a double Tubercle to the Vertebra's but with a Cartilage to the Sternum are hard and round the five lowermost which are the Bastard-Ribs are lesser softer and shorter having Cartilages about the Os Sternum but not touching it Between these Ribs on each side are Muscles found which are call'd Intercostals eleven within and as many without so that in all there are forty four the Fibres here are placed cross-wise In the Cavity of each Rib formed in the lower part of it resides a Vein Artery and Nerve which extend themselves into the middle of the foresaid Muscles The Vertebra's of the Back are for the most part accounted twelve and have nothing considerable Chirurgical Considerations I omit here divers operations having already treated largely enough of them before What now offers it self is a Fistula of the Breast of a more difficult cure in that than in any other part by reason of the continual motion of the Muscles therefore 't is highly necessary to distinguish these Fistula's for the oblique do very hardly admit of any Cure Those that perforate the Breast are not easily made whole again those that have their rise from between the Pleura and the Muscles the matter falls down whence it comes to pass that afterwards it is difficultly discharged therefore in this case there necessarily is a short breathing and a slower motion of the Breast The Callous is to be removed by the same Remedies we have set down in the Chapter of Fistula's and so sometimes the Pleura and the flesh of the Muscles unite again but if these effect nothing let the Chirurgeon put a little crooked Silver-pipe into the Fistula so that the end of it may touch the bottom through which let him pass a Needle fitted with Silk answering to the crookedness of the Pipe which being done let him with the Needle perforate the Skin then the Needle being drawn through let both ends of the Thred be tied together and the Thred every day be anointed with some Exedent Medicines and the Callosity being taken away let the Ulcer be skinned The Instruments which are used in this case are described in Tab. 38. Figure 5. of Scultetus of the old Edition The Breasts of Women often in those that give suck from the great quantity of Milk wax hard and painful and by the Dutch is called Drop which affect may be cured
Medicines thou canst be Master of to drive out the poyson if thou wilt save thy life I never found any thing that was considerable done in the Plague by means of Purging and Bleeding but rather on the contrary all those that had Spots if they were Purged or let Blood soon after died However I will prescribe nothing magisterially to any man let every one endeavour to do what he can give a good account of I have together with my Collegues treated many hundreds in our Hospitals infected with the Plague without ever opening a Vein and yet we have by Gods blessing recovered near 600 persons besides those that by the same mercy we have cured in their several Houses Now to procure sweat in the very beginning take the quantity of two Hasel-nuts of Treacle dissolve it in common Vinegar but if thou canst have a cordial Acetum made of Rosemary Lavender Elder-blossoms Rue Roses or Elder-berries use it much rather and give it the Patient to sweat Or take the roots of Celondine boyl them in Vinegar and dissolve some Treacle in it Or take Carduus benedictus Rue Petasites or Butter-burr a little Angelica Zedoaria or Saxifrage-roots boyl them together in half White-wine and half Vinegar or only Water dissolve a little Treacle or Mithridate in it and let the Patient take it warm to make him sweat Mithridate hath the like virtue with Treacle yet neither of them are safe to take for Women with Child old Persons and young Children You may also make use to good purpose of the Saxon-powder taking of it the weight of a Ducat in Caduus benedictus Scabius or Sorrel-water which Powder is thus to be prepared Take Valerian half an ounce Celondine or Nettel-roots of each one ounce Polypody Althaea or Marchmallow wild Angelica of each two ounces of garden Angelica four ounces of the rind of Laureola or Lowry an ounce and an half These roots are to be dug up in their best strength viz. between the middle of August and the middle of September and being cleansed they are to be cut small and then put in a glazed pot pouring a sharp Vinegar upon it so as to cover it two inches high Then lute on the cover with a lute made of whites of Eggs and Flower let all be boiled upon a gentle fire then pour off the liquor and dry the roots and reduce them to powder mixing with it some 26 berries of Herbe Paris or One-Berrie which look like Pepper-corns very good against poison and thus the powder is made This herb grows in shadowed and moderately moist places I have found of it several times in Koshinger-wood near Ingolstad It hath four leaves on one stalk and one berry on the top An herb belonging to the family of Solanum's or Night shades whence the leaves of it do very much cool Inflammations especially those of the Eyes when laid upon them Take notice of Sorrel bruise some of it and pour Vinegar on 't the Rue acetum is the best and strain the juice through a cloth put into it a little powder of Angelica about the weight of half a Ducat or of the root of Dictam or of Butter-burr or a little Treacle or Mithridate and give it to sweat On this occasion of mentioning Dictam I must add that in our Countrey there grows only the white Dictam which is among others an excellent Antidote but you must take of it the double quantity and weight to that of Creta You may boil of the root of half an ounce in half White-wine and half Vinegar or instead of the Wine in Carduus benedictus water and drink of the Decoction warm and put your self to sweat or take of the powder of it a drachm and an half in warm broth with a little Vinegar for the same purpose The Dictam of Creta hath hairy leaves and purpureous blossoms and is used in the prepation of Treacle This herb by its odour drives away Serpents The wild Goats being hurt by any Arrows eat this herb and 't is said that by this means the Arrows fall out of the wound This perhaps hath no other ground than that of the Poet Virgil affirming that Venus with this herb healed her Son Aeneas when wounded in the War His words are Aeneid 12. Hic Venus indigno nati concussa dolore Dictamnum genitrix Cretaea carpit ab Ida Puberibus caulem foliis flore comantem Purpureo non illa feris incognita Capris Gramina cum tergo volucres haesere sagittae About this time came in the Hungarian Infection which was a Disease that bred such a a putrefaction in the bodies of Men that even when they were near death they fell a vomiting but that with such a stench that no body could endure it Here those Medicines do well that preserve the body from putrefaction for the Plague Spotted Fevers and the Hungarian Distemper proceed all from inward corruption And of them the Plague attacks the Spirits residing in the Heart and so killeth very quickly whereas Spotted Fevers have their seat in the Blood and therefore do last twelve fourteen and sometimes twenty days before they kill But the Hungarian Disease is seated chiefly in the putrified Phlegm of the Head and Brains whence those that labour under it are tormented with great and maniacal head-ach But though these three Diseases have their rise from one and the same cause Putrefaction and are to be cured by the same remedies yet is therein required the discretion of a prudent Physitian for the ordering and prescribing of Medicines according to circumstances Take a drachm of Zedoary give it pulverised to the Patient in Acetum of Rue or Elder or Marrigold flowers or even in common Vinegar Let him sweat upon it 'T is good against all sorts of venom and causeth a sweet breath as resisting inward corruption In the Apothecary Shops you find an Electuary called Diascordium found by that famous Physician Hieronymus Fracastorius It is like to Treacle and Mithridate only 't is red from some Ingredients giving it that colour This may be used with safety by Women with Child young Children and all sorts of Persons whereas as was said above Treacle and Mithridate may not It is made chiefly of Scordium or Water-Germander which hath the smell of Leek when bruised Galen in his first Book De Antidotis Chap. 12. writeth that when in a great Battel some slain Bodies chanced to fall upon this Herb they rotted not as far as they were touched by this Herb. The said Fracastorius did compound this his Diascordium out of this Herb Scordium Tormentil Serpentaria Gentian Bole Armeniac and Terra Sigillata and such like Ingredients It is chiefly to be used in the hot Diseases of the Head which I have done many a hundred times Take of it the weight of about two ducats in common Vinegar or in Elder-water or rather in the expressed Juyce of fresh Sorrel and sweat upon it 'T is very good especially in the
and dip it into Smiths-water in which first some crude Allum hath been dissolved Let this lump be dried again and then draw it thorough the Spawn of Frogs so as that the Spawn may every where hang on it and expose it to the Air to dry and afterwards draw the same again thorough Frog-spawn Which repeat as often as you can during the season of Frog-spawn for the oftner you dip the raggs into it the more vertue they will receive This Spawn stauncheth bleeding with a good bandage I have often used with good success the distilled water of Frog-spawn in the bleeding of the Nose first mixt with crude Allum and then drawn up into the Nostrils Take a green Frog burn him in a pipkin not to ashes but so as to be reducible to powder This powder put into a small Taffaty-bagg and hang it about the neck of a woman that floods excessively and she will find great help from it Having often made mention of Allum which is one of the chief remedies for stopping of blood I will make publick the Magistery of Allum which I have hitherto kept secret Take then of the best and clearest Allum as much as you please pulverise it and put the powder into an Oxe-or Swines-bladder tying it very close Then throw it into a kettle of hot water and the Allum will be dissolved this Solution bring over the helm out of a low retort until the Allum get a caput mortuum then cease to urge the fire any more lest you force corrosive spirits from it which are noxious to our present purpose This caput mortuum put again into a bladder and dissolve it as before and do this so long until the whole body of your Allum be brought over the helm But you must filter the first solution for fear of any dust or other heterogeneous matter mixt with it This is the Magistery of Allum able to draw the veins together without corrosion Apply this to wounds or any other bleeding part You may mix with it Tragacanth Gummi Arabick Sanguis Draconis and well-beaten Whites of Eggs. Take good notice whether the wounded Patient have heated himself in storming a place or by any other military execution or whether he be yet distemper'd by passion for as long as this lasts the blood is in a rage and can hardly be stopped In this case stop the wound with Peacocks dung and take Vineger and Whites of Eggs well beaten together a little Allum and refined Salt-peter put to it as much Frog-spawn Shepherds-purse broad Plantain or other convenient water as is necessary so that there may be three parts of water and one part of vinegar dip pledgets into it and clap them cold to the wound and the bleeding will cease Crocus Martis also is an excellent stauncher of blood to be used both inwardly and outwardly For inwardly it cureth the Bloody Flux and other Fluxes and outwardly applied to wounds and strewed into them it closeth the veins But it must not be prepared with Aqua-fortis or distilled Vineger or any corrosive thing but only by the heat of a reverberating furnace and afterwards distil often from it some proper water as of Roses Speed-well Self-heal or broad Plantain after which preparation it is divers times to pass again through a reverberating furnace until it grow as light as a down-feather And then 't is fit for our purpose for as long as it is strong and heavy the body of it is not throughly opened Among other things you may make use of the Red earth of Vitriol which is to be thus prepared Take Vitriol as much as you please put it in a new unglased pipkin into a Potters oven to deprive it of its moisture and to reduce it to a Colcothar Then pulverise this calcined Vitriol and in a large glased earthen dish pour hot water on it letting it stand so for four or five hours then decant the water and pour other hot water upon it as before repeating this three four or five times until all the salt be got out of the said Colcothar which whether it be done may easily be found by the taste Then dry this red dulcified Earth and it will prove a very good blood-staunching medicine which may also in other cases be variously used as you 'l find it hereafter of great use in my plaister for wounds made by thrusting The water you had poured on this Colcothar you ought not to throw away as useless but to put it by and for other occasions you may boil it away and it will leave a Salt behind as white as snow with which you may do wonders in foul Sores I have used it with good success in such cases in which it cleanseth and maketh a firm ground for new and good flesh to grow upon For though there be many things that cleanse Sores yet they leave the flesh loose and spungy but this is both astringent and withal maketh such a sound and firm bottom that you may trust to it Whence also it is to be used in fistulous Sores But to return to the stopping of Blood take the blood of a Lamb or Sheep let it stand in a clean earthen vessel until the serum be sever'd from it pour this off and dry the blood well in a new glased pipkin upon hot embers Then pulverise it and mix with it a fourth part of clean pulverised Tragacanth and strew this into the wound If the issue of the blood be so impetuous that it washes away the first application then wipe the wound again and strew into it of the same powder the second time Putting amongst it Allum Crocus Martis or the red Earth of Vitriol you will do well Bind the wound with the Emplastrum Santalinum which is called Incognitum by our Chirurgeons or with the Ceratum ex pelle arietina due to Arnoldus de Villa nova The blood being stopt and the wound cleansed you must then apply good vulnerary Oyls or Wound-balsoms Oyls are all as I mention'd above fatty whence it is that they do not easily consolidate wounds unless you put to them some refined Mastic Sarco-colla Sanguis Draconis Sandarach or the like But to open unto you the good affection of my heart I shall describe here my Wound-balsom wherewith I have by Gods assistance done much good viz. Take as much as you please of Turpentine of Cyprus which comes from Venice and is taken inwardly and the same quantity of the red Oyl of St. Johns-wort dissolve them together Then take Gumm Elemy dissolve it apart and pour it among the other and so let all cool and when 't is half cold pour amongst it a little Oyl of Bees-wax and your Balsom is prepared I cannot tell you the precise weight of each ingredient because as often as I have prepared it I have done it by the Eye and as it seemed good unto me only note that there must be so much of the Gumm Elemy as to give it a due
CHIRURGERY According to the Moderne Practice Written by PAULE BARBETTE DOCTOR of Physick Practitioner at AMSTERDAM Printed for Henry Rhodes THESAVRVS CHIRVRGIAE THE CHIRURGICAL and ANATOMICAL WORKS OF PAVL BARBETTE M. D. Practitioner at Amsterdam Composed according to the Doctrine of the Circulation of the Blood and other new Inventions of the Moderns Together with a Treatise of the PLAGUE Illustrated with Observations Translated out of Low-Dutch into English THE FOURTH EDITION To which is added the Surgeon's Chest Furnished both with Instruments and Medicines all useful Illustrated with several Copper-Plates And to make it more compleat is adioyned a Treatise of Diseases that for the most part attend Camps and Fleets Written in High-Dutch by Raymundus Minderius LONDON Printed for Henry Rhodes next door to the Swan-Tavern near Bride-Lane in Fleet-Street 1687. THE AUTHOR'S PREFACE TO THE JUDICIOUS READER WHat should be the scope of putting forth this my not sufficient Polished Treatise after so many Excellent and Learned Writings of Physicians the Title before will declare unto thee viz. That my Design was both out of the Ancient and Modern to extract the very Marrow and plainly to shew the best way of Curing Diseases belonging to Chirurgery Therefore I have purposed not to obtrude upon thee this or that Man's Fancy or Conceit for Modern Practice For who ever was so mad as to Embrace the Opinion of any one Region City or Man Who ever though most ingenious and judicious equally excelled in all the Parts of his Profession Seeing it hath not pleased the Giver of all Arts to grant this perfectness to Men But I resolve to set down that Practice which Reason and Experience after a diligent Reading of the best Authors and an exact observation of several Operations have Taught me to be the safest convenientest and easiest for prolixity I have purposely avoided and used not more words than only to express the thing it self Nevertheless I have studied to conprehend the Foundation of the Art in few Chapters Read over all diligently and let not what I purposely omitted trouble thee Great Volumns easily affright the Reader as those that are too little betrays him I have carefully endeavoured what is hardly found a mean and therefore I have rather in few words inserted my Observations in the very descriptions of the Diseases then to waste thy time with a prolix discourse To this end that I might not repeat in particular Diseases what I had once set down in generals Tumors Wounds and Vlcers which neither in Cause nor Cure differ I have reduced under one Head contrary to what most Writers use to do who only from the difference of the Part and Member affected difference the Diseases which aftewards giving them new names they without any benefit multiply and so they render that Art which is difficult enough of it self much more difficult The most diligent of Students can scarce distinguish them who unprofitably spend much labour and time in the Controversies of the Ancients concerning the Name whose Opinions they suppose they ought to follow to a Tittle if they will arrive at the degree of Doctor We are the Ministers of Nature not the Slaves of those Men that describe it We account neither them Prophets nor their Writings sacred neither unlawful to add or diminish to them without the name Heretick I have set down both few and many Medicaments for those that I have produced although few in number yet of great vertue which by vast pains and no less charges I have found out and which dayly Practice hath confirmed to me as the safest of all Other Medicines seek for amongst others Farewel kind Reader and whil'st I am imployed about other and better if I can possible Writings receive these with a grateful mind and as I study to be profitable to thee so also do thou endeavour always by these to help others The Index of Chapters to Barbetty's Chirurgery The First Part. Chap. 1. OF Manual Operations in general Pag. 1. 2. Of Unition or Conjunction 2 3. Of the Nature Difference Signs Prognosticks and Cure of Fractures in general Ibid. 4. Of particular Fractures of Bones 10 5. Of the Nature Differences Signs Causes Prognosticks and Cure of Dislocations in general 17 6. Of particular Dislocations 20 7. Of Ruptures 26 8. Of the Falling down of the Matrix 34 9. Of the Falling down of the Anus 35 10. Of the second Operation called Diaeresis or the seperation of what was united together 36 11. Of opening a Vein 37 12. Of the opening of Abscesses or Imposthumes 42 13. Of the separation of parts unnaturally joyned 46 14. Of the Paracentesis 48 15. Of the opening of the Breast 54 16. Of removing a Cataract of the Eye 60 17. Of Leeches 63 18. Of cuting in the hard parts 65 19. Of Ustion or Burning 69 20. Of Issues 70 21. Of the Seton 71 22. Of the drawing forth of Bullets 73 23. Of the Extraction of a dead Child and the Secundine 74 24. Of the extirpating of a mortified part 78 25. Of the fleshy Rupture 80 26. Of the Extraction of the Stone out of the Bladder 82 27. Of a Hare Lip 87 An Index to the Second Part. Chap. 1. OF Tumors in general 88 2. Of Inflammation 90 3. Erysipelas 95 4. Of Oedema 98 5. Of Scirrhus 101 6. De Tumore Aquoso or Watry Tumor 103 7. Of the Flatuous or Windy Tumor 107 8. De Herpete 109 9. De Atheroma Steatoma and Meliceris 111 10. Of Scrophula Struma or Kings-Evil 113 11. Of a Bubo 116 12. Of the Carbuncle 121 13. Of a Cancer 122 14. Of a Gangrene and Sphacelus 126 15. Of Paronychia 133 16. Of an Aneurism 135 17. Of Opthalmia 136 18. Of a Quinsie 141 The Index of Chapters to the the second Book Of the second Part. Chap. 1. OF the Nature Difference Causes and Signs of Wounds pag. 147 2. Of the Cure of Wounds in general 152 3. Of the preservation of the strength and native heat in the wounded parts Ibid 4. Of the Symptoms of Wounds 153 5. Of the drawing forth of extraneous Bodies out of Wounds 157 6. Of the manner of joining the Lips of Wounds together 159 7. Of Medicines necessary for the curing of Wounds 161 8. Of Wounds of the Nerves 166 9. Of Wounds by Gun-shot 168 10. Of poisoned Wounds 170 11. Of particular Wounds 172 The Index of Chapters to the third Book of the second Part. Chap. 1. OF the Nature Differences Causes and Signs of Ulcers 177 2. Of the Cure of Ulcers 178 3. Of an Ulcer with foul Bones 182 4. De Ulcere depascente 184 5. Of Fistula's 186 6. Of Burns 190 7. Of particular Ulcers 193 The Index of the third Part of Chirurgery Chap. 1. OF the Practical Anatomy 201 2. Of the parts in general 205 3. Of Bones 207 4. Of Cartilages 215 5. Of Ligaments 217 6. Of Membranes 219 7. Of Fibres 220 8. Of Veins 221 9. Of Arteries 228
10. Of Nerves 233 11. Of the Flesh 237 12. Of the Skin 243 13. Of the Fat Nails and Hair 247 14. Of the generation of the Blood and its Circulation 250 15. The division of the Parts of the Body 266 The second Book of the Head 1. OF the outward parts of the Head 268 2. Of the inward parts of the Head 292 3. Of the Neck 296 The Third Book Of the Breast 1. OF the External parts of the Breast 300 2. Of the Internal parts of the Breast 305 The Fourth Book Of the lower Belly 1. OF the outward parts of this Belly 311 2. Of the Internal parts of the Abdomen 314 The Fifth Book Of the Joynts 1. OF the Hands 332 2. Of the Feet 337 An Index to the Treatise of the Plague A Description of the Plague Page 1 It 's Cause 3 It 's Diagnostick 5 Prognostick 6 It 's Cure 9 Whether Bleeding and Purging is convenient 9 10 The use of Sudorificks 11 Medicaments against the Plague 12 Symptoms of the Plague are 18 Feaver Ibid. Drowsiness 20 Continual watchings 21 Great pain of the Head Ibid. Vomiting and the Hicough 22 A Loosness 23 Spots 25 Bubo Ibid. Preservatives against the Plague 32 Practical Observation 36 BARBETTY'S CHIRURGERY The First Part. CHAP. I. Of Manual Operations in general ALthough the word Chirurgery signifies all Manual Operations in general yet by reason of its pre-eminence above all the rest it is now only given to that Art which endeavours to remove the Diseases of the Body by the assistance of the Hands 'T is true that External Accidents require not only the help of the Hands but also Internal Means therefore it is no wonder for a Part of Physick to require the whole Chirurgery being a Part which depends upon the Body of Physick But these internal Medicines we impart to you not as Chirurgeons but as Physicians The General Operations of this Art to which all the particular ones may be reduced are of four sorts 1. Synthesis which teacheth how to unite parts disjointed 2. Diaeresis To separate parts unnaturally joyned 3. Exaeresis To remove what is superfluous 4. Anaplerosis To supply those that are wanting CHAP. II. Of Synthesis or Vnition UNition is of two sorts one regards the Hard and Boney the other the Soft and Fleshy parts of the Body The Unition of Bones is again twofold the one setting Bones broken the other reducing Bones wrenched or disjointed We will begin with Fractures CHAP. III. Of the Nature Difference Signs Prognosticks and Cure of Fractures in general A Fracture is a Solution of Continuity in the hard parts of the Body caused by an hard Instrument externally forced upon the part The Differences are taken 1. From the Manner there being some transverse which are properly called Fractures others that are made according to the length of the Bone called Fissures and others are Comminutions when the Bone is broken into many small parts 2. From the Part it being some times in the Head sometimes in the Shoulders Ribs Arms Legs c. 3. From the Accidents there being sometimes a Wound accompanying it at other times a Dislocation Inflamation Gangrene c. Cause is Whatever is able to break bruise or cut Sometimes also a Bone corrupted by the Pox Gout or otherwise hath been broken without any external force Signs A Bone being transversly or obliquely broke by handling it you perceive an inequality the Patient is scarce able to move the Part affected and sometimes that Part is shorter than the other the Thigh Leg or Foot being broken the Patient cannot stand at all but he may somewhat though with pain in a Dislocation And this is the surest difference between a Fracture and a Dislocation A Fissure is discerned by the thickness pain and unevenness of the Part and requireth the judgment of a skilful Chirurgion A Comminution is easie to be perceived the Bone being very unequal and here and there yielding to the Fingers Prognosticks A Transverse Fracture is more easie to cure than an Oblique or when accompanied with apparent Inequalities that where but one Bone is broken than where two are or where the Bones are much shattered that which â—s made in the midst of the Bone than what happens to be near the Head and a single one than a compound If the Patient remain undressed beyond the seventh day the Member is in danger of mortifying especially if that the Part be too â—ard bound The Cure A broken Bone requires these four Operations Extention Conjoining Ligature Well-placing and withal the application of outward and inward Remedies Extention can hardly be performed without pain which yet will be much less if the Member be so extended that the Muscles do not labour that is to say The Part must be so laid that when in health they could hold out longest without tiring Sometimes the extension must be greater sometimes lesser which will be performed aright if regard be had to the time of the Fracture to the Age of the Patient and to the greatness of the Bone A recent Fracture a tender Patient a small Bone require a gentler Extention on the contrary an old Fracture a strong Patient and a big Bone a greater The manner of extending I describe not because it is better learnt by the frequent view of Practice than by Reading After Extention you are to join the Bones together in the doing of which the Muscles must not be wrested but retain their natural position and figure Then the Part must be bound with a double Rowler the first is to be rowled thrice about the Fracture and then upwards The second which must be twice as long is to be once wound about the Fracture proceeding downwards and then upwards again a little higher than the first Rowler to which you will give more firmness if you bind some convenient Splints of Wood or rather of Past-board round about the Member The Ligature ought not to be too strait lest it cause pain and rob the Part of its nourishment nor too loose lest the Bones slip out of their place And unless great pain or other symptoms require it must not be opened before the third day and at the second dressing it must be bound somewhat closer and afterwards changed but once every four five or six dayes Lastly The Part ought to be well placed that is softly evenly and a little raised If you lay it too low the Bone will bend outwards if too high it will bend inwards Wherefore you must observe a mean Now whether these four Operations have been duly performed may be known by the ensuing Signs The Extention is well done if the part be strait and as long as its fellow if it appear to outward view every where even and a little hollow about the Fracture The joining together is duly made if the Bone be any thing firm and all about the Fracture be found equal The Ligature is as it ought to be if the Patient as soon
Sugar therewith and of this let him drink a good draught and it will cool and refresh him Besides take some of the guts of Hens and some slices of Radish sprinkle them with Vinegar and Salt and bind them to the soles of his feet this will draw away the heat But let not the Radish lye too long upon them because it will give a stink that may increase the head-ach wherewith the People that have the Plague are commonly troubled enough without provoking it Moreover you will do well to tye about his wrists some Rue beaten with Vinegar Anoint his Loyns and Back-bone with the Unguent of Roses or with fresh Butter but if there appear any Spots forbear to anoint him lest they should be driven in You will do well to have Epithemata of good things about you as of Rose water and Elder-vinegar to lay over the Heart with which mix some Camphir But if you find any thing of Specks c. broke out you must use no wet thing Anoint his Heart with Oyl of Scorpions take the Oyl of Sea-blossoms and of those Earth-worms that appear after rain of each six ounces of St Johns-wort Oyl two ounces of fresh Elder-blossoms and Rue each a handful and an half of the Acetum of Marigold-flowers and Roses each about three ounces of live Spiders forty five Boil all these together till the Vinegar be so qualified that when 't is thrown into the fire it cause no cracking there Then strain it and in this strained Oyl put a matter of five and twenty Spiders more of the biggest sort and add to it of Camphir dissolved in the Spirit of Roses half a drachm let it stand in Balneo Mariae or upon hot embers for twelve hours and then put to it of Treacle and Mithridate of each half an ounce and let them work together With this Oyl anoint the eight Pulses viz. both Temples behind both Ears both Hands and both Knees as also the Heart And this is an excellent Succedaneum to Scorpion-oyl much used by the Germans Besides you must refresh and strengthen the Patient with convenient Meat and Drink I mean with good Flesh or Barley-broath with a little Vinegar in it to make it savoury to him who will have appetite to little else till he have shaken off this venomous Distemper which when he hath done his stomach will be so keen that you will find work enough to keep him from surfeiting Be also careful to keep thy Patients Body open if he be obstructed use a Clister or take Butter or Hogs-grease mixing a little Salt with it or if it be to be gotten a little Mice-trickles and put it into his bowels Physick at the mouth for this purpose is not always safe When the Patient is discharged of the venom a little liquor of stew'd Prunes with some Senna-leaves in it will do well for opening the body Some fresh Butter eaten in the morning or melted in warm Broath and taken down is wont also to keep the body soluble The Drink of these Patients may be Water with some Bread soaked in it or take of such Water wherein Bread hath been soaked one quart and a little Vinegar with two or three spoonfuls of Kitchin-sugar mingling it well together If you have no Sugar use such Water with Vinegar alone This affords good Drink in malignant Fevers Among the Romans it was drunk by the Souldiers under the name of Posca You may also take a handful of well cleaned Plantain-roots and boil them up in three quarts of Water and then decant the Water which though it be somewhat bitter yet 't is very good in Fevers and a good Drink in hot Distempers If you have Oyl of Vitriol let a few drops of it fall into clear Water mingling it well and you will have a factitious Sawer-brun or Acidula But use no Metalline Vessel for this purpose With this kind of Water many People have been served in all sorts of Fevers the Oyl of Vitriol in such Distempers if rightly used being very beneficial But if a Man should have with it any Pulmonick Disease in that case he must forbear acid things and use Liquorice and content himself with Ptisane Nor is it at all good to use acids in Pestilential Pleurisies And since on this occasion we mention this case and we having above given warning not easily to blood in Pestilential Diseases yet may Venae-section be sometimes upon good consideration used in that Pleurisie provided it be done in the very beginning and the Patient be strong and full of Blood Yet this is not to lessen the blood but only to give it vent but before bleeding the Patient is to sweat by taking some of the above specified Antidotes If the Patient have violent Head-ach lay on his head Vine-leaves or fresh Cabbage-leaves and if you have no Alablaster-salve take two parts of Vinegar and one part of Oyl of Olives the Sea-blossoms Oyl and Elder-Vinegar were better dip long rags of linnen therein and having well squeez'd them again lay them lukewarm over the face and temples Even Vinegar alone is good Of such Applications you may make many of Acetum of Roses Elder-blossoms and the like with a little Camphir The expressed Milk of Peaches is also very effectual in this case If at the going off of this Distemper a hot defluxion should fall into the Eyes take Camphir and infuse it in water and often moisten the Eyes therewith and if it should be cold and windy weather you will do well to keep your self out of the open Air and not to let this water dry up in your Eyes in the cold wind In case of having lost thy hearing take of thy own Urine and with it wash thy Ears within but withal dry them very well because that moisture is very noxious to the Ears And it often happens that after the Hungarian Sickness People grow deaf or hard of hearing Others put the water of Carduus-benedictus distilled with Wine into the Ears or the Oyl of bitter Almonds If thy Throat swell or the Palate of thy Mouth be fallen down gargarize thy Throat with warm Milk wherein Figgs have been boil'd or sweetned with Sugar The Flowers of Phyllirea or Mock-privet which grows in the Hedges boiled and used for a gargarism heals also a sore Throat The same doth the middle rind of Oxyacantha or Haw-thorn if boiled with a little Allom dissolved in the Decoction If you have the Juice of Mulberries mix a little Honey of Roses with it and often take a little thereof The Roots of Sloes boiled in red Wine and the Mouth often washed therewith is also very good If thou hast the Squinancy boil Scabious in Meath and drink thereof warm when strain'd Beat Turnips and fry them in Butter or Oyl and clap them in a cloth round about thy Neck If thou cast up blood take Mouse-ear Ground-Ivy Cumfrey boil them in half Wine and half Water or in Meat and Drink often of it But if
the Plague reign not open first a Vein For a violent Cough boil white Turnips well cleansed in common water throw away this first water pour on other water and in it let the Turnips boil till they grow soft Strain this water sweeten it with Sugar or infuse in it Liquorice cut small and drink of it mornings and evenings warm Or make a Decoction of St. Johns bread and drink it abstaining from all four and salt things The bleeding at the Nose is also incident to persons infected which is no good sign though in sound persons it often frees from the Head-ach and cools the Liver If this bleeding be too violent clap Ice-cold water about the Patients Neck or let him put his Pudenda in cold Vinegar CHAP. V. Of the Inflammation of the Tongue its rise and concomitants together with the Remedies WHen the Tongue is inflamed the whole Oesophagus or Weasand is inflamed also and this from beneath upward because the inward fire sends up its smoak all along as it were that chimney which like soot sticks to it drying and blackning the same But there is another Inflammation much more dangerous which taking its rise about the Heart and therefore is call'd the Inflammation of the Heart which proceeds from the great inflammation of the orifice of the Stomach situate near the heart in which is inserted the sixth pair of Nerves which maketh the said orifice very sensible of any pain This part being seized by so great an inflammation which is venomous withal it must in a manner harden and shrink and this heat is of that extent that the inner Membrane of the Stomach that of the Tongue being one and the same what befalls the Stomach the Tongue must needs be sensible of it Whence it comes to pass that if the Gall overflows and passeth into the Stomach the Tongue presently finds the bitterness of it or if the Stomach be full of slime or foul or the like the Tongue is soon affected therewith There is another kind of Inflammation by the Latins called Prunella alba This is of the same kind with the rest but not of the same degree for 't is not of so dry a nature as the others are but commonly is moist yet overlays all the Gums the Throat and the Weasand with such a tough white slime like a kind of Leather and so covers the Almonds with the same that sometimes it can hardly be removed even with Instruments The Tongue is as if it were crusted over with dough the Gums like an Oven that by the heat of fire is burnt white the Almonds cover'd as 't were with white leather and the Palate of the Mouth likewise And in this case if the Patient will speak he lalls and stutters his Tongue being burthen'd with a load of slime or if he make his Tongue wagg the slime spins out like a thred and so invades the Teeth as if they were laid over with varnish And when this varnish on the Teeth grows black as I have often observ'd it to do and drieth on them 't is a mortal sign of which Hyppocrates saith Quibus in febribus livores circumdentes nascuntur his fortes fiunt febres 4. Aph. 53. These are the three sorts of Inflammation for which let us now seek out the Remedies beginning from the last the White This is not to be master'd by gargarisins alone but the hand must be employed also Take therefore Cotton-wooll or Flax and wind it about a stick or rod and dip this in Vinegar and rake his Throat and Gums therewith yet taking care not to make it raw let him gargarise between and wash well his Mouth with Water and Vinegar or Mul-berry-juyce Privet that grows in the hedges or the middle rind of Haw-thorn boiled in Water and a little Vinegar then strained with a little Sal-armoniack put into it is in this case an excellent gargarism but if there be blisters upon the Tongue or elsewhere then take instead of Sal-armoniack a little unburnt Allom and mix it therewith If you can have the Juyce of Turnips or the Juyce of fresh House-leek dissolve therein also a little Sal-armoniack and use it to wet the stick wherewith thou cleansest the Throat of the Patient dipping it often therein and carrying it about the Vvula or Palate of the Mouth and you will see lumps come away as big as Pease The skin is under this Prunella alba fair and red but tender Whilst thou art cleansing the Patients Mouth let him often gargarise with the Waters above-specified and he will clear his Mouth of the loosen'd lumps If thou canst get Mul-berry-juyce mixt with Honey of Roses the Mouth will heal the better for upon this sort of Inflammation there usually follows a Putrefaction of the Mouth and in case thou perceivest any such thing take Wood-sorrel and the above said rind of Haw-thorn make a Decoction of it and put in it a little Allom and often gargarise with it Clean thy Teeth from the slime with Water well sharpned with Vitriol The common Inflammation of the Mouth may be cured with frequent washing of the Mouth taking a gargarism made of House-leek Lettice Night-shade or Self-heal Water mixing a little Honey of Roses and Mul-berry-juyce with it Of this gargarism the Patient is also to swallow a little thereby to moisten the Throat Some take House-leek and beat it and put to a pound of it half an ounce of Sal-armoniack mixing it well together And so they put it for some days in an earthen pot glased under ground then they distill of it a Water in Balneo or in Sand Which is excellent both to drink and to gargarise though the Sal-armoniack make it a little unpleasant But there is nothing better to allay this Inflammation than Niter which is so well known amongst Souldiers that they are wont to give one another Gunpowder to drink which Powder performs this effect not upon the account of the Coals or Brimstone but the Saltpeter For this cause Experienced Physitians and Chirurgeons endeavour to purifie Niter for this use that it may have the greater effect and this they do in manner following They take of the purest Niter they can get as much as they think fit they beat it to a fine powder and melt it in a large Crucible whilst it boils up and foameth they pour into it a little powdered Sulphur and so let it boil together till the blew Sulphur-flame ceaseth then they cast in more fresh Sulphur Which they repeat often and then pour out the Niter into an earthen vessel glased making Lozenges of it of which they put one pulverised into a quart of limpid water and so give the Patient to drink of it as much as he needs to quench his thirst Or they give of this purified Niter to their Patients labouring under this Inflammation the quantity of a ducat or half a ducat weight in Broath or in Ptisan till they find the Tongue cleared of its