we must look upon it as the mark and labour to preserve it by the use of convenient things as much as lies in our power Wherefore because it is very necessary to know the distinction of Temperaments I have thought good in this place briefly to handle the Temperaments of the parts of the Body Ages Seasons of the year Humors and Medicines Therefore the temperaments of the parts of our body are of this nature not only by the judgment of the touch of a mans hand which is justly tempered who is often deceived by flowing heat which What the temperaments of mans body are spread from the heart into all the body imparts a certain kind of heat to all the parts but also by the rule of their reason composure and substance as A Bone is the most dry and cold A Grisle less than it A Ligament less then a Grisle A Tendon is so much dryer and colder than the membrane by how much it in the same temper exceeds a Vein and Artery Then follow the harder Veins for the softer are in a middle temper of dryness and moisture like as the Skin although all both soft and hard are of a cold temper Wherefore all these parts of their own nature are cold and without blood although the Veins and Arteries wax hot by reason of the heat of the blood they contain which notwithstanding also borroweth that heat from the heart as a part most hot and softer than the skin the Liver next followeth the heart in the order of the hotter parts which is farre softer than the skin it self for if according to Galens opinion Ad finem lib. de Temper the heart is somewhat less hard then the skin and that is far harder than the liver as appears by touching them it must necessarily follow that the liver much exceeds the skin in softness I understand the skin simple and separated from the flesh lying under it to which it firmly cleaves The flesh is more moist and hot than the skin by reason of the blood dispersed in it The spinal marrow is colder and moister than the skin but the brain so much exceeds it in moisture as it is exceeded by the fat The lungs are not so moist as the fat and the spleen and kidneys are of the like nature and nevertheless they are all moisture than the skin According to the diversities of ages the temperaments both of the whole body The temperaments of ages and all its parts undergo great mutations for the bones are far harder in old men than in children because our life is as it were a certain progress to dryness which when it comes to the height consequently causeth death What an age is Wherefore in this place we must speak of the Temperaments of Ages when first we shall have defined what an Age is Therefore an Age is defined A space of life in which the constitution of the body of its self and own accord undergoeth manifest changes The whole course of life hath four such Ages The first is Childhood which extends from the birth to the eighteenth year of age and hath a hot and moist temper because it is next to the hot and moist beginnings of life seed and blood Youth followeth this which is prolonged from the eighteenth to the twenty fifth year and is temperate and in the midst of all excesses Mans estate succeedeth Youth which they deny to extend beyond the thirty fifth year of age in its proper temper it is hot and dry whereby it commeth to pass that then the heat is felt more acide and biting which in childhood seemed milde because the progress of the life to dryness Old-age divided into two parts hath much wasted the native humidity Then succeeds Old-age ever divided into two parts the first whereof extends from the thirty fifth to the forty ninth year those of this age are called Old-men but we commonly call them middâ—e ag'd men The latter is as it were divided by Galen into three * Three degrees of the second part of Old-age degrees the first whereof are those who having their strength sound and firm undergo civill affairs and businesses which things those which are in the second degree of Old-age cannot do because of the debility of their now decaying strength but those which are in the last degree are afflicted with most extream weakness and misery and are as much deprived of their senses and understanding as of the strength of their bodies whereof arose this Proverb Old men twice Children Those Old men of the first rank are pleasant and curteous and those we say are beginning to grow Old or in their green Old-age those of the second sort delight in nothing but the boord and bed but old decrepit men of the last order think of nothing else than their graves and monuments Old men have their solid parts dry Their firm and solid parts are of a cold and dry temperature by reason of the decay of the radical moisture which the inbred heat causeth in the continuance of so many years Which thing may happen in a short space by the vehement flame of the same natural heat turned by fevers into a fiery heat But if any to prove Old men moist will object That they cough oft and spit much I will answer him as an old Doctor once said That a pitcher filled with water may pour forth much moisture yet no man will deny but that such a vessel of its own terrene nature and matter is most dry so old men may plainly be affirmed to be moist by reason of their defect of heat and abundance of excrements But this description of ages is not to be taken so strictly as alwayes to be measured by the spaces and distances of years for there are many which by their own misdemeanour seem elder at forty than others do at fifty A comparison of the four ages to the four seasons of the year Lastly the famous Philosopher Pythagoras divided mans life into four ages and by a certain proportion compared the whole course thereof to the four seasons of the year as Childhood to the Spring in which all things grow and sprout out by reason of plenty and abundance of moisture And Youth to the Summer because of the vigor and strength which men enjoy at that age And mans estate or constant age to Autumn for that then after all the dangers of the fore-passed life the gifts of discretion and wit acquire a seasonableness or ripeness like as the fruits of the earth enjoy at that season And lastly he compares Old-age to the sterile and fruitless Winter which can ease and consolate its tediousness by no other means than the use of fruits gathered and stored up before which then are of a cold and troublesome condition But for extreme Old-age which extends to eighty or a hundred years it is so cold and dry that those which arrive at that decrepit age are
that the head of a Muscle is one while above another while below otherwhiles in the midst as in the Midriff as you may know by the insertion of the Nerve because it enters the muscle by its head From their Belly From their belly also there be some differences of muscles taken for some have their belly immediately at their beginning as the muscles of the buttocks others at their insertion as the Midriff others just at their head as those which put forth the Calf of the leg in others it is somewhat further off as in those which draw back the arm and which bend the leg in others the belly extends even from the head unto the tail as in the intercostal muscles and those of the wrist in others it is produced even to their insertion as in those of the palms of the hands and soles of the feet some have a double belly distinguished by a nervous substance as those which open the mouth and those which arise from the root of the lower process of the shoulder-blade From their Tendons Moreover the differences of muscles are drawn also from the Tendons for some have none at least which are manifest as the muscles of the lips and the sphincter-muscles the intercostal and those of the wrist others have them in part and want them in part as the Midriff for the Midriff wants a Tendon at the ends of the shorter ribs but hath two at the first Vertelra of the Loins in which it is terminated Others have a Tendon indeed But some of these move with the bone some not as the muscle of the eyes and besides some of these have broad and membranous tendons as the muscles of the eyes and Epigastrium except the right muscles In others they are thick and round as in the benders of the fingers in others they are less round but more broad than thick such is the Tendon arising from the twin muscles and Soleus of the leg others have short Tendons as the muscles which turn down the hand othersome long as those of the palms of the hands and soles of the feet besides others produce Tendons from the end of their belly which Tendons are manifest others from the midst as the Temporal Muscles Besides also others diffuse many Tendons from their belly as in the hands the benders of the fingers and extenders of the feet Othersome put forth but one which sometimes is divided into many as those which bend the third articulation of the foot otherwhile many muscles by their meeting together make one Tendon as the three muscles of the Calf of the leg and those which bend the cubit and leg All Tendons have their original when the nerves and ligaments dispersed through the fleshy substance of a muscle are by little and little drawn and meet together until at last carried to the joint they are there fastned for the fit bending and extension thereof From the contrariety of their Actions for some parts have contrary muscles benders and extenders From their action From their function other parts have none for the Cods and Fundament have only lifters up From their function for some are made for direct motions as those which extend the fingers and toes others for oblique as the Supinators of the hand and the Pronators others perform both as the pectoral muscle which moves the Arm obliquely upward and downward as the upper and lowers fibers are contracted and also outright if all the fibers be contracted together which also happens to the Deltoides and Trapezius I have thought it good to handle particularly these differences of muscles because that by understanding them the prognostick will be more certain and also the application of remedies to each part and if any occasion be either to make incision or future we may be more certain whether the part affected be more or less nervous CHAP. IX Of the parts of a Muscle HAving declared the nature and differences of a Muscle we must note that some of the parts thereof are compound and universal others simple or particular The compound and simple parts of a Muscle The compound are the head belly and tail The simple are ligaments a nerve flesh a vein artery and coat For the compound parts by the head we understand the beginning and original of a muscle which is one while ligamentous and nervous otherwhiles also fleshy By the belly that portion which is absolutely fleshy But by the tail we understand a Tendon consisting partly of a nerve partly of a ligament promiscuously coming forth from the belly of the Muscle For as much as belongs to the simple which are six in number three are called proper and three common The proper are a Ligament from a bone a nerve proceeding from the Brain or spinal marrow and flesh compact by the concretion of blood The common are a vein from the Liver or trunk arising from thence an artery proceeding from the Heart What use each simple particle hath in a muscle a Coat produced by the nervous and ligamentous fibers spreading over the superficies of the muscle But for the simple use of all such parts the nerve is as it were the principal part of a Muscle which gives it sense and motion the ligament gives strength the flesh contains the nervous and ligamentous fibers of the Muscle and strengthens it filling up all the void spaces and also it preserves the native humidity of these parts and cherisheth the heat implanted in them and to conclude defends it from all external injuries for like a fan it opposeth it self against the heat of the Sun and is a garment against the cold and is as a cushion in all falls and bruises and as a buckler of defence against wounding-weapons The vein nourishes the muscle the artery gives it life the coat preserves the harmony of all the parts thereof lest they should be any ways disjoined or corrupted by purulent abscesses breaking into the empty or void spaces of the Muscles as we see it hapneth in a Gangrene where the corruption hath invaded this membrane by the breathing out of the more acid matter or filth CHAP. X. A more particular inquisition into each part of a Muscle HAving gone thus far it remains that we more particularly inquire into each part of a Muscle that if it be possible nothing may be wanting to this discourse The nature of a Ligament Wherefore a Ligament properly so called is a simple part of mans body next of a bone and grislle the most terrestrial dry hard cold white taking its original immediatly or by the interposition of some Medium from the Bones or Grisles from whence also the Muscles have their beginning whereby it comes to pass that a ligament is void of sense unless it receive a nerve from some other place for so the ligaments which compose and strengthen the tongue and yard are partakers of sense and it inserts it self into the bone and grisle that
so it may bind them together and strengthen and beautifie the whole joint or connexion for these three be the principal uses of a ligament then diffusing it self into the membranes and muscles to strengthen those parts The treefold use of a Ligament What a Nerve is A Nâ—rve to speak properly is also a simple part of our body bred and nourished by a gross and pâ—legmatick humour such as the brain the original of all the nerves and also the Spinal marrow endued with the faculty of feeling and oftentimes also of moving For there be divers parts of the body which have nerves yet are destitute of all voluntary motion having the sense only of â—eeling as the membranes veins arteries guts and all the entrails A nerve is covered with a double cover from the two membranes of the brain and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebra's or else from the Pericranium What we mean by the nervous and ligamentous fibers We understand no other things by the fibers of a Nerve or of a Ligament than long and slender threds white solid cold strong more or less according to the quantity of the substance which is partly nervous and sensible partly ligamentous and insensible You must imagine the same of the fleshy fibers in their kind but of these threds some are streight for attraction others oblique for retention of that which is convenient for the creature and lastly some transverse for expulsion of that which is unprofitable But when these transverse threds are extended in length they are lessened in bredth but when they are directly contracted they are shortned in length But when they are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it self as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animal parts to perform voluntary motions others upon the vital to perform the agitation of the heart and arteries others upon the natural for attraction By what power the similar parts principally draw or attract What and of how many sorts the flesh is retention and expulsion Yet we must observe that the attraction of no similar part is performed by the help of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of emptiness or the familiarity of the substance The flesh also is a simple and soft part composed of the pure portion of the blood insinuating it self into the spaces between the fibers so to invest them for the uses formerly mentioned This is as it were a certain wall and bulwark against the injuries of heat and cold against all falls and bruises as it were a certain soft pillow or cushion yielding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kind is more pallid even in perfect creatures having blood such is the flesh of the heart stomach weason guts bladder womb The third is belonging to the entrails or the proper substance of each entrail as that which remains of the Liver the veins arteries and coat being taken away of the bladder of the gall brains kidnies milt Some add a fourth sort of flesh which is spongy that they say is proper to the tongue alone What a vein is A Vein is the vessel pipe or channel of the blood or bloody matter it hath a spermatick substance consists of one coat composed of three sorts of fibers What an Artery is An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermatick substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thick and dense than the utmost interwoven with transverse fibers and it doth not only contain blood and spirit but also a serous humour which we may believe because there be two emulgent Arteries as well as Veins Why an artery is more thick and dense than a vein But the inner coat of an Artery is therefore more thick because it may contain blood which is more hot subtil and spirituous for the spirit seeing it is naturully more thin and light and in perpetual motion would quickly fly away unless it were held in a stronger hold There is other reason for a Vein as that which contains blood gross ponderous and slow of motion Wherefore if it had acquired a dense and gross coat it could scarce be distributed to the neighbouring parts The mutual Anastomasis of the veins and arteries Where it is manifest God the maker of the Universe foreseeing this made the coats of the vessels contrary to the consistence of the bodies contained in them The Anastomasis of the Veins and Arteries that is to say the application of the mouths of the one to the other is very remarkable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that Anastomasis is apparent in the Vein and Artery that meet together at the joint and bending of the arm which I have sometimes shewed in the Physick schools at such time as I there dissected Anatomies From whence a muscle hath its beginning or head But the action or function of a Muscle is either to move or confirm the part according to our will into which it is implanted which it doth when it draws it self toward its original that is to say its head But we define the head by the insertion of the nerve which we understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower Belly NOw seeing that we have taught what a Muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remains that we come to the particular explication of each Muscle beginning with those of the lower belly as those which we first meet withal in dissection Eight muscles of the Epigastrium These are eight in number four oblique two on each side two right or direct one on the right another on the left side and in like manner two transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may add to this number the two little Supplying or Assisting muscles which are of a Pyramidal form The oblique
appetite for by Galen's opinion In arte parva Coldness increases the appetite by which it comes to pass that they have a greater quantity of Chylus by which plenty the Liver is nourished and grows larger Some Beasts as Dogs and Swine have the Liver divided into five or more Lobes but a man hath but one Lobe or two or three at the most and these not so much distinguished as which cherish the upper hollow region of the ventricle with embracing to help forward the work of concoction Therefore the liver is almost content with one Lobe although it is always rent with a small division that the umbilical vein piercing into the roots and substance of it may have a free passage but also oftentimes there is as it were a certain small Lobe of the Liver laid under that umbilical-vein as a cushion The figure of the Liver is gibbous rising up and smooth towards the Midriff The figure towards the stomach is the simous or hollow-side of it somewhat unequal and rough by reason of the distance of the Lobes the original of the hollow-vein and the site of the bladder of the Gall. The composition of the Liver is of Veins Nerves Arteries The composure the coat and proper substance thereof which we call the gross and concrete blood or Parenchyma The vessels Veins and arteries come to it from the navil but nerves immediately from these which are diffused over the stomach according to Hippocrates yet they penetrate not very deep into its substance for it seems not to stand in need of such exact sense but they are distributed upon the coat and surface thereof because this part made for distribution over the whole body keeps to it self no acrid or malign humor for the perception of which it should need a nerve although the coat investing it sends many nervous fibers into its substance as is apparent by the taking away of the coat from a boiled Liver we must think the same of the other entrails The coat of the Liver is from the Peritonaeum waxing small from the umbilical vein when it divides it self for the generation of the gate and hollow-veins as is observed by Galen Lib. de format Foetus The Liver is only one situate in the greater part on the right side The number and site but with the lesser part on the left quite contrary to the Stomach It s chief connexion is with the stomach and guts The connexion by the veins and membranes of the Peritonaeum by the hollow vein and artery with the heart by the nerve with the brain and by the same ligatures with all the parts of the whole body The temper It is of a hot and moist temper and such as have it more hot have large veins and hot bloud The action but such as have it cold have small veins and a discoloured hew The action of the Liver is the conversion of Chylus into the blood the work of the second concoction For although the Chylus entring into the meseraick veins receive some resemblance of blood yet it acquires not the form and perfection of blood before it be elaborate and fully concoct in the liver It is bound and tyed with three strong ligaments The ligaments two on the sides in the midst of the bastard ribs to bear up it sides and the third more high and strong descending from the blade to sustain its proper part which with its weight would press the lower orifice of the stomach and so cause a falling or drawing down of the sternon and coller-bone And thus much may suffice for its proper ligaments for we before-mentioned its common the veins arteries nerves and coat of the Peritonaeum by which it is knit to the loins and other natural parts But we must note that besides these three proper ligaments the liver is also bound with others to the Bastard-ribs as Sylvius observes in his Anatomical observations and Hollerius in his Practice Cap. de Pluritide CHAP. XVIII Of the Bladder of the Gall. The substance greatness and figure thereof NOw we must come to the bladder of the Gall which is of a nervous substance and of the bigness of a small Pear it is of figure round with the bottom more large but the sides and mouth more narrow and strait It is composed of a double coat one proper consisting of three sorts of fibers The composition the other from the Peritonaeum It hath a vein from the Porta or Gate-vein and an artery from that which is diffused into the Liver and a nerve from the sixt conjugation Number and connexion It is but one and that hid on the right side under the greater lobe of the Liver it is knit with the touching of its own body and of the passages and channels made for the performance of its actions with the Liver and in like manner with the Duodenum and not seldom with the stomach also by another passage and to conclude to all the parts by its veins nerves arteries and common coat Temper Action It is of a cold temper as every nervous part is The action of it is to separate from the Liver the cholerick humor and that excrementitious but yet natural by the help of the right fibers for the purifying of the blood and by the oblique fibers so long to keep it being drawn until it begin to become troublesome in quantity or quality or its whole substance then by the transverse fibers The channels of the Gall. to put it down into the Duodenum to provoke the expulsive faculty of the guts I know Fallopius denies the texture of so many fibers to be the minister of such action to the gall But Vesalius seems sufficiently to have answered him The bladder of the gall hath divers channels for coming with a narrow neck even to the beginning of the Gate-vein it is divided into two passages Lib. 2. de temper the one whereof suffering no division is carryed into the Duodenum unless that in some it send another branch into the bottom of the stomach as is observed by Galen which men have a miserable and wretched life being subject to cholerick vomitings especially when their stomachs are empty with great pains of their stomach and head as is also observed by Galen Cap. 74. Artis Med. The other coming out of the body of the Liver divides it self into two or three passages again entring the substance of the Liver is divided with infinite branches accompanying so many branches of the Gate-vein through the substance of the Liver that so the blood unless it be most elaborate and pure may not rise into the hollow-hollow-vein all which things Dissection doth manifestly teach The sixth Figure of the Bladder of the Gall. M. the Pylorus joyned to the Duodenum N. the Duodenum joyned to the Pylorus P. shews the bottom of the bladder of the gall QQ the holes of the bladder of Gall
dispersed through the Liver betwixt the roots of the hollow and Gate-veins R. the root of the Gate-vein in the Liver S. the root of the hollow-vein in the Liver a. The concourse or meeting of the passages of choler into one branch b. The neck of the bladder into which the passage is inserted c. The passage of the Gall into the Duodenum d. the Duodenum opened to manifest the insertion of the porus biliaris i. e. an artery going to the hollow part of the Liver and the bladder of the Gall. f. a small nerve belonging to the liver and the bladder of gall from the rib branch of the sixth pair gg the cistick twins from the gate-veins CHAP. XIX Of the Spleen or Milt BUt because we cannot well shew the distribution of the gate-vein unless the Spleen be first taken away and removed from its seat therefore before we go any futher The Substance I have thought good to treat of the Spleen Therefore the Spleen is of a soft rare and spongious substance whereby it might more easily receive and drink up the dregs of the blood from the liver and of a flesh more black than the liver For it resembles the colour of its muddy blood Magnitude Figure from which it is generated It is of an indifferent greatness but bigger in some than in othersome according to the diverse temper and complexion of men It hath as it were Composition a triangular figure gibbous on that part it sticks to the ribs and midriffe but hollow on that part next the stomach It is composed of a coat the proper flesh a vein artery and nerve The membrane comes from the Peritonaeum the proper flesh from the faeces or dregs of bloud or rather of the natural melancholy humor with which it is nourished The fourth branch of the vena porta or gate-gate-vein lends it a vein the first branch of the great descendent artery presently after the first entrance without the Midriff lends it an artery But it receives a nerve from the left costal from the sixt conjugation on the inner part by the roots of the ribs and we may manifestly see this Nerve Number and Site not only dispersing it self through the coat of the liver but also penetrating with its Vessels the proper flesh thereof after the self same manner as we see it is in the heart and lungs It is one in number situate on the left side between the stomach and the bastard-ribs or rather the midriffe which descends to their roots For it oft-times cleaves to the midriff on its gibbous part by a coat from the Peritonaeum as also on the hollow part to the stomach both by certain veins which sends it into the ventricle as also by the kall It hath connexion either primarily or secundarily Connexion with all the parts of the body by these its vessels It is of a cold and dry temper the action and use of it is to separate the Melancholick humor Temper and use which being feculent and drossie may be attenuated by the force of many arteries dispersed through its substance For by their continual motion and native heat which they carry in full force with them from the heart that gross blood puts off its grosness which the Spleen sends away by passages fit for that purpose retaining the subtler portion for its nourishment The passages by which it purges it self from the grosness of the melancholy bloud are a vein ascending from it into the stomach to stir up the appetite by its sourness and strengthen the substance thereof by its astriction also another vein which sometimes from the Spleen-branch sometimes from the gate-vein plainly under its orifice descends to the fundament there to make the Haemorrhoidal veins CHAP. XX. Of the Vena Porta and Gate-vein and the distribution thereof THe Gate-vein as also all the other veins is of a spermatick substance The substance and figure of a manifest largeness of a round and hollow figure like to a pipe or quill It is composed of its proper coat and one common from the Peritonaeum It is only one Composition Number and Site and that situate in the simous or hollow part of the Liver from whence it breaks forth or rather out of the umbilical vein into the midst of all the guts with which it hath connexion as also with the stomach spleen sphincter of the fundament and Peritonaeum by the coat which it receives from thence Temper and Action It is of a cold and dry temper The Action of it is to suck the Chylus out of the ventricle and guts and so to take and carry it to the Liver until it may carry back the same turned into bloud for the nutriment of the stomach spleen and guts This gate-gate-vein coming out of the simous part of the Liver is divided into six branches that is four simple and two compound again divided into many other branches Division thereof into 6 branches of which 4 simple 1. Clysticae gemellae 2. Gastrica 3. Gastrepiplois 4. Intestinalis The first of the simple ascends from the fore-part of the trunk of the bladder of the Gall by the passage of the Choler and are marked with g g with a like artery for life and nourishment and this distribution is known by the name of Cysticae gemellae or Cystick twins The second called the Gastrica or stomach vein arising in like manner from the forepart of the trunk is carryed to the Pylorus and the simous or back-part of the stomach next to it The third is called Gastrepiplois the Stomach and kall-vein which coming from the right side of the gate-vein goes to the gibbous part of the stomach next to the Pylorus the right side of the kal. The fourth going forth from behind and on the right hand of the gate-vein ascends above the root of the Meseraick branch even to the beginning of the gut Jejunum along the gut Duodenum from whence it is called Intestinalis or the Gut-vein And these are the four simple branches Now we will speak of the compound The first is splenick which is divided after the following manner Two compound I. Ramus Splenicus sending forth For in its first beginning and upper part it sends forth the Coronalis or Crown-vein of the stomach which by the back-part of the stomach ascends into the upper and hollow part thereof to which place assoon as it arrives 1. Coronalis it is divided again into two branches the one whereof climbs up even to its higher orifice the other descends down to the lower sending forth by the way other branches to the fore and back parts of the stomach These engird and on every side incompass the body or the ventricle for which cause they are named the crown-veins I have sometimes observed this coming forth of the trunk a little above the orifice of the splenick branch 2. Haemorrhoidalis Interna But
Ventricles of the Heart where kept in by the density thereof they turn into yellowish moisture as we see it happens in an Alembeck The Consistence Nature would have the Pericardium of a dense and hard consistence that by the force thereof the Heart might be kept in better state for if the Pericardium had been bony it would have made the Heart like iron by the continual attrition on the contrary if it had been soft and fungous it would have made it spongy and soft like the Lungs CHAP. XI Of the Heart What the Heart is and of what substance THe Heart is the chief mansion of the Soul the organ of the vital faculty the beginning of life the fountain of the vital spirits and so consequently the continual nourisherer of the vital heat the first living and last dying which because it must have a natural motion of it self was made of a dense solid and more compact substance than any other part of the body The three sorts of fibers of the Heart The flesh thereof is woven with three sorts of fibers for it hath the right in the inner part descending from the basis into the point that they might dilate it and so draw the blood from the hollow-Hollow-vein into the receptacles thereof and the breath or air from the Lungs by the Arteria venosa it hath the transverse without which pass through the right at right angles to contract the Heart and so drive the vital spirits into the great Artery Aorta and the cholerick blood to the Lungs by the Vena arteriosa for their nourishment It hath the oblique in the midst to contain the air and blood drawn thither by the forementioned vessels until they be sufficiently elaborate by the Heart All these fibers do their parts by contracting themselves towards the original as the right from the point of the Heart towards the basis whereby it comes to pass that by this contraction of the fibers the Heart dilated becomes shorter but broader no otherwise than it is made more long and narrow by the contraction of the tranverse but by the drawing of the oblique it is lessened in that part which looks towards the Vertebra's which chiefly appears in the point thereof The Magnitude It is of an indifferent bigness but yet in some bigger in some less according to the diverse temper of cold or hot men as we noted in the Liver Figure The figure thereof is pyramidal that is it is broader in the basis and narrower at his round point Composition It is composed of the most dense flesh of all the body by the affusion of blood at the divisions and foldings of the vessels and there concrete as it happens also to the other entrails For the blood being there a little more dryed than that which is concrete for the making of the Liver turns into a fleshy substance more dense than the common flesh even as in hollow ulcers when they come to cicatrize The proper Vessels It hath the Coronal veins and arteries which it receives either on the right side from the Hollow vein or on the left from the basis at the entrance of the artery Aorta You cannot by your eye discern that the Heart hath any other nerves than those which come to it with the Pleura The Nerves Yet I have plainly enough observed others in certain Beasts which have great hearts as Swine they appeared seated under the fat which covers the vessels and basis of the Heart lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the heart Whereby you may perceive that the heat of the Heart is different from the Elementary heat as that which suffers fat to grow about this entrail where otherwise it doth not concrete unless by cold or a remiss heat which thing is chiefly worth admiration The Heart is one alone situate most commonly upon the fourth vertebra of the Chest Number and site which is in the midst of the Chest Yet some think that it inclines somewhat to the left side because we there feel the motion or beating thereof but that happens by reason of its left ventricle which being it is filled with many spirits and the beginning of the Arteries it beats far more vehemently than the right It required that seat by the decree of Nature because that region is the most safe and armed besides it is here on every side covered as it were with the hands of the Lungs It hath connexion with the fore-mentioned Vertebra's but by the parts composing it Connexion with those parts from whence it hath them with the Lungs by the Vena arteriosa and the Arteria venosa and lastly with all the parts of the body by the Arteries which it sends to them all It is of a hot and moist temper as every fleshy part is The action thereof is Temper and action first to prepare the blood in its right ventricle for the fit nourishment of the Lungs for from hence it is that Galen saith This right ventricle was made for the necessity of the Lungs Secondly to generate the vital spirits in its left ventricle for the use of the whole body What the vital spirit is But this spirit is nothing else than a certain middle substance between air and blood fit to preserve and carry the native heat wherefore it is named the Vital as being the author and preserver of life In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them such are the Valvulae or Valves the Vessels and their mouths their distribution into the Lungs the wall or partition and the two productions or Ears of the Heart which because they are doubtful whether they may be reckoned amongst the external or internal parts of the heart I will here handle in the first place Therefore these Auriculae or Ears are of a soft and nervous substance The Auriculae Cordis or ears of the heart compact of three sorts of fibers that so by their softness they might the more easily follow the motions of the Heart and so break the violence of the matter entering the Heart with great force when it is dilated For otherwise by their violent and abundant entrance they might hurt the Heart and as it were overwhelm and suffocate it but they have that capacity which we see given by nature that so they might as it were keep in store the blood and air and then by little and little draw it forth for the use of the necessity of the Heart But if any enquire if such matters may be drawn into the Heart by the only force of the Diastole ad fugam vacui for avoiding of emptiness I will answer That that drawing in or attraction is caused by the heat of the Heart which continually draws these matters to it no otherwise than
a fire draws the adjacent air and the flame of a Candle the Tallow which is about the wiek for nourishments sake Whilst the Heart is dilated it draws the air whilst it is drawn together or contracted it expels it This motion of the Heart is absolutely natural as the motion of the Longs is animal Some add a third cause of the attraction of the Heart to wit the similitude of the whole substance But in my judgment this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the Heart than in that which is performed for attraction of matters for the benefit of the whole Body These Ears differ in quantity for the right is far more capacious than the left Their magnitude and Number because it was made to receive a greater abundance of matter They are two in number on each side one situate at the basis of the Heart The greater at the entrance of the hollow vein into the Heart the less at the entrance of the veinous and of the great Artery with which parts they both have connexion We have formerly declared what use they have that is Their use to break the violence of the matters and besides to be stays or props to the Arteria venosa and great Artery which could not sustain so rapid and violent a motion as that of the Heart by reason of their tenderness of substance Of the Ventricles of the Heart THe Ventricles are in number two on each side one The partition between the ventricles of the heart distinguished with a fleshy partition strong enough having many holes in the superficies yet no where piercing through The right of these Ventricles is the bigger and encompassed with the softer and rarer flesh the left is the lesser but is engirt with a threefold more dense and compact flesh for the right Ventricle was made for a place to receive the blood brought by the hollow-hollow-vein and for distributing of it partly by the Vena arteriosa into the lungs for their nourishment partly into the left ventricle by sweating through the wall or partition to yield matter for the generation of the vital spirits Therefore because it was needful there should be so great a quantity of this blood Why the right ventricle is more capacious and less compact it was likewise fit that there should be a place proportionable to receive that matter And because the blood which was to be received in the right ventricle was more thick it was not so needful that the flesh to contain it should be so compact but on the contrary the arterious blood and vital spirit have need of a more dense receptacle for fear of wasting and lest they should vanish into air and also less room that so the heat being united might become the stronger and more powerfully set upon the elaboration of the blood and spirits Therefore the right Ventricle of the Heart is made for preparation of the blood appointed for the nourishment of the Lungs and the generation of the vital spirits The action of the right ventricle as the Lungs are made for the mitification or qualifying of the Air. Which works were necessary if the Physical Axiome be true That like is nourished by like as the rare and spongious Lungs with more subtil blood the substance of the Heart gross and dense with the veinous blood as it flows from the Liver that is gross The action of the left ventricle And it hath its Coronal veins from the Hollow-vein that it might thence draw as much as should be sufficient But the left Ventricle is for the perfecting of the vital spirit and the preservation of the native heat Of the Orifices and Valves of the Heart The uses of the four orifices of the Heart THere be four Orifices of the Heart two in the right and as many in the left Ventricle the greater of the two former gives passage to the vein or the blood carryed by the hollow-Hollow-vein to the Heart the lesser opens a passage to the Vena arteriosa or the cholerick blood carried in it for the nourishment of the Lungs The larger of the two other makes a way for the distribution of the Artery Aorta and the vital spirit through all the body but the lesser gives egress and regress to the Ateria venosa or to the air and fuliginous vapors And because it was convenient that the matters should be admitted into their proper Ventricles by these orifices by the Diastole to wit into the right ventricle by the greater orifice and into the left by the lesser and because on the contrary it was fit that the matters should be expelled by the Systole from their ventricles by the fore-mentioned orifices The Valves Therefore nature to all these orifices hath put eleaven valves that is to say six in the right ventricle that there might be three to each orifice five in the left that the greater orifice might have three and the lesser two for the reason we will presently give How they differ These Valves differ many ways First in action for some of them carry in matter to the Heart others hinder that which is gone out that it come not back again Secondly they differ in site Action Site Figure for those which bring in have membranes without looking in those which carry out have them within looking out Thirdly in figure for those which carry in have a Pyramidal figure but those which hinder the coming back again are made in the shape of the Roman letter C. Fourthly Substance in substance for the former for the most part are fleshy or woven with fleshy fibers into certain fleshy knots ending towards the point of the heart The latter are wholly membranous Number Fiftly they differ in number for there be only five which bring in three in the right ventricle at the greater orifice and two in the left at the lesser orifice those which prohibit the coming back Motion are six in each ventricle three at each orifice Lastly they differ in motion for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit and contrariwise are shut in the Systole that they may contain all or the greater part of that they brought in The membranous on the contrary are opened in the Systole to give passage forth to the blood and spirits over all the body but shut in the Diastole that that which is excluded might not flow back into the Heart But you shall observe that Nature hath placed only two Valves at the orifice of the Arteria venosa Why there be only two Valves at the Orifice of the Arteria venosa because it was needful that this Orifice should be always open either wholly or certainly a third part thereof that the air might continually be drawn into the Heart by this Orifice in Inspiration and sent forth by
Exspiration in the contraction of the Heart Whereby we may gather this that there is but one third part of that air we draw into the Heart in breathing sent forth again in the form of vapor in exspiration because Nature would have but one third part of the Orifice to lye open for its passage out Therefore the exspiration or breathing out and the Systole of the Heart and Arteries is shorter than the inspiration so that we may truly say that the inspiration or drawing the breath in is equally so long as the exspiration is together with the rest which is in the midst between the two motions CHAP. XII Of the distribution of the Vena arteriosa and the Arteria venosa HAving hitherto shewed the original of the vessels of the Heart we must now speak of their distribution The Vena arteriosa or the Arterious vein and the Arteria venosa or the Veinous Artery each proceeding out of his proper ventricle that is the right and left are divided into two large branches one of which goes to the right and the other to the left hand the one lying cross-ways over the other the Vein always riding over the Artery as you may understand better by the sight of your eys The Artery always lies under the vein than by reading of Books These branches at their entrance of the Lungs are divided into two other large branches and each of them go to his peculiar Lobe of the Lungs and these again run almost into infinite other branches dispersed in three places over the Lungs These Vessels have acquired their names by reason of that transmutation of consistence whereby the composure of a vein degnerates into an Artery A twofold reason why the Vein was made arterious or like an artery and that of an Artery into a Vein for the commodity of life For this is a miracle of prudent Nature to change the Coats of the vessels of the Lungs producing a Vein which in its Body should imitate an Artery and an Artery which should represent a Vein for if the Vena arteriosa should have retained its proper consistence the arterious blood which is carryed by it from the Heart to nourish the Lungs might by reason of its subtilty penetrate through and flow away by reason of the rarity of the veinous texture and so nature should never have attained her conceived end that is to nourish the Lungs by reason of the continual motion of their contraction and dilatation For nourishment cannot be assimilated to the part unless it be put and cleave to it Wherefore it was fit that nature should make the Body of this vein solid that it might be immoveable unshaken and stubborn in respect of a vein which by its softness would have been too obsequious and yielding to the agitation of the Lungs that so it might have nourishment which might be diffused into all parts thereof and which might neither be drawn by its Diastole Why the Artery was made like a Vein nor driven back into the heart by its Systole But the artery hath the consistence of a vein that by that veinous softness according to the necessity of Nature it might be the more readily contracted and dilated to bring the air in and carry the vapours forth of the heart Here we meet with a difficulty which is By what way the Blood is carried out of the right and left ventricle of the heart Galen thinks that there be certain holes in the partition made for that purpose By what way blood may pass out of the right into the left ventricle and verily there are such but they are not perforated Wherefore Columbus hath found out a new way which is that the Blood is carried to the lungs by the Vena Arteriosa and there attenuated and carried from thence together with the air by the Arteria venosa to the left ventricle of the heart this he writes truly very probably Botallus in his Treatise de Catarrho hath found out a third way to wit a vein which he cals Arteriarum nutrix that is The nurse of the arteries The vein called the Nurse of the arteries Fallop initio obser Arteriarum Gal. lib. 15. de usu partium cap. 6. which creeps a little above the Coronal to the right ear of the Heart and then goes into the left ear thereof But yet I am very much afraid that this vein observed by Botallus is that vessel observed by Fallopius whereby the Vena Arterialis is joyned to the Aorta and by which the all vital Blood is carried for the forming and nourishment of the Lungs whilst the infant is yet in the womb Of which also Galen makes mention but it had lain hid from his time to this day but that Fallopius raised up the memory of it again CHAP. XIII The Distribution of the ascendent Hollow-Vein THe Hollow Vein rising out of the gibbous part of the Liver Gal. lib. de form foetus The greater descendent branch of the hollow vein and resembling according to Galen the Body of a Tree is divided into two notable Branches but not of a like bigness For the greater by the hind-part of the Liver upon the Back-bone and by the way receives certain other Branches from the substance of the Liver which enter not into the great trunck with the rest You may often see this descendent Branch even to the Back-bone upon which it lies in this its descent covered with the substance of the Liver so that it may seem that branch proceeds not from that common trunk together with the ascendent The upper branch of the hollow vein is the less although indeed it always doth But the lesser Branch ascends to the upper parts and is distributed after this manner following For first arising into the Midriff it bestows two small veins upon it on each side one which from that part are called Phrenicae But from thence when it arrives at the right Ear of the Heart it makes the Coronales the Coronal or Crown-veins Venae phrenica Coronales which compass the basis of the heart in manner of a Crown Thirdly entring somewhat more deeply into its right Ear in its greater part it produces the vena arteriosa Fourthly lifted up above the heart Vena Arteriosa on the right side it produces the vein Azygos or sine pari that is without a fellow which descending to the fourth rib reckoning from above downwards nourisheth the intercostal muscles and also the membranes of the eight lower ribs on both sides sending a Branch into each of the muscles at the lower part of the rib which may be sufficient for their nourishment Besides also oftentimes Vena Azygos or sine pari especially in little men this vein Azygos nourishes all the spaces between all the ribs by the like Branches which it sends in the same manner to the four upper ribs Moreover also this Azygos sometimes The Azygos sometimes two How the matter
with a cap stuffed with cotton on that side CHAP. XXIX Of the Wounds of the Neck and Throat THe Wounds of the Neck and Throat are somewhiles simple The differences of wounds of the neck and throat as those which only use the continuity of the muscles otherwhiles compound such as those which have conjoyned with them a fracture of the Bones as of the Vertebrae or hurt of the internal and external jugular Veins or sleepy Arteries sometimes the Trachea Arteria or Weazon and the oesophagus or gullet are wounded sometimes wholly cut off whence present death ensues Wherefore let not the Chirurgeon meddle with such wounds unless he first foretel the danger of death or the loss of some motion to those that are present The Palsie follows upon wounds of the neck For it often happens that some notable nerve or tendon is violated by a wound in the neck whence a Palsie ensues and that absolutely incurable if the wound shall penetrate to the spinal marrow also hurt therewith Wounds of the Gullet and Weazon are difficultly cured because they are in perpetual motion and chiefly of the latter by reason it is gristly and without bloud The wounds of the gullet are known by spitting of bloud Signs that the gullet is wounded by the breaking forth of meat and drink by the wound but if the Gullet be quite cut asunder the Patient cannot swallow at all For the cut parts are both contracted in themselves the one upwards and the other downwards But we know the weazon is hurt by casting up bloud at the mouth with a continual cough and by the coming forth of the breath or wind by the Wound The wounds of the jugular veins and sleepy Arteries are deadly by accident The Wounds of the jugular Veins and sleepy Arteries if they be great are usually deadly because they cannot be straitly bound up for you cannot bind the throat hard without danger of choaking or strangling the Patient But for defect of a strait ligature in this case the flux of bloud proves deadly If the recurrent Nerve of either side be cut it makes the voyce hoarse if cut on both sides it takes away the use of speech by hurting those instruments which impart motion to the muscles of the Larinx For the cure if the wound be small and not associated with the hurt of any notable vessel By hurting the recurrent Nerve the voyce is hurt nor of the Weazon and Gullet it is speedily and easily cured and if there shall be need you shall use a Suture then you shall put therein a sufficient quantity of Venice-Turpentine mixed with Bole-Armenick or else some of my Balsam of which this the Receipt â„ž Terebinth venetae lb ss gum elemi â„¥ iiij olei hypericonis â„¥ iij. boli armen sang draconis an â„¥ j. aqua vitae â„¥ ij The description of the Author's Balsom liquefiant simul omnia lento igne fiat Balsamum ut artis est ad dendo pulveris ireos florent aloes mastiches myrrhae an Ê’ j. I have done wonders with this Balsom in the agglutination of simple wounds wherein no strange body hath been Now when you have put it in The faculty of Diacalcitheos lay upon it a plaister of Diacalcitheos dissolved in Oyl of Roses and Vinegar as that which hath power to repress the flowing down of humors and hinder inflammation or in stead thereof you may apply Emp. de Gratia Dei or Emp. de Janua But if the jugular Veins and sleepy Arteries be cut let the bleeding be stayed as we have shewed in a chapter treating thereof When the Weazon or Gullet are wounded The cure of the wounded Weazon and Gullet the Chirurgeon shall sow them up as neatly as he can and the Patient shall not endeavour to swallow any hard thing but be content to be fed with gellies and broths When a gargarism is needful this following is very good â„ž hordei M. j. florum rosar p. j. passul mund juâ—ubarum an â„¥ ss glycyrhizae â„¥ j. bulliant omnia simul addendo mellis ros Julep ros an â„¥ ij fiat gargarisma ut artis est A Gargarism With which being warm the Patient shall moisten his mouth and throat for it will mitigate the harshness of the part asswage pain cleanse and agglutinate and make him breathe more freely But that the Chirurgeon may not despair of or leave any thing unattempted in such like wounds The manifold use thereof I have thought good to demonstrate by some examples how wonderful the works of Nature are if they be assisted by Art A certain servant of Monsieur de Champaigne a gentleman of Anjou was wounded in the throat with a sword whereby one of the Jugular-veins was cut together with his Weazon A History He bled much and could not speak and these symptoms remained until such time as the wound was sowed up and covered with medicines But if medicines at any time were more liquid he as it were sucked them by the wound and spaces between the stitches and presently put forth at his mouth that which he had sucked or drawn in Wherefore more exactly considering with my self the greatness of the wound the spermatick and therefore dry and bloudless nature unapt to agglutination of the affected part but chiefly of the Weazon and Jugular-vein as also for that the rough Artery is obnoxious to those motions which the gullet performs in swallowing by reason of the inner coat which is continued to the coat of the gullet by which means these parts mutually serve each other with a reciprocal motion even as the ropes which run to the wheel of a pulley furthermore weighing that the Artery was necessary for the breathing and tempering the heat of the heart as the jugular-Jugular-veins served for the nourishment of the upper parts and lastly weighing with my self the great quantity of bloud he had lost which is as it were the treasure of Nature I told those which were present that death was near and certainly at hand And yet beyond exceptation rather by divine favour then our Art he recovered his health A strange History Equally admirable is this History following Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne but one of them lying in wait to rob the other of his money and a massie chain of gold which he wore set upon him at unawares cut his throat and robbed him and so left him amongst the Vines which were in the way supposing he had kill'd him having with his dagger câ—t the Weazon and Gullet This murderer came back to the City the other half-dead crawled with much ado to a certain Peasant's house and being dressed with such medicines as were present and at hand he was brought to the City and by his acquaintants committed to my care to be cured I at the first as diligently as I could sowed up the Weazon
Cathaereticks which is excellent in these kinds of Wounds whether by it self or mixed with others You shall use these and such like even unto the perfect agglutination and cicatrization of the wound and you may of your self devise other things such as these as occasion shall offer its self CHAP. XXIV What just occasion moved the Author to devise this new form of remedy to stanch the blood after the amputation of a member and to forsake the common way used almost by all Chirurgeons which is by application of actual Cauteries VErily I confess I formerly have used to stanch the bleeding of members after amputation Hot Irons not to be used after another manner than that I have a little before mentioned Whereof I am ashamed and agrieved But what should I do I have observed my masters whose method I intended to follow alwayes to doe the like who thought themselves singularly well appointed to stanch a flux of blood when they were furnished with various store of hot Irons and caustick medicins which they would use to the dismembred part now one then another as they themselves thoâ—ght meet Which thing cannot be spoken or but thought upon without great horror much less acted For this kind of remedy could not but bring great and tormenting pain to the Patient seeing such fresh wounds made in the quick and sound flesh are endured with exquisite sense Neither can any caustick be applyed to nervous bodies but that this horrid impression of the fire will be presently communicated to the inward parts whence horrid symptoms ensue and oft-times death it self And verily of such as were burnt the third part scarce ever recovered and that with much adoe for that combust wounds difficultly come to cicatrization for by this burning are caused cruel pains whence a Feaver Convulsion and oft-times other accidents worse than these Add hereunto that when the eschar fell away oft-times a new haemorrhage ensued for stanching whereof they were forced to use other caustick and burning Instruments Neither did these good men know any other course so by this repetition there was great loss and waste made of the fleshy and nervous substance of the part Through which occasion the bones were laid bare whence many were out of hope of cicatrization being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembred which also took away the opportunity of fitting or putting to of an artificial leg or arm instead of that which was taken off Wherefore I must earnestly entreat all Chirurgeons that leaving this old and too too cruel way of healing they would embrace this new which I think was taught me by the special favour of the sacred Deity for I learnt it not of my masters nor of any other neither have I at any time found it used by any Only I have read in Galen Lib. 5. Meth. that there was no speedier remedy for stanching of blood than to binde the Vessels through which it flowed towards their roots to wit the Liver and Heart This precept of Galen of binding and sowing the Veins and Arteries in the new wounds when as I thought it might be drawn to these which are made by the amputation of members I attempted it in many yet so that at first in my budding practice thereof I alwayes had my Cauteries and hot Irons in a readiness that if any thing hapned otherwise then I expected in this my new work I might fetch succour from the ancient practice untill at length confirmed by the happy experience of almost an infinite number of particulars I bid eternally adieu to all hot Irons and Cauteries which were commonly used in this work And I think it fit that Chirurgeons do the like For antiquity and custom in such things as are performed by Art ought not to have any sway authority or place contrary to reason as they oft-times have in civil affairs wherefore let no man say unto us that the Ancients have alwayes done thus CHAP. XXV The practice of the former precepts is declared together with a memorable history of a certain Souldier whose Arm was taken off at the Elbow I Think it fit to confirm by an example the prescribed method of curing a Gangrene and Mortification A History Whilest I was Chirurgeon to the Marshall of Montejan at Turin a certain common souldier received a wound on his wrist with a musket-bullet by which the bones and tendons being much broken and the nervous bodies cruelly torn there followed a Gangrene and at length a mortification even to the Elbow besides also an inflammation seised upon the middle part of his Chest and there was as it were a certain disposition to a Gangrene whereby it followed that he was painfully and dangerously troubled with belchings hicketings watchings unquietnesse and frequent swoundings which occasioned many Chirurgeons to leave him as desperate But it so fell out that I orecome by his friends intreaty undertook the cure of this wretched person destitute of all humane help Wherefore knowing the mortification by its signs I cut off the arm by the Elbow as speedily as I could making first the ligature whereof I made mention I say I took it off not with a saw Dismembring at a joynt but only with an incision-knife cutting in sunder the ligaments which held the bones together because the sphacell was not passed the joynt of the Elbow Neither ought this section to be counted strange which is made in a joint for Hippocrates much commends it Sect. 4. Lib. de Art and saith that it is easily healed and that there is nothing to be feared therein besides swounding by reason of the pain caused by cutting the common tendons and ligaments But such incision being made the former ligature could not hinder but much blood must flow from thence by reason of the large vessels that run that way Wherefore I let the blood to flow plentifully so to disburden the part and so afterwards to free it from the danger and fear of inflammation and a Gangrene then presently I stanched the blood with an hot Iron for as yet I knew no other course Then gently loosing the ligature I scarified that part of the brawn of the Arm which was gangrenated with many and deep incisions shunning and not touching the inner part by reason of the multitude of the large vessels and Nerves which run that way then I presently applyed a cautery to some of the incisions both to stanch the bleeding and draw forth the virulent sanies which remained in the part And then I assailed and overcame the spreading putrefaction by putting and applying the formerly prescribed medicins I used all sorts of restrictive medicins to stay the inflammation of the Chest I also applyed Epithemaes to the region of the heart and gave him cordiall potions and boles neither did I desist from using them untill such time as his belching hicketting and swoundings had left him
aceti rosar an lb. ss sant rub ros rub anÊ’iii flor nenuph. violar camphur an Ê’ss methridat theriac an Ê’ii terantur misceantur simul omnia When you intend to use them take some portion of them in a vessel by its self wherewith let the affected bowel be fomented warm CHAP. XXIV Whether purging and blood-letting be necessary in the beginning of pestilent diseases SO soon as the heart is strengthened and corroborated with cordials and antidotes Reasons for and against blood-letting in the Plague we must come to phlebotomy and purging As concerning blood-letting in this case there is a great controversie among Physicians Those that wish it to be used say or affirm that the pestilent Fever doth infix it self in the blood and therein also the pestilent malignity taketh its seat and therefore it will soon infect the other humors unless that the blood be evacuated and the infection that remaineth in the blood be thereby taken away Contrariwise those that do not allow phlebotomy in this case alledg that it often cometh to pass that the blood is void of malignity when the other humors are infected with the venomous contagion If any man require my judgment in this doubtful question I say that the pestilence sometimes doth depend on the default of the Air this default being drawn through the passages of the body doth at length pierce unto the intrails as we may understand by the abscesses which break out The composing of this controversie one while behind the ears sometimes in the arm-holes and sometimes in the groins as the brain heart or liver are infected And hereof also come Carbuncles and other collections of matter and eruptions which are seen in all parts of the body by reason that nature using the strength of the expulsive faculty doth drive forth whatsoever is noisom or hurtful Therefore if the Physician will follow this motion of nature he must neither purge nor let blood lest that by a contrary motion that is by drawing in from without the motion of nature which proceeds outwardly from within should be troubled So we often see in those who are purged or let blood for such Buboes as come through unlawful copulation that the matter is thereby made contumacious and by drawing it inwardly it speedily causeth the French Pox. Wherefore When Bubes Carbuncles and other pestilent eruptions appear which come through the default of the air we ought to abstain from purging and phlebotomy but it is sufficient to fore-arm the heart inwardly and outwardly with Antidotes that are endued with a proper virtue of resisting the poison For it is not to be doubted but that when nature is debilitated with both kinds of evacuation and when the spirits together with the blood are exhausted the venomous air will soon pierce and be received into the empty body where it exerciseth its tyranny to the utter destruction thereof An history In the year of our Lord God 1566. in which year there was great mortality throughout all France by reason of the pestilence and pestilent diseases I earnestly and diligently inquired of all the Physicians and Chyrurgions of all the Cities through which King Charls the Ninth passed in his progress unto Bayon what success their patients had after they were let blood and purged whereunto they all answered alike that they had diligently observed that all that were infected with the Pestilence and were let bleed some quantity of blood or had their bodies somewhat strongly purged thence forwards waxed weaker and weaker and so at length died but others which were not let blood nor purged but took cordial Antidotes inwardly and applied them outwardly for the most part escaped and recovered their health for that kind of Pestilence took its original of the primitive and solitary default of the Air and not of the corruption of the humors When purging and bleeding may be used The like event was noted in the hoarsness that we spake of before that is to say that the patients waxed worse and worse by purging and phlebotomy but yet I do not disallow either of those remedies if there be great fulness in the body especially in the beginning and if the matter have a cruel violence whereof may be feared the breaking in unto some noble part For we know that it is confirmed by Hippocrates Aph. 22 sect 2. Aph. 10 sect 4. that what disease soever is caused by repletion must be cured by evacuation and that in diseases that are very sharp if the matter do swell it ought to be remedied the same day for delay in such diseases is dangerous but such diseases are not caused or inflicted upon mans body by reason or occasion of the pestilence but of the diseased bodies and diseases themselves commixed together with the pestilence therefore then peradventure it is lawful to purge strongly and to let a good quantity of blood least that the pestilent venom should take hold of the matter that is prepared and so infect it with a contagion whereby the pestilence taketh new and far greater strength especially as Celsus admonisheth us Cap. 7. lib. 3. where he saith that by how much the sooner those sudden invasions do happen by so much the sooner remedies must be used yea or rather rashly applyed therefore if the veins swell the face wax fiery red if the arteries of the temples beat strongly if the patient can very hardly breath by reason of a weight in his stomach if his spittle be bloody then ought he to be let blood without delay for the causes before mentioned It seems best to open the liver-Liver-vein on the left arm whereby the heart and spleen may be better discharged of their abundant matter Why blood must be let on the left arm in the Plague yet blood-letting is not good at all times for it is not expedient when the body beginneth to wax stiff by reason of the coming of a Fever for then by drawing back the heat and spirits inwardly the outward parts being destitute of blood wax stiff and cold therefore blood cannot be let then without great loss of the strength and perturbation of the humors And it is to be noted that when those phlethorick causes are present there is one Indication of blood-letting in a simple pestilent Fever and another in that which hath a Bubo id est a Botch or a Carbuncle joined therewith For in one or both of these being joined with a vehement and strong burning Fever blood must be letten by opening the vein that is nearest unto the tumor or swelling against nature keeping the straitness of the fibres that this being open the blood might be drawn more directly from the part affected for all and every retraction of putrefied blood unto the noble parts is to be avoided because it is noisom and hurtful to nature and to the patient Therefore for example sake admit the patient be plethorick by repletion which is called Ad Vasa id
concoct the same as may be seen in the ejaculatory spermatick vessels for which use also the length of the navel is half an ell so that in many infants that are somewhat grown it is found three or four times doubled about their neck or thigh As long as the child is in his mothers womb he taketh his nutriment only by the navel The childe in the womb taketh his nutriment by his navel not by his mouth and not by his mouth neither doth he enjoy the use of eyes ears nostrils or fundament neither needeth he the functions of the heart For spirituous blood goeth unto it by the artertes of the navel and into the Iliack arteries and from the Iliack arteries unto all the other arteries of the whole body for by the motion of these only the infant doth breath Therefore it is not to be supposed that the air is carried or drawn in by the lungs unto the heart in the body of the child How the childe breatheth but contrariwise from the heart to the lungs For neither the heart doth perform the generation or working of blood or of the vital spirits For the issue or infant is contented with them as they are made and wrought by his mother Which untill it hath obtained a full perfect and whole description of his parts and members cannot be called a child but rather an embryon or an imperfect substance CHAP. IX Of the ebullition or swelling of the seed in the womb and of the concretion of the bubbles or bladders or the three principal entrails IN the six first dayes of conception the new vessels are thought to be made and brought forth of the eminences or cotyledons of the mothers vessels and dispersed into all the whole seed as they were fibres or hairy strings Those as they pierce the womb so do they equally and in like manner penetrate the tunicle Chorion And it is carried this way being a passage not only necessary for the nutriment and conformation of the parts but also into the veins diversly woven and dispersed into the skin Chorion For thereby it cometh to pass that the seed it self boileth and as it were fermenteth or swelleth not only through occasion of the place but also of the blood and vital spirits that flow unto it and then it riseth into three bubbles or bladders like unto the bubbles which are occasioned by the rain falling into a river or channel full of water These three bubbles or bladders are certain rude or new forms The three bladders or concretions of the three principal entrails that is to say of the liver heart and brain All this former time it is called seed and by no other name but when those bubbles arise it is called an embryon or the rude form of a body untill the perfect conformation of all the members When the seed is called an embryon on the fourth day after that the vein of the navel is formed it sucketh grosser blood that is of a more full nutriment out of the Cotyledons And this blood because it is more gross easily congeals and curdles in that place where it ought to prepare the liver fully and absolutely made For then it is of a notable great bigness above all the other parts and therefore it is called Parenchyma Why the liver is called Parenchyma because it is but only a certain congealing or concretion of blood brought together thither or in that place From the gibbous part thereof springeth the greater part or trunk of the hollow vein called commonly vena cava which doth disperse his small branches which are like unto hairs into all the substance thereof and then it is divided into two branches whereof the one groweth upwards the other downwards unto all the particular parts of the body In the mean season the arteries of the navel suck spirituous blood out of the eminences or Cotyledons of the mothers arteries whereof that is to say of the more fervent and spirituous blood the heart is formed in the second bladder or bubble being endued with a more fleshie sound and thick substance as it behooveth that vessel to be which is the fountain from whence the heat floweth and hath a continual motion In this the virtue formative hath made two hollow places one on the right side another on the left In the right the root of the hollow vein is infixed or ingraffed carrying thither necessary nutriment for the heart in the left is formed the stamp or root of an artery which presently doth divide it self into two branches the greater whereof goeth upwards to the upper parts and the wider unto the lower parts carrying unto all the parts of the body life and vital heat CHAP. X. Of the third Bubble or Bladder wherein the head and the brain is formed THe far greater portion of the seed goeth into this third bubble that is to say Why the greater portion of seed goeth into generation of the head and brain yeelding matter for the conformation of the brain and all the head For a greater quantity of seed ought to go unto the conformation of the head and brain because these parts are not sanguine or bloody as the heart and liver but in a manner without blood bony marrow cartilaginous nervous and membranous whose parts as the veins arteries nerves ligaments panicles and skin are called spermatick parts because they obtain their first conformation almost of seed only although that afterwards they are nourished with blood as the other fleshie and musculous parts are But yet the blood when it come unto those parts degenerateth and turneth into a thing somewhat spermatick by virtue of the assimulative faculty of those parts All the other parts of the head form and fashion themselves unto the form of the brain when it is formed and those parts which are situated and placed about it for defence especially are hardened into bones Why the head is placed on the top of the body The head as the seat of the senses and mansion of the minde and reason is situated in the highest place that from thence as it were from a lofty tower or turret it might rule and govern all the other members and their functions and actions that are under it for there the soul or life which is the rectress or governess is situated and from thence it floweth and is dispersed into all the whole body Nature hath framed these three principal entrals as props and sustentations for the weight of all the rest of the body for which matter also she hath framed the bones The first bones that appear to be formed or are supposed to be conformed are the bones called ossa Ilium conneâ—ed or united by spondyls that are between them then all the other members are framed and proportioned by their concavites and hollownesses which generally are seven that is to say two of the ears two of the nose one of the mouth and in the parts beneath the
memory I may work more certainly and surely when as I have any more curious operation to be performed the left side remain whole and the Lungs Heart Diaphragma stomach splene kidnies beard hairs yea and the nails which being pated I have often observed to grow again to their form and bigness And let this be the bound of this our immense labor and by Gods favor our rest to whom Almighty all-powerful immortal and invisible be ascribed all honor and glory for ever and ever Amen Labor improbus omnia vincit The end of the Treatise of reports and embalming the dead The NINE and TWENTIETH BOOK The Apology and Treatise containing the voyages made into divers places By Ambrose Pare of Laval in Maine Counsellor and chief Chirurgion to the King Of what the Adversary accuseth the Author TRuly I had not put my hand to the pen to write on such a thing were it not that some have impudently injured taxed and more through particular hatred disgraced me then for zeal or love they bear to the publick good which was concerning my manner of tying the Veins and Arteries writing thus as followeth The words of the Adversary Male igitur nimium arroganter inconsultus temerarius quidam vasorum ustionem post emortui membri rejectionem à veteribus omnibus plurimum commendatam semper probatam damnare ausus est novum quendam deligandi vasa modum contra veteres omnes medicos sine ratione experientà judicio docere cupiens nec animadverit majora multo pericula ex ipsa vasorum deligatione quam acu partem sanam profunde transfigendo adminâ—strari vult imminere quam ex ipsa ustione Nam fi acu nervosam aliquam partem vel nervum ipsum pupugerit dum it à novo inusitato modo venam absurde conatur constringere nova inflammatio necessario consequetur à qua Convulsio a convulsione cita mors Querum symptomatum metu Galenus non ante transversa vulnera suere audebat quod tamen minus erat periculosum quam musculorum aponeuroses denudasset Adde quod forcipes quibus post sectionem iterum carnem dilacerat cum retracta versus originem vasa se posse extrahere somniat non minorem adferant dolorem quam ignita ferramenta admota Quod si quis laniatum expertus incolumis evaserit is Deo optimo maximo cujus Beneficentia crudelitate ista carnificina liberatus est maximas gratias habere semperagere debet which is thus Ill then and too arrogantly a certain indiscreet and rash person would blame and condemn the cauterizing of vessels after the amputation of a rotten and corrupted member much praised and commended and alwayes approved by the Antienâ—s desiring to shew and teach us without reason judgment and experience a new way to tie the vessels against the opinion of the Antient Physicians taking no heed nor being well advised that there happens far greater perils and accidents through this new way of tying the vessels which he will have to be made with a needle piercing deeply the sound part then by the burning and ustion of the said vessels for if the needle shall prick any nervous part yea the nerve it self when he shall by this new and unaccustomed way absurdly constrain the vein by binding it there must necessarily follow a new inflammation from the inflammation a convulsion from a convulsion death for fear of which accidents Galen never durst stitch transversal wounds which notwithstanding were less dangerous before he had discovered the Aponeuroses of the muscles Moreover the pincers with which after the section the flesh is again dilacerated while he thinks to draw the vessels out which are drawn in toward their original bring no less pain then the cautering irons do And if any one having experimented this new manner of cruelty have escaped danger he ought to render thanks to Almighty God for ever through whose goodness he hath been freed from such tyranny feeling rathet his executioner then his methodical Chirurgion The Authors answer O what sweet words are here for one who is said to be a wise and learned Doctor he remembers not that his white beard admonisheth him not to speak any thing unworthy of his age and that he ought to put off and drive out of him all envy and rancor conceived against his neighbor So now I will prove by authority reason and experience that the said Veins and Arteries ought to be tyed Authorityes AS for Authorityes I will come to that of that worthy man Hippocrates who wils and commands the cure of Fistulaâ— in the fundament by ligature as well to consume the callosity as to avoid hemoâ—â—hagy In the book of Fistulas of the fundament chap. 3. book 5 leaâ— 4. Galen Treâ—ise 2 chap. 17. in his method speaking of a flux of blood made by an outward cause of whom see here the words It is saith he most sure to tye the root of the vessel which I understand to be that which is most near to the Liver or the heart Avicen Treatise 3. Doct. 1. chap. 3. commands to tye the vein and the Artery after it is discovered towards his original Guido of Canliac speaking of the wounds of the Veins and Arteries injoyneth the Chirurgion to make the ligature in the vessel Master Hollier in the 3. book chap. 4. of the matter of Chirutgery speaking of a flux of blood commands expresly to tye the vessels Calmethâ—us in 12. chap. of the wounds in the Veins and Arteries tels a most sure way to stay a flux of blood by ligature of the vessel Celsus chap. 26. book 5. from whom the said Physiâ—ian hath snatched the most part of his book chargeth expresly to tye the vessels in a flux of blood happening to wounds as a remedy most easie and most sure Vesalius in his Chirurgery chap. 4. book 3. willeth that the vessel be tied in a flux of blood John de Vigo book 1. treatise 1. treating of hemoâ—â—hagy in bleedâ—ng wounds commands to tye the Vein and the Artery Tegaultius chap 12. book 2. treating of the means to stay the flux of blood commands to pinch the Vein or Artery with a Crow or Parrats-bill â—â—en to â—yâ— it with a very strong thred Peter of Argillata of Bullonge tâ—eatise 4. chap. 11 book 1. discoursing of a flux of blood and the means to stop it giveth a fourth way expresly which is made by ligature of the vessels John Andreas a Cruce â— Venetian book 1. sect 3. chap. 16. page 5 upon the 8â— chap of the book of Paul makes mention of a method to stay a flux of blood by the ligature of the vessels D. Alechamp commands to tye the Veinâ— and Arteries See then my little good man the â—â—thorities which command you to tye the vessels As for the â—eaâ—ons I will debate of them The hemoâ—hagy say you iâ— not so much to be feared in the section of the Call as that of
joyned by Anastomosis or ineculation 10. 10. The second called Pudenda 11. spent upon the privy parts 11. The third Coxalis 12 upon the Muscles of the Hip. 12. Here the outer Iliacal vein having past through the Peritoneum or rim of the Belly enters the Crus and begins to be called the Crural Trunk Γ Γ. that is undivided as far as to the two lower heads of the Thigh But it reaches forth four propagations before its division The first 13 13. is called Saphena which creeps through the inside of the Leg under the skin as far as to the ends of the Toes 14. Another 14 called Ichia is spread out into the skin upon the Hip-bone The third 15 named Muscula is sent to the Muscles 15. which extend the Leg. 16. The fourth 16 named Poplitea is distributed into the Calf of the Leg. 13. The vein Saphena also scatters from it self four surcles 17 the first 17 into the upper part of the skin of the inside of the Thigh 18. the second 18 about the middle of the Thigh 19. the third 19 into the Knee the fourth 20 is carried forward and backward to the middle of the Leg. 20. Δ. The division of the Crural Trunk near to the two lower heads of the Thigh into an inner branch Θ Θ. and an outer one Λ. Λ. Θ. The inner distributes little branches to the Muscles of the Calf 21 12. and then runs down under the inner ankle to the great Toe 22. 22. Λ. The outer presently is cleft into two branches an inner one Ξ Ξ. and an outer Π. That is spent wholly upon the Muscles of the Calf Π. this passes on near to the Fibula or lesser bone of the Leg through the outer and back-side of the Leg. The second Treatise Concerning The ARTERIES CHAP. I. Shews the upper or ascendent Trunk of the great Artery with its propagations that are distributed through the Head THere is no controversie among writers of Anatomy concerning the number and original of the Arteries The Original of the great Artery but an unanimous consent that all the propagations which are scattered throughout the body take their rise from one which they call Aorta and that this is derived out of the Heart But the Heart consisting of two sinus or cavities a right and a left one this great Artery grows out of the left sinus or ventricle A where it is largest and more hard and griestly then elswhere But as soon as it is grown out and before it fall out of the Pericardium or purse of the Heart Arteriae Coronariae the Crown-Arteries it presently propagates two small sprigs a a one of each side which they call Arteriae Coronariae the Crown-Arteries because together with the vena Coronalis or Crown-vein they compass the basis of the Heart in manner of a Crown and from these many propagations are scattered downward all along the Heart But they are more and greater about the left then the right ventricle as we have also formerly said concerning the vein because the Heart needs a greater plenty of blood on that side as which beats with a perpetual and more violent motion wherein more blood is digested then the right sinus or ventricle does yet that propagation is bigger and longer which arises on t of the right side of the Artery sometimes also there is only one at whose orifice a little valve is found Those propagations being thus disseminated the Artery ascends somewhat under the Trunk of the vena Arteriosa The divisions of the great Artery into two Trunks or Arterial vein and pierces through the Pericardium and having got above it is cleft B into two branches which because of their natural greatness we will call Trunks and because one ascends C and the other runs downward Q that shall be the Ascendent Trunk this the Descendent Yet the Descendent and lower one is bigger by much then the upper What parts both the Trunks nourish The order of that which is to be said because that serves more parts then this For the Ascendent one goes only to some parts of the Chest to the Head and Arms but the lower to very many parts of the Chest to all the lowest belly and the Legs That therefore we may treat of the great Artery with more perspicuity we will first shew the Ascendent Trunk and its progress through the Chest and Head and after that its branches distributed through the Arms. Then we will fall upon the Descendent one add explain the manner of its distribution through the Chest and lowest belly and lastly through the Legs The Ascendent therefore or upper Trunk of the Aorta C being fastened to the Oe sophagus or Gullet climbs upward betwixt the rough Artery and Hollow-vein and the mediastinum or partition of the Chest Which situation of it they ought diligently to observe who desire to know the reason of that Aphorism which is the four and twentieth of the fifth Section in Hippocrates For sayes he cold things as snow and ice are enemies to the Breast provoke coughs and cause eruptions of blood and distillations Truly they are enemies to the Breast because whilest they are swallowed down through the Gullet they cool the rough Artery that lyes next to it together with the Gullet which part being of it self cold does easily take harm from so violent a cold hence the cough and other diseases of the Brest follow one another in a long row But issues of blood happen in like manner the great Artery being cooled whereby the vital Spirits and the blood are driven back to the Heart and from thence are sent up forcibly to the Head which being stuft eruptions of blood are caused by its dropping forth at the Nostrils as also catarrhs and distillations it being driven down undigested to the inferiour parts And hence also a reason may be rendered why some upon drinking of cold water after vehement motions and exercise of body have presently been suffocated the passion of the heart and grievous swoundings following thereupon For the Artery being vehemently coold the blood is congealed as well that which was in the Aorta or Great artery as that which abides in the heart from whence happen at first fearful symptoms and then suddain death But we have seen in these men that a vein being opened the blood hath come out thick and cold and with very great difficulty whence also we have not found a more present remedy for them then such things as by reason of the thinness of their parts have a power of dissolving the clots of blood Hence also a reason may be given why in burning fevers the tongue becomes black the diseased can hardly swallow For although it be true which is the cause commonly assign'd that many vapors are sent up from the whole body to the head yet we may ascribe a main
than from the sweet falling down of Humors to the wounded part Which is the cause that often in the cure of these affects the Physitians are necessarily busied in tempering the blood that is bringing to a mediocrity the four Humors composing the mass of blood if they at any time offend in quantity or quality For whether if any thing abound or digress from the wonted temper in any excess of heat cold viscosity grosness thinness or any such like quality none of the accustomed functions will be well performed The helps of Health For which cause those chief helps to preserve and restore health have been divinely invented Phlebotomie or blood-letting which amends the quantity of too much bloud and Purging which corrects and draws away the vicious quality But now let us begin to speak of the Humors taking our beginning from the Definition An Humor is called by Physitians what thing soeuer is liquid and flowing in the body of living Creatures endued with Blood and that is either natural or against nature What an Humor is The natural is so called because it is fit to defend preserve and sustain the life of a Creature The manifold division of Humors Quite different is the nature and reason of that which is against nature Again the former is either Alimentary or Excrementitious The Alimentary which is fit to nourish the body is that Humor which is contained in the veins and arteries of a man which is temperate and perfectly well and which is understood by the general name of blood which is let out at the opening of a vein For Blood otherwise taken is an Humor of a certain kind distinguished by heat and warmness from the other Humors comprehended together with it in the whole mass of the blood Which thing that it may the better be understood I have thought good in this place to declare the generation of Blood by the efficient and material causes All things which we eat or drink are the materials of Blood The material and efficient causes of blood which things drawn into the bottom of the Ventricle by its attractive force and there detained are turned by the force of concoction implanted in it into a substance like to Almond-butter Which thing although it appear one and like it self yet it consists of parts of a different nature which not only the variety of meats but one and the same meats yields of it self We term this Chylus What the Chylus is when it is perfectly concocted in the stomach But the * Vena porta Gate-vein receives it driven from thence into the small Guts and sucked in by the Meseraick-veins and now having gotten a little rudiment of change in the way carries it to the Liver where by the Blood-making faculty which is proper and natural to this part it acquires the absolute and perfect form of Blood But with that Blood Where the Blood is perfected at one and the same time and action all the Humors are made whether alimentary or excrementitious Therefore the Blood that it may perform its Office that is the faculty of nutrition must necessarily be purged and cleansed from the two excrementitious Humors of which the bladder of Gall draws one which we call yellow Choler and the Spleen the other which we term Melancholy These two Humors are natural but not alimentary or nourishing but of another use in the body as afterwards we will shew more at large The Blood freed from these two kinds of Excrements is sent by the veins and arteries into all parts of the body for their nourishment Which although then it seem to be of one simple nature The receptacles of Choler and Melancholy Four unlike Humors in the Blood yet notwithstanding it is truly such that four different and unlike substances may be observed in it as Blood properly so named Phlegm Choler and Melancholy not only distinct in colour but also in taste effects and qualities For as Galen notes in his Book de Natura humana Melancholy is acide or sour Choler bitter Blood sweet Phlegm unsavoury But you may know the variety of their effects both by the different temper of the nourished parts as also by the various condition of the diseases springing from thence For therefore such substances ought to be tempered and mixed amongst themselves in a certain proportion which remaining health remains but violated diseases follow For all acknowledg A comparison of Blood and new Wine that an Oedema is caused by Phlegmatick a Scirrhus by Melancholick an Erysipelas by Cholerick and a Phlegmone by pure and laudable blood Galen teaches by a familiar example of new wine presently taken from the Press that these four substances are contained in that one mass and mixture of the blood In which every one observes four distinct Essences for the flower of the wine working up swims at the top the dregs fall down to the bottom but the crude and watery moisture mixed together with the sweet and vinous liquor is every where diffused through the body of the wine the flower of the wine represents Choler which bubbling up on the superficies of blood as it concretes and grows cold shineth with a golden colour the dregs Melancholy which by reason of its heaviness ever sinketh downward as it were the mud of the blood the crude and watery portion Phlegm for as that crude humor except it be rebellious in quantity Phlegm is Blood half concocted or stubborn by its quality there is hope it may be changed into Wine by the natural heat of the Wine so Phlegm which is blood half concocted may by the force of native heat be changed into good and laudable blood Which is the cause that nature decreed or ordained no peculiar place Why it hath no proper receptacle as to the other two humors whereby it might be severed from the blood But the true and perfect liquor of the wine represents the pure blood which is the more laudable and perfect portion of both humors of the confused mass It may easily appear by the following Scheme of what kind they all are and also what the distinction of these four Humors may be  NATURE CONSISTENCE COLOUR TASTE USE Blood is Of Nature airy hot and moist or rather temperate Of indifferent consistence neither too thick nor too thin Of Colour red rosie or crimson Of Taste sweet Of such use that it chiefly serves for the nourishment of the fleshy parts and carryed by the vessels imparts heat to the whole body Phlegm is Of Nature watery cold and moist Of Consistence liquid Of Colour white Of Taste sweet or rather unsavory for we commend that water which is unsavory Fit to nourish the brain and all the other cold and moist parts to temper the heat of the blood and by its slipperiness to help the motion of the joynts Choler is Of Nature fiery hot and dry Of Consistence thin Of Colour yellow or
pale Of Taste bitter It provoketh the expulsive faculty of the guts attenuates the Phlegm cleaving to them but the Alimentary is fit to nourish the parts of like temper with it Melancholy is Of Nature earthly cold and dry Of Consistence gross and muddy Of Colour blackish Of Taste acide sour or biting Stirs up the Appetite nourishes the Spleen and all the parts of like temper to it as the bones Blood hath its nearest matter from the better portion of the Chylus and being begun to be laboured in the veins at length gets form and perfection in the Liver but it hath its remote matter from meats of good digestion and quality seasonably eaten after moderate exercise but for that one age is better than another and one time of the year more convenient than another For blood is made more copiously in the Spring because that season of the year comes nearest to the temper of the bloud by reason of which the blood is rather to be thought temperate than hot or moist for that Galen makes the Spring temperate and besides at that time blood-letting is performed with the best success Lib. 1. de temp Youth is an age very fit for the generation of blood or by Galens opinion rather that part of life that continues from the 25 to the 35 year of our age Those in whom this Humor hath the dominion are beautified with a fresh and rosie colour gentle and wel-natured pleasant merry and facetious The generation of Phlegm is not by the imbecillity of heat as some of the Ancients thought who were perswaded that Choler was caused by a raging Blood by a moderate and Phlegm and Melancholy by a remiss heat But that opinion is full of manifest error for if it be true that the Chylus is laboured and made into blood in the same part One and the same Heat is the efficient cause of all humors at the same time and by the same fire that is the Liver from whence in the same moment of time should proceed that strong and weak heat seeing the whole mass of the blood different in its four essential parts is perfected and made at the same time and by the same equal temper of the same part action and blood-making faculty therefore from whence have we this variety of Humors From hence for that those meats by which we are nourished enjoy the like condition that our bodies do from the four Elements and the four first Qualities for it is certain and we may often observe In what kind soever they be united or joyned together they retain a certain hot portion imitating the fire another cold the water another dry the earth and lastly another moist like to the air Neither can you name any kind of nourishment how cold soever it be not Lettuce it self in which there is not some fiery force of heat Therefore it is no marvail if one and the same heat working upon the same matter of Chylus varying with so great dissimilitude of substances do by its power produce so unlike humors as from the hot Choler from the cold Phlegm and of the others such as their affinity of temper will permit There is no cause that any one should think that variety of humors to be caused in us The heat of the Sun alone doth melt was and harden clay rather by the diversity of the active heat than wax and a flint placed at the same time and in the same situation of climat and soil this to melt by the heat of the Sun and that scarse to wax warm Therefore that diversity of effects is not to be attributed to the force of the efficient cause that is of Heat which is one and of one kind in all of us but rather to the material cause seeing it is composed of the conflux or meeting together of various substances gives the heat leave to work as it were out of its store which may make and produce from the hotter part thereof Choler and of the colder and more rebellious Phlegm Yet I will not deny but that more Phlegm or Choler may be bred in one and the same body according to the quicker or slower provocation of the heat yet nevertheless it is not consequent that the Original of Choler should be from a more acide and of Phlegm from a more dull heat in the same man Every one of us naturally have a simple heat and of one kind which is the worker of divers operations not of it self seeing it is always the same and like it self but by the different fitness pliableness or resistance of the matter on which it works Wherefore Phlegm is generated in the same moment of time The divers condition of the matter alone is the cause of variety in the fire of the same part by the efficiency of the same heat with the rest of the blood of the more cold liquid crude and watery portion of the Chylus Whereby it comes to pass that it shews an express figure of a certain rude or unperfect blood for which occasion nature hath made it no peculiar receptacle but would have it to run friendly with the blood in the same passages of the veins that any necessity hapning by famin or indigency and in defect of better nourishment it may by a perfecter elaboration quickly assume the form of blood Cold and rude nourishment make this humor to abound principally in Winter and in those which incline to old-age by reason of the similitude which Phlegm hath with that season and age It makes a man drowsie dul fat The effect of Phlegm swollen up and hastneth gray-hairs Choler is as it were a certain heat and fury of humors which generated in the Liver together with the blood is caryed by the veins and arteries through the whole body That of it which abounds is sent partly into the guts and partly into the bladder of the gall or is consumed by transpiration or sweats It is somewhat probable that the arterial blood is made more thin hot quick and pallid than the blood of the Veins by the commixture of this Alimentary Choler This Humor is chiefly bred and expel'd in youth and acid and bitter meats give matter to it but great labours of body and mind give the occasion It maketh a man nimble quick ready for all performance lean and quick to anger and also to concoct meats The effects of Choler The melancholick humor or Melancholy being the grosser portion of the blood is partly sent from the Liver to the Spleen to nourish it and partly carryed by the vessels into the rest of the body and spent in the nourishment of the parts endued with an earthly dryness it is made of meats of gross juyce and by the perturbations of the mind turned to fear and sadness The effects of Melancholy It is augmented in Autumn and in the first and crude Old-age it makes men sad harsh constant froward envious and fearful
which causeth burning feavers The Kinds of such Choler are often cast forth by vomit in diseases the strength of the disease being past being troublesome to the parts through which they are evacuated by their bitterness acrimony and biting The signes of a Sanguine Person I Think it manifest because the matter and generation of flesh is principally from blood that a man of a fleshy dense and solid habit of body and full of a sweet and vaporous juice is of a Sanguine complexion And the same party hath a flourishing and rosie colour in his face tempered with an equal mixture of white and red of white by reason of the skin lying utmost Such as the humor is such is the colour of red because of the blood spread underneath the skin for always such as the humor is such is the colour in the face In manners he is curious gentle easie to be spoken to not altogether estranged from the love of women of a lovely countenance and smooth forehead seldom angry The manners and diseases of Sanguine persons but taking all things in good part for as the inclination of humors is so also is the disposition of manners But blood is thought the mildest of all humors but the strong heat of the inward parts maketh him to eat and drink freely Their dreams are pleasant they are troubled with diseases arising from blood as frequent Phlegmons and many sanguine pustles breaking through the skin much bleeding and menstruous fluxes Wherefore they can well endure blod-letting and delight in the moderate use of cold and dry things and lastly are offended by hot and moist things They have a great and strong Pulse and much urine in quantity but milde of quality of an indifferent colour and substance The signes of a Cholerick Person CHolerick men are of a pale or yellowish colour of a lean slender and rough habit of body Cholerick are not commonly fat with fair veins and large Arteries and a strong and quick pulse their skin being touched feels hot dry hard rough and harsh with a pricking and acid exhalation which breaths forth of their whole body They cast forth much choler by stool vomit and urine The manners and diseases of Cholerick persons They are of a quick and nimble wit stout hardy and sharp vindicators of received injuries liberal even to prodigality and somewhat too desirous of glory Their sleep is light and from which they are quickly waked their dreams are fiery burning quick and full of fury they are delighted with meats and drinks which are somewhat more cold and moist and are subject to Tertian and burning feavers the Phrensie Jaundise Inflammations and other Cholerick pustles the Lask Bloody flux and bitterness of the mouth The signes of a Phlegmatick Person THose in whom Phlegm hath the dominion are of a whitish coloured face The manners and diseases of phlegmatick persons and somtimes livid and swollen with their body fat soft and cold to touch They are molested with Phlegmatick diseases as Oedematous tumours the Dropsie Quotidian feavers falling away of the hairs and Catarrhs falling down upon the Lungs and the Aspera Arteria or Weason they are of a slow capacity dull slothful drowsie they do dream of rains snows floods swimming and such like that they often imagine themselves overwhelmed with waters they vomit up much watery and Phlegmatick matter or otherwise spit and evacuate it and have a soft and moist tongue And they are troubled with a dog-like hunger if at any time it should happen that their insipid Phlegm become acide and they are slow of digestion by reason of which they have great store of cold and Phlegmatick humors which if they be carried down into the windings of the Colick-gut they cause murmuring and noise and sometimes the Colick For much wind is easily caused of such like Phlegmatick excrements wrought upon by a small and weak heat such as Phlegmatick persons have From whence noise or rumbling in the belly proceeds which by its natural lightness is diversly carried through the turnings of the guts and distends and swells them up and whiles it strives for passage out it causeth murmurings and noises in the belly like wind breaking through narrow passages Signes of a Melancholick Person THe face of Melancholy persons is swart their countenance cloudy and often cruel Diseases familiar to Melancholy persons their asspect is sad and froward frequent Scirrhus or hard swellings tumors of the Spleen Haemorroids Varices or swollen Veins Quartain feavers whether continual or intermitting Quintain Sextain and Septimane feavers and to conclude all such wandering feavers or agues set upon them But when it happens the Melancholy humour is sharpened either by adustion or commixture of Choler then Tetters the black Morphew the Cancer simple and ulcerated the Leprous and filthy scab sending forth certain scaly and branlike excrescences being vulgarly called Saint Manis his evil and the Leprosie it self invades them They have small veins and arteries because coldness hath dominion over them whose property is to straiten as the quality of heat is to dilate But if at any time their Veins seem big that largeness is not by reason of the laudable blood contained in them but from much windiness From or by what their Veins are swollen by occasion whereof it is somewhat difficult to let them blood not only because that when the Vein is opened the blood flows slowly forth by reason of the cold slowness of the humors but much the rather for that the vein doth nor receive the impression of the Lancet sliding this way and that way by reason of the windiness contained in it and because that the harsh driness of the upper skin resists the edge of the instrument Their bodies seem cold and hard to the touch and they are troubled with terrible dreams for they are observed to seem to see in the night Devils Serpents dark dens and caves sepulchres dead corpses and many other such things ful of horror Their dreamâ— by reason of a black vapor diversly moving and disturbing the brain which also we see happens to those who * Hydrophob Their manners fear the water by reason of the biting of a mad Dog You shall find them froward fraudulent parsimonious and covetous even to baseness slow speakers fearful sad complainers careful ingenious lovers of solitariness man-haters obstinate maintainers of opinions once conceived slow to anger but angred not to be pacified But when Melancholy hath exceeded natures and its own bounds then by reason of putrefaction and inflammation all things appear full of extreme fury and madness so that they often cast themselves headlong down from some high place or are otherwise guilty of their own death with fear of which notwithstanding they are terrified From whâ—nce the change of the native temper But we must note that changes of the native temperament do often happen in the course of a mans life so that he
the evacuation of the conjunct matter Galen by a dream cures the Sciatica by the artery the Anckle of the same side being opened yet because it was not cut for this purpose but happened only by chance I judged it was not much dissenting from this argument Pliny writes that there was one named Phalereus which casting up blood at his mouth and at the length medicines nothing availing being weary of his life went unarmed in the front of the battel against the Enemy and there receiving a wound in his breast shed a great quantity of blood which gave an end to his spitting of blood the wound being healed and the vein which could not contain the blood being condensate At Paris Anno 1572. in July a certain Gentleman being of a modest and curteous cariage fell into a continual Feaver and by that means became Frantick moved with the violence of which he cast himself headlong out of a window two stories high and fell first upon the shoulder of Valterra the Duke of Alenzons Physitian and then upon the pavement with which fall he cruelly bruised his ribs and hip but was restored to his former judgment and reason There were present with the Patient besides Valterra witnesses of this accident these Physitians Alexis Magnus Duretus and Martinus The same happened in the like disease and by the like chance to a certain Gascoyn lying at the house of Agrippa in the Paved street Othomannus Doctor of Physick of Monpelier and the King's Professor told me that a certain Carpenter at Broquer a village in Switzerland being frantick cast himself headlong out of an high window into a river and being taken out of the water was presently restored to his understanding The cause of the last recited cures But if we may convert casualties into counsel and Art I would not cast the Patients headlong out of a window But would rather cast them sodainly and thinking of no such thing into a great cistern filled with cold water with their heads foremost neither would I take them out until they had drunk a good quantity of water that by that sodain fall and strong fear the matter causing the Frenzy might be carryed from above downwards from the noble parts to the ignoble the possibility of which is manifest by the forecited examples as also by the example of such as bit by a mad Dog fearing the water are often ducked into it to cure them CHAP. XXIV Of certain juggling and deceitful ways of Curing HEre I determin to treat of those Impostors who taking upon them the person of a Chirurgeon do by any means either right or wrong put themselves upon the works of the Art but they principally boast themselves amongst the ignorant common sort of setting bones which are out of joynt and broken Sciences are not hereditary affirming as falsly as impudently that they have knowledg of those things from their Ancestors as by a certain hereditary right which is a most ridiculous fiction for our minds when we are born is as a smooth table upon which nothing is painted Otherwise what need we take such labour and pains to acquire and exercise Sciences God hath endued all brute beasts with an inbred knowledge of certain things necessary for to preserve their life more than man But on the contrary he hath enriched him with a wit furnished with incredible celerity and judgment by whose diligent and laborious fatigation he subjects all things to his knowledg For it is no more likely that any man should have skill in Chirurgery because his father was a Chirurgeon than that one who never endured sweat dust nor Sun in the field should know how to ride and govern a great Horse and know how to carry away the credit in tilting only because he was begot by a Gentleman and one famous in the Art of War A most impudent sort of Impostors There is another sort of Impostors far more pernicious and less sufferable boldly and insolently promising to restore to their proper unity and seat bones which are broken and out of joynt by the only murmuring of some conceited charms so that they may but have the Patients name and his girdle In which thing I cannot sufficiently admire the idleness of our Countreymen so easily crediting so great and pernicious an error not observing the inviolable law of the ancient Physitians and principally of Divine Hippocrates by which it is determined that three things are necessary to the setting of bones dislocated and out of joynt to draw the bones asunder to hold the bone receiving firmly immoveable with a strong and steddy hand to put the bone to be received into the cavity of the receiving For which purpose the diligence of the Ancients hath invented so many Engines Three things necessary for the cure of a Luxation Glossocomies and Bands lest that the hand should not be sufficient for that laborious work What therefore is the madness of such Impostors to undertake to do that by words which can scarse be done by the strong hands of so many Servants and by many artificial Engines Of late years another kind of Imposture hath sprung up in Germany they beat into fine powder a stone which in their mother tongue they call Bemâ—ruch and give it in drink to any who have a bone broken or dislocated and affirm that it is sufficient to cure them Through the same Germany there wander other Impostors who bid to bring to them the Weapon with which any is hurt they lay it up in a secret place and free from noise and put and apply medicines to it as if they had the patient to dress and in the mean time they suffer him to go about his business and impudently affirm that the wound heals by little and little by reason of the medicine applyed to the weapon But it is not likely that a thing in animate which is destitute of all manner of sense should feel the effect of any medicine and less probable by much that the wounded party should receive any benefit from thence Neither if any should let me see the truth of such juggling by the events themselves and my own eyes would I therefore believe that it were done naturally and by reason but rather by Charms and Magick In the last assault of the Castle of Hisâ—in the Lord of Martigues the elder was shot through the breast with a Musket bullet I had him in cure together with the Physitians and Chrirurgeons of the Emperour Charles the fifth and Emanuel Phiâ—rt the Duke of Savoy who because he entirely loved the wounded prisoner caused an Assembly of Physitians and Chirurgeons to consult of the best means for his cure They all were of one opinion that the wound was deadly and incurable because it passed through the midst of his lungs and besides had cast forth a great quantitv of knotted blood into the hollowness of his breast There was found at that time a certain Spaniard
into the bladder Their Substance The substance of the Kidneys is fleshy dense and solid lest they should be hurt by the sharpness of the urine Their magnitude is large enough as you may see Their figure is somewhat long and round Magnitude Figure almost resembling a semicircle and they are lightly flatted above and below They are partly hollow and partly gibbous the hollow lies next the hollow vein and on this side they receive the Emulgent Veins and Arteries and send forth the Ureters their gibbous part lies towards the loins They are composed of a coat coming from the Peritonaeum their own peculiar flesh Composition with the effusion of blood about the proper vessels as happens also in other entrails generates a small nerve which springing from the Costal of the sixth conjugation is diffused to each Kidney on his side into the coat of the kidney it self although others think it always accompanies the vein and artery But Fallopius that most diligent Author of Anatomy hath observed that this nerve is not only oftentimes divaricated into the coat of the Kidneys but also pierces into their substance They are two in number Number that if the one of them should by chance be hurt the other might supply those necessities of nature Site for which the Kidneys are made They lie upon the loyns at the sides of the great vessels on which they depend by their proper veins and arteries and they stick to them as it were by a certain second coat lest that they might be shaken by any violent motions Wherefore we may say that the Kidneys have two coats one proper adhering to their substance the other as it were coming from the Peritonaeum on that part they stick to it The right Kidney is almost alwayes the higher for those reasons I gave speaking of the original of the Emulgent vessels Columbus seems to think the contrary but such like controversies may be quickly decided by the Eye Connexion They have connexion with the Principal vessels by the veins nerves and arteries by the coats with the loins and the other parts of the lower belly but especially with the bladder by the ureters Temper Action They are of a hot and moist temper as all fleshy parts are Their action is to cleanse the Mass of the blood from the greater part of the serous and cholerick humour I said the greater part because it is needful that some portion thereof should go with the alimentary blood to the solid parts to serve instead of a vehicle lest otherwise it should be too thick Their Strainer Besides you must note that in each Kidney there is a cavity bounded by a certain membrane encompassed by the division of the Emulgent veins and arteries through which the urine is strained partly by the expulsive faculty of the Kidneys partly by the attractive of the Ureters which run through the substance of the Kidneys on the hollow side no otherwise than the Porus cholagogus through the body of the Liver CHAP. XXVI Of the spermatick Vessels Ureters NOw we should have spoken of the Ureters because as we said before they are passages derived from the Kidneys to carry the urine to the bladder But because they cannot be distinguished and shewed unless by the corrupting and vitiating the site of the spermatick vessels therefore I have thought it better to pass to the explication of all the spermatick parts And first of all you must gently separate them that so the Declaration of them may be more easie and manifest and that from the coat which comes from the peritonaeum and the fat which invests them even to the sharebone having diligently considered their site before you separate them Their Substance Then you shall teach that the substance of these vessels is like to that of the veins and arteries Their quantity is small in thickness but of an indifferent length by reason of the distance of their original from the Testicles Quantity They are longer in men than in women because these have their Testicles hanging without their belly but women have them lying hid within their belly Their figure and composure is wholly like the figure and composition of the veins and arteries Figure and Composure except in this one thing that from that place where they go forth of the great capacity of the Peritonaeum they are turned into many intricate windings like crooked swoln veins even to the Testicle That the spermatick matter in that one tract which yet is no other than blood may be prepared to concoction or rather be turned into Seed in these vessels by the irradiation of the faculty of the Testicles Number These vessels are six in number four preparing and two ejaculatory of which we will speak hereafter Therefore on each side there be two preparing vessels that is a vein and an artery arising as we told you when we spoke of the distribution of the hollow vein They are inserted into the Testicles through that coat which we call Epididymis others Darton Site Their site is oblique above the loins and flanks whilst they run down between the ends of the share and haunchbone they are knit to the parts lying under them both by certain fibers which they send from them as also by the membrane they have from the Peritonaeum They have like temperature as the veins and arteries have Their action is to carry blood to the Testicles for generating of seed CHAP. XXVII Of the Testicles or Stones THe Testicles are of a Glandulous white soft and loose substance Their Substance that so they may the more easily receive the spermatick matter their magnitude and figure equal and resemble a small pullet's Egg somewhat flatted their composure is of veins arteries Magnitude and Figure Composition coats and their proper flesh Their veins and arteries proceed from the spermatick vessels their nerves from the sixth conjugation by the roots of the ribs and out of the Holy-bone They are wrapped in four coats two whereof are common and two proper The common are the Scrotum or skin of the Cods proceeding from the true skin and the fleshy coat which consists of the fleshy Pannicle in that place receiving a great number of vessels through which occasion it is so called The proper coats are first the Erythrois arising from the process of the Peritonaeum The Coat Erythrois going into the Scrotum together with the spermatick vessels which it involves and covers this appears red both by reason of the vessels as also of the Cremaster-muscles of the Testicles The Epididymis or Dartos Then the Epididymis or Dartos which takes its original of the membrane of the spermatick preparing vessels The flesh of the Testicles is as it were a certain effusion of matter about the vessels as we said of other entrails But you must observe that the Erythrois encompasses the whole stone except
Membranes Nerves and Tendons What we must consider in performing the cure wherefore they cannot indure acrid and biting medicines Having called to mind these indications the indication will be perfected by these three following intentions as if we consider the humor flowing down or which is ready to flow the conjunct matter that is the humor impact in the part the correction of accidents yet so that we alwayes have care of that which is most urgent and of the cause Therefore first repercussives must be applyed for the antecedent matter strong or weak having regard to the tumor as it is then only excepting six conditions of tumors What things disswade us from using repercussives the first is if the matter of the tumor be venenate the second if it be a critical abscess the third if the defluxion be neer the noble parts the fourth if the matter be gross tough and viscid the fifth when the matter lies far in that is flows by the veins which lies more deep the sixth when it lies in the Glandules But if the whole body be plethorick a convenient diet purging and Phlebotomy must be appointed frictions and bathes must be used Ill humors are amended by diet and purging If the weakness of the part receiving draw on a defluxion it must be strengthned If the part be inferior in its site let the patient be so seated or layed that the part receiving as much as may be may be the higher If pain be the cause of defluxion we must asswage it by things mitigating it If the thinness or lightness of the humor cause defluxion it must be inspissate by meats and medicines But for the matter contained in the part because it is against Nature it requires to be evacuate by resolving things as Cataplasms Ointments Fomentations Cupping-glasses or by evacuation as by scarifying or suppurating things as by ripening and opening the Impostume Lastly for the conjunct accidents as the Feaver pain and such like they must be mitigated by asswaging mollifying and relaxing medicines as I shall shew more at large hereafter CHAP. VI. Of the four principal and general Tumors and of other Impostumes which may be reduced to them THe principal and chief Tumors which the abundance of humors generate are four a Phlegmon What tumors may be reduced to a Phlegmon Which to an Eâ—â—sipelas Which to an Oedema Erysipelas Oedema and Scirrhus innumerable others may be reduced to these distinguished by divers names according to the various condition of the efficient cause and parts receiving Wherefore a Phygethlum Phyma Fellon Carbuncle Inflammation of the Eyes Squincy Bubo and lastly all sorts of hot and moist tumors may be reduced to a Phlegmon The Herpes miliaris the eating Herpes Ring-worms and Tetters and all Impostumes brought forth by choler are contained under an Erysipelas Atheromata Steatomata Melicerides the Testudo or Talpa Ganglion Knots Kings-Evils Wens watery Ruptures the Ascites and Lencophlegmatia may be reduced to an Oedema as also all flatulent tumors which the abundance of corrupt Phlegm produces Which to a Scirrhus In the kindred of the Scirrhus are reckoned a Cancer Leprosie Warts Corns a Thymus a Varix Morphew black and white and other Impostumes arising from a Melancholy humor Now we will treat of these Tumors in particular beginning with a Phlegmon CHAP. VII Of a Phlegmon What a true Phlegmon is A Phlegmon one thing and a Phlegmonous tumor another A Phlegmon is a general name for all Impostumes which the abundance of inflamed bloud produces That is called a true Phlegmon which is made of laudable bloud offending only in quantity But a bastard Phlegmon or a Phlegmonous Impostume hath some other and proper name as a Carbuncle Fellon Gangrene Sphacel and the like malign Pustuls So when there is a conflux of divers humors into one tumor divers kinds of Phlegmonous Impostumes called by divers names according to the more abundant humor arise as if a small portion of Phlegm shall be mixed with a greater quantity of bloud it shall be called an Oedematous Phlegmon but if on the contrary the quantity of phlegm be the greater it shall be named a phlegmonous Oedema and so of the rest always naming the tumor from that which is predominant in it Therefore we must observe that all differences of such tumors arise from that either because the bloud causing it offends only in quantity which if it do it causes that tumor which is properly called a Phlegmon if in quality it makes a Phlegmonous tumor because the matter thereof is much departed from the goodness of bloud But bloud is said to offend in quantity either by admixture of some other matter as Phlegm Choler or Melancholy from whence proceeds Oedematous Erysipelous and Scirrhous Phlegmons or by corruption of its proper substance from whence Carbuncles and all kinds of Gangrenes or by concretion and when Nature is disappointed of its attempted and hoped for suppuration either by default of the Air or Patient or by the error of the Physitian and hence oft-times happen Atherema's Steatoma's and Melicerides Although these things be set down by the Ancients of the simple and similar matter of the true Phlegmon yet you must know that in truth there is no Impostume whose matter exquisitely shews the Nature of one and that simple humor without all admixture of any other matter for all humors are mixed together with the bloud yet from the plenty of bloud predominating they are called Sanguine as if they were of bloud alone Wherefore if any tumors resemble the nature of one simple humor truly they are not of any natural humor but from some humor which is corrupt vitiated and offending in quality for so bloud by adustion degenerates into Choler and Melancholy Therefore a true Phlegmon is defined by Galen A tumor against Nature of laudable bloud Gal. lib. de tumoribâ—n c. ad Glauc Hippoc. lib. de vuln cap. Gal. lib. de tumor praeter naturam flowing into any part in too great a quantity This tumor though most commonly it be in the flesh yet sometimes it happens in the Bones as Hippocrates and Galen witness A Phlegmon is made and generated thus when bloud flows into any part in too great a quantity first the greater veins and arteries of the part affected are filled then the middle and lastly the smallest and capillary so from those thus distended the bloud sweats out of the pores and small passages like dew and with this the void spaces which are between the similar parts are first filled and then with the same bloud all the adjacent parts are filled but especially the flesh as that which is most fit to receive defluxions by reason of the spongious rarity of its substance but then the nerves tendons membranes and ligaments are likewise stuffed full whereupon a Tumor must necessarily follow by reason of the repletion which exceeds the bounds of Nature and from hence also are Tension and Resistance
and pain also happens at the same time both by reason of the tension and preternatural heat And there is a manifest pulsation in the part specially whilst it suppurates because the veins The cause of a beating pain in a Phlegmon arteries and nerves are much being they are not only heated within by the influx of the fervid humor but pressed without by the adjacent parts Therefore seeing the pain comes to all the foresaid parts because they are too immoderately heated and pressed the arteries which are in the perpetual motion of their systole diastole whilst they are dilated strike upon the other inflamed parts whereupon proceeds that beating pain Hereunto add The Arteries then filled with more copious and hot bloud have greater need to seek refrigeration by drawing in the encompassing Air wherefore they must as of necessity have a conflict with the neighbouring parts which are swollen and pained Comm. ad Aph. 21. sect 7. Therefore from hence is that pulsation in a Phlegmon which is defined by Galen An agitation of the arteries painful and sensible to the Patient himself for otherwise as long as we are in health we do not perceive the pulsation of the arteries Wherefore these two causes of pulsation or a pulsifick pain in a phlegmon are worthy to be observed that is the heat and abundance of bloud contained in the vessels and arteries which more frequently than their wont incite the arteries to motion that is to their systole and diastole and the compression and straitning of the said arteries by reason of the repletion and distention of the adjacent partts by whose occasion the parts afflicted and beaten by the trembling and frequent pulsation of arteries are in pain Hence they commonly say that in the part affected with a Phlegmon they feel as it were Another kind of Pulsation in a Phlegmon the sense or stroke of a Mallet or Hammer smiting upon it But also besides this pulsation of the arteries there is as it were another pulsation with itching from the humors whilst they putrefie and suppurate by the permixtion motion and agitation of vapours thereupon arising The cause of heat in a Phlegmon is bloud which whilst it flows more plentifully into the part is as it were trodden or thrust down and causes obstruction from whence necessarily follows a prohibition of transpiration and putrefaction of the bloud by reason of the preternatural heat But the Phlegmon looks red by reason of the bloud contained it because the humor predominant in the part shines through the skin CHAP. VIII Of the Causes and Signs of a Phlegmon THe Causes of a Phlegmon are of three kinds for some are primitive some antecedent The Primitive causes of a Phlegmon The Antecedent and Conjunct and some conjunct Primitive are falls contusions immoderate labour frictions application of acrid ointments burnings long staying or labouring in the hot Sun a diet unconsiderate and which breeds much bloud The antecedent Causes are the great abundance of bloud too plentifully flowing in the veins The conjunct the collection or gathering together of bloud impact in any part The signs of a Phlegmon The signs of a Phlegmon are swelling tension resistance feaverish heat pain pulsation especially while it suppurates redness and others by which the abundance of bloud is signified And a little Phlegmon is often terminated by resolution but a great one by suppuration and sometimes it ends in a Scirrhus or a Tumor like a Scirrhus but otherwhiles in a Gangrene that is when the faculty and native strength of the part affected is over-whelmed by the greatness of the defluxion Gal. l. de Tum as it is reported by Galen The Chirurgeon ought to consider all these things that he may apply and vary such medicines as are convenient for the nature of the Patient and for the time and condition of the part affected CHAP. IX Of the cure of a true Phlegmon What kind of diet must be prescribed in a Phlegmon THe Chirurgeon in the cure of a true Phlegmon must propose to himself four intentions The first of D et This because a Phlegmon is a hot affect and causes a Feaver must be ordained of refrigerative and humecting things with the convenient use of the six things not natural that is air meat and drink motion and rest sleep and waking repletion inaninition and lastly the passions of the mind Therefore let him make choice of that air which is pure and clear not too moist for fear of defluxion but somewhat cool let him command meats which are moderately cool and moist shunning such as generate bloud too plentifully such will be Broths not too fat seasoned with a little Borage Lettuce Sorrel and Succory let him be forbidden the use of all Spices and also of Garlick and Onions and all things which heat the bloud as are all fatty and sweet things as those which easily take fire Let the Patient drink small Wine and much allayed with water or if the Feaver be vehement the water of the decoction of Licoris Barly sweet Almonds or Water and Sugar alwayes having regard to the strength age and custom of the Patient For if he be of that age or have so led his life that he cannot want the use of Wine let him use it but altogether moderately Rest must be commanded for all bodies wax hot by motion but let him chiefly have a care that he do not exercise the part possessed by the Phlegmon for fear of a new defluxion Let his sleep be moderate neither if he have a full body let him sleep by day specially presently after meat Let him have his belly soluble if not by Nature then by Art as by the frequent use of Clysters and Suppositories Let him avoid all vehement perturbations of minde as hate anger brawling let him wholly abstain from venery How to divert the defluxion of humors This maner of diet thus prescribed we must come to the second scope that is the diversion of the defluxion which is performed by taking away its cause that is the fulness and illness of the humors Both which we may amend by purging and bloud-letting if the strength and age of the Patient permit The pain must be asswaged But if the part receiving be weak it must be strengthned with those things which by their astriction amend the openness of the passages the violence of the humor being drawn away by Cupping-glasses Frictions Ligatures But if pain trouble the part which is often the occasion of defluxion it must be mitigated by Medicines asswaging pain The third scope is to overcome the conjunct cause That we may attain to this we must enter into the consideration of the tumor according to its times that is the beginning increase state and declination When we must use repercussives For from hence the indications of variety of medicines must be drawn For in the beginning we use repercussives to drive away the
It is more subtile it runs forth as it were leaping by reason of the vital spirit contained together with it in the Arteries On the contrary that which floweth from a Vein is more gross black and slow Now there many wayes of stanching Bloud The first way of staying bleeding The first and most usual is that by which the lips of the Wound are closed and unless it be somewhat deep are contained by Medicines which have an astringent cooling drying and glutinous faculty As terrae sigill Boli Armeni ana â„¥ ss Thuris Mastichis Myrrhae Aloes anaÊ’ ij Farinae volat molend â„¥ j Fiat pulvis qui albumine ovi excipiatur Or â„ž Thuris Aloes ana partes aequales Let them be mixt with the white of an Egge and the down of a Hare and let the pledgets be dipped in these Medicines as well those which are put unto the Wound as those which are applyed about it Then let the Wound be bound up with a double cloth and fit Ligature and the part be so seated as may seem the least troublesome and most free from pain But if the blood cannot be stayed by this means when you have taken off all that covereth it The 2. manner of stanching it you shall press the Wound and the orifice of the Vessel with your thumb so long untill the blood shall be concrete about it into so thick a clot as may stop the passage But if it cannot be thus stayed then the Suture if any be must be opened The 3. way by binding of the vessels and the mouth of the Vessell towards the originall or root must be taken hold of and bound with your needle and thred with as great a portion of the flesh as the condition of the part will permit For thus I have staid great bleedings even in the amputation of members as I shall shew in fit place To perform this work we are often forced to divide the skin which covereth the wounded vessell For if the Jugular vein or Artery be cut it will contract and withdraw it self upwards and downwards Then the skin it self must be laid open under which it lyeth and thrusting a needle and thred under it it must be bound as I have often done But before you loose the knot it is fit the flesh should be grown up that it may stop the mouth of the vessel An admonition lest it should then bleed But if the condition of the part shall be such as may forbid this comprehension The 4. way by Eschatoricks and binding of the vessel we must come to Escharoticks such as are the powder of burnt Vitriol the powder of Mercury with a small quantity of burnt Allum and Causticks which cause an Escar The falling away of which must be left to nature and not procured by art lest it should fall away before that the orifice of the vessel shall be stopt with the flesh or clotted blood But sometimes it happens that the Chirurgeon is forced wholly to cut off the vessel it self The 5. way by cutting off the vessels that thus the ends of the cut vessel withdrawing themselves and shrinking upwards and downwards being hidden by the quantity of the adjacent and incompassing parts the flux of the blood which was before not to be staid may be stopped with lesse labour Yet this is an extream remedy and not to be used unlesse you have in vain attempted the former CHAP. VIII Of the pain which happens upon Wounds THe pains which follow upon wounds ought to be quickly asswaged Pain weakens the body and causes deffluxions because nothing so quickly dejects the powers and it alwaies causes a defluxion of how good soever a habit and temper the body be of for Nature ready to yeeld assistance to the wounded part alwaies sends more humors to it than are needful for the nourishment thereof whereby it comes to passe that the defluxion is easily increased either by the quantity or quality or by both Therefore to take away this pain the author of deflux on Divers Anodynes or medicins to asswage pain let such medicines be applyed to the part as have a repelling and mitigating faculty as â„ž Olei Myrtili Rosarum ana â„¥ ij Cerae alb â„¥ i Farinae hordei â„¥ ss Boli armeni terrae sigillat ana Ê’ vj. Melt the Wax in the oyls then incorporate all the rest and according to Art make a medicine to be applyed about the part or â„ž Emplast Diacalcith â„¥ iv Ole Rosar aceti ana â„¥ ss liquefiant simul and let a medicine be made for the fore-mentioned use Irrigations of oyl of Roses and Myrtiles with the white of an Egge or a whole Egge added thereto may serve for lenitives if there be no great inflammation Rowlers and double cloaths moystened in Oxcycrate will be also convenient for the same purpose But the force of such medicines must be often renewed for when they are dryed they augment the pain But if the pain yeeld not to these we must come to narcotick Medicines such as are the Oyl of Poppy of Mandrake a cataplasm of Henbane and Sorrel adding thereto Mallows and Marsh-mallows of which we spoke formerly in treating of a Phlegmon Lastly we must give heed to the cause of the pain to the kind and nature of the humor that flows down and to the way which nature affects for according to the variety of these things the Medicines must be varied as if heat cause pain it will be asswaged by application of cooling things and the like reason observed in the contrary If Nature intend suppuration you must help forwards its indeavours with suppurating medicines CHAP. IX Of Convulsion by reason of a Wound A Convulsion is an unvoluntary contraction of the Muscles as of parts movable at our pleasure towards their original that is the Brain and Spinall Marrow What a Convulsion is for by this the convulsed member or the whole body if the convulsion be universal cannot be moved at our pleasure Yet motion is not lost in a Convulsion as it is in a Palsie but it is only depraved and because sometimes the Convulsion possesseth the whole Body otherwhiles some part thereof you must note that there are three kinds of Convulsions in general The first is called by the Greeks Tetanos Three kinds of an universal Convulsion when as the whole body grows stiffe like a stake that it cannot be moved any way The second is called Opisthotonos which is when the whole body is drawn backwards The third is termed Emphrosthotonos which is when the whole body is bended or crooked forwards A particular Convulsion is when as the Muscle of the Eye Tongue and the like parts which is furnished with a Nerve Three causes of a Convulsion Causes of Repletion is taken with a Convulsion Repletion or Inanition Sympathy or consent of pain cause a Convulsion Aboundance of humors cause Repletion dulling the body by
incompassing air under which also is comprehended that which is taken from the season of the yeer region the state of the air and soil and the particular condition of the present and lately by-past time Hence it is we read in Guido Why wounds of the head at Paris and of the legs at Avignion are hard to be cured that Wounds of the head are cured with far more difficulty at Paris than at Avignion where notwithstanding on the contrary the Wounds of the legs are cured with more trouble than at Paris the cause is the air is cold and moist at Paris which constitution seeing it is hurtfull to the brain and head it cannot but must be offensive to the Wounds of these parts But the heat of the ambient air at Avignion attenuates and dissolves the humors and makes them flow from above downwards But if any object that experience contradicts this opinion of Guido and say that wounds of the head are more frequently deadly in hot countries let him understand that this must not be attributed to the manifest and natural heat of the air but to a certain malign and venenate humor or vapor dispersed through the air and raised out of the Seas as you may easily observe in those places of France and Italy which border upon the Mediterranean Sea An indication may also be drawn from the peculiar temper of the wounded parts for the musculous parts must be dressed after one and the bony parts after another manner The different sense of the parts indicates and requires the like variety of remedies for you shall not apply so acrid medicins to the Nerves and Tendons An indication to be drawn from the quick and dull sense of the wounded part as to the ligaments which are destitute of sense The like reason also for the dignity and function of the parts needfull for the preservation of life for oft-times wounds of the brain or of some other of the naturall and vitall parts for this very reason that they are defixed in these parts divert the whole manner of the cure which is usually and generally performed in wounds Neither that without good cause for oft-times from the condition of the parts we may certainly pronounce the whole success of the disease for wounds which penetrate into the ventricles of the brain into the heart the large vessels the chest the nervous parts of the midriffe the liver ventricles small guts bladder if somewhat large are deadly as also those which light upon a joynt in a body repleat with ill humors as we have formerly noted Neither must you neglect that indication which is drawn from the situation of the part and the commerce it hath with the adjacent parts or from the figure thereof seeing that Galen himself would not have it neglected Gal. lib. 7. Meth 2. ad Glauc But we must consider in taking these forementioned Indications whether there be a composition or complication of the diseases for as there is one and that a simple indication of one and that a simple disease so must the indication be various of a compound and complicate disease But there is observed to be a triple composition or complication of affects besides nature for either a disease is compounded with a disease as a wound or a plegmon with a fracture of a bone or a disease with a cause as an ulcer with a defluxion or a disease with a symptome as a wound with pain or bleeding It sometimes comes to pass that these three the disease cause and symptome concur in one case or affect In artificially handling of which we must follow Galens counsell Gal. lib. 7. Meth. who wishes in complicated and compounded affects that we resist the more urgent then let us withstand the cause of the disease and lastly that affect without which the rest cannot be cured Which counsell must well be observed for in this composure of affects which distracts the Emperick on the contrary the rational Physitian hath a way prescribed in a few and these excellent words which if he follow in his order of cure he can scarse miss to heal the Patient Symptomes truly as they are symptomes yeeld no indication of curing neither change the order of the cure for when the disease is healed the symptome vanishes as that which follows the disease as a shadow follows the body But symptomes do oftentimes so urge and press How and when we must take indication of curing from a symptome that perverting the whole order of the cure we are forced to resist them in the first place as those which would otherwise increase the disease Now all the formerly mentioned indications may be drawn to two heads the first is to restore the parts to its native temper the other is that the blood offend not either in quantity or quality for when those two are present there is nothing which may hinder the repletion or union of wounds nor ulcers CHAP. IX What remains for the Chirurgeon to do in this kind of Wounds THe Chirurgeon must first of all be skilfull and labour to asswage pain hinder defluxions prescribe a diet in those six things we call not-natural forbidding the use of hot and acrid things as also of Wine for such attenuate humors and make them more apt for defluxion Why such as are wounded must keep a slender diet Therefore at the first let his diet be slender that so the course of the humors may be diverted from the affected part for the stomach being empty and not well filled draws from the parts about it whereby it consequently follows that the utmost and remotest parts are at the length evacuated which is the cause that such as are wounded must keep so spare a diet for the next dayes following Venery is very pernicious for that it inflames the spirits and humors far beyond other motions whereby it happens that the humors waxing hot are too plentifully carried to the wounded and over heated part The bleeding must not be stanched presently upon receiving of the wound for by the more plentiful efflux thereof the part is freed from danger of inflammation and fulness Why we must open a vein in such as are wounded by Gunshot Wherefore if the wound bleed not sufficiently at the first you shall the next day open a vein and take blood according to the strength and plenitude of the Patient for there usually flows no great store of blood from wounds of this nature for that by the greatness of the contusion and vehemency of the moved air the spirits are forced in as also I have observed in those who have one of their limbs taken away with a Cannon bullet For in the time when the wound is received there flows no great quantity of blood although there be large veins and arteries torn in sunder thereby But on the 4 5 6. or some more dayes after the blood flows in greater abundance and with more violence the native
according to the common rules of Art you cut it off close to that which is perished the Patient will be forced with trouble to use three Legs instead of two An observable Histâ—ry For I so knew Captain Francis Clerk when as his foot was stricken off with an iron bullet shot forth of a man of war and afterwards recovered and healed up he was much troubled and wearied with the heavy and unprofitable burden of the rest or his Leg wherefore though whole and sound he caused the rest thereof to be cut off some five fingers breadth below his knee and verily he used it with much more ease and facility than before in performance of any motion We must do otherwise if any such thing happen in the Arm that is you must cut off as little of the sound part as you can For the actions of the Legs much differ from those of the Arms and chiefly in this that the body rests not neither is carried upon the Arms as it is upon the Feet and Legs CHAP. XIX How the section or amputation must be performed THe first care must be of the Patients strength wherefore let him be nourished with meats of good nutriment easie digestion and such as generate many spirits as with the yolâ—s of Egs and bread tosted and dipped in Sack or Muskadine Then let him be placed as is fit and drawing the muscles upwards towards the sound parts let them be tyed with a strait ligature a little above that place of the member which is to be cut off with a strong and broad fillet like that which women usually bind up their hair withall The Ligature of the part This ligature hath a threefold use the first is that it hold the muscles drawn up together with the skin so that retiring back presently after the performance of the work they may cover the ends of the cut bones and serve them in stead of â—o â—isters or pillows when they are healed up and so suffer with lesse pain the compression in sustaiâ—ing the rest of the body besides also by this means the wounds are the sooner healed and cicatrized for by how much more flesh or skin is left upon the ends of the bones by so much they are the sooner healed and cicatrized The second is for that it prohibits the flux of bloud by pressing and shutting up the veins and arteries The third is for that it dulls the sense of the part by stupefying it the animal spirits by the strait compressing being hindred from passing in by the Nerves Wherefore when you have made your ligature cut the flesh even to the bone with a sharp and well-cutting incision-knife or with a crooked Knife such as is here expressed A crocked knife fit for dismembring or a dismembring knife The Figure of such a Saw A caution to be observed Now you must note that there usually lies beâ—ween the bones a portion of certain muscles which you cannot easily cut with a large incision or dismembring-knife wherefore you must carefully divide it and separate it wholly from the bone with an instrument made neatly like a crooked Incision-knife I thought good to advertise thee hereof for if thou shouldest leave any thing besides the bone to be divided by the Saw you would put the Patient to excessive pain in the performance thereof for soft things as flesh tendons and membranes cannot be easily cut with a Saw Therefore when you shall come to the bared bone all the other parts being wholly cut asunder and divided you shall nimbly divide it with a little Saw about some foot and three inches long and that as near to the sound flesh as you can And then you must smooth the front of the Bone which the Saw hath made rough CHAP. XX. How to stanch the bleeding when the member is taken off WHen you have cut off and taken away the member let it bleed a little according to the strength of the Patient that so the rest of the part may afterwards be lesse obnoxious to inflammation and other symptoms Then let the veins and arteries be bound up as speedily and straitly as you can that so the course of the flowing blood may be stopped and wholly stayed Which may be done by taking hold of the vessels with your Crows-beak whereof the figure follows The Crows-beak fit for to draw the vessels forth of the flesh wherein they lye hid that so they may be tyed or bound fast The ends of the vessels lying hid in the flesh How to draw forth the vessels and bind them must be taken hold of and drawn with this instrument forth of the muscles whereinto they presently after the amputation withdrew themselves as all parts are still used to withdraw themselves towards their originals In performance of this work you need take no great care if you together with the vessels comprehend some portion of the neighbouring parts as of the flesh for hereof will ensue no harm but the vessells will so be consolidated with more ease than if they being bloodlesse parts should grow together by themselves To conclude when you have so drawn them forth bind them with a strong double thred CHAP. XXI How after the blood is stanched you must dresse the wounded member WHen you have tyed the Vessels How the lips of the dismembred part are to be joined together loose your Ligature which you made above the place of amputation then draw together the lips of the wound with four stitches made across having taken good hold of the flesh for thus you shall draw over the bones that part of the skin and cut muscles drawn upwards before the amputation and cover them as close as you can that so the air may the lesse come at them and that so the wound may be the more speedily agglutinated But when we say draw together the lips of the wound with four stitches you must not so understand it as that you must endeavour to draw them so close as to touch each other for that is impossible for the stitches would sooner break out and so the part would lye bare Wherefore it will be sufficient to draw them indifferent close together that so you may suffer the skin and flesh thereunder to enjoy its former liberty which it possest before the drawing up and so in fine by nature's assistance the wound may be the more easily agglutinated CHAP. XXII How you must stop the bleeding if any of the bound-up vessels chance to get loose THe business hitherto being performed as we said if peradventure it happen that any bandage of any of the vessels be unloosed then must you again bind the member with that kind of Ligature which you did before the amputation thereof Or else which is better more easie and less painful let your servant take hold of the member with both his hands pressing his fingers strait stop the passage of the loosed vessell for so he may stanch the bleeding Then
to the side opposite to that towards which the bone fell that so also in some measure it may be more and more forced into its place In the mean time you must have a care that you do not too straitly press the great and large tendon which is at the heel This kinde of dislocation is restored in forty days unless some accident happen which may hinder it CHAP. LIII Of the dislocation of the Heel Causes and differences WHosoever leaping from an high place have fallen very heavy upon their heel have their heel dislocated and divided from the pastern-bone This dislocation happens more frequently inwardly then outwardly because the prominencie of the lesser Focile embraces the pastern-bone whence it is that there it is more straitly and firmly knit It is restored by extension and forcing it in which will be no very difficult matter The Cure unless some great defluxion or inflammation hinder it For the binding up it most be straitest in the part affected that so the blood may be pressed from thence into the neighbouring parts yet using such a moderation that it may not be painful not press more straitly than is fit the nerves and gross tendons which runs to the heel This dislocation is not confirmed before the fortieth day though nothing happen which may hinder it Yet usually it happeneth that many symptomes ensue by the vehemencie of the contusion Wherefore it will not be amiss to handle them in a particular chapter CHAP. LIV. Of the Symptoms which follow upon the contusion of the Heel Why blood-letting necessary in the fracture of a heel IT happeneth by the vehemencie of this contusion that the veins and arteries do as it were vomit up blood both through the secret passages of their coats as also by their ends or orifices whence an Ecchymosis or blackness over all the heel pain swelling and other the like ensue which implore remedies and the Surgeons help to wit convenient diet Hip. sect 3. de fracturis and drawing of bloud by opening a vein of which though Hippocrates makes no mention yet it is here requisite by reason of the Feaver and inflammation and if need require purgation principally such as may divert the matter by causing vomit and lastly the application of local medicines chiefly such as may soften and rarifie the skin under the heel otherwise usually hard and thick such as are fomentations of warm water and oil so that divers times wee are forced to scarifie it with a lancet shunning the quick flesh For so at length the blood poured forth into the part and there heaped up is more easily attenuated and at length resolved But these things must all bee performed before the inflamtion seiz upon the part otherwise there will bee danger of a convulsion For the blood Why the heel is subject to inflammation when it fall's out of the vessels readily putrifie's by reason the densitie of this part hinder's it from ventilation dispersing to the adjacent parts Hereto may bee added that the large and great tendon wich cover's the heel is endued with exquisite sens and also the part it self is on every side spred over with many nervs Besides also there is further danger of inflammation by lying upon the back and heel as wee before admonished you in the Fracture of a leg Therefore I would have the Surgeon to bee here most attentive and diligent to perform these things which wee have mentioned left by inflammation a Gangrene and Mortification for here the sanious flesh presently fall's uppon the bone happen together with a continued and sharp Fever with trembling hicketting and raving For the corruption of this part first by contagion assail's the next and thence a Fever assail's the heart by the arteries pressed and growing hot by the putrid heat and by the nervs and that great and notable tendon made by the concours of the three muscles of the calf of the leg Gal. ad sent 23. sect 2. lib. de fract the muscles brain and stomach are evilly affected and drawn into consent and so caus convulsions raving and a deadly hicketting CHAP. LV. Of the dislocated Pastern or Ancle-bone THe Astragalus or pastern bone may bee dislocated and fall out of its place to every side Wherefore when it fall's out towards the inner part Sign the sole of the foot is turned outwards when it flie's out to the contrarie the sign is also contrarie if it bee dislocated to the foreside on the hinde side the broad tendon coming under the heel is hardned and distended but if it bee luxated backards the whole heel is as it were hid in the foot neither doth this kinde of dislocation happen withou much violence It is restored by extending it with the hands and forcing it into the contrary part to that from whence it fell Beeing restored it is kept so by application of medicins and fit ligation The patient must keep his bed long in this case Cure lest that bone which sustain's and bear's up the whole bodie may again sink under the burden and break out the sinews beeing not well knit and strengthned CHAP. LVI Of the dislocation of the In-step and back of the foot THe bones also of the In-step and back of the foot may bee luxated and that either upwards or downwards or to one side though seldom sidewise for the reason formerly rendred speaking of the dislocation of the like bones of the hand Cure If that they stand upwards then must the patient tread hard upon som plain or even place and then the Surgeon by pressing them with his hand shal force them into their places on the contrary if they stand out of the sole of the foot then must you press them thence upwards and restore each bone to its place They may bee restored after the same manner if they bee flown out to either side But you must note that although the Ligatures consist but of one head in other dislocations yet here Hippocrates would have such used as have two heads for that the dislocation happen's more from below upwards Sent. 14. sect 2. lib. de fract or from above downwards then sidewise CHAP. LVII Of the dislocation of the Toes NOw the Toes may bee four wais dislocated even as the fingers of the hand The differences The and they may bee restored just after the same manner that is extend them directly forth and then force eath joint into its place and lastly binde them up as is fitting The restitution of all them is easie for that they cannot far transgress their bounds To conclude Cure the bones of the feet are dislocated and restored by the same means as those of the hands but that when as any thing is dislocated in the foot the patient must keep his bed but when any thing is amiss in the hand hee must carrie it in a scarf The patient must rest twenty daies that is until hee
so could that bee don without the infection and corruption of the whole mass of blood whil'st it flow's through the veins therefore to bee more probable that this quantitie of filth mixed with excrements urine flowed out by the default of the liver or of som other bowel rather than from the wounded arm I was of a contrarie opinion for these following reasons How the pus may flow from the wounded arm by the urine and excrements First for that which was apparently seen in the patient for as long as the excrement and urine were free from this purulent matter so long his arm plentifully flowed therewith this on the contrary being dry much purulent matter was voided both by stool urine Another was that as our whole bodie is perspirable so it is also if I may so term it confluxible The third was an example taken from the glasses with the French term Monte-vins that is Mount-wines for if a glass that is full of wine be set under another that is fill'd with water you may see the wine raise it self out of the lower vessel to the upper through the mid'st of the water and so the water descends through the mid'st of the wine yet so that they do not mix themselvs but the one take and possess the place of the other If this may bee don by art by things onely naturall and to bee discerned by our eies what may bee don in our bodies in which by reason of the presence of a more noble soul all the works of nature are far more perfect What is it which wee may dispair to bee don in the like case For doth not the laudable blood flow to the guts kidnies spleen bladder of the gall by the impuls of nature together with the excrements which presently the parts themselvs separate from their nutriment Doth not milk from the brests flow somtimes forth of the wombs of women lately dilivered Yet that cannot bee carried down thither unless by the passages of the mammillary veins and arteries which meet with the mouths of the vessels of the womb in the middle of the straight muscles of the Epigastrium Therefore no marvel if according to Galen Lib. de loc affec 6. cap. 4. the pus unmix't with the blood flowing from the whole body by the veins arteries into the kidnies and bladder bee cast forth together with the urine These and the like things are don by nature not taught by anie counsel or reason but onely assisted by the strength of the segregateing and expulsive facultie and certainly wee presently dissecting the dead bodie observed that it all as also all the bowels thereof were free from inflammation and ulceration neither was there anie sign of impression of anie purulent matter in anie part thereof CHAP. L. By what external causes the urine is supprest and prognosticks concerning the suppression thereof THere are also manie external causes through whose occasion the urine may bee supprest Such are batheing and swimmeing in cold water the too long continued application of Narcotick medicines upon the reins perinaeum and share the use of cold meats and drinks and such other like Moreover Why the dislocation of a vertebra of the loins may caus a suppression of urine the dislocation of som Vertebra of the loins to the inside for that it presseth the nerves disseminated thence into the bladder therefore it causeth a stupiditie or numness of the bladder Whence it is that it cannot perceiv it self to bee vellicated by the acrimonie of the urine and consequently it is not stirred up to the expulsion thereof But from whatsoever caus the oppression of the urine proceed's if it persevere for som daies death is to bee feared Why the suppression of the urine becom's deadly unless either a fever which may consume the matter of the urine or a scouring or flux which may divert it shall happen thereupon For thus by stay it acquireth an acrid and venenate qualitie which flowing by the veins readily infecteth the mass of blood and caried to the brain much molest's it by reason of that similitude and sympathie of condition which the bladder hath with the Meninges A fever following thereon help 's the suppression of urine But nature if prevalent easily free'th it self from this danger by a manifest evacuation by stool otherwise it must necessarily call as it were to its aid a feverish heat which may send the abounding matter of this serous humiditie out through the skin either by a sensible evacuation as by sweat becaus sweat and urine have one common matter or els dispers and breath it out by transpiration which is an insensible excretion CHAP. LI. Of bloodie Vrine SOm piss pure blood others mixt and that either with urine and then that which is expelled resembl's the washing of flesh newly killed The differences or els with pus or matter and that either alone or mixed with the urine There may bee divers causes of this symptom Causes as the too great quantitie of blood gathered in the body which by the suppression of the accustomed and period cal evacuation by the courses or hemorrhoids now turn's its cours to the reins and bladder the fretting asunder of som vessel by an acrid humor or the breaking thereof by carrying or lifting of som heavie burden by leaping falling from high a great blow the falling of som weight upon the loins rideing post too violently the too immoderate use of venerie and lastly from anie kinde of painfull and more violent exercise by a rough and sharp stone in the kidnies by the weaknes of the retentive facultie of the kidnies by a wound of som of the parts belonging to the urine by the too frequent use of diuretick and hot meats and medicines or els of things in their whole nature contrarie to the urinarie parts for by these and the like causes the reins are oft-times so inflamed that they necessarily impostumate and at length the impostume beeing broken it turn's into an ulcer casting forth quitture by the urine In so great varietie of the causes of blodie urine wee may gather whence the causes of this symptom may arise Signs of what causes they proceed by the depraved action of this or that part by the condition of the flowing blood to wit pure or mixt and that either with the urine alone or with pus For example if this bloodie matter flow from the lungs liver kidnies dislocated Vertebrae the straight gut or other the like part you may discern it by the seat of the pain and symptoms as a fever and the propriety of the pain and other things which have preceded or are yet present And wee may gather the same by the plentie and qualitie for if for example the pus flow from an ulcer of the arm the purulent matter will flow by turns one while by the urine so that little is cast forth by the ulcer then presently on the
come forth at the mouth Marianus Sanctuâ— wisheth by the counsel of many who have so freed themselves from this deadly symptome to drink three pounds of quick-silver with water only For the doubled The force of quick-siâ—ver in the unfolding of the guts An historie and as it were twined up-gut is unfolded by the weight of the quick-silver and the excrements are deprest and thrust forth and the worms are killed which gave occasion to this affect John of S Germans that most worthie Apothecary hath told me that he saw a Gentleman who when as he could not be fâ—eed from the pain of the colick by any means prescribed by learned Physicians at length by the counsel of a certain German his friend drank three ounces of oil of sweet almonds drawn without fiâ—e and mixed with some white wine and pellitorie-water and swallowed a leaden bullet besmeaâ—ed with quick-silver and that bullet coming presently out by his fundament he was wholly freed from his colick CHAP. LIX Of Phlebotomie or Blood-letting PHlebotomie is the opening of a vein evacuating the blood with the rest of the humors What Phlebotomie is thus Atteritomie is the opening of an arterie The first scope of phlebotomie is the evacuation of the blood offending in quantity The use although oft-times the Physician 's intention is to draw forth the blood which offends in qualitie or either way by opening a vein Repletion which is caused by the quantity is two-fold the one ad vires that is to the strength Repletion two-fold the veins being otherwise not very much swelled this makes men infirm and weak nature not able to bear his humor of what kinde soever it be The other is termed ad vasa that is to the vessells the which is so called comparatively to the plentie of blood although the strength may very well away therewith The vessels are oft-times broke by this kinde of repletion so that the patient casts and spits up blood or else evacuates it by the nose womb hemorhoids or varices The repletion which is ad vires The signs is known by the heaviness and wearisomness of the whole body but that which is ad vasa is perceived by their distension and fulness both of them stand in need of evacuation But blood is only to be let by opening a vein Five scopes in letting blood for five respects the first is to lessen the abundance of blood as in plethorick bodies and those who are troubled with inflammation without any plenitude The second is for diversion or revulsion as when a vein of the right is opened to stay the bleeding of the left nostril The third is to allure or draw down as when the saphena is opened in the ankle to draw down the courses in women The fourth is for alteration or introduction of another quality as when in sharp fevers we open a vein to breath out that blood which is heated in the vessels and cooling the residue which remains behinde The fifth is to prevent imminent diseases as when in the Spring and Autumn we draw blood by opening a vein in such as are subject to spitting of blood the squinancie plurifie falling-sicknesse apoplexie madnesse gout or in such as are wounded for to prevent the inflammation which is to be feared Before blood-letting if there be any old excrements in the guts they shall be evacuated by a gentle glyster or suppositorie least the mesaraick veins should thence draw unto them any impuritie Bloud must not be drawn from ancâ—ent people From whence we must not draw blood â—â—less some present necesitie require it least the native heat which is but languid in them should be brought to extreme debilitie and their substance decay neither must any in like sort be taken from children for fear of resolving their powers by reason of the tenderness of thei substance and â—areness of their habit The quantity of blood which is to be let must be considered by the strength of the patient and greatness of the disease therefore if the patient be weake and the disease require large evacuation it will be convenient to part the letting of blood When and foâ— what it is necessarie yea by the interposition of some daies The vein of the forehead being opened is good for the pain of the hind part of the head yet first we foment the part with warm water that so the skin may be softer and the blood drawn into the veins in greater plenty In the squinancie the veins which are under the tongue must be opened aslant without putting any ligatures about the neck for fear of strangling Phlebotomie is necessary in all diseases which stop or hinder the breathing or take away the voice or speech as likewise in all contusions by a heavy stroke or fall from high in an apoplexie sqâ—inancie and burning feaver though the strength be not great nor the blood faultie in quantity or quality blood must not be let in the height of a feaver Most judge it fit to draw blood from the veins most remote from the affected and inflamed part for that thus the course of the humors may be diverted the next veins on the contrary being opened the humors may be the more drawn into the affected part and so increase the burden and pain But this opinion of theirs is very erroneous for an opened vein alwaies evacuates and burdens the next part For I have sundry times opened the veins and arteries of the affected part as of the hands and feet in the Gout of 〈◊〉 parts of the temples in the Megrim whereupon the pain alwaies was somewhat asswaged for that together with the evacuated blood the malignitie of the Gout and the hot spirits the causers of the Head-ach or Megrim were evacuated For thus Galen wisheth to open the arteries of the temples in a great and contumacious defluxion falling upon the eies 13. meth cap. 〈◊〉 or in the Megrim or Head-ach CHAP. LX. How to open a vein or draw blood from thence How to pâ—ace the patient THe first thing is to seat or place the patient in as good a posture as you can to wit in his bed if he be weak but in a chair if strong yet so that the light may fall directly upon the vein which you intend to open Then the Surgeon shall rub the arm with his hand Rubbing the arm Binding it before we open the vein or a warm linnen cloth that the blood may flow the more plentifully into the vein Then he shall binde the vein with a ligature a little above the place appointed to be opened and he shall draw back the blood upwards towards the ligature from the lower part and if it be the right arm he shall take hold thereof with his left hand but if the left then with his right hand pressing the vein in the mean time with his thumb a little below the place where you mean to open it least it should
slip away and that it may be the more swoln by forcing up the blood Then with his nail he shall mark or design the place to be opened and shall anoint it being so marked with butter or oil whereby the skin may be relaxed and the lancet enter more easily and therefore the section may be the less painful Hee shall hold his lancet between his thumb and fore-finger neither too near nor too far from the point he shall rest his other three fingers upon the patients arm that so his hand may be the more steddie and less trembling Then shall he open the vein with an incision agreeable to the magnitude of the vessel Why the Basilica and Median may not be opened so safely as the Cephalick and the indifferent thickness of the contained blood somewhat aslant diligently avoiding the arterie which lies under the Basilica and the nerve or tendon of the two-headed muscle which lies under the Median vein But for the Cephalick it may be opened without danger As much blood as is sufficient being drawn according to the minde of the Physician he shall loose the ligature and laying a little bolster under he shall with a ligature binde up the wounded part to stay the bleeding the ligature shall be neither too straight The binding up after blood-letting nor loose but so that the patient may freely bend and extend his arm wherefore whilst that is in doing he must not hold his arm straight out but gently bended otherwise he cannot freely bend it The figure of a Lancet to let blood withall CHAP. LXI Of Cupping-glasses or Ventoses The use of Cupping-glasses CUpping glasses are applyed especially when the matter conjunct and impact in any part is to be evacuated and then chiefly there is place for scarification after the Cupping-glasses yet they are also applied for revulsion and diversion for when an humor continually flows down into the eies they may be applyed to the shoulders with a great flame for so they draw more strongly and effectually They are also applied under womens breasts for to stop the courses flowing too immoderately but to their thighs for to provoke them They are also applied to such as are bit by venemous beasts as also to parts possessed by a pestiferous Bubo or Carbuncle so to draw the poison from within outwards For as Celsus saith a Cupping-glass where it is fastned on Lib. 8. cap. 1. if the skin be first scarified draws forth blood but if it be whole then it draws spirit Also they are applied to the belly when any gross or thick windiness shut up in the guts or membranes of the Epigastrium or lower belly causing the collick is to be discussed Also they are fastned to the Hypocondries when as flatulencie in the liver or spleen swells up the entrail lying thereunder or in too great a bleeding at the nose Also they are set against the reins in the bottom of the belly whereas the ureters run down to draw down the stone into the bladder when as it stops in the middle or entrance of the ureter You shall make choice of greater and lesser Cupping-glasses according to the condition of the part and the contained matter But to those parts whereto these cannot by reason of their greatness be applied you may fit horns for the same purpose The figures of Cupping-glasses of different bigness with little holes in their bottoms which shall be stopped with wax when you apply them to the part but opened when you would take them off that so the air may enter in with the more case A Lancet Horns which without fire by only sucking at the upper hole draw from the part lying under them CHAP. LXII Of Leeches and their use The use of Leeches IN those parts of the body whereto Cupping-glasses and horns cannot be applyed to those Leeches may for the most part be put as to the fundament to open the coat of the hemorrhoid veins to the mouth of the womb the gums lips nose fingers After the Leech being filled with blood shall fall off if the disease require a large evacuation of blood and the part affected may endure it How to applie them Cupping-glasses or Horns or other Leeches shall be substituted If the Leeches be handled with the bare hand they are angred and become so stomachful as that they will not bite wherefore you shall hold them in a white and clean linnen cloth and applie them to the skin being first lightly scarified or besmeared with the blood of some other creature for thus they will take hold of the flesh together with the skin more greedily and fully To cause them fall off How to cause them to fall off you shall put some powder of aloes salt or ashes upon their heads If any desire to know how much blood they have drawn let him sprinkle them with salt made into powder as soon as they are come off for thus they will vomit up what blood soever they have sucked If you desire they should suck more blood then they are able to contain cut off their tails as they suck for thus they will make no end of sucking for that it runs out as they suck it The Leeches by sucking draw the blood not only from the affected part whereto they are applyed but also from the adjacent and distant parts Also sometimes the part bleeds a good while after the Leeches be fallen away which happens not by scarification after the application of Cupping-glasses or Horns If you cannot stop the bleeding after the falling away of the Leeches then press the half of a bean upon the wound untill it stick of it self for thus it will stay also a burnt rag may be fitly applied with a bolster and fit ligature The end of the Seventeenth Book The EIGHTEENTH BOOK Of the GOUT CHAP. I. The description of the Gout What it is THe Gout is a disease occupying and harming the substance of the Joints by the falling down and collection of a virulent matter accompanied by four humors This word Arthritis or Gout is general for everie joint so affected yet it enjoies diverse particular names in sundrie joints of the body as that which falleth upon the joint of the Jaw is termed Siagonagra for that the Greeks call the Jaw Siagon that which affects the neck is termed Trachelagra Particular Gouts for that the neck is termed Trachelos that which troubles the back-bone is called Rhacisagra for the spine is termed Rhacis that which molests the shoulders Omagra for the joint of the shoulder is called Omos that which affects the joint of the Collar-bones Cleisagra for that the Greeks call this bone Cleis that in the elbow Pechyagra for Pechys signifieth the elbow the gout in the hand is called Chiragra in the Hip Ischias in the knee Gonagra in the feet Podagra for that the Hand Hip Knee and Foot are in Greek termed Cheir Ischion Gony and Pous When
tendons What and how the matter of the gout come down from the brain ligaments and other bodies wherein the joint consists CHAP. IV. Out of what part the matter of the Gout may flow down upon the joynts THe matter of the Gout comes for the most part from the liver or brain that which descends from the brain is phlegmatick serous thin and clear such as usually drops out of the nose endued with a malign and venenate quality Now it passeth out by the musculous skin and pericranium as also through that large hole by which the spinal marrow the brains substitute is propagated into the spine by the coats and tendons of the nervs into the spices of the joynts and it is commonly cold That which proceedes from the liver is diffused by the great vein and arteries filled and puffed up and participates of the nature of the four humors of which the mass of the blood consist's more frequently accompanyed with an hot distemper together with a gouty malignity Besides this manner of the Gout Gut by congestion which is caused by defluxion there is another which is by congestion as when the too weak digestive faculty of the joynts cannot assimilate the juices sent to them CHAP. V. The signs of the Arthritick humor flowing from the brain WHen the defluxion is at hand there is an heaviness of the head a desire to rest and a dulness with the pain of the outer parts then chiefly perceptible when the hairs are turned up or backwards moreover the musculous skin of the head is puffed up as swoln with a certain oedematous tumor the patients seem to be much different from themselves by reason of the functions of the mind hurt by the malignity of the humor from whence the natural faculties are not free as the crudities of the stomach and the frequent and acrid belchings may testifie CHAP. VI. The signs of a gouty humor proceeding from the liver THe right Hypocondrie is hot in such gouty persons When the Gout which proceeds from the default of the liver assimiates the nature of an oedema Why the Gout seldom proceedâ— from melancholy yea the inner parts are much heated by the bowelâ— blood and choler carrie the sway the veins are large and swoln a defluxion suddenly falls down especially if there be a greater quantity of choler then of other humors in the mass of the blood But if as it often falls out the whole bloud by means of crudites degenerate into phlegm and a whayish humor then will it come to pass that the Gout also which proceeds from the liver may be pituitous or phlegmatick and participate of the nature of an oedema like that which proceeds from the brain As if the same mass of bloud decline towards melancholy the Gout which thence ariseth resembles the nature of a scirrhus yet that can scarce hâ—ppen that melancholy by reason of the thickness and slowness to motion may fall upon the joynts Yet notwithstanding because we speak of that which may be of these it will not be unprofitable briefly to distinguish the signs of each humor and the differences of Gouts to be deduced from thence CHAP. VII By what signs we may understand this or that humor to accompany the gouty malignity YOu may give a guess hereat by the patients age temper season of the year condition of the country where he lives his diet and condition of life the increase of the pain in the morning noon evening or night by the propriety of the beating pricking sharp or dull pain by numness as in a melancholy gout or itching as in that which is caused by tough phlegm by the sensible appearance of the part in shape and colour as for example sake in a phlegmatick Gout the colour of the affected part is very little changed from its sef and the neighbouring well parts in a sanguine Gout it look's red in a cholerick it is fiery or pale in a melancholy livid or blackish by the heat and bigness which is greater in a sanguine and phlegmatiâ—k then in the rest by the change and lastly by things helping and hurting And there be some who for the knowledge of these differences wish us to view the patients urine and feel their pulse and consider these excrements which in each particular nature are accustomed to abound or flow and are now suddenly and unaccustomarily supprest Foâ— hence may bee taken the signs of the dominion of this or that humor But a more ample knowledg of these things may be drawn from the humors predominant in each person and the signs of tumors formerly delivered Onely this is to be noted by the way that the gout which is caused by melancholy is rare to be found CHAP. VIII Prognosticks in the Gout BY the writeings of Physicians the pains of the Gout are accounted amongst the most grievous and acute so that through vehemency of pain many are almost mad and wish themselves dead They have certain periods and fits according to the matter and condition of the humor wherein this malign and inexplicable gouty virulency resides Yet they more frequently invade in the Spring and Autumn The Gout frequent in the Spring Fall What Gout uncureable such as have it hereditary are scarce ever throughly freâ— therefrom as neither such as have it knotty for in the former it was born with them and implanted and as it were fixed in the original of life but in the other the matter is become plaster-like so that it can neither be resolved nor ripened That which proceeds from a cold and pituitous matter causeth not such cruel tormenting pain as that which is of an hot sanguine or cholerick cause neither is it so speedily healed for that the hot and thin matter is more readily dissolved therefore commonly it ceaseth not until forty dayes be past Besides also by howmuch the substance of the affected part is more dense and the expulsive faculty more weak by so much the pain is more tedious Hence it is that those Gouty pains which molest the knee hee l ad huckle-bone Gal. ad aphor 49. sect 5. are more contumacious The Gout which proceeds of an hot matter rests not before the fourteenth or twentieth day That which is occasioned by acriâ—e choler by the bitterness of the inflamation of the pain causeth a difficulty of breathing raveing and sundry times a gangrene of the affected part and lastly death and healed it often leaves a palsie behinde it Why the Sciatica causeth lameness Amongst all the gouty pains the Sciatica challengeth the prime place by the greatness of the pain and multitude of symptoms it brings unquietness and watching a fever dislocation perpetual lameness and the decay of the whole leg yea and often-times of the whole body Now lameness and leanness or decay of the part are thus occasioned for that the decurrent humor forceth the head of the thigh-bone out of the cavity of the huckle-bone
they let him feed on veal kid and pork boiled with lettuce purslain barly and violet leaves the which by their humidity might relax the belly and by their toughnesse lenifie the roughness of asperity they applied also refrigerating things to the loins share and perinoeum to asswage the heat of the urine At length they put him into a warm bath and to conclude they left nothing unattempted to draw forth or weaken the poison But all their endeavors were in vain for the Abbot died not being destitute of remedies conveniently prescribed but overcome by the contumacious malignity of the poison An history The Physicians pains had far better success in a certain Gentlewoman against this kind of affect her whole face was deformed with red fiery and filthy pullies so that all shunned her company as if she had been troubled with a Leprosie and were ready to forbid her the society of men she came to Paris and calling Hollerius and Grealmus Physicians me and Caballus being Surgeons she made a grievous complaint and besought us earnestly for some remedy against so great a deformity of her face having diligently considered her case we pronounced her free from a Leprosie but we judged it fit to apply to her whole face a veficatory of Cantharides Cantharides applied to the head ulcerate the bladder three or four hours after the application whereof the medicine being come to work its effect her bladder began to burn exceedingly and the neck of her womb to swell with gripings continual vomitings making of water and scowring a troublesome agitation of the body and members a burning and absolutely fiery fever I forthwith called the Phisicians it was decreed that she should drink wine plentifully and that it should be injected by the fundament into the guts and by the urinary passage into the bladder and the neck of the womb and that she should keep her self untill the pain were mitigated in a warm bath made of the decoction of Line-seeds the roots and leavs of mallows marsh-mallows violets heâ—bane purslain and lettuce and her loins and genitals should be anointed with unguentum rosatum and populeon stirred and incorporated with oxyorate By these means all the symptoms were mitigated A remedy against Leprous pustles Her face in the interim rose all in a blister and much purulent matter came out thereof and so the deformity wherewith she was formerly troubled vanished away for ever so that within a while after she was married and had many children and is yet living in perfect health Buprestes also are of the kind of Cantharides being like unto them in shape and faculty If an Ox or sheep or any other creature shall in feeding devour one of them he will presently swell up like a Tun The reason of the name whence also they take their name if a man take them inwardly he shall endure the like symptoms as in taking Cantharides and over and besides both his stomach and his whole belly shall be wonderfully puffed up as if he had a Dropsie It is probable that this inflation like a tympany happeneth by humors diffused and resolved into vapors by the fiery acrimony of the venom They are to be cured after the same manner as such as have drunk Cantharides Lastly as in all other poisons which are taken into the body so also here if the poison taken by the mouth be thought as yet to be in the stomach you must then procure vomit If it be gotten into the guts then must it be drawn away by glisters if diffused over all the body then must you make use of such things as may drive the poison forth from the center to the circumference such as are baths and stoves CHAP. XXIX Of Hors-leeches HOrs-leeches are also venomous especially such as live in muddy stinking ditches What hors-leeches mosâ— virulent for these are less hurtful which reside in clear and pure waters Wherefore before they are to be used in cases of physick they must be kept for some daies space in clean water that so they may purge themselves otherwise they may chance to leave ulcers hard to cure in the places whereto they shall be applied and the rather if they be violently plucked off because they by that means leave their teeth fastned in the part Now he which by chance hath swallowed a Hors-leech must be asked in what part he feeleth her that is the sense of her sucking Divers remedies according to the diversity of the parts For if she stick in the top of the throat or gullet or in the midst thereof the part shall be often washed with mustard dissolved in vinegar If she be near the orifice of the ventricle it is fit that the patient by little and little swallow down oil with a little vinegar But if she fasten to the stomach or the bottom of the ventricle the patient by the plucking oft the part shall perceive a certain sense of sucking the patient will spit blood and will for fear become melancholik To force her thence he shall drink warm water with oil but if she cannot so be loosed then shall you mix aloes therewith or some thing endued with the like bitterness for she will by that means leave her hold and so be cast forth by vomit You may perceive this by such as are applied to the skin on the external parts for by the aspersion of bitter things whether they be full or empty they will forsake their hold Then shall the patient take astringent things which may stop the blood flowing forth of the bitten part such is Conserve of Roses with terra sigillata Bole-Armenick and other more astringent things if need so require For if they shall adhere to some greater branch of some vein or artery it will be more difficult to stop the flowing blood But for that not the earth only but the sea also produceth venomous creatures we will in like fort treat of them as we have already done of the other beginning with the Lampron CHAP. XXX Of the Lampron THe Lampron called in Latine Muraena is a sea-fish something in shape The description of the Lampron resembling a Lamprey but she is bigger and thicker and hath a larger mouth with teeth long sharp and bending inwards she is of a dusky colour distinguished with whitish spots and some two cubits length the Antients had them in great esteem because they yield good nourishment and may be kept long alive in pools or ponds and so taken as the owners please to serve their table as it is sufficiently known by the history of the Roman Crassus She by her biting induceth the same symptoms as the viper and it may be helped by the same means The natural friendship of the Lampron and Viper Verily the Lampron hath such familiarity with the Viper that leaving her natural element the sea she leapeth ashoar and seeketh out the Viper in her den to join with her in copulation as
of an Onion rosted under the embers and incorporated with Treacle and a little oil of Rue after the hoemorrhoid veins by these means come to shew themselves they shall be rubbed with rough linnen cloths or Fig-leaves or a raw Onion or an Ox-gall mixt with some powder of Collequintida Lastly you may apply Horse-leeches or you may open them with â— lancet if they hang much forth of the fundament and be swoln with much blood But if they flow too immoderately they may be staid by the same means as the courses CHAP. XXXIX Of procuring evacuation by stâ—ol or a flax of the belly NAture oftentimes both by it self of its own accord as also helped by laxative and purging medicines casts into the belly and guts as into the sink of the body the whole matter of a pestilâ—nt disease whence are caused Diarrhaeas Lienteries and Dysenteries you may distinguish these kinds of fluxes of the belly by the evacuated excrements For if they be thin and sincere that is retain the nature of one and that a simple humor as of choler melancholy or phlegm and if they be cast forth in a great quantity without the ulceration or excoriation of the guts vehement or freâ—ting pain then it is a Diarrhaea What a Diarrhaea is which some also call fluxus humoralis It is called a Lienteria when as by the resolved retentive faculty of tâ—e stomach and guts caused by ill humors either there collected or flowing from some other 〈◊〉 or by a cold and moist distemper the meat is cast forth crude and almost as it was taken A Dysenteria is when as many and different things and oft-times mixt with blood What a Disenteria is are cast forth with pâ—iâ—â—g gâ—ipings and an ulcer of the guts caused by acrid choler fretting in sunder the coats of the vessels But 〈…〉 â—ny kind of disease certainly in a pestilent one fluxes of the belly happen immoderate in quantity and horrible in the quality of their contents as liquid viscous frothy as from melted grease yellow red purple green ash-coloured black and exceeding stinking The cause of various and stinking excrements in the Plague The cause is various and many sorts of ill humors which taken hold of by the pestilent malignity turn into divers species differing in their whole kind both from their particulâ—r as also from nature in general by reason of the corruption of their proper substance whose inseparable sign is stench which is oft-times accompanied by worms In the camp at Amiens a pestilent Dysentery was over all the Camp An history in this the strongest souldiers purged forth meer blood I dissecting some of their dead bodies observed the mouths of the Mesaraick veins and arteries opened and much swollen and whereas they entered into the guts were just like little Catyledones out of which as I pressed them there flowed blood For both by the excessive heat of the Summers sun and the minds of the enraged souldiers great quantity of acrid and cholerick humor was generated and so flowed into the belly but you shall know whether the greater or lesser guts be ulcerated better by the mixture of the blood with the excrements then by the site of the pain therefore in the one you must rather work by clysters but in the other by medicines taken by the mouth Therefore if by gripings a tenesmus the murmuring and working of the guts you suspect in a pestilent disease that nature endeavors to disburden it self by the lower parts neither in the mean while doth it succeed to your desire then must it be helped forward by art as by taking a potion of â„¥ ss of hiera simplex and a dram of Diaphaenicon dissolved in Worm-wood wateâ— A person Also Clysters are good in this case not only for that they asswage the gripings and pains and draw by continuation or succession from the whole body but also because they free the mesaraick veins and guts from obstruction and stuffing so that by opening and as it were unlocking of the passages nature may afterwards more freely free it self from the noxious humors In such Clysters they also sometimes mix two or three drams of Treacle that by one and the same labour they may retund the venenate malignity of the matter There may also be made for the same purpose Suppositories of boiled hony â„¥ i of hiera picra and common salt of each Ê’ ss or that they may be the stronger of hony â„¥ iii. of Ox-gall â„¥ i. of Scammony Euphorbium and Coloquintida powdred of each Ê’ ss Suppositories The want of these may be supplyed by Nodulas made in this form â„ž vitell ovor nu iii. fellis bubuli mellis an â„¥ ss salis tom Ê’ss let them be stirred together and well incorporated and so parted into linnen rags and then bound up into Noduleas of the bigness of a Fil-berd and so put up into the fundament you may make them more acrid by adding some powder of Eupporbium or Coloquintida CHAP. XL. Of stopping the flux of the belly VIolent and immoderate scourings for that they resolve the faculty and lead the patient into a consumption and death if they shall appear to be such A hasty pudding to stay the lask they must be staied in time by things taken and injected by the mouth and fundament To this purpose may a pudding be made of wheat-flower boiled in the water of the decoction of one Pomegranat Berberies Bole-Armenick Terra sigillata white Poppy-seeds of each Ê’i The following Almond-milk strengthens the stomach and mitigates the acrimony of the cholerick humor provoking the guts to excretion Take sweet Almonds boiled in the water of Barly wherein steel or non hath been quenched â—eat them in a marble-mortar and so with some of the same water make them into an Almond-mâ—lk whereto adding Ê’i of Diarhâ—den Abbatis you may give it to the patient to drink This following medicine I learnt of Dr. Chappelain the Kings chief Physician who received it of his father and held it as a great secret and was wont to prescribe it with happy success to his patients D. Chappâ—lains medecine to stay a scouring It is 〈◊〉 â„ž beâ—â—â—rmen terrae sigil l. pid hamat an Ê’i picis nâ—valis Ê’ i ss coral rub marg 〈◊〉 câ—râ— câ—vi â—st 〈◊〉 in aq p. aâ—t an ℈ succar r. s â„¥ ii fiat pu vis Of this let the patient take a 〈◊〉 before meat or with the yâ—lk of an egg Chrisâ—â—pher Anarâ—â— in his 〈◊〉 much commendeth dogs-dung when as the dog hath for three dries before â—een fed only with bones Qâ—â—ces rosted in members or boâ—led in a pot the Conserve of Cornelian-cherries Preserved Berberies and Myrabolans rosted nutmeg taken before meat strengthen the stomach and stay the lask the patient must feed upon good meats Drink and these rather rosted then boiled His drink shall be caliâ—â—â—ate-water of the decoctâ—on of sower Pomegranats beaten or of the
immoderately the blood is sharp and burning and also stinking the sick woman is also troubled with a continual fever and her tongue will be dry ulcers arise in the gums and all the whole mouth In women the flowers do flow by the veins and arteries which rise out of the spermatick vessels and end in the bottom and sides of the womb but in virgins and in women great with child whose children are sound and healthful by the branches of the hypogastrick vein and artery which are spred and dispersed over the neck of the womb The cause of this immoderate flux is in the quantity or quality of the blood in both the fault is unreasonable copulation especially with a man that hath a yard of a monstrous greatness and the dissolution of the retentive faculty of the vessels The criticâ—l flux of the flowers The signs of blood flowing from the womb or neck of the womb oftentimes also the flowers flow immoderately by reason of a painful and a difficult birth of the childe or the after-birth being pulled by violence from the cotyledons of the womb or by reason that the veins and arteries of the neck of the womb are torn by the comming forth of the infant with great travel and many times by the use of sharp medicines and exulcerating pessaries Oft-times also nature avoids all the juice of the whole body critically by the womb after a great disease which flux is not rashly or suddenly to be stopped That menstrual blood that floweth from the womb is more gross black and clotty but that which commeth from the neck of the womb is more clear liquid and red CHAP. LVI Of stopping the immoderate flowing of the flowers or courses YOu must make choce of such meats and drinks as have power to incrassate the blood for as the flowers are provoked with meats that are hot and of subtil parts so they are stopped by such meats as are cooling thickning a stringent and sliptick as are barly-waters sodden rice the extreme parts of beasts as of oxen calves sheep either fried or sodden with sorrel purslain plantain shepherd's-purse sumach the buds of brambles berberries and such like It is supposed that a Harts-horn burned washed and taken in astringent water will stop all immoderate fluxes likewise sanguis draconis terra sigillata bolus armenus lapis haematites coral beaten into most subtil powder and drunk in steeled water also pap made with milk wherein steel hath oftentimes been quenched and the flowr of wheat barly beans or rice is very effectual for the same Quinces cervices medlars cornelian-berries or cherries may likewise be eaten at the second course Julips are to be used of steeled waters with the syrup of dry roses pomegranats sorrel myrtles quinces or old conserves of red roses but wine is to be avoided but if the strength be so extenuated that they require it you must chuse gross and astringent wine tempered with steeled water exercises are to be shunned especially Venerous exercises anger is to be avoided a cold air is to be chosen The institution or order of life which if it be not so naturally must be made so by sprinkling cold things on the ground especially if the summer or heat be then in his full strength sound sleeping stayes all evacuations except sweating The opening of a vein in the arm cupping-glasses fastened on the breasts bands and painful frictions of the upper parts are greatly commended in this malady But if you perceive that the cause of this accident lieth in a cholerick ill juice mixed with the blood Purging the body must be purged with medicines that purge choler and water as Rubarb Myrobalanes Tamarinds Sebestens and the purging syrup of Roses CHAP. LVII Of local medicines to be used against the immoderate flowing of the Courses ALso unguents are made to stay the immoderate flux of the terms and likewise injections and pessaries This or such like may be the form of an unguent â„ž ol mastich myrt an Ê’ii nucum cupres olibani An unguent myrtil an Ê’ii succi rosar rubr â„¥ i. pulv mastichin â„¥ ii boli armen terrae sigillat anÊ’ ss cerae quantum sufficit fiat unguentum An injection may be thus made â„ž aq plantag An astringent injection rosar rubr bursae pastor centinodii an lb ss corticis querni nucum cupressiâ— gallar non maturar an Ê’ ii berberis sumach balaust alumin. roch an Ê’i make thereof a decoction and inject it in a syringe blunt-pointed into the womb lest if it should be sharp it might hurt the sides of the neck of the womb also Snails beaten with their shells and applied to the navel are very profitable Quinces roasted under the coales and incorporated with the powder of Myrtles and Bole-Armenick and put into the neck of the womb are marvellous effectual for this matter The form of a pessarie may be thus A stringent pessaries â„ž gallar immaturar combust in aceto extinctar Ê’ii ammo Ê’ ss sang dracoâ— pulv rad symphyt sumach mastich fucci acaciae cornu cerust colophon myrrhae scoriae ferri an Ê’i caphur ℈ ii mix them and incorporate them all together with the juice of knot-grass syngreen night-shade hen-bane water-lillies plantain of each as much as is sufficient and make thereof a pessary Cooling things as Oxycrate unguentum rosatum and such like are with great profit used to the region of the loins thighs and genital parts but if this immoderate flux do come by erosion so that the matter thereof continually exulcerateth the neck of the womb let the place be annointed with the milk of a shee-Ass with barly-water or binding and astringent mucelages as of Psilium Quinces Gum Tragacanth Arabick and such like CHAP. LVIII Of Womens Fluxâ—s or the Whites The reason of the name BEsides the fore-named Flux which by the law of nature happeneth to women monthly there is also another called a Womans Flux because it is only proper and peculiar to them this sometimes wearieth the woman with a long and continual distillation from the womb The differences or through the womb comming from the whole body without pain no otherwise then when the whole superfluous filth of the body is purged by the reins or urine sometimes it returneth at uncertain seasons and sometimes with pain and exulcerating the places of the womb it differeth from the menstrual Flux because that this for the space of a few daies as it shall seem convenient to nature casteth forth laudable blood but this Womans Flux yeeldeth impure ill juice somtimes sanious sometimes serous and livid otherwhiles white and thick like unto barly-cream proceeding from flegmatick blood this last kind thereof is most frequent Therefore we see women that are phlegmatick and of a soft and loose habit of body to be often troubled with this disease and therefore they will say among themselves that they have the whites What women are apt to
the space of three years with extreme pain by reason of a great Caries which was in the bone Asiragal Cyboides great â—nd little â—â—cil and through all the nervous parts through which she felt extreme and intolerable pains night and day she is called Mary of Hostel aged 28 years or thereabouts wife of Peter Heâ—ve Esquire of the Kitchin to the Lady Ducheâ—s of Vzez dwelling in the meet of Verbois on the other side S. Martin in the fields dwelling at the sign of the S. John's-head where the said Charbâ—nel cut off the said leg The operation of Charbonel the bredth of 4 large fingers below the knee and after that he had inâ—â—ed the flesh and â—awed the bone he griped the vein with the Crow-bill then the Artery then tied them fâ—om whence I protest to God which the company that were there can witness that in all the operation that was suddenly done there was not spilt one porrenger of blood and I bid the said Charbonel to let it bleed more following the precept of Hippâ—crates that it is good in all wounds and also in inveterate ulcers to let the blood run by this means the part is less subject to inflammation In the â— Cent. of â—e bâ—ok of Ulcers The said Charbonel continued the dressing of her who was cured in two months without any flux of blood happening unto her or other ill accident and she went to see you at your lodging being perfectly cured Another History Another history of late memory of a singing-man of our Ladies Church named M. Colt who broke both the bones of his leg which were crusht in divers pieces insomuch that there was no hope of cure to withstand a gangrene and mortification and by consequence death Monsieur Helin Doctor Regent in the faculty of Physick a man of honor and good knowledge Claud. Viard and Simon Peter sworn Surgeons of Paris men well exercised in Surgery and Balthazar of Lestre and Leonard de Leschenal Operation done by Viaâ—d M. Barber-Surgeons weâ—l experimented in the operations of Surgery were all of opinion to withstand the accidents aforesaid to make entire amputation of the whole leg a little above the broken and shivered bones and the torn nerves veins arteries the operation was nimbly done by the said Viard and the blood stancht by the ligature of the vessels in the presence of the said Helin and M. Tousard great vicar of our Ladies Church and was continually drest by the said Leschenal and I went to see him otherwhiles he was happily cured without the applâ—cation of hot irons and walketh lustily on a woodden leg Another History In the year 1583. the 10. day of December Toussiant Posson born at Ronieville at this present dwelling at Beauvais near Dâ—urdan having his leg all ulcered and all the bones cariez'd and rotten prayed me for the honor of God to cut off his leg by reason of the great pain which he could no longer endure After his body was prepared I caused his leg to be cut off four fingers below the retula of the knee by Daniel Powlet one of my servants to teach him and to imbolden him in such works and there be readily tied the vessels to stay the bleeding without application of hot irons in the presence of James Guillemau ordinary Surgeon to the King and John Châ—â—bâ—nel Master-Surgeon of Paris and during the cure was visited by M. Laffile and M. Couâ—tin Doctor Regents in the faculty of medicine at Paris The said operation was made in the house of John â—â—hel Inn-keeper dwelling at the sign of the white-Horse in the Greve I will not heâ—e forget to say that the Lady Princess of Montpensier knowing that he was poor and in my hands gâ—ve him mony to pay for his chamber and diet He was well cured God be praised and is returned home to his house with a woodden-leg Another History A Gangreen happening by an Antecedent cause A Gangreen happened to half of the leg to one named Nicolas Mesnager aged 76. years dwelling in S. Honores street at the sign of the Basket which happened to him through an inward cause so that we were constrained to cut off his leg to save his life and it was taken off by Antony Renaud Master Barber-Surgeon of Paris the 16. day of December 1583. in the presence of M. Le Fort and M. La Nave sworn Surgeons of Paris and the blood was stanched by the Ligature of the Vessels and he is at this present cured and in health walking with a wooden-leg A water-man at the Port of Nesle dwelling near Monsieur de Mas Post-master Another History nâ—â—ed John Boussereau in whose hands a Musket brake asunder which broke the bones of his hâ—â—d 〈◊〉 â—ent â—nd tore the other parts in such sort that it was needful and necessary to make aâ—p◠〈…〉 the â—â—nd two fingers above the wrist Operation d nâ— by Gullâ—mâ—r which was done by James Guillemau then Surgâ—on 〈…〉 the King who dwelt at that time with me The operation likewise beiâ—â—â—ly â—one and the blood stanched by the Ligature of the vessels without burning â—ons he is 〈◊〉 this present living A Merchant Grocer dwelling in S. Denis-street at the sign of the 〈…〉 named the Judg who fell upon his head where was made a wound 〈…〉 â—poral muscle Another History Operation â— done by the Author where he had an artery opened from whence issued forth blood wâ—◠〈…〉 impeâ—â—oâ—â—y insomuch that common remedies would not serve the turn I was called tâ—â—â—her wâ—â—re I found Mr. Russe Mr. Câ—interet Mr. Viard sworn Surgeons of Paris to stay â— ood where presently I took a needle and thred and tied the artery and it bled no more after that and was quickly cured Mr. Rowssellet can witness it not long since Deacon of your Faculty who was in the cure with us A Sergaant of the Chastlet dwelling near S. Andrew des Aâ—ts Another History Another operation who had a stroak of a sword upon the throat in the Clacks medow which cut asunder the jugular vein extern as soon as he was hurt he put his hankeâ—â—her upon the wound and came to look me at my house and when he took away his hankercheâ— the blood leaped out with great impetuosity I suddenly tied the vein toward the root he by this this means was stanched and cured thanks be to God And if one had followed your manner of stanching blood by cauteries I leave it to be supposed whether he had been cured I think he had been dead in the hands of the operator If I would recite all those whose vessels were tied to stay the blood which have been cured I should not have ended this long time so that me thinks there are Histories enough recited to make you believe the blood of veins and arteries is surely stanched without applying any outward cauteries He that doth strive against experience Daigns not to talk of any learned science NOw my
Savoy with six other Surgeons following the Army to see the hurt of the said Lord of Martigues and to know of me how I had dressed him and with what medicines The Emperors Physician bid me declare the essence of the wound and how I had drest it Now all the assistants had a very attentive ear to know if the wound were mortal or not I began to make a discourse that Monsieur de Martigues looking over the wall to perceive them that did undermine it received a shot from an Arquebus quite through the body presently I was called to dress him I saw he cast out blood out of his mouth and his wounds Moreover he had a great difficulty of breathing and cast out winde by the said wounds with a whistling in so much that it would blow out a candle and he said he had a most sharp pricking pain at the entrance of the bullet I do beleive and think it might be some little pieces of bones which prickt the Lungs When they made their Systole and Diastole I put my finger into him where I found the entrance of the bullet to have broken the fourth Rib in the middle and scales of bones which the said bullet had thrust in and the out-going of it had likewise broken the fifth Rib with pieces of bones which had been driven from within outward I drew out some but not all because they were very deep and adherent I put in each wound a Tent having the head very large tied with a thred lest by the inspiration it might be drawn into the capacity of the Thorax which hath been known by experience to the detriment of the poor wounded for being faln in it cannot be taken out which is the cause that engenders putrefaction a thing contrary to nature The said Tents were annointed with a medicine composed of yelks of eggs Venice-turpentine with a little oyl of Roses My intention for putting the Tents was to stay the flux of blood and to hinder that the outward air did not enter into the brest which might have cooled the Lungs and by consequent the heart The said Tents were also put to the end that issue might be given for the blood that was spilt within the Thorax I put upon the wound great Emplasters of Di acolcitheos in which I had relented oyl of Roses and Vineger to the avoiding of the inflammation then I put great stupes of Oxycrate and bound him up but not too hard to the end he might have easie respiration that done I drew from him five porrengers of blood from the Basilisk vein of the right arm to the end to make revulsion of the blood which runs from the wounds into the Thorax having first taken indication from the wounded part and chiefly his forces considering his youth and sanguine temper He presently after went to stool and by his urine and sieg cast great quantity of blood And as for the pâ—â—n which he said he felt at the entrance of the bullet which was as if he had been pricked with a bodkinâ— that was because the Lungs by their motion beat against the splinters of the Broken Rib. Now the Lungs are covered with a coat comming from the membrane called Pleura interweâ—ved with nerves of the sixt Conjugation from the brain which was cause of the extreme pain â—e self likewise he had great difficulty of breathing which proceededd from the blood which was spilt in the capacity of the Thorax and upon the Diaphragm the principal instrument of respiration and from the dilaceration of the muscles which are between each Rib which help also to make the expiration and the inspiration and likewise because the Lungs were torn and wounded by the bâ—llet which hath caused him ever since to spit black and putrid blood in coughing The fever seised him soon after he was hurt with faintings and swoonings It seemed to me that the said fever proceeded from the putredinous vapors arising from the blood which is out of his proper vessels which hath falln down and will yet flow down The wound of the Lungs is grown great and will grow more great because it is in perpetual motion both sleeping and waking and is dilated and comprest to let the air to the heart and cast fuliginous vapors out by the unnatural heat is made inflammation then the expulsive vertue is constrained to cast out by cough whatsoever is obnoxious unto it for the Lungs cannot be purged but by coughing and by coughing the wound is dilated and grows greater from whence the blood issues out with great abundance which blood is drawn from the heart by the vein arterial to give them nourishment and to the heart by the vena cava his meat was barly broath stued prunes somtimes Panado his drink was Ptisan He could not lye but upon his baâ—k which shewed he had a great quantity of blood spilt within the capacity of the Thorax and being spread or spilled along the spondyls doth not so much press the Lungs as it doth being lain on the sides or â—itting What shall I say more but that the said Lord Martigues since the time he was hurt hath not reposed one hour only and hath alwaies cast out bloody urines and stools These things then Messieres considered one can make no other prognostick but that he will dye in a few dayes which is to my great grief Having ended my discourse I â—rest him as I was wont having discovered his wounds the Physicians and other assistants presently knew the truth of what I had said The said Physiciâ—ns having felt his pulse and known his forces to be almost spent and abolished they concluded with me that in a few dayes he would dye and at the same instant went all toward the Lord of Savoy where they all said that the said Lord Martigues would dye in a short time he answered it were possible if he were well drest he might escape Then they all with with one voice said he had been very well drest and sollicited with all things necessary for the curing of his wounds and could not be better and that it was impossible to cure him and that his wound was mortal of necessity The Monsieur de Savoy shewed himself to be very much discontented and wept and asked them again if for certain they all held him deplored and remediless they answered yes Then a certain Spanish impostor offered himself who promised on his life that he would cure him and if he failed to cure him they should cut him in an hundred pieces but he would not have any Physicians Surgeons or Apoâ—hecaries with him And at the same instant the said Lord of Savoy told the Physicians and Surgeons they should not in any wise go any more to see the said Lord of Martigues And he sent a Genâ—leman to me to forbiâ— me upon pain of life not to touch any more the said Lord of Martigues which I promised not to do wherefore I was very glad seeing he
The third use is to empty out the excrements from the body through the Guts Thus we see that the cholerick humor is sometimes poured forth out of the Liver through the Mesenterick-branch in the bloody flux and cholerick loosness and the melancholick dregs through the Emroid-vein The fourth The fourth use is to help the concoction of the Liver Thus we see that the thicker part of the Chylus which is called melancholy is attracted by the splenick branch not that the seat of melancholy is in the Spleen but that it may be more attenuated and better concocted by the benefit of the Arteries which are most abounding in the Spleen and so not disturb or hinder the concoction which is famed to be in the veins of the Liver as it usually happens that whensoever the Spleen is troubled with any disease the work of making blood is presently harmed The explanation of a certain Aphorism of Hippocrates But because there has been mention made here of the Emroid veins it seemed that it would not be unreasonable if I did refer to this place the explanation of a most excellent Aphorism which is the twelfth of the sixth Section when it cannot be understood without the History of Anatomy and is not so faithfully explained by others as was necessary Hippocrates writes in it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is he that is cured of old Emroids unless one of them be preserved is in danger of falling into a Dropsie or Consumption In explanation hereof we will first doubt of the Aphorism then we will dispute of the manner whereby a Dropsie or Consumption follows upon the Cure of old Emroids But we may not without cause doubt of the truth of it because the same Hippocrates in a Book concerning the Emroids which I think to be very much his own whatsoever Mercurialis say though otherwise a most learned man bids us to burn the Emroids and forbids us to leave any unburnt but to burn them all And truly Aetius in his 14. Book desirous to reconcile these two places at those words 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is unless one be preserved being overcome thinks that a manner of diet is to be understood not an Emroid as if Hippocrates should say Thou shalt not cure one that hath long had the Emroids unless the Patient will diligently observe a convenient manner of diet prescribed by thee for otherwise there is danger of his falling into a Dropsie or Consumption But Galen in his Comment upon that Aphorism writes expresly that Hippocrates sayes that unless one Emroid be preserved such danger will ensue and makes no mention at all of diet And what is more daily experience sufficiently witnesses that such mischiefs do ensue though never so exact a diet be kept and the reason taken from the manner wherein they happen and which we shall presently explain does abundantly manifest it Whence it is evident that these two places of Hippocrates are left still in controversie and contradicting one another from this answer of Aetius But the right answer will be if we say that Hippocrates when he writes in his book of the Emroids that for a perfect cure they must all be burnt speaks not of old Emroids but of such only as are lately come or when nature has already endeavoured to expel the humor which was otherwise purged out of the Emroids some other way whether it be by issues or by a Fistula or some ulcer in the Leg. For such may be very well cured and without danger of Consumption or Dropsie the rather if the entrails be yet whole and sound and especially if a good rule of diet follow Nor does the cure of all old Emroids necessarily bring on a Dropsie or Consumption but only for the most part they threaten a danger of these diseases to ensue for sometimes the melancholick matter being hurried up into the brains there follows madness as it happened to Alcippus in Hippocrates 4. Epidem For sayes he this Alcippus having the Emroids was forbidden to be cured for after the cure he fell mad but an acute Feaver following it he was recovered For explanation of the second doubt first let us hear Galen for he in his Commentary upon the Aphorism sayes That the Emroids came by reason of faeculent and melancholick blood which the Liver drives down to the mouths of certain veins and so this way being stopt an abundance of gross humors burdens the Liver and stifles the natural heat which being extinguisht no more blood is generated but only water which nature afterwards driving it into the Abdomen oâ— paunch makes a Dropsie But if the Liver send that abundance of melancholick humor to the Lungs some vessel being broken there follows a Consumption This interpretation of Galen besides that it seems very obscure to us is not altogether agreeable to truth For first it is false in my judgment which Galen sets down in his Comment that it is impossible that the Emroids should be caused without an abundance of faeculent and thick blood when it may be proved both by reasons and authority that they come also from choler and phlegm By the authority of Hippocrates who in the beginning of his Book concerning the Emroids witnesses that this disease is caused in this manner to wit when choler or phlegm falling down into the veins of the Strait-Gut heats the blood which is in the veins For these veins being heated attract the blood out of the little veins that are near and when they are filled the inward part of the Seat swels and the heads of the veins appear out of it But by reason it is proved thus when madnesses are caused by phlegm or choler as Hippocrates witnesseth in his Book De Morbo Sacro the same Author in the 6. Aphorism 21. professes that that madness is taken away if there follow swellings of the veins or Emroids in those that are so mad Now the madness would not be taken away if melancholick humors did only come forth by the Emroids for then the cause of the disease would not be purged out But I my self also have seen formerly in Germany some Noblemen that were troubled with salt catarrhs afterwards recovered by a great flux of the Emroids that I am of opinion that not only melancholy but also salt phlegm and choler are wont to be purged out by the Emroids Wherefore if it happen that one who has been long troubled with the Emroids be cured afterwards that choler and phlegm eiâ—her breed obstructions in the Liver or Spleen or being gathered together in some plenty by stretching the vessels contained in the Abdomen or paunch breaks through them or by their quality corrodes and eats their way out and makes a Dropsie in the Abdomen or else by raising obstructions in the Liver and extinguishing the natural heat generates much water and serous humor in stead of blood which passing through the veins make a species of the Dropsie called Lucophlegmatia but
if the humor go back to the Breast or Lungs it breaks through or eats out their vessels and hence follows a spitting first of blood then of corrupt matter and from thence at last a Consumption as Hippocrates teaches in his Aphorism But in this place it is first of all to be observed that there are two sorts of propagations of veins which make the Emroids for there are some propagations of the Gate-vein of which we have already treated but there are others of the Hollow-vein which arise from the Iliacal branches of which we are to speak hereafter Now if the forementioned humors whether melancholick or cholerick or phlegmatick and salt flow through the propagations of the Gate-vein the internal Emroids are caused which being cured the matters flow back into the branches of the Gate-vein that are scattered through the lower Belly into which the veins being loaden with these humors unburden themselves make a species of the Dropsie called Ascites But if they flow through the branches of the Hollow-vein they cause the external Emroids and these being cured against the Precept of Hippocrates there is danger of a Consumption to ensue because from hence there is an easie passage of the peccant matter through the Hollow-vein to the Lungs nigh to the Heart And this is that which we have of a good while observed that many who have been long troubled with Fistula's of the Fundament and afterwards cured through the ignorance of Physitians have faln into a spitting of blood and then into a Consumption Nay we remember that a Maid was once cured by us in Germany which had a Fistula in the middle of her Hip and for three years had sought help from many in vain but being cured she fell at length after three or four month into a spitting of much blood Although she was scarce ten years old I let her blood presently in the foot of that side on which she had been troubled with the Fistula and purging her body and laying on a cautery near the place in which the Fistula had been I easily freed her in this manner from imminent danger of a Consumption This spitting of blood happened from no other cause but that sharp and cholerick matter which when it could no longer finde a way out by the Fistula got up afterwards to the Lungs through the branches of the hollow-Hollow-vein But Hippocrates sayes expresly that there is danger of a Dropsie or Consumption to follow because it sometimes falls out that neither of these happen but rather some other disease insues as it happened to Alcippus who fell in to a madness and from that into an acute Feaver sometimes also the bloody flux follows and other mischiefs Sometimes also it happens that they who are so cured are preserved still in health by abundance of urine sweatings remedies and a good rule of diet CHAP. II. Treats of the superior or ascendent Trunk of the Vena Cava or Hollow-vein and the branches which it scatters through the Head WEE are now to consider the other vein which as we told you is called Cava the Hollow one a which spreads it self much wider then the Gate-vein The use of the Hollow-vein as being distributed throughout the whole body For its office is to nourish all those pars of our body which conduce not to the concoction of the food those parts being spread far and wide it is necessary that the Hollow-vein also be very large and extended to a great length and because they ought to be nourisht with a thinner and more elaborate blood and not so thick and faeculent as that wherewith the Stomach Spleen and Gall are nourisht therefore the blood which the hollow-Hollow-vein makes and carries is also more pure thin and sincere In delivering the History of this vein although we are not of their opinion The method to be observed in the History of this Vein who derive its beginning either from the liver or heart yet because we must begin our Treatise of it somewhere we thought fit to follow the received custome of Anatomists and so for perspicuities sake we shall alwayes speak of it as if it took its birth from the Liver It may be added that it spreads certain roots as it were in the Liver just like the Gate-vein in the History of which when for that reason we took our rise from those roots we may not without cause begin thence also with the Hollow one But this vein although it run directly through the whole Trunk of the body and make one very notable stock D that is drawn out through the middle and lowest belly like one straight line continued or rather in manner of a channel or conduit pipe is notwithstanding wont to be divided into two by reason of the Liver and so one to be called the Ascendent Trunk the other the Descendent For indeed that is not true to which many perswade themselves that the Hollow-vein in its going forth from the Liver like the great Artery when it comes out of the heart is cleft into two trunks but if hereafter they be called Trunks by me you must beleive that I do it only for orders sake in teaching The Ascendent thetefore of upper Trunk A.D. is that which stands about the Liver and is terminated about the Jugulum or Hollow of the Neck but that is called the Descendent one T.V. which is beneath the Liver and reaches down as far as the Legs For both of them are afterwards divided into two branches of which they of the Ascendent m and q â—re carried upwards to the head as the Jugular or Neck-branches or to the Arms as the Brachiales G and I or Arm-veins these of the Descendent Trunk to the Legs and are called the Crural b anches T We will speak therefore of all these in order so that we first deliver the History of the Ascendent Trunk then of its branches that grows up partly to the Head partly to the Arms after that we will come to the Descendent Trunk and its branches that are digested into the Legs The Ascendent Trunk As therefore we have said that many little Veins like roots grow out of the Hollow side of the Liver which alwayes by degrees inserted into the greater veins and all of them at length meeting together about the middle of it did make a Trunk so in the same manner out of the circuit of the Convex side of the Liver a numerous propagation of veins issues forth which afterwards meet together in one Trunk This Trunk makes its way through the nervous part of the midriff on its right side and passing through it goes undivided to the Jugulum or Hollow of the Neck and because it climbs upwards it is commonly called the Ascendent Trunk by them who conceive that the Hollow-vein rises out of the Liver It is much lesser then the Descendent because the upper parts are nourished by it alone but almost all the inferior parts that are contained
in the lowest Belly by the Gate-vein But although it be not parted into any branches until it come to the Jugulum Propagations of the Ascendent Trunk Phrenica yet before that it spreads some propagations at its sides and of those three notable ones The first ee is that which is called Phrenica or the vein of the Midriff on either side one and is distributed throughout the whole Midriff which is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 with a numerous issue sending little branches to the neighbouring Pericardium or purse of the Heart and the mediastinum or partition of the Chest which when it has now got above and entred the Chest it inclines a little to the left hand and enters the Pericardium and being hidden very close over against the eight Rack-bone of the Chest is very strongly infixt into the right ventricle C of the heart that Aristotle did not without cause guess that it sprung from hence But before it be so infixed it sends out another propagation bb which is a notable one and extends it self by the hinder part of the Heart and the left side of it towards the forepart compassing the basis of the Heart like a Crown Coronâ—ria from whence it is called Coronaria or the Crown-vein of the Heart This scatters many branches through all the outer surface of the Heart but especially through the left side as that which needed a more copious aliment then the right side because of the continual and greater motion there But because the flesh of the Heart is hard and solid it ought therefore to be nourisht with a thicker blood from whence it is that this branch grows out of the vein before it enters the Heart to wit when the blood is somewhat thicker and not yet attenuated in the cavities of the Heatt Near to the original of this there is a little valve or flood-gate which hinders the blood from flowing back to the hollow-Hollow-vein as it might easily do by reason of the continual motion of the Heart When the Hollow vein has now gotten above the Heart it becomes lesser and perforates again the Pericardium and for sakes the Rack-bones of the Back and being got above the Gullet the rough Artery and the Aorta or great Artery which lean so upon one another that the Gullet takes hold of the bodies of the Rack-bones the rough Artery lies upon that and the aorta again upon this it climbs upwards through the midst of the division of the Lungs where the right part is separated from the left But because by this means it could not get to the back and the little branches if it should have sent forth any such had been very liable to danger of breaking being so hanged up therefore it sends forth a third propagation cc as soon as it is got out of the Pericardium or purse of the Heart 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The Greeks call this vein 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the Latins sine pari or carens conjuge without a companion or wanting a mate because in a man there is but one and it has no companion or mate on the left side as other veins have though in creatures that chew the cud it is double and plainly to be perceived of both sides But it issues forth about the fifth Rack-bone of the Chest out of the hinder part of the Hollow-vein and the right side and goes downwards not directly but inclining a little toward the right hand is as it were reflected backwards to the Back-bone but as soon as it reaches the eight or ninth rib it is cleft above the Spine of the Back into two branches which running downwards pass through the division of the midriff which is betwixt its two productions and so are spread abroad into the lowest Belly Of these the left which is sometimes the greater hiding it self about the transverse Processes of the Rack-bones and under the left production of the midriff and the original of the first bending Muscle of the thigh is inserted into the left Emulgent either near to its beginning or as it oft happens into the middle of it But the right running on likewise under the membranes about the transverse processes of the right side and the right production of the Septum or Midriff and the beginning of the same first bender of the thigh which keeps the right side is implanted sometimes into the very Trunk of the Hollow-vein sometimes into the first vein of the Loins And we are indebted for this observation to the learned Fallopius who would have the matter that is gathered together in the Chest whether it be watery or purulent and corrupt or sanguinous to be evacuated by the benefit of the left branch of this vein of which notwithstanding we will say something briefly in the following Book But this vein in its journey downwards shoots forth twigs of both sides as well right as left of which the right are more notable and larger of which there are numbred almost alwayes ten which run out to as many distances of the lower ribs and make the inferior Intercostal veins But I say they are almost alwayes ten because it happens very seldome that all the distances of the ribs receive branches from this vein the two uppermost to wit the first and second distance getting their surcles or twigs from the fourth branch that is presently to be mentioned But these twigs run straight forwards near to to the lower side of the ribs where there are cavities cut out for them as we have taught in the second Book And truly this place is diligently to be taken notice of by Students in Chirurgery because of the opening of the Chest in the disease called Empyema that they may know that incision is to be made in the uppermost place of the rib because in the lower the vessels would be harmed to the great indangering of life But these veins do not run through the whole length of the true ribs but are terminated together with the bony part But the propagations of the Mammary vein nourish the six distances between the gristles of the seven true ribs as we shall tell you by and by Yet in the bastard ribs they run even beyond the Gristles towards the Abdomen or Paunch into whose Muscles they insinuate themselves But there are certain other little branches propagated from the same vein by which nourishment is derived to the marrow of the Rack-bones and the Muscles to wit those about which they are carried some also are implanted into the Mediastinum near to the back This vein sine pari without a companion being thus constituted the Hollow-vein ascends to the Jugulum or Hollow of the Neck D being supported by the Mediastinum and a certain soft and glandulous body which the Greeks call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and is placed in the highest part of the Chest to defend the divarications of the veins there hanging up from all danger of breaking And here
Axillary-vein reaches into the Arm. CHAP. III. Shews how the Axillary-vein is distributed through the Arm. THe Axillary-vein F therefore is cleft into two branches The division of the Axiliary vein as soon as it comes near to the Arm but those branches are of different bigness For the upper G which they call Cephalicus the Head-branch is smaller but the lower vein I called Basilica is almost thrice greater The Cephalick also is as it were wholly just under the skin sinks not with above one branch into the deeper retreats of the Muscles wherefore it has neither Artery nor Nerves for its companions they being addicted to the more inward rooms of the body But the Basilick-vein partly creeps on under the skin partly hides it self under the Muscles and therefore it ought with good reason to exceed the other in bigness as being destined for the nourishment of more parts It hath both Nerves and Arteries as companions in its journey which is the cause why upon the cutting of this vein the blood spins out with a force but of the contrary the â—hephalica being cut it comes forth softly which we see some Physitians unskilful in dissections standing by whilst the vein is opened foolishly refer to the strength or weakness of the minde or body We are now to speak briefly of the manner of the distribution of both these veins through the Arm beginning from the upper as the lesser branch The Cephalick-vein The Cephalica G therefore is called by Vsalius Humeraria or the vein of the Arm because by the Arm it descends into the Hand by others Cubiti exterior the outer vein of the cubit from its situation because it runs on the outside of the Cubit as the Basâ—ica contrariwise does on the inside By some later writers it is commonly called Cephalica the Head-vein because it is wont to be opened in diseases of the Head through the error of the Antients who thought ignorantly that it arises from the external Jugular vein and therefore empties the blood immediately out of the Head But it arises from the upper part of the Axillary vein climbing over the Tendon of the Serratus minor or lesser Saw-Muscle that bends the shoulder-blade forward to the Breast it runs betwixt the Muscle called Deltoides which lifts up the Arm and the beginning of the Pectoral Muscle which brings it forward to the Breast where it arises from the Clavicle or Coller-bone and so it runs down by the Arm to the outside of the first muscle that bends to the Cubit which they call Biceps or the double-headed Muscle by reason whereof the more learned Chirurgeons have wisely used to make issues betwixt the Muscles Biceps and Deltoides for issues ought alwayes to be made at the seat of some notable vein that the matter may more easily be voided out But although this vein be not divided into branches whilest it is thus carried down by the upper part of the Arm yet it scatters some twigs u and e of both sides into the aforesaid Muscles and the skin At length when it is come to the Cubit it runs under the fleshy Membrane as a vein under the skin should and presents it self to the sight without dissection Three branches of the Cephalick-vein But about the very joint of the Cubit at the external protuberation of the Arm it is wont to be divided H for the most part into three branches an outer an inner and a middle one The two former run under the skin the third deeper The first or middle one i which is often wanting is very little and deeper and penetrates into the substance of the Muscles especially of those two that bend the second and third joint of the finger as also of the long supinator of the Radius or wand of the Arm. The second x and inner and chief of the three branches is carried down obliquely under the skin and joins with the inner branch of the Basilica three fingers below the joint of the Cubit with which it makes up the vein that Physitians call Mediana the middle vein λ This running down obliquely by the middle Region of the Cubit distributes many Surcles to the Radius or wand and at length it self is divided into two lesser branches of which the outer Ï goes to the inside of the wrist toward the thumb the other and inner σ runs to the fore and middle fingers The outer of these is called by some Cephalica manus and is opened to very good purpose in the diseases of the Head or Teeth Now the third branch η or outer Cephalick-vein climbs up to the Muscle called the long supinator of the Radius or wand dispersing divers little veins into the skin and so is carried obliquely Ï… through the Radius or wand and having attained to the middle of its length enters the outside of the Cubit and in that same place is joyned with a little branch Ï„ of the Basilick-vein being united thereto it goes on to the outside of the wrist and distributes veins to that part of the Hand which lies before the little and Ring-fingers as also to the fingers themselves This vein especially that which respects the little finger Salvatella is commonly called Salvatella and the Section of it is much commended by Practitioners in Physick in melancholy diseases Which being sometimes called in question and I having observed that experience does favor those Practitioners endeavoured to find out the cause and found that the e are many inoculations here of this vein with the Arteries as the inoculations are usually more frequent about the extreme parts as being more removed from the fountain of heat and therefore wanting a hotter and more spirited blood This vein therefore being cut because the Inoculations are so near it cannot be but that the blood of the Arteries should be also let out which cannot be so well done by opening the veins of the Cubit because the Anastomoses or Inoculations are somewhat more distant from the place in which the vein is opened And hence it is that the blood which is emptied out of the Hand is much fairer and redder then that out of the Arm because the Arterious blood there alwaies runs out together with that of the veins But there being six times more Arteries then there are veins in the Spleen it is necessary that its diseases be much helped when the peccant blood is drawn out of those vessels wherein it was The basilick vein The other branch of the Axillary-vein that is the inner and greater is the Basilica I which according to its situation in different arms hath found different names among writers practised in Physick For in the right arm it is called Hepatica or the liver-vein but in the left Splenica or the spleen-vein They choose that to be opened in diseases of the liver this in diseases of the spleen But it issues forth under the armpit and dispersing many propagations of the
midriff the Coeliacal one then the upper Mesenterick the two emulgents as many spermatical ones at last the lower Mesenterick and the Lumbares or arteries of the loins Of these the Intercostals are scattered whilst the trunk is yet in the chest the rest whilst it passes on through the lowest belly But some of them accompany the branches of the gate-vein as the Coelicacal and both the Mesenterical arteries others those of the hollow vein as the rest Now we will treat of these in order beginning from the Intercostals or arteries between the ribs which are placed uppermost Presently therefore after the Descendent trunk Q is issued forth from its back-side it sends over little branches on both sides to the distances of the eight lower ribs which they call Intercostales inferiores Intercostales inferiores the arteries between the lower ribs the lower arteries between the ribs uuu in respect of the upper Intercostal of which we have spoken above These associating themselves with the veins and nerves of the same name go straight on by the lower side of the ribs where peculiar sinus or channels are cut out for them But as the Intercostal veins reach in the true ribs only to the gristles but in the bastard ones somewhat farther to wit to the sides of the abdomen so also the arteries end in them together with the bony parts of the ribs but in these run out a little farther And these arteries send over some propagations through the holes of the nerves to the spinal marrow and to the muscles that lye upon the rack-bones of the back just as we have said the Intercostal veins were propagated Their use But the use of them is to diffuse the vital spirit and the blood to the muscles betwixt the ribs besides which they have also another notable office to wit of carrying down the water and purulent matter that is gathered together in the chest into the great artery and from thence by the Emulgent branches to the bladder Although I am not ignorant that the most learned Fallopius and others who have read before me in this most famous University of Padua have shewn another way to their Auditors by which either purulent matter or water might be conveyed forth by help of the kidneys to wit the vein sine pari or without a companion a little branch whereof in the left side goes into the Emulgent of the left kidney But this way which we shew through the Intercostal arteries is by much the shorter that I pass by this that any matter heaped together may be more easily dispatcht away through the arteries then the veins Nor needs any one here to be afraid lest the vital spirits should be infected from these excrementitious and ill humurs whereby the heart may incurre fearful symptoms when we willingly grant which experience also hath often taught us that whilst the corrupt matter is emptied out by the urine the sick parties have often faln into fits of swounding and other diseases sometimes also have died suddenly when the peccant humor has been of too great a quantity or too bad a quality and has offered so much violence to nature that the heat and spirits have been over come therewith The explanation of a place in Hippocrates But here a certain place in Hippocrates calls upon me to explain it which has long and often troubled my minde The place is in Coacis praenotionibus where he says They who together with the heart have their whole lungs inflamed so that it falls to the side are deprived of motion all over and the parties so diseased lye cold senseless and dye the second or third day But if this happen to the lungs without the heart they live not so long Yet some also are preserved I have often thought with my self what should be that sympathy of the heart lungs with the brain and nerves that from the inflammation of those parts the patient should be so deprived of sense and motion all over when the same Hippocrates teacheth in the same place that the diseased suffer such deprivation in that part livid spots appear on the outside about the rib where-about the Aortae so he seems to call the lobes or division of the lungs being inflamed fall to the sides But if they be not much inflamed so that they fall not down to the side he sayes that there is a pain indeed all over but no deprivation of sense or motion nor any spots appear Having deliberated often with my self at length I came to be of this opinion that there was no other cause but the sympathy betwixt these Intercostal arteries and the marrow in the back-bone This sympathy arises from those propagations which we told you past through the holes of the rack-bones of the chest into the back-bone Wherefore if the lungs and heart be so mightily inflamed that great plenty of blood rush into the great artery whereupon it swels as also these vessels betwixt the ribs and consequently those surcles which go to the marrow of the back-bone truly it cannot be but that both the marrow and the nerves which issue out of it be comprest from whence what else can follow but the resolution of those parts into which those nerves are implanted to which they impart the faculty of motion This opinion seems to me to be wonderfully confirmed by a certain pretty observation which the learned Cornelius Gemma has in his book de hemititraeo pestilenti A certain studious young man sayes he through the whole course of his disease had his left eye less then the other He was paind in the left side especially all the time the fit raged but about the crisis or judication thereof the artery of his left leg being swoln up was moved according to its length that being to be seen by us it seemed to be turned upward and downward like a rope pull'd back Who will not here willingly confess that this matter was in the arteries when the crisis was made by them But from this that hath been said a reason may be also given of another observation of Galen which is l. 4 de locis affect c. 4. where he sayes thus In a certain man who was troubled with a vehement inflammation of the lungs as wel the outer as the inner parts of his arm from the cubit to the very ends of his fingers labour'd with difficulty of sense and their motion also was somewhat empair'd In the same man also the nerves which are in the first and second distances betwixt the ribs sustained harm And a little after This man was quickly restored to his health to wit a medicine being applyed to the place from whence the nerves issue forth near to the first and second spaces betwixt the ribs By reason of the same branches betwixt the ribs John Valeriola the son of that Physitian whose observations we have being yet a boy suffered Convulsion-fits in a grievous Pleurisie The arteries
into it self store of choler carries it directly over to the Colon or Collique-Cut In like manner the use of the left branch or Spleen Artery besides the common one is to throw down choler melancholy and wheay humors if at any time the Spleen abound with them to the Guts Moreover by this same way the waterish humors in such as have the Dropsie are sometimes committed either to the Guts or to the Kidneys and Bladder This same branch is that by which the drink passes so suddainly through the whole body and by which ill hâ—mors are cast out by vomit This same is the cause that upon a full Stomach we make little water but more when the concoction therein is finished For the Stomach being much distended presses it but that once empty it can perform its office This same branch teaches us that a slender diet is to be prescribed to them who are to take purges that the way may be open for the medicines as well that by which the excrements are sent over the Stomach as that by which they are conveyed to the Guts This same branch also if you adde the two Mesentericks is the seat of the hypochondriacal Melancholy For this disease arising from the obstruction of the entrails which are contained in the lowest belly it is necessary that the arteries here should suffer very much which the very sumptoms that happen in this disease may sufficiently inform us Mesenterica superior 4. Mesenterica superior the upper artery of the Mesentery y arises a little below the Coeliacal being distributed like the Meseraick vein which is its companion with numerous propagations in the Guts called Ilium and Jejunum as also that region of the Colon which reaches from the Hollow of the Liver as far as the right Kidney An observation and so for the most part into the upper part of the Mesentery In which place it is to be observed that the Artery sometimes lies upon the vein sometimes on the contrary the vein upon the Artery and so is carried betwixt the Membranes of the Mesentery But these Arteries in many places in the Mesentery have Glandules which were made for the free perspiration of the vessels and especially of the Arteries whereby is comes to pass that these Glandules labouring with a hard tumor or Scirrhus the vessels are comprest and a pining away of the whole body follows thereupon The Emulgent arteries z are two one the right and another the left one 5. Emulgenets Both issue out under the forementioned Artey where the first and second Rack-bones of the loins are coupled together by the Ligament But they arise out of either side of the Trunk although not directly over against one another as also it is in the Emulgent veins the right one being lower then the left These Arteries when they come to the Kidney are cleft into two branches with which they are inserted into the sinus or channels of the cavity of the Kidneys and like the veins are consumed in an infinite number of little sprigs upon their substance Their use besides the common one is to purge out the whey Their use which is found in great plenty in the Arteries The spermatical or seed-arteries α are likewise two 6. Spermatica which arise out of the forepart of the Trunk of the great Artery their originals touching each other for the left Artery issues not from the Emulgent as the left spermatical vein does Afterward in their descent they are made fast to the veins of their own side and in men are carried through the processes of the Peritoneum or Rim of the Belly to the Testicles but in women when they come somewhat near to the Testicles they are divided into two parts one of which is carried to the Testicles the other to the bottom of the Womb. But the arteries do so come to the womb that they only water it at the sides and pierce not at all into the inner parts of it Which truly came to pass by the great providence of wisest nature since it had not been so safe to have brought them down to the inner surface of the womb by reason that in the coming forth of the childe very great issuings of blood would be caused to the no small danger of the Woman in Child-bed if the Arteries had been annexed to the Womb on the inside Hence also it is that in the time of delivery they flow by little and little not rushing down with violence Mesenterica inferior the lower Artery of the Mesentery β arises near to the Os sacrum 7. Mesenterica inferior or great bone a little above the division of the Trunk into the Iliacal branches and goes into the left side of the Colon and into the strait Gut descending with the haemorrhoidal veins to the very end of the Fundament and making the haemorrhoidal Arteries It is questioned concerning the use of both the Mesentericks whether besides the common they have any peculiar one For Galen in his 4. of the use of the parts seems to make mention of some other when he would have some part of the Chylus to be attracted by them It s use And in the book whether blood be contained in the Arteries in the fifth Chapter he sayes If we divide the lowest belly and the inner membrane we shall plainly see the Arteries in the Mesentery filled with milk in Kids newly yeaned but in living creatures that are grown full of something else In which words Anatomical experience teaches us that not only the Meseraick veins but Arteries also do manifestly draw the Chylus to them Which being so indeed it is altogether to be believed that the Chylus is either afterward transported by them into the veins or else turned into blood by the Arteries themselves Nor will this seem wonderful to any one who shal consider also that the mothers blood is conveyed through the Umbilical Arteries to the child whilest it is yet shut up in the Womb. But if the blood which is received up by the veins ought yet to be better worked as any diligent inquirer into nature will conclude it ought truly that which is received by the Arteries will require to be so much the more exactly laboured by how much the better it is then that of the veins But it is so laboured in the Arteries themselves and in the Spleen being haled into the Coeliacal Artery and carried to the Spleen And this is an excellent use of the Mesenterick Arteries whilest a man enjoys perfect health besides which we will adde another also as often as he leaves to be in health For these Arteries take to them the excrements of the whole body that they may carry them down to the Guts in like manner as the veins do by which nature doth both attract the Chylus and likewise expell the noisom humors out of the body as choler phelgm and melancholy Choler is thus expelled oftentimes in continual and
being sent over from the Mesenterick arteries to those of the loins may easily go from them into the brain to which those very vessels are carried But the trunk of the great artery when it is come to the last rack-bone of the loins having taken its journey all the way which we have shewed under the hollow vein at the left side here gets above the vein lest it should be worn away in that continual motion by the hardness of the holy-bone But it is divided no otherwise then the hollow-vein is into two notable branches S.S. which are called by Anatomists the Iliacal arteries from their situation and being carried downward obliquely to the thigh resemble the Τ of the Greeks turned upside down But they also just like the Iliacal veins to which they are exactly answering before they be implanted into the thigh shoot out a pretty number of branches But from the lower side of the artery before the Iliacal branches be divided Sacrae issue forth sacrae the holy arteries δ which are notable ones and carried downward leaning upon the holy-bone pass through the holes thereof and run to the marrow and backside of the bone And through these also there is a way for the matter that makes the Colick to cause the Palsie of the legs After this a little below the division of the Trunk the Iliacal arteries are subdivided into two branches one of which is the inner and less the other outer and greater The less and inner Τ issues out two propagations one from its outside the other from its inside The outer ε is commonly called Muscula by us more directly Glutaea the muscle of the buttocks because it runs down with its name sake vein betwixt the holy and hip bones where they part one from another and scatters many twigs into the muscles which lye upon the Os Ilium or hanch-bone called Glutaei or the muscles of the buttocks because they are the authors of them The inner is called Hypogastrica ζ which is very notable and large The division of the Iliacal arteries into an inner outer branch Propagations of the inner or less branch and being carried directly down to the lower side of the holy-bone it affords certain propagations in men to the bottom and neck of the bladder as also to the strait gut which also may be called the Haemorrhoidal arteries but in women to whom this branch is somewhat larger it distributes a great number of propagations besides those to the fore-named parts into the lower region also of the bottom of the womb and likewise into its neck Hence we may gather the reason why if the womb reach to the middle of the hip Convulsions are caused as Hippocrates witnesseth lib. de natura muliebri As also if the womb fal down to the hip Glutaea why the monthly flowers are supprest and a pain is caused in the softness of the sides and in the lowest belly For the blood which nature drives to the womb cannot be laid in there Hypogastrica the arteries being prest together by the falling down of it so that necessarily flowing back it fils the the neighbouring veins and arteries which swelling up cause these pains For wee have oft-times seen in dissections these veins so swoln that they have been seven fold bigger then themselves Hence also a reason may be given of the thirty second Aphorism of the fifth section in the same Hippocrates where he witnesses that a woman vomiting blood is rid of her disease upon the issuing forth of her terms Which happening by the consent of all by revulsion or attraction of the humor to a contrary part and that not by the benefit of the veins because the veins of the Stomach arise out of the Gate-vein but they of the Womb from the Hollow one there is no other sympathy to be sought for then that which is caused by the arteries especially when the Hypogastrick or artery of the lower part of the lowest belly is not far distant from the Coeliacal or Artery of the Stomach Hence likewise a reason will be given of the Aphorism that follows this wherein he judgeth the Haemorrhagia or abundant issuing forth of blood at the nostrils to be profitable when the monthly courses do fail The remaining part of the lesser Iliacal artery descends and brings forth the Umbilical or navel artery η η Arteria umbilicalis which is carried down near to the length of the great artery and is tyed with strong membranes to the sides of the bladder of urine But it loses its hollowness in those that are once out of the womb After this θ like the Iliacal vein which is joyned to it it goes through the hole of the share bone or Os pubis which before it be past it takes to it a propagation issued from the outer Iliacal branch and so goes out of the hole and being departed from it spends it self in like manner as the inner Iliacal vein does upon the muscles partly those with which the hole is stopt Propagations of the outer or greater Iliacal branch partly those which arise from the share bone At length being terminated at the middle almost of the length of the thigh the end of it meets ο and is united with the ends of the branches ν of the inner muscle-artery of the â—eg of which we shall speak in the next Chapter The greater or outer Iliacal artery V produces likewise two propagations Epigostrica or the artery of the upper part of the lower belly the first of which ι is called Epigastrica which arising from the outside of it a little before it passes through the peritoneum or rim of the belly is reflected upward and ascends by the inside of the strait muscle til about the navel it be inoculated with the descendent Mammary artery Pudenda or the artery of the privy parts The other λ is called Pudenda which is a little inner propagation being not divided into so many branches as the vein of that name is But it arises presently after the artery is gone out of the peritonaeum and being carried overthwart along the commissure or joyning together of the share-bones is spent at the privy parts upon the skin of the yard That which remains of this trunk goes into the crus Χ whereof we shall now speak CHAP. IV. The propagations of the outer Iliacal branch which are distributed through the Crus or great foot containing the thigh leg and foot AFter that the outer branch V has propagated the fore-mentioned branches it departs out of the peritonaeum or rim of the belly and at the groin is carried into the Crus by the same way which the crural vein takes under which it goes The Trunk of the câ—ural artery and its propagations ere it be divided and is joyned in company therewith everywhere and so it makes the Trunk of the Crural Artery Χ as we will alwaies call it But
the marrow of the brain drawn out in length whilest it is yet contained within the limits of the skull that offers it self in the first place The first pair of the brain which makes the Optick Nerves that are so famous among all the Masters of Anatomy For these are not only the biggest if thou look upon their thickness but also without doubt the softest of all the nerves of the body But they arise out of the middle of the basis of the brain It s original on the forepart according to the opinion of the Antients but indeed if the head be turned upside down in the dissection wich is the proper way out of the beginning of the former trunks of the spinal marrow that their original is as it were in the back part of the head Progress and presently each of them by little and little making towards its mate they are united not only joyned as some would have it over the saddle of the wedg-bone and making one common square body the marrow within them being mixed together After that presently separating again each of them is carried obliquely into the eye of its own side Insertion entring the orb thereof through the first hole of the wedg-bone and entring at the very centre of the eye In this pair we may easily shew those two membranes which are derived to the nerves from the two Meninges of the brain as also the very inner marrowy substance which comes from the body of the brain Yet the nerve it self is not cleft into more branches as the other are but lying hid makes the coats of the eye and out of the thick membrane it forms that coat which is called Cornea the horney one out of the thin membrane that is called Vvea the grapy one but out of the substance of the marrow the Retina or coat like a net For as soon as it is arrived at the centre of the eye these membranes are displayed and making a sphere contain the humors in them Use These nerves convey the faculty of seeing to the eyes wherefore they being obstructed or comprest a blindeness ensues The holes of the optick nerves Galen hath ascribed holes to them and Herophilus for the same reason called them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the passages of the sight teaching that there is a sensible hollowness plainly to be seen in them whom for all that almost all Anatomists do contradict But I have heretofore shewen in the University of Padua and in a great assembly of them that there are certain passages continuing from the beginning of these Nerves as far as to the place where they meet together and presently after that vanish away toward the eye And therefore I shewed that the Ancients may not only be excused but also that they writ the truth especially when none of them have said that these passages were great but only such as did not altogether escape the sight if one would make tryal thereof in a great living creature and by a cleer light and presently after it is killed For Galen himself requires these three conditions 7. placit 4 and lib. de oculis that one may see them But before we depart hence I will bring in some problemes that besides the history it self Problemes I may also shew the use of that which I say especially when in our time they only for the most part follow the study of Anatomy who imploy their industry in the behalf of Physick The first therefore shall be what is the cause that many upon sneesing often especially when they have povoked it for the nonce have of a sodain faln blind This happens either because the branches of the sleepy arteries which are so near to the optick nerves that they touch are filled and bring so press together those nerves or else because a copious and that a phlegmatick humor has faln out of the brain into the optick nerves and obstructed them I have seen those that have been bling through the first cause sometimes cured by a Seton but I never remember that any in whom this arose from phlegmatick humors have recovered except one having the French Pox who being annointed with quick-silver all the humors melting away was restored to health But it is not the part of a good and pious Physitian to make use of those things which being full of danger may do more harm if they prove hurtful then they can procure good if they be profitable And truly it is better not to cure blindeness then to cause death although oftentimes rashness helps them whom reason helps not as the most elegant of Physitians Celsus sayes elegantly In the mean time in diseases of the eyes they who practise Physick may learn rather to administer those thing which bring the phlegm out by the palat then to draw the noxious humors to the nostrils That I may conceal besides the danger which they avoid that more profit arises from the medicines that void the phlegm out of the head through the mouth which both long experience hath hitherto taught and Anatomy perswades when the optick nerves in their original are not far distant from the palat but farther from the spongy bone and it is a preternatural way by which the humors are carried as hath been already demonstrated by the learned Vesalius Then it is disputed by what means the eye can fall out of its orb the optick nerve not being broke whereof we may have very many histories But it is not hard to give an answer to wit that the nerves may be very much extended in length Whilest therefore this nerve receives much moisture in the inflammations of the eyes it easily comes to pass that it is slackned but the muscles themselves swelling very much when they can no longer be contained in the orb leap forth out of it For this falling forth of the eyes most commonly proceeds from inflammations such as are the stories the most learned Vega who cured a woman in this case by procuring the flux of her terms and a young man by digesting ointments But the question is very worthy to be made memtion of and that gives me an occasion to explain it which I have read in some Authors that such as were before blind upon receiving of a wound overthwart the forehead and some upon a great loosness of the belly arising on a sodain have received their sight and that presently The cause of their blindness was no other then the compression of these nerves proceeding from the neighbour-vessels to wit the veins and arteries being swoln with blood which such a wound presently emptyed Wherefore I also sometimes and not without success in that species of blindness with the Barbarians tall Gutta serena open the middle vein of the fore-head out of which I draw blood so long till it ceases to run of its one accord The second pair It s original The second pair arises as the ancient Anatomists say
those things which are not agreeable to nature To what things besides nature But the things which are called Natural may be reduced to seven heads besides which there comes into their fellowship those which we term Annexed The seven principal heads of things Natural are Elements Temperaments Humors Parts or members Faculties Actions Spirits To these are annexed as somewhat near Age Sex Colour Cmpoosure Time or season Region Vocation of life CHAP. IV. Of Elements AN Element by the definition which is commonly received amongst Physitians is the least and most simple portion of that thing which it composeth or What an Element is that my speech may be the more plain The four first and simple bodies are called Elements Fire Air Water and Earth which accommodate and subject themselves as matter to the promiscuous generation of all things which the Heavens engirt whether you understand things perfectly or unperfectly mixed Such Elements are only to be conceived in your mind Elements are understood by reason not by sense being it is not granted to any external sense to handle them in their pure and absolute nature Which was the cause that Hippocrates expressed them not by the names of substances but of proper qualities saying Hot Cold Moist Dry because some one of these qualities is inherent in every Element as his proper and essential form not only according to the excess of latitude but also of the active faculty Why Hipp. expressed the Elements by these names of Qualities to which is adjoined another simple quality and by that reason principal but which notwithstanding attains not to the highest degree of his kind as you may understand by Galen in his first Book of Elements So for example sake in the Air we observe two qualities Heat and Moisture both principal and not remitted by the commixture of any contrary quality Two principal qualities are in each Element for otherwise they were not simple Therefore thou maist say What hinders that the principal effects of heat shew not themselves as well in the Air as in the Fire Because as we said before although the Air have as great a heat according to his nature extent and degree no otherwise than Fire hath yet it is not so great in its active quality Why the Air heats not so vehemently as the Fire The reason is because that the calfactory force in the Air is hindered and dulled by society of his companion and adjoined quality that is Humidity which abateth the force of heat as on the contrary driness quickneth it The Elements therefore are endewed with qualities Names of the substances Fire Air Water Earth is Hot and dry Moist and hot Cold and moist Cold and dry Names of the qualities These four Elements in the composition of natural bodies How the Elements may be understood to be mixed in compound bodies retain the qualities they formerly had but that by their mixture and meeting together of contraries they are somewhat tempered and abated But the Elements are so mutually mixed one with another and all with all that no simple part may be found no more then in a mass of the Emplaister Diacalcitheos you can shew any Axungia oil or Litharge by it self all things are so confused and united by the power of heat mixing the smallest particulars with the smallest and the whole with the whole in all parts You may know and perceive this concretion of the four Elementary substances in one compound body by the power of mixture in their dissolution by burning a pile or heap of green wood For the flame expresses the Fire the smoak the Air the moisture that sweats out at the ends Why of the first qualities two are active and two passive the Water and the ashes the Earth You may easily perceive by this example so familiar and obvious to the senses what dissolution is which is succeeded by the decay of the compound body on the contrary you may know that the coagmentation or uniting and joyning into one of the first mixed bodies is such that there is no part sincere or without mixture For if the heat which is predominant in the fire should remain in the mixture in its perfect vigor it would consume the rest by its pernicious neighbourhood the like may be said of Coldness Moisture and Driness although of these qualities two have the title of Active that is Heat and Coldness because they are the more powerful the other two Passive because they may seem more dull and slow being compared to the former The temperaments of all sublunary bodies arise from the commixture of these substances and elementary qualities which hath been the principal cause that moved me to treat of the Elements But I leave the force and effects of the Elementary qualities to some higher contemplation content to have noted this that of these first qualities so called because they are primarily and naturally in the four first bodies others arise and proceed which are therefore called the second qualities as of many these Heaviness Why the first qualities are so called Lightness variously distributed by the four Elements as the Heat or Coldness Moistness or Driness have more power over them For of the Elements two are called light because they naturally affect to move upwards the other two heavie What the second qualities are by reason they are carryed downward by their own weight So we think the fire the lightest because it holds the highest place of this lower world the Air which is next to it in site we account light for the water which lies next to the Air we judg heavie What Elements light what heavy and the earth the center of the rest we judg to be the heaviest of them all Hereupon it is that light bodies and the light parts in bodies have most of the lighter Elements as on the contrary heavie bodies have more of the heavier This is a brief descripion of the Elements of this frail world which are only to be discerned by the understanding to which I think good to adjoin another description of other Elements as it were arising or flowing from the commixture of the first For besides these there are said to be Elements of generation and Elements of mans body Which as they are more corporal so also are they more manifest to the sense By which reason Hippocrates being moved in his Book de Natura humana after he had described the Nature of Hot Cold Moist and Dry What the Elements of generation are he comes to take notice of these by the order of composition Wherefore the Elements of our generation as also of all creatures which have blood What the Elements of mâ—xt bodies are seed and menstruous blood But the Elements of our bodies are the solid and similar parts arising from those Elements of generation Of this kind are bones membranes ligaments veins arter es and many others manifest to the eys
All men ought to think that such Humors are wont to move at set hours of the day as by a certain peculiar motion or tide Therefore the blood flows from the ninth hour of the night to the third hour of the day then Choler to the ninth of the day What motions are in each quarter of the body then Melancholy to the third of the night the rest of the night that remains is under the dominion of Phlegm Manifest examples hereof appears in the French-Pox From the elaborate and absolute mass of the blood as we said before two kind of Humors as excrements of the second concoction are commonly and naturally separated the one more gross the other more thin This is called either absolutely Choler or with an adjunct yellow Choler That is called Melancholy which drawn by the Spleen in a thinner portion and elaborate by the heat of the Arteries which in that part are both many and large becomes nourishment to the part the remnant thereof is carryed by the veiny Vessel into the orifice of the ventricle whereby it may not cause but whet the appetite and by its astriction strengthen the actions thereof But yellow Choler drawn into the bladder of the gall remains there so long till being troublesome either in quantity or quality The Melancholy Humor doth not cause but whet the appetite it is excluded into the guts whereby it may cast forth the excrements residing in them the expulsive faculty being provoked by its acrimony and by its bitterness kills the worms that are bred there This same Humor is accustomed to die the urine of a yellow colour There is another serous Humor which is not fit to nourish but profitable for many other things which is not an excrement of the second but of the first concoction Therefore nature would that mixed with the Chylus A serous or wheyish humor it should come to the Liver and not be voided with the excrements whereby it might allay the grosness of the blood and serve it for a vehicle for otherwise the blood could scarse pass through the capillary veins of the Liver and passing the simous and gibbous parts thereof come to the hollow vein Part of this serous humour separated together with the blood which serves for the nourishment of the Reins and straight carried into the bladder is turned into that urine which we daily make the other part thereof carried through all the body together with the blood performing the like duty of transportation is excluded by sweats into which it degenerates Besides the forenamed the Arabians have mentioned four other humors which they term Alimentary and secondary Secundary Humors as being the next matter of nourishment as those four the blood contains the remote They have given no name to the first kind but imagin it to be that humour which hangs ready to fall like to little drops in the utmost orifices of the veins They call the second kind * â—os Dew being that humour which entred already into the substance of the part doth moisten it The third they call by a barbarous name Cambium which already put to the part to be nourished is there fastned The fourth named Gluten or Glew is only the proper and substance-making humidity of the similar parts not their substance The distinction of the degrees of nutrition recited by Galen in his books of Natural faculties answer in proportion to this distinction of humours The first is that the blood flow to the part that requires nourishment then that being there arrived it may be agglutinated then lastly that having lost its former form of nourishment it may be assimilated Humors against nature Those humours are against nature which being corrupted infect the body and the parts in which they are contained by the contagion of their corruption retaining the names and titles of the humours from whose perfection and nature they have revolted they all grow hot by putrefaction although they were formerly by their own nature cold And they are corrupted either in the veins only or within and without the veins In the veins Blood and Melancholy but Into what Humors the blood when it corrupts doth degenerate both without and within the veins Choler and Phlegm When blood is corrupted in its thinner portion it turns into Choler when in its thicker into Melancholy for the Blood becomes faulty two manner of wayes either by the corruption of its proper substance by putrefaction or by admixtion of another substance by infection The Melancholy humor which is corrupted in the veins The Melancholy Humor corrupted is of three kinds is of three sorts The first is of a Melancholy juice putrefying and by the force of a strange heat turned as it were into ashes by which it becomes adust acid and biting The other ariseth from that Choler which resembles the yolks of eggs which by adustion becomes leek-coloured then aeruginous or of a blewish green then red and lastly black which is the very worst kind of Melancholy hot malign eating and exulcerating and which is never seen or voided with safety The third comes from Phlegm putrefying in the veins which first degenerates into salt Phlegm but straight by the strength of extraneous heat degenerates into Melancholy Phlegm not naturall is bred either In the Veins and is either Acide and very crude as which hath had none or very little impression of heat but that which it first had in the stomach Salt which is bred by the sweet putrefying and adust or mixture of adust and salt particles Or without the Veins is of four sorts either Waterish as is that thin moisture which distils from the the brain by the nostrils Mucous as when that waterish is thickned into filth by the help of some accidental or small heat Glassie or * Albumineâ—â— Albuminous resembling molten glass or rather the white of an egg and is most cold Gypsea or Plaister-like which is concrete into the hardness and form of chalk as you may see in the joints of the fingers in a knotty gout or in inveterate distillations upon the Lungs Choler not naturall is bred either In the Veins as the * Vitellinâ— Vitelline like in consistence to the yolk of a raw egg which the acrimony of strange heat breeds of yellow Choler which same in diseases altogether deadly degenerates into green aeruginous lastly into a blue or colour like that which is dried by woad Or in the capacity of the upper belly as the ventricle and this is of five kinds The first is called Porracea or leek-coloured resembling the juice of a leek in greenness The second aeruginosa or aeruginous like in colour to verdigrease The third blewish or woad-coloured like the colour died by woad The fourth red differing in this from blood whose colour it imitates that it never commeth into knots or clods like blood The fifth very red generated by the excess of the former
tamed desirous of sedition and novelty stubborn impatient of servitude as may be perceived by the sole example of the Inhabitants of Narbon a Province of France Those who dwell in poor and barren places are commonly more witty and diligent most patient of labors the truth of which the famous wits of the Athenians Ligurians and Romans and the plain country of the Boeotians in Greece of the Campanians in Italy and of the rest of the Inhabiters adjoyning to the Ligurian Sea approves CHAP. VIII Of the Faculties What a faculty is A Faculty is a certain power and efficient cause proceeding from the temperament of the part and the performer of some actions of the body There are three principal Faculties governing man's body 3. Faculties as long as it enjoys its integrity the Animal Vital and Natural The Animal is seated in the proper temperament of the Brain from whence it is distributed by the Nerves into all parts of the body which have sense and motion This is of three kinds for one is Moving another sensitive the third principal The sensitive consists in five external senses sight hearing taste smell and touch The moving principally remains in the Muscles and Nerves as the fit instruments of voluntary motion The Principal comprehends the Reasoning Faculty the Memory and Fantasie Galen would have the common or inward Sense to be comprehended within the compass of the Fantasie although Aristotle distinguish between them The Vital abides in the heart from whence heat and life is distributed by the Arteries to the whole body this is principally hindred in the diseases of the Breast as the Principal is when any disease assails the Brain The triple use of the Pulse the prime Action of the vital faculty is Pulsation and that continued agitation of the Heart and Arteries which is of threefold use to the body for by the dilatation of the Heart and Arteries the vital Spirit is cherished by the benefit of the Air which is drawn in by the contraction thereof the vapours of it are purged and sent forth and the native heat of the whole body is tempered by them both The natural faculty is threefold The last is the Natural faculty which hath chosen its principal seat in the Liver it spreads or carries the nourishment over the whole body but it is distinguished into three other faculties The Generative which serves for the generation and forming of the Issue in the womb the Growing or Increasing faculty which flourisheth from the time the Issue is formed until the perfect growth of the solid parts into their full dimensions of length heighth and bredth The nourishing faculty which as servant to both the other repairs and repays the continual efflux and waste of the threefold substance What Nutrition is for Nutrition is nothing else but a replenishing or repairing whatsoever is wasted or emptied This nourishing-faculty endures from that time the Infant is formed in the womb until the end of life It is a matter of great consequence in Physick to know the four other faculties Four other faculties attend upon the nourishing faculty which as servants attend upon the nourishing faculty which are the Attractive Retentive Digestive and Expulsive faculty The Attractive draws that juyce which is fit to nourish the body that I say which by application may be assimilated to the part This is that faculty which in such as are hungry draws down the meat scarce chewed and the drink scarce tasted into the gnawing and empty stomach The Retentive faculty is that which retains the nourishment once attracted until it be fully laboured and perfectly concocted And by that means it yields no small assistance to the Digestive faculty The necessity of the retentive faculty For the natural heat cannot perform the office of concoction unless the meat be embraced by the part and make some stay therein For otherwise the meat carried into the stomach never acquires the form of Chylus unless it stay detained in the wrinkles thereof as in a rough passage until the time of Chilification The Digestive faculty assimilates the nourishment being attracted and detained into the substance of that part whose faculty it is by the force of the inbred heat and proper disposition or temper of the part So the stomach plainly changes all things which are eat and drunk into Chylus and the Liver turns the Chylus into blood But the Bones and Nerves convert the red and liquid blood which is brought down unto them by the capillary or small veins into a white and solid substance Such concoction is far more laborious in a Bone and Nerve than in the Musculous flesh For the blood being not much different from its nature by a light change and concretion turns into flesh But this Concoction will never satisfie the desire of Nature and the parts unless the nourishment purged from its excrements put away the filth and dross which must never enter into the substance of the part Two excrements of every concoction Wherefore there do not only two sorts of excrements remain of the first and second Concoction the one thick the other thin as we have said before but also from the third Concoction which is performed in every part The one of which we conceive only by reason being that which vanisheth into Air by insensible transpiration The other is known sometimes by sweats sometimes by a thick fatty substance staining the shirt sometimes by the generation of hairs and nails whose matter is from fuliginous and earthly excrements of the third Concoction The work of the expulsive faculty Wherefore the fourth faculty was necessary which might yield no small help to nourishment it is called the Expulsive appointed to expel those superfluous excrements which by no action of heat can obtain the form of the part Such faculties serving for nutrition are in some parts two-fold as some common the benefit of which redounds to the whole body as in the ventricle liver and veins Others only attending the service of those parts in which they remain and in some parts all these four aswell common as proper are abiding and residing as in those parts we now mentioned some with the four proper have only two common as the Gall Spleen Kidnies and Bladder Others are content only with the proper as the Similar and Musculous parts who if they want any of these four faculties their health is decayed either by want of nourishment and ulcer or otherwise By what degrees the nourishment is assimilated The like unnatural affects happen by the deficiency of just and laudable nourishment But if it happen those faculties do rightly perform their duty the nourishment is changed into the proper part and is truly assimilated as by these degrees First it must flow to the part then be joyned to it then agglutinated and lastly as we have said assimilated Now we must speak of the Actions which arise from the faculties
spongy flesh of the tongue it self which affected with the quality of the Object doth presently so possess the nerve that is implanted in it that the kind and quality thereof by the force of the spirit How touching may be carryed into the common sense All parts endued with a nerve enjoy the sense of touching which is chiefly done when a tractable quality doth penetrate even to the true and nervous skin which lyeth under the Cuticle or scarf-skin we have formerly noted that it is most exquisite in the skin which invests the ends of the fingers The Object is every tractable quality whether it be of the first rank of qualities as Heat Cold Moisture Dryness or of the second as Roughness Smoothness Heaviness Lightness Hardness Softness Rarity Density Friability Unctuosity Grosness Thinness The Medium by whose procurement the instrument is affected is either the skin or the flesh interwoven with many Nerves Of motion The next Action is that Motion which by a peculiar name we call Voluntary this is performed and accomplished by a Muscle being the proper Instrument of voluntary Motion Furthermore every motion of a member possessing a Muscle is made either by bending and contraction or by extention Although generally there be so many differences of voluntary motion as there are kinds of site in place therefore Motion is said to be made upward downward to the right hand to the left forward and backward Hither are referred the many kinds of motions which the infinite variety of Muscles produce in the body How respiration may be a voluntary motion Into this rank of Voluntary Actions comes Respiration or breathing because it is done by the help of the Muscles although it be chiefly to temper the heat of the Heart For we can make it more quick or slow as we please which are the conditions of a voluntary Motion Lastly that we may have somewhat in which we may safely rest and defend our selves against the many questions which are commonly moved concerning this thing we must hold that Respiration is undergone and performed by the Animal faculty but chiefly instituted for the vital The third principal Action The principal Action and prime amongst the Voluntary is absolutely divided in three Imagination Reasoning and Memory Imagination is a certain expressing and apprehension which discerns and distinguisheth between the forms and shapes of things sensible or which are known by the senses Reasoning is a certain judicial estimation of conceived or apprehended forms or figures by a mutual collating or comparing them together Memory is the sure storer of all things and as it were the Treasury which the mind often unfolds and opens the other faculties of the mind being idle and not imployed But because all the fore-mentioned Actions whether they be Natural or Animal and Voluntary are done and performed by the help and assistance of the Spirits therefore now we must speak of the Spirits CHAP. X. Of the Spirits THe Spirit is a subtile and airy substance What a Spirit is raised from the purer blood that it might be a vehicle for the faculties by whose power the whole body is governed to all the parts and the prime instrument for the performance of their office For they being destitute of its sweet approach do presently cease from action and as dead do rest from their accustomed labours From hence it is that making a variety of Spirits according to the number of the faculties they have divided them into three as one Animal another Vital Spirits threefold another Natural The Animal hath taken his seat in the Brain for there it is prepared and made that The Animal Spirit from thence conveyed by the Nerves it may impart the power of sense and motion to all the rest of the members An argument hereof is that in the great cold of Winter whether by the intercepting them in their way or by the concretion or as it were freezing of those spirits the joynts grow stiff the hands numb and all the other parts are dull Why so called destitute of their accustomed agility of motion and quickness of sense It is called Animal not because it is the * Anima Life but the chief and prime instrument thereof wherefore it hath a more subtil and airy substance and enjoys divers names according to the various condition of the Sensories or seats of the senses into which it enters for that which causeth the sight is named the Visive you may see this by night rubbing your eys as sparkling like fire That which is conveyed to the Auditory passage is called the Auditive or Hearing That which is carried to the instruments of Touching is termed the Tactive and so of the rest This Animal spirit is made and laboured in the windings and foldings of the Veins and Arteries of the brain of an exquisit subtil portion of the vital brought thither by the Carotidae Arteriae How it is made or sleepy Arteries and sometimes also of the pure air or sweet vapour drawn in by the Nose in breathing Hence it is that with Ligatures we stop the passage of this spirit from the parts we intend to cut off An Humor which obstructs or stops its passage doth the like in Apoplexies and Palsies whereby it happens that the members situate under that place do languish and seem dead sometimes destitute of motion sometimes wanting both sense and motion The Vital spirit is next to it in dignity and excellency The Vital Spirit which hath its chief mansion in the left ventricle of the Heart from whence through the Channels of the Arteries it flows into the whole body to nourish the heat which resides fixed in the substance of each part which would perish in short time unless it should be refreshed by heat flowing thither together with the spirit And because it is the most subtil next to the Animal Nature lest it should vanish away would have it contained in the Nervous coat of an Artery which is five times more thick than the coat of the Veins as Galen out of Herophilus hath recorded It is furnished with matter from the subtil exhalation of the blood What the matter of it is and that air which we draw in breathing Wherefore as it doth easily and quickly perish by immoderate dissipations of the spirituous substance and great evacuations so it is easily corrupted by the putrefaction of Humors or breathing in of pestilent air and filthy vapours which thing is the cause of the so suddain death of those which are infected with the Plague This Spirit is often hindred from entring into some part by reason of obstruction fulness or great inflammations whereby it follows that in a short space by reason of the decay of the fixed and inbred heat the parts do easily fall into a Gangrene and become mortified The Natural spirit if such there be any hath its station in the Liver and Veins There is some
brute Beasts as Pliny affirmeth The infallible vertue of the herb Dictammus in drawing darts out of the flesh was taught us by the Hart who wounded with the Huntsman's darts or arrows by means hereof draws out the weapons which remain sticking in her Which is likewise practised by the Goats of Candy as Aristotle writeth The wonderful effect which Celandine hath upon the sight was learnt by the practice of Swallows who have been observed with it to have besmeared and so strengthened the eyes of their young Serpents rub their eye-lids with fennel and are thought by that means to quicken and restore the decaying sight of their eyes The Tortois doth defend and strengthen her self against the biting of Vipers by eating of savory Bears by eating of Pismires expel that poison that they have contracted by their use of Mandrakes And for correction of that drousiness and sloth which grows upon them by their long sleep in their dens The craftiness of Bears they eat the herb of Aron i. Cuckopint But the Art they use in the enticing and catching of Pismires is very pretty they go softly to the holes or hils of the Pismires and there lay themselves all their length upon the ground as if they were dead hanging out their tongue wet with their foam which they draw not again into their mouth before they feel them full of Pismires which are enticed by the sweetness of the foam And having taken this as a purging medicine they expel by the guts those ill humors wherewith they were offended We see that Dogs give themselves a vomit by eating a kind of grass which is from thence called Dog-grass Swine when they find themselves sick will hunt after smalt or river-lobsters Stockdoves Blackbirds and Partridges purge themselves by Bay-leaves Pigeons Turtles and all sort of Pullen disburden themselves of gross humors by taking of Pellitory of the wall The bird Ibis the first inventer or shewer of Clysters The invention of removing a Cataract The invention of Phlebotomy The Bird Ibis being not much unlike the Stork taught us the use of Clysters For when he finds himself oppressed with a burden of hurtful humors he fills his bill with salt-water and so purgeth himself by that part by which the belly is best discharged The invention of the way of removing the Cataract of the eye we must yield unto the Goat who by striking by chance against the thorny bushes pulls off the Cataract which hinders the sight and covers the ball of the eye and so recovers his sight The benefit of Phlebotomy we owe unto the Hippotamus or River-horse being a kind of horse and the Inhabitant of the River Nilus who being a great devourer when he finds himself surcharged with a great deal of blood doth by rubbing his thigh against the sharp sands on the bankside open a vein whereby the superfluous bloud is discharged which he stoppeth likewise when it is fit by rowling himself in the thick mud The Tortois having chanced to eat any of the flesh of a Serpent doth make Origanum and Marjoram her Antidote The Ancients found help from brute beasts A preservative against thunder even against the dreadful and non-sparing force of lightning for they were of opinion that the wings of an Eagle were never struck with lightning and therefore they put about their heads little wreaths of these feathers They were perswaded the same thing of the Seal or Sea-calf and therefore were wont to encompass their bodies with his skin as a most certain safe-guard against lightening It were a thing too long and laborious to speak of all those other muniments of life and health observed here and there by Aristotle and Pliny which we have learnt of brute beasts I will therefore end this Chapter after that I have first added this That we are beholding to Beasts not only for the skill of curing diseases and of preservation of health but for our food our rayment and the ornament and beautifying of our bodies Of the Faculty of brute Beasts in presaging THe first knowledg and skill of Prognostication and observation of weather by the Air was first delivered unto us from Beasts of the land and water and from Fowl What the butting of Rams signifies For we see in dayly observation that it is a sign of change of weather when Lambs and Rams do butt at one another with their horns and playing wantonly do kick and keep up their heels The same is thought to be presaged when the Ox licks himself against the hair and on the sodain fils the Air with his lowing and smels to the ground and when he feeds more greedily than he used to do But if the Pismires in great multitudes fetch their prey so hastily Presages of rain that they run and tumble one upon another in their narrow paths it is thought a sign of rain As is also the busie working of Moals and the Cats rubbing and stroaking of her head and neck and above her ears with the bottom of her feet Also when Fishes play and leap a little above the water it is taken for a sign of rain But if the Dolphins do the same in the Sea and in great companies The sign at Sea of a storm at hand it is thought to presage a sodain storm and tempest Whereby the Mariners fore-warned use all care possible for the safety of themselves and their ships and if they can cast Anchor And it is sufficiently known what the louder croaking of Frogs than ordinary portends But the faculty of Birds in this kind of presaging is wonderful If Cranes flie through the air without noise it is a sign of fair weather and of the contrary if they make a great noise and flie straglingly As also if Sea-fowl flie far from the Sea and light on the land The cry or scrieching of Owls portends a change of the present weather whether foul or fair Plutarch saith that the loud cawing of the Crow betokens winds and showers as also when he slaps his side with his wings Geese and Ducks when they dive much and order and prune and pick their feathers with their beaks and cry to one another fore-tel rain and in like manner Swallows when they flie so low about the water that they wet themselves and their wings And the Wren when he is observed to sing more sweetly than usual and to hop up and down And the Cock when he chants or rather crows presently after the setting of the Sun And Gnats and Fleas when they bite more then ordinary If the Hern soar aloft into the air it betokeneth fair weather if on the contrary he flie close by the water rain If Pigeons come late home to the Dove-house it is a sign of rain If Bats fly in the evening they fore-shew wet weather And lastly the Crocodile lays her egs in that place The Crocodile by laying her egs shews the bounds of the River Nilus which must be
means being moveable they may drive and shake off their flies and other troublesome things by their shaking and contracting their backs These things considered we say the fleshy Pannicle in its proper body is of a nervous or membranous substance The substance as that which hath its original from the coat Amnios which is next to the Infant dilated near to the navel and stretched forth for the generation of this Pannicle in which thing I think good to note that as the membranes Chorion and Amnios mutually interwoven with small nervous fibers encompass and invest the child as long as it is contained in the womb so the skin and the fleshy Pannicle knit together by such like bands engirt the whole body Therefore the fleshy Pannicle is equal in magnitude and like in figure to the true skin The magnitude and figure Number but that it lies under it and is contained in it in some places mixt with the fat in others increased by the flesh interwoven with it and in other some is only a simple Membrane The composition of it is such as the sight of it presents to our eye that is of veins arteries Composure nerves and the proper flesh some whites mixed and interlaced with fat and sometimes with musculous flesh It is but one by reason of the use we shall presently shew it is situated between the skin and fat or common coat of the muscles annexed to these and the other parts lying under it by the veins nerves and arteries ascending from these inward parts and implanting themselves into the substance thereof and then into the true skin The temperature thereof is divers according to the variety of the parts interwoven with it The temperature The use of it is to lead direct and strengthen in their passage the vessels which are disseminated into the true skin and the whole superficies of the body But in beasts it hath another commodity The use that is it gives a shaking or trembling motion to their skin and back for that cause which we formerly touched CHAP. VI. Of the Fat. THe Fat coming near the condition of an excrement rather than of a part as we said The Fat is rather an excrement than a part The substance The efficient cause of fat when we treated of the similar parts is of an oily substance bred of the airy and vaporous portion of the blood which sweating through the pores of the coats or mouths of the vessels becomes concrete about the membranes and nerves and cold bodies and turns into fat by the coldness of the place Whereby we may know that cold or a more remiss heat is the efficient cause of fat which is manifest by contemplation not only of creatures of divers kinds but also by those of the same species and sex if so be that the one be colder than the other By which we may understand that the fat is the more or less in quantity The quantity according to the different temper of the whole body The composure and of its particular parts For its composition it consists of that portion of the blood which we formerly mentioned intermixt with certain membranes nervous fibers The site veins and arteries The greatest part of it lies between the fleshy Pannicle and the common coat of the Muscles * I was present at the opening of a Body Feb. 1630. in which the fat in the lower part of the lower belly was in thickness above eight inches upon the breast between four and five inches which I thought good to remâ—mber in this place both for the rarity of the thing as also because it was increased by report and the place mistaken some saying the Omentum or Kall was so thick which was false for it did not much exceed the quantity of that part in other fat men Otherwise it is diffused over all the body in some places more in some less yet is always about the nervous bodies to which it delights to cleave Most Anatomists enquire whether the fat lie above or beneath the fleshy Pannicle But me-thinks this question is both impertinent and idle being we often see the fat to be on both sides a The Temper It is of a middle temper between heat and cold being it ariseth of the more aery portion of the blood although it may seem cold in respect of the efficient cause that is of cold by which it concretes For the rest moisture is predominant in the fat b The use The use thereof is to moisten the parts which may become dry by long fasting vehement exercise or immoderate heat and besides to give heat or keep the parts warm Although it do this last rather by accident than of its own nature as heated by exercise or by some such other chance it heats the adjacent parts or may therefore be thought to heat them because it hinders the dissipation of the native and internal heat like as cold heats in winter whereby the bellies are at that time the hotter I know some learned Physitians of our time stiffly maintained that the fat was hot neither did they acknowledge any other efficient cause thereof than temperate heat and not cold But I think it best to leave the more subtil agitation of these questions to natural Philosophers But we must note c The solider fat or seam that at the joints which are more usually moved there is another sort of Fat far more solid and hard than that which we formerly mentioned often found mixed with a viscid and tough humour like the whites of Eggs that so it might be sufficient for a longer time to moisten these parts subject to be hurt by driness and to make them slippery and so fitter for motion in imitation whereof they usually grease hard bodies which mâ—st be in frequent motion as Coach-wheels and Axletrees And there is another kind of fat which is called Sebum seam in one thing differing from the ordinary fat that it is much dryer the moister and softer portion of the fat being dissipated by the raging heat of the place For it is found principally about the d In what parts and for what cause the fat is more dense Midriff where there are many windings of arteries and veins and â—t is also about the reins loins and basis of the heart The Fat is wasted by long fasting is dried and hardened by vehement exercise and immoderate heat Hence it is that it is much more compact in the palms of the hands and soles of the feet about the eyes and heart so that it resembles the flesh in density and hardness because by the continual motion and strong heat of these parts the thinner portion being dissipated and diffused the more gross and terestrial remains CHAP. VII Of the common Coat of the Muscles The substance The quantity NExt under the Fat appears a certain coat spred over all the Muscles and called the common coat of
descendant Their substance and arise from the Share-bone above the insertion of the right muscles Of the oblique Muscles of each side the one ascends the other descends whereupon it comes to pass that they are called the Oblique descendant and ascendant Muscle Those oblique which we first meet with are the descendant whose substance is partly sanguine partly spermatick for they are fleshy nervous ligamentous veinous arterious and membranous Their greatness and figure Yet the fleshy portion is predominant in them out of which respect Hippocrates is wont to express the muscles by the name Fleshes their greatness is indifferent between the large and the small muscles their figure is three square They are composed of the fore-mentioned parts they are two in number Their composure and site their site is oblique taking their beginning from the touching of the great Saw-muscle and from the sixt and seventh true ribs or rather from the spaces between the six lower ribs and rather on the forepart of the muscles than of the ribs themselves from whence shunning the Vertebra's of the Loins the fleshy parts of them are terminated in the external and upper eminency of the Haunch-bone and the membranous end in the lower eminency of the Share-bone and the White-line Yet Columbus dissenting from this common description of the oblique Muscles thinks that they are only terminated in the White-line and not in the Share-bone For saith he wherefore should they be inserted into the Share-bone which is not moved But because it would be an infinite labour and trouble to set down at large the several opinions of all Authors of Anatomy I have thought it sufficient for me to touch them lightly by the way Their connexion is with the oblique ascendant lying under them and with the direct or right Their temperament is twofold Their connexion Their temperament Their action the one hot and moist by reason of the belly and the fleshy portion of them the other cold and dry in respect of their ligamentous and tendinous portion Their action is to draw the parts into which they are inserted towards their original or else to unite them firmly Yet each of these privately and properly draws the hip in an oblique manner towards the Cartilago Scutiformis or brest-blade Then follow the oblique ascendant who have the same substance quantity figure The oblique ascendant composure number and temper the descendant have They are situate between the descendant and transverse with whom they have connexion Their site and connexion especially by the vessels which are brought from the parts beneath All the fleshy parts arise from the rack-bones of the Haunch to the ends of the bastard-ribs which they seem to admit above and below being fleshy even to the fourth and then becoming membranous they take their way to the White-line with a double aponeurosis which passes through the right Muscles above and below as we may plainly see from the Navel downwards In their fleshy part they draw their original from the spine of the Haunch-bones a little lower than the descendant end in their fleshy part But for their membranous parts they arise before from the share-bone but behind from the spondyls of the Holy-bone and Vertebra's of the Loins obliquely ascending upwards to the White-line into which they are terminated by an aponeurosis or membranous tendon which seems to penetrate the right Muscle upwards and downwards especially under the Navel but by their fleshy part at the ends of all the bastard ribs which they seem to receive above and below And because these Muscles are terminated in the White-line they have also another use yet such as is common to all the Muscles of the Epigastrium that is to press down the Guts Their action Their action is if they perform it together to draw and dilate the brest but if their actions be separate they draw the chest to the hip with an oblique motion After these follow the right Muscles so called The right muscles of the Epigastrium because they descend according to the length of the body and because they have right or streight fibres We will say nothing to shun prolix ty which in all other places we will avoid of their substance and other conditions which they have common with the fore-mentioned Muscles Their site They are situate in the eminentest or extuberating region of the belly bounding the Epigastrium taken in general or the superficiary belly they are divided by the manifest intercourse of the White-line even to the Navel in which place they seem to be united even to the place of their insertion They draw their original not from the Share-bone as some would have it Original but according to the insertion of their nerves from the sides of the Cartilago scutiformis and the ends of the sixth seventh and eighth ribs but they end in the Share-bone where they make a common Tendon sufficiently strong and short Sylvius Vesalius and Columbus think they arise from the Share-bone because they cannot be inserted into that bone because it is unmovable You may perceive in these Muscles certain nervous and transverse intersections oftentimes three in number for the strength of these Muscles of which Galen makes no mention although they may be seen in Apes And also in the inner side of these muscles you may see four veins and as many arteries of which some creep upwards others run downwards The upper called the Mamillary descend from the Axillary by the side and lower parts of the Sternon the slenderer portions thereof being distributed by the way to the Mediastinum and about the fourth and fifth rib to the Dugs from whence they take their name That which remains breaking out by the sides of the Brest-blade inserts it self into those muscles creeping along even almost to the navel in which place they are manifestly united that is The meeting together of the Epigastrick and mamillary veins and arteries the veins with the veins and arteries with the arteries with the Epigastrick which ascend from the upper part of the Iliack on each side under the said muscles until they meet with these four mamillary vessels That you may find the concourse of the veins and arteries about the navel you must follow both the upper and the lower somewhat deep into the flesh pressing the blood on both sides from above downwards and from below upward until you shall find the exosculation of these vessels which will appear by this That the blood will flow from this into that and from that into this otherwise you can scarce perceive it by reason of the smalness of such vessels which want blood But that by the benefit of such concourse of the vessels the matters may be communicated and transported both from the womb to the dugs and again from the dugs to the womb appears in Nurses who want their courses when the milk comes into their dugs and on the contrary
see it comes to pass in most Beasts which have one Gut stretched straight out from the stomach to the fundament as in the Lynx and such other Beasts of insatiable gluttony always like plants regarding their food CHAP. XV. Of the Mesentery The substance Magnitude Figure Composure AFter the Guts follows the Mesentery being partly of a fatty and partly of spermatick substance The greatness of it is apparent enough although in some it be bigger and in some lesser according to the greatness of the body It is of a round figure and not very thick It is composed of a double coat arising from the beginning and root of the Peritonaeum In the midst thereof it admits nerves from the Costal of the sixt Conjugation veins from the Vena Porta or Gate-vein Arteries from the descendent artery over and besides a great quantity of fat and many glandulous bodies to prop up the division of the vessels spred over it as also to moisten their substance It is in number one situate in the middle of the guts from whence it took its name Number The connexion Yet some divide it into two parts to wit into the Meseraeum that is the portion interwoven with the smal guts and into the Meso-colon which is joyned with the Great It hath connexion by it vessels with the principal parts by its whole substance with the guts and in some sort with the kidneys from whose region it seems to take its coats The temper It is of a cold and moist temper if you have respect to his fatty substance but if to the rest of the parts cold and dry The action and use The action and use of it is to bind and hold together the guts each in his place lest they should rashly be folded together and by the Meseraick-veins which they term the hands of the Liver carry the Chylus to the Liver All the miseraick veins come from the liver In which you must note that all the Meseraick Veins come from the Liver as we understand by the dissection of bodies although some have affirmed that there be some veins serving for the nourishment of the guts no ways appertaining to the Liver but which end in certain Glandulous bodies dispersed through the Mesentery of whose use we will treat hereafter CHAP. XVI Of the Glandules in general and of the Pancreas or Sweet-bread A Glandule is a simple part of the body sometimes of a spongy and soft substance Substance of the glandules sometimes of a dense and hard Of the soft Glandules are the Tonsillae or Almonds like in substance to blanched Almonds the Thymus Pancreas Testicles Prostatae But the dense and hard are the Parotides and other like The Glandules differ amongst themselves in quantity and figure for some are greater than othersome and some are round and others plain Quantity and figure as the Thymus and Pancreas Others are compounded of veins nerves arteries and their proper flesh Composition as the Almonds of the ears the milky glandules in the breasts and the testicles Others want nerves at least which may be seen as the Parotides the axillary or those under the arm-holes and others The number of glandules is uncertain by reason of the infinite multitude and variety of sporting nature Number You shall find them always in those places where the great divisions of vessels are made as in the middle ventricle of the brain in the upper part of the Chest in the Mesentery and other like places Although othersome be seated in such places as nature thinks needful to generate and cast forth of them a profitable humor to the creature as the Almonds at the root of the tongue the kernels in the dugs the spermatick vessels in the scrotum and at the sides of the womb or where Nature hath decreed to make emunctories for the principal parts as behind the ears under the arm-holes and in the groins The connexion of glandules is not only with the vessels of the parts concurring to their composition but also with those whose division they keep and preserve Connexion They are of a cold temper wherefore Physitians say the blood recrudescere i to become raw again in the dugs when it takes upon it the form of milk But of these some have action as the Almonds Temper Action and use which pour out spattle useful for the whole mouth the dugs milk the Testicles seed others use only as those which are made to preserve under-prop and fill up the divisions of the vessels The substance of the Pancreas Besides this we have spoken of glandules in general we must know that the Pancreas is a glandulous and flesh-like body as that which hath every-where the shape and resemblance of flesh It is situate at the flat end of the Liver under the Duodenum with which it hath great connexion The site and under the Gate-vein to serve as a Bulwark both to it and the divisions thereof whilst it fils up the empty spaces between the vessels themselves and so hinders that they be not pluckt asunder nor hurt by any violent motion as a fall or the like CHAP. XVII Of the Liver HAving gone thus far order of dissection now requires that we should treat of the distribution of the gate-vein but because it cannot well be understood unless all the nature of the Liver from whence it arises be well known therefore putting it off to a more fit place we will now speak of the Liver Wherefore the Liver according to Galen's opinion What the Liver is lib. de form foetus is the first of all the parts of the body which is finished in conformation It is the shop and Author of the blood and the original of the veins the substance of it It s substance and quantity is like the concrete mud of the blood the quantity of it is divers not only in bodies of different but also of the same species as in men amongst themselves of whom one will be gluttonous and fearful another bold and temperate or sober for he shall have a greater Liver than this because it must conceive and concoct a greater quantity of Chylus yet the Liver is great in all men because they have need of a great quantity of blood for the repairing of so many spirits and the substantifick moisture which are resolved and dissipated in every moment by action and contemplation But there may be a twofold reason given why such as are fearful have a larger Liver Why Cowards have great Livers The first is because in those the vital faculty in which the heat of courage and anger resides which is in the heart is weak and therefore the defect of it must be supplyed by the strength of the natural faculty For thus nature is accustomed to recompence that which is wanting in one part by the increase and accession of another The other reason is because cold men have a great
this same splenick branch on its lower part produces the branch of the Haemorrhoidal veins which descending to the fundament above the left side of the loins diffuses a good portion thereof into the least part of the colick gut and the right gut at the end whereof it is often seen to be divided into five Haemorrhoidal veins sometimes more sometimes less Silvius writes that the Haemorrhoidal branch descends from the mesenterick and truly we have sometimes observed it to have been so Yet it is more sutable to reason that it should desscend from the Splenick 3. Gastrepiplois major sinistra not only for that we have seen with our eyes that it is so but also because it is appointed by nature for the evacuation of the excrementitious melancholick humor But this same splenick branch out of the middle almost of its upper part produces the third branch going to the gibbous part of the stomach and the kall they term it the greater middle and left Gastrepiplois 4. Epiplois simplex But on the lower part towards the Spleen it produces the simple Epiplois or Kall-vein 5. Vas breve seu venosum which it diffuses through the left side of the Kall Moreover from its upper part which touches the Liver it sends forth a short branch called vas breve or venosum to the upper orifice of the ventricle for stirring up the appetite Lib. 4. de usu partium We have oftentimes and almost always observed that this vein-vessel which Galen calls vas breve comes from the very body of the Spleen and is terminated in the midst of the Stomach on the left side but never pierces both the coats thereof Wherefore it is somewhat difficult to find how the melancholy juyce can that way be powred or sent into the capacity of the Stomach Now the Splenick branch when it hath produced out of it those five fore-mentioned branches is wasted and dispersed into the substance and body or the spleen II. Ramus mesentereus divided into three parts Then follows another compound branch of the vena porta called the Mesenterick which is divided into three parts the first and last whereof goes to the Blind-gut and to the right and middle part of the Colick-gut divided into an infinite multitude of other branches The second and middle is wasted in the Ileon as the third and greater in the Jejunum or Empty-gut It is called Mesenterick because it is diffused over all the Mesentery as the Splenick is in the Spleen And thus much we have to say of the division of the Gate-vein the which if at any time thou shalt find to be otherwise than I have set down you must not wonder at it for you shall scarce find it the same in two bodies by reason of the infinite variety of particular bodies which as the Philosophers say have each their own or peculiar gifts Our judgment is the same of other divisions of the vessels Yet we have set down that which we have most frequently observed CHAP. XXI Of the original of the Artery and the division of the Branch descending to the natural parts THese things being thus finished and considered the guts should be pulled away but seeing that if we should do so we should disturb and lose the division of the artery descending to the natural parts therefore I have thought it better to handle the division thereof The original of arteries The division of the great descendant Artery is into these before the Guts be pluckt away Therefore we must suppose according to Galen's opinion that as all the veins come from the Liver so all Arteries proceed from the Heart This presently at the beginning is divided into two branches the greater whereof descends downwards to the natural parts upon the spine of the back taking its beginning at the fifth vertebra thereof from whence it goes into the following arteries The first called the intercostal runs amongst the intercostal muscles and the distances of the ribs and spinal marrow through the perforation of the nerves on the right and left hand from the fifth true even to the last of the bastard ribs 1. Arteria interâ—ostalis 2 â—brenica 3. Coeliaca This in going this progress makes seven little branchings distributed after the forementioned manner going forth of the trunk of the descendent over against each of the intercostal Muscles The second being parted into two goes on each side to the Midriffe whence it may be called or expressed by the name of the Diaphragmatica or Phrenica i the Midriffe Artery The third being of a large proportion arising from the upper part of the Arterie presently after it hath passed the Midriffe is divided into two notable Branches whereof one goes to the Stomach Spleen Kall to the hollow part of the Liver and the Gall the other is sent forth to the Mesentery and Guts after the same manner as we said of the Meseraick vein wherefore it is called the Coeliaca or Stomach Artery But we must note all their mouths penetrate even to the innermost coat of the Guts that by that means they may the better and more easily attract the Chylus contained in them 4. Emulgent The fourth carryed to the reins where it is named the Reinal or Emulgent because it sucks fit matter from the whole mass of blood 5. Spermatica The fifth is sent to the Testicles with the preparing spermatick-Spermatick-veins whence also it is named the Spermatick Artery which arises on the right side from the very Trunk of the descendent Artery that it may associate the Spermatick-vein of the same side they run one above another beneath the hollow-vein wherefore we must have a great care whilest we labour to lay it open that we do not hurt and break it The seventh Figure of the lower Belly A A The Midriff turned back with the ribs of the Peritonaeum BB The cave or hollow part of the liver for the liver is lifted up that the hollow part of it may be better seen C The least ligament of the Liver D The Umbilical vein E The hollowness of the Liver which giveth way to the stomach F the left orifice of the stomach GG Certain knubs or knots and impressions in the hollow part of the liver H The bladder of Gall. I The Gate-vein cut off and branches which go to the bladder of gall K A nerve from the liver coming from the stomachical nerve L An Artery common to the liver and bladder of gall M A nerve common also to them both coming from the right costal nerve of the ribs N The passage of the Gall the Guts cut off OO The hollow of the fore-parts of the Spleen P The line where the vessels of the Spleen implanted Q. The trunk of the hollow veia R The trunk of the great Artery S The Coeliacal Artery cut off T V The Kidneys yet wrapped in their membrane X Y The fatty veins called venae
adiposae a b The Emulgent veins with the Arteries under them cc dd The Ureter from either kidney to the bladder e f The spermatical veins to the testicles the right from the hollow vein the left from the Emulgent g g Veins coming from the spermatical to the peritonaeum h i the spermatical Arteries k The lower mesenterical Artery l. The ascending of the great Artery above the hollow vein and the division of it and the hollow vein into two trunks m The Arterie of the loins called lumbaris n The holy Artery called Sacra o A part of the right gut p The bladder of Urine * The connexion of the bladder with the peritonaeum q A part of the vessels which lead the seed from the Testicles is here reflected r s The scrotum or cod that is the skin that invests the Yard and Testicles t The fleshy Pannicle or membrane which is under the cod u The coat which is proper to the Testicles with his vessels x A part of the yard excoriated or flayed and hanging down The sixth going from the fore and upper part of this descend nt artery 6. Haemorrhoidalis sue mesenterica inferior descends with the Haemorrhoidal veins to the fundament presently from his beginning sending forth certain branches alongst the colick gut which by Anastomasis are united with other branches of the Coeliacal Arterie for whosoever shall look more attentively he shall often observe that veins are so united amongst themselves and also arteries and sometimes also the veins with the arteries For Anastomasis is a communion and a communicating of the vessels amongst themselves by the application of their mouths that so by mutual supplies they may ease each others defect But they call this the lower meseraick artery The seventh proceeding from the trunk with so many branches as there be Vertebra's in the loins goes to the loins and the parts belonging to them that is the spinal marrow of that part 7. Lumbaris and other parts encompassing these Vertebra's whereupon it is stiled the Lumbaris or Loin-Artery The eighth maketh the Iliack arterie until such time as it departs from the Peritonaeum where the Crural Arteries take their original This Iliack Artery sends many divarications towards the Holy bone where it takes its beginning and to the places lying neer the Holy bone which Iliacâ— because they run the same course as the Iliack veins for brevitie's sake we will let pass further mention of them till we come to treat of the Iliack veins CHAP. XXII Of the distribution of the Nerves to the natural parts IT remains that before the bowels be taken away we shew the nerves sent to the entrails and natural parts that as wise and provident men we may seem to have omitted nothing The originaâ— of the nerves which are carried to the natural parts First we must know that these nerves are of the sixth Conjugation which descend as well to the stomach all alongst the Gullet and the sides thereof as those at the roots of the ribs on both sides within But when they are passed through the Midriff those which are distributed amongst the natural parts follow the turnings of the veins and arteries but specially of the arteries Wherefore if you have a mind to follow this distribution of the nerves you must chiefly look for it in those places in which the artery is distributed amongst the Guts above the loins Their Magnitude and Use These nerves are but small because the parts serving for nutrition needed none but little nerves for the performance of the third duty of nerves which is in the discerning and knowing of what is troublesom to them For unless they had this sense there is nothing would hinder but these bowels necessary for life being possessed with some hurtful thing the creature should presently fall down dead but we have this benefit by this sense that as soon as any thing troubles and vellicates the bowels we being admonished thereof may look for help in time And besides if they were destitute of this sense they might be gnawn ulcerated and putrified by the raging acrimony of the excrements falling into and staying in them but now by means hereof as soon as they find themselves pricked or pluckt presently by the expulsive faculty they endeavour to expel that which is troublesom and so free themselves of present and future dangers CHAP. XXIII The manner of taking out the Guts WHen the Guts are to be taken out you must begin with the right Gut And you must divide it being first straitly tied in two different places at a just distance about four fingers from the end with a sharp knife between two ligatures Then you must shew its proper coats and fibers and that common one which it hath from the Peritonaeum This being done you must in like manner bind the trunk of the gate-vein as neer the original as you can that so all his branches being in like manner tied there may be no fear of effusion of blood you must do the like with the Coeliack Artery at the left Kidney and in the lower Mesenterick which descends to the right Gut with Haemorrhoidal veins This being done pull away the guts even to the Duodenum which being in like manner tied in two places which ought to be below the insertion of the Porus Cholagogus or passage of the Gall that you may shew the oblique insertion thereof into that gut for the obliquity of its insertion is worth observation as that which is the cause that the Gall cannot flow back into its bladder by the compression of this Gut from below upwards Then all these windings of the Guts may be taken away from the body CHAP. XXIV The Original and Distribution of the descendent Hollow Vein The original of the Hollow vein It is divided into two Trunks BEcause the rest of the natural parts do almost all depend upon the descendent Hollow Vein therefore before we go any further we will shew its original and distribution We said before that all Veins proceeded from the Liver but yet in divers places For the gate-vein goes out of the hollow part and the hollow vein out of the Gibbous part of the liver which going forth like the body of a tree is divided into two great branches the lesser of which goes to the vital and animal parts and the extremities of these parts as we shall shew in their place The greater descending from the back-part of the Liver above the Vertebra's of the loins to the parts beneath The division of the greater branch of the hollow vein goes in the manner following The first division thereof is to the membranes of the reins which come from the Peritonaeum Wherefore there it produces the Venae adiposae or fatty veins so called because they bring forth a great quantity of fat in those places Of these fatty veins there is a diverse original for the right doth oftentimes arise from
the right emulgent 1. Adiposa because it is higher but the less comes from the very trunk of the hollow vein because the Emulgent on that side is lower and you shall scarce see it happen otherwise 2. Emulgens The second being the Kidney or Emulgent veins go to the Reins which at their entrance or a little before is divided into two branches like as the Artery is the one higher the other lower and these again into many other through the substance of the Kidneys as you may learn better by ocular inspection than by book They are thick and broad that the serous humour may without impediment have freer passage Their original is different for the right Emulgent oftentimes comes forth of the hollow vein somewhat higher than the left that seeing their office and duty is to purge the mass of blood from the cholerick and serous humour that if any part thereof slide by the one it may not so scape but fall as it were into the other Which certainly would not have happened if they had been placed the one just opposite to the other For the serous or wheyish humour would have stayed as equally ballanced or poised by reason of the contrariety of the action and traction or drawing thereof But we must remember that in dissecting of bodies I have ofttimes found in such as have been troubled with the Stone seven Emulgent veins and so many arteries four from the left side coming from divers places of which the last came from the Iliack three from the right hand likewise in divers places 3. Spermatica The third division is called the Spermatick or Seed-vein it goes to the Testicles the original thereof is thus That the right arises on the fore-part of the trunck of the hollow vein but the left most commonly from the Emulgent Besides you shall sometimes find that these have companions with them to the right Emulgent but to the left another from the hollow vein in some but on one side in others on both But also I have sometimes observed the left emulgent to proceed from the spermatick or Seed-vein 4. Lumbaris The fourth because it goes to the Loins is called Lumbaris which in his original and insertion is wholly like the Artery of the loins But there are four Lumbares or Loin-veins 5. Iliacae which are divided into on each side that is one in each of the four spaces of the five Vertebra's of the loins The fifth division makes the Iliacae until passing through the Peritonaeum they take the names of Crural veins These are first divided into the musculous so called because they goe to the oblique ascendent and transverse muscles and to the Peritonaeum Sometimes 1. Musculosae they have their original from the end of the Trunk And the same Iliacae are divided into the Sacrae or Holy 2. Sacrae which go to the spinal marrow of the Holy-bone through those holes by which the nerves generated of this marrow have their passage Thirdly the Iliacae are divided into the Hypogastricae so called 3. Hypagastricae which produce the Haemorrhoidales externae because they are distributed to all the parts of the Hypogastrium or lower part of the lower belly as to the right Gut the muscles thereof the musculous skin in which place they often make the external Haemorrhoidal ordained for the purging of such blood as offends in quantity as those other that is the inward Haemorrhoidal which descend from the right Gut from the gate-Gate-vein by the spleenick branch serves for cleansing that which offends in quality to the bladder the neck thereof even to the end of the Yard to the Womb and even to the neck of the womb and utmost part of the privities from whence it is likely the courses break forth in Women with child and Virgins But this same vein also sends a portion also without the Epigastrium by that perforation which is common to the share and haunch-bones which strengthened by the meeting of the other internal Crural vein descends even to the Ham but in the mean time by the way it is communicated to the muscles of the thigh called Obturatores and other parts within Fourthly the Iliacae produce the Epigastricae 4. Epigastricae which on both sides from below ascend according to the length of the right muscles spreading also by the way some branches to the oblique and transverse muscles and also to the Peritonaeum Fifthly these produce Iliacae the Pudendae or veins of the privities 5. Pudendae because they go in women to their privities and in men to the Cods where they enter that fleshy coat filled with veins and going to the skin of the Yard they take their beginning under the Hypogastricae CHAP. XXV Of the Kidneys or Reins NOw follow the Kidneys which that they may be more easily seen after that you have diligently observed their situation you shall despoil of their fat if they have any about them as also of the membrane they have from the Peritonaeum First you shall shew all their conditions beginning at their substance The ninth and tenth figure of the vessels of seed and urine The first figure sheweth the fore-side the second the hinder-side a a a 1. The fore-part of the right kidney b b b 2. The back-part of the left kidney e 1. The outside d d 1 2. The inner-side e e 1 2. The two cavities whereinto the emulgent vessels are inserted f f 1 2. The trunk of the hollow vein g g 1 2. The trunk of the great artery h i 1 2. The emulgent vein and artery k k 1 2. The right fatty vein l 1. The left fatty vein * 1. The Coeliacal artery m n 1 2. The Ureters o p q 1 2. The right spermatick vein which ariseth neer p. the left neer q. r 1. The place where the Arteries of the seed arise s 1 2. Small branches distributed from the spermatical veins to the Peritonaeum t 1 2. The spiry varicous body called Varicosum Vas pyramidale u 1 2. The Parastatae or Epididymis x 1. The Testicle yet covered with its coat y 1 2. The place where the leading vessel called vas deferens doth arise α 1 2. The descent of the same leading vessel β 1 2. The revolution of the same leading vessel γ 1 3. The passage of the same vessel reflected like a recurrent nerve δ 2. The meeting of the same leading vessels ε 1 2 The bladder of urine the first figure sheweth it open the second sheweth the back-parts ζζ 1. The small bladder of the seed opened η η 2. The Glandules called Glandulae Prostatae θ 1. The Sphincter-muscle of the bladder ιι 1 2. The two bodies which make the substance of the yard κ κ 1. The vessels which go unto the yard and neck of the bladder λ 1. The passage which is common to the urine and seed cut open ψ 2. The implantation of the Ureters
branches By this difference of the spermatick vessels you may easily understand why women cast forth less seed than men For their Testicles they differ little from mens but in quantity For they are lesser In what their testicles differ from mens and in figure more hollow and flat by reason of their defective heat which could not elevate or lift them up to their just magnitude Their composure is more simple for they want the Scrotum or cod the fleshy coat and also according to the opinion of some the Erythroides but in place thereof they have another from the Peritonaeum which covers the proper coat that is the Epididymis or Dartos Silvius writes that womens Testicles want the Erythroides yet it is certain that besides their peculiar coat Dartos they have another from the Peritonaeum which is the Erythroides or as Fallopius calls it the Elythroides that is as much as the vaginalis or sheath But I think Lib. 14. de usu partium that this hath sprung from the mis-understanding that place in Galen where he writes that womens testicles want the Epididymis For we must not understand that to be spoken of the coat Site but of the varicous parastats as I formerly said They differ nothing in number but in site for in men they hang without the belly at the share-bone above the Peritonaeum women have them lying hid in their belly neer the bottom at the sides of the womb but yet so as they touch not the body of the womb But these testicles are tied to the womb both by a coat from the Peritonaeum Connexi-on as also by the leading vessels descending to the horns of the womb but to the rest of the body by the vessels and the nerves arising from the Holy-bone and Costal nerves They are of a colder Temper than mans Temper The ejaculatory or leading vessels in women differ thus from mens Their ejaculatory Vessels they are large at the beginning and of a veiny consistence or substance so that you can scarce discern them from the coat Peritonaeum then presently they become nervous and wax so slender that they may seem broken or torn though it be not so but when they come nearer to the horns of the womb they are again dilated in their own conditions they agree with mens Why they have more intricate windings Their site but that they are altogether more slender and short They have a round figure but more intricate windings than mens I believe that these windings might supply the defect of the varicous Parastats They are seated between the testicles and womb for they proceed out of the head of the testicle then presently armed with a coat from the Peritonaeum they are implanted into the womb by its horns CHAP. XXIII Of the Womb. THe Womb is a part proper only to women given by nature instead of the Scrotum as the neck thereof and the annexed parts instead of the yard Wherein the privy parts in women differ from those in men so that if any more exactly consider the parts of generation in women and men he shall find that they differ not much in number but only in situation and use For that which man hath apparent without that women have hid within both by the singular providence of nature as also by the defect of heat in women which could not drive and thrust forth those parts as in men The womb is of a nervous and membranous substance that it may be more easily dilated and contracted as need shall require The magnitude thereof is divers according to the diversity of age the use of venery The substance and magnitude of the Womb. the flowing of their courses and the time of conception The womb is but small in one of unripe age having not used venery nor which is menstrous therefore the quantity cannot be rightly defined The figure of the womb is absolutely like that of the bladder Figure The Horns of the womb if you consider it without the productions which Herophilus called horns by reason of the similitude they have with the horns of Oxen at their first coming forth It consists of simple and compound parts The simple are the veins arteries nerves and coats The veins and arteries are four in number Composure two from the preparing spermatick vessels the two other ascend thither from the Hypogastrick after this manner The Veins and Arteries First these vessels before they ascend on each side to the womb divide themselves into two branches from which othersome go to the lower part of the womb othersom to the neck thereof by which the menstruous blood if it abound from the conception may be purged Nerves come on both sides to the womb both from the sixth conjugation Nerves descending by the length of the back-bone as also from the holy bone which presently united and joyned together ascend and are distributed through the womb like the veins and arteries The utmost or common coat of the womb proceeds from the Peritonaeum The Coats on that part it touches the Holy-bone but the proper it hath from the first conformation which is composed of the three sorts of fibers of the right on the inside of the attraction of both seeds the transverse without to expel if occasion be the oblique in the midst for the due retention thereof The womb admits no division unless into the right and left side by an obscure line or seam such as we see in the scrotum but scarce so manifest No Cells in the Womb. neither must we after the manner of the ancients imagine any other cels in the womb For by the law of nature a woman at one birth can have no more than two An argument hereof is they have no more than two dugs If any chance to bring forth more it is besides nature and somewhat monstrous because nature hath made no provision of nourishment for them The site Nature hath placed the Womb at the bottom of the belly because that place seems most fit to receive the seed to carry and bring forth the young It is placed between the bladder and right gut and is bound to these parts much more straitly by the neck than by the body thereof but also besides it is tied with two most strong ligaments on the sides and upper parts of the sharebone on which it seems to hang but by its common coat from the Peritonaeum chiefly thick in that place it is tied to the hollow bone and the bones of the hanch and loins By reason of this strait connexion a woman with child feeling the painful drawings back and as it were The temper and action convulsions of those ligaments knows her self with child It is of a cold and moist temper rather by accident than of it self The action thereof is to contain both the seeds and to cherish preserve and nourish it so contained until the
fibers of the nerves are disseminated to these parts by mediation of their coat Lib. 1. de Locis affectis or membrane I say so small that they can scarce be discerned by the eyes unless as Galen saith by plucking such coats away from the parts Why the bones have such small veins But it is no marvail if Nature would have these parts in like manner to have such small veins contrary to the lungs and most part of the muscles only to yield so much nourishment to the part as should be needful for seeing the substance of the Bones is cold hard dense and solid it wastes the less Wherefore they need not so much blood for their nourishment as the hot and soft parts and besides the lesser Bones have neither Veins â—or Arteries but draw fit nourishment only by the force of the attractive faculty implanted in them Whence the difference of Bones may be taken The differences of Bones are taken from many things as from their Apophyses Epiphyses Grisles Necks Heads Solidity Cavity Eminencies Marrow Consistence Bigness Number Figure Site We will prosecute all these as they shall offer themselves in the demonstration of the Bones to which doctrine we will give a beginning at the Clavicles or Coller-bones The Clavicles or Coller-bones The Clavicles are two very hard and solid Bones without any great or notable cavity situate on each side betwixt the side and upper part of the Sternon and top of the Shoulder-blade for the strength and stability of these parts whence they take the name of Claviculae Clavicles from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies a Key or any other Bar or fastning of a Door They carry the shape of a Surgeons Levatory But you must note that the Clavicles seem to be fastned to the Sternon by the mediation of a grisly-bone Moreover the space and cavity contained within the coller-bones is called by the Latines jugulum by the French the upper furcula because the jugular-veins pass that way Lib. 13. de usu part cap. 13. it sticks to the upper process of the shoulder by a Grisle which Galen calls the small Grisle-bone although it be nothing else but a production of the Os juguli For the Sternon which we said is framed of divers Bones as sometimes 3 sometimes 4 5 6 7 and sometimes 8 you must note they are very spongy and full of pores and of a far softer consistence than the coller-bones wherefore more subject to corruption besides they are mutually joined by interposition of muscles Their use is to be as a shield to defend the vital parts The Ribs are 24 in number on each side 12. seven of these are called true or perfect ribs The Ribs because they make a circle at the one end joyned to the Sternon on the other to the vertebra's the other are called bastard or short-ribs because they fall short in their way and come not to the Sternon but they are fastned on the foreside of the Sternon by Grisles and Ligaments but on the back-part to the transverse vertebra's of the Back-bone and to the sides of the said vertebra's But the short-ribs are only knit to the vertebra's wherefore that part of the vertebra's is called the root of the ribs The exterior or fore-part of the bastard or short-ribs is grisly that they should not be broken and that they might be the easier lifted up in the distensions of the Stomach filled with meat They are of a consistence sufficiently hard yet more towards their root than at the Sternon Their Consistence where they come nearer together and are more hardly broken they are smooth both within and without but in the midst they have some sign of being double or hollow to receive the veins and arteries which nourish their bony substance they are fashioned like a bow their use is the same with the Sternon and besides to carry and strengthen the muscles serving for respiration CHAP. V. The Anatomical administration of the Sternon THe coat investing the ribs which the common Anatomists call Pleura is the last of the containing parts of the Chest which because it lies hid in the inner part thereof it cannot be shown unless by pulling asunder of the Sternon wherefore we must now shew the manner of opening the Sternon that hereby we may not violate the original or insertion of any of the muscles Wherefore first you must understand that he which will shew in their proper place their original and insertion of the pectoral muscles of the Mastoides of the two muscles of the bone Hyois of the muscles subclavii and intercartilaginei ought first of all to separate all the pectoral muscles from the Sternon and the Grisles from the true-ribs then to cut the Ligaments next the Bones themselves even from the sixth true rib to the clavicles And then shewing the Mediastinum stretched under the Sternon all the length thereof he must separate the Sternon with his knife and bend it up to the clavicâ—es and there cut it reserving together with it the four muscles that is the two Mastoides and the two moving the Bone Hyois because they either wholly or for the most part arise from the Sternon Lastly the Clavicles being somewhat thrust upwards the Grisles must on each side be turned outward towards the arm that so the containing parts of the Chest may not lye only open to view and be easily shewed but also the muscles may be contained in their place until they come to be shewed in their order And because the Coller-bones must be lifted up very high that the recurrent nerves may be more easily seen and the distribution of the veins and arteries the two small Subclavian muscles one on each side must be shown by the way who have their original from the inner and fore-part of the Clavicles and an oblique descent to the Sternon towards the grisle of the first rib For the Clavicles cannot be thus separated but that these muscles must be violated and spoiled Also you may divide the Sternon in the midst that you may shew the inward pectoral muscles whole having separated the muscles which arise from the upper part All which things being performed as they ought we must come to the coat investing the ribs and then to the Mediastinum as arising from it CHAP. VI. Of the Pleura or coat investing the Ribs THe Tunica Subcostalis or coat investing the Ribs What the membrane investing the ribs is being the last of the containing parts of the Chest is a large and a broad membrane answerable in proportion of use and action to the Peritonaeum of the lower Belly For as the Peritonaeum generally and particularly covers all the natural parts binding and holding them in their places so this coat invests all the vital parts in general because it is stretched over all the inside of the Chest but in particular whilst it gives each a coat from it self It hath
its original from the Periosteum or as others will have it It s original from the Pericranium investing the Vertebra's of the Chest at the roots of the ribs Wherefore it sticks very fast to the ribs scarce to be separated as also to all the parts bounding the Chest and contained in it Vesalius reprehends Galen because he said that this was double on both sides yet Columbus defends Galen and verily it is seen to be double in the inner part of the Chest under the ribs and the muscles of the ribs that in that space there may be way for the Veins Arteries and Nerves Whether as there is a twofold Plurisie so also a double Pleura Some have made it twofold and divided it into the internal and external as those which have made two sorts of Pleurisies the true and bastard placing the external above the Ribs and intercostal muscles but the internal under the ribs muscles Diaphragma and Sternon But we to shun ambiguity intend only to prosecute those things which are manifest to the eys wherefore we say that the ribs are lined on the inside with a double coat One which immediately and firmly sticks to them on every side called the Periosteum which is common to them and other Bones The other which lies upon that Periosteum and on the inside invests all the Ribs whence is it called the Subcostalis tunica The substance temper and composure are the same as in other membranes The Magnitude Figure The magnitude in length as also the figure is the same with the compass of the inner part of the Chest the thickness of it is very little This coat is commonly called the Pleura from the name of the part which it covers or lines for the Greeks call the ribs 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and in like manner that which happens betwixt the Periosteum and this Pleura is called either a true or bastard Pleurisie CHAP. VII Of the Mediastinum The Substance and Magnitude NOw we must speak of the parts contained in the Chest seeing we have already handled the containing beginning with the Mediastinum as being a part which in dissection first presents it self to our sight The Mediastinum is of the same substance thickness composure number temper as the Pleura For the substance of the Mediastinum is membranous and though it be stretched all the length of the Chest yet it is of a small thickness receiving Veins Nerves and Arteries from all the parts to which it is knit like as the Pleura doth but especially from the Mammillary vessels descending under the Sternon It is in number one but it is made of two membranes produced from the Subcostal for this ascending on each side by the hollowness of the Chest to the Sternon and then at right Angles is reflected to the bodies of the Vertebra's whence the Pleura hath its original In that reflection there is so much distance between each Membrane as may be sufficient to receive two fingers For otherwise seeing that they cannot penetrate through the Heart it was fit each side of the Pleura should turn to the Pericardium that so they might arrive at the appointed place without offence Neither yet is that space void and empty but woven with many small nervous fibers Columbus adds that that place is often filled with a certain humor besides Nature which you may draw out or evacuate by opening the Sternon The figure Yet I would gladly learn of Columbus by what signs we may know that such an humor is contained there For the figure the Mediastinum with the Pleura on each side represents the figure of a Leather-bottle whose flat side is the Mediastinum whose other side the Pleura the bottom that part of the Pleura which is next the Midriff the mouth the upper part of Pleura at the first ribs We shewed the site and connexion of the Mediastinum when we declared its original The use The use thereof is to separate the vital parts as it were into two cels the right and left that if peradventure it happen that the one be hurt the creature may live by the benefit of the other And it hath another use which is to prop and hold up the Pericardium that it fall not upon the Heart with its weight but tossed with the motions of the Heart and Chest it may move to this or that side CHAP. VIII Of the Diaphragma or Midriff What the Midriff is ALthough the Midriff may seem to be accounted rather a part containing than contained yet for commodities sake we have deferred the demonstration thereof till now Therefore It is a muscle round and long terminating the lower part of the Chest It s substance composition c. It is of the same substance composition and temper as the Muscles of the Epigastrium it is made of two coats the lower whereof is from the Peritonaeum and the upper from the Pleura Which getting to them flesh but not there but in their circumference by the benefit of the bloud brought thither by the Veins and Arteries distributed through it turn into a muscle whose middle is nervous and membranous but the extremities by which it is inserted one while fleshy as in that part next to the bastard-ribs another while tendonous as where it touches the first and second Vertebra's of the Loins for it ends in them by two Tendons manifest enough It is one in number Connexion interposed with an oblique site betwixt the natural and vital parts It hath connexion with the lower part of the Sternon and short-ribs and the two first Vertebra's of the Loins but by its coats and vessels with the parts from whence it received them Quantity The extent thereof is equal to the compass of the lower part of the Chest The length of it is from the brest-blade even to the first and second vertebra of the loins The thickness is diverse for it is far thicker in its fleshy extremity than in its nervous original The Action thereof is to help the expulsion of the Excrements by the mutual assistance of the Epigastrick muscles but the chief use is for respiration of which it is one of the prime instruments Action This partition the Ancients called Phrenes Why the Diaphragma was called Phrenes because the inflammation thereof caused like symptomes as the inflammation of the Brain by reason of the large nerves on each side one which come to it directly and primarily from the third fourth and fifth Vertebra's of the neck This muscle differs from other muscles specially in figure It is perforated in three places to give way or passage to the ascendent Hollow-vein to the artery Aorta and the Gullet CHAP. IX Of the Lungs THe Lungs are of a soft substance and fleshy rare and like a sponge Their Substance Quantity The Lobes thereof of a various colour pamered their quantity is sufficiently large for most commonly they are
hath bestowed some surcles upon the rough artery T the external Jugular vein V the division of this vein under the root of the ear X a branch of the external Jugular which goeth into the inside of the mouth and is diversly divided into the parts therein contained Y the exterior branch distributed near the Fauces into the muscles of the chops and the hole skin of the head Z a portion of the branch y reaching unto the face a ae the vein of the fore-head a a portion of it creeping through the temples ae * a propagation that goeth unto the skin of the Nowl or Occiput a. a the vein called Cephalica or the external vein of the arm which others call Humeraria b Muscula superior a propagation of the Cephalica vein which goeth unto the backward muscles of the neck Betwixt b. and d. on the back-side issueth a branch from the Cephalica which passeth unto the outside of the blade and a portion thereof runneth betwixt the flesh and the skin d d a vein from the Cephalica which attaineth unto the top of the shoulder and is consumed into the muscle that elevateth or lifteth up the arm and into his skin e e a small vein from the Cephalica dispersed through the skin and the muscles of the arm f the division of the Cephalica into three parts g the first branch runneth deep unto the muscles which arise out of the external protuberation of the arm h the second branch which goeth to make the median vein i i the third branch running obliquely above the wand and the outside of the arm k from his branch certain circles are divided into the skin the chief whereof is marked with k. l the third branch at the wrist which is joined at l. with the branch of the Basilica marked with x. m the Basilica which on the right hand is called Hepatica on the left hand Lienaris n o a branch of the Basilica going to the heads of the muscles of the cubit at n. and to the muscles themselves at o. p a notable branch of the Basilica running obliquely and bestowing surcles upon the muscles that issue from the external protuberation This branch descendeth together with the fourth nerve q division of the Basilica into two branches and that which is noted with q is ever accompanyed with an artery s a branch of this vein bestowed upon the arm t a branch of the Basilica which together with the branch of the Cephalica marked with h. makes the mediana or middle vein marked with a. u a branch of the Basilica going to the inner head of the arm xx a branch issuing out of the former that creepeth along unto the wrist and toward the little finger conjoyning it self with a branch of the Cephalica y A vein running out unto the skin at the outside of the cubit Upper z. a propagation issuing out of a branch of the Basilica marked with t lower z a branch of the Basilica x going to the inside of the arm α the Median or common vein β the partition of the Median vein above the wrist This division should have been made above γ. γ the external branch of the partition which goeth to the outside of the head δ from which issueth a small branch to the inside ε the internal branch under ε. which toward the middle and the ring-finger is especially disposed que the vein of the thumb dispersed into the mountainet or hillock which is conjoynd with the branch noted with δ. ζ the trunk of the hollow-vein from which issue branches unto the parts seated under the liver η the fatty vein called Adiposa sinistra which goeth unto the fat of the kidneys θ ι the two Emulgents which lead whey-whey-blood unto the kidneys λ μ the two spermatical veins leading the matter of the seed unto the testicles V the beginning of the bodden vessel called Vas varicosum ξ the veins of the loins called Lumbares which are sent in the knots or knees to the rack-bones to the marrow of the back to the muscles that lie upon the loins and to the Peritonaeum ο. the bifurcation of the hollow-vein into the Iliack branches which bifurcation is not unlike λ. Ï€ Muscula superior a transverse branch going to the muscles of the Abdomen and to the Peritonaeum Ï Ïƒ the division of the left Iliack vein into an inner branch at Ï. and an utter at σ. Ï„ Muscula media the utter propagation of the branch Ï‚. distributed through the muscles of the coxa and the skin of the buttocks Ï… an inner propagation of the same branch Ï. which goeth unto the holes of the holy-bone φ the vein called Sacra which goeth unto the upper holes of the holy-bone χ ψ the vein Hypogastrica distributed to the bladder to the muscles of the fundament and the neck of the womb ω a vein arising from the utter branch marked with σ. which is joyned with some branches of the internal vein near the holes or perforations of the share-bone 31 a vein which when it is passed the share-bone distributeth one branch into the cup of the coxendix to the muscles of that place κ another small branch which runneth under the skin at the inside of the thigh χ. the congress or meeting of the fore-said vein with a branch marked with char 2. and distributed into the leg 1. the Epigastrick vein a propagation of the utter branch σ. perforating the Peritonaeum whereto as also the muscles of the Abdomen and the skin it offereth branches the chief branch of this vein is joyned with the descending mammary above the Navel at M. Δ Pudenda an inner propagation of the branch σ running overthwart unto the privities Θ Ï Saphaena or the ancle-vein or the inner branch of the crural trunk which creepeth through the inside of the leg under the skin unto the tops of the toes Λ the first interior propagation of the Saphaena offered to the groin Ξ the utter propagation thereof divided to the foreside or outside of the thigh Î . the second propagation of the Saphaena going to the first muscle of the leg Σ the third propagation of the Saphaena going to the skin of the whirle-bone and unto the ham φ the fourth propagation of the Saphaena dispersing his muscles forward and backward Ψ branches from this unto the foreside of the inward ankle to the upper part of the foot and to all the toes Ω Ischias minor called also Muscula interior the utter branch of the crural trunk diuided into the muscles of the coxendix and to the skin of that place 1 2. and this also may be called muscula 1 the exterior and lesser which passeth into some muscles of the leg 2 the interior greater and deeper unto the muscles of the thigh 3 4 the vein called Poplitea made of two crural veins divided under the knee 5. From this a surcle is reached upward unto the skin of the thigh 6 but the greater part runs
by a toothed saw or comb-like connexion But if any ask why the head consists not of one Bone that so it might be the stronger I answer It is that so it might be the safer both from internal and external injuries Why the scull consists of divers bones For the skull being as it were the tunnel of the chimney of this humane fabrick to which all the smoky vapours of the whole Body ascend if it had been composed of one Bone these vapours should have had no passage forth In what bodies and by what mean the vena pupis sometimes enters into the parts within the skull Wherefore the grosser vapours pass away by the Sutures but the more subtile by the pores of the skull some have their Sutures very open but others on the contrary very close Therefore nature hath otherwise compendiously provided for such as want Sutures For it hath made one or two holes some two fingers bredth from the Lambdoides through which the Vena pupis enters into the skull and they are of that largeness that you may put a points tag into them that the vapours may have free passage forth otherwise there would be danger of death thus nature hath been careful to provide for man against internal injuries and in like manner against external for it hath made the head to consist of divers bones that when one is broken the other may be safe the violence of the stroke being stayed in the division of the Bones In what men one part of the head being stricken the opposite is broken Whereby you may know that if the skull chance to be broken in the opposite side to that which received the blow that it happens either by reason of the defect of sutures or else because they are unperfect too firmly closed otherwise it is impossible such fractures should happen by reason of the separation of the Bones which breaks the violence of the blow that it can go no further And certainly as it is rare to find a skull without Sutures so it is rare to find such kind of fractures Therefore Chirurgeons must diligently observe the Sutures and site of them lest they be deceived and take them for fractures or unawares apply a Trepan to them Why we must not apply a Trepan to the Sutures whence by breaking the veins arteries and nervous fibers by which the internal parts communicate with the external there may ensue increase of pain a violent defluxion of blood upon the Crassa meninx and the falling thereof upon the Brain the fibers being broken by which it stuck to the Pericranium and so consequently a deadly interception of the pulsion of the Brain CHAP. IV. Of the Cranium or Skull THe Cranium or Skull covering the Brain like an Helmet What the Cranium is is composed and consists of seven Bones of which some are more dense thick and hard than othersome The first is the Os Occipitis or Nowl-bone seated in the Back-part of the head Why the nowl-bone is harder than the rest more hard and thick than the rest because we want hands and eyes behind whereby we may keep or save our selves from falling This Bone is circumscribed or bounded by the suture Lambdoides and the * My Author means by the Os Basilare in this place the wedg-bone but some Anatomists make it a Synonyma of this Os Occipitis The forehead-bone next to the nowl-bone is harder thâ—n the rest A Cavity to be observed in the forehead-bone Os basilare The eminencies and as it were heads of this Bone are received into the first Vertebra for upon this the head is turned forwards and backwards by the force of fourteen muscles and strong ligaments which firmly tie these heads of the Nowl-bone in the cavities of this first vertebra The second Bone of the skull is in the forepart and is called the Os Coronale or Os frontis the fore-head-bone it hath the second place in strength and thickness It is bounded by the Coronal suture and the ends of the wedg-bone in this forehead-bone there is often found a great cavity under the upper part of the eye-brows filled with a glutinous gross viscid and white matter or substance which is thought to help to elaborate the air for the sense of smelling Chirurgeons must take special notice of this cavity because when the head chances to be broken in that place it may happen that the fracture exceeds not the first table wherefore being ignorant of this cavity and moved with a false perswasion that they see the Brain they may think the Bone wholly broken and to press the Meninges whereupon they will dilate the womb and apply a Trepan and other instruments to lift up the second table of the Bone without any need at all and with the manifest danger of the life of the Patient The third and fourth Bones of the skull are the Ossa parietalia or Bregmatis Ossa parietalia Bregmatis having the third place of density and thickness although this density and thickness be different in divers places of them For on the upper part of the head or crown where that substance turns not to a Bone in children until they have all their teeth so that it feels soft in touching and through it you may feel the beating of the Brain these Bones are very tender so that oft-times they are no thicker than ones nail that so the moist and vaporous excrements of the Brain shut up where the greater portion of the Brain resides may have a freer passage by the Brain 's Diastole and Systole These two square Bones are bounded above with the Sagittal suture below with the scaly on the fore-part with the coronal and on the hind-part with the Lambdoides The fifth and sixth Bones of the skull are the two Ossa Petrosa stony or scaly Bones Ossa petrosa or the scaly bones which are next to the former in strength They are bounded with the false or bastard-Suture and with part of the Lambdoides and wedg-bone The seventh is the Os sphenoides basilare or Cuneiforme that is the wedg-bone Os sphenoides or the wedg-bone It is called Basilare because it is as it were the basis of the head To this the rest of the Bones of the head are fitly fastned in their places This Bone is bounded on each side with the Bones of the forehead the stony Bones and Bones of the Nowl and Palat. The figure represents a Bat and its processes her wings There is besides these another Bone at the basis of the forehead-bone Os Ethmoides or Cribrosum into which the mamillary processes end the Greeks call it 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the Latins Cribrosum and Spongiosum the spongy-Bone because it hath many holes in it not perforated in a direct passage as in a sive but winding and anfractuous that the air should not by the force of attraction presently leap or ascend into the brain
The three bones of the Auditory passage and affect it with its qualities before it be elaborated by its lingring in the way There are besides also six other little Bones lying hid in the stony Bones at the hole or auditory-passage on each side three that is to say the Incus or Anvil the Malleolus or Hammer and the Stapes or stirrop because in their figure they represent these three things the use of these we will declare hereafter But also in some skulls there are found some divisions of Bones as it were collected fragments to the bigness almost of ones thumb furnished and distinguished by their proper commissures or sutures which thing is very fit to be known to a Chirurgion in the use of a Trepan By what means a Chirurgeon may conjecture that there are extraordinary Sutures in certain places of the skull The skulls of such as inhabit the Southern countreys are more hard and dense Verily he may give a conjecture hereof whilst he separates the pericranium from the skull for the pericranium is with greater difficulty pluckt away from the sutures because the Crassa meninx hath straiter connexion therewith by his nervous fibers sent forth in such places The skulls in women are softer and thinner than in men and in children more than in women and in young men more than in men of a middle age Also the Aethiopians or Black-moors as also all the people inhabiting to the South have their skulls more hard and composed with fewer sutures Therefore as it is written by Hippocrates such as have their Skulls the softer the Symptoms in fractures are more dangerous and to be feared in them But the Skull by how much the softer it is by so much it more easily and readily yields to the perforating Trepan Moreover in some skulls there be bunches standing out besides nature made either round or cornered which the Chirurgeon must observe for two causes We must observe the extuberancies besides nature which are in some skulls the first is for the better consideration of a blow or fracture For in these bunches or knots the solution of the continuity cannot be if it seem to be stretched in length but that the wound must penetrate to the inner parts For in a round body there can be no long wound but it must be deep by the weapon forced the deeper because as a round body touches a plain but only in puncto in a prick or point so whatsoever fals only lightly or superficially upon it touches a point thereof But on the contrary a long wound must be upon a plain surface which may be but only superficial The Site and Substance of the Diploe Another cause is because such Bunches change the figure and site of the Sutures And the Chirurgeon must note that the skull hath two tables in the midst whereof the Diploe is which is a spongy substance into which many veins and arteries and a certain fleshiness are inserted that the skull should not be so heavy and that it might have within it self provision for the life thereof and lastly that there might be freer passage out for the fuliginous vapors of the brain The upper table is thicker denser stronger and smoother than the lower For this as it is the slenderer so it is the more unequal that it may give place to the internal veins and arteries which make a manifest impression into the second table on the inside thereof from which Branches enter into the skull by the holes which contain the eyes Which thing fastens the Crassa meninx to the skull and is therefore very worthy to be observed There may be a deadly rupture of the Vessels of the Brain without any fracture of the skull Caution to be had in the use of the Trepan For in great contusions when no fracture and fissure appears in the skull by reason of the great concussion or shaking of the Brain these vessels are often broken whence happens a flux of blood between the skull and membranes and lastly death But it is fit the Chirurgeon take good heed to the tender and soft substance of the Diploe that when he comes to it having passed the first table he may carefully use his Trepan lest by leaning too hard it run in too violently and hurt the membranes lying underneath it whence convulsion and death would follow To which danger I have found a remedy by the happy invention of a Trepan as I will hereafter more at large declare in handling the wounds of the head CHAP. V. Of the Meninges that is the two Membranes called Dura Mater and Pia Mater Why the Bone Ethmoides is perforated THe Crassa meninx is one of the first and principal Membranes of the Body it goes forth by the sutures and holes of the nerves that proceed out of the skull and it passes forth by the Bone Ethmoides perforated for that purpose to carry smells to the Brain and purge it of excrementitious humors This same Crassa meninx invests the inner coat of the Nose also it passes forth of the great hole through which the spinal marrow passes vested with this Crassa meninx with all the nerves and membranes For which cause if any membrane in the whole body be hurt by reason of that continuation which it hath with the Meninges it straight communicates the hurt to the head by consent The consistence of the Crassa meninx The Crassa meninx is thicker and harder then all other membranes in the Body whereupon it hath got the name of the Dura mater besides also it begirts produces and defends the other membranes The use The use of it is to involve all the Brain and to keep it when it is dilated that it be not hurt by the hardness of the skull For the course of nature is such that it always places some third thing of a middle nature betwixt two contraries Also the Crassa meninx yields another commodity which is that it carries the veins and arteries entring the skull for a long space For they insinuate themselves into that part where the duplicate or folded Meninges separate the Brain from the Cerebellum and so from thence they are led by the sides of the Cerebellum until they come as it were to the top thereof where being united they insinuate themselves into that other part of the Crassa meninx where in like manner being duplicated and doubled it parts the Brain at the top into the right and left These united veins run in a direct passage even to the forehead after the manner of the Sagittal suture They have called this passage of the mutually infolded veins the Torcular or Press What the Torcular is because the blood which nourishes the Brain is pressed and drops from thence by the infinite mouths of these small veins Therefore also here is another use of the Crassa meninx to distinguish the Brain by its duplication being it thrusts it self deep into its Body into two parts
passions of hope The Countenance is the bewrayer of the will fear sorrow and delight possess our minds and what state our bodies are in sound sick or neither Wherefore seeing the Face is of so much moment let us return to the Anatomical description thereof which that we may easily and plainly perform we will begin with the Bones thereof whereby as we formerly said the original and insertion of the Muscles may be more certain and manifest to us CHAP. I. Of the Bones of the Face Bones in each orb of the Eye THe Bones of the Face are 16 or 17. in number And first there be reckoned six about the orbs of the Eyes that is three to each orb of which one is the bigger another lesser and the third between both each of these touch the forehead-bone in their upper part Besides the greater is joyned with a Suture to the process of the stony-bone and so makes the Zygoma VVhat the Zygoma is and what use it hath that is the Os Jugale or Yoke-bone framed by Nature for preservation of the temporal muscle The lesser is seated at the greater corner of the Eye in which there is a hole perforated to the Nose and in this is the glandule in which the Aegylops doth breed The middle is in the bottom The Aegylops or inner part of the orb very slender and as it were of a membranous thinness The two bones of the Nose then follow the two bones of the Nose which are joyned to the fore-head-bone by a suture but on the foreside between themselves by harmony But on the back and hind-part with two other bones The two inner bones of the Palat. on each side one which descending from the bone of the fore-head to which also they are joyned by a suture receive all the teeth These two in Galen's opinion are seldom found separated But these are the thickest of all the bones of the face hitherto mentioned knit by a suture with the greatest bone of the Orb on the back-part with the wedg-bone on the inner side with the two little inner bones of the Palat which on the inside make the extremity thereof whereby it comes to pass that we may call these bones the hinder or inner bones of the Palat. They reckon one of these bones the eleventh and the other the twelfth-bone of the head these two little bones on their sides next to the winged productions of the wedg-bone receive on each-side one of the nerves of the fourth conjugation which in the former book we said were spent upon the membrane of the Palat. The two bones of the Jaw And in Galen's opinion there be other two in the lower Jaw joined at the middle of the chin although some think it but one bone because by the judgment of sense there appears no division or separation therein Two productions on each side of the lower Jaw But you may see in Children how true this their supposition is for in men of perfect growth it appears but one bone these two are reckoned for the thirteenth and fourteenth bones Now these two bones making the lower Jaw have in their back-part on each side two productions as they lye to the upper Jaw the one of which represents the point of a sword and is called the Corone the other is obtuse and round which is inserted into the cavity seated at the root of the process of the stony-bone neer to the passage of the Ear. This may be strained to the fore-part by violent gaping by retraction of the muscles arising from the wing-like processes and ending at the lower angles of the broader part of the same Jaw The Luxâ—tion of the lower Jaw The lower Jaw filled with a marrowy humor This Jaw is hollow as also the upper especial in the back-part being filled with a white and glutinous humor conducing to the growth of the teeth This humor hath its matter from the blood brought thither by the vessels veins arteries and nerves from the third Conjugation entring here by a passage large enough Whereby it comes to pass that this part is not only nourished and lives but also the teeth receive sense by the benefit of the nerves entring thither with the vein and artery by small holes to be seen at the lower roots of the teeth How the teeth feel Why the teeth have a beating pain and thence it is that a beating pain may be perceived in the Tooth-ach because the defluxions may be by the Arteries or rather because the humor flowing to the roots of the teeth may press the artery in that place beside also you may see same appearance of a nervous substance in the root of a tooth newly pluckt out But also you must consider The nerves of the lower jaw must be observed that this Jaw from its inner capacity produces at the sides of the chin two nerves of a sufficient magnitude over against the lower Dog-teeth and the first of the smaller grinding teeth as I have noted in the description of nerves of the third conjugation I have thought good to put thee in mind of these that when thou shalt have occasion to make incision in these places thou maist warily and discreetly handle the matter that these parts receive no harm There remains another bone seated above the Palat from which the gristly partition of the Nose arises being omitted of all the Anatomists for as much as I know The bone of the nose above the palate or the partition of the nose Now therefore that you may the better remember the number of the bones of the Face I will here make a repetition of them There are six of the Orbs of the Eyes at each three The seventh and eighth we may call the Nasal or Nose-bones The ninth and tenth the Jaw-bones The eleventh and twelfth are called the inner bones of the Palat. The thirteenth and fowerteenth the bones of the lower Jaw The partition of the Nose may be reckoned the fifteenth Now it remains having spoken of these bones that we treat of the Teeth the Eye-brows the skin the fleshy pannicle the Muscles and lastly the other parts of the Face CHAP. II. Of the Teeth THe Teeth are of the number of the bones and those which have the most The teeth are bones have thirty two that is sixteen above and so many below of which in the forepart of the mouth there are four above and as many beneath which are called Incisorii Cutting or shearing Teeth to cut in sunder the meat and they have but one root The shearing teeth To these are joyned two in each Jaw that is on each side of the other one which are called the Canini Dentes Dog-teeth because they are sharp and strong like Dogs-teeth these also have but one root The Dogteeth but that is far longer then the other have Then follow the Molares or grinders on each side five that is ten
the Hand taken in general NOw it befits us to describe in order the Muscles of the Arm but first we must know what it is that we call the Arm. But seeing that cannot fitly be understood unless we know what the Hand is seeing that the Arm is a part of the Hand therefore first we must define what a Hand is and then divide it into its parts Therefore the Hand is taken two manner of wayes that is generally and specially The Hand generally taken signifies all that which is contained from the joyning of the Arm to the Shoulder-blade What is meant by the hand in general even to the ends of the fingers But in particular it signifies only that which is comprehended from the furthest bones of the cubit or the beginning of the wrist to the very fingers ends Therefore the Hand in general is an instrument of instruments made for to take up and hold any thing It is composed of three great parts that is of the Arm Cubit and Hand vulgarly and properly so called but the hand taken thus in particular is again divided in three other parts the Carpus or Brachiale the wrist the Metacarpium or Postbrachiale the After-wrist and the fingers all these parts seeing each of them are not only organical parts but also parts of organical parts are composed of all or certainly of the most of the similar parts that is of both the skins the fleshy pannicle the fat Veins Arteries Nerves Muscles or Flesh Coats both common and proper Bones Gristles and Ligaments all which we will describe in their order The differences of the hand from the site thereof But first I think good to admonish you of the differences of the hand taken from the site thereof and these differences are six in number the fore the hind the internal the external the upper and lower side or part thereof By the fore we mean that part which looks directly from the Thumb to the Shoulder by the hind we understand the part opposite to it which from the little finger looks towards the basis of the Shoulder-blade By the inside we signifie that part which lies next to the sides of the body when the hand retains its natural site by the out-side the part opposite to it The upper and lower side you may know by the very naming thereof Why the hand is divided into so many fingers Why the nails are added to the soft flesh of the fingers The Hand properly so called is divided into five fingers that so it may hold and take up bodies of all figure as round triangular square and the like and gather up the least bodies with the Fingers ends as Needles Pins and such like Nature hath bestowed two Hands upon us that so they may help each other each moving to each side But for the taking up and holding of small bodies it was fit that the Fingers of their own nature soft should be armed with nails that consisting of soft flesh and a hard nail they might serve for all actions for the nail is a stay to the soft flesh which otherwise would turn away in meeting with an hard body the use of the Nails is to scratch shave and pull off the skin to rend pinch and pluck asunder small bodies They have not bony hardness that so they might not break but bend Why the nails grow continually Yet other creatures have hard Nails to serve them instead of weapons Their figure is round because such a figure is less obnoxious to external injuries and by reason they are subject to wearing they grow continually Nature hath placed flesh on the inner and side-part of the Fingers so to press more straitly the things they once take hold of so that by holding them close together we can hold water that it may not run out The length of the Fingers is unequal that when they are opened and stretched forth they make as it were a circular figure for so it comes to pass that the hand can hold all bodies but especially round It remains that we prosecute the distribution of the Veins Arteries and Sinews which run over all the parts of the Hand taken in general and particular whereby we may more commodiously hereafter handle all the proper parts thereof CHAP. XXI The distribution of the Subclavian Vein and first of the Cephalica or Humeraria TWo large Veins descend from the Subclavian the one from the lower-side the other from the higher Yet sometimes and most usually both these proceed from the same common orifice as in men of a low stature in the Arm. The one of these is called the Axillaris The Cephalick vein the other the Humeraria or Cephalick therefore this Cephalick passing forth of the Subclavian runs superficially along the fore-side between the Muscle Deltoides and the Tendon of the pectoral Muscle and descends in the midst between the common Coat of the Muscles and the fleshy pannicle even to the bending of the cubit where in lean bodies it is plainly to be seen whereas in fat bodies it is hardly to be perceived being as it were buryed in abundance of fat This vein having in its descent sent forth some small branches both to the skin as also to certain Muscles over which it runs is divided into two a little above the outward protuberation of the Arm. One of the branches into which it is divided descending obliquely to the fore-part of the cubit a little below the bending of the cubit it meets and is united with the like branch in the same place as shall be shown hereafter The median vein How by opening the median vein you may draw more or less blood from the head or liver That which arises from this concourse is called the median-Median-vein because it arises from two branches and is seated between them They usually open this Median-vein in the diseases of the head and Liver which require Phlebotomy but if it shall not be sufficiently manifest when you judg it must be opened for a general evacuation of the whole body you may cut one of these branches by whose concourse it is made which you shall think the fitter and because each branch draws from the next parts according to the straightness of the fibers rather than from the opposite side if you would evacuate the Head and Liver equally by opening either of these branches it is convenient that opening that branch for example which comes from the Cephalick you presently lay your Thumb upon it until you suppose you have drawn a just quantity of blood from the Liver by the Basilica or liver-Liver-vein which done you may take off your Thumb and suffer the bloud to follow freely by the open branch of the Cephalick until you have drawn as much bloud as you shall judge requisite otherwise you will draw it but from one part to wit the head So you shall evacuate it only from the Liver if you open the branch which comes from
digested and ripened thirdly by induration when it degenerates into a Scirrhus the thinner part of the humor being dissolved the fourth which is the worst of all by a corruption and Gangrene of the part which is when overcome with violence or the abundance or quality of the humor or both it comes to that distemper that it loses its proper action It is best to terminate a tumor by resolution and the worst by corruption suppuration and induration are between both although that is far better than this The signs of a tumor to be terminated by resolution The signs by which the Chirurgeons may presage that an Impostume may be terminated by resolving are the remission or slacking of the swelling pain pulsation tension heat and all other accidents and the unaccustomed liveliness and itching of the part and hot Impostumes are commonly thus terminated because the hot humor is easily resolved by reason of its subtilty Signs of suppuration are the intension or encrease of pain heat swelling pulsation The signs of suppuration and the Feaver for according to Hippocrates Pain and the Feaver are greater when the matter is suppurating than when it is suppurated The Chirurgeon must be very attentive to know and observe when suppuration is made for the purulent matter oft-times lies hid as Hippocrates saith by reason of the thickness of the part lying above or over it The signs of an Impostume degenerating into a Scirrhous hardness The signs and causes of a tumor terminated in a Scirrhus are the diminution of the tumor and hardness remaining in the part The causes of the hardness not going away with the swelling are the weakness of nature the grosness and toughness of the humor and unskilfulness of the Chirurgeon who by too long using resolving things hath occasioned that the more subtil part of the humor being dissolved the rest of the grosser nature like earthy dregs remains concret in the part For so Potters vessels dryed in the Sun grow hard But the unskilful Chirurgeon may occasion a Scirrhous hardness by another means as by condensating the skin and incrassating the humors by too much use of repercussives The signs of a Gangrene at hand But you may perceive an Impostume to degenerate into a Gangrene thus if the accidents of heat redness pulsation and tension shall be more intense than they are wont to be in suppuration if the pain presently cease without any manifest cause if the part wax lived or black and lastly if it stink But we shall treat of this more at large when we come to treat of the Gangrene and Sphacelus Of disappearance of a tumor and the signs thereof A sodain diminution of the tumor and that without manifest cause is a sign of the matter fallen back and turned into the body again which may be occasioned by the immoderate use of refrigerating things And sometimes much flatulency mixed with the matter although there be no fault in those things which were applyed Feavers and many other malign Symptoms as Swoundings and Convulsion by translation of the matter to the noble parts follow this flowing back of the humor into the body CHAP. IV. Of the Prognostique in Impostumes TUmors arising from a melancholy phlegmatick gross tough or viscous humor Cold tumors require a longer cure ask a longer time for their cure than those which are of bloud or choler And they are more difficultly cured which are of humors not natural than those which are of humors yet contained in the bounds of nature For those humors which are rebellious offend rather in quality than in quantity Tumors made of matter not natural are more difficultly cured and undergo the divers forms of things dissenting from Nature which are joyned by no similitude or affinity with things natural as Suet Poultis Hony the dregs of Oil and Wine yea and of solid bodies as Stone Sand Coal Straws and sometimes of living things as Worms Serpents and the like monsters The tumors which possess the inner parts and noble entrails are more dangerous and deadly is also those which are in the joynts or neer to them And these tumors which seise upon great vessels as veins arteries and nerves for fear of great effusion of blood Hippo. Aph. 8. sect 6. wasting of the spirits and convulsion So Impostumes of a monstrous bigness are often deadly by reason of the great resolution of the spirits caused by their opening Those which degenerate into a Scirrhus are of long continuance and hard to cure as also those which are in hydropick leprous scabby and corrupt bodies for they often turn into malign and ill-conditioned Ulcers CHAP. V. Of the General cure of Tumors against Nature THere be three things to be observed in the cure of Impostumes What must be considered in undertaking the cure of tumors The first is the essence thereof the second the quality of the humor causing the Impostume the third the temper of the part affected The first indication drawn from the essence that is from the greatness or smalness of the tumor varies the manner of curing for the medicines must be increased or diminished according to the greatness of the tumor The second taken from the nature of the humor also changes our counsel for a Phlegmon must be otherwise cured than an Erysipelas and an Oedema than a Scirrhus and a simple tumor otherwise than a compound And also you must cure after another manner a tumor coming of an humor not natural than that which is of a natural humor and otherwise that which is made by congestion than that which is made by defluxion What we must understand by the nature of the part The third Indication is taken from the part in which the tumor resides by the nature of the part we understand its temperature conformation site faculty and function The temperature indicates that some medicines are convenient for the fleshy parts as those which are more moist others for the nervous as more drie for you must apply some things to the eye and others to the throat one sort of things to these parts which by reason of their rarity are easily subject to defluxion another to those parts which by their density are not obnoxious to it But we must have good regard to the site of the part as if it have any connexion with the great vessels and if it be fit to pour forth the matter and humor when it is suppurated What we must understand by the faculty of the part Galen by the name of Faculty understands the use and sense of the part This hath a manifold indication in curing for some parts are principal as the Brain Heart and Liver for their vertue is communicated to the whole body by the Nerves Arteries and Veins Others truly are not principal but yet so necessary that none can live without them as the Stomach Some are endued with a most quick sense as the Eye the
transpiration or by the moisture of the skin The unputrid Synochus or by a sweat natural gentle and not ill smelling to this Diary we may refer the unputrid Synochus generated of bloud not putrid but only heated beyond measure For usually there arises a great heat over all the body by means of the bloud immoderately heated whence the veins become more tâ—mid the face appears fiery the Eyes red and burning the breath hot and to conclude the whole habit of the body more full by reason of that ebullition of the bloud and the diffusion of the vapours thence arising over all the body Whence it is that this kind of Synochus may be called a vaporous Feaver To this Children are incident as also all sanguine bodies which have no ill humors The cure of this and the Ephemera or Diary is the same because it may scarse seem different from the Ephemera in any other thing than that it may be prolonged for three or four dayes Wherefore whatsoever we shall say for the cure of the Ephemera may be applyed to the Synochus bloud-letting excepted which in an unputrid Synochus is very necessary Now the cure of a Diary-Feaver consists in the decent use of things not natural The cure of a Diary Feaver contrary to the the cause of a disease wherefore bathes of warm and natural water are very profitable so that the Patient be not Plethorick nor stuft with excrements nor obnoxious to Catarrhs and defluxions because a Catarrh is easily caused and augmented by the humors diffused and dissolved by the heat of a Bath therefore in this case we must eschew frictions and anointing with warm Oil which things notwithstanding are thought very useful in these kinds of Feavers especially when they have their original from extreme labour by astriction of the skin or a Bubo Let this be a general rule that to every cause whence this Feaver proceeded you oppose the contrary for a remedy as to labour rest to watching sleep to anger and sorrow grateful society of friends and all things replenished with pleasant good will and to a Bubo the proper cure thereof The use of Wine in a Diary Wine moderately tempered with water according to the custom of the sick Patient is good and profitable in all causes of this Feaver except he be pained in his head or that the Feaver drew its original from anger or a Bubo for in this last case especially the patient must abstain wholly from Wine until the inflammation come to the state and begins to decline This kind of Feaver often troubles Infants and then you must prescribe such medicines to their Nurses as if they were sick that so by this means their milk may become medicinable Also it will be good to put the Infant himself into a Bath of natural and warm water and presently after the Bath to anoint the ridg of the Back and Brest with Oyl of Violets But if a Phlegmon possess any inward part or otherwise by its nature be great or seated near any principal Bowel so that it may continually send from it either a putrid matter or exhalation to the heart and not only affect it by a quality of preternatural heat by the continuity of the parts thence will arise the putrid Synochus if the blood by contagion putrefying in the greater vessels consists of one equal mixture of the four humors This Feaver is thus chiefly known How a putrid Synochus is caused it hath no exacerbations or remissions but much less intermissions it is extended beyond the space of twenty four hours neither doth it then end in vomit sweat moisture or by little and little insensible transpiration after the manner of intermitting Feavers or Agues but remains constant until it leaves the Patient for altogether it commonly happens not unless to those of a good temper and complexion which abound with much bloud and that tempered by an equal mixture of the four humors It commonly indures not long because the bloud by some peculiar putrefaction degenerating into Choler or Melancholy will presently bring forth another kind of Feaver to wit a Tertian or continued Quartain Phlebotomy necessary in a putrid Synochus The cure of this Feaver as I have heard of most learned Physitians chiefly consists in blood-letting For by letting of bloud the fulness is diminished and therefore the obstruction is taken away and lastly the putrefaction And seeing that in this kind of Feaver there is not only a fault of the matter by the putrefaction of the bloud but also of the Temper by excess of heat certainly Phlebotomy helps not only as we said the putrefaction but also the hot distemper For the bloud in which all the heat of the creature is contained whilst it is taken away the acrid and fuliginous excrements exhale and vanish away with it which kept in encrease the Feaverish heat Moreover the veins to shun emptiness which Nature abhors are filled with much cold air in stead of the hot bloud which was drawn away which follows a cooling of the habit of the whole body yea and many by means of Phlebotomy have their Bellies loosed and sweat both which are much to be desired in this kind of Feaver What benefit we may reap by drawing bloud even to fainting This moved the ancient Physitians to write that we must draw bloud in this disease even to the fainting of the Patient Yet because thus not a few have poured out their lives together with their bloud it will be better and safer to divide the evacuations and draw so much bloud at several times as the greatness of the disease shall require and the strength of the Patient may bear Why we must give a Clyster presently after bloud-letting When you have drawn bloud forthwith inject an emollient and refngerative Clyster lest that the veins emptied by Phlebotomy may draw into them the impurity of the Guts but these Clysters which cool too much rather bind the belly than loose it The following day the Morbisick matter must be partly evacuated by a gentle Purge as a bole of Cassia or Catholicon then must you appoint Syrups which have not only a refrigerative quality When Syrrups profitable in this case but also to resist putrefaction such as the Syrup of Limmons Berberries of the Juyce of Citrons of Pomgranates Sorrel and Vinegar Why a slender Diet must be used after letting much bloud let his diet be absolutely cooling and humecting and also slender for the native heat much debilitated by drawing of great quantity of bloud cannot equal a full diet Therefore it shall suffice to feed the Patient with Chicken and Veal Broths made with cooling Herbs as Sorrel Lettice and Purslin Let his drink be Barly-water Syrrup of Violets mixed with some pretty quantity of boyled water Julepum Alexandrium especially if he be troubled with scouring or lask But the Physitian must chiefly have regard to the fourth day for if then
there appear any signs of concoction in the excrements the Crisis must be expected on the seventh day and that either by a loosness of the belly or an abundance of urin by vomits sweats or bleeding Therefore we must then do nothing but commit the whole business to Nature When drinking of water is to be permitted in a putrid Synochus But for drinking cold water which is so much commended by Galen in this kind of Feaver it is not to be suffered before there appear signs of concoction moreover in the declining of the disease the use of Wine will not be unprofitable to help forwards sweats CHAP. XII Of an Erysipelas or Inflammation HAving declared the cure of a Phlegmon caused by laudable bloud we must now treat of those Tumors which acknowledg Choler the material cause of their generation by reason of that affinity which intercedes between Choler and Bloud The definition of an Erysipelas Therefore the Tumors caused by natural Choler are called Erysipelata or Inflammations these contain a great heat in them which chiefly possesses the skin as also oftentimes some portion of the flesh lying under it For they are made by most thin and subtle bloud which upon any occasion of inflammation easily becomes Cholerick or by bloud and choler hotter than is requisite and sometimes of choler mixed with an acrid serous humor That which is made by sincere and pure choler is called by Galen a true and perfect Erysipelas Gal. cap. 2. lib. 14. Meth. med 2. ad Glau. But there arise three differences of Erysipelas by the admixture of choler with the three other kinds of humors For if it being predominant be mixed with bloud it shall be termed Erysipelas Phlegmonades if with Phlegm Erysipelas oedematodes if with Melancholy Erysipelas Scirrhodes So that the former and substantive-word shews the humor bearing dominion but the latter or adjective that which is inferior in mixture But if they concurr in equal quantity there will be thereupon made Erysipelas Phlegmone Erysipelas oedema Erysipelas scirrhus Galen acknowledges two kinds of Erysipelas one simple and without an ulcer Two kinds of Erysipelas the other ulcerated For choler drawn and severed from the warmness of the bloud running by its subtilty and acrimony unto the skin ulcerates it but restrained by the gentle heat of the bloud as a bridle it is hindered from piercing to the top of the skin and makes a tumor without an ulcer But of unnatural choler are caused many other kinds of cholerick tumors as the Herpes exedens and miliaris and lastly all sorts of tumors which come between the Herpes and Cancer You may know Erysipelas chiefly by three signs as by their colour which is a yellowish red by their quick sliding back into the body at the least compression of the skin the cause of which is the subtlety of the humor and the outward site of it under the skin whereupon by some Erysipelas is called a disease of the skin lastly by the number of the Symptoms as heat pulsation pain The heat of an Erysipelas is far greater than that of a Phlegmon but the pulsation is much less for as the heat of the bloud is not so great as that of choler so it far exceeds choler in quantity and thickness which may cause compression and obstruction of the adjacent muscle Gal. lib. 2. ad Glauc For Choler easily dissipable by reason of its subtlety quickly vanishes neither doth it suffer it self to be long contained in the empty spaces between the muscles Hip. Apho. 79. Sect. 7. Aph. 25. Sect. 16. Aph. 43. Sect. 3. neither doth an Erysipelas agree with a Phlegmon in the propriety of the pain For that of an Erysipelas is pricking and biting without tension or heaviness yet the primitive antecedent and conjunct causes are alike of both the tumors Although an Erysipelas may be incident to all parts yet principally it assails the face by reason of the rarity of the skin of that place and the lightness of the cholerick humor flying upwards It is ill when an Erysipelas comes upon a wound or ulcer and although it may come to suppuration yet it is not good for it shews that there is obstruction by the admixture of a gross humor whence there is some danger of erosion in the parts next under the skin It is good when Erysipelas comes from within outwards but ill when from without it retires inward But if an Erysipelas possess the womb it is deadly and in like manner if it spread too far over the face by reason of the sympathy of the membranes of the Brain CHAP. XIII Of the cure of an Erysipelas FOr the cure of an Erysipelas we must procure two things to wit evacuation and refrigeration But because here is more need of cooling than in a Phlegmon Gal. 14. Meth. the chief scope must be for refrigeration Which being done the contained matter must be taken away and evacuated with moderately resolving medicines Four things to be performed in curing an Erysipelas We must do four things to attain unto these fore-mentioned ends First of all we must appoint a convenient manner of Diet in the use of the six things not natural that is we must incrassate refrigerate and moisten as much as the nature of the disease and patient will suffer much more than in a Phlegmon then we will evacuate the Antecedent matter by opening a vein and by medicines purging choler and that by cutting the Cephalick vein if there be a portion of the bloud mixed with Choler if the Erysipelas possess the face and if it be spread much over it But if it shall invade another part although it shall proceed of pure choler In what Erysipelas it is convenient to let bloud in what not Phlebotomy will not be so necessary because the bloud which is as a bridle to the Choler being taken away there may be danger lest it become more fierce yet if the body be plethorick it will be expedient to let bloud because this as Galen teacheth is oft-times the cause of an Erysipelas It will be expedient to give a Clyster of refrigerating and humecting things before you open a vein but it belongs to a learned and prudent Physitian to prescribe medicines purging choler What topick medicines are fit to be used in the beginning of an Erysipelas The third care must be taken for Topick or local medicines which in the beginning and encrease must be cold and moist without any either dryness or astriction because the more acrid matter by use of astringent things being driven in would ulcerate and fret the adjacent particle Galen and Avicen much commend this kind of remedy Take fair water â„¥ vi of the sharpest Vinegar â„¥ i make an Oxycrate in which you may wet linnen clothes and apply to the affected part and the circumjacent places and renew them often Or â„ž Succi solani plantag sempervivi an â„¥ ij aceti
all be mixed together and make a liniment with which anoint the part after the fomentation â„ž Farinae fabar crobi an â„¥ iij coquantur in de cocto pulegii origani calamenth salviae addita pulverum chamaem melilot an m ss furfur farinae fab orobi an â„¥ ij coquantur cum lixivio communi addendo terebinth â„¥ iij oleor aneth rut an â„¥ ij make an emplaister for the foresaid use The emplaister of Vigo with Mercury and without is very good for the same purpose But you must note that such medicines must be applyed to the part actually hot and the same heat must be contained and renewed by putting about it linnen Clothes Bricks Bottles and such like hot things Corroborating medicines The humor and flatulency which were kept shut up in the part being resolved the part must be strengthened lest now and then it receive or generate the like matter That may be done by the following fomentation and cataplasm â„ž Nucum cupressi corticum granat sumach berberis â—alaust an Ê’ i caudae equin arnogloss tupsi barb absinth salviae rorism lavendul m. ss flor chamaem melil rosar anthos an p. i alum salis com an â„¥ i bulliant omnia in aequis partibus aquae fabrorum vini austeri make bags for a fomentation or use the decoction for the same purpose with a spunge â„ž Farinae fab hordei lupin an â„¥ ij terebinth commun â„¥ iiij pulver radicis ireos mastic an â„¥ ss mellis com â„¥ ij ss of the foresaid decoction as much as shall suffice so to make a Capalasm to the form of a poultis liquid enough let it be applyed hot to the affected part having used the fomentation before The signs of a waterish tumor The signs of a waterish tumor are the same as of a flatulent but over and besides it shines and at the pressing with your fingers there is heard a noise or murmur as of a bladder half filled with water Why a waterish tumor must be opened with an instrument Therefore the waterish tumor if it shall not yield to the fore-mentioned resolving medicines the way must be opened with an Incision-Knife after the same manner as we mentioned in a Phlegmon For oftentimes this kind of remedy must be necessarily used not only by reason of the contumacy of the humor which gives no place to the resolving medicines but also because it is shut up in its proper cist or bag the thickness of which frustrates the force of the resolving medicines neither suffers it to penetrate into the humor A History As I some years ago found by experience in a maid of 7 years old which troubled with a Hydrocele or waterish rupture to whom when I had rashly applyed to dissolve it resolving medicines of al sorts at length I was forct to open it with my knife not only to evacuate the contained matter but also that I might pluck out the bag which unless it were cut up by the root would be a mean to cause a relapse John Aâ—tine Doctor of Physick called me to this business James Guilemeau the Kings Chirurgeon over saw the cure CHAP. XIX Of an Atheroma Steatoma and Meliceris ALthough these tumors may be thought to be comprehended under one genus with the other Oedematcus tumors yet they differ as thus that is their matter is shut up in its bladder or bag as it were in a peculiar cell But their difference amongst themselves is thus In what an Atheroma Steatoma and Meliceris differ the matter of the Steatoma as the name signifieth is like unto Tallow for 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 in Greek signifieth Tallow or Seam yet it oft-times is found stuffed with other divers hard bodies stony bony or callous like unto the claws of an Hen. For Philoxenus reports that he sometimes saw flyes in a Steatoma at the opening thereof and such other like things wholly dissenting from the common matter of Tumors The matter contained in an Atheroma is like to pap with which they feed little Children A Meliceris contains matter resembling Honey in colour and consistence these tumors appear and rise without any inflammation going before them Thus you shall know these tumors a Steatoma is harder than the other two neither yields it to the pressure of your finger but when it once yields it doth not speedily and easily return to its former figure because the matter is more gross it is of the same colour as the skin without pain and of a longish figure The Meliceris yields to the touch as being a loose and soft body and as it is easily disposed and diffused so it quickly returns to its former place and tumor It differs from the Atheroma in figure and substance For it is more globous and of a subtiler and more shining matter besides also it takes up a large space and is more obsequious to the touch and for the rest without pain Of Chirurgey to be used to these tumors As for the manual operation of the Chirurgeon in their cure it seems to be of no great consequence of what sort the matter is whether resembling Tallow Honey or Pap for there is one simple manner of operation which is that you pluck away the contained humor as also the receptacle in which it is contained Yet you must note such tumors sometimes as it were hanging in the surface of the skin are easily to be moved this way and that way but othersome again deeper fastned firmly cohere with the adjacent bodies and these require an exquisite hand and also industry for fear of a great flux of bloud and convulsion by cutting a vein There are many other kinds of tumors as the Testudo or Mole the Nata the Glandula Nodus Botium Lupia which as in matter for they are all of a thick clammy and viscous Phlegmatick humor so also in kind they agree with an Atheroma Steatoma and Meliceris But also in these for the most part when they are opened What the cause may be that we sometimes find Insecta in these Tumors you may see bodies of all sorts far different from the common matter of tumors as stones chalk sand coals snails straws or awnes of corn hey horn hairs flesh both hard and spongeous gristles bones whole creatures as well living as dead The generation of which things by the corruption and alteration of humors shall not make us much to admire it if we consider that as Nature of all seeds and elements of the whole great world hath made man the Microcosm or little world that he might be as it were the lively Image of that greater world so in him it being never idle in us would have all the kinds of all motions and actions to shew themselves as long as matter for generation is not wanting But because there is little or rather no mention of these tumors amongst the Ancients we will briefly shew the opinions of the latter Writers concerning
he open not the Scrophulae A note to be observed in opening Scrophulous tumors Natural heat the cause of suppuration before that all the contained humor be fully and perfectly turned into pus or matter otherwise the residue of the humor will remain crude and will scarse in a long time be brought to maturation which precept must be principally observed in the Scrophulae also sometimes in other abscesses which come to suppuration For we must not assoon as any portion of the contained humors appear converted into pus procure and hasten the apertion For that portion of the suppurated humor causes the rest sooner to turn into pus which you may observe in inanimate bodies For fruits which begin to perish and rot unless we presently cut away the putrefying part the residue quickly becomes rotten there is also another reason The native heat is the efficient cause of suppuration it therefore the sore being opened diminished and weakned by reason of the dissipation of the spirits evacuated together with the humor will cause the remaining portion of the humor not to suppurate or that very hardly and with much difficulty Yet if the tumefied part be subject by its own nature to corruption and putrefaction as the fundament if the contained matter be malign or critical it will be far better to hasten the apertion The Chirurgical manner of curing Scrophulae There is also another way of curing the Scrophulae which is performed by the hand For such as are in the neck and have no deep roots by making Incision through the skin are pulled and cut away from those parts with which they were intangled But in the performance of this work we take especial care that we do not violate or hurt with our Instrument the Jugular Veins the Sleepy Arteries or Recurrent Nerves If at any time there be danger of any great efflux of bloud after they are plucked from the skin they must be tyed at their roots by thrusting through a needle and thred and then by binding the thred strait on both sides that so bound they may fall off by themselves by little and little without any danger The remainder of the cure may be performed according to the common rules of Art CHAP. XXIII Of the Feaver which happens upon an oedematous Tumor How an intermitting Quotidian happens upon oedematous tumor The cause of a Quotidian Feaver HAving shewed all the differences of oedematous tumors it remains that we briefly treat of the Symptomatical Feaver which is sometimes seen to happen upon them This therefore retaining the motion of the humor by which it is made is commonly of that kind which they name intermitting Quotidians Now the fit of a Quotidian comes every day and in that repetition continues the space of eighteen hours the residue of the day it hath manifest intermission The primitive causes of this Feaver are the coldness and humidity of the air encompassing us the long use of cold meats and drinks and of all such things as are easily corrupted as Summer-fruits crude fishes and lastly the omission of our accustomed exercise The antecedent causes are a great repletion of humors and these especially phlegmatick The conjunct cause is phlegm putrefying in the habit of the body and first region thereof without the great veins The Signs The signs of this Feaver are drawn from three things as first natural for this Feaver or Ague chiefly seizes upon those which are of a cold and moist temper as Old-men Women Children Eunuchs because they have abundance of phlegm and it invades Old-men by its own nature because their native heat being weak they cannot convert their meats then taken in a small quantity How children come to be subject to Quotidian Feavers into laudable bloud and the substance of the parts But it takes children by accident not of its self and their own nature for children are hot and moist but by reason of their voracity or greediness and their violent inordinate and continual motion after their plentiful feeding they heap up a great quantity of crude humors fit matter for this Feaver whereby it comes to pass that fat children are chiefly troubled with this kind of Feaver because they have the passages of their bodies strait and stopped or because they are subject to Worms they are troubled with pain by corruption of their meat whence ariseth a hot distemper by putrefaction and the elevation of putrid vapors by which the heart being molested is easily taken by this kind of feaver From things not natural the signs of this feaver are thus drawn It chiefly takes one in Winter and the Spring in a cold and moist region in a sedentary and idle life by the use of meats not only cold and moist but also hot and dry if they be devoured in such plenty that they overwhelm the native heat How phlegmatick humors happen to be generated by hot and dry meats For thus Wine although it be by faculty and nature hot and dry yet taken too immoderately it accumulates phlegmatick humors and causes cold diseases Therefore drunkenness gluttony crudity bathes and exercises presently after meat being they draw the meats as yet crude into the body and veins and to conclude all things causing much phlegm in us may beget a Quotidian Feaver But by things contrary to nature because this Feaver usually follows cold diseases the Center Circumference and habit of the body being refrigerated The Symptoms of Quotidians The symptoms of this Feaver are the pain of the mouth of the Stomach because that phlegm is commonly heaped up in this place whence follows a vomiting or casting up of phlegm the face looks pale and the mouth is without any thirst oftentimes in the fit it self because the Stomach flowing with phlegm the watery and thinner portion thereof continually flows up into mouth and tongue by the continuity of the inner coat of the ventricle common to the gullet and mouth The manner of the pulse and heat in a Quotidian It takes one with coldness of the extream parts a small and deep pulse which notwithstanding in the vigour of the fit becomes more strong great full and quick Just after the same manner as the heat of this Feaver at the first touch appears mild gentle moist and vaporous but at the length it is felt more acrid no otherwise than fire kindled in green wood which is small weak and smokie at the first but at the length when the moisture being overcome doth no more hinder its action it burns and flames freely Critical sweats The Urin. The Patients are freed from their fits with small sweats which at the first fits break forth very sparingly but more plentifully when the Crisis is at hand the urin at the first is pale and thick and sometimes thin that is when there is obstruction But when the matter is concoct as in the state it is red if at the beginning of the fit they
moderate feeding tending to humidity and indifferent heat for his manner of life let it be quiet and free from all perturbation of anger grief and sadness as also abhorring the use of venery The second is placed in the evacuation of the antecedent matter as by Phlebotomy if need require and by purging by procuring the Haemorrhoids in men and the Courses in women let purgations be prescribed of Diacatholicon Hicra diasenna Polypody Epithymum according to the mind of the learned Physitian The third consists in the convenient use of Topick medicines that is emollient at the beginning and then presently resolving Lib. 2. ad Glauconem or rather such as are mixed both of resolving and emollient faculties as Galen teaches for by the use of only emollient things there is danger of putrefaction and a Cancer and only of resolving there is fear of concretion the subtiler part being resolved and the grosser subsiding Emollients The emollient shall be thus â„ž Rad. alth lib. s rad liliorum â„¥ iij coquantur in aqua com pistentur trajiciantur per setaceum addendo olei chamaem lilior an â„¥ ij oesipi humid â„¥ ss emplastri diachyl alb cum oleo liliorum dissoluti â„¥ iij cerae albae quantum sit satis fiat cerotum Or â„ž gummi ammoniaci galb bdellii styracis liquidae in aceto dissolutorum an â„¥ i diachyl mag â„¥ i ss olei liliorum axungiae anseris an â„¥ i ceroti oesip descriptione Philagr â„¥ ij liquescant omnia simul cerae quantum sit satis ut inde fiat cerotum satis molle When you have sufficiently used emollient things fume the tumor with strong Vinegar and Aqua vitae poured upon a piece of a Milstone Flint or Brick heated very hot for so the mollified humor will be rarified attenuated and resolved then some while after renew your emollients and then again apply your resolvers to wast that which remains which could not be performed together and at once for thus Galen healed a scirrhus in Cercilius his son Goats-dung is very good to discuss Scirrhous tumors Lib. ad Glauc The efficacy of the Empl. of Vigo with Mercury but the Emplaister of Vigo with a double of Mercury is effectual above the rest as that which mollifies resolves and wastes all tumors of this kind CHAP. XXVI Of a Cancer already generated What a Cancer is A Cancer is an hard tumor rough and unequal round immoveable of an ash or livid colour horrid by reason of the veins on every side swollen with black bloud and spread abroad to the similitude of the stretched out legs and claws of a Crab. It is a tumor hard to be known at the first as that which scarse equals the bigness of a Chick or Cicer after a little time it will come to the greatness of a Hasel-nut unless peradventure provoked by somewhat too The figure of the Crab called Cancer in Latin acrid medicins it sodainly increase being grown bigger according to the measure of the encrease it torments the Patient with pricking pain with acrid heat the gross bloud residing in the veins growing hot and inferring a sense like the pricking of Needles from which notwithstanding the Patient hath oft-times some rest The nature of the pain The reason of the name But because this kind of tumor by the veins extended and spread about it like claws and feet being of a livid and ash-colour associated with a roughness of the skin and tenacity of the humor represents as it were the toothed claws of the Crab therefore I thought it not amiss to insert as before the figure of the Crab that so the reason both of the name and thing might be more perspicuous CHAP. XXVII Of the causes kinds and prognosticks of a Cancer HEre we acknowledg two causes of a Cancer the antecedent and conjunct The causes of a Cancer The antecedent cause depends upon the default of irregular diet generating and heaping up gross feculent bloud by the morbifick affection of the Liver disposed to the generation of that bloud by the infirmity or weakness of the Spleen in attracting and purging the bloud by the suppression of the Courses or Haemorrhoids or any such accustomed evacuation The conjunct cause is that gross and melancholick humor sticking and shut in the affected part as in a strait That melancholick bloud which is more mild and less malign The causes of a not ulcerated Cancer only increased by a degree of more fervid heat breeds a not ulcerated Cancer but the more malign and acrid causes an ulcerated For so the humor which generateth Carbuncles when it hath acquired great heat acrimony and malignity corrodes and ulcerates the part upon which it alights A Cancer is made more fierce and raging by meats inflaming the bloud by perturbations of the mind anger heat and medicines too acrid oily and emplastick unfitly applyed both for time and place Amongst the sorts or kinds of Cancers there be two chiefly eminent that is The sorts and differences of Cancers the ulcerated or manifest Cancer and the not ulcerated or occult But of Cancers some possess the internal parts as the Guts Womb Fundament others the external as the Brests also there is a recent or late bred Cancer and also an inveterate one There is one small another great one raging and malign another more mild Every Cancer is held almost incurable or very difficult to be cured for it is a disease altogether malign to wit a particular Leprosie Therefore saith Aetius Aetius lib. 6. The parts most subject to Cancers A Cancer is not easily stayed until it hath eaten even to the innermost of the part which it possesses It invades women more frequently than men and those parts which are lax rare fungous and glandulous and therefore opportune to receive a defluxion of a gross humor such are the brests and all the emunctories of the noble parts When it possesses the brests it often causes inflammation to the Arm-holes and sends the Swelling ever to the glandules thereof whereupon the Patients do complain that a pricking pain even pierces to their hearts But this same pain also runs to the clavicles and even to the inner side of the shoulder-blades and shoulders When it is increased and covers the noble parts it admits no cure but by the hand but in decayed bodies whose strength fail especially if the Cancers be inveterate we must not attempt the cure neither with Instrument nor with Fire neither by too acrid medicines as potential Cauteries but we must only seek to keep them from growing more violent and from spreading further by gentle medicines and a palliative cure For thus many troubled with a Cancer have attained even to old age What Cancers one must not undertake truly to cure Therefore Hippocrates admonishes us that it is better not to cure occult or hidden Cancers for the Patients cured saith he do quickly die but such as are
not cured live longer CHAP. XXVIII Of the Cure of a Cancer beginning and not yet ulcerated A Cancer beginning is oft hindred from encreasing before it fasten it roots but when it hath once encreased it admits no cure but by iron as that which contemns by reason of the malignity and contumacy the force of all medicines Galen affirms Lib. 2. ad Glauc he cured a Cancer not ulcerated Now that cure is performed by medicines purging melancholy by Phlebotomy when the strength and age of the Patient may well endure it by shunning all things which may breed ill and faeculent bloud The distemper of the Liver must first be corrected the Spleen as also the part affected in men the Haemorrhoides in women their Courses must be procured Therefore thick and muddy Wines Vinegar brown Bread cold Herbs old Cheese Diet. old and salted Flesh Beef Venison Goat Hare Garlick Onions and Mustard and lastly all acrid acid and other salt things which may by any means incrassate the bloud and inflame the humors must be eschewed A cooling and humecting dyet must be prescribed fasting eschewed as also watchings immoderate labours sorrow cares and mournings let him use Ptisans and in his Broths boil Mallows Spinace Lettuce Sorrel Purslain Succory Hops Violets Borrage and the four cold seeds But let him feed on Mutton Veal Kid Capon Pullet young Hares Partridges Fishes of Stony-Rivers rear Eggs and use white Wine but moderately for his drink The part affected with the Cancer must be gently handled and not over-burdened by over hard or heavy things How to handle the cancerous part Antidotes Asses-milk or by too solid or fat Emplaisters on the contrary gentle and mitigating medicines must be used applying also at certain times such things as resist venom or poyson as Treacle and Mithridate Asses-milk is exceeding fit to asswage the acrimony of the cancerous humor Therefore it must not only be taken inwardly but also applyed outwardly to the cancerous ulcer making thereof a fomentation CHAP. XXIX Of the cure of an ulcerated Cancer The Signs AN Ulcerated Cancer hath many signs common with that which is not ulcerated as the roundness of the tumor the inequality roughness and pain to the judgment of the eye the tumor seems soft but it is hard to the touch the Ulcer is filthy with lips thick swoln hard knotty turned out and standing up having a horrid aspect and casting forth ichorous filthy and carion-like filth sometimes black sometimes mixed with rotten filth and otherwhiles with much bloud This kind of ulcer is malign rebellious and untractable as that which contemns milde remedies and becomes more fierce by acrid and strong the pain feaver and all the symptoms being increased from whence the powers are dejected the wasting and consumption of the body follows How where a Cancer may be cut away What to be observed in cutting away a Cancer and lastly death Yet if it be small and in a part which may suffer amputation the body being first purged and bloud drawn the strength of the Patient not disswading it will be convenient to use the hand and to take hold of and cut away whatsoever is corrupt even to the quick that no fear of contagion may remain or be left behind The amputation finished the bloud must not be presently stopped but permitted to flow out in some measure yea verily pressed forth all about it that so the veins swoln with black and melancholy bloud may be disburdened The benefit of applying a cautery after amputation of the Cancer When you have taken a sufficient quantity of bloud the place must be seared with an actual cautery For that will strengthen the part affected draw forth the venenate quality and also stay the defluxion Then must you apply mitigating medicines and procure the falling away of the Eschar To conclude that which remains must be performed according to the cure of other Ulcers Signs that a Cancer is well taken away Now we know and understand that all the Cancer is cut away and all the malignity thereof extinct when the ulcer casts forth laudable matter when that good flesh begins to grow by little and little like to the grains of a Pomegranate the pricking pain and all the symptoms being asswaged Yet the cure of an ulcerated Cancer which shall possess the lips may be more happily and mildly performed no caustick medicine being applyed after section so also that scarse any deformity will be left when it is cicatrized Which new and never formerly tryed or written of way as far as I know I found and performed in a man of fifty years old Doctor John Altine a most learned Physitian being called to Counsel James Guillemeau and Master Eustachius the King's Chirurgeons and John Le Jeune the Duke of Guise his most worthy Chirurgeon being present A new and observable way of taking away a Cancer from the lip The way is this The Cancer must be thrust through the lips on both sides above and below with a needle and thred that so you may rule and govern the Cancer with your left hand by the benefit of the thread lest any portion thereof should scape the instrument in cutting and then with your Sizers in the right hand you may cut it off all at once yet it must be so done that some substance of the inner part of the lip which is next to the teeth may remain if so be that the Cancer be not grown quite through which may serve as it were for a foundation to generate flesh to fill up the hollowness again Then when it hath bled sufficiently the sides and brinks of the wound must be scarified on the right and left sides within and without with somewhat a deep scarification that so when we would draw together the sides and lips of the wound by that manner of stitching which is used in an hare-lip we may have the flesh more pliant and tractable to the needle and thred The residue of the cure must be performed just after the same manner as we use in hare-lips of which we shall treat hereafter CHAP. XXX Of the Topick-medicines to be applyed to an ulcerated and not ulcerated Cancer Repelling medicines WE at the beginning use repercussive medicines such as are the juices of Night-shade Plantain Henbane Lettuce Sorrel Houseleek Water Lentil or Ducks-meat Knot-grass Pomegranates and the like Also oleum rosarum Omphacinum the powders of Sumach Berberies Litharge Ceruse Burnt-lead Tutia Quick-silver and the like Of which you may compose fomentations Liniments Ointments Cataplasms Emplaisters Emplastrum Diacalcitheos dissolved with juyce of Night-shade and Oyl of Roses is very fit for not ulcerated Cancers Pompholix or Tutia washed in juyce of Nightshade or Plantain is very good for ulcerated Cancers Besides this following medicine is very commendable â„ž Lytharg cerus an â„¥ i terantur in mortario plumb cum oleo rosar donec reducantur ad consistentiam linimenti
Feaver which happeneth in Scirrhous Tumors Why a Quartain happens upon Scirrhous tumors SUch a Feaver is a Quartain or certainly comming near unto the nature of a Quartain by reason of the nature of the Melancholick humor of which it is bred For this shut up in a certain seat in which it makes the tumor by communication of putrid vapours heats the heart above measure and enflames the humors contained therein whence arises a Feaver Now therefore a Quartain is a Feaver comming every fourth day and having two days intermission The primitive causes thereof are these things which encrease Melancholick humors in the body such as the long eating of pulse of coarse and burnt bread of salt flesh and fish of gross meats as Beef Goat Venison old Hares old Cheese Cabbadge thick and muddy Wines and other such things of the same kind The antecedent causes are heaped up plenty of Melancholick humors abounding over all the body But the conjunct causes are Melancholick humors putrefying without the greater vessels in the small veins and habit of the body The signs We may gather the signs of a Quartain Feaver from things which they call natural not natural and against nature From things natural for a cold and dry temper old age cold and fat men having their veins small and lying hid their Spleen swollen and weak are usually troubled with Quartain Feavers Why they are frequent in Autumn Of things not natural this Feaaer or Ague is frequent in Autumn not only because for that it is cold and dry it is fit to heap up Melancholick humors but chiefly by reason that the humors by the heat of the preceding Summer are easily converted into adust Melancholy whence far worser and more dangerous quartains arise than of the simple Melancholick humor to conclude through any cold or dry season in a region cold and dry men that have the like Temper easily fall into Quartains if to these a painful kind of life full of danger and sorrow doth accrew Of things contrary to nature because the fits take one with painful shaking inferring as it were the sense of breaking or shaking the bones further it taketh one every fourth day with an itching over the whole body and oft-times with a thin skurf and pustules especially on the legs the pulse at the beginning is little slow and deep and the Urin also is then white and waterish inclining to somewhat a dark colour In the declination when the matter is concocted the Urin becomes black not occasioned by any malign Symptom or preternatural excess of heat for so it should be deadly but by excretion of the conjunct matter The Fit of the Quartain continues 24 hours and the intermission is 44 hours At often takes its original from an obstruction pain and Scirrhus of the Spleen and of the suppression of the Courses and Haemorrhoides Prognostick Quartains taken in the Summer are for the most part short but in the Autumn long especially such as continue till Winter Those which come by succession of any disease of the Liver Spleen or any other precedent disease are worse than such as are bred of themselves and commonly end in a Dropsie From what diseases a Quartain frees one But those which happen without the fault of any bowels and to such a Patient as will be governed by the Physitian in his Diet infer no greater harm but free him from more grievous and long diseases as Melancholy the Falling-sickness Convulsion Madness because the Melancholy humor the Author of such diseases is expelled every fourth day by the force of the fit of the Quartain A Quartain Feaver if there be no error committed commonly exceeds not a year for otherwise some Quartains have been found to last to the twelfth year according to the opinion of Avicen the Quartain beginning in Autumn is oft-times ended in the following Spring the Quartain which is caused by adust bloud or choller or Salt-flegm is more easily and sooner cured than that which proceeds from adust Melancholy humor because the Melancholy humor terrestrial of its own nature and harder to be discussed than any other humor is again made by adustion the subtiller parts being dissolved and the grosser subsiding more stubborn gross malign and acrid The cure is wholly absolved by two means that is by Diet and medicines Diet. The diet ought to be prescribed contrary to the cause of the Feaver in the use of the six things not natural as much as lies in our power Wherefore the Patient shall eschew Swines flesh flatulent viscid and glutinous meats fenny Fowls salt Meats and Venison and all things of hard digestion The use of white Wine indifferent hot and thin is convenient to attenuate and incide the gross humor and to move urin and sweat yea verily at the beginning of the fit a draught of such Wine will cause vomitting which is a thing of so great moment that by this one remedy many have been cured Yet if we may take occasion and opportunity to provoke vomit How much Vomiting prevails to cure a Quartain there is no time thought fitter for that purpose then presently after meat for then it is the sooner provoked the fibers of the stomach being humected and relaxed and the Stomach is sooner turned to vomitting whereupon follows a more plentiful happy and easie evacuation of the Phlegmatick and Cholerick humor and less troublesome to nature and of all the crudities with which the mouth of the ventricle abounds in a Quartain by reason of the more copious afflux of the Melancholick humor which by his qualities cold and dry disturbs all the actions and natural faculties Moreover exercises and frictions are good before meat such passions of the mind as are contrary to the cause from which this Feaver takes his original are fit to be cherished by the Patient as Laughter Jesting Musick and all such like things full of pleasure and mirth At the beginning the Patient must be gently handled and dealt withal and we must abstain from all very strong medicins until such time as the disease hath been of some continuance For this humor contumacious at the beginning when as yet nature hath attempted nothing is again made more stubborn terrestrial and dry by the almost fiery heat of acrid medicins If the body abound with bloud some part thereof must be taken away by opening the Median or basilick-Basilick-vein of the left Arm with this caution that if it appear more gross and black we suffer it to flow more plentifully if more thin and tinctured with a laudable and red colour that we presently stay it The matter of this Feaver must be ripened concocted and diminished with the Syrrups of Epithymum of Scolopendrium Medicines of Maiden-hair Agrimony with the waters of Hops Bugloss Borage and the like I sincerely protest next unto God I have cured very many quartains by giving a portion of a little Treacle dissolved in about some
two ounces of Aqua vitae also sometimes by two or three grains of Musk dissolved in Muskadine given at the beginning of a particular fit towards the general declination of the disease after general purgations the humor and body being prepared and the powers strong And certainly an inveterate Quartain can scarse ever be discussed unless the body be much heated with meats and medicines Therefore it is not altogether to be disproved which many say that they have driven away a quartain by taken a draught of Wine every day assoon as they came forth of their beds in which some leaves of Sage had been infused all the night Also it is good a little before the fit to anoint all the Spine of the back with Oyls heating all the nervous parts such as are the Oyl of Rue Walnuts of the Peppers mixing therewith a little Aqua vitae but for this purpose the Oyl of Castoreum which hath been boyled in an Apple of Coloquintida the Kernels taken out upon hot coles to the Consumption of the half part mixing therewith some little quantity of the Powders of Pepper Pellitory of Spain and Euphorbium is excellent Certainly such like Inunctions are good not only to mitigate the vehemency of the terrible shaking but also to provoke sweats for because by their humid heat they discuss this humor being dull and rebellious to the expulsive faculty for the Melancholy is as it were the dross and mud of the bloud Therefore if on the contrary the Quartain Feaver shall be caused by adult choler What quartains must be cured with refrigerating things we must hope for and expect a cure by refrigerating and humective medicins such as Sorrel Lettuce Purslane broths of the decoction of Cowcumbers Gourds Mellons and Pompions For in this case if any use hot medicines he shall make this humor most obstinate by the resolving of the subtiler parts Thus Trallianus boasts that he hath cured these kinds of Quartain Feaver by the only use of refrigerating Epithemaes being often repeated a little before the beginning of the fit And this is the sum of the Cure of true and legitimate intermitting Feavers That is What bastard Agues are and how they must be cured of those which are caused by one simple humor whereby the Cure of those which they call Bastard intermitting Feavers may be easily gathered and understood as which are bred by a humor impure and not of one kind but mixt or composed by admixture of some other matter for example according to the mixture of divers humors Phlegmatick and Cholerick the Medicins must also be mixt as if it were a confused kind of Feaver of a Quotidian and Tertian it must be cured by a medicin composed of things evacuating flegm and choler CHAP. XXXII Of an Aneurisma that is the dilatation or springing of an Artery Vein or Sinew AN Aneurisma is a soft tumor yielding to the touch What it is made by the bloud and spirit poured forth under the flesh and Muscles by the dilatation or relaxation of an Artery Yet the Author of the definitions seems to call any dilatation of any veinous vessel by the name or an Aneurisma Galen calls an Aneurisma An opening made of the Anatomists of an Artery Also an Aneurisma is made when an Artery that is wounded closeth too slowly the substance which is above it being in the mean time agglutinated filled with flesh and cicatrized which doth not seldom happen in opening of Arteries unskilfully performed and negligently cured therefore Aneurisma's are absolutely made by the Anastomôsis In what parts they chiefly happen springing breaking Erosion and wounding of the Arteries These happen in all parts of the body but more frequently in the Throat especially in women after a painful travail For when as they more strongly strive to hold their breath for the more powerful expulsion of the birth it happens that the Artery is dilated and broken whence follows an effusion of bloud and spirits under the skin The signs are a swelling one while great another small with a pulsation and a colour not varying from the native constitution of the skin It is a soft tumor and so yielding to the impression of the fingers that if it paradventure be small it wholly vanisheth the Arterious bloud and spirits flying back into the body of the Artery but presently assoon as you take your fingers away they return again with like celerity Some Aneurismaes do not only when they are pressed but also of themselves make a sensible hissing if you lay your ear near to them by reason of the motion of the vital spirit rushing with great violence through the straitness of the passage Prognostick Wherefore in Aneurismaes in which there is a great rupture of the Artery such a noise is not heard because the spirit is carryed through a larger passage Great Aneurismaes under the Arm-pits in the Groins and other parts wherein there are large vessels admit no cure because so great an eruption of bloud and spirit often follows upon such an Incision that death prevents both Art and Cure A History Which I observed a few years ago in a certain Priest of Saint Andrews of the Arches Mr. John Maillet dwelling with a chief President Christopher de Thou Who having an Aneurisma at the setting on of the shoulder about the bigness of a Wall-nut Aneurismaes must not rashly be opened I charged him he should not let it be opened for if he did it would bring him into manifest danger of his life and that it would be more safe for him to break the violence thereof with double clothes steeped in the juyce of Night-shade and Housleek with new and wheyey cheese mixt therewith Or with Unguentum de Bolo or Emplastrum contra rupturam and such other refrigerating and astringent medicines if he would lay upon it a thin plate of Lead and would use shorter breeches that his doublet might serve to hold it too to which he might fasten his breeches in stead of a swathe and in the mean time he should eschew all things which attenuate and inflame the bloud but especially he should keep himself from all great straining of his voyce Although he had used his dyet for a year yet he could not so handle the matter but that the tumor increased which he observing goes to a Barber who supposing the tumor to be of the kind of vulgar Impostumes applyes to it in the Evening a Caustick causing an Eschar so to open it In the Morning such an abundance of bloud flowed forth from the tumor being opened that he therewith astonished implores all possible aid and bids that I should be called to stay this his great bleeding and he repented that he had not followed my direction Wherefore I was called but when I was scarse over the threshold How they must be cured he gave up his ghost with his bloud Wherefore I diligently admonish the Chirurgeon that he do not rashly
open Aneurismaes unless they be smal in an ignoble part not indued with large vessels but rather let him perform the cure after this manner Cut the skin which lies over it until the Artery appear and then separate it with your knife from the particles about it then thrust a blunt and crooked needle with a thred in it under it bind it then cut it off and so expect the falling off of the thread of it self whiles Nature covers the orifices of the cut Artery with the new flesh then the residue of the cure may be performed after the manner of simple wounds Those of the inward parts incurable The Aneurismaes which happen in the internal parts are incurable Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease because being so attenuated and heated therewith that it cannot be contained in the receptacles of the Artery it distends it to that largeness as to hold a man's Fist Which I have observed in the dead body of a certain Taylor who by an Aneurisma of the Arterious vein suddenly whilst he was playing at Tennis fell down dead A History and vessel being broken his body being opened I found a great quantity of bloud poured forth into the capacity of the Chest but the body of the Artery was dilated to that largness I formerly mentioned and the inner coat thereof was boney For which cause within a while after I shewed it to the great admiration of the beholders in the Physitians School whilest I publiquely dissected a body there whilst he lived he said he felt a beating and a great heat over all his body the force of the pulsation of all the Arteries by the occasion whereof he often swounded Doctor Sylvius the Kings Professor of Physick at that time forbad him the use of Wine and wished him to use boyled water for his drink and Curds and new Cheeses for his meat and to apply them in form of Cataplasms upon the grieved and swoln part At night he used a Ptisan of Barly meal and Poppy-seeds and was purged now and then with a Clyster of refrigerating and emollient things or with Cassia alone by which medicines he said he found himself much better The cause of such a bony constitution of the Arteries by Aneurismaes is for that the hot and fervid bloud first dilates the Coats of an Artery then breaks them which when it happens it then borrows from the neighbouring bodies a fit matter to restore the loosed continuity thereof This matter whilest by little and little it is dryed and hardened it degenerates into a gristly or else a bony substance just by the force of the same material and efficient causes by which stones are generated in the reins and bladder For the more terrestrial portion of the bloud is dryed and condensed by the power of the unnatural heat contained in the part affected with an Aneurisma whereby it comes to pass that the substance added to the dilated and broken Artery is turned into a body of a bony consistence In which the singular providence of Nature the Hand-maid of God is shewed as that which as it were by making and opposing a new wall or bank would hinder and break the violence of the raging bloud swelling wich the abundance of the vital spirits unless any had rather to refer the cause of that hardness to the continual application of refrigerating and astringent medicines Which have power to condensate and harden Lib 4. cap. ult de praesaex pulsu A Caution in the knowing Aneurismaes as may not obscurely be gathered by the writings of Galen But beware you be not deceived by the fore-mentioned signs for sometimes in large Aneurismaes you can perceive no pulsation neither can you force the bloud into the Artery by the pressure of your fingers either because the quantity of such bloud is greater than which can be contained in the Ancient receptacles of the Artery or because it is condensate and concrete into clods whereupon wanting the benefit of ventilation from the heart it presently putrefies Thence ensue great pain a Gangrene and mortification of the part and lastly the death of the Creature The End of the Seventh Book The Eighth BOOK Of Particular TVMORS against NATVRE The Preface BEcause the Cure of Diseases must be varyed according to the variety of the temper not only of the body in general but also of each part thereof the strength figure form site and sense thereof being taken into consideration I think it worth my pains having already spoken of Tumors in general if I shall treat of them in particular which affect each part of the body beginning with those which assail the head Therefore the Tumor either affects the whole head or else only some particle thereof as the Eyes Ears Nose Gums and the like Let the Hydrocephalos and Physocephalos be examples of those tumors which possess the whole head CHAP. I. Of an Hydrocephalos or watry tumor which commonly affects the heads of Infants THe Greeks call this Disease Hydrocephalos as it were a Dropsie of the Head What it is The causes by a waterish humor being a disease almost peculiar to Infants newly born It hath for an external cause the violent compression of the head by the hand of the Midwife or otherwise at the birth or by a fall contusion and the like For hence comes a breaking of a vein or artery an effusion of the bloud under the skin Which by corruption becoming whayish lastly degenerateth into a certain waterish humor It hath also an inward cause which is the abundance of serous and acrid bloud which by its tenuity and heat sweats through the pores of the vessels sometimes between the Musculous skin of the head and the Pericranium sometimes between the Pericranium and the skull and sometimes between the skull and membrane called Dura mater Differences by reason of place and otherwhiles in the ventricles of the Brain The signs of it contained in the space between the Musculous skin and the Pericranium Signs are a manifest tumor without pain soft and much yielding to the pressure of the fingers The Signs when it remaineth between the Pericranium and the skull are for the most part like the fore-named unless it be that the Tumor is a little harder and not so yielding to the finger by reason of the parts between it and the finger And also there is somewhat more sense of pain But when it is in the space between the skull and Dura-mater or in the ventricles of the Brain or of the whole substance thereof there is a dulness of the senses as of the sight and hearing the tumor doth not yield to the touch unless you use strong impression for then it sinketh somewhat down especially in Infants newly born who have their skuls almost as soft as wax and the junctures of their Sutures lax both by nature as also
Iron so thrust into a Trunk or Pipe with an hole in it that so no sound part of the mouth may be offended therewith A hollow Trunk with a hole in the side with the hot Iron inserted or put therein CHAP. VIII Of the Angina or Squinzy What it is THe Squinancy or Squincy is a Swelling of the jaws which hinders the entring of the ambient air into the Weazon and the vapours and the spirit from passage forth and the meat also from being swallowed The differences There are three differences thereof The first torments the Patient with great pain no swelling being outwardly apparent by reason the Morbisick humor lyes hid behind the Almonds or Glandules at the Vertebrae of the Neck The first kind so that it cannot be perceived unless you hold down the Tongue with a Spatula or the Speculum oris for so you may see the redness and tumor there lying hid The Symptoms The Patient cannot draw his breath nor swallow down meat nor drink his tongue like a Gray-hound's after a course hangs out of his mouth and he holds his mouth open that so he may the more easily draw his breath to conclude his voyce is as it were drown'd in his jaws and nose he cannot lye upon his back but lying is forced to sit so to breathe more freely and because the passage is stopt the drink flies out at his Nose the Eyes are fiery and swollen and standing out of their orb Those which are thus affected are often sodainly suffocated a foam rising about their mouths The second kind The second difference is said to be that in which the tumor appears inwardly but little or scarse any thing at all outwardly the Tongue Glandules and Jaws appearing somewhat swollen The third The third being least dangerous of them all causes a great swelling outwardly but little inwardly The Causes The Causes are either Internal or External The External are a stroak splinter or the like thing sticking in the Throat or the excess of extreme cold or heat The Internal causes are a more plentiful defluxion of the humors either from the whole body or the Brain which participate of the nature either of bloud choler or flegm but seldom of Melancholy The signs by which the kind and commixture may be known have been declared in the general Treatise of Tumors The Squincy is more dangerous by how much the humor is less apparent within and without That is less dangerous which shews it self outwardly because such an one shuts not up the wayes of the meat nor breath Some dye of a Squincy in twelve hours others inâ—â—o four or seven days Hip. sect 3. proe 2. Apâ—â—r 10 sect 5. Those saith Hippocrates which scape the Squincy the disease passes to the Lungs and they dye within seven dayes but if they scape these days they are suppurated but also oftentimes this kind of disease is terminated by disappearing that is by an obscure reflux or the humor into some noble part as into the Lungs whence the Emprema proceeds and into other principal parts whose violating brings inevitable death sometimes by resolution otherwise by suppuration The way of resolution is the more to be desired it happens when the matter is small and that subtle especially if the Physitian shall draw bloud by opening a vein and the Patient use fitting Gargarisms A Critical Squincy divers times proves deadly by reason of the great falling down of the humor upon the throttle by which the passage of the breath is sodainly shut up Broths must be used made with Capons and Veal seasoned with Lettuce Purslain Sorrel and the cold Seeds If the Patient shall be somewhat weak let him have potched Egges and Barly Creams Diet. the Barly being somewhat boyled with Raisons in Water and Sugar and other meats of this kind Let him be forbidden Wine in stead whereof he may use Hydromelita and Hydrosachara that is drinks made of Water and Honey or Water and Sugar as also Syrups of dryed Roses of Violets Sorrel and Limmons and others of this kind Let him avoid too much sleep But in the mean time the Physitian must be careful of all because this disease is of their kind which brook no delayes Wherefore let the Basilica be presently opened on that side the tumor is the greater Cure then within a short time after the same day for evacuation of the conjunct matter let the vein under the tongue be opened let Cupping-Glasses be applyed sometimes with scarification sometimes without to the neck and shoulders and let frictions and painful ligatures be used to the extreme parts But let the humor impact in the part be drawn away by Clysters and sharp Suppositories Repelling Gargarisms Whilst the matter is in defluxion let the mouth without delay be washed with astringent Gargarisms to hinder the defluxion of the humor lest by its sodain falling down it kill the Patient as it often happens all the Physitians care and diligence notwithstanding Therefore let the mouth be frequently washed with Oxycrate or such a Gargarism â„ž Pomorum sylvest nu iiij sumach Rosar rub an m. ss berber Ê’ ij let them be all boyled with sufficient quantity of water to the consumption of the half adding thereunto of the Wine of sour Pomgranats â„¥ iiij of Diamoron â„¥ ij let it be a little more boyled and make a gargle according to Art And there may be other Gargarisms made of the waters of Plantain Night-shade Verjuyce Julep of Roses and the like But if the matter of the defluxion shall be Phlegmatick Alum Pomgranat-pill Cypress-nuts and a little Vinegar may be safely added But on the contrary Repercussives must not be outwardly applyed but rather Lenitives whereby the external parts may be relaxed and rarified and so the way be open either for the diffusing or resolving the portion of the humor You shall know the humor to begin to be resolved if the Feaver leave the Patient if he swallow speak and breathe more freely if he sleep quietly and the pain begin to be much asswaged Ripening Gargarisms Therefore then Nature's endeavour must be helped by applying resolved medicines or else by using suppuratives inwardly and outwardly if the matter seem to turn into Pus Therefore let Gargarisms be made of the roots of March-Mallows Figs Jujubes Damask-Prunes Dates perfectly boyled in water The like benefit may be had by Gargarisms of Cows-milk with Sugar by Oyl of Sweet-Almonds or Violets warm for such things help forward suppuration and asswage pain let suppurating Cataplasms be applyed outwardly to the neck and throat and the parts be wrapped with wooll moistned with Oyl of Lillies When the Physitian shall perceive that the humor is perfectly turned into pus let the Patients mouth be opened with the Speculum oris and the abscess opened with a crooked and long Incision-knife then let the mouth be now and then washed with cleansing Gargles as â„ž Aquae hordei
lib. ss mellis ros syr rosar sic an Detergent Gargarisms â„¥ i fiat gargarisma Also the use of oenomel that is Wine and Hony will be fit for this purpose The Ulcer being cleansed by these means let it be cicatrized with a little Roch-Alum added to the former Gargarisms The Figure of an Incision-Knife opened out of the hast which serves for a sheath thereto CHAP. IX Of the Bronchocele or Rupture of the Throat The reason of the name THat which the French call Goetra that the Greeks call Bronchocele the Latins Gutturis Hernia that is the Rupture of the Throat For it is a round tumor of the Throat the matter whereof comming from within outwards is contained between the skin and weazon it proceeds in women from the same cause as an Aneurisma The differences But this general name of Bronchocele undergoes many differences for sometimes it retains the nature of Melicerides other-whiles of Steatoma's Atheroma's or Aneurisma's in some there is found a fleshy substance having some small pain some of these are small others so great that they seem almost to cover all the Throat some have a Cist or bag others have no such thing all how many soever they be and what end they shall have may be known by their proper signs these which shall be curable may be opened with an actual or potential cautery or with an Incision-knife The Cure Hence if it be possible let the matter be presently evacuated but if it cannot be done at once let it be performed at divers times and discussed by fit remedies and lastly let the ulcer be consolidated and cicatrized CHAP. X. Of the Pleurisie What it is THe Pleurisie is an inflammation of the membrane investing the ribs caused by subtile and cholerick bloud springing upwards with great violence from the hollow vein into the Azygos Of a Pleurifie coming to suppuration and thence into the intercostal veins and is at length poured forth into the empty spaces of the intercostal muscles and the mentioned membrane Being contained there if it tend to suppuration it commonly infers a pricking pain a Feaver and difficulty of breathing This suppurated bloud is purged and evacuated one while by the mouth the Lungs sucking it and so casting it into the Weazon and so into the mouth otherwhiles by Urin and sometimes by Stool Of the change thereof into an Empyema But if nature being too weak cannot expectorate the purulent bloud poured forth into the capacity of the chest the disease is turned into Empyema wherefore the Chirurgeon must then be called who beginning to reckon from below upwards may make a vent between the third and fourth true and legitimate ribs Of the apertion of the side in an Empyema and that must be done either with an actual or potential cautery or with a sharp knife drawn upwards towards the back but not downwards lest the vessels should be violated which are disseminated under the rib This apertion may be safely and easily performed by this actual cautery it is perforated with four holes through one whereof there is a pin put higher or lower according to the depth and manner of your Incision then the point thereof is thrust through a plate of Iron perforated also in the midst into the part designed by the Physitian lest the wavering hand might peradventure touch and so hurt the other parts not to be medled withall The same plate must be somewhat hollowed that so it might be more easily fitted to the gibbous side and bound by the corners on the contrary side with four strings Wherefore I have thought good here to express the figures thereof The Figure of an actual Cautery with its Plate fit to be used in a Pleurisie But if the Patient shall have a large Body Chest and Ribs you may divide and perforate the Ribs themselves with a Trepan howsoever the apertion be made the pus or matter must be evacuated by little and little at several times and the capacity of the Chest cleansed from the purulent matter by a detergent injection of vi ounces of Barley-water and â„¥ ij Honey of Roses and other the like things mentioned at large in our cure of Wounds CHAP. XI Of the Dropsie THe Dropsie is a Tumor against nature by the aboundance of waterish humor What the Dropsie is of statulencies or Phlegm gathered one while in all the habit of the body otherwhiles in some part and that especially in the capacity of the belly between the Peritonaeum and entrails From this distinction of places and matters there arise divers kinds of Dropsies First that Dropsie which fils that space of the belly is either moist or dry The moist is called the Ascites by reason of the similitude it hath with a leather-bottle or Borachio The differences thereof because the waterish humor is contained in that capacity as it were in such a vessel The dry is called the Tympanites or Tympany by reason the belly swollen with wind sounds like a Tympanum that is a Drum But when the whole habit of the body is distended with a phlegmatick humor it is called Anasarca or Leucophlegmatia In this last kind of Dropsie the lower parts first swell as which by reason of their site are most subject to receive defluxions The Symptomes and more remote from the fountain of the native heat wherefore if you press them down the print of your finger will remain sometime after the patients face will become pale and puffed up whereby it may be distinguished from the two other kinds of Dropsie For in them first the belly then by a certain consequence the thighs and feet do swell There are besides also particular Dropsies contained in the strait bounds of certain places such are the Hydrocephalos in the head the Bronchocele in the throat the Pleurocele in the Chest the Hydrocele in the Scrotum or Cod The Causes and so of the rest Yet they all arise from the same cause that is the weakness or defect of the altering or concocting faculties especially of the liver which hath been caused by a Scirrhus or any kind of great distemper chiefly cold whether it happen primarily or secondarily by reason of some hot distemper dissipating the native and inbred heat such a Dropsie is uncurable or else it comes by consent of some other higher or lower part for if in the Lungs Midriff or Reins there be any distemper or disease bred it is easily communicated to the gibbous part of the Liver by the branches of the hollow vein which run thither But if the mischief proceed from the Spleen Stomach Mesentery How divers diseases turn into Dropsies Guts especially the jejunum and Ileum it creeps into the hollow side of the liver by the meseraick veins and other branches of the Vena porta or Gate-vein For thus such as are troubled with the Asthma Ptisick Spleen Jaundise and also the Phrensie fall into a Dropsie
by amputation or cutting it away but you must diligently observe that the flesh be not grown too high and have already seized upon the groin for so nothing can be attempted without the danger of life But if any man think that he in such a case may somewhat ease the Patient by the cutting away of some portion of this same soft flesh The Cure he is deceived For a Fungus will grow if the least portion thereof be but left being an evil far worse than the former but if the Tumor be either small or indifferent the Chirurgeon taking the whole tumor that is the testicle tumified through the whole substance with the process incompassing it and adhering thereto on every side and make an Incision in the Cod even to the tumor then separate all the tumid body that is the Testicle from the Cod then let him thrust a needle with a strong thred in it through the midst of the process above the region of the swoln testicle and then presently let him thrust it the second time through the same part of the process then shall both the ends of the Thred be tied on a knot the other middle portion of the Peritonaeum being comprehended in the same knot This being done he must cut away the whole process with the testicle comprehended therein But the ends of the thred with which the upper part of the process was bound must be suffered to hang some length out of the wound or Incision of the Cod. Then a repercussive medicine shall be applyed to the wound and the neighbouring parts with a convenient ligature And the cure must be performed as we have formerly mentioned What a Cirsocele is The Cirsocele is a tumor of veins dilated and woven with a various and mutual implication about the Testicle and Cod and swelling with a gross and melancholy bloud The causes are the same as those of the Varices But the signs are manifest The Cure To heal this Tumor you must make an Incision in the Cod the bredth of two fingers to the Varix Then put under the Varicous vein a Needle having a double thred in it as high as you can that you may bind the roots thereof then let the Needle be again put after the same manner about the lower part of the same vein leaving the space of two fingers between the ligatures But before you bind the thred of this lowest ligature the Varix must be opened in the midst almost after the same manner as you open a vein in the arm to let bloud That so this gross Bloud causing a Tumor in the Cod may be evacuated as is usually done in the cure of the Varices The wound that remains shall be cured by the rules of Art after the manner of other wounds leaving the threds in it which presently fall away of themselves To conclude then it being grown callous especially in the upper part thereof where the vein was bound it must be cicatrized for so afterwards Bloud cannot be strained or run that way Hernia Humoralis Hernia Humoralis is a tumor generated by the confused mixture of many humors in the Cod or between the Tunicles which involve the Testicles often also in the proper substance of the Testicles It hath like causes signs and cures as other Tumors While the cure is in hand Rest Trusses and fit Rowlers to sustain and bear up the Testicles are to be used CHAP. XVIII Of the falling down of the Fundament WHen the Muscle called the Sphincter which ingirts the Fundament is relaxed The causes then it comes to pass that it cannot sustain the right gut This disease is very frequent to Children by reason of the too much humidity of the Belly which falling down upon that Muscle mollifieth and relaxeth it or presseth it down by an unaccustomed weight so that the Muscles called Levatores Ani or the lifters up of the Fundament are not sufficient to bear up any longer A great Bloudy-flux gives occasion to this effect A strong endevour to expel hard excrements the Haemorrhoids which suppressed do over-load the right gut but flowing relax it Cold as in those which go without Breeches in Winter or sit a long time upon a cold Stone a stroak or fall upon the Holy-bone a Palsie of Nerves which go from the Holy-bone to the Muscles the lifters up of the Fundament the weight of the Stone being in the Bladder That this Disease may be healed we must forbid the Patient too much drinking The cure too often eating of Broth and from feeding on cold Fruits For local medicines the part must be fomented with an astringent decoction made of the rinds of Pomegranats Galls Myrtles Knotgrass Shepherds-purse Cypress Nuts Alum and common Salt boyled in Smiths-water or Red-wine After the fomentation let the Gut be anointed with Oyl of Roses or Myrtles and then let it be gently put by little and little into its place charging the Child if he can understand your meaning to hold his breath When the Gut shall be resotred the part must be diligently wiped lest the Gut fall down again by reason of the slipperiness of the unction Then let the powder prescribed for the falling down of the Womb be put into the Fundament as far as you can Then you must straitly bind the Loins with a swathe to the midst whereof behind let another be fastned which may be tied at the Pubes coming along the Peritonaeum so to hold up the Fundament the better to contain it in its place a Spunge dipt in the astringent decoction The Patient if he be of sufficient age to have care of himself shall be wished when he goes to Stool that he sit upon two pieces of wood being set some inch a sunder lest by his straining he thrust forth the Gut together with the excrement but if he can do it standing he shall never by straining thrust forth the Gut But if the Gut cannot by the prescribed means be restored to its place Hippocrates hiâ— cure Hippocrates bids that the Patient hanging by the heels be shaken for so the Gut by that shaking will return to his place but the same Hippocrates wisheth to anoint the Fundament because that remedy having a drying faculty hath also power to resolve the flatulent humors without any acrimony by reason of which the Gut was the less able to be contained in his place CHAP. XIX Of the Paronychia THe Paronychia or Panaris is a tumor in the ends of the fingers with great inflammation What the Paronychia is coming of a malign and venemous humor which from the Bones by the Periosteum is communicated to the Tendons and Nerves of that part which it affecteth whereof cruel symptoms do follow as pulsifique pain a Feaver restlesness so that the affected through impatiency of the pain are variously agitated like those tormented with Carbuncles for which cause Guido and Johannes de Vigo judge this disease to be
with sense and life but this Dracunculus when he is drawn too violently especially if he be broken thereby will cause extream pain We do answer that the conclusion doth not follow and is of no consequence for these pains happen not unless when the unprovident Surgion draws or puls in stead of the Dracunculus some nervous or membranous body swoln and repleat with an adust humor whence there cannot but be great pain that part being pull'd which is the author of sense But it is childish to say that the Dracunculus feels for that it causeth sharp pains to the living body in which it is Therefore that at last we may determin something of the nature essence and generation of these Dracunculi I dare boldly affirm It is nothing else but a tumor and abcess bred from the heat of the blood in a venerate kind Such blood driven by the expulsive faculty through the veins to the External parts especially the limits that is the Arms and Legs causeth a tumor round and long often stretched from the joynt of the shoulder even to the wrist or from the groin even to one of the Ankles with tension heat renitency pricking pain and a feaver But this tumor is some while stretched forth streight otherwhiles into oblique and crooked tumors which hath been the cause that many taken with this kind of disease and having their limbs so infolded as with the twinings of a Serpent would say they had a Serpent I have thus much to say of the Dracunculi especially of those of our own country For the cure it is not unlike to the cure of a Phlegmon arising from a Defluxion The Cure for here also in like manner the remedies must be varied according to the four times of the disease and the same rule of diet phlebotomy and purging must be observed which is before prescribed in the cure of a Phlegmon The mention of the Dracunculi cals to my memory another kind of Abscesse altogether as rare So the Malum pilate in Aristotle cap. 11. lib. 7. hist animal This our French men name Cridones I think á Crinibus i. from hayrs it chiefly troubles children and pricks their backs like thorns They toss up and down being not able to take any rest This disease ariseth from small hairs which are scarce of a pins length but those thick and strong It is cured with a fomentation of water more than warm after which you must presently apply an oyntment made of hony and wheaten flower for so these hairs lying under the skin are allured and drawn forth and being thus drawn they must be plucked out with small mullets I imagine this kind of disease was not known to the ancient Physitians The End of the Eighth Book The Ninth BOOK Of WOVNDS in General CHAP. I. What a wound is what the kinds and differences thereof are and from whence they may be drawn or derived A Wound is a solution of Continuity caused by a stroak fall or bite newly done What a wound properly is bloody and with putrefaction and filth They also call it a new simple Ulcer for the solution of continuity happens to all parts of the body but according to the diversity of parts it hath divers names amongst the Greeks For in the flesh it is called Helcos in the bone Catagma in the nerve Spasma in the ligament Thalasma in the vessels Apospasma in the Muscles Regma and that solution of continuity Divers appellations of wounds according to the varieties of the parts which happens in the vessels their mouths being open is termed Anastomosis that which happens by erosion Aneurosis that which is generated by sweating out and transcolation Diapedesis That these may be the more easily understood I have thought good to describe them in the following table A Table of the Differences of Wounds The differences of Wounds are drawn or taken From the nature of the parts in which they are made or happen But these parts are Either similar and these Either soft as the Glandules Flesh Fat Marrow Or hard as A Bone A Gristle Or of a midle consistence as the Membranes Ligaments Fibers Vessels Nerves Veins Arteries Or Organical and these either Principal as the Brain Heart Liver to which some add the Womb and Testicles Or serving the principal as The Weason Lungs Gullet Stomach Guts Bladder Or neither as The Ears Nose Feet Hands and other of the same kind From their proper essence from whence they are called Simple wounds When there is no complication of any other disease or symptom besides Or compound When there is a complication of some one or more diseases which unless they be taken away we must not hope for to cure the wound From their quantity according to which they are called Great Indifferent Little Long broad Deep Short Narrow Superficiary From their figure according to which they are named Streight Oblique Cornered CHAP. II. Of the Causes of Wounds Divers denominations from their causes ALl things which may outwardly assail the body with force and violence may be counted the causes of wounds which are called green and properly bloudy These things are either animate or inanimate The animate as the bitings and prickings of Beasts The Inanimate as the stroak of an Arrow Sword Club Gun Stone a Dagger and all such like things From the variety of such like causes they have divers names for those which are made by sharp and pricking things are called punctures those caused by cutting things are called wounds or gashes and those which are made by heavy and obtuse things are named Contusions or wounds with contusions CHAP. III. Of the Signs of Wounds WOunds are first known by sight and by the signs drawn from thence A caution for making reports of Wounds The Chirurgeon ought first and chiefly to consider what Wounds are curable and what not what wounds will scarse admit of cure and what may be easily cured for it is not the part of a prudent Chirurgeon to promise cure in a deadly or dangerous and difficult wound lest he may seem to have killed him whom not the unsufficiency of the Art but the greatness of the wound hath slain But when the wound is dangerous but yet without despair of recovery it belongs to him to admonish the Patient's friends which are by of the present danger and doubtful state of the wound that if Art shall be overcome by the greatness thereof he shall not be thought ignorant of the Art neither to have deceived them But as this is the part and duty of a good and prudent Chirurgeon A Jugling cheating Chirurgeon so it is the trick of a cheating and jugling Knave to enlarge small wounds that so he may seem to have done a great cure when it is nothing so But it is agreeable to reason that the Chirurgeon professing the disease easie to be cured will think himself in credit bound by such promises and his duty and therefore seek
all means for the quick recovery of the Patient lest that which was of its own nature small may by his negligence become great Therefore it is expedient he should know what wounds are to be accounted great This as Galen saith is three ways to be known The first is by the magnitude and principality of the part affected for thus the wounds of the Brain Heart and of the greater vessels Lib. 4. Meth. cap. 6.1 though small of themselves yet are thought great Wounds are called Great out of three respects Then from the greatness of the solution of continuity for which cause wounds may be judged great in which much of the substance of the part is lost in every dimension though the part be one of these which are accounted servile Then from the malignity through which occasion the wounds of the joynts are accounted great because for the most part they are ill conditioned CHAP. IV. Of Prognosticks to be made in Wounds THose Wounds are thought dangerous wherein any large Nerve vein or Artery are hurt What wounds are dangerous From the first there is fear of Convulsion but from the other large effusion of the veinous or arterious bloud whence the powers are debilitated also these are judged evil which are upon the Arm-pits groins leggs joynts and between the fingers and likewise those which hurt the head or tail of a Muscle They are lest dangerous of all other which wound only the fleshy substance But they are deadly which are inflicted upon the Bladder Brain Heart Liver Lungs Stomach and small guts But if any Bone Gristle Nerve or portion of the cheek What least dangerous What deadly Hip. aphor 19. Lib. 6. or prepuce shall be cut away they cannot be restored Contused wounds are more difficult to cure than those which are from a simple solution of continuity for before you must think to heal them up you must suppurate and cleanse them which cannot be done in a short time Wounds which are round and circular are so much the worse for there can be no unity unless by an angle that is a meeting together of two lines which can have no place in round wounds because a circular figure consists of one oblique line Besides wounds are by so much thought the greater by how much their extreams and lips are the further disjoyned which happens to round wounds Why round Wounds are difficult to heal Contrary to these are cornered wounds or such as are made alongst the fibers as such as may be healed Wounds may be more easily healed in young men than in old because in them Nature is more vigorous and there is a greater plenty of fruitful or good bloud by which the loss of the flesh may be the better and more readily restored which is slowlier done in old bodies by reason their bloud is smaller in quantity and more dry and the strength of nature more languid Wounds received in the Spring Hip. lib. de ulcer Hip. aph 66. lib. 5. are not altogether so difficult to heal as those taken in Winter or Summer For all excess of heat and cold is hurtful to them it is ill for a Convulsion to happen upon a Wound for it is a sign that some Nervous body is hurt the Brain suffering together therewith as that which is the original of the Nerves A Tumor coming upon great wounds is good for it shews the force of nature is able to expel that which is harmful and to ease the wounded part The organical parts wholly cut off cannot again be united because a vital part once severed and plucked from the trunk of the body cannot any more receive influence from the heart as from a root without which there can be no life The loosed continuity of the Nerves Veins Arteries and also the Bones is sometimes restor'd not truly and as they say according to the first intention but by the second that is by reposition of the like but not of the same substance The first intention takes place in the fleshy parts by converting the Alimentary bloud into the proper substance of the wounded part But the second in the spermatique in which the lost substance may be repaired by interposition of some heterogeneous body which nature diligent for its own preservation substitutes in place of that which is lost for thus the body which restores and agglutinates What a Callus is and whence it proceeds is no Bone but a Callus whose original matter is from an humor somewhat grosser than that from whence the Bones have their original and beginning This humor when it shall come to the place of the fracture agglutinateth the ends of the Bones together which otherwise could never be so knit by reason of their hardness The Bones of Children are more easily and speedily united by reason of the pliantness of their soft and tender substance Small and contemptible Wounds often prove mortal Aphor. 1. sect 1. Lastly we must here admonish the Chirurgeon that small Wounds and such as no Artisan will judg deadly do divers times kill by reason of a certain occult and ill disposition of the wounded and incompassing Bodies for which cause we read it observed by Hippocrates that it is not sufficient for the Physitian to perform his duty but also external things must be rightly prepared and fitted CHAP. V. Of the Cure of Wounds in general The general Indication of Wounds THe Chirurgeon ought for the right cure of wounds to propose unto himself the common and general indication that is the uniting of the divided parts which indication in such a case is thought upon and known even by the vulgar for that which is dis-joyned desires to be united because union is contrary to division But by what means such union may be procured is only known to the skilful Artisan Therefore we attain unto this chief and principal Indication by the benefit of Nature as it were the chief Agent and the work of the Chirurgeon as the servant of Nature And unless Nature shall be strong the Chirurgeon shall never attain to his conceived and wished for end therefore that he may attain hereto he must perform five things Five things necessary for uniting wounds the first is that if there be any strange Bodies as pieces of Wood Iron Bones bruised Flesh congealed Bloud or the like whether they have come from without or from within the Body and shall be by accident fastened or stuck in the wound he must take them away for otherwise there is no union to be expected Another is that he joyn together the lips of the Wound for they cannot otherwise be agglutinated and united The third is that he keep close together the joyned lips The fourth that he preserve the temper of the wounded part for the distemper remaining it is impossible to restore it to its unity The fifth is that he correct the accidents if any shall happen because these urging
But it is only required in great Wounds where there is fear of defluxion pain Delirium Raving and unquietness and lastly in a Body that is Plethorick and when the joynts tendons or nerves are wounded Gentle purgations must be appointed because the humors are moved and inraged by stronger whence there is danger of defluxion and inflammation wherefore nothing is to be attempted in this case without the advice of a Physitian The Topick and particular Medicines are Agglutinative What medicines are to be judged agglutinative which ought to be indued with a drying and astrictive quality whereby they may hold together the lips of the wound and drive away defluxion having always regard to the nature of the part and the greatness of the disease The Simple Medicines are Olibanum Aloes Sarcocolla Bole-Armenick Terra sigillata Sanguis Draconis Common Venice Turpentine Gum Elemni Plantane Horse-tail the greater Comfry Parina Volatilis many other things of this kind which we shall speak of hereafter in our Antidotary The fifth scope of healing Wounds is the correction of those Symptoms or Accidents which are accustomed to follow Wounds which thing verily makes the Chirurgeon have much to do For as he is often forced to omit the proper cure of the disease so to resist the accidents and symptoms as Bleeding Pain Inflammation a Feaver Convulsion Palsie talking Idly or distraction and the like Of which we shall treat briefly and particularly after we have first spoken of Sutures as much as we shall think sitting for this place CHAP. VI. Of Sutures WHen Wounds are made alongst the Thighs Legs and Arms they may easily want Sutures because the Solution of continuity is easily restored by Ligatures What wounds stand in no need of a Suture but when they are made overthwart they require a Suture because the flesh and all such like parts being cut are drawn towards the sound parts whereby it comes to pass that they part the further each from other wherefore that they may be joyned and so kept they must be sewed and if the Wound be deep you must take up much flesh with your Needle for if you only take hold of the upper part the wound is only superficially healed but the matter shut up and gathered together in bottom of the wound will cause abscesses and hollow Ulcers Wherefore now we must treat of making of Sutures The first called Interpunctus leaves the distance of a fingers breadth The first manner of Suture and therefore is fit for the green wounds of the fleshy parts which cannot be cured with a Ligature and in which no heterogeneous or strange body remains The form of your Needle It is performed after this manner You must have a smooth Needle with a thred in it having a three-square point that so it may the better enter the skin with the head of it somewhat hollowed that the thred amy lie therein for so the Needle will the better go through The form of the pipe with a window in it You must also have a little Pipe with a hole or window in the end which you must hold and thrust against the lip of the wound that it be not moved to the one side or other whilst you thrust through the Needle And that we may see through that window when the Needle is thrust through and also draw it together with the thread and withal hold the lip of the Wound in more firmly that it follow not at the drawing forth of the Needle and thred Having thus pierced the lips of the Wound tie a knot near to which cut off the thread lest that if any of it be left below the knot it may so stick to the Emplasters that it cannot be plucked and separated from them without pain when they are taken off But you must note the first stitch must be thrust through the midst of the Wound and then the second must be in that space which is between the midst and one of the ends but when you have made your stitches the lips of the Wound must not be too closely joyned but a little space must be left open between them that the matter may have free passage forth and inflammation and pain may be avoided otherwise if they shall be closely joyned together without any distance between a tumor after arising when the matter shall come to suppuration the lips will be so much distended that they may easily be broken by the stifness of the thred But you must neither take hold of too much nor too little flesh with your Needle for too little will not hold and too much causeth pain and inflammation And besides leaves an ill favoured scar Yet in deep wounds such as are those which are made in the thicker Muscles the Needle must be thrust home that so it may comprehend more of the fleshy substance lest the thred drawn away by the weight of the flesh not taken hold of may be broken But oft-times wounds are seen made in such places as it would be needful the Chirurgeon should have a crooked Needle and Pipe otherwise the Suture will not succeed according to his desire Wherefore I have thought good to set forth both their figures that you may use either as occasion shall serve The Figures of Pipes with Fenestels in them and Needles fit for Sutures The second means of Suture The second Suture is made just after the same manner as the Skinner sows their fels or furs And the guts must be sowed with this kind of Suture if they shall be at any time wounded that the excrements come not forth by the wound The third manner of Suture The third Suture is made by one or more Needles having thred in them thrust through the wound the thred being wrapped to and again at the head and the point of the Needle as Boys use to fasten their Needle for fear of losing it in their caps or clothes This kind of Suture is fit in the curing and healing of Hare-lips as we shall shew you hereafter expressed by a Figure The fourth kind of Suture termed Gastroraphia The fourth kind of Suture is termed Gastroraphia invented for the restoring and uniting the great Muscles of the Epigastrium or lower Belly cut with a great wound together with the Peritonaeum lying under them The manner whereof we shall shew in due place The fift kind called the Dry Suture The fifth kind is called the dry Suture which we use only in the wounds of the face which also we will describe in its proper place CHAP. VII Of the Flux of Blood which usually happens in Wounds The signs of bloud flowing from an artery OFt-times great bleeding follows upon wounds by reason of some vessel cut broken or torn which there is need to heal and help diligently because the Bloud is the treasure of Nature without which life cannot consist The Bloud which floweth from an Artery is thus known
that the broken cleft or cut Bone can neither be perceived by your sight nor Instrument wherefore if you think there is any such thing by the rational signs above-mentioned anoynt the place with writing Ink and Oyl and so you shall find the crack or clift by the means we shall shew you hereafter When you are certain of the fracture Lib. 5. Epid. in Aaâ—onomus of Omilum Hippocrates was deceived by the sutures then you must diligently consider the greatness of the disease and apply medicines speedily Verily when a fracture chances to light upon any suture the disease is hard to be known unless the fracture be very great because the sutures by their clifts and roughness resemble fractures wherefore Hippocrates saith that he was deceived by them Now having briefly delivered the differences and signs of a broken Skull it is time to come to the several kinds thereof with a Fissure CHAP. IV. Of a Fissure being the first kind of a broken Skull IF the Chirurgeon by the fore-mentioned signs shall know that the Skull is broken or crakt Upon what occasion the hairy scalâ— must be câ—â— and if the wound made in the musculous skin shall not be thought sufficient for ordering the Fissure thâ—â— must he shave off the hair and cut with a razour or Incision-knife the musculous skin with the Pericranium lying under it in a triangular or quadrangular figure to a proportionable bigness alwayes shunning as much as in him lyes the sutures and temples neither must he fear any harm to ensue hereof Celsus for it is farr better to bare the Bone by cutting the skin than to suffer the kind and nature of the fracture to remain unknown by a too rel gious preservation of the skin for the skin is cured without any great ado though pluckt off to no purpose For it is much more expedient in Hippocrates opinion to cure diseases safely and securely Hippocrates though not speedily than to do it in a shorter time with fear of relapse and greater inconveniencies Let this dissection be made with a razour or sharp knife and if there be any wound made in the skin by the weapon let one of your Incisions be made agreeable thereto A Razour or Incision-Knife Now therefore the Musculous skin together with the Pericranium must be divided and cut with a sharp razour pressed and guided with a strong and steddy hand then it must be so pluckt from the Bone The manner how to pull the hairy scalp from the broken Skull or Skull lying under it that none thereof remain upon the Bone for if it should be rent or torn with the Trepan it would cause vehement pain with inflammations You must begin to pull it back at the corners of the lines crossing each other with right angles with this Chissel whose figure you see here expressed A Chissel or Instrument to pull back or separate the Pericranium from the Skull Then you must fill all the wound with boulsters of fine soft lint that so the lips may be kept further a-sunder But you shall apply upon it medicines fit to stanch bloud But if it come so to pass that the bloud flows forth so violently that it can be stayed by no means the vessel it self must be bound after this manner The manner to bind a vessel in case of too much bleeding First thrust through the musculous skin on the outside with a needle and thred then thrust the Needle back again then tye the thred on a knot on the outside but first put some lint rolled up to the bigness of a Goose-quill between the thred and the hairy scalp on both sides thereof lest the strait twitching of the thred which may serve to stay the bleeding may cut and tear the skin or cause pain then must you raise his head somewhat higher A History I have lately tryed and performed this upon a certain Coach-man who thrown from the Coach upon his Head on a pavement of free-stone exceedingly bruised the hind-part of the Bregma for which cause it was fit to open the musculous skin with a cross Incision both that the congealed bloud might be pressed out as also that the fracture if there were any might be observed But an Artery being cut in performance hereof when as the Chirurgeon who was there present could not stay the bloud leaping out with violence and the Coachman already had lost so great a quantity thereof that his strength was so much decayed that he could not stir himself in his Bed or scarse speak I being called shewed them by experience that whereas astringent medicines were used before to no purpose it was better to stay the bleeding by binding the vessel than to let the Patient dye for a childish fear of pricking him But that we may return to our former matter the Chirurgeon shall the next day consider with what kind of fracture the Bone is hurt and if no signs of hurt appear to the eyes nor be perceived with your fingers and probe yet some of the rational signs may cause one to have a conjecture that there is a fracture A way to find a fracture in the skull when it presents not it self to the view at the first Then you must anoint as we told you before the bared Bone with writing Ink and a little Oyle of Roses that the cleft or crack may be dyed or coloure therewith if that there be any there Then the next dressing you must dry the Bone with a linnen cloth and scrape off the Ink and Oyl with scraping Instruments made for the purpose if any part thereof shall be sunk into the Bone for if there be any crack it will be black Wherefore you must continue scraping until no sign of the fissure remain or else until you come even to the Dura Mater But that he may be more certain whether the Fissure pierce through both the Tables of the Skull he must bid the Patient that stopping his Nose and Mouth he strive to breathe with a great indeavour A sign that both the Tables are broken For then bloudy matter or sanies will sweat through the Fissure For the breath driven forth of the Chest and prohibited passage forth swells and lifts up the substance of the Brain and the Meninges whereupon that frothy humidity and Sanies sweats forth Therefore then the Bone must be cut even to the Dura Mater with a Radula and other scraping Instruments fit for that purpose yet so as you hurt not the Membrane but if the Fissure shall be somewhat long it will not be convenient to follow it all the extent thereof for Nature will repair and restore the remnant of the Fissure by generating a Callus besides also the Chirurgeon according to Celsus opinion must take away as little of the Bone as he can because there is nothing so fit to cover the Brain as the Skull Therefore it shall suffice to make a passage whereby the bloud
within by the stroak may cast forth some bloud upon the Membranes of the Brain which being there concrete may cause great pain by reason whereof it blinds the Eyes if soâ—e that the place can be found against which the pain is and when the skin is opened the bone look pale it must presently be cut out as Celsus hath written Now it remains that we tell you how to make your Prognosticks in all the fore-mentioned fractures of the Skull CHAP. X. Of Prognosticks to be made in fractures of the Skull Hip. de vul cap. WE must not neglect any Wounds in the Head no not those which cut or bruise but only the hairy scalp but certainly much less those which are accompanyed by a fracture in the skull for oft-times all horrid symptoms follow upon them consequently death it self especially in bodies full of ill humors or of an ill habit such as are these which are affected with the Lues venerea Leprosie Dropsie Pthysick Consumption for in these simple wounds are hardly or never cured for union is the cure of wounds but this is not performed unless by the strength of nature and sufficient store of laudable bloud but those which are sick of hectick Feavers and Consumptions want store of bloud and those bodies which are repleat with ill humors and of an ill habit have no afflux or plenty of laudable bloud but all of them want the strength of nature the reason is almost the same in those also which are lately recovered of some disease Whether the wounds of children or old people are better to heal Those wounds which are bruised are more difficult to cure than those which are cut When the Skull is broken then the continuity of the flesh lying over it must necessarily be hurt and broken unless it be in a Resonitus The bones of children are more soft thin and replenished with a sanguine humidity than those of old men and therefore more subject to putrefaction Wherefore the wounds which happen to the bones of children though of themselves and their own nature they may be more easily healed because they are more soft wherby it comes to pass that they may be more easily agglutinated neither is there fit matter wanting for their agglutination by reason of the plenty of bloud laudable both in consistence and quality than in old men whose Bones are dryer and harder and so resist union which comes by mixture and their bloud is serous and consequently a more unfit bond of unity and agglutination yet oft-times through occasion of the symptoms which follow upon them that is putrefaction and corruption which sooner arise in a hot and moist body and are more speedily encreased in a soft and tender they usually are more suspected and difficult to heal The Patient lives longer of a deadly fracture in the Skull in Winter than in Summer for that the native heat is more vigorous in that time than in this besides also the humors putrefie sooner in Summer because then unnatural heat is then easily inflamed and more predominant as many have observed out of Hippocrates Aph. 15. sect 1. The wounds of the Brain and of the Meninges or Membranes thereof are most commonly deadly because the action of the Muscles of the Chest and others serving for respiration is divers times disturbed and intercepted whence death insues If a swelling happening upon a wound of the head presently vanish away it is an ill sign unless there be some good reason therefore as bloud-letting Aph. 65. sect 5. purging or the use of resolving local medicines as may be gathered by Hippocrates in his Aphorisms If a Feaver ensue presently after the beginning of a wound of the head that is upon the fourth or seventh day which usually happens you must judg it to be occasioned by the generating of Pus Aph. 47. sect 2. or Matter as it is recited by Hippocrates Neither is such a Feaver so much to be feared as that which happens after the seventh day in which time it ought to be terminated but if it happen upon the tenth or fourteenth day with cold or shaking it is dangerous because it makes us conjecture that there is putrefaction in the Brain the Meninges or Skull through which occasion it may arise chiefly if other signs shall also concurr which may shew any putrefaction as if the wound shall be pallid and of a faint yellowish colour as flesh looks after it is washed Wounds which are dry rough livid and black are evil For as it is in Hippocrates Aphoris 2. Sect. 7. It is an ill sign if the flesh look livid when the Bone is affected for that colour portends the extinction of the heat through which occasion the lively or indifferently red colour of the part faints and dyes and the flesh thereabout is dissolved into a viscid Pus or filth Commonly another worse affect follows hereon wherein the wound becoming withered and dry looks like salted flesh sends forth no matter is livid and black whence you may conjecture that the Bone is corrupted especially if it become rough whereas it was formerly smooth and plain for it is made rough when Caries or corruption invades it but as the Caries increases it becomes livid and black sanious matter with all sweating out of the Diploe as I have observed in many all which are signs that the native heat is decayed and therefore death at hand but if such a Feaver be occasioned from an Erysipelas which is either present or at hand it is usually less terrible The signs of a Feaver caused by an Erysipelas But you shall know by these signs that the Feaver is caused by an Erysipelas and conflux of cholerick matter if it keep the form of a Tertian if the fit take them with coldness and end in a sweat if it be not terminated before the cholerick matter is either converted into Pus or else resolved if the lips of the wound be somewhat swoln as also all the face if the eyes be red and fiery if the neck and chaps be so stiffe that he can scarse bend the one or open the other if there be great excess of biting and pricking pain and heat and that far greater than in a Phlegmon Why an Erysipâ—las chiâ—fly assâ—ils the face For such an Erysipelous disposition generated of thin and hot bloud chiefly assails the face and that for two causes The first is by reason of the natural levity of the cholerick humor the other because of the rarity of the skin of these parts The cure of an Erysipelas on the â—â—ce The cure of such an affect must be performed by two means that is evacuation and cooling with humectation If choler alone cause this tumor we must easily be induced to let bloud but we must purge him with medicines evacuating choler If it be an Erysipelas Phlegmonodes you must draw bloud from the cephalick-Cephalick-vein of that side which is most affected
Oyl of Roses but you must apply no humid thing to the bone because we desire to keep it sound and whole For Galen's opinion is Gal. 6 mâ—th The bones are offended with the application of humid thiâ—gs that bared bones must not be touched with unctuous things but rather on the contrary all dry things must be applyed to them which may consume the superfluous humidity Therefore we must lay some lint and the cephalick powders which we shall hereafter describe upon the bone we intend to preserve and must have diligent care that it be not offended either by the air or touch of humid medicines You must in Trepaning have a special care of the Crassa meninx For I have often observed a great quantity of bloud to have flowed from some broken vessel which adhered to the second Table neither must we presently and forthwith stay such bleeding but suffer it to flow according to the plenitude and strength of the Patient for thus the feaver and together therewith the rest of the symptoms are diminished For the opinion of Hippocrates Lib. de ulcer in every green wound it is good to cause often bleeding except in the bellies for thus the vehemency of pain inflammation and other accidents will be less troublesome also it is not amiss too for old Ulcers to bleed much for so they are freed from the burden of the impact humors When you think it hath bled sufficiently it may be stanched with this following medicine described by Galen â„ž pulveris AloesÊ’ ij thuris Mastiches Gal. 6. mith an Ê’i ss albumina ovorum nu ij agitentur simul cum pilis leporinis minutim incisis fiat medicamentum When the bleeding is stayed you shall for the asswageing of pain drop upon the Meninx some Pigeons bloud yet warm by opening a Vein under the wing then it shall be strewed over with this following powder â„ž Aloes Thuris Myrrhae sanguinis draconis an Ê’ i. Misce fiat pulvis subtilis Also you may make an irrigation with Rose Vinegar or some repelling medicine such as is a cataplasm ex farinis oleo rosaceo Which may be applyed until the fourth day to asswage and mitigate pain Vigo's Cerate will be of good use in this case Vigo's Ceraiâ— good for a broken Skull as that which in my opinion is most fit for fractures of the Skull because it draws powerfully resolves and dryes moderately and by reason of the smell refreshes the animal spirits and strengthens the Brain and Membranes thereof as you may easily perceive by things which enter into the composition thereof â„ž Olei ros Omph. resinae pini gummi Elemi an â„¥ ij Mastiches â„¥ i ss pinguedinis vervecis castrati â„¥ ij ss foliorum beton caprifol anthos an M j. ammoniaciÊ’ ss granorum tinctorumÊ’ x. liquata pinguedine terenda terantur ammoniacum simul cum aceto scillitico eliquetur deinde bulliant omnia simul in lib. ij vini boni lento igne usque ad consumptionem vini deinde exprimantur cum expressione addantur terebinth Ven. â„¥ iiij cerae albae quantum sufficit fiat cerotum molle ad usum praedictum Also let the neck and all the Spine of the Back be anointed with a liniment which hath force of mollifying the Nerves lest they should suffer Convulsion such is this â„ž Rutae marrubii rorismar ebulor salviae â—erb paralys an M. s rad Ireos cyperi baccarum lauri A liniment good against Convulsions an â„¥ i. florum chamae melil hyperici an M j. pistentur macerentur omnia in vino albo per noctem deinde coquantur in vase duplici cum oleo lumbricorum liliorum de terebinthina axungiae anseris hum an â„¥ ij usque ad consumptionem vini postea colentur in colatura adde terebrinth venet â„¥ iij aquae vitaeÊ’ ss cerae quantum sufficit Fiat linimentum secundum artem Gal. 4. meth But when the pain is asswaged we must abstain from all such unctuous things lest they make the wound become sordid and malign and putrefie the adjacent parts and consequently the Crassa meninx and Skull for the integrity of all parts may be preserved by their like and such are dry things in a fracture of the Skull Wherefore all humid and oyly things must be shunned in the cure thereof unless peradventure there shall be some need to mitigate pain and bring the humor to suppuration For according to Galen we are oft forced for a time to admit the proper cure of the disease so to resist the symptoms How farr humid things are good for a fractured skull furthermore Hippocrates would have us not to foment the Skull no not with Wine but if we do to let it be but with very little Vidius interprets that little to be when there is fear of inflammation for Wine if it be red tart and astringent hath a repressing refrigerating and drying faculty for otherwise all Wine although it heats and dryes by its faculty yet it actually humects and cools both which are very hurtful in wounds of the head or a fractured skul especially when the Bone is bare for from too much cooling of the Brain there is fear of a Convulsion or some other evil symptom Wherefore let this be ratified that is we must not use humid and unctuous medicines in wounds of the head except for curing of inflammation or the mitigation of pain caused thereby Why Cephalick or Catagmatick powders are good Therefore let the bared Skull be strewed with catagmatick and cephalick powders being so called by the Ancients for that they are convenient and good in fractures of the Skul and the rest of the Bones for by their dryness they consume the superfluous humidity and by that means help Nature in the separating of the broken Bones and the regenerating of flesh Such powders usually consist of such things as these ensuing Thus Radix Iridos florent farina hordci Ervi pulvis Aloes Hepaticae sanguis Draconis Mastiche Myrrha rad Aristolochiae Gentianae and generally all such Simples as have a drying and an abstergent faculty without biting but you must not use these things before the pain inflammation and apostumation be past that is then When to be used when the membranes must be cleansed the bones scaled and the flesh generated For the Skull by how much it is the dryer by so much it requires and more easily endures more powerful and dryer medicines than the Dura Mater How to be mixed when they are to be applyed to the Meninges or Pericranium as that which in quickness of sense comes far short of these two Wherefore when you would apply the fore-mentioned cephalick powders to the Meninges they must be associated and mixed with Hony Syrup of Roses or of Wormwood and such other like that so their too violently drying faculty may be allayed and tempered CHAP. XVII Why we use Trepaning in the Fractures of the Skull THere
are four causes of this remedy The first is to raise up the deprest Bones and take forth their fragments which press upon the Meninges or also upon the substance of the Brain The second is that the Sanies or matter may be evacuated clensed wasted and dryed up which by the breaking of any vessel is poured forth upon the Membrans whereby they and not they only but the Brain also is in a great danger of corruption The third is for the fitter application of medicines convenient for the wound and fracture The fourth is that so we may have something whereby we may supply the defect of a Repelling Ligature and such an one as may hinder defluxions Why a repelling Ligature cannot be used in fractures of the skull for such a Ligature cannot take place here as it may in the other parts of the body by reason of the Sphaerical or Round figure of the head which doth not easily admit binding and then the density and hardness of the interposed Skull is a means that the vessels lying under it by which usually the defluxion comes cannot easily be bound with a rowler sufficiently to repel the running bloud And the external vessels to whom the force of the Ligature may come cannot be bound without great pain and danger of inflammation For by such a compression the pulsation of the Arteries would be intercepted and the efflux of the fuliginous excrements which useth to pass pass through the sutures of the Skull would be supprest by reason of the constriction of these sutures How the Patient must be placed when you Trepan him Besides also the bloud would thus be forced from the wounded part without to within into the Membranes and Brain when pain inflammation a Feaver Abscess Convulsion Palsie Apoplexie and lastly Death it self would insue And these are the cheif causes that Trepaning is necessary in fractures of the skull and not so in the fractures of other Bones But before you apply or put to your Trepan the Patient must be fitly placed or seated and a double cloth must be many times wrapped about his head and then his head must be so laid or pressed upon a Cushion or Pillow that when you come to your operation it may not sink down any further but remain firm and stedy Then you must stop the Patients Ears with Cotten-wool that so he may not hear the noise made by the Trepan or any other Instrument What to be done before the application of the Trepan But before you put to your Trepan the Bone must be pierced with an Instrument having a three-square point that so it may be the more speedily and certainly perforated The point thereof must be no bigger then the pin of a Trepan that so the Trepan which is forthwith to be applyed may stand the more firm and not to play to and again in too wide a hole The shape of this Instrument is not much different from a Gimblet but that the point is three-square and not twined like a screw as you may perceive by this following figure A Gimblet or Piercer to perforate the Skull before the setting of the Trepan A. Shews the handle B. The points which may be screwed and fitted into the handle CHAP. XVIII A Description of Trepans TRepans are round Saws which cut the Bone circularly more or less according to their greatness they must have a pin standing in the middle a little further out than their teeth so to say and hold fast the Trepan that it stir neither to this side nor that until it be entred and you have cut through the first Table at the least then you must take forth the pin lest going quite through the bone it may prick or hurt the Crassa Meninx Wherefore when you have taken forth the pin you may safely turn it about until you have cut through both the Tables Your Trepans must also have a cap or somewhat to ingirt or incompass them lest no way hindred they cut more of the one than we would and in conclusion run into the Meninx They must also be anointed with Oyl that so they may cut more readily and gently for thus Carpenters use to grease their saws But you must during the time of the operation often dip them in cold water The harm the bone receives by being heated with the Trepan What things hasten the scaling of the bone lest the bone by attrition become too hot for all hard solid bodies by quick and often turning about become hot but the bone made more hot and dry is altered and changeth its nature so that after it is cut more off its scales and falls away Now you must know that the Bone which is touched with the Trepan or the Air alwayes casts off scales for the speedier helping forwards whereof you must strew upon it powders made of Rocket Briony wild Cowcumber and Aristolochia-roots When the bone is sufficiently scaled let this following powder be put upon it which hath a faculty to cover the bone with flesh and to harden it with dryness convenient to its kind â„ž Pulver Ireos Illyricae Aloes Mannae thuris Myrrhae Aristolochiae an Ê’ i. Flesh being by this means generated let it be cicatrized by strewing upon it the rinds of Pomegranates and Alum burnt Neither shall the Chirurgeon forcibly take away these scales The bone must not be forcibly scaled but commit that whole work to Nature which useth not to cast them off before that it hath generated flesh under them For otherwise if he do any thing rashly he brings new corruption to the Bone as we shall more at large declare when we come to treat of Caries or rottenness of Bones He which useth the Trepan must consider this that the head is of a round figure A caution in Trepaning and also the Trepan cuts circularly and therefore it is unpossible to cut the Bone so equally on every side as if it were performed upon a plain body Furthermore the thickness of the Skull is not alike in all places wherefore you must look and mark whether the Trepan go not more deep on one side than on the other which you may do by measuring it now and then with a pin or needle and if ye find that it is cut deeper on one side than on the other you must press down the Trepan more powerfully upon the opposite part But seeing there are many sorts of Trepans invented and expressed by many men A safe and convenient Trepan yet if you weigh rightly consider them all you shall find none more safe than that I invented have here delineated For it cannot pierce one jot further into the skul than he pleases that uses it and therefore it cannot hurt either the Meninges or the Brain An Iron head or cover stays it as a bar that it can penetrate no further than you shall think it requisite This head or cover is to be drawn up and down and set
Divers repercussives to be applyed to the Eye but let this repercussive be laid upon the eye and the neigbouring parts â„ž Albumin ovor nu iiij pulver aluminis rechae combustiÊ’ ij sanguinis DraconisÊ’j aquae rosar plantag an â„¥ ij agitentur simul make a repercussive which you may frequently use Or else apply cheese-curds well wrung mixed with Rose-water the white of an Egge and as much acacia as shall suffice This which followeth doth more powerfully stay the flowing humor â„ž gum arab tragac an Ê’ ij psilii cydon semin portul plant sumach an Ê’ ij fiat mucag. cum aqua plantag solan rosar concinnetur collyrium of which you may drop some both within and about the Eye Things actually cold are hurtful to the Eyes But note that all such remedies must be applyed warm both that they may the better penetrate by their moderate heat as also for that all actual cold things are hurtful to the eyes and sight because they dull the sight by incrustating the visive spirits For I have knnown many who have become dull of sight by the frequent using of medicines actually cold to the eyes I have on the contrary seen not a few who have recovered with the fit use of such like medicines who have had any part of their eye so it were not the pupilla or apple of the eye so pricked with a needle or bodkin that much of the waterish humor ran forth thereat Anodyne medicines for the Eyes The milk of a woman which suckles a girl for that is reputed the cooler mitigates pain and cienses if it be milked out of the dug into the eye to which propose also the bloud of turtles pgeons or chickens much much conduces being dropt into the eye by opening a vein under their wings Also this following cataplasm asswageth pain and inflammation and hinders defluxion being applyed to the eye and the adjacent parts â„ž Carnis pomorum sub cinâ—re calido decoctorum â„¥ v. vitel â—vorum num iij. cassiae fistulae recenter extractae â„¥ ss mucaginis psilii altheae cydon an â„¥ i. farin hordei parum incorporentur omnia simul fiat cataplasma Also Sheeps Lungs boyled in Milk and applyed warm and changed as they grow cold are good to asswage pain But if the too violent heat and pain shall not yield to such medicines but require more vehement Narcoticks then Foliorum Hyoscyami m. j. sub cineribus coquatur atque in mortario cum mucagine seminis psilii cydonior extract in aquis solani plantag pistetur then let this medicine be wrapped in a linnen cloth and applyed to the Eyes and Temples The mucilages of Psilium or Flea-wort and Quince-seeds extracted in a decoction of Poppy-heads and mixed with a little Opium and Rose-water are used for the same purpose But when there is need of detergent and sarcotick medicines then â„ž Syrup rosar siccat â„¥ i. aq faenic rutae an Ê’ ij aloes lotae olibani an â„¥ ss mix them for the foresaid use The galls of Scates Hares and Partridges dissolved in Eye-bright and Fennil-water are fit for clensing such wounds as also this following Collyruim â„ž Aquae hordei â„¥ j. Detergent medicines mellis despumati Ê’ iij. Aloes ter lotae in aqua plantaginis sacchari cand an Ê’ j fiat collyrium Also this insuing medicine is very sarcotick â„ž Mucagin gummi olibani arabici tragacanth sarcocol A sarcotick medicine for the eyes in aq hordei extract an Ê’ iij. aloes ter lotae in aq rosarum Ê’ j. cerus ustae lotae tutiae praepar an Ê’ss fiat collyrium But here you must note that the coat Adnota often swells so much by reason of a wound or some other injury and stands so forth by the falling down of humors access and mixture of flatulencies that it hides the whole Pupilla and hangs forth of the Eye-lids like as if it were an unnatural fleshy excrescence and it loses the native colour and looks very red so that the Eye can neither be shut nor opened Wherewith a young Chirurgeon being deceived determined to cut away this protuberancy of the Adnata as though it had been some superfluous flesh and then to waste it with cathaeretick powders had I not forbidden him telling him of the certain danger of blindness which would thereupon befal the Patient Wherefore I prescribed a fomentation of Chamomil Melilote Rose-leaves Wormwood Rue Fennil and Aniseeds boyled in Milk with the roots of Oris and Marigolds Then I presently added this following Fomentation being more powerful and drying â„ž Nucis cupressi gallar balaust an â„¥ i. plantag absinth hippuris flo chamaem ros rub A drying fomentation an M ss bulliant simul cum aqua fabrorum fiat decoctum pro fotu cum spongia Besides also you may apply a cataplasm made of Barly and Bean-flour the powders of Mastick Myrrhe and Aloes and some of the last described decoction The tumor beginning to decline I dropt the flowing liquor into the Eye which hath a very astringent drying and strengthening faculty Roast a new laid Egge in Embers until it be hard then pill off the shell take forth the yolk and in place thereof put a scruple of Roman Vitriol in fine powder then put it in a linnen cloth and wring it hard forth into some clean thing and drop thereof for some dayes into the Eye with a little Smiths-water wherein Sumach and Rose-leaves have been boyled I have found by experience the certain force of this remedy but if notwithstanding there be a true fleshy excrescence upon the coat Adnata it may be taken away by this following powder â„ž Ossis sepiae testae ovorum calcinatae an Ê’ j. fiat pulvis Calcined Vitriol burnt Alum A medicine to consume a fleshy excrescence without out biting and the like may be commodiously used to this purpose Yet you must warily make use of all such things and always lay repercussives about the Eye that no harm insue thereof For divers times acrid humors fall down into the Eye with such violence that they break the Horney-coat whereupon the humors of the Eye are poured out Remember also that in diseases of the Eyes the Patient lye with his head somewhat high and that he keep shut not only the pained but also the sound Eye because rest is always necessary for the grieved part But one Eye cannot be moved without some motion of the other by reason of the connexion they have by their optick and moving nerves both the Meninges and the Pericranium Veins and Arteries which is the cause that when the one suffers the other in some sort partakes therewith But if we cannot prevail by all these formerly prescribed medicines fit to stay the defluxion A Seton a good remedy against in veterate defluxions into the eyes then it remains that we apply a Seton to the neck for it is a singular remedy against inveterate defluxions into
in the parts thereunder an unvoluntary excretion of the Urine and other excrements Signs that the Spine is wounded or a totall suppression of them seises upon the Patient When the hollow vein and great Artery are wounded the Patient will dye in a short time by reason of the sodain and aboundant effusion of the blood and spirits which intercepts the motion of the Lungs and heart whence the party dies suffocated CHAP. XXX Of the cure of the Wounds of the Chest WE have read in John de Vigo that it is disputed amongst Chirurgeons concerning the consolidation of wounds of the Chest For some think that such wounds must be closed up Vigo tract de vuln thoraâ— cap. 10. and cicatrized with all possible speed lest the cold air come to the heart and the vitall spirits fly away and be dissipated Others on the contrary think that such wounds ought to be long kept open and also if they be not sufficiently large of themselves that then they must be inlarged by Chirurgery that so the blood poured forth into the capacity of the Chest may have passage forth which otherwise by delay would putrefie whence would ensue an increase of the feaver a fistulous ulcer and other pernicious accidents The first opinion is grounded upon reason and truth if so be that there is little or no blood poured forth into the capacity of the Chest But the latter takes place where there is much more blood contained in the empty spaces of the Chest Which lest I may seem rashly to determin I think it not amiss to ratifie each opinion with a history thereto agreeable Whilst I was at Turin Chirurgeon to the Marshall of Montejan the King of France his General A History I had in cure a Souldier of Paris whose name was Levesque he served under captain Renovart He had three wounds but one more grievous than the rest went under the right brest somewhat deep into the capacity of the Chest whence much blood was poured forth upon the midriff which caused such difficulty of breathing that it even took away the liberty of his speech besides through this occasion he had a vehement feaver coughed up blood and a sharp pain on the wounded side The Chirurgeon which first drest him had so bound up the wound with a strait and thick suture that nothing could flow out thereat But I being called the day after and weighing the present symptoms which threatned speedy death judged that the sowing of the wound must straight be loosed which being done there instantly appeared a clot of blood at the orifice thereof which made me to cause the Patient to lye half out of his bed with his head downwards and to stay his hands on a Settle which was lower than the bed and keeping himself in this posture to shut his mouth and nose that so his Lungs should swell the midriffe be stretched forth and the intercostal muscles and those of the Abdomen should be compressed that the blood poured into the Chest might be evacuated by the wound but also that this excretion might succeed more happily I thrust my finger somewhat deep into the wound that so I might open the orifice thereof being stopped up with the congealed blood and certainly I drew out some seven or eight ounces of putrefied and stinking blood by this means When he was laid in his bed I caused frequent injections to be made into the wound of a decoction of Barly with Honey of Roses and red Sugar which being injected I wisht him to turn first on the one and then on the other side and then again to lye out of his bed as before for thus he evacuated small but very many clots of blood together with the liquor lately injected which being done the symptomes were mitigated and left him by little and little The next day I made another more detergent injection adding thereto wormwood Why bitter things must not be cast into the Chest centaury and Aloes but such a bitterness did rise up to his mouth together with a desire to cast that he could no longer indure it Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris in one who had a fistulous ulcer in his Chest Therefore when I had considered with my self that such bitter things may easily pass into the Lungs and so may from thence rise into the Weazon and mouth I determined that thenceforwards I would never use such bitter things to my Patients for the use of them is much more troublesome than any way good and advantagious But at the length this Patient by this and the like means recovered his health beyond my expectation Read the History of Maryllus in Galen lib. 7. de Anaâ—om administra But on the contrary I was called on a time to a certain Germain gentleman who was run with a sword into the capacity of his Chest the neighbouring Chirurgeon had put a great tent into the wound at the first dressing which I made to be taken forth for that I certainly understood there was no blood powred forth into the capacity of the Chest because the Patient had no feaver no weight upon the Diâ—phrâ—gma nor spitted forth any blood Wherefore I cured him in few dayes by only dropping in some of my balsome and laying a plaister of Diacalcitheos upon the wound What harm ensues the too long use of Tents The like cure I have happily performed in many others To conclude this I dare boldly affirm that wounds of the Chest by the too long use of tents degenerate into Fistula's Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest you shall not presently shut them up at the first dressing No liniments must be used in wounds of the Chest but keep them open for two or three dayes but when you shall find that the Patient is troubled with none or very little pain and that the midriffe is pressed down with no weight and that he breathes freely then let the tent be taken forth and the wound healed up as speedily as you can by covering it only with lint dipped in some balsome which hath a glutinative faculty and laid somewhat broader than the wound never apply liniments to wounds of this kind lest the Patient by breathing draw them into the capacity of the Chest Wherefore also you must have a care that the tent put into those kinds of wounds may be fastned to the pledgets and also have somewhat a large head lest they should be drawn as we said into the capacity of the Chest for if they fall in they will cause putrefaction and death Let Emplast Diacalcitheos or some such like be applyed to the wound But if on the contrary you know by proper and certain signs that there is much blood fallen into the spaces of the Chest then let the orifice of
can for two or three hours in his bed when he wakes let him take some Ptisan or some such like thing and then repeat his bath after the foresaid manner Things strengthening the ventricle He shal use this bath thrice in ten days But if the Patient be subject to crudities of the stomach so that he cannot sit in the bath without fear of swooning and such symptoms his stomach must be strengthened with oyl of quinces wormwood and mastich or else with a crust of bread toasted and steeped in muskadine and strewed over with the powders of roses sanders and so laid to the stomach or behind neer to â—e 13. verteâ—ra of the back under which place Anatomy teaches that the mouth of the stomach lies Epithems shall be applyed to the liver and heart to temper the too acrid heat of these parts Epithems and correct the immoderate dryness by their moderate humidity Now they shal be made of refrigerating and humecting things but chiefly humecting for too great coldness would hinder the penetration of the humidity into the part lying within The waters of bugloss and violets of each a quartern with a little white wine is convenient for this purpose But that which is made of French barly the seeds of gourds pompious or cowcumbers of each three drams in the decoction mixed with much tempering with oyl of Violets or of sweet Almonds is most excellent of all other Let cloaths be dipped and steeped in such epithems and laid upon the part and renewed as oft as they become hot by the heat of the part And because in hectick bodies by reason of the weakness of the digestive faculty many excrements are usually heaped up and dryed in the guts it will be convenient all the time of the disease to use frequently clysters made of the decoction of cooling and humecting herbs flowers and seeds wherein you shall dissolve Cassia with Sugar and Oyl of Violets or Water-lillies What a flux happening in a hect ck feaver indicates But because there often happen very dangerous fluxes in a confirmed hectick Feaver which shew the decay of all the faculties of the body and wasting of the corporeal substance you shall resist them with refrigerating and assisting medicins and meats of grosser nourishment as Rice and Cicers and application of astringent and strengthening remedies and using the decoction of Oats or parched Barly for drink Let the Patient be kept quiet and sleeping as much as may be especially if he be a child For this Feaver frequently invades children by anger great and long fear or the too hot milk of the nurse over-heating in the Sun the use of wine and other such like causes they shall be kept in a hot and moist air have another Nurse and be anointed with oyl of violets to conclude you shal apply medicins which are contrary to the morbifick cause CHAP. XXXIII Of the Wounds of the Epigastrium and of the whole lower Belly How children be cured THe wounds of the lower Belly are sometimes before sometimes behind some only touch the surface thereof others enter in some pass quite through the body so that they often leave the weapon therein some happen without hurting the contained parts others grievously offend these parts the Liver Spleen Stomach Guts Kidneys Womb Bladder Ureters and great Vessels Their differences so that oft-times a great portion of the Kall falls forth We know the Liver is wounded when a great quantity of bloud comes forth of the wound when a pricking pain reaches even to the Sword-like gristle Signs of a wounded liver Signs that the stomach and smaller guts are wounded Signs to know when the greater Guts are wounded Signs that the Kidneys are hurt Signs that the Bladder is wounded Signs that the womb is wounded to which the Liver adheres Oft-times more choler is cast up by vomit and the Patient lyes on his Belly with more ease and content When the Stomach or any of the small Guts are wounded the meat and drink break out at the wound the Ilia or flanks swell and become hard the Hicket troubles the Patient and oft-times he casts up more choler and grievous pain wrings his Belly and he is taken with cold sweats and his extream parts wax cold If any of the greater Guts shall be hurt the excrements come forth at the wound When the Spleen is wounded there flows out thick and black bloud the Patient is oppressed with thirst and there are also the other signs which we said use to accompany the wounded Liver A difficulty of making water troubles the Patient whose reins are wounded bloud is pissed forth with the Urin and he hath a pain stretched to his groins and the regions of the Bladder and Testicles The Bladder or Ureters being wounded the flanks are pained and there is a Tension of the Pecten or Share Bloud is made instead of Urin or else the Urin is very bloudy which also divers times comes forth at the wound When the Womb is wounded the Bloud breaks forth by the Privities and the symptoms are like those of the Bladder The wounds of the Liver are deadly for this part is the work-house of the bloud wherefore necessary for life besides by wounds of the Liver the branches of the Gate or hollow-Hollow-veins are cut whence ensues a great flux of bloud not only inwardly but also outwardly and consequently a dissipation of the spirits and strength Prognosticks Lib. 6. cap. 88. But the bloud which is shed inwardly amongst the Bowels putrefies and corrupts whence follows pain a feaver inflammation and lastly death Yet Paulus Aegineta writes that the lobe of the Liver may be cut away without necessary consequence of death Also the wounds of the Ventricle and of the small Guts but chiefly of the Jejunum are deadly for many vessels run to the Jejunum or empty Gut and it is of a very nervous and slender substance and besides it receives the cholerick humor from the Bladder of the Gall. So also the wounds of the Spleen Kidneys Ureters Bladder Womb and Gall are commonly deadly but alwayes ill for that the actions of such parts are necessary for life besides divers of these are without bloud and nervous others of them receive the moist excrements of the whole body and lye in the innermost part of the body so that they do not easily admit of medicins Furthermore all wounds which penetrate into the capacity of the Belly are judged very dangerous though they do not touch the contained Bowels for the encompassing and new air entring in amongst the Bowels greatly hurts them as never used to the feeling thereof add hereto the dissipation of the spirits which much weakens the strength Neither can the filth of such wounds be wasted away according to the mind of the Chirurgeon whereby it happens they divers times turn into Fistula's as we said of wounds of the Chest and so at length by collection of matter cause death
well in a plethorick body or in a body replete with ill humors or indued with exquisite sense Therefore in such a case it will be safer to follow the course here set down For wounds of the nerves do not only differ from other wounds but also among themselves in manner of curing For although all medicines which draw from far and waste sanious humors may be reputed good for the wounds of the nerves yet those which must be applyed to punctures and to those nerves which are not wholly laid open ought to be far more powerful sharp and drying yet so that they be not without biting that so penetrating more deep they may draw forth the matter or else consume and discuss that which either lies about the nerves or moistens their substance On the contrary Medicines fit for wounds of the nerves when the sinews are bared from flesh and adjoyning particles they stand in need but of medicines which may only dry Here you may furnish your selves with sufficient store of medicines good for the nerves howsoever pricked As â„ž Terebinth vin olei veteris an â„¥ j. aquae vitae parum Or â„ž olei Terebinth â„¥ j. aqua vitaeÊ’ j. cuphor Ê’ ss Or â„ž radices Dracontiae Brioniae Valerianae Gentianae exsiccatas in pulverem redactas misce cum decocto centaurii aut oleo aut exungia veteri drop hereof warm into the wound as much as shall suffice Or else put some Hogs Goose Capons or Bears-grease old Oyl Oyl of Lillies or the like to Gall anum pure Rozin opopanax dissolved in Aqua-vitae and strong Vinegar Or â„ž olei hypericonis samâ—uti de cuphorâ—io an â„¥ j. suâ—phuris vivi subtiliter pulverisati â„¥ ss gummi ammoni bdellii an Ê’ ij aceti boni â„¥ ij vermium terrest praeparat â„¥ j. bulliant omnia simul ad consumptionem aceti Let as much hereof as shall suffice be dropped into the wound then apply this following Cerate which draws very powerfully â„ž olei supra-scripti â„¥ j. Terebinth venet â„¥ ss diachylonis albi cum gummi Ê’ x. ammoniac â—dellii in aceto dissoluterum an Ê’ ij resin pini gum clemi picis navalis an Ê’ v. cerae quod sufficit fiat ceratum satis molle We must use some whiles one some whiles another of these medicines in punctures of the Nerves with choice and judgment according to their conditions manner depth and the temperaments and habits of the wounded bodies But if the pain yield not to such remedies but rather increase What wounds of the N rves must be burnt with the inflammation of the affected part a swelling of the lips of the wound and sweating forth of a serous thin and virulent matter or filth then you shall pour into it scalding Oyl and shall touch three or four times not only the surface of the wound but the bottom thereof with a rag dipped therein and tyed to the end of a Spatula For this will take away the sense from the Nerve Tendon or Membrane A certain Anodyne in pain of the teeth like as if they were burnt with a cautery and so the pain will be eased So in the most grievous pains of rotten teeth the thrusting of an hot iron into their roots or stopping them with Cotton dipped in Oyl of Vitriol or Aqua-vitae gives most certain ease for by burning the Nerve which is inserted into their roots the sense and so consequently the pain is taken away So also in malignant Why Escharoticks must be used to spreading ulcers gnawing eating and spreading ulcers which are alwayes associated with much pain the pain ceases by applying an Escharotick the powder of Alum or Mercury or Aegyptiacum made somewhat more strong than usual That the young Chirurgeon may be more ready for this practise and the use of the former medicines I have thought good to insert the following History both for the lateness of the thing and the pleasing memory of the most laudable Prince Charles the ninth the French King being sick of a Feaver A famous History Monsieur Chapellan and Castellan his Physitians thought it fit he should be let bloud for the performance whereof there was called a Chirurgeon wondrous famous for that business but when as he by chance had pricked a nerve in stead of a vein the King cryed out that he felt a mighty pain in that place Then I bid that the ligature should straight-wayes be loosed otherwise the arm would presently be much swelled But he going slowly about it behold the arm began to swell with such contraction that he could not bend it nor put it forth and cruel pain molested not only the pricked particle but all the whole member besides I forthwith laid upon the wound a plaister of Basilicon to hinder the agglutination thereof and then I wrapped all the arm in a double linnen cloth dipped in Oxycrate putting upon it an expulsive ligature which beginning at the wrist and ending at the top of the shoulder might keep the bloud and spirits from fear of defluxion and inflammation This being thus performed we went aside to consult what was necessary to be done both to asswage the pain as also to divert the other symptoms which usually happen upon punctures of the nerves I being desired thus delivered my opinion that in my mind there were nothing better then presently to drop into the wound some Oyl of Turpentine warmed and mixed with a little Aqua-vitae And then all the arm should be covered with a plaister of Diacalcitheos dissolved in Vinegar and Oyl of Roses bound over and besides with the expulsive ligature which we formerly mentioned For the Oyl and Aqua-vitae have a faculty to penetrate into the bottom of the wound and to exhaust and dry up the serous and virulent humor which sweats from the substance of the pricked nerve and also to mitigate the pain by its actual heat Furthermore emplaister Diacalcitheos hath a faculty to dissolve the humor which hath already fallen down into the arm and to hinder the entrance and defluxion of any new matter And the ligature is such as by its moderate astriction would serve to strengthen the muscles and to press out and repel the humors which were fallen down into the upper part and to prohibit that which is ready to fall down Mine advice being approved of the Physitians both in word and deed the pain was mitigated But the humor stayed in the part A discussing and drying cataplasm for the dissolving and drying whereof this following remedy was used â„ž far hordei crobi an Ê’ ij flor chamaem melilot an p. ij butyr recentis siue sale â„¥ i ss lixivii â—arbitonsoris quod sufficit fiat cataplasma ad formam pultis By these remedies the King at last after three months space was perfectly healed so that there remained no sign of the depraved action in the part But if at any time there shall be so great contumacy that it will
not yield to these means but that there is imminent danger of a convulsion it will be better to cut it in sunder whether Nerve Tendon or Membrane than to expose the Patient to the danger of a deadly convulsion for thus indeed the peculiar action of that part will be lost but the whole body preserved thereby for so we had determined by common consent that if the pain which afflicted the King would not yield to the prescribed remedies either to pour in scalding Oyl or else to cut the sinew quite asunder A History For the late and sad memory of Mistris Courtin dwelling in the street of Holy-Cross was in our minds who of a vein not well opened in her arm fell into a Gangrene and total mortification of that whole part of which she dyed because she was not dressed with the formerly mentioned medicines Yet we must abstain from these two powerful remedies when the pricked nerve shall lye bare for else the pain would be increased and more grievous symptoms follow Wherefore as I formerly wished more mild medicines must be applyed which may dry up the serous humor without biting or acrimony as â„ž Terebinth venet in aq ros lota â„¥ ij boli armeni subtiliter pulverisati Ê’ ij An Anodyne and Saicotick Balsom incorporentur simul Our Balsom also is excellent in this case and this of Vigo's which follows â„ž Olei rosar emphacini â„¥ j ss olei de terebinth Ê’ iij. succi plantag â„¥ ss semin hypericonis aliquantulum contritiâ—m ss tutiae praepar Ê’ iij. calcis decies lotae cum aqua plantagin Ê’ ij antimoniiÊ’ j. sâ—vi hircini vitulini an â„¥ v. vermium terrestrium cum vino lotorum â„¥ jss bulliant omnia simul dempta tutia in cyatho decoctionis hordei ad consumptionem aquae vini colentur rursumque igni admoveantur addendo tutiam fiat linimentum cum cera alba â„¥ ss croci This liniment asswages pains and covers the bared nerves with flesh This cure of punctured nerves may with choyce and judgement and observing the proportion of the parts be transferred to the pricked Tendons and membranes But take this as a general and common rule A general rule for all wounds of all Nervous parts that all nervous bodies howsoever hurt are to be comforted by anointing them with hot Oyls such as the Oyl of Bays Lillies of Worms Sage or some other such like remedy being applyed to their originals and more notable passages as to the original of the spinal marrow the armpits and groins Neither do I think it fit in this place to omit an affect which sometimes happens to the large Tendon of the heel of which we formerly made mention For it oft-times is rent or torn by a small occasion without any sign of injury or solution of continuity apparent on the outside as by a little jump the slipping aside of the foot the too nimble getting on Horse-back or the slipping of the foot out of the stirrop in mounting into the saddle When this chance happens it will give a crack like Coach-mans whip above the heel where the tendon is broken the depressed cavity may be felt with your finger there is great pain in the part and the party is not able to go This mischance may be amended by long lying and resting in bed and repelling medicines applyed to the part affected in the beginning of the disease for fear of more grievous symptoms and then applying the Black-plaister or Diacalcitheos or some other such as need shall require neither must we hereupon promise to our selves or the Patient certain or absolute health But on the contrary at the beginning of the disease we must foretel that it will never be so cured but that some reliques may remain as the depression of the part affected and depravation of the action and going for the ends of this broken or relaxed Tendon by reason of its thickness and contumacy cannot easily be adjoyned nor being adjoyned united CHAP. XXXIX Of the Wounds of the Joynts Why wounds of the joynts are malignant BEcause the wounds of the Joynts have something proper and peculiar to themselves besides the common nature of wounds of the Nerves therefore I intend to treat of them in particular Indeed they are alwayes very dangerous and for the most part deadly by reason of the nervous productions and membranous Tendons wherewith they are bound and ingirt and into which the Nerves are inserted whereby it comes to pass that the exquisite sense of such like parts will easily bring malign symptoms especially if the wound possess an internal or as they term it a domestique part of them as for example the arm-pits the bending of the arm the inner part of the wrist and ham by reason of the notable Veins Arteries and Nerves of these parts the loosed continuity of all which brings a great flux of bloud sharp pain and other malignant symptoms all which we must resist according to their nature and condition as a flux of bloud with things staying bleeding The cure pain with anodynes If the wound be large and wide the severed parts shall be joyned with a suture leaving an orifice in the lower part by which the quitture may pass forth This following powder of Vigo's description must be strewed upon the Suture â„ž thuris sang draconis boli armen terrae sigill an Ê’ ij aloes mastich an Ê’ j. fiat pulvis subtilis And then the joynt must be wrapped about with a repercussive medicine composed of the whites of Eggs a little oil of Roses Bole Mastich and Barly flowr If it be needful to use a Tent let it be short and according to the wound thick lest it cause pain and moreover let it be anointed with the yolk of an egg oil of Roses washed turpentine and a little saffron But if the wound be more short and narrow it shall be dilated if there be occasion that so the humor may pass away more freely You must rest the part and beware of using cold relaxing mollifying humecting and unctuous medicines unless peradventure the sharpness of the pain must be mitigated For on the contrary astringent and desiccant medicines are good as this following cataplasm â„ž furfur macri farin An astringent and drying cataplasm hordei fabarum an â„¥ iiij florum chamae melil an m. ss terebinth â„¥ iij. mellis communis â„¥ ij ol myrt â„¥ j. oxymelitis vel oxycrat vel lixivii com quantum sufficit fiat cataplasma ad formam pultis Or you may compose one of the Lees of wine Wheat bran the powder of Oaken bark cypress nuts galls and Turpentine and such like that have an astringent strengthening and drying quality and thereby asswaging pain and hindering the defluxion of humors This following medicine is astringent and agglutinative â„ž terebinth venet â„¥ ij aq vitae parum pulvâ—ris mastich aloes myrrhae bâ—li armen an ℈ ij And also our balsam
head and then take fast hold of the head with your Cranes-bill and so draw them forth all three together CHAP. XX. What to be done when an Arrow is left fastned or sticking in a Bone BUt if the weapon be so depart and fastned in a Bone that you cannot drive it forth on the other side neither get it forth by any other way than that it entred in by A Caution you must first gently move it up and down if it stick very fast in but have a special care that you do not break it and so leave some fragment thereof in the bone then take it forth with your Crows-bill or some other fit Instrument formerly described Then press forth the bloud The benefit of bleeding in wounds and suffer it to bleed somewhat largely yet according to the strength of the Patient and nature of the wounded part For thus the part shall be eased of the fulness and illness of humors and less molested with inflammation putrefaction and other symptoms which are customarily feared When the weapon is drawn forth and the wound once dressed handle it if simple as you do simple wounds if compound then according to the condition and manner of the complication of the effects Certainly the Oyl of Whelps formerly described is very good to asswage pain To conclude you shall cure the rest of the symptoms according to the method prescribed in our Treatise of wounds in general and to that we have formerly delivered concerning wounds made by Gunshot CHAP. XXI Of poysoned Wounds IF these Wounds at any time prove poysoned they have it from their Primitive cause to wit The signs of poysoned wounds the empoysoned Arrows or Darts of their enemies You may find it out both by the property of the pain if that it be great and pricking as if continually stung with Bees for such pain usually ensues in wounds poysoned with hot poyson as Arrows usually are Also you shall know it by the condition of the wounded flesh for it will become pale and grow livid with some signs of mortification To conclude there happen many and malign symptoms upon wounds which are empoysoned being such as happen not in the common nature of usual wounds Remedies in poysoned wounds Therefore presently after you have plucked forth the strange bodies encompass the wound with many and deep scarifications apply ventoses with much flame that so the poyson may be more powerfully drawn forth to which purpose the sucking of the wound performed by one whose mouth hath no soarness therein but is filled with Oyl that so the poyson which he sucks may not stick nor adhere to the part will much conduce Lastly it must be drawn forth by rubefying vesicatory and caustick medicines and assailed by Oyntments Cataplasms Emplaisters and all sorts of local medicines The End of the Eleventh Book The Twelfth BOOK Of CONTVSIONS and GANGRENES CHAP. I. Of Contusions A Contusion according to Galen is a solution of continuity in the flesh or bone Gal. Lib de artis c nstitut Sect. 2 lib. de fracturis caused by the stroak of some heavy and obtuse thing or a fall from on high The symptom of this disease is by Hippocrates called Peliosis and Melasma that is to say blackness and blewness the Latins term it Sugillatum There are divers sorts of these Sugillations or blacknesses Causes of Bruises and Sugillations according as the bloud is poured forth into the more inward or outward part of the body The bloud is poured forth into the body when any for example falls from an high or hath any heavy weight falls upon him as it often happens to such as work in Mines or are extreamly racked or tortured and sometimes by too loud and forcible exclamations Besides also by a Bullet shot through the body bloud is poured forth into the Belly and so often evacuated by the passages of the Guts and Bladder The same may happen by the more violent and obtuse blows of a hard Trunchion Club Stone and all things which may bruise and press the cloud out of the vessels either by extending or breaking them For which causes also the exteriour parts are contused or bruised sometimes with a wound sometimes without so that the skin being whole and as far as one can discern untoucht the bloud pours it self forth into the empty spaces of the muscles and between the skin and muscles which affect the Ancients have tearmed Ecchymosis Hippocrates calls it by a peculiar name Nausiosis Sect. 2. Lib. de fract for that in this affect the swoln veins seem as it were to vomit and verily do vomit or cast forth the superfluous blood which is contained in them From these differences of Contusions are drawn the indications of curing as shall appear by the ensuing discourse CHAP. II. Of the general cure of great and enormous Contusions THe blood poured forth into the body must be evacuated by visible and not-visible evacuation The visible evacuation may be performed by blood-letting Cupping-glasses horns scarrification horsleeches and fit purgative medicins if so be the patient have not a strong and continual feaver The not-visible evacuation is performed by resolving and sudorifick potions Ad sentent 62. sect 3. lib. de A ticulis baths and a slender diet Concerning Blood-letting Galens opinion is plain where he bids in a fall from an high place and generally for bruises upon what part soever they be to open a vein though the parties affected are not of a full constitution for that unless you draw blood by opening a vein there may inflammations arise from the concreat blood from whence without doubt evill accidents may ensue After you have drawn blood give him foure ounces of Oxycrate to drink for that by the tenuity of its substance hinders the coagulation of the blood in the belly A portion to disolve an evacuate clotted blood A hot sheeps skin or in stead thereof you may use this following Potion â„ž rad GentianaeÊ’iij bulliant in Oxycrato in cilaâ—ura dissolve rhei electiÊ’ j. fiat potio These medicins dissolve and cast forth by spitting and vomit the congealed blood if any thereof be contained in the ventricle or lungs it will be expedient to wrap the Patient presently in a sheeps skin being hot and newly taken from the sheep and sprinkled over with a little myrrhe cresses and salt and so to put him presently in his bed then cover him so that he may sweat plentifully The next day take away the sheeps-skin A discussing ointment and anoint the body with the following anodyne and resolving unguent â„ž unguent de althaea â„¥ vj. olei Lumbric chamaem anethi an â„¥ ij terebinth venetae â„¥ iiij farinae foenugrae rosar rub pulverisat pul myrtillorum an â„¥ j. fiat liâ—us ut dictum est Then give this potion which is sudorifick and dissolves the congealed blood A Sudorifick potion to dissolve congealed blood Syrups hindering putrefaction
an humor malign by its acrimony which frets asunder the roots of the hairs and depraves the natural construction of the pores of the skin whence it is Aph. 4. sect 6. that such as are troubled with Quartain agues the Leprosie or Lues venerea have their hair fall off A livid flesh is ill in Ulcers which cause a rottenness or corruption of the bones lying under the flesh for it is an argument of the dying heat and corruption of the bone whence the flesh hath its original and integrity Those Ulcers which happen by occasion of any disease as a Dropsie are hard to be cured Hip. Lib. de ult Gal. cap. 2. 5 lib. Meth. 4. as also those whereinto a varix or swoln vessell continually casts in matter which a present distemper foments which have swoln hard and callous lips and such as are circular or round An Hypersarcosis or fleshy excrescence usually happens to Ulcers not diligently mundified and if they possess the arms or Legs they cause a Phlegmon or some other tumor in the groins chiefly if the body be full of ill humors as Avicen hath noted For these parts by reason of their rarity and weakness are fit and subject to defluxions Albucrasis writes that for nine causes Ulcers are difficultly replenished with flesh and cicatrized The first for want of blood in a bloodlesse body For what causes Ulcers are hard to heal the second by reason of ill humors and the impurity of the blood the third by the unfit application of unconvenient medicins the fourth by reason of the sordidness of the Ulcer the fifth by the putrefaction of the soft and carion-like flesh encompassing the Ulcer the sixth when they take their original from a common cause which every where rages with fury such as are those which are left by the pestilence the seventh by reason of the callous hardness of the lips of the Ulcer The eighth when the heavens and air are of such condition as ministers fuell to the continuance of the Ulcer as at Sarogoza in Aragon the ninth when the bones which lye under it are wasted by rottenness An Ulcer that casts forth white smooth equall quitture What pus or matter is smooth is equallâ— and white Ad sement 32. sect 2. de fract Aph. 21. sect 7. Two sorts of excrements flow from a malign Ulcer and little or no stinking is easily healed for it argues the victory of the native heat and the integrity of the solid parts We term that smooth quitture which is absolutely concocted neither yeelds any asperity to the touch whereby we might suspect that as yet any portion of the humor remains crude we call that equall wherein you can note no diversity of parts and white not that which is perfectly so but that which is of an ash colour as Galen observes But it is ill if when the cure is indifferently forward a flux of blood suddainly break forth in those Ulcers which beat strongly by reason of the great inflammation adjoyned therewith For as Hippocrates observes an effusion of blood happening upon a strong pulsation in Ulcers is evill for the blood breaking out of an Artery cannot be stayed but by force and also this blood is so furious by reason of the heat and inflammation the nourishers of this Ulcer that it breaks its receptacles and hence ensues the extinction of the native heat whence the defect of suppuration and a Gangrene ensues Now for that there flowes two sorts of excrements from malign Ulcers the more thin is tearmed Ichor or saniâ—s but the more grosse is named sordes that is virulent and flowes from pricked nerves and the periostea when they are evill affected but the other usually flowes from the Ulcers of the joints and it is the worser if it be black reddish ash-coloured if muddy or unequall like wine Lees if it stink Sanies is like the water wherein flesh hath been washed it argues the preternatural heat of the part but when it is pale coloured it is said to shew the extinction of the heat CHAP. IV. Of the generall cure of Ulcers The curing of a simple Ulcer consists in exsiccation Gal 7 Meth. cap. 12. AN Ulcer is either simple or compound A simple Ulcer as an Ulcer hath one and that a simple indication that is exsiccation and that more than in a wound by how much an Ulcer is moister than a Wound There are many indications proposed for the cure of a compound Ulcer in respect of which Galen would have us to keep this order that we have the first regard of the most urgent then of the cause then of that which unless it be taken away the Ulcer cannot be healed By giving you an example you may easily understand the meaning hereof Imagin on the â—â—de of the Leg a little above the ancle an Ulcer very painful hollow putrid associated with the rottenness of the bone circular having hard and swoln Lips and engirt with the inflammatâ—on and varices of the neighbouring parts If you take this to cure before you do any thing about the Ulcer unlesse you be called upon by that which urges as by vehemency of pain you must first use general means by calling and advising with a Physitian For in Galens opinion Gal. lib. 4. de comp med secund gen if the whole body require a preparation then must that be done in the first place for in some Ulcers pâ—rgation onlâ— will be sufficient in some blood-letting others are better by using both meaâ—s which is as the cause of the Ulcer proceeds from a repletion or ilness of humors Now by t eâ—e means having taken away the cause of the Ulcer you must come to the particular cure thereoâ— begâ—nniâ—g with that which is most urgent Wherefore you must first asswage the pain by applicaâ— oâ— of things contrary to the cause thereof as if it proceed from a Phlegmonous distemper whic h t loâ—g possest distended and hardned the part it must be eased by evacuation First batâ—ng â— wi h warm water to mollifie and relax the skin that so you may the more easily evacuateâ—â—ec â—a eâ— hâ—mors then shall you draw away a portion of the matter cauâ—â—g the swelling and pa n by scar fication if the Patient shall be of sufficient courage or else by application of horse-leâ—câ—es if â—e be more faint-hearted and then you shall temper the heat thereof by applying Unguentum refrigerans Galeni To conclude you shall attempt all things which we have formerly delivered in our Treatise of Tumors to take away the swelling thereof When you have brought this to that pass you desire yoâ— shall come to those which are such that it cannot be taken away or healed without them which shall be done by orderly helping the defects against nature which were coâ—joâ—ned with the Ulcer to wit the rottenness of the bone which you shall help by actual cauter es and in the mean while you shaâ—l draw the Ulcer
it again for unless the medicin adhere long to the skin it will do no good Which thing notwithstanding many Physitians have been ignorant of thinking if they wiped away the sanies from the Ulcer thrice on a day they should do better than those who did the same but twice a day But those who dress it but once a day are reproved by the Patients as negligent But they are much mistaken for you must remember as we have delivered in most of our writings that the qualities of all neighbouring bodies do mutually actuate and affect each other in some degree although the one thereof be much more powerfull for by this reason in space of time they become somewhat alike though they otherwise differ much But when the quality of the medicin shall be like the species to the body to be cured there follows the better success Wherefore he which moved by these reasons first appointed to use the emplaister formerly applyed is worthy of commendations and we ought to follow him much the rather seeing that which he found out by reason is approved by experience Neither did he unadvisedly command to foment the wound every third day that is every dressing for seeing it is a powerfull medicin therefore it stands in need of mitigation Thus much Galen whose opinion grounded on reason he can again confirm with another reason Galens reason further explained It is already sufficiently known that medicins can do nothing in us unless by the force of the native heat which stirs up the faculty of the medicin to operation But in Ulcers which are absolutely malign the native heat of the affected part is very languid being broken and debilitated by the presence of the preternatural heat so that it stands in need of a great space of time to actuate the vertue and faculty of the medicin Wherefore if in that time when as the native heat hath much moved and stirred up the faculty of the medicin the Ulcer be loosed or opened and that emplaister cast away which was laid upon the part and a fresh one laid in stead thereof the heat implanted in the part is either dissipated by the contact of the air or is weakned and driven in and that endeavour which was made by the emplaister was to no purpose being as it were stopped in the midst of the course But a new emplaister being laid on the heat of the part must undergo a new labour so to stir up the faculty to bring it to act Medicins are only such in faculty For all medicins are what they are in faculty Equal to this is their error who by too oft renewing their emplaisters on the same day do too powerfully cleanse for so they do not only take away the excrementitious humors both sordes and sanies but also the alimentary juice to wit the Rob Cambium and Gluten which are the next matter for procreating of laudable flesh Wherefore it is not good to dress Ulcers so often in one day and to loose them to apply new emplaisters unless some grievous symptom as pain force us to do it which requires to be asswaged and mitigated by the often changing and renewing of Anodyne medicins CHAP. XII How to binde up Ulcers The beginning of your binding must be at the Ulcer Hip. lib. de ult FOr the binding up of Ulcers you must alwayes begin your bandage at the Ulcer Now the Rowler must be so large that it may not only cover and comprehend the Ulcer but also some portion of the adjacent parts above and below and let it press the Ulcer with that moderation that it may only press out the excrementitious humors For so the Ulcer will become dry and consequently more neer to healing as it is observed by Hippocrates Let this be the measure of your binding that it be neither too strait for hence would ensue pain and defluxion nor too lax for such is of no use You may moisten your boulsters and Rollers in Oxycrate or in red and astringent Wine especially in Summer when you have bound it up the part must be kept quiet For according to Hippocrates those who have an Ulcer in the leg ought neither to stand nor sit but to lye on a bed Wherefore when the legs are ulcerated the arms must be exercised by handling Revulsion into contrary parts lifting up and casting down of divers things But on the contrary if the arms be ulcerated the legs must be exercised with walking or frictions from above downwards if the Patient cannot endure to walk So the humors and spirits which with more violence and greater plenty run down to the part affected may be drawn back and diverted CHAP. XIII Of the cure of particular Ulcers and first of those of the Eyes 4. Mâ—â—h FOr that in Galens opinion the divers indications in curing diseases are drawn from the condition of the part to wit the temper complexion site figure use dull or quick sense Therefore having briefly handled the general cure both of simple and compound and implicit Ulcers I think it fit to treat of them now as they are distinguished by the parts beginning with these of the eyes These according to Celsus are sometimes caused by pustules or a sharp defluxion which frets or eats in sunder the coats thereof or else by a stroak Lib. 6. cap. 6. Lib. 3. Botryon Caeloma Argemon Epicauma Paulus sets down these differences of the Ulcers of the eyes If saith he a small little and hollow Ulcer be upon the horny-coat it is by the Greeks tearmed Botryon but if it be broader and less deep it is termed Caeloma about the circle of the Iris or Rainbow it is called Argemon If it be crusty and sordid it is termed Epicauma These in general require the same cure as the former that is to be mundified incarnated dryed and cicatrized but the part affected indicates more gentle medicins Wherefore having purged the Patient and taken some blood both from his arm The cure as also from his veins and temporall Arteries and bathed him if it be needful to divert the defluxion you shall to his shoulders apply cupping-glasses with scarification or else bread newly drawn out of the oven and sprinkled with aqua vitae or some good wine shall be applyed to the original of the spinall marrow A Collyrium to cleanse the ulcers of the eyes But you shall apply to the forehead and temples an astringent emplaister made of emplastrum contra rupturam ung Cemmitissae and resiccativum rubrum mixed together But this ensuing Collyrium described by Celsus and approved by Hollerius shall be dropped into the eye â„ž aeris usti cadmiae ustae lotae an â„¥ j. ex aqua fingatur collyrium quod liquore ovi dislolvatur But in the mean time you must diligently observe whether you put the eye to any great pain Wherefore now and then by putting anodyne medicins thereto it will be good to comfort it Also you
medicins as those of the reins are but these not only taken by the mouth but also injected by the urinary passage These injections may be made of Gordonius his Trochisces formerly prescribed being dissolved in some convenient liquor but because Ulcers of the bladder cause greater and more sharp pain than those of the Kidnies therefore the Chirurgeon must be more diligent in using Anodynes For this purpose I have often by experience found that the oil of henbane made by expression gives certain help He shall do the same with Cataplasms and Liniments applyed to the parts about the Pecten and all the lower belly and perinaeum Aegyptiacum for the ulcers of the bladder as also by casting in of Clysters If that they stink it will not be amiss to make injection of a little Aegyptiacum dissolved in wine plantain or rose-water For I have often used this remedy in such a case with very prosperous success CHAP. XIX Of the Ulcers of the Womb. The causes ULcers are bred in the womb either by the conflux of an acrid or biting humour fretting the coats thereof or by a tumour against nature degenerating into an abscess or by a difficult and hard labour they are known by pain at the perinaeum and the efflux of Pus and Sanies by the privity Lib. 3. sect 12. tract 2. cap. 5. All of them in the opinion of Avicen are either putrid when as the Sâ—nies breaking forth is of a stinking smell and in colour resembles the water wherin flesh hath been washed Signs or else sordid when as they flow with many virulent and crude humours or else are eating or spreading Ulcers when as they cast forth black Sanies and have pâ—lsation joyned with much pain Besides they differ amongst themselves in site for either they possess the neck and are known by the sight by putting in a speculum or else are in the bottom and are manifested by the condition of the more liquid and serous excrements and the site of the pain The cure They are cured with the same remedies wherewith the Ulcers of the mouth to wit with aqua fortis the oil of Vitriol and Antimony and other things made somewhat more milde and corrected with that moderation that the ulcerated parts of the Womb may be safely touched with them it is requisite that the remedies which are applyed to the ulcers of the womb do in a moment that which is expected of them for they cannot long adhere or stick in the womb as neither to the mouth Galen saith Why strongly drying things are good for Ulcers of the womb that very drying medicins are exceeding fit for ulcers of the womb that so the putrefaction may be hindred or restrained whereto this part as being hot and moist is very subject besides that the whole body unto this part as unto a sink sends down its excrements If an ulcer take hold of the bottom of the womb it shall be cleansed and the part also strengthened by making this following injection â„ž hordei integri p. ij guajaci â„¥ j. An injection for an Ulcer in the bottom of the wombe rad Ireos â„¥ ss absinth plant centaur utriusque an M. j. fiat decoct in aqua fabrorum ad lb ij in quibus dissolve mellis rosati syrupi de absinthio an â„¥ iij. fiat injectio For amending the stinking smell I have often had certain experience of this ensuing remedy â„ž vini rab lb.j. unguent aegyptiaci â„¥ ij bulliant parum Thus the putrefaction may be corrected An injection hindering putrefaction and the painfull maliciousness of the humor abated Ulcers when they are cleansed must presently be cicatrized that may be done with Alum water the water of Plantain wherein a little Vitriol or Alum have been dissoved Lastly if remedies nothing availing the ulcer turn into a cancer it must be dressed with anodynes and remedies proper for a Cancer which you may finde set down in the proper treatise of Cancers The cure of Ulcers of the fundament was to be joined to the cure of these of the womb but I have thought good to referre it to the treatise of Fistulaes as I do the cure of these of the urinary passage to the Treatise of the Lues Venerea CHAP. XX. Of the Varices and their cure by cutting A Varix is the dilatation of a vein some whiles of one and that a simple branch What a Varix is and what be the differences thereof other whiles of many Every varix is either straight or crooked and as it were infolded into certain windings within its self Many parts are subject to Varices as the temples the region of the belly under the navil the testicles womb fundament but principally the thighs and legs The matter of them is usually melancholy blood The matter for Varices often grow in men of a melancholy temper and which usually feed on gross meats or such as breed gross and melancholy humours Also women with childe are commonly troubled with them by reason of the heaping together of their suppressed menstrual evacuation The causes The precedent causes are a vehement concussion of the body leaping running a painfull journey on foot a fall the carrying of a heavy burden torture or racking This kinde of disease gives manifest signs thereof by the largeness thickness Signs swelling and colour of the veins It is best not to meddle with such as are inveterate The cure for of such being cured there is to be feared a reflux of the melancholly blood to the noble parts whence there may be imminent danger of malign Ulcers a Cancer madness or suffocation When as many Varices and diversly implicit are in the legs they often swell with congealed and dryed blood and cause pain which is increased by going and compression The cutting of Varices Such like varices are to be opened by dividing the vein with a Lancet and then the blood must be pressed out and evacuated by pressing it upwards and downwards which I have oft-times done and that with happy success to the Patients whom I have made to rest for some few dayes and have applyed convenient medicins A varix is often cut in the inside of the leg a little below the knee in which place commonly the originall thereof is seen He which goes about to intercept a varix downwards from the first originall and as it were fountain thereof makes the cure far more difficult For hence it is divided as it were into many rivulets all which the Chirurgeon is forced to follow A varix is therefore cut or taken away so For what intention a Varix must be cut Paulus cap. 82. lib. 6. The manner how to cut it to intercept the passage of the blood and humours mixed together therewith flowing to an ulcer seated beneath or else lest that by the too great quantity of blood the vessel should be broken and death be occasioned by
a haemorrhagie proceeding from thence Now this is the manner of cutting it Let the Patient lye upon his back on a Bench or table then make a Ligature upon the leg in two places the distance of some four fingers each from other wherein the excision may be made for so the vein will swell up and come more in sight and besides you may also mark it with ink then taking the skin up between your fingers cut it long-wayes according as you have marked it then free the bared vein from the adjacent bodies and put thereunder a blunt-pointed needle lest you prick the vein thred with a long double thred and so bind it fast and then let it be opened with a Lancet in the middle under the ligature just as you open a vein and draw as much therehence as shall be fit Then straight make a ligature in the lower part of the forementioned vein and then cut away as much of the said vein as is convenient between the ligatures and so let the ends thereof withdraw themselves into the flesh above and below let these ligatures alone untill such time as they fall away of themselves The operation being performed let an astringent medicine be applyed to the wound and the neighbouring parts neither must you stir the wound any more for the space of three dayes Then do all other things as are fit to be done to other such affects CHAP. XXI Of Fistulaes A Fistula is a sinuous white narrow callous and not seldom unperceivable Ulcer What a Fistula is It took its denomination from the similitude of a reeden Fistula that is a pipe like whose hollowness it is A Fistula is bred in sundry parts of the body and commonly followes upon abscesses or Ulcers not well cured What a Callous is The differences of Fistulaes A Callous is a certain fleshy substance white solid or dense and hard dry and without pain generated by heaping up of dryed excrementitious phlegme or else adust melancholy encompassing the circuit of the Ulcer and substituting it self into the place of laudable flesh The Sinus or cavity of a Fistula is sometimes dry and other while drops with continual moisture sometimes the dropping of the matter sodainly ceases and the orifice thereof is shut up that so it may deceive both the Chirurgeon and the Patient with a false shew of an absolute cure for within a while after it will open again and run as formerly it did Some Fistulaes are bred by the corruption of a bone others of a nerve others of membranes and others of other parts of the body Some run straight in others and that the greater part have turnings and windings some have one others have more orifices and windings some are at the joints others penetrate into some capacity of the body as into the chest belly guts womb bladder some are easily others difficultly cured The signs and some wholly uncurable There are divers signs of Fistulaes according to the variety of the parts they possess for if that which you touch with the end of your probe make resistance and resound then you may know that it is come to the bone and then if the end of the probe slip up and down as on a smooth and polite superficies it is a sign that the bone is yet sound but if it stop and stay in any place as in a rough way The sign that the bone is bare from the condition of the matter which is cast forth Aetius tetr 4. sect 2. cap. 55. then know that the bone is eaten rough and perished sometimes the bone lies bare and then you need not use the probe Besides also it is a sign that the bone is affected if there be a purulent efflux of an unctuous or oily matter not much unlike that marrow wherewith the bone is nourished For every excrement shewes the condition of the nourishment of the part whence it is sent in a Fistula which penetrates to a nerve the Patient is troubled with a pricking pain especially when you come to search with a Probe especially if the matter which slowes down be more acrid Oft-times if it be cold the member is stupified the motion being weakened besides also the matter which flowes from thence is more subtle and somewhat like unto that which flowes from the bones yet not oily nor fat but sanious and viscous resembling the condition of the alimentary humour of the nerves The same usually appears and happens in Fistulaes which penetrate to the Tendons and those membranes which involve the muscles If the Fistula be within the flesh the matter flowing thence is more thick and plentifull smooth white and equal If it descend into the veins or arteries the same happens as in those of the nerves but that there is no such great pain in searching with your Probe nor no offence or impediment in the use of any member yet if the matter of the fistulous Ulcer be so acrid as that it corrode the vessels Old Fistulaes if closed prove mortall blood will flow forth and that more thick if it be from a vein but more subtle and with some murmuring if from an artery Old Fistulaes and such as have run for many years if suddainly shut up cause death especially in an ancient and weak body CHAP. XXII Of the cure of Fistulaes How to finde out the windings cavities of Fistulaes FOr the cure in the first place it will be expedient to search the Fistula and that either with a wax size a probe of lead gold or silver to finde out the depth and windings or corners thereof But if the Fistula be hollowed with two or more orifices and those cuniculous so that you cannot possibly and certainly search or find them all our with your probe then must you cast an injection into some one of these holes and so observe the places where it comes forth for so you may learn how many and how deep or superficiary cavities there be then by making incisions you must lay open and cut away the callous parts You must make incisions with an incision knife or razour or else apply actual or potential cauteries for nature cannot unless the callous substance be first taken away restore or generate flesh or agglutinate the distant bodies For hard things cannot grow together unless by the interposition of glue such as is laudable blood but a callous body on all sides possessing the surface of the ulcerated flesh hinders the flowing of the blood out of the capillary veins for the restoring of the lost substance and uniting of the disjointed parts If you at any time make caustick injections into the Fistula Caustick injections you must presently stop the orifice thereof that so they may have time to work the effect for which they are intended Which thing we may conjecture by the tumor of the part the digesture of the flowing matter and its lesser quantity Then you must hasten the falling
which sometimes in space of time contracts a Callus others only swell and cast forth no moisture some are manifest others lye only hid within Those which run commonly cast forth blood mixed with yellowish serous moisture which stimulates the blood to break forth and by its acrimony opens the mouths of the veins But such as do not run are either like blisters such as happen in burns and by practitioners are usually called vesicales and are caused by the defluxion of a phlegmatick and serous humor or else represent a Grape whence they are called Uvales generated by the afflux of blood laudable in quality but overabundant in quantity or else they express the manner of a disease whence they are termed morales proceeding from the suppression of melancholick blood or else they represent Warts whence they are stiled Verrucales enjoying the same material cause of the generation as the morales do This affect is cause of many accidents in men Symptomes for the perpetual efflux of blood extinguisheth the vivid and lively colour of the face calls on a Dropsie overthrows the strength of the whole body The flux of Haemorrhoides is commonly every moneth sometimes only four times in a year Great pain inflammation an Abscesse which may at length end in a Fistula unless it be resisted by convenient remedies do oft-times fore-run the evacuation of the Haemorrhoides But if the Haemorrhoides flow in a moderate quantity if the Patients brook it well they ought not to be stayed for that they free the Patients from the fear of eminent evils as melancholy leprosie Sent. 37. sect 6. epid strangury and the like Besides if they be stopped without a cause they by their reflux into the Lungs cause their inflammation or else break the vessels thereof and by flowing to the Liver cause a dropsie by the suffocation of the native heat they cause a Dropsie and universal leanness on the contrary if they flow immoderately by refrigerating the Liver by loss of too much blood wherefore when as they flow too immoderately they must be stayed with a pledget of Hares-down dipped in the ensuing medicin A remedy for the immoderate flowing of the Haemorrhoides ℞ pul aloes thuris baulast sang draconis an ℥ ss incorporentur simul cum ovi albumine fiat medicamentum ad usum When they are stretched out and swoln without bleeding it is convenient to beat an Onion roasted in the embers with an Oxes gall and apply this medicin to the swoln places and renew it every five hours For supprest Haemorrhoides This kind of remedy is very prevalent for internal Haemorrhoides but such as are manifest may be opened with Horse-leaches or a Lancet The juice or mass of the hearb called commonly Dead-nettle or Arch-angel applyed to the swoln Haemorrhoides opens them and makes the congealed blood flow there-hence The Fungus and Thymus being diseases about the Fundament are cured by the same remedy If acrimony heat and pain do too cruelly afflict the Patient you must make him enter into a bath and presently after apply to the Ulcers if any such be this following remedy ℞ Olei ros ℥ iiij cerusae ℥ i. Litharg ℥ ss cerae novae ʒ vj. opii ℈ j. fiat unguent secundum artem Or else ℞ thuris myrrhae croci an ʒ j. opii ℈ j. fiat unguentum cum oleo rosarum mucilagine sem psillii addendo vitellum unius ovi You may easily prosecute the residue of the cure according to the general rules of Art The End of the Thirteenth Book The FOURTEENTH BOOK Of Bandages or Ligatures CHAP. I. Of the differences of Bandages BAndages wherewith we use to binde do much differ amongst themselves Lib. de fasciis But their differences in Galens opinion are chiefly drawn from six things to wit their matter figure length breadth making and parts whereof they consist Now the matter of Bandages is threefold Membranous or of skins which is accommodated peculiarly to the fractured grisles of the Nose of Woollen proper to inflamed parts as those which have need of no astriction of Linnen as when any thing is to be fast bound and of Linnen cloaths some are made of flax other some of hemp as Hippocrates observes Sect. 3. de Chir. offic But Bandages do thus differ amongst themselves in structure for that some thereof consist of that matter which is sufficiently close and strong of it self such are the membranous others are woven as the linnen ones But that Linnen is to be made choice of for this use and judged the best What cloth best for rowlers not which is new never formerly used but that which hath already been worn and served for other uses that so the Bandages made thereof may be the more soft and pliable yet must they be of such strength that they may not break with stretching and that they may straitly contain and repell the humor ready to flow down and so hinder it from entring the part These besides must not be hemmed nor stitched must have no lace nor seam for hems and seams by their hardness press into and hurt the flesh that lies under them Lace whether in the midst or edges of the rowler makes the Ligature unequal For the Member where it is touched with the lace as that which will not yield is pressed more hard but with the cloth in the middle more gently as that which is more lax Furthermore these Ligatures must be of clean cloth that if occasion be they may be moistened or steeped in liquor appropriate to the disease and that they may not corrupt or make worse that liquor by their moistening therein Now the Bandages which are made of Linnen clothes must be cut long-wayes and not athwart for so they shall keep more firm and strong that which they bind and besides they will be alwayes alike and not broader in one place then in another But they thus differ in figure for that some of them are rolled up to which nothing must be sowed for that they ought to be of a due length to bind up the member others are cut or divided which truely consist of one piece but that divided in the end such are usually taken to binde up the breasts or else in the midst others are sowed together which consist of many branches sowed together and ending in divers heads and representing divers figures such are the Bandages appropriated to the head But they thus differ in length for that some of them are shorter others longer so in like sort for breadth for some are broader others narrower Yet we cannot certainly define nor set down neither the length nor breadth of Rowlers for that they must be various according to the different length and thickness of the members or parts Generally they ought both in length and breadth to fit the parts whereunto they are used For these parts require a binding different each from other the head the neck shoulders arms
conveniency as you can that it may be so large as to encompass and cover all the wound for these reasons which shall be delivered at large in our Treatise of Fractures But if the wound run long-wayes let the boulsters and splints be applyed to the sides of the wound that so the lips of the wound may be pressed together and the contained filth pressed forth Ad sent 12. sect de fract But if it be made overthwart we must abstain from boulsters and splints for that in Galens opinion they would dilate the wound and the purulent matter would be pressed out and cast back into the wound CHAP. V. Certain common precepts of the binding up of Fractures and Luxations IN every Fracture and Luxation the depressed hollow and extenuated parts such as are neer unto the joints ought to be filled up with boulsters or clothes put about them so to make the part equal that so they may be equally and on every side pressed by the splints and the bones more firmly contained in their seats So when the knee is bound up you must fill the ham or that cavity which is there that so the ligation may be the better and speedilier performed The same must be done under the arm-pits Hipp. sent 37. 38. sect 1. de fract above the heel in the arm neer the wrist and to conclude in all other parts which have a conspicuous inequality by reason of some manifest cavity When you have finished your binding then enquire of the Patient whether the member seem not to be bound too strait For if he say that he is unable to endure it so hard bound then must the binding be somewhat flackned The signs of too strait and loose binding up For too strait binding causes pain heat defluxion a gangrene and lastly a sphacel or mortification but too loose is unprofitable for that it doth not contain the parts in that state we desire It is a sign of a just ligation that is neither too strait nor too loose if the ensuing day the part be swoln with an oedematous tumor caused by the blood pressed forth of the broken place but of too strait ligation if the part be hard swoln and of too loose if it be no whit swoln as that which hath pressed no blood out of the affected part Now if a hard tumor caused by too strait binding trouble the Patient it must presently be loosed for fear of more grievous symptoms and the part must be fomented with warm Hydraeleum and another indifferent yea verily more loose ligature must be made instead thereof as long as the pain and inflammation shall continue in which time and for which cause you shall lay nothing upon the part which is any thing burdensome When the Patient begins to recover for three or four dayes space especially if you find him of a more compact habit and a strong man the ligature must be kept firm and not loosed If on the third day and so untill the seventh the spires or windings be found more loose and the part affected more slender then we must judge it to be for the better For hence you may gather that there is an expression and digestion of the humors causing the tumor made by force of the ligation Verily broken bones fitly bound up are better set and more firmly agglutinated which is the cause why in the place of the fracture the ligation must be made the straiter Why we must make more strait ligation on the broken part in other places more loosly If the fractured bone stand forth in any part it must there be more straitly pressed with boulsters and splints To conclude the seventh day being past we must bind the part more straitly then before for that then inflamation pain and the like accidents are not to be feared But these things which we have hitherto spoken of the three kinds of Ligatures cannot take place in each fractured part of the body as in the chaps collar-bones head nose ribs For seeing such parts are not round and long a Ligature cannot be wrapped about them as it may on the arms thighs and legs but only be put on their outsides CHAP. VI. The uses for which Ligatures serve The first benefit of Ligatures BY that which we have formerly delivered you may understand that Ligatures are of use to restore those things which are separated and moved forth of their places and joyn together those which gape as in fractures wounds contusions sinewous Ulcers and other like affects against nature in which the solution of continuity stands in need of the help of Bandages for the reparation thereof The second Besides also by the help of Bandages these things are kept asunder or separated which otherwise would grow together against nature as in Burns wherein the fingers and the hams would mutually grow together as also the Arm-pits to the Chest the Chin to the Breast The third unless they be hindred by due ligation Bandages do also conduce to refresh emaciated parts wherefore if the right leg waste for want of nourishment the left leg beginning at the foot may be conveniently rowled up even to the groin If the right arm consume binde the left with a strait Ligature beginning at the hand and ending at the arm-pit For thus a great portion of bloud from the bound-up part is sent back into the vena cava from whence it regurgitates into the almost empty vessels of the emaciated part But I would have the sound part to be so bound that thereby it become not painfull for a dolorifick ligation causes a greater attractation of blood and spirits as also exercise wherefore I would have it during that time to be at rest and keep holy-day The fourth Ligatures also conduce to the stopping of bleedings which you may perceive by this that when you open a vein with your lancet the blood is presently stayed laying on a boulster and making a Ligature The fifth Also Ligatures are usefull for women presently after their delivery for their womb being bound about with Ligatures the blood wherewith their womb was too much moistened is expelled the strength of the expulsive faculty being by this means stirred up to the expulsion thereof and it also hinders the empty womb from being swoln up with wind which otherwise would presently enter thereinto The sixth This same Ligature is a help to such as are with childe for the more easie carrying of their burden especially those whose Childe lyes so far downwards that lying as it were in the den of the hips it hangs between the thighs and so hinders the free going of the mother Therefore the woman with childe is not only eased by this binding of her womb with this Ligature which is commonly tearmed the Navil-ligature but also her childe being held up higher in her womb she hath freer and more liberty to walk The seventh Ligatures are in like sort good for
ribs for that they are bony may be broken in any part of them In what place the short ribs may be broken But the bastard ribs cannot be truly broken unless at the back-bone because they are only bony in that part but gristly on the foreside toward the breast-bone wherefore there they can only be folded or crooked in These which are subject to fractures may be broken inwards and outwards But oft-times it comes to pass that they are not absolutely broken but cleft into splinters and that sometimes inwards but not outwards Thus the fissure doth oft-times not exceed the middle substance of the rib but sometimes it so breaks through it all that the fragments and splinters doe prick and wound the membrane which invests and lines them on the inside and then there is great danger But when the fracture is simple without a wound compression puncture of the membrane and lastly without any other symptome then the danger is less Therefore Hippocrates wisheth that those who are thus affected Sent. 56. sect 3. de art fill themselves more freely with meat for that moderate repletion of the belly is as it were a certain prop or stay for the ribs keeping them well in their place and state which rule chiefly takes place in fractures of the bastard ribs For such as have them broken usually feel themselves better after than before meat For emptiness of meat or of the stomach makes a suspension of the ribs as not underpropped by the meat Now that fracture which is outwardly is far more easie to heal Why an internal fracture of the ribs is deadly than that which is inwardly for that this pricketh the membrane or Pleura and causeth inflammation which may easily end in an Empyema Adde hereunto that this is not so easily to be handled or dealt withall as the other whereby it cometh to pass that it cannot be so easily restored for that these things cannot be so fully and freely performed in this kinde of fracture which are necessary to the setting of the bone as to draw it out hold it and join it together It is therefore healed within twenty dayes if nothing else hinder The signs of fractured ribs are not obscure The signs for by feeling the grieved part with your fingers you may easily perceive the fracture by the inequality of the bones and their noise or crackling especially if they be quite broke asunder The cause of spitting blood when the ribs are broken But if a rib be broken on the inside a pricking pain far more grievous than in a plurisie troubles the Patient because the sharp splinters prick the Costall membrane whence great difficulty in breathing a cough and spitting of bloud ensue For bloud flowing from the vessels broken by the violenee of the thing causing the fracture is as it were sucked up by the lungs and so by a dry cough carryed into the Weazond and at length spit out of the mouth Some to pull up the bone that is quite broken and deprest apply a Cupping-glass and that is ill done for there is caused greater attraction of humours and excess of pain by the pressure and contraction of the adjacent parts by the Cupping-glass wherefore Hippocrates also forbids it Sent. 15. sect 3. de art Paulus lib. 6. cap. 96. Avicen 4. The cure Therefore it is better to endeavour to restore it after this following manner Let the Patient lye upon his sound side and let there be laid upon the fractured side an emplaister made of Turpentine Rosin black Pitch Wheat flour Mastick and Aloes and spread upon a strong and new cloth When it hath stuck there some time then pluck it suddenly with great violence from below upwards for so the rib will follow together therewith and be plucked and drawn upwards It is not sufficient to have done this once but you must do it often untill such time as the Patient shall finde himself better and to breath more easily There will be much more hope of restitution if whilest the Surgeon do this diligently the Patient forbear coughing and hold his breath Otherwise if necessity urge as if sharp splinters with most bitter tormenting pain prick the Costall membrane overspread with many nerves veins and arteries which run under the ribs whence difficulty of breathing spitting of bloud a cough and feaver ensue then the only way to deliver the Patient from danger of imminent death is to make incision on the part where the rib is broken that so laying it bare you may discern the pricking fragments and take them out with your instrument or else cut them off And if you make a great wound by incision then shall you sew it up and cure it according to the common rules of curing wounds Now diet phlebotomy and purgation A simple fracture may be cured only by Surgery which as Hippocrates saith are not very needfull in a simple fracture for that there are no symptomes which may require such remedies yet they by reason of the complicated symptoms as a convulsion feaver Empyema and the like must here be prescribed by the advice of the Physician which oversees the cure A Cerate and other remedies fitting the occasion shall be applyed to the grieved part no other ligatures can be used than such as are fit to hold fast and stay the local medicins There is no other Rule of site and lying than such as is taken from the will and content of the Patient CHAP. XII Of certain preternatural affects which ensue upon broken Ribs MAny symptoms ensue upon fractured and contused ribs but amongst the rest there are two which are not common whereof we will treat in this place The first is the inflation or rising up of the contused flesh which also ensues upon light affects of the bone which have been neglected at the beginning But the flesh is not meerly puffed up of it self but also within a certain phlegmatick glutinous and viscous humour gathering thereinto The cause hereof is The cause the weakness of the digestive faculty of the part occasioned by the stroak and distemper which therefore cannot affimilate the nourishment flowing more plentifully than it was wont either drawn thither by means of the pain or sent thither by a blinde violence of nature stirred thereto by a desire of its own preservation Wherefore this half crude humor remaining there raiseth much flatuling from its self or else wrought upon by the weaker heat it is resolved into cloudy vapours whence it cometh to pass that the flesh is swoln up in that place The signs and the skin on the contrary grows soft as if it were blown up with a quill Therefore laying your hand thereon you may hear the noise of the winde going forth thereof and see a cavity left in the part as it is usually seen in oedematous tumors Unless you remedy this inflation there will ensue an inflammation feaver abscess difficulty of breathing and lastly that
for as much as pertains to the generating of a Callus as light meats are For that makes the Callus too dry these too tender Lib. 6. meth c. 5. Wherefore Galen pronounces these meats onely fit for generating a Callus which are neither fragil nor friable neither serous and thin nor too dry but indifferent gross and also viscid fat and tough These meats digested by the stomach into chylus are sent into the guts and from hence by the mesaraick veins into the gate-vein and the hollow part of the Liver thence into the hollow vein and so into the veins dispersed over all the body and parts thereof There are also some of these veins which carry bloud into the bones but in the large cavities of the bones is marrow contained as in the small a certain marrowy substance proportionable thereto being their proper nourishment The generation of marrow is from the grosser portion of the bloud which flows into the greater cavities of the bones by larger veins and arteries but into the less by lesser which end in their pores and small passages For in large bones you may observe large and apparent passages by which the veins and arteries enter for the forementioned use Why the marrow may seem to have sense of feeling By the same ways the nerves also insinuate themselves from whence proceeds a membrane which involves the marrow of the bones the which by that means is endued with most exquisite sense as experience teacheth which is the cause that makes many believe that the marrow hath sense of feeling because the membranes thereof being hurt cause most bitter pain Therefore out of the marrow and the proper substance of the bone there sweats a certain gross and terrestrial juice whereof by the power of the assimilating faculty which serves in stead of the formative a Callus grows and knits In what space the leg is usually knit Simple fractures of the leg are usually knit in fifty days but through the occasion of the wound and the scales quite broke off and other accidents which befel me it was three whole months before the fragments of the bones were perfectly knit and it was also another month before I could go upon my leg without the help of a crutch Going was painful to me for some few days because the Callus had taken up some place of the muscles for before my former freedom of motion could return again to the broken and knit part it was necessary that the tendons and membranes should separate themselves by little and little from the scar In the performance of all these things I had the diligent and faithful assistance amongst the Surgeons to omit Physitians of Anthony Portal the Kings Surgeon CHAP. XXIX Of those things which may hinder the generation of a Callus and how to correct the faults thereof if it be ill formed HAving already spoken of the signs of a Callus beginning to concrete of its generation and the manner thereof it now remains that we treat of those things which hinder the generation thereof and what on the contrary help forwards the conformation and concretion thereof Now these things which either wholly hinder Discussing and unctuous medicines hinder the generation of a Callus What helps forward the generation thereof or else retard the generation of a Callus have a strong and powerful discussive and attenuating faculty or else they are unctuous oily and moist For by such the juice whereof the Callus ought to be is either melted and consumed or else grows soft and is relaxed But on the contrary those things which help forwards a Callus must be drying incrassating thickening hardning and emplastick moderately hot and astringent But for moist and relaxing medicines they ought to have no place here unless when it happens that the Callus is ill formed that is too thick or crooked or otherwise ill shapen whereby it may be wasted and broken so to be restored again after a better manner Yet notwithstanding such things are not to be attempted unless when the Callus is yet green and so depraved that the fault thereof doth very much pervert the native conformation of the part and exceedingly offend the action Then therefore in such a case the place must be fomented with a decoction of a Sheeps head and guts wherein shall be boiled the roots of Marsh-mallows of Briony the seeds of Line of Faenugreek Pigeons dung Bay-berries and the like You shall also use this following ointment and plaster ℞ Vnguenti de Althaeâ ℥ iv olei liliorum axungiae anseris an ℥ j. aquae vitae parum liquefiant fimul fiat linimentum quo lineatur pars Then apply this following emplaster ℞ Emplast de Vigo cum Mercurio cerati oesypati descriptione Phylagrii an ℥ iij. olei anethini liliorum an ℥ j. liquefiant omnia simul fiat emplastrum let it be spread upon leather for the aforesaid use When by this means the Callus shall seem to be sufficiently mollified it shall be broken and the bones restored to their natural state and the cure of the fracture to be followed as at the beginning What Callus must not be broken though distort or otherwise ill conformed If the Callus be become too hard through age it is better not to break it but to let it alone lest some worse accident befal the Patient For it may so fall out that by your labouring to break it the bone may break in some other part before it break in that which is knit by the Callus Therefore the discreet Patient had rather live lame than for eschewing it to undergo the hazzard of his life If the Callus be too gross it shall be diminished if it be as yet fresh with emollient resolving and powerfully astringent medicines which have force to dissolve dry and exhaust It will also be good strongly to rub the Callus with oyl of Bays wherein Salt-petre or some other kind of Salt hath been dissolved then wrapped about with a rowler to binde it very straitly putting a leaden plate thereon whereby the flowing down of the nourishing humour into the part may be forbidden that thus by little and little the Callus may decay and diminish If on the contrary The causes of too slender a Callus it any ways happen that the Callus be more thin and slender and grows more slowly for that it is too straitly bound or because the idle part is longer kept in quiet than is fit without exercising of its proper function which cause is to be reckoned amongst the chief causes of the leanness even for this reason for that exercise stirs up the native heat of the part the worker of digestion and nutrition or else for that they feed upon such nourishments as offend in quality or quantity or both or for that the ligature used to the part is too often loosed or because the part it self is too hastily and before the time
can firmly stand upon his feet CHAP. LVIII Of the symptoms and other accidents which may befal a broken or dislocated member MAnie things may befal broken or dislocated members by the means of the fracture or dislocation such as are bruises great pain inflammation a fever impostume Remedies for a contusion grangrene mortification ulcer fistula and atrophia all which require a skilfull and diligent Surgeon for their cure A contusion happen's by the fall of som heavie thing upon the part or by a fall from high whence follow 's the effusion of blood poured out under the skin wich if it bee poured forth in great plentie must bee speedily evacuated by scarification and the part eased of that burden lest it should thence gangrenate And by how much the blood shall appear more thick and the skin more dens by so much the scarification shall be made more deep You may also for the same purpose apply Leeches What may happen by pain Concerning pain wee formerly said that it usually happen's by reason that the bones are mooved out of their places whence it happeneth that they becom troublesom to the muscles and nervs by pricking and pressing them Hence ensue inflammations as also impostumation and a fever oft times a gangrene and in conclusion a mortification corrupting and rotting the bones otherwhiles a sinuous ulcer or fistula But an atrophia and leanness ariseth by the sloth and idelness of the member decaying all the strength thereof and by too straight ligation intercepting the passages of the blood otherwise readie to fall and flow thither Remedies for the leanness or Atrophia of any member Now the leanness which is occasioned by too straight ligation receive's cure by the flackning of the ligatures wherewith the member was bound That which proceed's from idleness is helped by moderate exercise by extending bending lifting up and depressing the member if so bee that hee can away with exercise Otherwise hee shall use frictions and fomentations with warm water The frictions must be moderate in hardness and gentleness in length and shortness The same moderation shall be observed in the warmness of the water What measure to bee used in fomenting and in the time of fomenting For too long fomenting resolv's the blood that is drawn But that which is too little or short a space draw's little or nothing at all after the fomentation hot and emplastick medicins made of pitch turpentine euphorbium pellitorie of Spain sulphur and the like shall bee applied They shall bee renued every day more often or seldom as the thing it selfe shall seem to require A dropax These medicines are termed Dropaces whose form is thus ℞ picis nigriae ammoniaci bdelii gummi elemi in aquâ vitae dissolutorum an ℥ ii olei laurini ℥ i. pulveris piperis zinziberis granorum paradisi Binding of the sound part opposite to the emaciated baccarum lauri juniperi anʒii fiat emplastrum secundùm artem extendatur super alutam It is also good to binde about the opposite sound part with a ligature yet without pain as if the right arm shall decay for want of nourishment the left shall bee bound beginning your ligation at the hand and continuing it up to the arm-pit If this mischance shall seiz upon the right leg then the left shall bee swathed up from the sole of the foot to the groin For thus a great portion of the blood is forced back into the vena cava or hollow vein and from this being distended and over full into the part affected and gapeing with the vessels almost empty beside also it is convenient to keep the sound part in rest that so it may draw the less nourishment and by that means there will bee more store to refresh the weak part How to binde up the emaciated part Som wish also to binde up the decaying member with moderate ligation for thus say they the blood is drawn thither for when as wee intend to let blood by opening a vein with a lancet wee bind the arm Also it is good to dip it into water somwhat more than warm and hold it there util it grow red and swell for thus blood is drawn into the veins as they finde which use to draw blood of the saphena and salvatella Now if when as these things and the like bee don the lame part grow's hot red and swollen then know that health is to bee hoped for but if the contrary happen the case is desperate wherefore you need attempt nothing further Signs that an Atrophia is curable Furthermore there is somtimes hardness lest in the joints after fractures and dislocations are restored It is fit to soften this by resolving the contained humor by fomentations liniments cataplasms emplasters made of the roots of marsh-mallows brionie lillies line seed fenugreek seed and the like and also of gums dissolved in strong vineger as ammoniacum bdelium opopanax labdanum sagapenum styrax liquida and adeps anserinus gallinaceus humanus oleum liliorum and the like Also you must wish the patient to moov the part ever now and then every day yet so that it bee not painfull to him that so the pent up humor may grow hot bee attenuated and at length discussed and lastly the part it self restored as far as art can performe it for oft-times it cannot bee helped any thing at all For if the member bee weak and lame by reason that the fracture happend neer the joint for the residue of his life the motion thereof useth to bee painful and difficult and oft-times none at all especially if the callus which grow's there bee somwhat thick and great and lastly if the joint it self shall bee contused and broken by the stroke as it oft-times happen's in wounds made by gun-shot Of divers other PRETER-NATURAL AFFECTS Whose cure is commonly performed by Surgerie THE SEVENTEENTH BOOK CHAP. I. Of an Alopecia or the falling away of the hairs of the head AN Alopecia is the falling away of the hair of the head and somtimes also of the eie-brows chin and other parts the French commonly call it the Pelade Physicians term it the Alopecia for old Foxes subject Gal. c. 2. lib. 1. de comp med secun locos by reason of their age to have the scab are troubled oft-times with this diseas This affect is caused either through defect of nourishment fit to nourish the hairs as in old age through want of the radical humiditie The caus or by the corruption of the alimentarie matter of the same as after long Fevers in the Lues venerea Leprosie the corruption of the whole bodie and all the humors whence follow 's a corruption of the vapors and fuliginous excrements or els by the vitious constitution of pores in the skin in raritie and constriction or densitie as by too much use of hot ointments made for coloring the hair or such as are used to take off hair
by that means bee plucked away therewith you shall use this medicine so long as need shall seem to require For the third kinde of Scall which is termed a Corrosive or Ulcerous the first indication is to cleans the ulcers with this following ointment The cure of an ulcerous scall â„ž unguenti enulati cum mercurio duplicato aegyptiaci an â„¥ iii. vitriol albi in pulverem redactiÊ’i incorporentur simil fiat unguentum ad usum also you may use the formerly discribed ointment But if any pain or other accident fall out you must withstand it by the assistance and direction of som good Physician verily these following medicins against all kindes of Scalls have been found out by reason and approved by use â„ž Camphur â„¥ ss alum roch vitriol vir aeris sulp vivi fullig forn an Ê’vi olei amygd dulcium anxungiae porci an â„¥ ii incorporentur simul in mortario fiat unguentum Som take the dung which lieth rotting in a sheep fold thay use that which is liquid and rub it upon the ulcerated places and lay a double cloath dipped in that liquor upon it But if the patient cannot bee cured with all these medicines and that you finde his body in som parts thereof troubled in like sort with crustie ulcers I would wish that his head might bee anointed with an ointment made of Axungia argentum vivum and a little Sulphur and then fit som emplastrum Vigonis cummercuiro into the fashion of a cap also som plaisters of the same may bee applied to the shoulders A contumacious scall must bee cured as wee cure the Lues venerea thighs legs so let him bee kept in a very warm chamber and all things don as if hee had the Lues venerea This kind of cure was first that I know of attempted by Simon Blanch the King's Surgeon upon a certain young man when as hee in vain had diligently tried all other usual medicines A scalled head oft-times appeareth verie loathsom to the eie casting forth virulent and stinking saines at the first it is hardly cured but being old far more difficultly For divers times it breaketh out afresh when you think it kill'd by reason of the impression of the malign putrefaction remaining in the part which wholly corrupt's the temper thereof Moreover oft-times beeing healed it hath left an Alopecia behinde it a great shame to the Surgeons Which is the reason that most of them judge it best to leave the cure thereof to Empericks and women CHAP. III. Of the Vertigo or Giddinesse THe Vertigo is a sudden darkning of the eyes and sight by a vaporous and hot spirit which ascendeth to the head by the sleepy arteries and fills the brain What the Vertigo is and the causes thereof disturbing the humors and spirits which are contained there and tossing them unequally as if one ran round or had drunk too much wine This hot spirit oft-times riseth from the heart upwards by the internal sleepy arteries to the Rete mirabile or wonderfull net otherwhiles it is generated in the brain it self being more hot than is fitting also it oft-times ariseth from the stomach spleen liver and other entrails being too hot The Signs The sign of this disease is the sudden darkning of the sight and the closing up as it were of the eyes the body being lightly turned about or by looking upon whee is running round or whirle-pits in waters or by looking down any deep or steep places If the original of the disease proceed from the brain the patients are troubled with the headache heaviness of the head and noise in the ears and oft-times they lose their smell Lib. 6. Paulus Aegineta for the cure bids us to open the arteries of the temples But if the matter of the disease arise from some other place as from some of the lower entrails such opening of an artery little availeth Wherefore then some skilfull Physician must be consulted with who may give directions for phlebotomy if the original of the disease proceed from the heat of the entrails by purging if occasioned by the foulness of the stomach But if such a Vertigo be a critical symptom of some acuse disease affecting the Crisis by vomit or bleeding A critical Vertigo then the whole business of freeing the patient thereof must be committed to nature CHAP. IV. Of the Hemicrania or Megrim THe Megrim is properly a disease affecting the one side of the head right or left It sometimes passeth no higher than the temporal muscles otherwhiles it reacheth to the top of the crown The cause of such pain proceedeth either from the veins and external arteries or from the Meninges or from the very substance of the brain or from the pericranium or the hairy scalp covering the pericranium or lastly from putrid vapours arising to the head from the ventricle womb or other inferiour member Yet an external cause may bring this affect to wit the too hot or cold constitution of the encompassing air drunkenness gluttony the use of hot and vaporous meats some noisom vapour or smoak as of Antimony quick silver or the like drawn up by the nose which is the reason that Goldsmiths and such as gild metals are commonly troubled with this disease But whensoever the cause of the evil proceedeth it is either a simple distemper or with matter with matter I say which again is either simple or compound Now this affect is either alone The differences or accompanied with other affects as inflammation and tension The heaviness of head argues plenty of humor pricking beating and tension shewes that there is a plenty of vapours mixed with the humors and shut up in the nervous arterious or membranous body of the head If the pain proceed from the inflamed Meninges a feaver followeth thereon especially if the humor causing pain do putrefie If the pain be superficiary it is seated in the pericranium If profound deep and piercing to the bottom of the eyes it is an argument that the meninges are affected and a feaver ensues if there be inflammation and the matter putrefie and then oft-times the tormenting pain is so great and grievous that the patient is afraid to have his head touched if it be but with your finger neither can he away with any noise or small murmuring nor light nor smells however sweet no nor the fume of Wine In what kinde of Megrim the opening of an Artery is good The pain is sometimes continual othetwhiles by fits If the cause of the pain proceed from hot thin and vaporous blood which will yield to no medecins a very necessary profitable and speedy remedy may be had by opening an artery in the temples whether the disease proceed from the internal or external vessels For hence alwayes ensueth an evacuation of the conjunct matter blood and spirits I have experimented this in many but especially in the Prince de la Roche-sur-you His Physicians when he was
troubled with this grievous Megrim were Chaplain the King 's and Castellane the Queen's chief Physicians A History and Lewes Duret who notwithstanding could help him nothing by blood-letting cupping bathes frictions diet or any other kinde of remedy either taken inwardly or applyed outwardly I being called said that there was onely hope one way to recover his health which was to open the artery of the temple in the same side that the pain was for I thought it probable that the cause of his pain was not contained in the veins but in the arteries in which case by the testimony of the ancients there was nothing better than the opening or bleeding of an artery whereof I have made trial upon my self to my great good When as the Physicians had approved of this my advice I presently betake my self to the work and choose out the artery in the pained temple which was both the more swoln and beat more vehemently than the rest I open this as we use to do in the bleeding of a vein with one incision and take more than two sawcers of blood flying out with great violence and leaping the pain presently ceased neither did it ever molest him again Yet this opening of an Artery is suspected by many for that it is troublesom to stay the gushing forth blood and cicatrize the place by reason of the density hardness and continual pulsation of the artery and lastly for that when it is cicatrized there may be danger of an Aneurisma Wherefore they think it better first to divide the skin then to separate the artery from all the adjacent particles and then to binde it in two places and lastly divide it as we have formerly told you must be done in Varices No danger in opening an artery But this is the opinion of men who fear all things where there is no cause for I have learn'd by frequent experience that the apertion of an attery which is performed with a Lancet as we do in opening a vein is not at all dangerous and the consolidation or healing is somewhat flower than in a vein but yet will be done at length but that no flux of blood will happen if so be that the ligation be fitly performed and remain so for four dayes with fitting pledgets CHAP. V. Of certain affects of the Eyes and first of staying up the upper Eye-lid when it is too lax OF the diseases which befall the eyes some possess the whole substance thereof as the Ophthalmia a Phlegmon thereof others are proper and peculiar to some parts thereof Differences as that which is termed Gutta serena to the optick nerve Whence Galen made a threefold difference of the diseases of the eyes as that some happened to the eye by hurting or offending the chief organ thereof that is the crystalline humor others by hindering the animal faculty the chief causer of sight from entring into them and lastly other some by offending the parts subservient to the prime organ or instrument Now of all these diseases the eye hath some of them common with the other parts of the body such as are an ulcer wound Phlegmon contusion and the like other some are peculiar and proper to the eye Paul Aegin lib. 8. cap. 6. such as are the Egilops Cataracta Glaucoma and divers others of this kinde Some have their upper eye-lid fall down by reason that the upper skin thereof is relaxed more than is sufficient to cover the eye the gristle in the mean while not relaxing it self together therewith Hence proceeds a double trouble the first for that the eye cannot be easily opened the other because the hairs of the relaxed eye-lid run in towards the eye The cause and become troublesom thereto by pricking it The cause of such relaxation is either a particular palsie of that part which is frequent in old people or the defluxion or falling down of a waterish humor and that not acrid or biting which appears by this that those who are thus affected have a rank of hairs growing under the natural rank by reason of abundance of heaped-up humor as it is most probable For thus a wet and marish ground hath the greatest plenty of grass Now if this same humor were acrid it would cause an itching and consequently become troublesom to the patient and it would also fret in sunder and destroy the roots of the other hairs so far it is from yielding matter for the preternatural generation of new The cure It is fit before you do any thing for the cure that you mark with ink the portion thereof which is superfluous and therefore to be cut away left if you should cut off more than is requisite the eye-lid should remain turned up and so cause another kinde of affect which the ancients have called Ectropion Then the eye being covered take and lift up with your fingers the middle part of the skin of the eye-lid not taking hold of the gristle beneath it and then cut it athwart taking away just so much as shall be necessary to make it as it were natural lastly join the lips of the wound together with a simple future of three or four stitches that so it may be cicatrized for the cicatrization restrains the eye-lid from falling down so loosly at least some part thereof being taken away There ought to be some measure and heed taken in the amputation otherwise you must necessarily run into the one or other inconvenience as if too much be cut a way then the eye will not be covered if too little then you have done nothing and the patient is troubled to no purpose If there shall be many hairs grown preternaturally you shall pluck them away with an instrument made for the same purpose then their roots shall be burned with a gentle cautery the eye being left untoucht for a scar presently arising will hinder them from growing again CHAP. VI. Of Lagophthalmus or the Hare-eye SUch as have their eye-lids too short sleep with their eyes open for that they cannot be covered by the too short skin of the eye-lids The Greeks term this affect 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The cause is either internal or external internal as by a Carbuncle Paulus Aegi◠lib. 6. cap. 10. Impostume or Ulcer external as by a wound made by a sword burn fall and the like If this mishap proceed by reason of a cicatrization it is curable if so that the short eye-lid be of an indifferent thickness But if it have been from the first conformation or by some other means whereby much of the substance is lost as that which happens by burning and a carbuncle then it is uncurable For the cure The cure you shall use relaxing and amollient fomentations then the skin shall be divided above the whole scar in figure of an half-Moon with the horns looking downwards Then the edges of the incision shall be opened and lint put into the middle thereof that
rag dipped therein but with care that none thereof fall upon the eye But when the Patient goes to bed let him cause them to be anointed with the following ointment very effectual in this case â„ž axungiae porci butyri recentis an â„¥ ss tut praepar Ê’ ss antimon in aqua euphrasiae praeparati ℈ ij camphorae gra iv misce in mortario plumbeo ducantur per tres horas conflatum indè unguentum servetur in pyxide plumbeâ Some commend and use certain waters fit to cleanse drie binde strengthen and absolutely free the eye-lids from itching and redness of which this is one â„ž aquae euphrag foeniculi chelidon an â„¥ ss sarcocol nutritae ℈ ij vitriol rom Ê’j misceantur simul bulliant uniâ—â â—bullitione postea coletur liquor servetur ad usum dictum Or else â„ž aquae ros vini alb boni an â„¥ iv tut praepar aloes anÊ’j flor aeni ℈ ij camphor gra ij Let them be boiled according to art and kept in a glass to wash the eye-lids Or else â„ž vini albi lb ss salis com Ê’ j. let them be put into a clean Barbars bason and covered and kept there five or six days and be stirred once a day and let the eye-lids be touched with this liquor Some wish that the Patients urine be kept all night in a Barbars bason and so the Patients eye-lids be washed therewith Verily in this affect we must not fear the use of acrid medicines for I once saw a woman of fifty years of age You need not fear to use acrid medicines in the itching of the eyelids Lib. 2. cap. 9. tract 3. who washed her ey-lids when they itched with the sharpest vinegar she could get and affirmed that she found better success of this then of any other medicine Vigo prescribes a water whose efficacie above other medicins in this affect he saith hath been proved and that it is to be esteemed more worth then gold the description thereof is thus â„ž aq ros vini albi odoriferi mediocris vinofitatis an â„¥ iiij myrobalan citrini trit Ê’j ss thurisÊ’ij bulliant omnia simul usque ad consumptionem tertiae partis deinde immediatè addantur flores aeris ℈ ij camph. gr ij Let the liquor be kept in a glass well stopped for the foresaid use CHAP. XI Of Lippitudo or Blear-eyes THere are many whose eyes are never drie but always flow with a thin acrid and hot humour which causeth roughness and upon small occasions inflamations blear or blood-shot eyes and at length also Strahismus or squinting What lippitudo is Lippitudo is nothing else but a certain white filth flowing from the eyes which oft-times agglutinates or joins together the eye-lids This disease often troubles all the life time and is to be cured by no remedy in some it is cureable Such as have this disease from their infancie are not to be cured for it remains with them till their dying day For large heads and such as are repleat with acrid or much excrementitious phlegm scarce yield to medicines There is much difference whether the phlegm flow down by the internal vessels under the skul or by the external which are between the skull and the skin or by both For if the internal veins cast forth this matter it will be difficultly cured if it be cured at all But if the external vessels cast forth that cure is not unprofitable which having used medicins respecting the whole body applies astringent medicines to the shaved crown as Empl. contra rupturam which may streighten the veins and as it were suspend the phlegm useth cupping and commands frictions to be made towards the hind part of the head and lastly maketh a Seton in the neck There are some who cauterize the top of the crown with an hot iron even to the bone so that it may cast a scale thus to divert and stay the defluxion A Collyrium of vitriol to stay the defluxions of the eyes For local medicines a Collyrium made with a good quantity of rose-water with a little vitriol dissolved therein may serve for all CHAP. XII Of the Ophthalmia or inflamation of the Eyes AN Ophthalmia is an inflamation of the coat Adnata What Ophthalmia is and the causes thereof and consequently of the whole eye being troublesome by the heat redness beating renitencie and lastly pain It hath its original either by some primitive cause or occasion as a fall stroke dust or small sand flying into the eyes For the eye is a smooth part so that it is easily offended by rough things as saith Hippocrates lib. de carnibus Or by an antecedent cause as a defluxion falling upon the eyes The signs follow the nature of the material cause Signs for from blood especially cholerick and thin it is full of heat redness and pain from the same allaied with phlegm all of them are more remiss But if a heaviness possess the whole head the original of the disease proceeds there from But if a hot pain trouble the forehead the disease may be thought to proceed from some hot distemper of the Dura mater or the pericranium but if in the very time of the raging of the disease the Patient vomit the matter of the disease proceeds from the stomach But from whencesoever it cometh there is scarce that pain of any part of the body which may be compared to the pain of the inflamed eyes Verily the greatness of the inflamation hath forced the eyes out of their orb and broken them asunder in divers Therefore there is no part of Physick more blazed abroad then for sore eyes For the cure The cure the Surgeon shall consider and intend three things diet the evacuation of the antecedent and conjunct cause and the overcoming it by to pick remedies The diet shall be moderate eschewing all things that may fill the head with vapours and those things used that by astriction may strengthen the orifice of the ventricle and prohibit the vapors from flying up to the head the Patient shall be forbidden the use of wines unless peradventure the disease may proceed from a gross and viscid humour as Galen delivers it The evacuation of the matter flowing into the eye shall be performed by purging medicines phlebotomie in the arm cupping the shoulders and neck with scarification and without and lastly by frictions Com. ad aphor 31. sect 6. as the Physitian that hath undertaken the cure shall think fit Galen after universal remedies for old inflamations of the eyes commends the opening of the veins and arteries in the forehead and temples Lib. 13. meth cap. ult because for the most part the vessels thereabouts distended with acrid hot and vaporous bloud cause great and vehement pains in the eye For the impugning of the conjunct cause divers to pick medicins shall be applied according to the four sundry times or seasons that every phlegmon usually hath For in the beginning
when as the acrid matter flows down with much violence repercussives do much conduce and tempred with resolving medicines are good also in the increase â„ž aq ros A repercussive medicine plantag an â„¥ ss mucilag gum Tragacanth Ê’ij album ovi quod sufficit fiat collyr let it be dropped warm into the eye and let a double cloth dipped in the same collyrium be put upon it Or â„ž mucil sem psil cydon extractae in aq plant an â„¥ ss aq solan lactis muliebris an â„¥ j. trochisc alb rha ℈ fiat collyrium use this like the former The veins of the temples may be streightned by the following medicine â„ž bol arm sang drac mast an â„¥ ss alb ovi Astringent emplasters aquae ros acet an â„¥ j. tereb lot ol cidon an â„¥ j. ss fiat defensivum You may also use Vng de Bolo empl diacal or contra rupturam dissolved in oyl of myrtles and a little vineger But if the bitterness of pain be intolerable the following cataplasm shall be applied â„ž medul An anodine cataplaâ—m pomor sub ciner coctorum â„¥ iij. lactis muliebris â„¥ ss let it be applied to the eye the formerly prescribed collyrium being first dropped in Or â„ž mucilag sem psil cidon an â„¥ ss micae panis albi in lacte infusi â„¥ ij aquae ros â„¥ ss fiat cataplasma The blood of a Turtle dove pigeon or Hen drawn by opening a vein under the wings dropped into the eye asswageth pain Baths are not onely anodine The efficacie of Bathes in pains of the eyes Ad Aphor. sect 7. Detergent Collyâ—ia but also stay the defluxion by diverting the matter thereof by sweats therefore Galen much commends them in such defluxions of the eyes as come by fits In the state when as the pain is either quite taken away or asswaged you may use the following medicines â„ž sarcocol in lacte muliebri nutritae Ê’i aloes lotae in aq rosar ℈ ij trochis alb rha Ê’ ss sacchar cand Ê’ij aq ros â„¥ iij. fiat collyrium Or â„ž sem foeniculi foenug an Ê’ij flo chamae melil an m. ss coquantur in aq com ad â„¥ iij colaturae adde tutiae praep sarcoc nutritae in lacte muliebri anÊ’j ss sacchari cand â„¥ ss fiat collyrium ut artis est In the declination the eye shall be fomented with a carminative decoction and then this collyrium dropped thereinto â„ž sarcoc nutritaeÊ’ij aloes myrrh an Ê’i aq ros euphrag an â„¥ ij fiat collyrium ut artis est CHAP. XIII Of the Proptôsis that is the falling or starting forth of the eye and of the Phthisis and Chemôsis of the same THe Greeks call that affect Proptôsis the Latines Procidentia or Exitus oculi when as the eye stands and is cast out of the orb by the occasion of a matter filling and lifting up the eye into a great bigness The cause and largeness of substance The cause of this disease is sometimes external as by too violent straining to vomit by hard labour in child-birth by excessive and wondrous violent shouting or crying out It sometimes happeneth that a great and cruel pain of the head or the too strait binding of the forehead and temples for the easing thereof or the palsie of the muscles of the eye give beginning to this disease Certainly sometimes the eye is so much distended by the defluxion of humours that it breaks in sunder and the humours thereof are shed and blindness ensues thereof as I remember befel the sister of Lewis de Billy merchant dwelling at Paris near S. Michaels Bridge The cure The cure shall be diversified according to the causes Therefore universal medicines being premised cupping glasses shall be applied to the original of the spinal marrow and the shoulders as also Cauteries or Setons the eye shall be pressed or held down with clothes doubled and steeped in an astringent decoction made of the juice of Acacia red roses the leaves of poppy henbane roses and pomegranate pills of which things poultifles may be made by addition of barly-meal and the like The Atrophia of the eye There is sometimes to be seen in the eye an affect contrary to this and it is termed Atrophia By this the whole substance of the eye grows lank and decays and the apple it self becomes much less But if the consumption and emaciation take hold of the pupil onely the Greeks The Phthisis thereof Lib 3. cap. 22. by a peculiar name and different from the general term it a Phthisis as Paulus teacheth Contrary causes shall be opposed to each affect hot and attractive fomentations shall be applied frictions shall be used in the neighbouring parts and lastly all things shall be applied which may without danger be used to attract the blood spirits into the parts There is another affect of the eye of affinitie to the Proptôsis which by the Greeks is termed Chemôsis The Chemosis Paulus l. 3 c. 2. Now this is nothing else then when both the eye-lids are turned up by a great inflammation so that they can scarce cover the eyes and the white of the eye is lifted much higher up then the black Sometimes the Adnata changing his wont looketh red besides also this affect may take its original from external causes as a wound contusion and the like But according to the varietie of the causes and the condition of the present affect fixed and remaining in the part divers remedies shall be appointed CHAP. XVI Of the Vngula or Web. THe Vngula Pterygion or Web is the growth of a certain fibrous and membranous flesh upon the upper coat of the eye called Adnata arising more frequently in the bigger but sometimes in the lesser corner towards the temples When it is neglected it covers not onely the Adnata but also some portion of the Cornea and coming to the pupil it self hurts the sight therefore Such a web sometimes adheres not at all to the Adnata but is onely stretched over it from the corners of the eye so that you may thrust a probe between it and the Adnata it is of several colours somewhiles red somewhile yellow somewhiles duskish and otherwhiles white It hath its original either from external causes as a blow fall and the like or from internal as the defluxion of humours into the eys The Vngula which is inveterate What web curable and what incurable and that hath acquired much thickness and bredth and besides doth difficultly adhere to the Adnata is difficultly taken away neither may it be helped by medicines whereby scars in the eyes are extenuated But that which covereth the whole pupil must not be touched by the Surgeon for being cut away the scar which is left by its densitie hindereth the entrance of objects to the crystalline humour and the egress of the animal spirit to them But oftentimes it is accompanied with
an inflammation of the eyes a burning itching weeping defluxion and swelling of the eye-lids That the cure may rightly and happily proceed he must first use a spare diet The cure purgeing medicines shall be given and blood taken away by opening a vein especially if there be great inflamation For particular remedies this excrescence shall be eaten away or at least kept from growth by dropping into the eye collyrium of vitriol described in wounds of the eyes But if that we profit nothing by this means it remaineth that we take it a way with the hand after the following manner You shall set the Patient upon a form or stool and make him lean much back The cutting of the Web. and be held so firmly that he may not fall nor stir then must you open his sore eye putting therein a speculum oculi formerly described in treating of the wounds of this part and then must you lift up the web it self with a sharp little hook with the point turned a little in and put under the midst of the web when you have lifted it a little up thrust a needle threded with a smooth thred between it and the Adnata then taking hold of the hook and the two ends of the thred drawn through with the needle and lifting up the web by them you shall gently begin to separate it from the substance of the eye lying thereunder beginning at the original thereof with a crooked incision-knife and so prosecute it even to the end yet so as you hurt no part of the Adnata nor Cornea The figure of little hooks a needle and crooked incision-knife Little hooks A needle A crooked incision-knife Then must it be cut off with a pair of scissers and the white of an egg beaten with some Rose water laid thereon and often renewed Afterwards the eye must every day be opened left coming to cicatrization the eye-lids shall be glewed together in that part where as the web is taken a way which also shall be hindered by putting of common salt sage and cummin seeds into the eye being first champed and chawed in the mouth There are some who in stead of the crooked knife separate the web from the Adnata with a horses hair others do it with a goose quill made ready for the same purpose taking heed that they hurt not the caruncle at the corner by the nose for it will follow if that you draw the web away too violently and if it be cut there will remain a hole through which during the rest of the life a weeping humour will continually flow a disease by the Greeks termed Rhyas If after the cutting there be fear of inflammation linnen rags moistned in repelling medicines formerly prescribed in wounds of the eye shall be laid thereupon CHAP. XV. Of the Egilops Fistula lacrymosa or weeping Fistula of the Eye AT the greater corner of the eye there is a glandule made for the receiving The use of the glandule at the greater corner of the eye and containing the moisture which serveth for the lubricating and humecting the eye lest it should drie by continual motion The differences This glandule sometimes by a sanguine or pituitous defluxion falling violently from the brain swells impostumates and ulcerates with an ulcer not seldom degenerating into a fistula so that in success of time it rotteth the bone that lieth under it Of such fistulaes some are open outwardly and these usually have their original from a phlegmon othersome are inwardly and those are such as at first swelled by the defluxion or congestion of a phlegmatick matter so that there appeareth no hole outwardly but onely a tumour of the bigness of a pease this tumor being pressed floweth with a sanious serous and red or otherwise with a white and viscid matter and that either by the corner of the eye Periodical and typical fistulaes or by the inside of the nose Some have this matter slowing continually others have it only monethly which is proper also to some fistulaes Such weeping fistulaes if they become old cause an Atrophia of the eye and sometimes blindness and a stinking breath Therefore we must diligently and speedily by physical and chirurgical means resist the breeding disease Wherefore having used general medicins we must come to particulars Therefore if the ulcer be not sufficiently wide it shall be enlarged by putting tents of spunge therein The cure The flesh of the glandule encreasing more then is fit shall be corrected by putting therein the catheretick powders of Mercury calcined vitriol or some aqua fortis or oyl of vitriol and lastly by a potential cautery If you cannot prevail by these means and that the bone begins to rot The efficacie of an actual cauterie and the Patient be stout hearted then use an actual cauterie whose use is far more effectual ready certain and excellent then a potential cauterie as I have tried in many with happy success In my opinion it makes no matter whether the cautery be of gold silver or iron for the efficacy it hath proceedeth not from the matter but from the fire Yet if we must religiously observe and make choice of metals I had rather have it of iron as that which hath a far more drying and astringent faculty then gold for that the element of earth beareth the chief sway therein as appeareth by the waters which flow through iron mines Wherefore you shall cause to be made a triangular iron sharp at the end that it may the more speedily penetrate And then the sound eye and adjacent parts being well covered and defended and the Patients head firmly holden in ones hand left the Patient being frighted stir himself in the very instant of the operation But a plate of iron somewhat depressed in the midst for the cavity of the greater corner shall be applied and fitted to the pained eye This Plate shall be perforated that the hot iron may pass thereby to the fistula lying thereunder and so may onely touch that which is to be cauterized The figure of a cauterie and a plate with a hole therein Things to be done after the cauterizing After the bone is burnt with the cautery a collyrium made of the whites of egs beaten in plantain and night-shade waters must be poured into the hole it self the eye and all the neighbouring parts but the Patient shall be laid in bed with his head somewhat high and the collyrium shall be renued as often and as soon as you shall perceive it to grow dry Then the fall of the Eschar shall be procured by anointing it with fresh butter when it is fallen away the ulcer shall be cleansed filled with flesh and lastly cicatrized CHAP. XVI Of the Staphyloma or grape-like swelling What a Staphyloma is and the causes thereof STaphyloma is the swelling of the horny and grape-like coat bred through the occasion of an humor flowing down upon the eye or by an ulcer the
horny coat being relaxed or thrust forth by the violence of the pustule generated beneath It in shape resembleth a grape whence the Greeks stile it Staphyloma This tumor is sometimes blackish otherwhiles whitish For if the horny coat be ulcerated and fretted in sunder so that the grapy coat shew it self fall through the ulcer then the Staphyloma will look black like a ripe grape for the utter part of the Vvea is blackish But if the Cornea be only relaxed not broken then the swelling appears of a whitish colour like an unripe grape Paulus and Aetius The Antients have made many kinds or differences thereof For if it be but a smal hole of the broken Cornea by which the Vvea sheweth or thrusteth forth it self then they termed it Myccephalon that is like the head of a flie But if the hole were large and also callous they called it Clavus Every Slaphiloma infers incurable blindness or a nail if it were yet larger then they termed it Acinus or a grape But in what shape or figure soever this disease shall happen it bringeth two discommodities the one of blindness the other of deformitie Wherefore here is no place for Surgerie to restore the sight which is already lost but onely to amend the deformitie of the eye which is by cutting off that which is prominent But you must take heed that you cut away no more then is fit for so there would be danger of pouring out the humours of the eye CHAP. XVII Of the Hypopyon that is the suppurate or putrified eye PVS or Quitture is sometimes gathered between the hornie and grapie coat from an internal or external cause From an internal as by a great defluxion The cause and oft-times after an inflamation but externally by a stroke through which occasion a vein being opened hath poured forth bloud thither which may presently be turned into Quitture For the cure universal remedies being premised cupping glasses shall be applied with scarifications and frictions used Anodine and digestive collyria shall be poured from above downwards Galen writes that he hath sometimes evacuated this matter Lib. 14. method cap. ult the Cornea being opened at the Iris in which all the coats meet concur and are terminated I have done the like and that with good success James Guillemeau the Kings Surgeon being present the Quitture being expressed and evacuated after the apertion The Ulcer shall be cleansed with Hydromel or some other such like medicine CHAP. XVIII Of the Mydriasis or dilatation of the Pupil of the Eye MYdriasis is the dilatation of the pupil of the eye The Cause and this happeneth either by nature or chance the former proceedeth from the default of the first conformation neither is it cureable but the other is of sorts for it is either from an internal cause the off-spring of an humour flowing down from the brain wherefore Physical means must be used for the cure thereof The cure Now that which cometh by any external occasion as a blow fall or contusion upon the eye must be cured by presently applying repercussive and anodine medicines the defluxion must be hindered by diet skilfully appointed phlebotomie cupping scarification frictions and other remedies which may seem convenient Then must you come to resolving medicines as the bloud of a Turtle-dove Pigeon or chicken reeking-hot out of the vein being poured upon the eye and the neighbouring parts Then this following cataplasm shall be applied thereto A digesting Cataplasm â„ž farinae fabar hordei an â„¥ iij. ol rosar myrtillor an â„¥ j. ss pul ireos flor Ê’ij cum sapa fiat cataplasm You may also use the following fomentation â„ž rosar rub myrtyl an m.j florum melil chamaem an p.j. nucum cupress â„¥ j. vini ansteri lb ss aq rosar plantag an â„¥ iij. make a decoction of them all for a fomentation to be used with a sponge CHAP. XIX Of a Cataract A Cataract is called also by the Greeks Hypochima by the Latines suffusio A Cataract Howsoever you term it it is nothing else but the concretion of an humour into a certain thin skin under the hornie coat just against the apple or pupil and as it were swimming upon the waterie humour and whereas the place ought to be emptie opposing it self to the internal faculty of seeing whereby it differeth from spots and scars growing upon the hornie coat and Adnata It sometimes covereth the whole pupil The differences otherwhiles but the one half thereof and somewhiles but a small portion thereof According to this varietie the sight is either quite lost weak or somewhat depraved because the animal visive spirit cannot in its entire substance pass through the densitie thereof Causes The defluxion of the humour whence it proceeds is either caused by an external occasion as a stroke fall or by the heat or coldness of the encompassing air troublesome both to the head and eyes or else it is by an internal means as the multitude or else the acrid hot and thin quality of the humours This disease also sometimes taketh its original from gross and fumid humours sent from a crude stomach or from vaporous meats or drinks up to the brain and so it falleth into the eyes where by the coldness straitness and tarrying in the place they turn into moisture and at length into that concretion or film which we see The signs may be easily drawn from that we have already delivered Signs For when the cataract is formed and ripe it resembleth a certain thin membrane spred over the pupil and appeareth of a different colour accorcing to the variety of the humor whereof it consisteth one while white another while black blue ash-coloured livid citrine green It sometimes resembleth quick-silver which is very trembling and fugitive more than the rest At the first when it beginneth to breed they seem to see many things as flyes flying up and down hares nets and the like as if they were carelesly tossed up and down before their eyes sometimes every thing appeareth two and somewhiles less than they are because the visive spirit is hindred from passing to the objects by the density of the skin like as a cloud shadowing the light of the Sun Whence it is that the patients are duller fighted about noon and surer and quicker sighted in the morning and evening for that the little visive spirit diffused through the air is dispersed by the greater light but contracted by the less Now if this film cover half the pupil then all things shew but by halfs but if the midst thereof be covered and as it were the centre of the chrystalline humor then they seem as if they had holes or windows but if it cover at all then can he see nothing it all but only the shadows of visible bodies and of the Sun Moon Stars lighted cancles and the like luminous things and that but confusedly and as
sit The figure of a Chair for a Semicupium A. Sheweth the whole frame of the Chair B. The hole wherein the patient must sit C. The Cistern that holds the water D. A Cock to empty the water when it groweth cold E. A Funnel whereby to pour in warm water There may also bee another decoction made for the bath as thus ℞ rad raph alib an lb. ii rad rusc petrosel asparag an lb. i. cumin foenicul ameos an ℥ iiii sem lini faenug anʒvi fol. marub parietar florum chamaem melil anethi an m. ii bulliant omnia secundum artem in aquae sufficienti vini albi odoriferi exigu â quantitate ad consumptionem tertiae partis pro Semicupio Also the same decoction may be used for glisters adding thereto two yolks of eggs and four ounces of oil of lillies with ʒi of oil of juniper which hath a certain force to asswage the pain of the stone and collick But a far less quantity of the decoction in a glyster must be used in these diseases than usually is appointed in other diseases otherwise there will be danger lest the guts being distended should more press upon the kidnies and ureters troubled in some sort with inflammation and so increase the pain and other symptoms This following cataplasm shall be profitably applyed to the grieved place to wit the loins or flanks and bottom of the belly for it is very powerful to asswage pain and help forwards the falling down of the stone An anodine Cataplasm ℞ rad alth raphani an ℥ iiii pariet foenic. senicionis nasture berul an m. i. herniariae m. ss omnibus in aquâ sufficienti decoctis deinde contritis adde clei aneth chamaem pingued cuniculi an ℥ ii farin cicer quantum sufficit-fiat cataplasma ad usum praedictum Signs of the stone fallen out of the ureter into the bladder After by these means the stone forced out of the ureter is fallen into the bladder the pain presently if there be but one stone for sometimes more with much gravel do again fall into the ureter is mitigated and then the patient is troubled with an itching and pricking at the end of his yard and fundament Therefore then unless he be very weak it is fit that he ride and walk a foot and take ʒiv of species Lithontribon in four doses with white wine or the broth of red Cicers three hours before dinner and supper Besides let him plentifully drink good wine and after he hath drunk let him hold in his urine as long as he can that so it being gathered in great plenty it may presently thrust the stone out of the bladder with the more force for which purpose you may also inject the following liquor into the bladder ℞ syrupi capill ven ℥ i. aquae alkekengi ℥ iii. oleo scorpionum ℥ ss Let it be injected into the bladder with a syringe CHAP. XXXIX What must be done the stone being fallen into the neck of the bladder or passage of the yard AFter the stone is fallen out of the capacity of the bladder and stops in the neck thereof or passage of the yard the Surgeon shall have a special care that he do not force or thrust back the stone from whence it came but rather that hee presse it gently with his fingers to the end of the yard the passage being first made slipperie by injecting some oil of sweet almonds But if it stop in the end of the Glans it must be plucked out with some crooked instrument to which if it will not yeeld a Gimlet with a pipe or case thereto shall bee put into the passage of the yard and so it shall bee gotten out or els broken to pieces by the turning or twining about of the Gimblet which I remember I have divers times attempted and don for such Gimblets are made with sharp scrues like ordinary gimblets The delineation of a Gimblet made to break the stones in the passage of the yard together with its pipe or case The effigies of another lesser Gimblet Verily what Gimblets soever are made for this business their bodie or poin◠must bee no thicker then a small probe least whil'st thay are forced or thrust into the Vrethra or urinarie passage they might hurt the bodies next unto them by ther violent entrance CHAP. XL. What cours must bee taken if the stone sticking in the Urethra or urinarie passage cannot bee gotten out by the fore-mentioned arts BUt if the stone bee more thieck hard rough and remote from the end of the yard than that it may bee gotten out by the means formerly mentioned in the precedent Chapter and if that the urine bee wholly supprest therewith then must you cut the yard upon the side with a straight wound When the yard may bee safely cut for you must not make incision on the upper part for fear of a flux of blood for a large vein and arterie lieth there-under nor in the lower part for so it would scarce ever heal again for that it is a bloodless part and besides the continual and acrid falling of the urine would hinder the agglutination wherefore the incision must bee made on the side on that part whereas the stone most resist's and swels out For that part is the more fleshie yet first the end of the skin of the prepuce must bee much drawn up so to cover the Glans which beeing don the Vrethra shall bee tied with a thred a little above the stone that so the stone may bee staied there and may not fall back again Therefore then incision beeing made the stone must bee taken forth and the skin which was drawn more violently to cover the Glans is to bee let go back again for so it will com to pass that a whole part of the skin may cover the cut-yard and so it may bee more the speedily united and the urine may naturally flow out I have by this means oft-times taken forth the stone with the instruments here delineated Instruments fit to take the stone forth of the opened Urethra or urinarie passage of the yard Then for the agglutination if need require it will bee requisit to sow up the lips of the wound An agglutinative medicine and applie this agglutinative medicine following ℞ tereb venet ℥ iiii gum elemi ℥ i. sang dracon mastic an ʒ ss fiat medicamentum ut dictum est then the whole yard must bee covered over with a repercussive medicine made of the whites of eggs with the pouder of bole armenick aloës farina volatilis and oil of roses Lastly if need so require a wax-candle How to hasten the agglutination or leaden string anointed with Venice turpentine shall bee thrust into the Vrethra to hasten the agglutination and retain the natural smoothness and straightness of the urinarie passage least peradventure a a caruncle grow therein CHAP. XLI What manner of section is to bee made when a
incorporentur simul fiat cataplasma Or â„ž farinae fabarum et hordei an â„¥ iii. â—lei rosati â„¥ ii oxycrati quantum sufficit câ—quantur simul fiat cataplasma Another â„ž mucilag sent psilii â„¥ iiâ—i â—l rosati â„¥ ii acet â„¥ i. vitellos ovorum nu iii. croci ℈ i. misce Pliny reporteth that Sextus Pomponius the Governor of the hither-Spain as he overlooked the winowing of his corn Lib. 22. cap. â—5 was taken by the pain of the Gout in his feet wherefore he coverd himself with the Whear above his knees and so was eased his feet being wonderfully dryed and he afterwards used this kind of remedy It is note-worthie which often happeneth that the pain cannot be altogether eased by such remedies by reason of the abundance of blood impact in the part wherefore it must be evacuated Phlebotomie to evacuate the conjunct matter and asswage pain which I have done in many with good success opening the vein which was most swelled and nigh to the affected part for the pain was presently asswaged Neither must we too long make use of repercussives least the matter become so hardned that it can scarce be afterwards resolved as when it shall be concrete into knots and plaster-like stones resolving medicines are to be mixed with repercussives conveniently applyed so to discuss the humor remaining as yet in the part whereof shall be spoken in the following Chapter CHAP. XVII Of Locall medicines for a cholerick Gout What repercussives are beâ—e required THe repercussives that must first be used in this kinde of Gout ought to be cold and moist that so they may resist both the qualities of choler such are the leaves of night-shade purslain hous-leek henbane sorrel plantain poppy cold water and the like whereof may be made divers compositions As â„ž succi hyoscyami sempervivi lactuc. an â„¥ ii farin hordeiÊ’i olei rosati â„¥ ii agitando simul fiat medicamentum Let it be applyed and often changed for so at length it will asswage the inflammation Some think the brain of a hog mixed with white starchs or barly-meal and oil of roses an excellent medicine The leaves of mallows boiled in water and beaten with a pestil and applyed asswage pain â„ž mucilag sem psilii extract in aq solani vel resarum â„¥ ii â—arin hordei â„¥ i. aceti q s fiat linimentum Or else â„ž unguent rosat mesue popules an â„¥ iii. succi melâ—num â„¥ ii alb overum nu iii. misceantur simul pro litu Also a spunge dipped in oxycrate and pressed out again and applied thereto doth the same Or else â„ž fol caulium rub m. ii câ—quantur in â—xycrato terantur adde overum vitellos tres olei rosati â„¥ ii farinae hordei quantum sufficit flugantur cataplasma Also you may take the crude juice of cole-worts cane-weed and roses beaten and pressed out and of these incorporated with oil of roses and barly-meal make a cataplasm In winter-time when as these things cannot be had green you may use unguent infrigidanâ— Galeni populeon A cerâ—te with opium Or else â„ž cerae albae â„¥ i. croci ℈ i opii ℈ iiii olei rosati quantum sufficit macerentur opium crocus in acelo deinde terantur et incorporentur cum cera et oleo fiat cetatum spread it upon a cloth and lay it upon the part and all about it and let it be often renewed Some cut frogs open and apply them to the grieved part It is confirmed by sundry mens experience that pâ—in of the Sciatica when it would yeeld to no other remedy to have been asswaged by anointing the affected part with the mucous water or gelly of Snails The water of Snails being used for the space of seven or eight daies truth whereof was assured me by the worthy Gentleman the Lord of Longemau a man of great honesty and credit who himself was troubled for six months space with the Sciatica This water is thus made Take fifty or sixty red Snails put them in a copper-pot or kettle and sprinkle them over with common salt and keep them so for the space of a day then press them in a course or hair-cloth in the expressed liquor dip linnen rags and apply them so dipped to the part affected and renew them often But if there be great inflammation the Snails shall he boiled in Vinegar and Rose-water They say that Citrons or Oranges boiled in Vinegar and beaten in a mortar and incorporated with a little barly or bean flower are good against these pains Or else â„ž â—â—morum coctorum in lacte lb. i. butyri â„¥ i. vitellos ovorum nu ii aceti â„¥ i fiat cataplasma There are some who take chees-curd newly made and mix it in a mortar with oil of Roses and barly-meal and so apply it it represseth inflammation and asswageth pain Others mix cassia newly extracted forth of the cane with the juice of Gourds or Melons Others apply to the part the leavs of Coleworts and Dane-weed or smallage or all three mixed together and beaten with a little Vinegar Others macerate or steep an ounce of linseed in Wort and make the mucilage extracted therefrom into a Cataplasm with some oil of Roses and barly-meal Some put oil of poppies to the pulp of Citrulls or Gourds being beaten and so incorporate them together and apply it An history This following medicine hath its credit from a certain Gascoin of Basas that was throughly cured therewith when as he had been vexed long and much with gouty pains above the common custom of such as are troubled with that disease Thus it is Take a great ridg-tile thick and strong and heat it red hot in the fire A particulars stove then put it into such another tile of the same bigness but cold least it should burn the bed-clothes then forthwith fill the hot one with so many Dane-wort-leaves that the patient may safely lay the affected part therein without any danger of burnâ—ng it Then let the patient endure the heat that comes there from and by sweat receive the fruit thereof for the space of an hour substituting fresh Dane-wort-leaves if the forme become too drie as also another hot tile if the former shall grow too cold before the hour be ended This being done let the part be dried with warm and drie linnen clothes Use this particular stove for the space of fifteen daies and that in the morning fasting afterward annoint the part with this following ointment An ointment of the juice of Dane-wurt â„ž succi â—buli lb. i. ss olei com lb. i. misceantur simul and let them be put into a straight mouthed glass and well luted up then let it boil in balneo Mariae being first mixed with some wine untill the half thereof be consumed for the space of ten or twelve hours then let it cool and so keep it for use adding thereto in the time of anointing some few dropâ— of aqua
and most grievous symptoms as lameness and the decay not only of the thigh and leg but at length of the whole body and lastly a slow and hectick fever which in continuance of time will consume the patient for the causes formerly mentioned Therefore let Physicians and Surgeons have a care that they resist it at the first and with such powerful remedies as are mentioned in the following Chapter hinder the springing up and growth of the formerly mentioned symptoms CHAP. XXIII The cure of the Sciatica Why we must open a vein in the Sciatica THough the Sciatica be commonly occasioned by tough phlegm yet if the patient be strong and abound with blood and all things else consent it shall be good to draw blood by opening a vein for phlebotomy equally evacuates all humors therefore the falling down of the humors into the part affected is thereby hindered or retarded Verily I have known no speedier remedy to asswage the pain of inflammation then blood-letting being first mace on the Basilica of the grieved side for revulsions sake and then for evacuation of the conjunct matter on the vena Ischiadica which is at the out-side of the ankle if the pain of the Sciatica be more on the out-side When the vena Ischiadica and Sopheia must be opened in the Stiatica or else on the Sapheia which is on the inside of the ankle if the inner parts be more pained The quantity of blood which is to be drawn must be left to the Judgment of the Physician without whose advice I would attempt nothing in this case Also acrid glysters are good if there be nothing which may hinder as ulcers of the guts or hemorrhoids â„ž rad acor â„¥ ii centaur rut salv rorism calam origan puleg. an m. ss staechad arabic flo cham melil aneth an p.i. sem anis faenic an â„¥ ss fiat decoctio ad lbi in colatura dissolve hiera diaphen an â„¥ ss mellis authes secâ—h rub an â„¥ i. olei liliorum â„¥ iii. fiat clyster Strong purgations are also here useful as of pillul faetia arthâ—itic Assajereth de Hermodactylis Strong purgations in the Sciatica and others used in phlegmatick causes Electuarium Diacarthami purgeth choler and phlegm Often vomitings do not only evacuate the humors but also make revulsion as we have formerly delivered Baths and sweats profit no otherwise then a decoction of Guaicum or sarsaparilla If heat molest the part then foâ—ent it with oil of roses and vinegar especially if the pain be deep in for vinegar by its tenuity pierceth to the bottom and makes way for the oil which of its own nature is anodyne After the use of general medicines you shall apply attractive and resolving things emplasters of pitch and sulphur or of ammoniacum euphorbium terebinthina propolis galbanum bdelium Opopanax draw the humor from within to the surface or skin As in like sort also the chymical oil of sage rosemary Pellitory of Spain and other such like do the same which by reason of the tenuity of their substance and their separation from earthy impurity have far more powerful and expedite faculties to penetrate and discuss Yet must you use none of all these without very good judgment and deliberation otherwise ther be danger of inflammation There may also be made fomentations of discussing and resolving herbs as the roots and leavs of dane-weeds orsis bay and juniper-berries the seeds of fenugreek anis sennel the leaves of sage rosemary chamomile melilote elder and the like boiled in wine and oil the following plaster is much commended by the antients to digest or resolve and asswage the pain with this which draws forth thorns splinters and rotten bones â„ž sem urtic. mundat spumae borac salis ammoniaci rad aristoloch rotund colocynth terebinth venet an.Ê’.x. faenug piperis longi xylcbalsam thur myrrhae adipis cap. gum pini an Ê’.v cerae lbss lactis ficus sylv â„¥ ss ex omnibus secundum artem praeparatis cum olei liliorum vini generosi quantitate sufficiente fiat emplastrum Let it be applied to the hip Or â„ž sinapi acerrimo aceto dissoluti â„¥ ii fermenti acris â„¥ ss pul hermodact Ê’ii mellis com â„¥ iii. tereb â„¥ iv olei laur de spica an â„¥ ii far faenug â„¥ iss terrae formicarum cum ovis lbi fol. laur salv rut rorism an m. ss vermium terrest praepar lbss The earth with the eggs and worms shall be boiled apart with the white wine and herbs cut in pieces and these being strained out the rest of the things shall be added according to art and then it shall be applyed to the hip Or else â„ž rad enul camp sigil salom bryon bismal an â„¥ ii coquantur complete terantur trajiciantur per setaectum addendo farin faenug hordei an â„¥ .i. olei liliorum chamaem an â„¥ iii. tereb â„¥ iv cerae quantum suffâ—cit fiat cataplasma It resolves asswageth pain and calleth forth the humors to the skin Or else â„ž rad sigil beatae Mariae â„¥ vi empl diachyl albi Ê’iv crâ—ci in aqua vitae dissoluti â„¥ ii terebinth â„¥ i. â—l de spica narâ—i quantum sufficit fiat empl Let it be spread upon leather and applied warm I have oftentimes suddenly asswaged the pain of the Sciatica Black briory discuâ—â—th by putting to the pained hip the root of black Briâ—ny â—ut into slices and applyed when the matter was cold Or else â„ž cerae citrin tereb abiet an â„¥ ii liquefiant simul in vase duplici ubi refrixerint adde pulv hermodact â„¥ ss flor chamaem irid flor an Black briony discusseth Ê’iii spicae nardi flor thymi an Ê’ii interioris cinamoni elect semin nasturt anÊ’ii croci ℈ iv malaxantur simul manibus axungiâ porci vetere non salità unctis fiat massa empl But if the pain be not by this means asswaged then must we come to powerful medicines as to use great cupping-glasses applied with much flame and to vesicatories As â„ž cantharid quibus detractae sunt alae A strong vesâ—catory Ê’ii staphisagr Ê’iii sinapi Ê’iss fermenti acerrimi â„¥ ss incorporentur simul fiat vesiccatorium Also blisters may be raised by applying the inner rinde of Travellers-joy to the weight of some two drams The inner rinde of Travellers-joy a vesicatory a little beneath the grieved part you must have a care that the ulcers that remain after the skin of the blisters is taken off do run and be kept open for some time after that so more of the humor contained in the part may be drawn away But if we cannot avail by these means we must according to Hippocrates his counsel come to the last and extremest remedy Aep ult sect 6. Such saith he as are troubled with a long pain of the Sciatica have their hip fall out of joint their leg consumes and they become lame unless they be burnt We have also
efficient causes of the Lues venerea the first is a certain occult and specifick quality which cannot be demonstrated yet it may be referred to God as by whose command this hath assailed mankinde as a scourge or punishment to restrain the too wanton and lascivious lusts of unpure whoremongers The other is an impure touch or contagion and principally that which happeneth in copulation Whether the man or woman have their privities troubled with virulent ulcers or be molested with a virulent strangury which disease crafty Whores colour by the name of the whites the malignity catcheth hold of the other thus a woman taketh this disease by a man casting it into her hot open and moist womb but a man taketh it from a woman which for example sake hath some small while before received the virulent seed of a whore-master polluted with this disease the mucous sanies whereof remaining in the wrinckles of the womans womb may be drawn in by the pores of the standing and open yard whence succeed malign ulcers and a virulent strangury This virulency like a torch or candle set on fire will by little and little be propagated and sent by the veins arteries and nerves to the noble parts whose malignity a strong liver not endureing by the strength of the natural expulsive faculty will send it into the groins whereon follow abscesses therefore called Venereal Buboes Venereal buboes returning in again occasion the Lues venerea These if they return in again and cast not forth matter by being opened will by their falling back into the veins and arteries infect the mass of the blood by the like tainture and thence will ensue the Lues Venerea Yet this disease may be got by a more occult manner of touch as by breathing only For it is not altogether besides reason and experience that a woman long troubled with this disease may by importunate and often kissing The Lues venerea may be got by the only communication of vapor transfuse malignity into a childe for the tender and soft substance of a little childe may be altered infected and by little and little corrupted by receiving of filthy and in their whole kind malign vapors For it is known and now vulgarly believed that mid-wives by receiving the child of a woman infected with this disease have got this affect the malignity being taken and drawn into their bodies through the pores of their hands by the passage of the veins and arteries Neither doth it spare any condition sex nor age of men for not only whosoever use copulation but such as only â—ie with them may be taken with this virulency yea verily if they only lie in the sheets or coverings which retain his sweat or the virulency cast forth by an ulcer The same danger may assail those who shall drink in the same vessel after such as are troubled with this disease For by the impure touch of their lips they leave a virulent sanies and spittle upon the edges of the cup which is no lesse contagious in its kinde then the verulency of leprous persons How nurses may infect children and they their nurses or the fome of mad dogs Wherefore it is no marvel if children nursed by an infected nurse draw in the seeds of this disease together with the milk which is only blood whitened in the breasts or infected suâ—king children by their hot and ulcerated mouths may transfuse this malignity into the body of the nurse by the rare loose and porous substance of the dogs which it frequently sucketh This following history is very memorable to this purpose An history A certain very good Citizen of this City of Paris granted to his wife being a very chaste woman that conditionally she should naâ—e her own child of which she was lately delivered she should have a nurse in the house to ease her of some part of the labor by ill hap the nurse they took was troubled with this disease wherefore she presently infected the childe the childe the mother the mother her husband and he two of his children who frequently accompanied him at bed and board being ignorant of that malignity wherewith he was inwardly tainted In the mean while the mother when she observed that her nurse-childe came not forward but cried almost perpetually she asked my counsell to tell her the cause of the disease which was not hard to be done for the whole body thereof was replenished with venereal scabs and pustles the hired nurses and the mothers nipples were eaten in with virulent ulcers also the fathers and the two other childrens bodies whereof the one was three the other four years old were troubled with the like pustles and scabs I told them that they had all the Lues Venerea which took its original and first off-spring by malign contagion from the hired nurse I had them in cure and by Gods help healed them all except the sucking child which died in the cure But the hired nurse was soundly lashed in the prison and should have been whipped through all the streets of the City but that the Magistrate had a care to preserve the credit of the unfortunate family CHAP. III. In what humor the malignity of the Lues Venerea resides THough in the opinion of many the antecedent cause of this disease be the mass of blood containing the four humors yet I had rather place the matter and primarie and chief seat thereof in gross and viscid phlegm infected with the malign quality of the venereous venom and from this begining and foundation I think by a certain contagious growth it sooner or later infects the other humors as each of them is disposed or apt to suffer Of which my opinion there are many arguments but this chiefly That by the evacuation of a phlegmatick humor whether by the mouth and salivation or by stool urine or sweat in men of what temper soever whether cholerick sanguine or melancholick the disease is helped or cured Secondly for that the excess of pain is more by night then by day Why the pain is worse upon the night then on the day because then the phlegm bearing sway severs the periestium from the bone or else offends it and the rest of the membranous and nervous bodies by the acrimony of its malignity Thirdly because the patients are hurt by the use of cold things but usually finde benefit by hot medicines whether they be ointments plaisters fumigations or whatsoever else inwardly taken or outwardly applied Fourthly for that in venereous pustles there is found a certain hardness at the root though outwardly they make shew of choler or blood For being opened you shall finde them stuffed with a certain plaister-like and tophous matter or else with rough phlegm or viscous pus whence arise these hard tophi or bony excrescences upon the bones if not from phlegmatick humors there heaped up and concrete Fifthly for that the spermatick and cold parts do primarily and principally feel
decoction of the lesser hous-leek and sebestens given with sugar before meat it is no less affectual to put wormseeds in their pap and in rosted apples and so to give them it Also you may make suppositories after this manner Supposâ—ory against the Ascarides and put them up into the fundament â„ž coralli subalbi rasurae eboris cornu cervi usti ireos an ℈ ii mellis albi â„¥ ii ss aquae centinodiae q. s ad omnia concorporanda fiant Glandes let one be put up every day of the weight of Ê’ii for children these suppositories are chiefly to be used for Ascarides as those which adhere to the right gut To such children as can take nothing by the mouth you shall apply cataplasms to their navels made of the powder of cummin-seeds the flower of Iupines wormwood southern-wood tansie the leaves of artichokes Rue the powder of coloquintida citron-seeds aloes ars-smart hors-mint peach-leaves Costus amarus Zedoaria sope and ox-gall Such cataplasms are oftimes spread over all the belly mixing therewith astringent things for the strengthening of the part as oil of myrtils Quinces and mastich you may also apply a great onion hollowed in the midst and filled with aloes and treacle and so rosted in the Embers then beaten with bitter almonds and an ox-gall Also you may make emplasters of bitter things as this which follows â„ž fellis bubuli succi absinth an â„¥ ii colocyn â„¥ i. terantur misceantur simul incorporentur cum farinâ lupinorum make hereof an emplaster to be laid upon the Navel Liniments and ointments may be also made for the same purpose to annoint the belly A plaster against the worms you may also make plasters for the navel of pillulae Ruf. annointing in the mean time the fundament with hony and sugar that they may be chased from above with bitter things and allured downwards with sweet things Or else take worms that have been cast forth dry them in an iron-pan over the fire then powder them and give them with wine or some other liquor to be drunk for so they are thought quickly to kill the rest of the worms Hereto also conduceth the juice of citrons drunk with the oil of bitter almonds or sallet-oil Also some make bathes against this affect of worm-wood galls peach-leavs boiled in water and then bathe the childe therein But in cureing the worms you must observe that this disease is oftimes entangled with another more grievous disease as an acute and burning fever a flux or scouring and the like in which as for example sake a fever being present and conjoined therewith if you shall give worm-seeds old Treacle myrrh aloes you shall increase the fever and flux for that bitter things are very contrary to these affects But if on the contrary in a flux whereby the worms are excluded you shall give corral and the flower of Lentils you shall augment the fever makeing the matter more contumacious by dry and astringent things Therefore the Physician shall be careful in considering whether the fever be a symptom of the worms or on the contrary it be essential A fever sometimes a symptom and sometimes a disease and not symptomatick that this being known he may principally insist in the use of such medicines as resist both affects as purgeing and bitterish in a fever and worms but bitter and somewhat astrictive things in the worms and flux CHAP. VI. A short description of the Elephantiasis or Leprosie and of the causes thereof THis disease is termed Elephantiasis because the skin of such as are troubled therewith is rough scabious wrinkled and unequal like the skin of an Elephant Yet this name may seem to be imposed thereon by reason of the greatness of the disease Some from the opinion of the Arabians have termed it Lepra or Leprosie but unproperly for the Lepra is a kinde of scab and disease of the skin which is vulgarly called Malum sancti manis which word for the present we will use as that which prevails by custome and antiquity Lib. 4. cap. 1. Lib. 2. cap. 11. Now the Leprosie according to Paulus is a Cancer of the whole body the which as Avicen adds corrupts the complexion form and figure of the members Galen thinks the cause ariseth from the error of the sanguifying faculty through whose default the assimulation in the flesh and habit of the body is depraved and much changed from it self and the rule of nature But ad Glauconem he defines this disease An effusion of troubled or gross blood into the veins and habit of the whole body This disease is judged great for that it partakes of a certain venenate virulency depraveing the members and comeliness of the whole body Now it appears There is a certain hidden virulency in the Leprosie that the Leprosie partakes of a certain venenate virulency by this that such as are melancholick in the whole habit of their bodies are not leprous Now this disease is composed of three differences of diseases First it consists of a distemper against nature as that which at the beginning is hot and dry and at length the ebullition of the humors ceasing and the heat dispersed it becomes cold and dry which is the conjunct cause of this symptom Also it consists of an evill composition or conformation for that it depraves the figure and beauty of the parts Also it consists of a solution of continuity when as the flesh and skin are cleft in divers parts with ulcers and chops The Leprosie hath for the most part three general causes that is the primitive antecedent and conjunctive The primitive cause of a Leprosie How they may be leprous from their first conformation The primitive cause is either from the first conformation or comes to them after they are born It is thought to be is him from the first conformation who was conceived of depraved and menstruous blood and such as inclined to melancholie who was begot of the leprous seed of one or both his parents for leprous persons generate leprous because the principal parts being tainted and corrupted with a melancholick and venenate juice it must necessarily follow that the whole mass of blood and seed that falls from it and the whole body should also be vitiated This cause happens to those that are already born by long staying and inhabiting in maritime countries whereas the gross and misty air in success of time induceth the like fault into the humors of the body for that acccording to Hippocrates such as the air is such is the spirit and such the homors Also long abideing in very hot places because the blood is torrified by heat but in cold places for that they incrassate and congealing the spirits do after a manner stupifie may be thought the primitive causes of this disease Thus in some places of Germany there are divers leprous persons but they are more frequent in Spain and over all Africa then in all the
power to kill it no otherwise then meat well drest is apt to nourish it For Conciliator writes that the properties of poyson are contrary to nourishments in their whole substance for as nourishment is turned into blood in each part of the body whereto it is applied to nourish by perfect assimilation substituted in the place of that portion which flows away each moment Thus on the contrary poyson turns our bodies into a nature like it self and venenate for as every agent imprints the force and qualities thereof in the subject patient thus poyson by the immoderation of faculties in their whole nature conttary to us changeth our substance into its nature no otherwise then fire turneth chaff in a moment into its own nature and so consumes it Therefore it is truly delivered by the Antients who have diligently pried into the faculties of natural things that it is poyson that may kill men by destroying and corrupting their temper and the composure and conformation of the body Now all poysons are said to proceed either from the corrupt air or from living creatures plants and minerals or by any artificial malignity in distilling The differences of poyson subliming and diversly mixing of poysonous and fuming things Hence arise sundry differences of poysons neither do they all work after the same manner for some corrupt onr nature by the unmeasureableness of the manifest and elementary qualities whereof they consist All poysons have not a peculiar antipathy with the heaâ—r others from a specifick and occult property Hence it is that some kill sooner then other some neither is it true that all of them presently assail the heart but others are naturally at deadly strife with other parts of the body as Cantharides with the bladder the sea-Hare with the lungs the Torpedo with the hands which it stupefieth though the fishers rod be betwixt them Thus of medicines there are some which are apt presently to comfort and strengthen the heart others the brain as stoechas others the stomach as cinnamon Also there are some poysons which work both wayes that is by manifest and occult qualities as Euphorbium for that both by the excessive heat and the whole substance or the discotd of the whole substance with ours corrupts our nature An argument hereof is that Treacle which by its quality is manifestly hot infringeth the force thereof as also of all others of an occult propetry Poysons which work by an occult and specifick property do not therefore do it because they are too immoderately hot cold dry moist but for that they are absolutely such and have that essence from the starrs and celestial influence which is apt to dissolve and destroy the strength of mans body because being taken but even in a small quantity yet are they of so pernicious a qualityâ— that they kill almost in a moment Now poysons do not only kill being taken into the body but some being put or applied outwardly neither do venomous creatures onely harm by their stinging and biting but also by their excrements as spittle blood the touch and breath CHAP. II How poysons being small in quantity may by their only touch cause so great alterations IT seemeth strange to many how it may come to pass that poyson taken or admitted in small quantity may almost in a moment produce so pernicious effects over all the body and all the parts faculties and actions so that being admitted but in a little quantity it swells up the body into a great bigness Neither ought it to seem less strange how Antidotes and Counter-poysons which are opposed to poyson can so suddenly break and weaken the great and pernicious effects thereof being it is not so likely that so small a particle of poyson or Antidote can divide it self into so many Cap. 5. lib. 6. de loc affect and so far severed particles of our body There are some saith Galen who think that some things by touth onely by the power of their quality may alter those things which are next to them and that this appears plainly in the fish Torpedo as that which hath so powerful a quality that it can send it alongst the fishers rod to the hand and so make it become torped or numb But on the contrary Philosophers teach that accidents such as qualities are cannot without their subjects remove and diffuse themselves into other subjects The true reason of the wondrous effects of poysons Therefore Galens other answer is more agreeable to reason that so many and great affects of poysons and remedies arise either from a eertain spirit or subtil humidity not truly for that this spirit and subtil humidity may be dispersed over the whole body and all the parts thereof which it affects but that little which is entred the body as cast in by the stroak of a Spider or the sting of a Scorpion infects and corrupts all the next parts by contagion with the like quality these other that are next to them until from an exceeding small portion of the blood if the stroke shall light into the veins it shall spread over the whole mass of blood or of phlegm if the poyson shall chance to come to the stomach and so the force thereof shall be propagated and diffused over all the humors and bowels The doubt of Antidotes is less for these being taken in greater quantity when they shall come into the stomach warmed by the heat of the place they become hot and send forth vapors which suddenly diffused over the body by the subtility of their substance do by their contrary forces dull and weaken the malignity of the poyson Wherefore you may often see when as Antidotes are given in less quantity then is fit that they are less prevalent neither do they answer to our expectation in overcoming the malignity of the poyson so that ir must necessarily follow thar these must not onely in qualities but also in quantity be superior to poysons CHAP. III. Whether there be any such poysons as will kill at a set time No poysons kill in a set time TO the propounded question whether there may be poysons which within a certain and definite time put case a mouth or year may kill men Theophrastus thus answers of poysons some more speedily perform their parts others more slowly yet may you find no such as will kill in set limits of time according to the will and desire of men For that some kill sooner or later then others they do not this of their own or proper nature as Physicians rightly judg but because the subject upon which they light doth more or less resist or yield to their efficacy H w poysons come to kill sooner or later Experience sheweth the truth hereof for the same sort of poyson in the same weight and measure given to sundry men of different tempers and complexions will kill one in an hour another in six hours or in a day and on the contrary will not
thereof taken inwardly is very effectual in this case as Aetius affirms To the same purpose you may with good success make a lotion and friction with mustard dissolved in urine or vinegar leaving upon the wound a double cloth moistened in the same decoction lastly all acrid biting and very attractive medicines are convenient in this case Wherefore some apply rocket boiled and beaten with butter and salt others take the flower of Orobus and temper it with hony salt and vinegar and apply it hot Hors-dung boiled in sharp vinegar or brimstone beaten to powder and tempered with ones spittle is good Also black pitch melted with some salt and a little Euphorbium mixed therewith and so applied is good Some write that the hairs of the dog whose bite caused the madness applied by themselves by their sympathy or similitude of substance draw the venom from within outwards for so a Scorpion beaten and applied to the place whereas it stung by drawing out the poison that it sent in restores the patient to health both these by often experience are affirmed to have certain event Others chaw unground wheat and lay it upon the wound others rost beans under hot embers then husk them and cleave them and so apply them The force of Docks Also the wound may be wholsomly washed and fomented with a decoction of Docks and then the herb beaten may be applied thereto also the patient may drink the decoction and by this one remedy Aetius affirms that he hath recovered divers for thus it moves urine plentifully which is thought much to conduce to the cure of this disease There be some who apply the leaves of betony and nettles beaten with common salt others make a medicine to the same purpose and after the same manner of an Onion the leaves of rue and salt Yet the rest are exceeded by treacle dissolved in aqua vitae or strong wine and rubbed hard upon the part so that the blood may follow laying upon the wound when you have wiped it cloths dipped in the same medicine then presently apply garlick or onions beaten with common salt and turpentine by this only remedy I freed one of the daughters of Madamoisella de Gron from the symptoms of madness An history and healed the wound when as a mad dog had bit her grievously in the calf of the right leg Also it is good presently to eat garlick with bread and then to drink after it a draught of good wine for garlick by its spirituous heat will defend the noble parts from poison There be some who wish to eat the rosted liver of the dog that hurt them or else the liver of a goat of which remedies as yet I have had no experience Others prescribe a dram of the seeds of Agnus castus to be drunk with wine and butter Others the powder of river-crabs burnt and drunk in wine Or â„ž rad gent. Ê’ii astacorum fluviat in fumo combust in pollinem redact Ê’iii terrae sigil â„¥ ss misce Give Ê’i of this same powder in the decoction of river-crabs and let them drink thereof oft at sundry times Many have cast themselves into the sea neither have they thence had any help against madness as Ferrand Pozet the Cardinal testifieth in his book of poisons Leaping into the sea no certain remedy against madness wherefore you must not rely upon that remedy but rather you must have recourse to such things as are set in the books of Physicians and approved by certain and manifold experience But seeing that no poison can kill unless it be taken or admitted into the body we must not fear any harm by sprinkling our bodies with the sanies of a mad dog viper toad or any other such like venemous creature if so be that it be presently wiped or washed clean away CHAP. XV. What cure must be used to such as fear the water but yet are able to know themselves in a glass SUch as have not their animal faculty as yet orecome by the malignity of the rageing venom must have strong purgations given them Wherefore if in any case Antimony be useful The force of Antimony against madness then is it in this as that which causeth sweats looseth the belly and procures vomiting For it is a part of extreme and dangerous madness to hope to overcome the cruel malignity of this poison already admitted into the bowels by gentle purging medicines Assuredly such and so great danger is never overcome without danger Baths also conduce which may disperse and draw forth the poison by causing sweats Also many and frequent treacle-potions are good to retund the venom and strengthen the bowels also it will be fitting to give them water and all other liquid things which they so much abhor in a cup with a cover Alwaies let such as are poisoned or stung or bitten by a mad dog or other venomous beast keep themselves in some warm and light place that the poison which by coldness is forced in may be the readil yet drawn out by the means of heat and the spirits be recreated by the brightness of the air and therefore move from the center to the circumference of the body and let the room be perfumed with sweet things To eat very hot and salt things presently at the beginning as onions leeks all spiced meats and strong wine not allaied seem not to be besides reason because such things by their spirituous heat hinder the diffusion of the poison over the body and strengthen the filled entrails There be some also that would have them to feed upon gross and viscous meats which by obstructing the vessels may hinder the passage of the poison to the heart and other parts and by the same reason it will be better to fill themselves with meat to satiety then otherwise because the malignity of humors is encreased by hunger then which nothing can be more harmful to venomous wounds Yet within a short while after as within five or six daies they must return to a mediocrity and use all things temperate boiled meats rather then rosted and that in a decoction of opening things so to move urine Lastly they must keep such a diet as melancholick persons ought to do neither shall they let blood left so the poison should be further drawn into the veins but it is good that the patients body be soluble from the very first Let their drink be wine indifferently allaied with water oxymel simplex or the syrup of the juice of Citron with boiled water or else this following Julip â„ž succi limonum malorum citri an â„¥ ss suc gran acid â„¥ ii aquae acetosae min ros an â„¥ i. aq font coct quantum sufficit fiat Julep ut artis est Why sleep is hurtful to such as are bitten by a mad dog and all such as are poisoned Sleep is to be avoided untill the force of the poison is abated for by sleep the humors flow back
female sour as it also happens in the bitings of vipers Now for that the poison of Asps congeals the blood in the veins and arteries therefore you must use against it such things as are hot and subtil of parts as mithridate or treacle dissolved in aqua vitae and the same powred into the wound the patient must be waâ—med by baths frictions walking and the like When as the hurt part becometh purple black or green it is a sign that the native heat is extinct and suffocated by the malignity of the venom Therefore then it is best to amputate the member if the patient be able to endure it and there be nothing which may hinder An history Vigo writes that he saw a Mountebank at Florence who that he might sell the more of his Antidotes and at the better rate let an Asp to bite him by the finger By what means Asps may be made less hurtful but he died thereof some four hours after To the same purpose you may read Matthiolus whereas he writes that those Impostors or Mountebanks to cozen the better and deceive the people use to hunt and take vipers and asps long after the spring that is Gal. lib. de Ther. ad pisonem then when as they have cast forth their most deadly poison then they feed them with meats formerly unusual to them so that by long keeping and care and at the length they bring it to pass that they put off a great part of their venomous nature neither being thus satisfied they make them oftentimes to bite upon pieces of flesh that so they may cast forth into them the venom which is contained in the membrane between their teeth and gums Lastly they force them to bite lick and swallow down an astringent medicine which they compose and carry about for the same purpose that so they may obstruct the passages by which the venom used to flow out for thus at length their bites will be harmless or without great danger This therefore is their art that so they may sell their counterfeit treacle to the people at a high rate as that which is a most safe remedy against all poisonous bites Against the bites of what serpents treacle doth no good Christopher Andrew in his book called Oicoiatria writes that the Islands of Spain are every where full and stored with serpents asps and all sorts of venomous beasts against whose bites they never observed or found any benefit in treacle But the efficacy of the following Antidote is so certain and excellent and approved by so manifold experience that in the confidence thereof they will not be affraid to let themselves be bitten by an Asp Now this medicine is composed of the leaves of Muller A certain remedy against the biting of Asps Avens and red-stock-gilliflowers in like quantity which they boil in sharp vinegar and the urine of a sound man and therewith foment the wounded part Yet if he have not taken nor used any thing of a good while after the wound it will be better and more certain if the patient drink three ounces of this decoction fasting two hours before meat CHAP. XXIII Of the biting of a Snake I Have thought good in a true history to deliver the virulent malignity of the bite of a Snake An history and the remedies thereof When as King Charls the ninth was at Moulins Mounsieur le Feure the Kings Physician and I were called to cure the Cook of the Lady of Castelophers Who gathering hops in a hedg to make a sallet was bit on the hand by a snake that there lay hid he putting his hand to his mouth sucked the wound to ease the pain by sucking forth the venom But his tongue forthwith swelled so big that he could not speak his mind besides his whole arm even to his shoulder was in like sort much swelled his pain was so vehement that it hath made him swound twice in my presence his face was wan and livid like to a dead body The cure and though I despaired of his recovery yet not suffering him to be quite forsaken I washed his mouth with Treacle dissolved in white wine and gave him some thereof to drink adding thereto some aqua vitae I opened his swoln arm with many and deep scarifications especially in the place where he was hurt I suffered the blood which was wholly serous and sanious to slow more plentifully I washed the wounds with treacle and mithridate dissolved in aqua vitae and then I put him exceeding warm in bed procuring sweat and making him to lie awake lest sleep should draw the poison inwards to the entrails I by these means so far prevailed that on the day after he was freed from all his malign symptoms Therefore I judged it only remained for a perfect cure that the wound should be long kept open and washed with treacle neither was I deceived for within a few daies he was perfectly recovered CHAP. XXIV Of the bitings of Toads THough Toads want teeth The bites of Toads how harmful yet with their hard and rough gums they so straitly press or pinch the part which they shall take hold on that they will force their poison thereinto and so over the whole body by the pores of the pressed part Moreover they cast forth their venom by urine spittle and vomit upon herbs but chiefly upon Strawberries the which they are reported greatly to affect Hence many suddenly and ignorantly catch their deaths I heard from a man of very good credit An history that there were two Merchants not far from the City Tholous who whilest dinner was providing walked into the Garden that belonged to the Inn where they gathered some sage leaves and unwashed as they were put them into their wine The symptoms occasioned by the poison of Toads They had not as yet dined when being taken with a sudden Vertigo the whole Inn seemed to run round then losing their sight they fell into a swound intermixed now and then with convulsions But they stamered with their lips and tongues becomming black a froward and horrid look with continual vomiting and a cold sweat the fore-runner of death which presently seized upon them their bodies becoming exceedingly much swoln But the Justices of the place suspecting that they were poisoned made the Inn-keeper and the Guests to be apprehended being examined they all constantly and with one voice answered That the dead parties ate of the same meat and drink which the rest did but only they put sage into their wine A Physician was asked the question whether sage might be poisoned he answered it might but to come to the purpose it must appear whether any venomous creature hath poisoned the plant with her spittle or venomous sanies This which was lightly pronounced and only by conjecture was by the eie found to be true For at the root thereof there was found a hole in the ground full of Toads who got
speedily putrefie Men that are of an ill juyce are also most apt to this kind of Pestilence for in the naughty quality of the juyce there is a great preparation of the humors unto putrefaction You may know it by this that when the Pestilence reigneth there are no other diseases among the common people which have their original of any ill juyce but they all degenerate into the Plague Therefore when they begin to appear and wander up and down it is a token that the Pestilence will shortly cease or is almost at an end But here also I would have you to understand those to be of an ill juyce which have no pores in their skin by which as it were by rivers the evil juyce which is contrary to nature may be evacuated and purged Who least subject to take the Plague And I have noted and observed that those are less in danger of the Pestilence which have Cancerous Ulcers and stinking sores in their Noses and such as are infected with the French-Pox and have by reason thereof tumors and rotten Ulcers or have the Kings-evil running upon them the Leprosie or the Scab and to conclude all those that have Fistulaes and running in their bodies I think those that have quartane Fevers are the better priviledged for the same because that by the fit causing sweat that cometh every fourth day they avoid much of the evill juyce that was engendred This is more like to be true then to think that the poyson that cometh from without may be driven away by that which lurketh within Contrariwise women that are great with childe as I have noted Who subject thereto because they have much ill juyce being prohibited from their accustomed evacuations are very apt to take this disease and so seldom recover after they are infected Black or blew Impostumes and spots and pustles of the same colour dispersed over the skin Signs the disease is incurable A good sign argue that the disease is altogether incurable and mortal When the swelling or sore goeth or cometh before the Fever it is a good sign for it declareth that the malignity is very weak and feeble and that nature hath overcome it which of it self is able to drive so great portion thereof from the inner parts A deadly sign But if the sore or tumor come after the Fever it is a mortal and deadly sign for it is certain that it cometh of the venomous matter not translated but dispersed not by the victory of nature but through the multitude of the matter with the weight whereof nature is overcome When the Moon decreaseth those that are infected with the Pestilence are in great doubt and danger of death because then the humors that were collected and gathered together before the Full of the Moon through delay and abundance do swell the more and the faculties by which the body is governed become more weak and feeble because of the imbecillity of the native heat which before was nourished and augmented by the light and so consequently by the heat of the Full Moon For as it is noted by Aristotle the Wainings of the Moon are more cold and weak and thence it is that women have their menstrual fluxes chiefly or commonly at that time In a gross and cloudy air the pestilent infection is less vehement and contagious In what air most contagious then in a thin and subtil air whether that thinness of the air proceed from the heat of the Sun or from the North winde and cold Therefore at Paris where naturally and also through the abundance of filth that is about the City the air is dark and gross the pestilent infection is less fierce and contagious then it is in Province for the subtilty of the air stimulates or helps forward the Plague But this disease is mortal and pernicious wheresoever it be because it suddenly assaulteth the heart which is the Mansion or as it were the fortress or castle of life but commonly not before the signs and tokens of it appear on the body and yet you shall scarce find any man that thinketh of calling the Physician to help to preserve him from so great a danger before the signs thereof be evident to be seen and felt but then the heart is assaulted And when the heart is so assaulted what hope of life is there or health to be looked for What effects fear and confidence produce in the Plague Therefore because medicines come oft-times too late and this malady is as it were a sudden and winged messenger of our death it cometh to pass that so many die thereof And moreover because of the first suspicion of this so dire and cruel a disease the imagination and mind whose force in the diversly much stirring up of the humors is great and almost incredible is so troubled with fear of imminent death and despair of health that together with the preturbed humors all the strength and power of nature falleth and sinketh down This you may perceive and know by reason that the keepers of such as are sick and the bearers which are not fearful but very confident although they do all the basest offices which may be for the sick are commonly not infected and seldom die thereof if infected CHAP. XVIII How a pestilent Fever comes to be bred in us THe Plague oft-times findeth fuel in our bodies and oft-times allurements to wit the putrefaction of humors or aptness to putrefie but it never thence hath its first original for that comes alwayes from the defiled air therefore a pestilent Fever is thus bred in us The pestilent air drawn by inspiration into the lungs The original of the Plague alwayes from the air and transpiration into the utmost mouths of the veins and arteries spread over the skin the bloud or else the humors already putrefying or apt to putrefie therein are infected and turned into a certain kind of malignity resembling the nature of the agent These humors like unquench't lime when it is first sprinkled with water send forth a putrid vapor which carryed to the principal parts and heart especially infecteth the spirituous bloud boyling in the ventricles thereof and therewith also the vital spirits and hence proceeds a certain feverish heat This heat diffused over the body by the arteries together with a malign quality taints all even the solid parts of the bones with the pestiferous venom and besides causeth divers symptoms according to the nature thereof and the condition of the body and the hâ—mors wherein it is Then is the conflict of the malignity assailing and nature defending manifest in which if nature prevail it using the help of the expulsive faculty will send and drive it far from the noble parts either by sweats vomits bleeding evacuation by stool or urine buboes carbuncles pustles spots and other such kinds of breakings out over the skin Signs that nature is oâ—â—come But on the contrary if the malignity prevail
est unto the Vessels and Ad Vires id est unto the Strength and therewithal he hath a tumor that is pestilent in the parts belonging unto head or neck the blood must be let out of the cephalick or median vein or out of one of their branches dispersed in the arm on the grieved side But if through occasion of fat or any other such like cause those veins do not appear in the arm there be some that give counsel in such a case to open the vein that is between the fore-finger and the thumb the hand being put into warm water whereby that vein may swell and be filled with blood gathered thither by means of the heat If the tumor be under the arm-hole or about those places the liver-liver-vein or the median must be opened which runneth alongst the hand if it be in the groin the vein of the ham or Saphena or any other vein above the foot that appeareth well but alwaies on the grieved side And phlebotomy must be performed before the third day for this disease is of the kind or nature of sharp diseases because that within four and twenty hours it runneth past help In letting of blood you must have consideration of the strength You may perceive that the patient is ready to swound when that his forehead waxeth moist with a small sweat suddenly arising by the a king or pain at the stomach with an appetite to vomit and desire to go to stool gaping blackness of the lips and sudden alteration of the face unto paleness and lastly most certainly by a small and slow pulse and then you must lay your finger on the vein and stop it untill the patient come to himself again either by nature or else restored by art that is to say by giving unto him bread dipped in wine or any other such like thing then if you have not taken blood enough you must let it go again and bleed so much as the greatness of the disease or the strength of the patient will permit or require which being done some of the Antidotes that are prescribed before will be very profitable to be drunk which may repair the strength and infringe the force of the malignity CHAP. XXV Of purging medicines in a Pestilent disease IF you call to minde the proper indications purging shall seem necessary in this kinde of disease and that must be prescribed as the present case and necessity requireth What purges fit in the Plague rightly considering that the disease is sudden and doth require medicines that may with all speed drive out of the body the hurtful humor wherein the noisome quality doth lurk and is hidden which medicines are divers by reason of the diversity of the kinde of the humor and the condition or temperature of the patient For this purpose six grains of Scammony beaten into powder or else ten grains are commonly ministred to the patient with one dram of Treacle Also pils may be made in this form Take of Treacle and Mithridate of each one dram Pils of Sulphur vivum finely powdred half a dram of Diagridium four grains make thereof Pils Or take three drams of Aloes of Myrrh and Saffron of each one dram of white Hellebore and Asarabacca of each ℈ iiii make thereof a mass with old treacle and let the patient take four scruples thereof for a dose three hours before meat Ruffus his pils may be profitably given to those that are weak The ancient Physicians have greatly commended Agarick for this disease because it doth draw the noisom humors out of all the members and the virtues thereof are like unto those of Treacle for it is thought to strengthen the heart and to draw out the malignity by purging To those that are strong the weight of two drams may be given and to those that are more weak half a dram It is better to give the infusion in a decoction then in substance for being elected and prepared truly into Trochisces it may be called a divine kinde of medicine Antimonium is highly praised by the experience of many but because I know the use thereof is condemned by the councel and decree of the School of Physicians at Paris I wll here cease to speak of it Those medicines that cause sweats are thought to excel all others when the Pestilence commeth of the venomous Air among whom the efficacy of that which followeth hath been proved to the great good of many in that Pestilence which was lately throughout all Germany as Matthias Rodler Chancelor to Duke George the Count Palatine signified unto me by letters They do take a bundle of Mug-wort and of the ashes thereof after it is burnt An effectual sudorifick and also purging medicine they make a lee with four pints of water then they do set it over the fire and boil it in a vessel of earth well leaded until the liquor be consumed the earthy dregs falling into the bottom like unto salt whereof they make Trochisces of the weight of a crown of gold then they dissolve one or two of these Trochises according to the strength of the patient in good Muskadine give it the patient to drink and let him walk after that he hath drunk it for the space of half an hour then lay him in his bed and there sweat him two or three hours and then he will vomit and his belly will be loosed as if he had taken Antimony and so they were all for the most part cured especially all those that took that remedy betimes and before the disease went to their heart The virtues of Mugwort as I my self have proved in some that were sick at Paris with most happy success Truly Mugwort is highly commended by the Ancient Physicians being taken and applied inwardly or outwardly against the bitings of venomous creatures so that it is not to be doubted but that it hath great virtue against the Pestilence I have heard it most certainly reported by Gilbertus Heroaldus Physician of Mompilier Vide rondelet lib. 7 depis c. 3. that eight ounces of the pickle of Anchovies drunk at one draught is a most certain and approved remedy against the Pestilence as he and many other have often found by experience For the Plague is no other thing but a very great putrefaction for the correction and amendment whereof there is nothing more apt or fit then this pickle or substance of Anchovies being melted by the Sun and force of the salt that is strewed thereon There be some which infuse one dram of Walwort-seed in white wine and affirme that it drunken will performe the like effect as Antimony Others dissolve a little weight of the seed of Rue being bruised in Muskadine with the quantity of a bean of Treacle and so drink it Others beat or bruise an handful of the leaves or tops of Broom in half a pinte of white wine and so give it to the patient to drink to cause him to vomit loose
his belly and make him to sweat Truly those that are wounded or bit with venomous beasts If they bind broom above the wound it will prohibit or hinder the venom from dispersing it self or going any further therefore a drink made thereof will prohibit the venom from going any nearer the heart Some take of the root of Elecampane Gentian Tormentil Kermes-berries and broom of the powder of Ivory and Harts-horn of each half a dram they do bruise and beat all these and infuse them for the space of four and twenty hours in white wine and aqua vitae on the warm embers and then strain it and give the patient three or four ounces thereof to drink this provokes sweat and infringeth the power of the poysons and the potion following hath the same virtue Take good Mustard half an ounce of Treacle or Mithridate the weight of a bean A Potion dissolve them in white wine and a little aqua vitae and let the patient drink it and sweat thereon with walking You may also roast a great Onion made hollow and filled with half a dram of Treacle and vinegar under the embers and then strain it and mix the juice that is pressed out of it with the water of Sorrel Carduus Benedictus or any other cordial thing and with strong wine and give the paticet to drink thereof to provoke sweat to repel the malignity Or else take as much Garlick as the quantity of a Nut of Rue and celandine of each twenty leaves bruise them all in white wine and a little aqua vitae then strain it and give the patient thereofto drink There besome that do drink the juice that is pressed out of Celandine and Mallows with three ounces of Vinegar and half an ounce of the oil of Wall-nuts and then by much walking do unburthen their stomach and belly upwards end downwards and so are helped When the venomous air hath already crept into and infected the humors one dram of the dried leaves of the Bay-tree macerated for the space of two dayes in Vinegar and drunk is thought to be a most soveraign medicine to provoke sweat loosnes of the belly and vomiting Matthiolus in his Treatise de Morbo gallico writeth that the powder of Mercury ministred unto the patient with the juice of Carduus Benedictus or with the Electuary de Gemmis will drive away the pestilence before it be confirmed in the body by provoking vomit loosness of the belly and seat one dram of Calcauchum of white Copperas dissolved in Rose-water performeth the like effect in the same disease Some do give the patient a little quantity of the oil of Scorpions with white wine to expel the the poyson by vomit and therewithall they annoint the region of the heart the breast and the wrists of the hands I think these very meet to be used often in bodies that are strong and well exercised because weaker medicines do evacuate little or nothing at all but only move the humors whereby cometh a Fever When a sufficient quantity of the malignity is evacuated then you must minister things that may strengthen the belly and stomach and with-hold the agitation or working of the humors and such is the confection of Alkermes CHAP. XXVI Of many Symptoms which happen together with the Plague and first of the pain of the head The cause of phrensie in the Plague IF the malignity be carried into the brain and nature be not able to expel it it inflames not only it but also the menbranes that cover it which inflamation doth one while hurt trouble or abolish the imagination another while the judgment and sometimes the memory according to the situation of the inflamation whether it be in the former or hinder or middle part of the head but hereof cometh alwaies a Phrensie with fiery redness of the eies and face and heaviness and burning of the whole head If this will not be amended with Clysters and with opening the Cephalick vein in the arm the arteries of the Temples must be opened taking so much blood out of them The benefit of opening an artery as the greatness of the Symptoms and the strength of the patient shall require and permit Truly the incision that is made in opening an arterie will close and joyn together as readily and with as little difficulty as the incision of the vein And of such an incision of an artery cometh present help by reason that tensive and sharp vapours do plentifully breath out together with the arterious blood It were also very good to provoke a flux of blood at the nose Aph. 10. sect 6. if nature be apt to exonerate her self that way For as Hippocrates saith when the head is grieved or generally aketh if matter water or blood flow out at the nostrils mouth or ears it presently cures the disease Such bleeding is to be provoked by strong blowing or striving to cleanse the nose by scratching or pricking of the inner side of the nostrils by pricking with an hors hair and long holding down of the head An history The Lord of Fontains a Knight of the Order when we were at Bayon had a bleeding at the nose which came naturally for the space of two dayes and thereby be was freed of a pestilent Fever which he had before a great sweat arising there-withall and shortly after his Carbuncles came to suppuration To stay bleeding and by Gods grace he recovered his health being under my cure If the blood do flow out and cannot be stopped when it ought the hands arms and legs must be tied with hands and sponges wet in Oxycrate must be put under the arm-holes cupping glasses must be applied unto the dugs the region of the Liver and Spleen and you must put into the nostrils the doun of the willow-tree or any other astringent medicine incorporated with the hairs plucks from he flank belly or throat of an Hare Bole-Armenick Terra Sigillata the juice of Plantaine and Knot-grass mixed together and furthermore the patient must be placed or laied in a cool place But if the patient be nothing mitigated notwithstanding all these fluxes of blood we must come to medicines that procure sleep whose forms are these Medicines to procure sleep Take of green Lettuce one handful flowers of water-Lillies and Violets of each two pugils one head of white-Poppy bruised of the four cold seeds of each two drams of Liquorice and Raisins of each one dram make thereof a decoction and in the straining dissolve one ounce and a half of Diacodium make thereof a large potion to be given when they go to rest Also Barly-cream may be prepared in the water of water-Lillies and of Sorrel of each two ounces adding thereto six or eight grains of Opium of the four cold seeds and of white-Poppy seeds of each half an ounce and let the same be boiled in broth with Lettuce and Purslain also the pils de Cynoglesso i. e. Hounds-tongue
temperature of his inâ—ward parts so that disâ—ases are oft times hereditary the weakness of this or that entral being translated from the parent to the child Wherefore many diseases are heredetary How seed is to be understood to faâ—l from the whole body There are some which suppose this falling of the seed from the whole bodie not to â—e uâ—derstood according to the weight and matter as if it were a certain portion of all the bloud separated from the rest but according to the power and form that is to say the animal natural and vital spirits being the frâ—mers of formation and life and also the formative faculty to fall down from all the parts into the seed that is wrought or perfected by the Testicles for proof and confirmation whereof they alledge that many perfect sound absolute and well proportioned children are born of â—ame and decrepit Parents CHAP. I. Why the generative parts are endued with great pleasure What moveth a man to copulation A Certain great pleasure accompanieth the function of the parts appointed for generation and before it in living creatures that are of a lusty age when matter aboundeth in those parts there goeth a certain fervent or furious desire the causes thereof many of which the chiefest is That the kind may be preserved and kept for ever by the propagation and substitâ—tion of other living creatures of the same kind For brute beasts which want reason and therefore cannot be sol citous for the preservation of their kind never come to carâ—al copulation unless they be moved thereunto by a certain vehement provocation of unbridled lust and as it were by the stimulation of Venery But man that is endued with reason being a divine and most noble creature would never yield nor make his minde subject to a thing so abject and filthy as is carnal copulation but that the Venereous ticklings raised in those parts relax the severity of his minde or reason admonisheth him that the memory of his name ought not to end with his life but to be preserved unto all generations as far as may be possible by the propagation of hâ—s seed or issue Therefore by reason of this profit or commodity nature hath endued the genitals with a far more exact or exquisite sense then the other parts by sending the great sinews unto them and moreover she hath caused them to be bedewed or moistned with a certain whayish humor not much unlike the seed sent from the glandules or kernels called prostata situated in men at the beginning of the neck of the bladder but in women at the bottom of the womb this moisture hath a certain sharpness or biting for that kind of humors of all others can chiefly provoke those parts to their function or office and yeeld them a d lectable pleasure while they are in execution of the same For even so whayish and sharp humors when they are gathered together under the skin if they wax warm tickle with a certain pleasant itching and by their motion infer delight but the nature of the genital parts or members is not stirred up or provoked to the expulsion of the seed with these provocations of the humors abounding either in quantity or quality only but a certain great and hot spirit or breath contained in those parts doth begin to dilate it self more and more which causeth a certain incredible excess of pleasure or voluptuousness wherewith the genitals being replete are spread forth or distended every way unto their ful greatness The yard is given to men whereby they may cast out their seed directly or straitly into the womans womb and the the neck of the womb to women whereby they may receive that seed so cast forth by the open or wide mouth of the same neck and also that they may cast forth their own seed sent through the speâ—matick vessels unto their testicles The cause of folding of the spermatick vessels these spermatick vessels that is to say the vein lying above and the artery lying below do make many flexions or windings yet one as many as the other like unto the tendâ—ils of vines diversly platted or folded together and in those folds or bendings the blood and spirit which are carried unto the testiles are concocted a longer time and so converted into a white seminal substance The lower of these flexions or bowings do end in the stones or testicles But the testicles forasmuch as they are loose thin and spongeous or hollow receiving the humor which was begun to be concocted in the fore-named vessels concoct it again themselves but the testicles of men concoct the more perfectly for the procreation of the issue and the testicles of women more imperfectly because they are more cold less weak and feeble Wâ—mens testicles more imperfect but the seed becommeth white by the contact or touch of the testicles because the substance of them is white The male is such as engendreth in another and the female in her self by the spermatick vessels which are implanted in the inner capacity of the womb Why many men and women abhor venerous copulation But out of all doubt unless nature had prepared so many allurements baits and provocations of pleasure there is scarce any man so hot and delighted in venerous acts which considering and marking the pâ—ace appointed for humane conception the loathsomness of the filth which daily falleth down into it and wherewithall it is humected and moistned and the vicinity and nearness of the great gut under it and of the bladder above it but would shun the embraces of women Nor would any women desire the company of man which once premeditates or fore-thinks with her self on the labour that she should sustain iâ— bearing the burthen of her childe nine moneths and of the almost deadly pains that she shall suffer in her delivery Men that use too frequent copulation Why the str ngury ensueth immoderate copulation oftentimes in stead of seed cast forth a crude and bloody humor and sometimes meer blood it self and oft-times they can hardly make water but with great pain by reason that the clammy and oily moisture which nature hath placed in the glandules called prostatae to make the passage of the urine slippery and to defend it against the sharpness of the urine that passeth through it is wasted so that afterward they shall stand in need of rhe help of a Surgeon to cause them to make water with ease and without pain by injecting of a little oyl out of a Syringe into the conduit of the yard What things necessary unto generation For in generation it is fit the man cast forth his seed into the womb with a certain impetuosity his yard being stiff and distended and the woman to receive the same without delay into her womb being wide open lest that through delay the seed wax cold and so become unfruitful by reason that the spirits are dissipated and consumed The yard is
miseries of mans life as it were by the enticements of that pleasure also the great store of hot blood that is about the heart wherewith men abound maketh greatly to this purpose which by impulsion of imagination which ruleth the humors being driven by the proper passages down from the heart and entrails into the genital parts doth stir up in them a new lust The males of brute beasts being provoked or moved by the stimulations of lust rage and are almost burst with a Tentigo or extension of the genital parts and sometimes wax mad but after that they have satisfied their lust with the female of their kinde they presently become gentle and leave off such fierceness CHAP. IV. What things are to be observed as necessary unto generation in the time of copulation How women may be moved to Venery conception WHen the husband commeth into his wives chamber he must entertain her with all kinde of dalliance wanton behaviour and allurements to Venery but if he perceive her to be slow and more cold he must cherish embrace and tickle her and shall not abruptly the nerves being suddenly distended break into the field of nature but rather shall creep in by little and and little intermixing more wanton kisses with wanton words and speeches handling her secret parts and dugs that she may take fire and be enflamed to Venery for so at length the womb will strive and wax servent with a desire of casting forth it own seed and receive the mans seed to be mixed together therewith But if all these things will not suffice to enflame the woman for women for the most part are more slow and slack unto the expulsion or yeelding forth of their seed it shall be necessary first to foment her secret parts with the decoction of hot herbs made with Muscadine or boiled in any other good wine and to put a little Musk or Civet into the neck or mouth of the womb and when she shall perceive the efflux of her seed to approach by reason of the tickling pleasure she must advertise her husband thereof that at the very instant time or moment The meeting of the seeds most necessary for generation he may also yeeld forth his seed that by the concourse or meeting of the seeds conception may be made and so at length a child formed and born And that it may have the better success the husband must not presently separate himself from his wives embraces lest the air strike into the open womb and so corrupt the seeds before they are perfectly mixed together When the man departs let the woman lye still in quiet laying her legs or her thighs across one upon another and raising them up a little lest that by motion or downward situation the seed should be shed or spilt which is the cause why she ought at that time not to talk especially chiding nor to cough nor snees but give her self to rest and quietness if it be possible CHAP. V. By what signs it may be known whether the woman have conceived or not IF the seed in the time of copulation or presently after be not spilt if in the meeting of the seeds the whole body do somewhat shake that is to say the womb drawing it self together for the compression and entertainment thereof if a little feeling of pain doth run up and down the lower belly and about the navel if she be sleepy if she loath the embracings of a man and if her face be pale it is a token that she hath conceived In some after conception spots or freckles arise in their face Spots or specks in the faces of those that are with child their eies are depressed and sunk in the white of their eyes waxeth pale they wax giddy in the head by reason that the vapors are raised up from the menstrual blood that is stopped sadness and heaviness grieve their minds with loathing and waywardness by reason that the spirits are covered with the smoaky darkness of the vapors pains in teeth and gums and swounding often-times commeth the appetite is depraved or overthrown with aptness to vomit and longing whereby it happeneth that they loath meats of good juice and long for and desire illaudable meats Why many women being great with childe refuse laudable meats and desire those that are illaudable and contrary to nature The suppressed terms divided into three parts and those that are contrary to nature as coles dirt ashes stinking salt-fish sowr austere and tart fruits pepper vinegar and such like acrid things and other altogether contrary to nature and use by reason of the condition of the suppressed humor abounding and falling into the orifice of the stomach This appetite so depraved or over-thrown endureth in some untill the time of child-birth in others it cometh in the third month after their conception when hairs do grow on the child and lastly it leaveth them a little before the fourth month because that the child being now greater and stronger consumes a great part of the excremental and superfluous humor The suppressed or stopped terms in women that are great with childe are divided into three parts the more pure portion maketh the nutriment for the child the second ascendeth by little and little into the dugs and the impurest of all remaineth in the womb about the infant and maketh the secondine or after-birth wherein the infant lieth as in a soft bed Those women are great with child whose urine is more sharp fervent and somewhat bloody the bladder not only waxing warm by the compression of the womb fervent by reason of the blood contained in it but also the thinner portion of the same blood being expressed and sweating out into the bladder Hip. 1. de morb mul. A swelling and hardness of the dugs and veins that are under the dugs in the breasts and about them and milk comming out when they are pressed with a certain stirring motion in the belly are certain infallible signs of greatness with child Neither in this greatness of child-bearing the veins of the dugs only but of all the whole body appear full and swelled up especially the veins of the thighs and legs so that by their manifold folding and knitting together they do appear varicous Aph. 41. sect 5. whereof commeth sluggishness of the whole body heaviness and impotency or difficulty of going especially when the time of deliverance is at hand Lastly if you would know whether the woman have conceived or not give unto her when she goeth to sleep some mead or honied water to drink and if she have a griping in her guts or belly she hath conceived if not she hath not conceived CHAP. VI. That the womb so soon as it hath received the seed is presently contracted or drawn together AFter that the seeds of the male and female have both met and are mixed together in the capacity of the womb then the orifice thereof doth draw it self close together lest
the seeds should fall out There the females seed goeth and turneth into nutriment Why the female seed is nutriment for the male seed and the increase of the males seed because all things are nourished and do increase by those things that are most familiar and like unto them But the similitude and familiarity of seed with seed is far greater then with blood so that when they are perfectly mixed and co-agulated together and so wax warm by the straight and narrow inclosure of the womb a certain thin skin doth grow about it like unto that that will be over unsâ—immed milk Moreover this concretion or congealing of the seed is like unto an egg laied before the time that it should that is to say whose membrane or tunicle that compasseth it about hath not as yet increased or grown into a shelly hardness about it in folding-wise are seen many small threds dividing themselves over-spread with a certain clammy whitish or red substance as it were with black blood In the middest under it appeareth the navel from whence that small skin is produced A compendious way to understand humane conception But a man may understand many things that appertain unto the conception of mankind by the observation of twenty eggs setting them to be hatched under an Hen and taking one every day and breaking it and diligently considering it for in so doing on the twentieth day you shall find the Chick perfectly formed with the navel That little skin that so compasseth the infant in the womb is called the secundine or Chorion but commonly the after-birth Lib. de nat puer This little skin is perfectly made within six daies according to the judgment of Hippocrates as profitable and necessary not only to contain the seeds so mixed together but also to sâ—â—k nutriment through the oâ—ifices of the vessels ending in the womb What the Câ—tyledones are Those orifices the Greeks do call Câ—tyledones and the Latines Acetabula for they are as it were hollowed eminences like unto those which may be seen in the feet or snout of a Cuttle-fish many times in a double order both for the working and holding of their meat Those eminences called Acetabula do not so greatly appear in women as in many brute beasts Therefore by these the secundiâ—e cleaveth on every side unto the womb for the conservation nutrition and increase of the conceived â—eed CHAP. VII Of the generation of the navel AFter the woman hath conceived to every one of the aforesaid eminences groweth presently another vessel that is to say a vein to the vein and an aâ—tery to the aâ—tery these soft and yet thin vessels are framed with a little thin membrane which being spread under sucketh to them for to them it is in stead of a membrane and a ligament and a tunicle oâ— a defence and it is doubled with the others and made of the vein and artery of the navel These new small vessels of the infant with their orifices do answer directly one to one to the Cotyledones or eminencies of the womb they are very small and little as it were the hairy fibres that grow upon roots that are in the earth and when they have continued so a longer time they are combined together that of two they are made one vessel untill that by continual connexion all those vessels go and degenerate into two other great vessels called the umbilical vessels or the vessels of the navel because they do make the navel and do enter into the childs body by the hole of the navel The vein never joyneth it selfe with the artery Here Galen doth admire the singular providence of God and Nature because that in such a multitude of vessels and in so long a passage or length that they go or are produced the vein doth never confound it self nor stick to the artery nor the artery to the vein but every vessel joineth it self to the vessel of its own kind But the umbilical vein or navel-vein entering into the body of the child doth join it self presently to the hollow part of the liver but the artery is divided into two which join themselvs to the two Iliack arteries along the sides of the bladder and are presently covered with the peritonaeum and by the benefit thereof annexed unto the parts which it goes unto Those small veins and arteries are as it were the roots of the childe but the vein and artery of the navel are as it were the body of the tree Hippocrates calleth all the membranes that compass the infa t in the womb according to the judgment of Galen in his book de usu pâ—rtium by the name of the secandines to bring down the nutriment to nourish the child For first we live in the womb the life of a plant and then next the life of a sensitive creature and as the first tunicle of the child is called Châ—riâ—ns or Allantâ—ides so the other is called Amnios or Aguiâ—a which doth compass the seed or child about on every side These membranes are most thin yea for their thinness like unto the Spiders web woven one upon another and also connexed in many places by the extremeties of certain small and hairy substances which at length by the adjunction of their like do get strength whereby you may understand what is the cause why by divers and violent motions of the mother in going and dancing or leaping and also of the infant in the womb those membranes are not almost broken For they are so conjoined by the knots of those hairy substances that between them nothing neither the urine nor the sweat can come as you may plainly and evidently perceive in the dissection of a womans body that is great with child not depending on any other mans opinion be it never so old or inveterate yet the strength of those membranes is not so great but that they may be soon broken in the birth by the kicking of the child GHAP. VIII An old opinion confuted Of the Vmbilical vessels or the vessels belonging to the navel MAny of the antient Writers have written that there are five vessels found in the navel But yet in many nay all the bodies I sought in for them I could never find but three that is to say one vein which is very large so that in the passage thereof it will receive the tag of a point and two arteries but not so large but much narrower because the child wanteth oâ— standeth in need of much more blood for his conformation and the nutriment or increase of his parts then of vital spirit These vessels making the body of the navel which as it is thought To what use the knots of the childes navel in the womb serve is formed within nine or ten dayes by their doubling and folding make knots like unto the knots of a Franciscan Friers girdle that staying the running blood in those their knotty windings they might more perfectly
reduceth all the simple and divided formes or images or things into one heap that by dividing collecting and reasoning it might discern and trie truth from falshood The functions of Reason This faculty of Understanding or Reason is subject to no faculty or instrument of the body but is free and penetrateth into every secret intricate and hidden thing with an incredible celerity by which a man seeth what will follow perceiveth the originals and causes of things is not ignorant of the proceedings of things he compareth things that are past with those that are present and to come decreeing what to follow and what to avoid This bridleth and with-holdeth the furions motions of the minde bridleth the over-hasty motions of the tongue and admonisheth the speaker that before the words pass out of his mouth he ought with diligence and discretion to ponder and consider the thing whereof he is about to speak What memory is After Reason and Judgment followeth Memory which keeping and conserving all forms and images that it receiveth of the senses and which Reason shall appoint and as a faithfull keeper and conserver receiveth all things and imprinteth and sealeth them as well by their own virtue and power as by the impulsion and adherence of those things in the body of the brain without any impression of the matter that when occasion serveth we may bring them forth there-hence as out of a treasury or store-house For otherwise to what purpose were it to read hear and note so many things unless we were able to keep and retain them in minde by the care and custody of the Memory or Brain Therefore assuredly God hath given us this only remedy and preservative against the oblivion and ignorance of things which although of it self and of its own nature it be of greater efficacy yet by dayly and often meditation it is trimmed and made more exquisite and perfect Wisdome the daughter of memory and experience And hence it was that the Antients termed wisedome the daughter of memory and experience Many have supposed that the mansion or seat of the Memory is in the hinder part or in the ventricle of the Cerebellum by reason that it is apt to receive the forms of things because of the engrafted driness and hardness thereof CHAP. XII Of the natural excrements in general and especially of those that the childe or infant being in the womb excludeth What an excrement is BEfore I declare what excrements the infant excludeth in the womb and by what passages I think it good to speak of the excrements which all men do naturally void All that is called an excrement which nature is accustomed to separate and cast out from the laudable and nourishing juice The excrement of the first concoction There are many kindes of those excrements The first is of the first concoction which is performed in the stomach which being driven down into the intestines or guts is voided by the fundament The second commeth from the Liver and it usually is three-fold or of three kindes one cholerick whereof a great portion is sent into the bladder of the gall that by sweating out there-hence The excrement of the second concoction is triple it might stir up the expulsive faculty of the guts to expel and exclude the excrements The other is like unto whay which goeth with the blood into the veins and is as it were a vehicile thereto to bring it unto all the parts of the body and into every capillar vein for to nourish the whole body and after it hath performed that function it is partly expelled by sweat and partly sent into the bladder and so excluded with the urine The third is the melancholick excrement which being drawn by the milt the purer and thinner part thereof goeth into nourishment of the milt and after the remnant is partly purged our downwards by the Hemorrhoidal veins and partly sent to the orifice of the stomach to instimulate and provoke the appetite The excrement of the third concoction is triple The last cometh of the last concoction which is dissolved in the habit of the body and breathed out partly by insensible transpiration is partly consumed by sweating and partly floweth out by the evident and manifest passages that are proper to every part as it happeneth in the brain before all other parts for it doth unload it self of this kinde of excrements by the passages of the nose mouth ears eyes palat-bone and futures of the scul Therefore if any of these excrements be staied altogether or any longer then it is meet they should the default is to be amended by diet and medicine Furthermore there are other sorts of excrements not natural of which we have entreated at large in our book of the Pestilence When the infant is in the mothers womb The use of the navel-stâ—ing until be is fully and absolutely formed in all the lineaments of his body he sends forth his urine by the passage of the navel or urachus But a little before the time of childe-birth the urachus is closed and then the man-childe voideth his urine by the conduit of the yard and the woman-childe by the neck of the womb This urine is gathered together contained in the coat Chorion or Allantcides together with the other excrements that is to say sweat and such whaysh superfluities of the menstrual matter for the more easie bearing up of the floating or swimming childe But in the time of childe-birth The signs of speedy and easie deliverance when the infant by kicking breaketh the membranes those humors run out which when the midwives perceive they take it as a certain sign that the childe is at hand For if the infant come forth together with those waters the birth is like to be more easie and with better success for the neck of the womb and all the genitals are so by their moisture relaxed and made slippery that by the endeavour and stirâ—ing of the infant the birth will be more easie and with the better success contrariwise if the infant be not excluâ—ed before all these humors be wholly flowen out and gone but remaineth as it were in a drie place presently through driness the neck of the womb and all the genitals will be contracted and drawn together so that the birth of the childe will be very difficult and hard unless the neck of the womb to amend that default be annointed with oil or some other relaxing liquor Moreover when the childe is in the womb he voideth no excrements by the fundament unless it be when at the time of the birth the proper membranes and receptacles are burst by the striving of the infant for he doth not take his meat at the mouth wherefore the stomach is idle then and doth not execute the office of turning the meats into chylus nor of any other concoction wherefore nothing can go down from it into the guts Children born
not absolutely performe the duty of a mother unto the childe Gel. lib. 12. ca. as Marcus Aurelius the Roman Emperor was wont to say For it is a certain unnatural imperfect and half kinde of mothers dutie to bear a childe and presently to abandon or put it away as if it were forsaken to nourish and feed a thing in their womb which they neither know not see with their own blood and then not to nourish it when they see it in the world a live a creature or reasonable soul now requireing the help and sustentation of the mother CHAP. XXI Of the choice of Nurses MAny husbands take such pity on their tender wives that they provide Nurses for their children that unto the pains that they have sustained in bearing them they may not also add the trouble of nursing them wherefore such a Nurse must be chosen which hath had two or three children For the duggs which have been already sucked and accustomed to be filled have the veines and arteries more large and capable to receive the more milk In the choice of a Nurse there is ten things to be considered very diligently as her age the habit of her body her behaviour the condition of her milke the form not only of her duggs or breasts but also of her teats or nipples the time of her childe birth the sex of her last infant or childe The best age of a Nurse that she be nor with childe that she be sound and and in perfect health As concerning her age she ought not to be under twenty five years not above thirty five the time that is between is the time of strength more temperate and more wholsome and healthy and less abounding with excremental humors And because her body doth not then grow or increase she must of necessity have the more abundance of blood After thiâ—ty five years in many the menstrual fluxes do cease and therefore it is to be supposed that they have the less nutâ—iment for children The best habit of body in a Nurse The Nurse must also be of good habit or square or wel-set body her breast broad her colour lively not fat nor lean but well made her flesh not soft and tender but thick and hard or strong whereby she may be the more able to endure watching and takeing of pains about the childe she must not have a red or freckled face but brown or somewhat shadowed or mixed with redness for truly such women arâ— more hot then those that are red in the face by reason whereof they must needs concoct and turn their meat the better into blood For according to the judgment of Sextus Cheronensis Lib. de iâ—f nâ—tr as blackish or brown ground is more fertil then the white even so a bâ—own woman hath more store of milk You must look wel on her head lest she should have the scuâ—fâ—e or running sores see that her teeth be not foul or rotten not her breath stinking nor no ulcer nor sore about her body and that she be not born of gouty or leprous Parents Of what behavâ—or the Nurse must be She ought to be quiâ—k and diligent in keeping the childe neat and clean chaste sober merry alwayes laughing and smiling on her Infant often singing unto it and speaking distinctly and plainly for she is the only Mistress to teach the childe to speak Let her be well-manner'd because the manners of the nurse are participated unto the Infant together with the milke For the whelpes of dogs if they do suck Wolves or Lionesses will become more fierce and cruel then otherwise they would Contrariwise the Lions whelps wil leave their savageness and fierceness if that they be brought up and nourished with the milke of any Bitch or other tame beast If a Goat give a Lamb suck the same Lambs-wool will be more hard then others contrariwise if a sheep give a Kid suck the same Kids hair will be more soft then another Kids-hair She ought to be sober and the rather for this cause because many Nurses being overladen with wine and banqueting often set their children unto their breasts to suck and then fall asleep and so suddenly strangle or choak them Why the Nurse must abstain from copulation She must abstain from copulation for copulation troubleth and moveth the humors and the blood and therefore the milke it self and it diminisheth the quantity of milk because it provoketh the menstrual flux and causeth the milke to have a certain strong and virulent quality such as we may perceive to breath from them that are incensed with the fervent lust and desire of Venery And moreover because that thereby they may happen to be with chide whereof ensueth discommodity both to her own childe that is within her body and also to the Nurse-childe to the Nurse-childe because that the milk that it sucketh will be worse and more depraved then otherwise it would be by reason that the more laudable blood after the conception remaineth about the womb for the nutriment and increasing of the infant in the womb and the more impure blood goeth into the dugs which breedeth impure or uncleane milk but to the conceived childe because it will cause it to have scarcity of food for so much as the sucking-childe sucketh so much the childe conceived in the womb wanteth What dugs a Nurse ought to have Also she ought to have a broad breast and her dugs indifferently big not slack or hanging but of a middle consistence between soft and hard for such dugs will concoct the blood into milk the better because that in firm flesh the heat is more strong and compact You may by touching trie whether the flesh be solid and firm as also by the dispersing of the veines easily to be seen by reason of their swelling and blewness through the dugs as it were into many streames or little rivulets for in flesh that is loose and slack they lie hidden Those dugs that are of a competent bigness receive or contain no more milk then is sufficient to novrish the infant In those dugs that are great and hard the milke is as it were suffocated stopped or bound in so that the childe in in sucking can scarce draw it out and moreover if the dugs be hard the childe putting his mouth to the breast may strike his nose against it and so hurt it whereby he may eirher refuse to suck or if he doth proceed to suck by continual sucking and placeing of his nose on the hard breast it may become flat and the nostrils turned upwards to his great deformity when he shall come to age If the teats or nipples of the dugs do stand somewhat low or depressed inwards on the tops of the dugs the childe can hardly take them between its lips therefore his sucking will be very laborious If the nipples or teats be very big they will so fill all his mouth that he cannot well use his tongue in sucking
the orifice of the neck of the womb an impostume rotten and running as if it had been out of an abscess newly broken with saâ—ious matter somewhat red yellow and pale running a long time Yet for all this the feeling of the heaviness or weight was nothing diminished but did rather increase daily so that from the year of our Lord 1573. she could not turn her self being in her bed on this or that side unless she laid her hand on her belly to bear and ease herself of the weight and also she said when she turned herself she seemd to feel a thing like unto a bowle or rowle in her belly unto the sâ—de whereunto she turned her self neither could she go to stoole or avoid her excrements standing or sitting unless she lift up that weight with her hands towards her stomach or midriff when she was about to go she could scarce set forwards her feet as if there had something hanged between her thighs that did hinder her going At certain seasons that rotten apostume would open or unclose of it self and flow and run with its wonted sanious matter but then she was grievously vexed with pain of the head and all her members swouning loathing vomiting and almost choaking so that by the perswasion of a foolish woman she was induced and contented to take Antimonium Antimoniam taken in a potion doâ—h cause the womb to fall down the working and the strength thereof was so great and violent that after many vomits with many frettings of the guts and waterie dejections of stools she thought her fundament fell down but being certified by a woman that was a familiar friend of hers unto whom she shewed her self that there was nothing fallen down at or from her fundament but it was from her womb she called in the year of our Lord 1575. Surgeons as my self Jaemes Guillemeau and Antonie Vieux that we might help her in extremity The signs of the substance of the womb drawn out When we had diligently and with good consideration weighed the whole estate of her disease we agreed with one consent that that which was fallen down should be cut away because that by the black colour stinking and other such signs it gave a testimony of a putrefied and corrupted thing Therefore for two daies we drew out the body by little and little and piece-meal which seemed unto the Physicians that we had called as Alexius Gaudinus Feureus and Violaneus and also to our selves to be the body of the womb wich thing we proved to be so because one of the testicles came out whole and also a thick membrane or skin being the relick of the Mola which being suppurated and the abscess broken came out by little and little in matter after that all this body was so drawn away the sick woman began to wax better better yet notwithstanding for the space of nine daies before it was taken away she voided nothing by siege and her urine also was stopped for the space of four daies After this all things became as they were before and she lived in good health three moneths after and then died of a Pluerisie that came on her very suddenly and I haveing opened her body observing and marking every thing very diligently could not finde the womb at all but in stead thereof there was a certain hard and callous body which Nature who is never idle had framed in stead thereof to supply the want thereof or to fill the hollowness of the bellie CHAP. XLII Of the tunicle or membrane called Hymen Whether there be a membrane called Hymen IN some virgins or in maidens the orifice of the neck of the womb there is found a certain tunicle or membrane called of antient writers Hymen which prohibiteth the copulation of a man and causeth a woman to be barren this tunicle is supposed by many and they not of the common sort only but also learned physicians to be as it were the enclosure of the virginity or maiden-head But I could never finde it in any seeking of all ages from three to twelve of all that I had under my hands in the Hospital of Paris An history Yet once I saw in a virgin of seventeen years whom her mother had contracted to a man and she knew nevertheless there was something in her privie parts that hindred her from bearing of children who desired me to see her and I found a very thin nervous membrane a little beneath the nymphaea near unto the orifice of the neck of the womb in the midst there was a very little hole whereout the terms might flow I seeing the thickness thereof cut it in sunder with my scissars and told her mother what she should do afterwards Lib. 11 cap. 16 and truly she married shortly after and bore children Realdus Columbus is of my opinion and saith that this is seen very seldome for these are his words under the nymphaea in many but not in all virgins there is another membrane which when it is present which is but seldome it stoppeth so that the yard cannot be put into the orifice of the womb for it is very thick above towards the bladder it hath an hole by which the courses flow out And he also addeth that he observed it in two young virgins and in one elder maid Avicen writes that in virgins in the neck of the womb there are tunicles composed of veins and ligaments very little rising from each part of the neck thereof Lib. 3. seâ—t 2â— tract 1. cap. 1. which at the first time of copulation are wont to be broken and the blood run out Almansor wâ—iteth that in virgins the passage of the neck of the womb is very wrinkled or narrow and strait and those wrinkles to be woven or stayed together with many little veins and arteries which are broken at the first time of copulation These are the judgments of Physicians of this membrane The trifles of midwives abâ—ut the membrane called Hymen Midwives will certainly affirm that they know a virgin from one that is defloured by the breach or soundness of that membrane But by their report too credulous judges are soon brought to commit an error For that Midwives can speak nothing certainly of this membrane may be proved by this because that one saith that the situation thereof is in the very entrance of the privie parts others say it is in the midst of the neck of the womb and others say it is within at the inner orifice thereof and some are of an opinion that they say or suppose that it cannot be seen or perceived before the first birth But truly of a thing so rare and which is contrary to nature theâ—e cannot be any thing spoken for certainty Therefore the blood that commeth out at the first time of copulation comes not alwaies by the breaking of that membrane but by the breaking and violating of renting of the little veins which are woven and bespread
at all it this necessary humor were wanting in the womb yet it may be some women may conceive without the flux of the courses but that is in such as have so much or the â—â—mor gathered together as is wont to remain in those which are purged although it be not so great a quantity that it may flow out as it is recorded by Aristotle But as it is in some very great and in some very little so it is in some seldom and in some very often What womeâ— have this mâ—nstrual flux often abundantly and for a lo ger space then others There are some that are purged twice and some thrice in a moneth but it is altogether in those who have a great liver large veins and are filled and fed with many and greatly nourishing meats which sit idlely at home all day which having slept all night do notwithstanding lie in bed sleeping a great part of the day also which live in a hot moist rainy and southerly air which use warm baths of sweet waters and gentle frictions which use and are greatly delighted with carnal copulation in these and such like women the courses flow more frequently and abundantly What women hâ—ve this flâ—x mâ—re 〈◊〉 leâ— and a far more short time then others But contrariwise those that have small and obscure veins and those that have their bodies more furnished and big either with flesh or with fat are more seldom purged and also more sparingly because that the sâ—perfluous quantity of blood useth to go into the habit of the body Also tender delicate and fair women are less purged than those that are brown and endued with a more compact flesh because that by the rarity of their bodies they suffer a greater wasting or dissipation of their substance by transpiration Moreover they are not so greatly purged with this kind of purgation which have some other solemn or accustomed evacuation in any other place of their body as by the nose or hemorrhoids Why young women are purged in the new of the Moon And as concerning their age old women are purged when the Moon is old and young women when the Moon is new as it is thought I think the cause thereof is for that the Moon ruleth moist bodies for by the variable motion thereof the Sea floweth and ebbeth and bones marrow and plants abound with their genital humor Therefore young people which have much blood and more fluxible and their bodies more fluxible are soon moved unto a flux although it be even in the first quarter of the Moons rising or increasing Why old women are purged in the wane of the Moon but the humors of old women because they wax stiff as it were with cold and are not so abundant and have more dense bodies and straighter vessels are not so apt to a flux nor do they so easily flow except it be in the full of the Moon or else in the decrease that is to say because the blood that is gathered in the full of the Moon falls from the body even of its own weight for that by reason of the decreasing or wane of the Moon this time of the moneth is more cold and moist CHAP. L. The causes of the Monethly Flux or Courses The material cause of the Monethtly flux BEcause a woman is more cold and therefore hath the digestive faculty more weak it cometh to pass that she requireth and desireth more meat or food than she can digest or concoct And because that superfluous humour that remaineth is not digested by exercise nor by the efficacy of strong and lively heat therefore by the providence or benefit of nature it floweth out by the veins of the womb by the power of the expulsive faculty at its own certain and prefixed season or time But then especially it beginneth to flow and a certain rude portion of blood to be expelled being hurtful and malign otherwise in no quality When the monthly flux begins to flow when nature hath laid her principal foundations of the increase of the body so that in greatness of the body she hath come as it were in a manner to the highest top that is to say from the thirteenth to the fiftieth year of her age Moreover the childe cannot be formed in the womb nor have his nutriment or encrease without this flux therefore this is another finall cause of the monethly flux The final cause Many are perswaded that women do far more abound with blood than men considering how great an abundance of blood they cast forth of their secret parts every month A woman exceeds a man in quantity of blood from the thirteenth to the fiftieth year of their age how much women great with child of whom also many are menstrual yeeld unto the nutriment and encrease of the childe in their wombs and how much Physicians take from women that are with childe by opening of a vein which otherwise would be delivered before their natural and prefixed time how great a quantity thereof they avoid in the birth of their children and for ten or twelve daies after and how great a quantity of milk they spend for the nourishment of the child when they give suck which milk is none other thing than blood made white by the power of the kernels that are in the dugs which doth suffice to nourish the child be he great or little yet notwithstanding many nurses in the mean while are menstrual A man exceedeth a women in the quality of his blood and as that may be true so certainly this is true that one dram that I may so speak of a mans blood is of more efficacy to nourish and encrease than two pounds of womans blood because it is far more perfect more concocted wrought and better replenished with abundance of spirits whereby it commeth to pass that a man endued with a more strong heat A man is more hot than a woman and therefore not menstrual doth more easily convert what meat soever he eateth unto the nourishment and substance of his body and if that any superfluity remains he doth easily digest and scatter it by insensible transpiration But a woman being more cold than a man because she taketh more than she can concoct doth gather together more humors which because she cannot disperse by reason of the unperfectness and weakness of her heat it is necessary that she should suffer and have her monthly purgation especially when she groweth unto some bigness but there is no such need in a man CHAP. LI. The causes of the suppression of the courses or menstrual flux THe courses are suppressed or stopped by many causes as by sharp vehement and long diseases by fear sorrow hunger immoderate labors watchings fluxes of the belly great bleeding haemorrhoids fluxes of blood at the mouth and evacuations in any other part of the body whatsoever often opening of a vein great sweats ulcers flowing much and long scabbiness
at the mouth and sweats In the mean while let him put in an instrument made like unto a pessary and cause the sick woman to hold it there this instrument must have many holes in the upper end through which the purulent matter may pass which by staying or stopping might get a sharpness as also that so the womb may breath the more freely and may be kept more temperate and cool by receiving the air by the benefit of a springe whereby this instrument being made like unto a pessary is opened and shut The form of an Instrument made like unto a Pessary whereby the womb may be ventilated A. Sheweth the end of the Instrument which must have many hâ—les therein B. Sheweth the body of the Instrument C. Sheweth the plate whereby the mouth of the Instrument is opened and shut as wide and as close as you will for to receive the air more freely D. Sheweth the springe EE Shew the laces and bands to tie about the patients body that so the Instrument may be staied and kept fast in his place CHAP. LXI Of the Hoemorrhoids and Warts of the neck of the womb The differences of the Haemorrhoids of the neck of the womb LIke as in the fundament so in the neck of the womb there are Hoemorrhoides and as it were varicous veins often-times flowing with much blood or with a red and stinking whayish humor Some of these by reason of their redness and great inequality as it were of knobs are like unripe Mulberries and are called vulgarly venae morales that is to say the veins or hoemorrhâ—ids like unto Mulberries others are like unto Grapes and therefore are named uvales other some are like unto warts and therefore are called venae verucales some appear and shew themselves with a great tumor others are little in the bottom of the neck of the womb others are in the side or edg thereof Acrochordon is a kinde of wart with a callous bunch or knot having a thin or slender root What an Acrochoâ—don is and a greater head like unto the knot of a rope hanging by a small thred it is called of the Arabians veruca botoralis What a Thymus it There is also another kind of wart which because of its great roughness and inequality is called Thymus as resembling the flower of Thyme All such diseases are exasperated and made more grievous by any exercise especially by Venerous acts many times they have a certain malignity and an hidden virulency joined with them by occasion whereof they are aggravated even by touching only because they have their matter of a raging humor therefore to these we may not rightly use a true S. Fiacrius figs. but only the palliative cure as they term it the Latines call them only ficus but the French men name them with an adjunct Saint Fiacrius figs. CHAP. LXII Of the cure of the Warts that are in the neck of the womb What warts of the womb must be bound and so cut off THe warts that grow in the neck of the womb if they be not malignant are to be tied with a thred and so cut off Those that lie hid more deep in the womb may be seen and cured by opening the matrix with a dilater made for the purpose Divers Specula matricis or Dilaters for the inspection of the Matrix Another form of a Dilater or Speculum matricis whereof the declaration followeth A. Sheweth the screw which shutteth and openeth the dilater of the Matrix BB. Shew the arms or branches of the instrument which ought to be eight or nine fingers long But these Dilaters of the matrix ought to be of a bigness correspondent to the patients bodie let them be put into the matrix when the woman is placed as we have said when the childe is to be drawn out of her bodie That instrument is most meet to tie the warts which we have described in the relaxation of the palate or Vvula let them be tied harder and harder every day until they fall away Therefore for the curing of warts there are three chief scopes as bands sections Three scopes of the cure of warts in the womb An effectual water to consume warts cauteries and lest they grow up again let oil of vitriol be dropped on the place or aqua fortis oâ— some of the â—ee whereof potential cauteries are made This water following is most effectual to consume and waste warts â„ž aq plantag â„¥ vi virid aeris Ê’ii alum roch Ê’ iii. sal com â„¥ ss vit rom sublim an Ê’ ss beat them all together and boil them let one or two drops of this water be dropped on the grieved place not touching any place else but if there be an ulcer it must be cured as I have shewed before A certain man studious of physick Unguents to consume warts of late affirmed to me that Ox-dung tempered with the leaves or powder of Savine would wast the warts of the womb if it were applied thereto warm which whether it be true or not let Experience the mistress of things be judge Verily Cantharides put into unguents will do it and as it is likely more effectually for they will consume the callousness which groweth between the toes or fingers I have proved by experience that the warts that grow on the hands may be cured by applying of purslain beaten or stampt in its own juice The leaves and flowers of Marigolds do certainly perform the self-same thing CHAP. LXIII Of Chaps and thâ—se wrinkled and hard excrescences which the Greeks call Condylomata What Chaps are CHaps or Fissures are cleft and very long little Ulcers with pain very sharp and burning by reason of the biting of an acrid salt and drie humor making so great a contraction and often-times narrowness in the fundament and the neck of the womb that scarcely the top of ones finger may be put into the orifice thereof like unto pieces of leather or parchment which are wrinkled and parched by holding of them to the fire They rise sometimes in the mouth so that the patient can neither speak eat nor open his mouth so that the Surgeon is constrained to cut it The cure In the cure thereof all sharp things are to be avoided and those which mollifie are to be used and the grieved place or part is to be moistened with fomentations liniments cataplasms emplasters and if the maladie be in the womb a dilater of the matrix or pessarie must be put thereinto very often so to widen that which is over hard and too much drawn together or narrow What Condylomata are and then the cleft little ulcers must be cicatrized Condylomata are certain wrinkled and hard bunches and as it were excrescences of the flesh rising especially in the wrinkled edge of the fundament and neck of the womb Cooling and relaxing medicines ought to be used against this disease The cure such as are oil of
linnen-clothes dipped therein A water also distilled of snails gathered in a vine-yard juice of lemmons the flowers of white mullain mixed together in equal proportion with a like quantity of the liquor contained in the bladders of Elm-leaves is very good for the same purpose Also this â„ž micae panis albi lb iv flor fabar rosar alb flor nenuph. lilior ireos an lb ii lactis vaccini lb vi ova nu viii aceti â—pt lb i. distillentur omnia simul in alembico vitrâ—c fiat aqua ad faciei et manuum lotionem Or â„ž olei de tartaro â„¥ iii. mucag. sem psilii â„¥ i. cerus in oleo ros dissolut â„¥ i. ss borac sal gem an Ê’ i. fiat linimentum profacie Or â„ž caponem vivum et caseum ex lacte caprino recenter confectum limon nu iv ovor nu iv cerus lâ—t in aq rosar â„¥ ii boracis â„¥ i ss camph. â„¥ ii aq flor fabar lb iv fiat omnium infusio per xxiv horas postea distillentur in alembico vitreo The marrow of sheeps-bones good to smooth the face There is a most excellent fucus made of the marrow of sheeps-bones which smooths the roughness of the skin beautifies the face now it must be thus extracted Take the bones severed from the flesh by boiling beat them and so boil them in water when they are well boiled take them from the fire and when the water is cold gather the fat that swims upon it and there with anoint your face when as you go to bed and wash it in the morning with the formerly prescribed water How to make Sal ceâ—ussa â„ž salis ceruss Ê’ ii ung citrin vel spermat ceti â„¥ i. malaxentur simul et fiat linimentum addendo olei ovor Ê’ ii The Sal cerussae is thus made grinde Ceruss into very fine powder and infuse lb 1. thereof in a bottle of distilled vineger for four or five daies then filter it then set that you have filtred in a glased earthen vessel over a gentle fire until it concrete into salt just as you do the capitellum in making of cauteries â„ž excrementi lacert ossis saepiae tartari vini albi rasur corn cerv farin oriz. an partes aequales fiat pulvis infundatur in aqua distillata amygdalarum dulcium limacum vinealium flor nenuph. huic addito mellis albi par pondus let them all be incorporated in a marble morter and kept in a glass or silver vessel and at night anoint the face herewith it wonderfully prevails against the redness of the face if after the anointing it you shall cover the face with a linnen cloth moistened in the former described water â„ž sul lim Ê’i argent viv saliv extinct Ê’ii margarit non perforat Ê’i caph Ê’ i ss incorporentur simul in mortario marmoreo cum pistillo ligneo per tres horas ducantur et fricentur reducanturque in tenuissimum pulverem confectus pulvis abluatur aquâ myrti et desiccetur serveturque ad usum adde follorum auri et argenti nu x. When as you would use this powder put into the palm of your hand a little oyl of mastich or of sweet-almonds then presently in that oyl dissolve a little of the described powder and so work it into an ointment wherewith let the face be anointed at bed-time but it is fit first to wash the face with the formerly described waters and again in the morning when you arise How to paint the face When the face is freed from wrinkles and spots then may you paint the cheeks with a rosie and flourishing colour for of the commixture of white and red ariseth a native and beautiful color for this purpose take as much as you shall think fit of brasil and alchunet steep them in alum-water and therewith touch the cheeks and lips and so suffer it to dry in there is also spanish red made for this purpose others rub the mentioned parts with a sheeps-skin died red moreover the friction that is made by the hand only causeth a pleasing redness in the face by drawing thither the blood and spirits GHAP. XLV Of the Gutta Rosacea or a fiery face THis treatise of Fuci puts me in minde to say something in this place of helping the preternatural redness which possesseth the nose and cheeks Why worse in winter then in summar and oft-times all the face besides one while with a tumor otherwhiles without sometimes with pustles and scabs by reason of the admixture of a nitrous and adust humor Practitioners have termed it Gutta rosacca This shews both more and more ugly in winter then in summer because the cold closeth the pores of the skin so that the matter contained thereunder is bent up for want of transpiration whence it becomes acrid and biting so that as it were boiling up it lifts or raiseth the skin into pustles and scabs it is a contumacious disease and oft-times not to be helped by medicine For the general method of curing this disease it is fit that the patient abstain from wine Diet. and from all things in general that by their heat inflame the blood and diffuse it by their vaporous substance he shall shun hot and very cold places and shall procure that his belly may be soluble either by nature or art Let blood first be drawn out of the basilica then from the vena frontis and lastly from the vein of the nose Let leeches be applied to sundry places of the face and cupping-glasses with scarification to the shoulders For particular or proper remedies if the disease be inveterate Remedies the hardness shall first be softned with emollient things then assaulted with the following ointments which shall be used or changed by the Chirurgian as the Physician shall think fit â„ž succi citri â„¥ iii. cerus quantum sufficit ad eum inspissandum An approved ointment argenti vivi cum saliva et sulphure vivo extincti Ê’ ss incorporentur simul et fiat unguentum â„ž boracis Ê’ii farin ciser et fabar an Ê’ i ss caph Ê’i cum melle et succo cepae fiant trochisci when you would use them dissolve them in rose and plantain-water and spread them upon linnen cloths and so apply them on the night-time to the affected parts and so let them oft-times be renewed â„ž unguenti citrini recenter dispensati â„¥ ii sulphuris vivi â„¥ ss cum modico olei sem cucurb et succi limonum fiat unguentum with this let the face be annointed when you go to bed in the morning let it be washed away with rose-water being white by reason of bran infused therein moreover sharp vineger boiled with bran and rose-water and applied as before powerfully takes away the redness of the face â„ž cerus litharg auri sulphuris vivi pulverisati an â„¥ ss ponantur in phiala cum aceto aquae rosarum linnen cloths dipped herein shall be applied to the
concavity of the body Signs that a wound hath pierced in the concavity of the chest if the air come forth at the wound making a certain whizzing noise if the patient breathe with great difficulty if he feel a great heaviness or weight on or about the midriff whereby it may be gathered that a great quantity of blood lieth upon the place or midriff and so causeth him to feel a weight or heaviness which by little and little will be cast up by vomiting But a little after a fever commeth and the breath is unsavory and stinking by reason that the putrifying blood is turned into sanies the patient cannot lye but on his back and he hath an often desire to vomit but if he escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting Signs that the Lungs are wounded That the Heart is wounded he is vexed with a grievous shortness of breath and with pain in his sides We may perceive the heart to be wounded by the abundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse paleness of the face cold sweat with often swooning coldness of the extreme parts and sudden death When the midriff which the Latins call Diaphragma is wounded The Midriff the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortness of winde a cough and fit of grievous pain and drawing of the intrals upwards Wherefore when all these accidents appear we may certainly pronounce that death is at hand Death appeareth suddenly by a wound of the hollow Vein or the great Artery The Vena Cava and great Artery by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindered The marrow of the back bone being pierced The spinal marrow the patient is assaulted with a palsie or convulsion very suddenly and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood cometh out at the wound The Liver and pricking-pain disperseth it self even unto the sword-like gristle which hath its situation at the lower end of the breast-bone called Sternon the blood that followeth from thence down into the intestines doth oft-times infer most malign accidents yea and sometimes death When the stomach is wounded the meat and drink come out at the wound The Stomach there followeth a vomiting of pure choler then commeth swearing and coldness of the extreme parts and therefore we ought to prognosticate death to follow such a wound When the Milt or Splene is wounded black and gross blood cometh out at the wound The spleen the patient will be very thirsty with pain on the left side and the blood breaks forth into the belly and there purrifying causeth most malign and grievous accidents and often-times death to follow When the guts are wounded the whole body is griped and pained The Guts the excrements come out at the wound whereat also oft-times the guts break forth with great violence When the reins of Kidnies are wounded the patient will have great pain in making his urine The Kidnies and the blood commeth out together therewith the pain commeth down even unto the groin and yard and testicles When the Bladder and Ureters are wounded the pain goeth even unto the entrails The Bladder the parts all about and belonging to the groin are d stended the urine is bloody that is made and the same also commeth oftentimes out of the wound When the womb is wounded the blood commeth out at the privities The womb and all other accidents appear like as when the bladder is wounded The nerves When the sinews are pricked or cut half asunder there is great pain in the affected place and there followeth a sudden inflammation flux abscess fever convulsion and oftentimes a gangrene or mortification of the part whereof commeth death unless it be speedily prevented Having declared the signs and tokens of wounded parts it now remaineth that we set down other signs of certain kindes of death that are not common or natural whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgment of the descreet Physician or Surgeon Signs that an infant is smothered or over-laid Therefore if it chance that a nurse either through drunkenness or negligence lies upon the infant lying in bed with her and so stifles or smothers it to death If your judgment be required whether the infant died through the default or negligence of the nurse or through some violent or sudden disease that lay hidden and lurking in the body thereof you shall finde out the truth of the matter by these signs following For if the infant were in good health before if he were not froward or crying if his mouth and nostrils now being dead be moistened or bedewed with a certain foam if his face be not pale but of a Violet or Purple colour if when the body is opened the Lungs be found swoln and puffed up as it were with a certain vaporous foam and all other intrails sound it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corps of a man be found lying in a field or house alone and you be called by a Magistrate to deliver your opinion whether the man were slain by lightning or some other violent death you may by the following signs finde out the certainty hereof Signs of such as are slain by lightning For every body that is blasted or stricken with lightning doth cast forth or breathe out an unwholsome stinking or sulphureous smell so that the birds and sowls of the air or dogs will not once touch it much less prey or feed upon it the part that was stricken oftentimes sound and without a wound but if you search it well you shall finde the bones under the skin to be bruised broken or shivered in pieces Lib. 2. cap. 54. But if the lightning hath pierced into the body with making a wound therein according to the judgment of Pliny the wounded part is far colder then all the rest of the body For lightning driveth the most thin and fiery air before it and striketh it into the body with great violence by the force whereof the heat that was in the part is soon dispersed wasted and consumed Lightning doth alwaies leave some impression or sign of some fire either by ustion or blackness for no Lightning is without fire Moreover whereas all other living creatures when they are
was contained in that little close chamber was partly consumed by the fire of coals no otherwise then the air that is contained in a cupping-glass is consumed in a moment by the flame so soon as it is kindled Furthermore it was neither cold nor temperate but as as it were inflamed with the burning fire of coals Thirdly it was more gross in consistence then it should be by reason of the admixtion of the grosser vapor of the coals for the nature of the air is so that it may be soon altered and will very quickly receive the forms and impressions of those substances that are about it Lastly it was noisome and hurtful in substance and altogether offensive to the aiery substance of our bodies For Charcoals are made of green wood burnt in pits under ground and then extinguisht with their own fume or smoak as all Colliers can tell These were the opinions of most learned men although they were not altogether agreeable one unto another yet both of them depended on their proper reasons For this at least is manifest that those passages which are common to the brest and brain were then stopped with the grossness of the vapors of the coals whereby it appeareth that both these parts were in fault for as much as the consent and connexion of them with the other parts of the body is so great that they cannot long abide sound and perfect without their mutual help by reason of the loving and friendly sympathy and affinity that is between all the parts of the body one with another Wherefore the ventricles of the brain the passages of the Lungs and the sleepy Arteries being stopped the vital spirit was prohibited from entring into the brain and consequently the animal spirit retained and kept in so that it could not come or disperse it self thorough the whole body whence happeneth the defect of two of the faculties necessary for life It many times happeneth and is a question too frequently handled concerning womens maiden-heads whereof the judgment is very difficult Of the signs of virginity Yet some antient women and Midwives will brag that they assuredly know it by certain and infallible signs For say they in such as are virgins there is a certain membrane of parchment like skin in the neck of the womb which will hinder the thrusting in of the finger if it be put in any thing deep which membrane is broken when first they have carnal copulation as may afterwards be perceived by the free entrace of the finger Besides such as are defloured have the neck of their womb more large and wide as on the contrary it is more contract strait and narrow in virgins But how deceitful and untrue these signs and tokens are shall appear by that which followeth for this membrane is a thing preternatural and which is scarce found to be in one of a thousand from the first conformation Now the neck of the womb will be more open or strait according to the bigness and age of the party For all the parts of the body have a certain mutual proportion and commensuration in a well-made body Joubertus hath written that at Lectaure in Gascony Lib. de error popul a woman was delivered of a childe in the ninth year of her age and that she is yet alive and called Joan de Parie being wife to Videau Bechâ— the receiver of the amercements of the King of Navare which is a most evident argument that there are some women more able to accompany with a man at nine years old then many other at fifteen by reason of the ample capacity of their womb and the neck thereof besides also this passage is enlarged in many by some accident as by thrusting their own fingers more strong thereinto by reason of some itching or by the putting up of a Nodule or Pessary of the bigness of a mans yard for to bring down the courses Aph. 39. sect 5. Neither to have milk in their brests is any certain sign of lost virginity For Hippocrates thus writes But if a woman which is neither with childe nor hath had one have milk in her brests then her courses have failed her Moreover Aristotle reports that there be men who have such plenty of milk in their breasts that it may be sucked or milked out Cardan writes that he saw at Venice one Antony Bussey some 30. years old Lib. 4. de hist animal c. 20. Lib 12 de subtilitate who had milk in his brest in such plenty as sufficient to suckle a childe so that it did not only drop but spring out with violence like to a womans milk Wherefore let Magistrates beware lest thus admonished they too rashly assent to the reports of women Let Physicians and Chirurgions have a care lest they do too impudently bring Magistrates into an error which will not redound so much to the judges disgrace as to theirs But if any desire to know whether one be poysoned let him search for the symptoms and signs in the foregoing and particular treatise of poysons But that this doctrine of making reports may be the easier I think it fit to give presidents in imitation whereof the young Chirurgion may frame others The first president shall be of death to ensue a second of a doubtful judgement of life and death the third of a impotency of member the fourth of the hurting of many members I A. P. Chirurgion of Paris A certificatâ— of death this twentyeth day of May by the command of the Counsel entred into the house of one John Brossey whom I found lying in bed wounded on his head with a wound in his left temple piercing the bone with a fracture and effracture or depression of the broken bone scales and meninges into the substance of the brain by means whereof his pulse was weak he was troubled with raving convulsion cold sweat and his appetite was dejected Whereby may be gathered that certain and speedy death is at hand In witness whereof I have signed this Report with my own hand By the Coroners command I have visited Peter Lucey whom I found sick in bed Another in a doubtful case being wounded with a Hilbert on his right thigh Now the wound is of the bredth of three fingers and so deep that it pierces quite through his thigh with the cutting also of the vein and artery whence ensued much effusion of blood which hath exceedingly weakned him and caused him to swound often now all his thigh is swoln livid and gives occasion to fear worse symptoms which is the cause that the health and safety of the party is to be doubted of By the Justices command I entred into the house of James Bertey to visit his own brother In the loss of a member I found him wounded in his right arm with a wound of some four fingers bigness with the cutting of the tendons bending the leg and of the veins arteries and Nerves Wherefore I
was forced to forego it he was so infamous amongst all men during the rest of his life as one banished or forlorn and losing his freedom he shall become a servant yea scorned and reviled of all men he should be accounted unworthy to enjoy the light and society of men And certainly the Egyptians understanding the life which we here lead to be of short continuance comparison being made with that which we are to live after separation of the soul from the body they were more negligent in building their houses they dwelt in but in rearing the Pyramids which should serve them in stead of sepulchres The reason of building of the Egyptians Pyramids they were so beyond reason sumptuous and magnificent that for the building of one of these edifices so renowned over all the world which King Cheopes begun a hundred thousand men were every three months for twenty years space there kept at work It was five furlongs and being square each side was 800. foot long and so much in height Almost all the pieces of marble went to the building thereof were thirty foot long engraven and carved with various workmanship as Heredotus reports Lib. 2. But before the bodies were committed to these magnificent Sepulchres they were carrried to the Salters and Embalmers who for that purpose had allowance out of the publick stock These besmeared them with Aromatick and Balsamick ointments and sewed up the incisions they made then strewed them over with salt and then covered them with brine for 70. dayes which being expired they washed them being taken thence and all the filth being taken off they wrapped then in Cotton-Cloths glued together with a certain gum then their kinsmen placed them thus ordered in a wooden Coffin carved like to a man This was the sacred and accustomed rite of Embalming and Burying dead bodies amongst the Egyptians which were of the richer sort Our country-men the French stirred up with the like desire embalm the bodyes of their Kings and Nobles with spices and sweet ointments Which custom they may seem piously and Christianly to have taken from the Old and and New Testament and the antient and laudable custome of the Jews for you may read in the Nest Testament that Joseph bought a fine linnen cloth John 19.39 and Nicodemus brought a mixture of myrrh and Aloes about 100. pound weight that they might embalm and bury the body of Jesus Christ our Saviour for a sign and argument of the renovation and future integrity which they hoped for by the resurrection of the dead Which thing the Jews had received by tradition from their ancestors For Joseph in the old Testament commanded his Physicians Gen. 50.2 The manner of embalming for a long continuance that they should enbalm the dead body of his father with spices But the body which is to be Embalmed with spices for very long continuance must first of all be embowelled keeping the heart apart that it may be embalmed and kept as the kinsfolks shall thing fit Also the brain the scull being divided with a saw shall be taken out Then shall you make deep incisions along the arm thighs legs back loins and buttocks especially where the greater veins and arteries run first that by this means the blood may be pressed forth which otherwise would putrifie and give occasion and beginning to putrefaction to the rest of the body and then that there may be space to put in the aromatick powders the whole body shall be washed over with a spunge dipped in aqua vitae and strong vinegar wherein shall be boyled wormwood aloes coloquintida common salt and alum Then these incisions and all the passages and open places of the body and the three bellies shall be stuffed with the following spices grosly powdered â„ž pul rosar chamaem melil balsami menthae anethi salviae lavend. rorismar marjoran thymi absâ—nthii cyperi calami aromat gentianae ireos florent assae odoratae caryophyll nucis moschat cinnamomi styracis calamitae benjoini myrrhae aloes santal omnium quod sufficit Let the incisions be sowed up and the open spaces that nothing fall out then forthwith let the whole body be annointed with Turpentine dissolved with oyl of Roses and Camomil adding if you shall think it fit some Chymical oyls of spices and then let it be again strewed over with the fore-mentioned powder then wrap it in a linnen-cloth and then in sear-cloths How to embalm bodies when as we want spices Lastly let it be put in a Coffin of Lead sure sondered and filled up with dâ—ye sweet herbs But if there be no plenty of the fore-mentioned spices as it usually happens in besieged towns the Surgeon shall be contented with the powder of quenched lime common ashes made of oke-wood For thus the body being over and above washed in strong vinegar or Lye Why the bodies of our Princes how well soever embalmed corrupt in a few daies shull be kept a long time if so be that a great dissolving heat do not bear sway or if it be not put in a hot and moist place And this condition of time and place is the cause why the dead bodies of Princes and Kings though enbalmed with Art and cost within the space of six or seven dayes in which they are kept to be shewed to the people after their embalming do cast forth so greivous a sent that none can indure it so that they are forced to be put in a leaden Coffin For the air which incompasseth them groweth so hot by reason of the multitude of people flowing to the spectacle and the burning of lights night and day that the small portion of the native heat which remaineth being dissipated they easily putrifie especially when as they are not first moistened and macerated in the liquor of aromatick things as the Aegyptians antiently used to do steeping them in brine for 70 dayes as I formerly told you out of Herodotus I put in minde hereby use that so the embalming may become the more durable to steep the bodies being embowelled and pricked all over with sharp bodkins that so the liquor hindering putrefaction may penetrate the deeper into them in a wooden tub filled with strong vineger of the decoction of aromatick and bitter things as Aloes Rue Wormwood and Coloquintida and there keep them for twenty dayes pouring thereinto eleven or twelve pintes of Aqua vitae Then takâ—ng it forth and setting it on the feet I keep it in a clear and drye place I have at home the body of one that was hanged which I begged of the Sheriff embalmed after this manner which remains sound for more then 25 years so that you may tell all the muscles of the right side which I have cut up even to their heads and plucked them from those that are next them for distinctions sake that so I may view them with mine eyes and handle them with my hands as often as I please that by renewing my
the Varices and the inâ—â—ion of the temporal Arteries as after the amputation of a member Now you your self command that in cutting the Varices the flux of blood be stopped by the ligature of the vessels In the book 2 chap. of Angealogy leaf 176. you command the same in the book of stitches 1. chap. speaking of the stitch with the amputation and section of the Call changed by the outward air see here your own words After that must be considered concerning the Câ—lâ— for if there be any part corrupted putrified withered or blackish first having tyed for fear of a flux of blood you do not bid afterward to have it cauterised but to say the truth you have your eyes shâ—t and all your sences dulled when you would speak against so sure a method and that it is not but through anger and an ill will For there is nothing which hath more power to drive reason from her seat then cholet and anger Moreover when one comes to canterize and dismemper the parts oftentimes when the 〈◊〉 comes to fall off there happens a new flux of blood As I have seen divers times not having been yet inspired by God with so suâ—e a means then when I used the heat of fire Which if you have not found or understood this method in the books of the Antients you ought not thus to â—â—ead it under your feet and speak unluâ—kily of one who all his life hath preferred the profit oâ— the Common-wealth before his own particular It is not more then reasonable to be found upon the saying of Hippocrates in the chapter of burning 2. book leaf 206. upon whose authority you serve your self which is thus That what the medicament cureth not the iron doth and what the iron doth not amend the fire exterminateth Galen in 4. book of the Meth. and in the book of Art of Hippocratâ—s Apho. the 2. book 1. In the book of arte panva It is a thing which savors not of a Christian to fall to burning at the first dash withoâ—t staying for any more gentle remedies As you your self write in the first book leaf 5. speaking of the conditions required in a Chirurgion to cure well which passages you borrow from some other place for that which may be done gently without fire is much more commended then otherwise Is it not a thing which all schools hold as a Maxiâ—â— that we must alwayes begin with most easie remedies which if they be not sufficient we must then come to extreme following the doctrine of Hippocrates Galen commands in the place before alledged to treat or dress the diseased quickly safely and with the least pain that is possible Let us come to Reason NOw so it is that one cannot apply hot irons but with extreme and vehement pain in a sensible part void of a Gangrene which would be cause of a Convulsion Fever yea oft-times of Death Moreover it would be a long while afteâ—wards before the poor patient were cured because that by the actions of there is made an either Of what the eâ—coar is made which proceeds from the subject flesh which being fallen nature must regenarate a new flesh in stead of that which hath been burned as also the bone remains discovered and bare and by this means for the most part there remains an ulcer incurable Moreover there is yet another accident It happeneth that oftentimes the crust being faln off the flesh not being well renewed the blood issueth out as it did before But when they shall be tied the ligature falls not off until the first flesh have very well covered them again which is proved by Galen in the 5. book of his Math. saying that escharotick medicines which cause a crust or eschar whensoever they fall off leave the part more baâ—e then the natural habit requires For the generation of a crust proceeds from the parts subject and which are situate â—ound about it being also burned as I may say wherefore by how much the part is burnt by so much it loseth the natural heat Words of the adversary Then tell me when it is necessary to use escarotick medicines or cautering irons T is when the flux of blood is caused by erosion or some Gâ—ngrene or putrefaction Now is it thus in fresh bleeding wounds there is neither Gangrene nor putrefaction Therefore the cauteries ought not to be there applied And when the Antients commanded to apply hot irons to the mouths of the vessels it hath not been only to stay the flux of blood but chiefly to correct the malignity or gangâ—enous putrefaction which might spoil the neighboring parts And it must be here noted that if I had known such accidents to happen which you have declared in your book in drawing and tying the vessels I had never been twice deceived nor would I ever have left by my writings to posterity such a way of stopping a flux of blood But I writ it after I had seen it done and did it very often with happy success See then what may happen through your inconsiderate counsel Propositions of the Adversary without examining or standing upon the facility of tying the said vessels For see here 's your scope and proposition to tie the vessels after amputation is a new remedy say you then it must not be used it is an ill argument for a Doctor But as for that say you one must use fire after the amputation of members to consume and dry the putrefaction which is a common thing in Gangrenes and mortifications that indeed hath no place here because the practice is to amputate the part above that which is mortified and corrupted as Celsus writes and commands to make the amputation upon the second part rather then to leave any whit of the corrupted I 5. book c. 26. and 7. book c. 33. I would willingly ask you if when a vein is cut transverse and that it is very much retracted towards the original whether you would make no conscience to burn till that you had found the orifice of the vein or artery and if it be not more easie only with a Crow-bill to pinch and draw the vessel and so tie it In which you may openly shew your ignorance In the ch of cutting Book the 2. and that you have your mind seized with much rancor and choler We daily see the ligature of the vessels practised with happy success after the amputation of a part which I will now verifie by experiences and histories of those to whom the said ligature hath been made and persons yet living Experiences A â—oâ—â—ble history The 16. of June 1582. in the presence of Mr. John Lieâ—aud doctor in the faculty of Physick at Paris Claud Viard sworn Surgeon Mr. Mathurin Hurâ—n Surgeon of Mounsieur de Sâ—uvâ—â—y and I Jâ—hn Charbonel M. Barber-Surgeon of Paris well understanding the Theorick and Fractick of Surgerie did with good dexterity amputate the left leg of a woman tormented
little master Du Bâ—rtas Book 6. c. 4. book 2. c. 4. book 3. c. 9. sect 7. seeing that you reproach me that I have not written all the operations of Surgery in my works which the antients write of I should be very sorry for it for then indeed might you justly call me Carnifex I have left them because they are too cruel and am wiling to follow the moderns who have moderated such cruelty which notwithstanding you have followed step by step as appeareth by the operations here written extracted from your book which you have drawn here and there from certain antient Authors such as follow and such as you have never practised nor seen The first operation TO inveterate fluxions of the eyes and Megtimes In the second book of the chap. of Hypospatism book 14 ch lâ—st of the Meth. In the 4 ch of the 16 book of my work Book 6. c. 7. Book 2. c. 3. Paulus Aeginata as also Albucasis command to make Arteriotomy see here the words of the same Aeginete You mark the Arteries which are behinde the ears then divide them in cutting to the very bone and make a great incision the bredth of two fingers even till the artery be found as you command to be done in your book but I holding the opinion of Galen who commands to dress the disease quickly safely and with the least pain that is possible I teach the young Surgeon the means to remedy such evils in opening the Arteries behinde the ears and those of the temples with one only incision as a letting blood and not to make a great incision and cut out work for a long time The second TO fluxions which are made a long time upon the eyes In the 2 book chap. of Periscythism Paul Aeginete and Albucasis command to make incision which they call Periscythismos or Augiology of the Greeks and see here the words of Paul In this operation first the head is shaved then taking heed of touching the temporal muscles a transverse incision must be made beginning at the lest temple and finishing at the right which you have put in your book word for word without changing any thing which sheweth openly you are a right wound-maker as may be seen in the Chapter which you call the Crown cut In the 26. ch of the 9. book of my works which is made half round under the Coronal future from one temple to another even to the bone Now I do not teaâ—h such a cruel kinde of remedy but instruct the operator by reason authority and notable proof of a sure and certain way to remedy such affections without butchering men in this kinde The third operation IN the cure of Empyema Paul Aeginete The third Book 6. ch 4â— book â— ch 3. Book 3. ch 22 Albucasis and Celsus commanded to apply some thirteen others fifteen Cauteries to give issue to the matter contained in the brest as the said Celsus in the afore-said place appointeth for Asthmatick people which is a thing out of all reason with respect to their honor be it spoken that since the Surgeons scope is to give issue to the matter therein contained there is no other question then to make a pertion to evacuate the matter in the most inferiour part I have shewed the young Surgeon the means to do it safely without tormenting the patients for nothing The fourth operation Guido of Caulâ—ac the 2 treatise doct 1. c. 1. Book 7. c. 10. book 6. c. 46 book 2. c. 47. In the first book chap. 29. and 30. a. â—oin b 2. c. 32 b. 6. c. 47. and 48 In the 5. book chap. 1. Dâ— inte nâ—s mâ—â—bi boâ—k 1 caâ— â—3 book 3. sect 2 ch â— 89 bo k 6 â—p 50 〈…〉 3. book 12. ch 6.7 IN Paps that are too great Paul Aeginet and Albucasis commands to make a cross-incision to take out all the fat and then joyn together the wound by stitch in brief it is to flea a man alive which I have never practised nor counsel it to be done by the young Surgeon The fifth operation ALbucasis and Paul Aeginet will cauteâ—ize the Liver and the Splene with hot irons which the moderns have never practised â—o indeed reason is manifestly repugnant thereunto The sixth operation IN the Paracentesis which is made in the thiâ—d kinde of Dâ—opsie called Ascites Celius Aurelianus commandeth diverse apertions to be made in the belly Albucasis applies nine actual Cauteries that is to say four about the Navel one upon the stomach and one upon the Splene one upon the Liver two behinde the spondyls one of them near the brest the last near the stomach Aetius is likewise of the same opinion to open the belly with diverse cauteries Paul Aeginet commandâ— to apply five actual Câ—uteâ—ies â—o make the said Paracentâ—â—is But abhoâ—â—ing suâ—h a kinde of burning of which you speak much in your third book I shew another kinde of pâ—actice the which is done by making a simple incision in the said belly as may be seen in my wâ—rks with happy success I do not teach young man in my works the manner of burning which the Antients have called infibulare that is not in practice though Celâ—â—s writeth of it The seventh operation In the 7 book c 25. book 6. c. 76. book 2. c. 72. upon the sentence 49. of the 1. â—â—ction of the book of Arts. IN the Sciatick proceeding from an internal cause and because the visâ—ous humors displace the bones Paul commands to burn or cauterize the said joynt to the bone Diascâ—riaes commands the same Which I do not finde expedient taking indication from the â—bjâ—â—eâ—t parts for therâ— where one would burn t is in the place of four twin-muscles under which passeth the great Neâ—ve descending from the Holy-bone which being burnt I leave it to your censure what might happen as Galen remarketh speaking of the ustion which must be made in the shoulders called humerus The eighth operation Sentence â—he 22. and 23 of the 3. sâ—ctiâ—n of the â—ooâ— of the joynts c. 16. of the 15. book IN the outward laxation of the Spondyls Hippocrates commands to binde the man right upon a Lâ—dder the Arms and Legs tied and bound then afterwards having raised the Ladder to the top of a tower or the ridge of an house with a great â—ope in a pully then to let the patient fall plumb down upon the hard pavement which Hippocrates saies was done in his time But I do not shew of any such way of giving the strapado to men but I shew the Surgeon in my works the way to reduce them surely and without great pain Moreover I should be sorry to follow the saying of the said Hippocrates in the third book De morbis who commands in the disease called Volvulus to cause the belly to be blown with a pair of bellows putting the nosel of them into the inteâ—tinum rectum and then blow there till the belly be
should not dye in my hands and commanded the said Impostor to dress the said Lord of Martigues And that he should have no other Physicians nor Surgeons but him he came presently to the said Lord of Martigues who told him Senor Cavallero el senor Duge me ha mandadâ— que veniasse a curar vastra herida yo os juro a Dios que antes de achio dias yo os haga subir a Cavello con la lansa en puno contasque no ago que yo quos tâ—gâ—e Comeris y biberis to dis comidas que sueren de vastro gusto y yo hare la dieta pro V. M. y desto os de veu aâ—eguirar sobre de mi yo he sanaâ—o mun hos que tenian magores heridas que la vastra That is to say Lord Cavallere Monsieur the Duke of Savoy hath commanded me to come dress thy wound I swear to thee by God that before eight dayes I will make thee mount on hors-back with thy Lance in thy hand provided that no man may touch thee but my self thou shalt eat and drink any thing that thou hast a minde to I will perform thy diet for thee and of this thou mayest be assured upon my promise I have cured divers who have had greater wounds then thine and the Lord replied God give you grace to do it He demanded of the said Lord a shirt and tore it in little rags which he put across muttering and murmuring certain words over the wounds and having dress him permitted him to eat and drink what he would telling him he would observe a diet for him which he did eating but six prunes and six bits of breatd at a meal and drinking but beer Notwithstanding two dayes after the said Lord of Martigues died and my Spaniard seeing of him in the Agony eclipst himself and got away without bidding farewell to any body and I beleive if he had been taken he had been hangd for his false promises which he had made to monsieur the Duke of Savoy and to divers other Gentlemen He died about ten of the clock in the morning and after dinner the said Lord of Savoy sent Physicians and Surgeons and his Apothecary with a great quantity of Drogues to embalm him they came accompanied with divers Gentlemen and Captains of the Army The Emperors Surgeon came near tome and prayed me kindely to open the body which I refused telling him I was not worthy to carry his plaster-box after him he prayed me again which then I did for his sake if it so liked him I would yet again have excused my self that seeing he was not willing to embalm him that he would give this charge to another Surgeon of the company he made me yet answer that he would it should be I and if I would not do it I might here after repent it knowing this his affection for fear he should not do me any displeasure I took the razor and presented it to all in particular telling them I was not well practised to do such operations which they all refused The body being placed upon a Table truly I purposed to shew them that I was an Anatomist declaring to them divers things should be here too long to recite I began to tell all the company that I was sure the bullet had broken two ribs and that it had pass'd through the Lungs and that they should find the wound much enlarged became they are in perpetual motion sleeping or waking and by this motion the wound was the more dilacerated Also that there was great quantity of blood spilt in the capacity of the brest and upon the midriff and splinters of the broken ribs which were beaten in at the entrance of the bullet and the issuing forth of it had carried out Indeed all which I had told them was found true in the dead body One of the Physicians asked me which way the blood might pass to be cast out by urine being contained in the Thorax I answered him that there was a manifest conduit which is the Vena Azygos which having nourish'd the ribs the rest of the blood descends under the Diaphragm and on the left side is conjoined to the emulgent vein which is the way by which the matter in Pleurisies and in Empuema do manifestly empty themselves by urine and stool As it is likewise seen the pure milk of the brests of women newly brought to bed to descend by the Mammillarie veins and to be evacuated downwards by the neck of the womb without being mixt with the blood And such a thing is done as it were by a miracle of nature by her expulsive and sequestring virtue which is seen by experience of two glass-vessels called Mount-wine let the one be filled with water and the other with Claret-wine and let them be put the one upon the other that is to say that which shall be filled with water upon that which shall be filled with wine and you shall apparently see the wine mount up to the top of the vessel quite through the water and the water descend atraverse the wine and go to the bottom of the vessel without mixture of both and if such a thing be done so exteriorly and openly to the sence of our eye by things without life you must believe the same in our understanding That nature can make matter and blood to pass having been out of their vessels yea through the bones without being mingled with the good blood Our discourse ended I embalmed the body and put it into a coffin after that the Emperors Surgeon took me apart and told me if I would remain with him that he would use me very well and that he would cloath we anew also that I should ride on hors-back I thank'd him very kindly for the honor he did me and told him that I had no desire to do service to strangers and enemies to my country then he told me I was a fool and if he were Prisoner as I he would serve the devil to get his liberty In the end I told him flat that I would not dwell at all with him The Emperors Physician returned towards the said Lord of Savoy where he declared the cause of the death of the said Lord of Martigues and told him that it was impossible for all the men in the world to have cured him and confirmed again that I had done what was necessary to be done and prayed him to win me to his service and spake better of me then I deserved Having been perswaded to take me to his service he gave charge to one of his stewards named Monsieur dn Bouches to tell me if I would dwel in his service that he would use me kindly I answered him that I thanked him most humbly and that I had resolved not to dwell with any stranger This my answer being heard by the Duke of Savoy he was some what in choler and said he would send me to the Gallies Monsieur de
Haemorrhoidalis interna the inner emroid vein to distinguish it from the outer which is derived from the Hollow-vein It is truly and properly called the Emroid vein I say properly and truly because sometimes they call by that name the veins of the nostrils gums and mouth that cast forth blood and without pain In this large sence the Philosopher took it 3. de part animal where he makes menstrous purgation also a species of the emroids But the Emroids properly so called by Physitians are dilatations of this vein in the fundament caused as well by black and yellow choler as also by a salt phlegm as by the melancholick humor And these are of two kinds Caecae blind piles which cast out no blood but swell out like the stone of a grape into the fundament or out of it Others apertae open which cast out the blood which they contain The learned Hippocrates hath left us a peculiar book a golden one indeed concerning the cure of these The remaining part of the Spleen-branch is spent upon the whole Spleen and therein is scattered into divers and very small propagations entring the very flesh of it about the hollow and middle line And these are the sprigs which gâ—ow out of the Spleen-branch The Mesenterick vein or right branch of the Gate-vein is joyned to the Mesentery as soon as it comes from the back and is divided into two chief branches which passing through the Mesentery betwixt its two coats are each of them cleft into an infinite number of small branches and they again into less twigs which going to the Guts make up those veins so famous among Physitians that are called the Mesaraick-veins The first of these branches is called the right Mesenterick vein from the right side The right Mesenterick branch wherein it is placed and is likewise twofold whence it came to pass that Vesalius and almost all others who follow him reckon three Mesenterick veins This branch is inserted into the Jejunum or empty Gut the Ileum or circle Gut the caecum or blinde Gut and the right side of the Colique Gut where it lies next to the reins and Liver and although both its branches shoot forth many propagations from themselves so that it is very hard to express any number of them as well because they vary much by reason of their subjects as also because they do not observe the very same order and course yet it hath been observed that for the most part there are fourteen which afterwards are scattered into an infinite company of other twigs These when they are come to the Guts only gape with their little mouths into their Coat and enter not the cavity it self that being compassed about within with a certain crust But as in most parts of our body the divarications or divisions of the vessels are attended with certain glandules partly that they may make the safer progress partly lest they should sink down and withall the flow and ebb of the blood so very necessary be hindered so here also the divisions of the vessels which are scattered through the Mesentery are bolstered up with certain glandules which with their propagations observe such an exact propagation that the greater glandules do sustain the greater branches and the less the lesser When these glandules swell with a Scirrhus the vessels being prest close together and the distribution of the chylus through the veins and consequently of the blood through the body being hindered there follows a Consumption and pining of the whole body The left Mesenterick vein is distributed into the middle part of the Mesentery and also that part of the Colique Gut The left Mesenterick which runs from the left region of the Stomach as far as to the strait Gut The haemorrhaidalis interna or inner Emroid vein of which we spake a little before sometimes arises from this vein as Vesalius hath observed which affording some sprigs to the Colique Gut at last running forward through the whole length of the strait Gut determines in the fundament But before the Mesenterick Trunk be divided into these two branches Propagations that arise before the division of the Mesenterick Gastro-epiplois it first sends forth two propagations one of which is called Gastro-epiplois dextra or the Right Stomach and Kall-vein which creeps through the right bottom of the Stomach before and behinde as also through the upper membrane of the Kall the other called by others Intestinalis or the Gut-vein by us the Duodena reaches to the middle of the Gut Duodenum and the beginning of the Empty Gut or Jejunum and descends all along through them The chief use of the Gate-vein is to nourish those parts Dextra Intestinalis The first use of the Gate-vein which are seated in the lowest belly and need a thicker and more faeculent blood such as are all those parts which serve for nutrition For their blood ought to be thicker that it might be hotter when heat is alwaies more powerful in a thicker body so then the Roots of the gate-Gate-vein nourish the Liver the Trunk nourishes the Pancreas or Sweet-bread of the Twigs the Cysticus or Gall-twig nourishes the bladder of the Gall the Spleen-branch all the entrails which serve for nutrition except the Mesentery and the Guts the Twig Pyloricus or of the lower mouth of the Stomach the Gastricus or Stomach-branch both the Stomach and Kall-veins and the short vessel nourish the stomach For I do not think that the short vessel was made by nature for the carrying back of melancholick humors to the Stomach but chiefly fot its nourishments sake when that blood which is generated in the Spleen is not a melancholy and excrementitious humor but rathet the best although somewhat thicker then other blood and that because the parts that are to be nourished by the Spleen branch needed a thicker blood then they which are to be nourished by the Mesenterick Both the Stomach and kall-Kall-veins nourish the upper membrane of the Kall the right and the hinder Epiplois or the Kall-veins the lower The Spleen is nourished by those two branches into which the Spleen-vein is cleft and which enter its parenchyma or flesh through its middle line the Mesentery and almost all the Guts by the two Mesenterick branches the Gut Duodenum by the propagation called Duodena but the empty Gut the Ileum or circle Gut the blind Gut and the right side of the Colique or Colon by the right Mesenterick-branch The left side of the Colique and all the strait-Gut by the haemorrhoidal vein but the middle part which lies under the Stomach by the hinder Kall-vein The second use is to attract the Chylus and carry it to the Liver The second use whose veins are most famous for the making of blood But the same veins which nourish the Mesentery branch do also attract the Chylus as we shall shew you hereafter when we shall insist upon the History of it The third use
vein out of it But the beginning of both answers not directly one to another lest one should be hindered by the action of the other And the left is higher then the right because the left Kidney is also seated higher then the right But the Emulgent branches as soon as they arise out of the Trunk do not presently go to the cavity of the Kidneys but are first divided into two greater branches and so accompanied with Arteries enter the concavous side of the Kidneyes and afterward being broken into lesser branches are scattered quite through the whole substance of the Kidneyes and at last determin with their small hairy ends in certain fleshy processes which they call Mammillares These veins do serve not only for the bringing of nourishment to the Kidneyes but also for the carrying down of the serous moisture to those fleshy Processes called Mammillares throught which it is strained into the pipes of the Ureters and then gathered together into that cavity of theirs called the Pelvis The place in which the stones of the Kidneys are bred and so drops down by little and little into the bladder as we shall shew when we open the history of the Kidneys And here the place is to be noted in which the stones of the Kidneys are wont to be generated which is not in the Emulgent vessels I mean veins or Artery but rather in the very cavity of the Kidneys or in the Pelvis and pipes of the Ureters For in these if a viscous matter be at any time received either it is hardened there by reason of a notable heat or else through cold is congealed into graveâ—l or stone For this matter is not only a crude and uncocted kinde of blood which like a mucus matter sometimes is wont to abound in the mass of blood but oftentimes also that excrementitious phlegm which falls down from the head through the veins and Arteries both into the hollow vein and the great Artery and sometimes into the Stomach and Guts Of which this seem to be a manifest sign that they who are subject to diseases of the Stone are very often troubled with reumes and pains of the collique of which whilst some perswade themselves that it is caused by wind daily experience hath taught me that it comes from phlegm because I have observed that they who are troubled with the stone in the Kidneyes had their Colon or Collique-gut alwaies stuft with plenty of this phlegm and that this being taken away the Stone has been no longer bred And therefore oft-times I give scouring Clysters and such as gently purge phlegm not only to such as have the Stone already but also to such as are threatned with the breeding of it with a great deal of benefit to the Patients But all those things are perpetually to be avoided which drive out the stones as well because most of thar nature are hot as also because they are able to drive down the crude matter plentifully to the Kidneyes We though fit therefore to insist upon this that we may accommodate the study of Anatomy to the very practice of Physick especially seeing that the place wherein the stone is bred is not commonly known because the most famed Fernelius whom the greatest number of Physitians does for the most part follow Lib. 6. Patholog c. 12. thinks that small gravell is bred in the proper substance of the Kidneys Why the left Kidney is more subject to the stone then the right and washed from thence by the flowing of the Urine and carryed into the cavity and so the Urine full of gravel slides down through the Ureters into the Bladder But if any one enquire also the cause why the left Kidney is more subject to the Stone then the right we must conclude that this happens because the Collique-gut lies more up on the left Kidney in whose cells this phlegm of which we spake abounding either it sweats through the pores and is suckt into the Kidneys or else by reason of its nearness the Kidneys are exceedingly cooled experience having often taught us that this kinde of phlegmatick matter is indeed actually exceeding cold in the body as they have sufficiently perceived Spermatica who have voided it in great plenty by Stool After this there follows a third part χ and ψ called spermaticae or seminales the spermatical or seed veins because they carry down matter for making of the seed These differ in their original For the left ψ arises from the inside and middle part of the Emulgent and communicating some surcles to that part of the Peritoneum or rim of the belly which covers the Muscles that lye in the Loins it goes fast by the said Peritoneum and descends obliquely but when it has attained to the Os pubis or the Share-bone riding over it it passes through the Peritoneum and holes of the oblique and transverse Muscles of the Abdomen with whose processes being sustained it is contorted into certain varicous circlings which are â—oyned with the spermatical Artery by Anastomoses or Inoculations and at length it ends in the Testicle of its own side But the right spermaticall vein χ arises not out of the Emulgent but the Trunk it self and the forepart of it a little beneath the Emulgent-vein and afterwards observes a like course with the former And thus they are in males though we may observe nature oftentimes varying in them but in Women although they arise in the same manner and observe the same course with those in Men as far as the Holy-bone yet they fall not out of the Peritoneum nor reach into the share-bones but before they come to the Testicles are cleft into two unequall branches the lesser of which is scattered into the sides of the womb toward the bottom of it the greater being joyned to the spermatical Artery and inoculated with it enters into the Testicle of its own side Last of all the fourth pair is called X Lumbares the Loin-veins 444 two Lumbareâ— or three which the Hollow-vein sends forth from its back side which looks towards the bodies of the Rack-bones of the Loins and therefore they are not to be seen unless the Trunk of the Hollow-vein be lifted up These veins go in through the holes of the Rack-bones through which the Nerves go out and so carry nourishment to the Spinal marrow From them two other veins tyed on both sides to the side of the Marrow ascend toward the brain with which afterward two veins descending from the internall Jugular are joyned by an Anastomosis or Inoculation These propagations being thus sent out The division of the Trunk into the two Iliâ—cal branches when the Hollow-vein has almost attained to the Sacrum or Holy-bone about the fifth Rack-bone of the Loins it inclines under the great Artery and is cut into two notable branches called Iliaci XX which having gone a little way are again cleft into two others Y and Z of unequal bigness
of which one is called the inner the other the outer The inner is less the outer lager and greater But before they be so divided they scatter two other propagations the first of which 5 is commonly called Muscula superior the upper Muscle-vein which is disseminated overthwart Muscula superior through the Muscles of the Loins and Abdomen or paunch from whence I would call it Muscula lumbalis the Muscle-vein of the Loins the other 6 is named Sacra or the Holy-vein Sacra because it reaches some little twigs to the upper holes of the Holy-bone for the nourshing of the said bone and the Spinal-marrow But from both the Iliacal branches many veins issue Propagations of the inner Iliacal branch before they go out of the Peritoneum or Rim of the Belly toward the Legs and from the inner branch two The first 7 arises from the out-side called Muscula media the middle Muscle-vein because it is scattered into all the Muscles of the Buttocks and into their skin For it carries aliment to all those Muscles which are of the out-side or Back of the bone Ilium or Hanch-bone as also to the very joint of the Hip that for this cause it ought to be especially taken notice of by them who would somewat curiously consider the cause of the ach in the Hip or the Sciatica Glutaea I should think that this vein may not be amiss called Glutaea from its insertion because it is implanted into the Muscles called Glutaei or Muscles of the Buttocks The other 8 grows out of the inside and is a notable vein Hypogastrica called Hypogastrica or the vein of the water-course from its distribution into almost all the parts of the Hypogastrium or water-course Haemorrhoidals externa From this issues a branch named Haemorrhoidalis externa the outer Emroid-vein because if at any time it swels with a more faeculent blood or hot or salt it makes the outward Emroids of the Fundament This affords twigs to the holes of the Os sacrum or Holy-bone but bestows greater branches upon the Muscles of the Rectum Intestinum or the Strait gut as far as to the outer skin of the Fundament There is also another branch arising from the same Hypogastrick-vein which we call Cysticus Cysticus the Bladder-branch and is worthy of observation both in men and women in men because it is spent upon the Bladder but in women because in them being sustained with a fat membrane it goes with some twigs to the Bladder but with more to the bottom of the Womb and with more manifest ones to the Neck of it by which veins alone some think that the monthly courses flow in Virgins and some also think the same in Women But the monthly courses do not only flow out by these branches but by those also which we told you were sent from the spermatical branch and which go to the bottom of the womb not to the Neck For the menstruous blood is is usually purged out whether in Virgins or women every month not only through the Neck but especialy through those passages of the Womb called Cotyledones Which we have shown here at Padua publickly in the Theater the first year of our being Professor in the carkass of a certain Woman having her monthly courses For we saw that the Hypogastrick branches and the spermatick vessels with the Testicles were filled with blood and that the Womb it self did pour out a thicker blood the little mouths of the veins in the inner part of the Womb lying open and manifestly gaping Yet I saw twice in others that the menstruous blood came out of the veins of the Neck only not also out of the womb and in another on the contrary that it flowed out of the Womb only But the ordinary way is for women to be purged at them both and not at one only except when besides the intent of nature obstructions do seem to hinder their flowing But we have observed and seen divers times whilest we were about the cure of Ulcers in the privie members and the neck of the Womb that at what time the monthly courses do flow the month of the Womb gapes I saw also then that those parts were dilated with a certain stinking moisture and that the neck of the Womb appeared much larger then it was wont to be at other times And therefore no man need to wonder at that which hath been observed by some Writers of our age that in the time of their courses these parts have been so widened in some that being new married although they were true Virgins they have for this reason been accused and thought to have been defloured Wherefore if it happen that any who are new married doubt of their Wives virginity because they finde the privy passage very wide it will behove them to consider whether their flowers were not at that time upon them Now at length the remainder of the inner Iliacal Trunk makes to the Share bone and taking to it a propagation of the outer Iliacall together with which it makes one vein and so passing throught the Perito neum and hole of the Share-bone it spreads it self into the leg and is extended almost beyond the middle of the Thigh on the inside Propagations of the outer Iâ—iacal branch Epigastrica From the outer branch in like manner some veins issue and first of all that which is called Epigastrica or vein of the lower Belly 9 which arises from the higher part of the branch and is so named because it goes to the Muscles of the Epigastrum to wit the rich muscles of the Abdomen For passing with its chief branch out of the Peritoneum or Rim of the Belly it climbs strait up of both sides under the right Muscles till it come near to the Navill where it is joyned by Anastomosis with the descending Mammary-veins But this Anastomosis or Inoculation is seldome found in men but in women it is very conspicuous from whence also Galen Lib. de Dissect Ven. Arter Cap. 8. witnesseth that great sympathy betwixt the womb and the Brests or Dugs is caused by these two vessels But the most learned Hippocrates has explained this sympathy in many Aphorisms of the fifth Section For in the fiftieth Aphorism he sayes If you would stop the courses in a woman apply a very great Cupping-glass to her Brests And in the thirty seventh If the Brests of a great bellied woman do of a suddain become small the child proves Abortive And in the thirty eight If one of the brests of a great bellyed woman become small one of the Twins that she goes with proves Abortive and that a Male if the right Breast be small a Female if the left so the womb being diseased the Nipples become pale and upon a Dropsie in the Womb they swell up But there is a sympathy also not only by reason of the veins but also of the Nerves that come from
called Phrenicae of the midriff xx are two one of each side 2. Phrenica the arteries of the midriff which arising out of the Trunk presently after it is come forth of the hollow of the chest being divided into more branches are scattered into the midriff but especially into the lower side of it near to the rack-bones of the back They sprinkle some small twigs also into the upper part which afterwards go to the Pericardium or purse of the heart there where it growes to the midriff The Coeliaca or Stomach-artery is but one so called 3. Coeliaca because it sends over branches to the 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 that is the Stomach This being most like to the splenick branch of the Gate-vein affords many branches to the Stomach Liver Bladder of Gall Kall the gut Duodenum the beginning of the Jejunum or empty Gut a part of the Colon or Colique-Gut the Sweet-bread and Spleen But it arises out of the foreside of the body of the Trunk and being stayed up all the way by the upper part of the lower membrane of the Kall The two branches thereof The right branch is divided into two notable branches but of unequall bigness one of which goes to the right the other to the left that is the less this is the greater The right branch therefore is joined with the descendent Gate-vein in the Pancreas or Sweet-bread that is placed under the hinder part of the Stomach and leaning there upon the membranes of the Kall goes to the Liver and its smallness is worth the taking notice of if you look upon the largeness of the Liver which the Ancients long since and many at this day have made the work-house of the blood But it is inserted in the hollow part near to the Trunk of the gate-Gate-vein and is so small because that part of the Liver which entertains the roots of the Gate-vein needed not a greater Artery but the other part which hath the propagations of the Hollow-vein receives great plenty of vital spirits sent over from the heart through the Hollow-vein Yet before it enters into the Liver it disseminates in the way many surcles Propagations from its upper part and those partly from its upper side partly from its lower from the upper side two first that which I call Pyloricus which arises in the mid-way and being divided into many little branches is scattered into the back-side of the right orifice of the Stomach The outer is called Cysticae gemellae the Twin-Arteries of the bladder of Gall which are two little branches From its lower part and go into the bladder of Gall and presently are divided into many propagations From the lower side likewise two arise The first is Epiplois Dextra or the right Kall-Artery which is implanted into the right side of the lower membrane of the Kall and part of the Colique-Gut annexed thereunto The outer is cleft into two branches of which one called Intestinalis the Gut-Artery passes on to the Duodenum and beginning of the Jejunum or empty Gut the other named Gastro-epiplois dextra the right Stomach and Kall-Artery somewhat larger then the former turns down to the right side of the bottom of the Stomach and being supported by the upper membrane of the Kall issues out some shoots from the upper part to the fore and back-sides of the Stomach but from the lower to that membrane of the Kall upon which it leans The left and greater branch is called Arteria Splenica the Spleen Artery The left branch which sticking to the lower membrane of the Kall and the Glandules placed therein passes on together with the Spleen-vein to which it is fastened and in the like manner distributes its propagations to the Spleen But in the way likewise it distributes branches from both parts of it from the upper issues Gastrica the Stomach-Artery Propagations from its upper part which reaches into the middle of the hinder part of the Stomach or that wherewith it leans upon the back and ascending from thence it compasses the left orefice of the Stomach round about like a Crown and disperses little twigs partly upward to the end of the Gullet partly downward and those greater and more numerous into the Stomach and so it makes the Arteria Coronaria or Crown-Artery like to the Crown-vein which arises from the Gate-vein as we have said in the fore-going Treatise From its lower part But from its lower side the Spleen-Artery sends out the Epiplois sinistra or left Kall-Artery about that part wherewith it now attains to the Spleen which runs out into the left sidt of the membrane of the lower parr of the Kall This Artery presently after its rise is cleft into two branches which part very far asunder from each other from which many other Arteries arise that ate all consumed upon the said membrane of the Kall and the Colique Gut that is tyed thereto These branches being issued the Spleen-Artery draws nearer to the Spleen and just like the vein of the same name which accompanies it all the way It s division is cleft into two branches like the Letter Y one of which may be called the upper the other the lower which afterward entring by the hollow part of the Spleen are splintered into an infinite number of little sprigs so that there are five times more Arteries there then veins Whence it comes to pass that in inflammations of the Spleen if you lay your hand to the left Hypochondrium or place under the Gristle of the Bastard-ribs it seems to pant But before this entry of the Artery the lower branch makes a totable Anastomosis or inoculation with the lower branch of the vein and propagates a twig to the lower membrane of the Kall But from the upper branch issues one called Gastro-epiplois sinistra the left Stomach and Kall-Artery which being fastened to the upper membrane of the Kall is derived into the left side of the bottom of the Stomach bestowing little branches upon the fore and back-sides of it or also upon the upper part of the Kall Another issuing from the upper branch makes the vas breve Arteriosum or short Arterial vessel carries like the vein its name-sake to the left side and orifice of the Stomach The use of the right branch Why ulcers are more frequent in the great guts The use of the cleft The use of the right branch which goes to the Liver besides the common one which it hath is this as often as the bladder of Gall is obstructed to carry down the choler to the Guts and especially to the Colon into which some of its branches are implanted Which is the reason that in bloody flixes the Ulcers are almost alwaies found in the great Guts and especially in the Colon very seldome in the small ones For this artery when either the Liver being over hot breeds abundance of choler or the bladder of Gall is obstructed receiving
intermitting cholerick feavers a solution whereof follows by a loosness Phlegm is so expell'd as often as bloody fluxes happen to such as have the gout in the feet which ease them of their pain if the intent of nature be advanced by the help of a wise Physitian Lastly melancholy is conveyed out by both the Mesentericks but especially by the Haemorrhoidal branch whence Hippocrates sayes 6. Epidem He which has the Emroids naturally shall neither be troubled with the pain of the side or inflammation of the lungs nor with felons or black pustles called Terminthi nor with the Leprosie canker or other diseases For there is a very great sympathy betwixt the brest and the haemorrhoidal artery because the trunk out of which it arises An observation descending from the heart presently after it first issues from thence propagates the intercostal branches Moreover all black cholerick humors are purg'd by this means out of the whole body that cankers and leprosie cannot be caused by them From these voluntary purgings which nature it self has found out we may now judg of such as are caused by the help of a Physitian and may be termed artificial For an opinion of some men hath prevailed much in our age that the body cannot be purged by clyster but only by those medicines which are taken at the mouth But I will not only believe but also being taught it by experience can witness that if the clysters contain in them purging medicines the whole body is very commodiously cleansed For the whole colick gut receiving the matter of the clyster the vertue it self of the medicine draws down the noisome humors by the arteries out of the Aorta or great artery Which being granted we may give a reason what we have seen very often why Suppositories made of white helebore produce the same symptoms as are wont to be caused in them who have taken in white hellebore at the mouth Why anointing of the navel with such things as purge loosens the belly How the colick is changed into the gout on the contrary In like manner from hence we may fetch the reason why the belly is strongly purged the region about the navel being anointed with purging medicines For the vertue of the medicine is attracted by the arteries and by them afterward it purges These arteries are they by which the disease of the colick is changed into the gout and on the contrary the gout into the colick as we have it in Hippocrates 6. Epidem Sect. 4. where he sayes One that was vexed with the pain of the colick on the right side had some ease whilest the Gout held him but this disease being cured he was pained more The reason whereof was this because that humor which caused the gout was carried out of the joints to the colick gut whereby the colick disease was increased Laurentius inquiring into the cause of this refers us to hidden and unknown passages to which it seems to me that we need not fly if we say that the humors are brought out of the crural arteries into the trunk and out of this into the Mesenterick branches and lastly out of these into the guts for this is the shortest and most convenient way Nor is there any reason that we should be afraid of that pollution of the vital spirits which they will object to us if the excremenitious humors pass through the arteries for this betrayes their great ignorance as well in Anatomy as in solid Physick and it would be very easie if I would digress to prove in this place that a great part of the humors in our body flow down through the arteries For in them the strength of nature exceeds and is more vigorous that whensoever it is provoked it is most apt to expel and the blood being stirred by their continual beating as also by its own nature makes all that is therein more fit to flow And who will not beleive that excrements are carried through the arteries who considers the flowings down from the spleen in which there being five times more arteries then there are veins truly it is necessary that that ballast of the spleen be carried out through the Arteries Lumbares The four Lumbares or loin-arteries γ γ γ arise out of the backside of the trunk of the great artery all along as it passes through the region of the loins They run through the common holes in the rack-bones of the loins and to their marrow and also into the neighbouring muscles And at the side of the marrow after they have entred the rackbones they climb upon both sides to the brain together with the veins of the loins But they are all equally big if you excep those two which issue out near to the Os sacrum or holy-bone which are not only derived into the rackbones to the marrow and to the muscles thereabout but are also sent overthwart through the Peritoneum and muscle of the Abdomen The two last are by some called Musculae superiores the upper muscle-arteries and are distinguisht from the Lumbares And these are the arteries which if we observe we shall easily give the reasons of many things of which Physitians do still dispute very hotly but especially of that most difficult question which is controverted among Physitians by what wayes and in what manner the colick ends in a palsie or in the falling sickness How the colick disease ends in a palsie or Epilepsie For we have the observation in Paulus Aegineta lib. 3. c. 43. where he sayes the colick as it were by a certain pestilent contagion ended with many in the falling sickness with others in a resolution of the joints or palsie their sence remaining and they who fell into the falling sickness for the most part dyed but they who fel into the palsie were most of them preserved the cause of the disease being carried to another place in the solution For the humor that caused the disease came back out of the colick gut through the mesenterical arteries from whence being afterward transported into the trunk of the great Artery it came also to the lumbares or arteries of the loins which swelling with blood prest together the neighbouring nerves from which came the palsie in the feet And this we have often observed as well in our selves as in others especially in former years when these diseases at Padua were Epidemical Yet the Palsie is not alwayes a perfect one but often as I am wont to call it imperfect because the power to walk is not wholly taken away but the diseased stand upon their feet with a great deal of difficulty Many at that time being deceived in the knowledg of the disease mistaking this for a great weakness of body contracted by their sickness endeavoured to take it away by eating and drinking largely but in vain This also is the cause why the Falling-sickness and Lethargies too as we have oft-times seen follow after the Colick because the matter
of water adding thereto cinnamon Ê’ ii in one pint of the decoction dissolve after it is strained of the syrup of mugwort and of hyssop an â„¥ ii diarrhâ—d abbat Ê’i let it be strained through a bag with Ê’ ii of the kernels of Dates and let her take â„¥ .iiii in the morning Let pessaries be made with galbanum ammoniacum and such like mollifying things beaten into a mass in a mortar with a hot pestel and made into the form of a pessary and then let them be mixed with oil of Jasmine euphorbium an ox-gall the juice of mugwurt and other such like wherein there is power to provoke the flowers as with scammony in powder let them be as big as ones thumb six fingers long and rowled in lawn or some such like thin linnen cloth of the same things nodula's may be made Also pessaries may be prepared with hony boiled adding thereto convenient powders as of scammony pellitory and such like Neither ought these to stay long in the neck of the womb least they should exulcerate and they must be pulled back by a thred that must be put through them and then the orifice of the womb must be fomented with white wine of the decoction of penniroyal or mother-wort What causes of the stopping of the flowers must be cured before the disease it self But it is to be noted that if the suppression of the flowers happeneth through the default of the stopped orifice of the womb or by inflammation these maladies must first be cured before we come unto those things that of their proper strength and virtue provoke the flowers as for example if such things be made and given when the womb is inflamed the blood being drawn into the grieved place and the humors sharpned and the body of the womb heated the inflammation will be increased So if there be any superfluous flesh if there be any Callus of a wound or ulcer or if there be any membrane shutting the orifice of the womb and so stopping the flux of the flowers they must first be consumed and taken away before any of those things be administred But the opportunity of taking and applying of things must be taken from the time wherein the sick woman was wont to be purged before the stopping or if she never had the flowers The fittest time to provoke the flowers Why hot houses do hurt those in whom the flowers are to be provoked in the decrease of the Moon for so we shall have custom nature and the external efficient cause to help art When these medicines are used the women are not to be put into baths or hot houses as many do except the malady proceed from the density of the vessels and the grosness and clamminess of the blood For sweats hinder the menstrual flux by diverting and turning the matter another way CHAP. LIV. The signs of the approaching of the menstrual flux WHen the monthly flux first approacheth the dugs itch and become more swoln and hard then they were wont the woman is more desirous of copulation by reason of the ebullition of the provoked blood and the acrimony of the blood that remaineth her voice becommeth bigger her secret parts itch burn swell and wax red If they stay long What women do love and what women do loath the act of generation when the months are stopped With what accidents those that are marriageable and are not married are troubled The cause of so many accidents she hath pain in her loins and head nauseousness and vomiting troubleth the stomach notwithstanding if those matters which flow together in the womb either of their own nature or by corruption be cold they loath the act of generation by reason that the womb waxeth feeble through sluggishness and watery humors filling the same and it floweth by the secret parts very softly Those maids that are marriageable although they have the menstrual flux very well yet they are troubled with headach nauseousness and often vomiting want of appetite longing an ill habit of body difficulty of breathing trembling of the heart swouning melancholy fearful dreams watching with sadness and heaviness because that the genital parts burning and itching they imagine the act of generation whereby it commeth to pass that the seminal matter either remaining in the testicles in great abundance or else poured into the hollowness of the womb by the tickling of the genitals is corrupted and acquireth a venemous quality and causeth such like accidents as happen's in the suffocation of the womb Maids that live in the country are not so troubled with those diseases because there is no such lying in wait for their maiden-heads and also they live sparingly and hardly and spend their time in continual labor You may see many maids so full of juice that it runneth in great abundance as if they were not menstrual into their dugs and is there converted into milk which they have in as great quantity as nurses as we read it recorded by Hippocrates Aph. 36 sect 5. If a woman which is neither great with childe nor hath born children hath milk she wants the menstrual fluxes whereby you may understand that that conclusion is not good which affirmeth that a woman which hath milk in her breasts either to be delivered of childe or to be great with childe Lib. 2. de subt for Cardanus writeth that he knew one Antony Buzus at Genua who being thirty years of age had so much milk in his breasts as was sufficient to nurse a childe The efficient cause of the milk is to be noted for the breeding and efficient cause of milk proceeds not only from the engrafted faculty of the glandulous substance but much rather from the action of the mans seed for proof whereof you may see many men that have very much milk in their breasts and many women that almost have no milk unless they receive mans seed Also women that are strong and lusty like unto men which the Latines call Viragines that is to say whose seed commeth unto a manly nature when the flowers are stopped concoct the blood and therefore when it wanteth passage forth by the likeness of the substance it is drawn into the dugs and becommeth perfect milk those that have the flowers plentifully and continually for the space of four or five daies are better purged and with more happy success then those that have them for a longer time CHAP. LV. What accidents follow immoderate fluxes of the flowers or courses IF the menstrual flux floweth immoderately there also follow many accidents for the concoction is frustrated the appetite overthrown then follows coldness throughout all the body exolution of all the faculties an ill habit of all the body leanness the dropsie an hectick fever convulsion swouning and often sudden death By what pâ—res the flowers do flow in a woman and in a maid The causes of an unreasonable flux of blood if any have them too exceeding