no effect Have a care that the stitches break not else they will cause scarrs but supply them with stitching-plaisters CHAP. IV. Of abuses committed in blood-stenching with Corrosives nealed Irons and the like and the dangers or hurts which ensue upon it illustrated with some examples BLood-stenching in Surgery is a very necessary point insomuch Stenching of blood is necessary that without it little is effected For Patients loose their lives if they bleed too much neither are the medicaments effectual if by a continual running of blood they be hindered in their operation and where there is a necessity of blood-stenching there it ought to be used and applyed according to Art And God be thanked Surgeons are found which have reasonable judgement in it and know how to stench blood and use it without any prejudice but rather to the great benefit of their Patients But the ruder sort goes to work basely whose number alwayes overtops the better sort and refuse better instructions Blood-stenching abused keeping and sticking to their old wayes obstinately observing their abuses even as when they intended nothing else but the ruine of their Patients I speak of such onely which use Corrosives supposing the stenching of blood must be effected onely with nealed Irons and other burning meanes among others they use sublimed Mercury crude or sublimed Arsenick calcined Vitriol Alumen Plumosum Caput mort of Aqua fort Euphorbium and such like things whereby they suppose to stench the blood Some there are found which to mend the matter take one or two of the mentioned things put them together and mingle other medicaments among it as Bole Armoniack Terra sigillata Millers dust Crocus Martis and such like This they hold for a rare Secret and Master-piece calling it a sharp Blood-stenching not without a cause for it is sharp enough nay too sharp It is a great pitty that these and such like things must be Abuses condemned cried up for rarities and master-pieces whereas they are nothing else but heavy and dangerous abuses and errors whereby infinite wrongs are done For all those above mentioned things one or more of them being used to a fresh wound for to stench the blood withall effect or do little or no good at all which were tollerable yet but they cause thereby infinite wrongs and do no lesse therewith as if they had strayed the wounds full of venom Tell me I pray if a wound bleedeth vehemently and you will stench it with one of the above named materials or corrosives when you stray that pouder into doth the wound cease to bleed presently Whoever affirms it I deny it For these materials in and outside I know very well and understand whither they have any efficacy in them to stench blood presently yea or no Must not the Wound being straid full be bound up with cotton Wool plaisters and the like that the blood may not issue forth Now vvhen you have thus bound up the wound and stench'd the blood so that it can run out no more could you not procure also that the in-strayed pouder should not work in the wound and that the corrosive which pulleth the running veins together cannot effect that because the running blood driveth it back and washeth it away For if a wound be carefully bound so that no blood can run out then of necessity the blood is stench'd and congealeth in the Wound This being done then the corrosive incorporates with it and begins then to work that is to say to rage to eat and to burn I would fain know here of what use Corrosives are in Corrosives are hurtful extreamly blood stenching as long as the blood congealeth without such fretting things and may be stayed onely by a careful binding of the Wound Perhaps you think the Patient is not sufficiently tormented unless you put more affliction and plagues upon him you immagine the Patient is not weak enough and so with your sharp Corrosives you must make him a Martyr Ah how many veins ah how many sinews which are not hurt at all by the blow nor toucht are eaten through by your sharp corrosiive blood-stenchers and are forcibly torn in pieces or at least benummed or mortified which would not have been so if you had not medled with them Are not lamenesses caused thereby and much wrong and evill inflicted upon Patients whose Wounds might have been easily cured if they had been dealt honestly withall I knew one who professed Surgery he was to stench a Example of one whose blood was stenched bleeding wound He took his pouder of the which he boasted much thrust the pouder into the Wound with some cotten wooll bound it up supposing he had done enough at it a little while after the Patient cried out extreamly complaining of his paines by reason of the raging and burning he felt in the Wound I asked the said Surgeon what he had put into the Patients Wound He was loath to reveal it because he held it for a great Secret and Master-piece however upon my importuning he said it was calcined Vitriol and Gummi Euphorbium sublimed Mercury mingled with Bole and Terra sigillata and a little quantity of Vinegar among it which he called quenching This was his great Skill and Secret wherewith he usually bound up Wounds But what happened He did more hurt then a wound twice as big would have done For though this mans Wound was not such where a lameness might be feared yet was he made a Cripple because this corrosive pouder hath corroded and eaten off his sinnews which were not hurt at all I pray what simpathy have these said simples one with the other especially Terra sigillata Gummi Euphorbium In like manner many Receipts are screwed together with a company of simples which do fit as much as a piece of new cloth a Beggar-patch'd coat of severall sorts of old rags all this is no sport or pastime to the poor Patient whose skin must reach for it These abuses hitherto shewed about blood stenching are great and grosse ones whereby incurable hurts are caused Abuse of hot Irons in blood-stenching which cause great hurt A horrible Skill and yet are they not comparable unto those which are committed with hot Irons whereby the Patients wounded veins sinews and other parts are drawn and shrunk together and haled as if pulled by a horse And this is held a great Skill amongst many but it is in my opinion such a terrible Skill which meerly belongeth to murthers and I am easily perswaded that Hangmen have taught this way at first Others that will outstrip their fellows in their Skill take cotten wool thrust it lighted into the Wound whereby they suppose to have done well for the good of the Patient But as I have said in general that I reject nor condemn blood stenching but rather hold it necessary and allowable as occasion serveth neither do I wholly condemn hot Irons to stench bloud withal and hold it to
were less dangerous and the less refuseable if the shot had hurt no sinews and bloud veines but this being very seldom I hold this scouring should be omitted For it often fals out when a bloud vein is hurt and hath stencht her self this thorough pulling causeth in her a fresh bleeding which bloud stayeth within and causeth no good And in case a sinew be hurt-in that Wound then this line must needs hurt the wounded sinew at the several dressings and stir it at this pulling or drawing which doubtless is not done without causing of great pains and thereby the worst simptoms are occasioned For these and many other reasons which I could alledge here I hold this thorough-drawings to be a very dangerous abuse and count the following way which I made use of far better as being an easier and slighter way causing less pains anâ— dangers in respect of simptoms Object It may be objected here that such cords draw out the filth which the fire hath left in the Wound and the Wound is throughly cleansed within It may do so but in respect of other inconveniences pains dangers whereby some Patients are quite spoiled I hold it for nought For Nature is her own best Physitian and desires to be aided in these things which are not contrary unto her and the matter burnt flesh bloud c. through Natures help separateth of its own accord and Nature ought to be helped herein with convenient meanes as you shall here hereafter Therefore the burning or fire being quenched then there is no more need but that Nature be assisted and that be expelled which the fire in the Wound hath spoiled the which is easier and sooner done through the following Medicines better than with all their thorough-drawings I must needs give a hint here of the cooling Ointments Abuses in the Coolers committed which some Surgeons prepare of Oyle and other shorty and greasie things Though indeed they do no hurt and in that respect I reject them not But there is one thing in the way at which I am offended and must needs speak of All fat things be they what they will grow hot suddenly and cool slowly Must now such a cooling Ointment be â—ut and forced into the Wound where the bullet sticks either in the bone or in the flesh whilst it is yet hot Surely that Wound must needs be more inflamed thereby Besides this will ensue also when such Ointments are poured into the Wound the Patient must endure the more smarting paines especially when the bullet is still hot warm in the Wound Therefore I hold it to be better to use means which cause less pains for it is usual that to pained places worse things are incident But where there is no pain there the Wound settleth the sooner unto rest As for the healing of such Wounds I will tell you what I found to be good not that there should not be other cures for them but onely that the courteous Reader may see that I and others have endeavoured to the utmost that hurts and dangers might be prevented and the good of all Patients promoted CHAP. XXIII How to cure Wounds made with Shot and how the Coolers are made and how the Saltpeter is prepared thereto THe first thing belonging to such Cures is that the bullet be taken out and I gave a hint of my meaning for it in the precedent Chapter and let it rest thereby Touching the burning and fire in the Wound to quench it you may note the following things First when the fire in the Wound is at the highest prepare an Ointment of Honey and not of Oyl or other greasie things spout it into the Wound three or four times or any other way you can best get it in and moisten all places within even the bullet also if it be in it Then take a Tent of Gum Tragadanth annoint it with the said Wound-ointment and thrust it into the Wound But if the Wound be shot quite thorough then you must use two of these Tents be they short or long as the occasion of the Wound requireth let the Tentâ— be thin and not thick that they may the easier be put in at last apply a good stiptick Plaister upon and take notice of its operation Then minister to the Patient of prepared Saltpeter Ê’ ss which follows hereafter in fresh Well water or according unto occasion sirrup of Violets or of Sloe-thorn floures minister to the Patient without delay of this you may give before you dress him the fire within will the sooner be allayed and quenched for outward means do not alwayes quench such fire inward things must be used In case the pain of this burning will not cease in two or three hours then undress the Wound and dress it again and let him have one drachm more of the prepared Saltpeter surely that burning will cease in a short time If it be not yet quenched then try the third time and be provided with a better thing In the mean while let the Patient drink Water let him not be opprest with thirst the raw Water is better than if boyled but things cannot alwayes be had in readiness If inwardly a Joynt or Principal part be hurt in the Wound at which you cannot come with the Medicine of such Wounds I will not speak here because they are usually mortal The greatest pain being gone then another Cooler may After burning be used made of Oyls or fat things as you shall find hereafter and that may be done safely onely my advise is not to meddle with oyly things at first for reasons spoken of before Note also that when all the fieriness and burning is gone Phlebotomy will be of good use in such places as the Wound will permit and that is to be done when the fire is quenched but if you do it before that then you do nothing but make the fire to prevail the more and get the predominancy for I found it so by experience In case the great pain and burning holdeth still and is not quite ceased and the Wound also doth not purge out its When a Wound it poysoned filth and groweth redder and redder round about the brim and the Patient be thereby the more weakened from thence you may argue that the Wound is fallen into a venomous simptom Now is it necessary to let the Patient have a draught of Aqua vitae described in the Chapter of Wound-diseases and let him sweat being well covered For what is such a Wound thus burned by Gun-powder but a venomous Wound And in case you cannot have the aforesaid Aqua vitae in lieu thereof take good Mithridate or Treacle and let the Patient sweat upon For I found it by experience that with such sweating the heat was taken off and quenched more than with the best Medicines outwardly applied the Patient may be thus sweated twice or thrice In the interim neglect not the Wound and dress it as it ought As Wounds are
not Abuses in Phlebotomy chuse but to declare some abuses committed by some Nations as in Italy and France in phlebotomy where they make many Experiments upon wounded men in stenching of blood and in doing other great feats For if any be wounded among them falling into their hands then the next day they open a vein and that without measure and knowledge not regarding how much the Patient hath bled already but what good they effect thereby may be seen out of this ensuing example where I was an eye witness In a certain place which for some reason shall go nameless I saw a wounded party which had bled very much and was brought very low thereby the next day came the Doctor which undertook to cure him who brought a Barber with him to open a vein of the Patient who had already lost too much blood that opened vein could not bleed because there was but little of blood in it and that little Nature reserved in store for to help her self withall This Doctor would needs have blood and seeing that that vein would not yeild so much as he expected he caused another vein to be opened whether that would satisfie his thirst after blood but little came out of it and the poor Patient died under his hand This is related here not to that end as if I would condemn Phlebotomy altogether for the defence of the wounds Phlebotomy not wholly condemned for I have seen more than once that Phlebotomy hath done much good to wounded men and fell out very well for their healing I onely related it to that end because it is used by some very indiscreetly whereby they did all manner of mischeif true they give some reason why they do so as namely in respect of a rheum which fals down from the head as they call it so will I call it also that it may not altogether fall upon the wounded side but may be diverted that the wounded party may be in the lesse perill Whether this be so I cannot tell nor can I agree with them herein for the symptoms of wounds take for the most part their cause from the place where the wound is and not from the head as I shall make further declaration of it neither are these symptoms caused by the blood but rather by the abuses that are committed amongst which this abuse also of the which I now treat may be numbered It is true Phlebotomy is used with great utility in all such wounds where the wounded have either gotten a Paroxisme of a Feaver or they fear one which may be caused either by frights or by anger Phlebotomy is used also with advantage when a party hath received a stab in the body and it is feared that there is congealed blood in the body in such a case Phlebotomy is not onely advantagious but also necessary when the blow given was done either by force or with a fall and the party bled but little especially in head Wounds which bleed but little Such Wounds are dangerous by reason of congealed blood which by this meanes may be driven out Here I must needs relate a custom which some have to expel congealed blood For when they have a wounded man in cure especially if his wound be in the body or belly and if they suppose that there is congealed blood there then they lay him on the ground with the wound downwards shake him to and fro even as a Butcher useth to do with a Swine in this manner they suppose to get the congealed blood out of the body all which is little to the purpose And if there be at hand a hot Feaver or other inflammation which is known by some signes of the which shall be treated hereafter there Phlebotomy may safely be used but it must be done upon mature advise for it is not good in all cases in some accidents it is good and in some it is dangerous therefore care must be had to be sure when it is necessary and when needless Many use Phlebotomy in all wounds without distinction little regarding the scituation and condition of the wound whether in legs armes joynts supposing to prevent hereby the Prunellain wounds known unto few but they effect nothing at all thereby for this rash and indiscreet Phlebotomy used keeps off none of these fore-named symptoms if the Wound be in a dangerous place then you must deal with it in another manner of way if so be you will be honest and get credit in the cure This also must be made account of that the lesse the wounded hath bled in the lesse perill his life standeth But this is considered little by many which are bluntly for blood Many do advise if a bleeding Wound cannot be stenched Many use Phlebotomy to stench blood easily then the Patient is to be phlebotomized in the opposite side and to let him bleed well for thereby the bloud as they perswade themselves will take another course and be drawn away from the Wound be the Wound never so big or wide and never so many veines wounded and the blood turned to the little and narrow mouthed veines opened But let them tell me what reason they have for this and whether this was ever done that a bleeding Wound was ever stenched in this manner Some reasons were produced in their answer but without any truth because experience sheweth the clean contrary This is true when the blood is thus inflamed and in this Phlebotomize when the blood is in an angry course his anger it taketh an unconstant course then through Phlebotomy this angry and impetuous course is in some sort allayed But without this anger I know not to what end Phlebotomy should be used unless it were to bring the Patient the sooner to the Church-yard For if a party were wounded in the four outer joynts and at each did bleed vehemently on what side must he be phlebotomized to divert the blood from the Wound In this case much more could be alledged and I rest to make any further relation of it of this I intended onely to give a hint that when in the next part of this Book I treat of the stenching of blood through easie mean and honest wayes and meanes thereby to overthrow these Imposters so the courteous Reader may the better understand upon what occasion I undertook the writing hereof CHAP. VI. What grosse abuses are crept in in binding up fresh Wounds with searching groaping grabling BEing already noted more than once how through the carelesness of Surgeons often evil and perillous symptoms are caused whereby afterwards are caused lameness-fistulaes cankers and such like therefore is it needful to shew what manner of abuses these are intimated by the word carelesness Having cleared the two head points as stitching and stenching of blood and shewed how grosse abuses are therein committed I will touch also other abuses which are as usually committed as the other The next unto stitching and blood stenching is
Bloud which forsook their natural places as veins turneth to water and if there be no great quantity of such water-bloud it will be exiccated by natural applyed medicines and quite expelled But if you use much of greasie things and many wet Cataplasmes as some Surgeons usually do it will not onely be to no purpose but also cause perillous Symptomes for such applyed greasie wet Poultesses force the congealed bloud to turn unto corruption What wil that prove but a dangerous Imposthumation which after a long time in great pains breaks if it falls out so well sometimes it turns to a Fistula or other Ulcer yea sometimes such anger is caused that death ensueth upon Thus much of this one thing more I add a pulverise Potion may be used here also it will hasten the healing and ease the Patient the sooner CHAP. VIII Of Synptomes which are incident unto congealed Blood to be expelled by inward means THings spoken of in the precedent Chapter touching congealed Bloud are to be understood thus they concern such parties that find themselves well besides the trouble they are at of congealed bloud In our language I know not whether any sufficient information is extant touching this particular and I think it not amiss to give some hints of it If congealed Bloud in the body be left there so long till Congealed blood in the body it turn into matter then the aforesaid means will not help as being too weak Surgeons either out of carelesness or out of ignorance let their Symptomes run on If in the side back breast or a vein be broken be it about the milt liver or any other part and that sprained or broken vein bled very much but that bloud doth not run into the belly but sticks between flesh and skin and is nearer to the inside than to the skin and makes little shew at the outside and may be nearer the liver or milt however it is betwixt the flesh and the skin and there it putrifieth and comes to ulceration this will not be cured nor helped by purging c. Reader understand it thus if nature be opprest by abundance of bloud or neglected by Surgeons of these we intend not to speak For nature is able to expel it of her own strength The four outer parts of the body may be opprest with congealed bloud caused by a fall throw c. if neglected or by Surgeons dawbing brought to ulceration then the things spoken of in the precedent Chapter avail nothing therefore other medicaments must be had of which I will give you a hint Note one thing there is but one process be the hurt from what cause it will either from the superfluity of bloud or the Patients carelesness or the neglect of the Surgeon I will be orderly in my instruction and tell you the best way how to help congealed bloud in the body which is turned into corruption if the Imposthume be not absolutely within the body but more to the outside and that befals the four outer parts of the body either through the Patients or the Surgeons fault Then if that congealed bloud begins to putrifie it may be Signes of congealed blood known by signes the Patient wil feel it at his side whether it will come to any Imposthume he may know it also by the matter he brings up whether in clots and stinking if so then that congealed bloud begins to putrifie Such a party must not be delayed but speedily be taken into cure for delayes will make it run on to an Imposthume which must break at last If it comes to that then the party is neglected and the help will come too late for Nature having once begun to cast up that matter then she must be aided As I told you above so I say still when these foresaid signes are apparent then the named remedies will availe nothing because the Imposthumation is too sturdy for them and goes on in growing For putrified bloud goeth slowly out of mans body infecting other parts as the lungs liver milt c. Besides a dangerous cough will be incident which will breed mischief mischief therefore other means must be thought upon Tonching my medicine I tell you thus if congealed bloud be in the body and that within the hollow of it then use not Mercury spoken of afterward Diaphoreticks are to be used But if the Wound was not into the hollow body and none of the inward parts is hurt then these things may be used which I will speak of If the case be such as was told now then first make a gentle purging drink of sirup of Roses to give the Patient two stools the second day minister to him in Ê’ ss of succus Rosarum 5 6 7 or 8 grains of the following prepared Mercury still regarding the Patients condition and let him lye still when it begins to work let the patient take some spoonfuls of broth and two hours after he may eat a broth into which two yolks of Eggs are beaten afterward let him take his rest and sweat upon This Mercury may safely be used if it fumeth up but once and that very gently according as he meets with an Mercuries operation object above in the body but it purgeth bravely by stool carrying away the congealed bloud and other filth though it had been an Imposthume it must go with a gentle stirring not so as usually precipitated Mercury doth If you are an Artist you wil prepare this Mercury in my way and you may prepare also somewhat of Antimony But Vitrum Antimonij is nought here by reason of its strong vomiting quality I tell you without Chymical preparations congealed bloud will not be eradicated out of the body if turn'd to an Imposthume The next day after the ministration of this purge phlebotomize the party provided Phlebotomie if the party cannot tell where his greatest pain lyeth then breath the Median of the right arm or open the Liver vein on the right arm if the party complaines of his left side then open the Spleen vein on the left arm This being Diaphoretick done and the patient is not wel yet as it fals out commonly then take the precious red Balsam of Sulphur whose preparation you find above in the Chapter of breast Wounds four or five drops of it and â„¥ 1 of the Aquavitae described in Wound-diseases mingle these let the Patient drink it and sweat upon This Diaphoretick may be used twice or thrice once a day and so long till the party be eased of his pains Thus you will do much good Reader this is the remedie I opposed such malignant and mortal Symptoms with True I have seen other process with Pills Potions c. whereby congealed blood is expelled but these waies were to little purpose I neither reject nor condemn the means others do use Mercury is thus prepared â„ž â„¥ 1 of Mercuâ—â—â—urged with salt and water taking away all his blackness â—â—d impuritie put it into a
be of very good use in Surgery as at the off-cutting of a member at the thickest part in the thigh and in two or three places more as when an Excrescence is to be cut off or other things well known to judicious Surgeons But that it should be of any use in wounds there I deny it absolutely and am fully perswaded that nothing but misery thereby is caused For as soon as the little white veines feel the heat of the fire they shrink presently grow shorter and may never be brought to their former length all judicious Surgeons must confess so much Unto which misery this is incident also or rather will ensue thereupon that a Wound thus burnt will never heal so soon and so well as those will which never had such things supplied the reason of it is known to many And ah how many Wounds are thereby inflamed and the parties lame when doubtless they might have done better In my youthful dayes I have been an eye witness how one received a Wound about his temple of four fingers Example breadth oh how was this poor man tortured with Corrosives with lighted cotten Wooll with nealed Iron and the like being thrust into his Wound and all to no purpose for the bleeding of it could not be quenched All these Surgeons being in a despair about their Patient whom they thus unmercifully tormented not knowing what to do any further in this case they wish'd the Patient to commit himself to God Almighty which however ought to be done without their grave advise when all their applied meanes would neither take nor work there came forth an old Woman laid some kind of haires on a leather and laid into the Wound a piece of lint or quilt and then she applied her plaister it stenched the blood and the Party was healed was not this old Woman more skilful and surer in her Art than all these Surgeons Barbers Doctors that were then present My self at that time being very young and unexperienced was ashamed for their sake though I had very little judgement that they professing that Art had so little judgement in it Some sixteen yeares ago there was a young man at B. Sharp oil of Marcasts is said to stanch bleeding which received hurt in his buttocks which did bleed very much which a Barber-Surgeon could not stench with his sharp bloud-stencher which in that place was held a Master-piece to stench it What do you think this Barber-Surgeon had done He took that biting oil of Antimony prepared with Sublimed Mercury dipt cotten Wool in it thrust it to the Wounds bottom this was such a rarity and secret skill that this young man out-breathed his last within few houres after for it most miserably tormented him who might have been very well saved if this Barber had not medled with him If I should rehearse all what miseries I have seen committed Intolerable miseries caused by burning by burning of wounds that did bleed though I have seen but little and have but small experience yet time would fall short with me to rehearse all and it would prove tedious unto the Reader to hear and read such a long tale besides I should but pull an old house about my eares if I should put them to the publick view and the rather because some antient Surgeons find some of the above named blood stenchings very necessary Therefore I let it rest hoping that judicious Surgeons will take my writing in good part and gather from thence that among the Antients there was great ignorance by misunderstanding as well as there is now adayes or rather more To prevent these abuses in my judgement there is nothing better to be used in blood stenching then quilts lints or mulli puffs cotten Wool or the like As for example if a Wound bleedeth and the cause of it is unknown then do not feel nor stir in the Wound nor apply any ointment but onely use a plaister but in case the bleeding would not cease then such said things may be used or any other fitting thing but if the Wound doth bleed but little in time when the Patient either walketh or sleepeth then bind it gently and apply the plaister where it bleedeth then you may soonest know from whence the blood cometh and if there be any loose or shatterd piece in it which causeth the bleeding being bound slack it casts up a ball or soft flesh like coam'd wool let it be gently press'd in again it is a sure token that there is a shatterd piece in it which is not altogether loose yet striveth to come forth where lieth a blood-vein which that loose piece doth hurt when stirred Now such like things being at hand no haste at all must be made with nor search made into the Wound for that search would put the Surgeon and Patient upon more work and increase the bleeding and the vein being deeply hid out of sight and no coming unto it would produce new troubles Therefore onely burnt Allom very subtilly pulverised clapped in and upon which is strong enough for it for if stronger or sharper things should be used they would through-run the Wound insomuch that the cure would be delayed where it had been almost performed That Allum must be let alone till it drops away or comes off by melting and in case it should not come out the next day then stray more Allum upon it then it will soon take away that flesh which hangeth on that splinter but in case that splinter should follow also and the flesh about it all consumed then that splinter hangeth yet on a panick which must come out also However proceed in the healing as if there were no such splinter therein it will loosen of its own accord the healing will put that aside even as an old tooth must give way to a young one even so the new flesh driveth out that piece at the wound easily insomuch that it may be taken away without danger Search not with any Iron or Silver Instruments into the Wound for if you touch any bone or crisle especially in such members that are full of them then that joynt will never take any flesh I give warning to all I have found it so desire no more to search it is a common saying amongst them because there are more such loose pieces in the Wound they will have them all out and feel and search in the Wound like a blind man It is a great foolishness to feel and groap about Wounds touch them with hard fingers without and search their inside with Instruments You Novices in Surgery when three five or more are called together to such a Patient suffer not the Patients Wound so rudely to be toucht for I speak by knowledge and not out of other mens opinions and know what hurt is done thereby CHAP. V. Of the Abuses in Phlebotomy how some supposed to stench bleeding with an example illustrated HAving begun to treat of blood stenching I could
distinction is to be had of a Summer and of a Winter Season touching heat and cold And I mentioned it onely for that end that every one may see that it is fit Surgeons should observe such distinctions about persons and still be regulated after the form and condition of things as well in the diet as elsewhere Touching the said diet some have that custom as soon Abuses in diet forbidden and commanded as they have got a Patient into their hands presently forbid him Wine Beer and all good Meats and make Decoctions for him which are very unsavoury and would make a sound body sick however some meats are forbidden as Cabbage Coleworts Pork and Bacon all manner of water Fowls and Fishes because these are of hard digestion and give no good nourishment to the body and such food is allowed which nourisheth well A certain Physitian forbidding all meats to his Patient was asked what his Patient should eat then He said young boyled Cocks he was laughed at What diet is good for a wounded party Use him like a Woman that lies in according to the custome of the several Countries and I declare it further not onely in general but in particular also as much as concerns eating and drinking Concerning the meats let the wounded suffer no hunger and what he hath a mind too let him have it in case it be not hurtful to him observing the sex age and climate of the Land as you heard above Neither ought the Patient to be forced to eat this and that which goeth and is against his stomack that Nature may not be opprest whereby danger would be caused And this must be observed when the Patient hath a stomack to eat For sometimes Patients have lost their stomack in such a case what is to be done Then endeavour to give him some Cordials to corroborate his stomack But in case the Patient will take none Then apply stomack-plaisters and use the oil of Nutmegs Mace I will set down how to make good broth for the wounded to strengthen his stomack withal Take a Hen or in want of that a piece of lean Flesh cut Good Pottage for the wounded it in pieces put it in a pot put Calmus Cinnamon and Salt to it as much as will season it lute the pot and let it boyl for three hours in a sufficient quantity of water at the opening of it you will have good broth pleasant to the Patients stomack or boil and roast such things as you shall think fitting for him Touching his drink wounded men being alwayes more His drink dry than hungry having lost much blood their Liver striveth to have that want supplied besides bloud is like a food to the Wound and drink generates bloud and the more bloud the drink breeds the sooner the Wound healeth Hence you may note that the wounded must have drink sufficient and let him not suffer thirst or keep him not too dry as some usually do for thereby mischiefs are caused as daily experience witnesseth But the distinction mentioned at the beginning of this Chapter ought to be well observed and let the drink be neither too hot nor too cold and not too much Salt to be used ye may permit him small Wine to drink which is very good for such parties especially when the party hath lost much bloud but no Wine is to be permitted if the Wound be mortal and in the head or any great Wound of the body be it inward or outward The same rule is to be kept in such Countries which affordeth but Beer Let the drink be what it will the Patient ought to be kept in a cool temper rather than in a hot in which case Barly water is of good use I advise no wounded party to drink great draughts at a No great draught good for them time for such hasty drinking oppresseth the Liver which is hot and dry and would prove no better then when oyl is poured into fire to quench it withall and thereby the Liver would be obstructed and hindered in her sending forth nourishment to the rest of the members as being opprest and hindered in her operation which would cause great inconveniences and a slime would settle about the Liver and choak her and being thus obstructed how can the veins receive any bloud and you may easily guess what the issue would be Touching other things the Surgeon ought to observe Hasty motion hurtful that the Patient do not stir and move too hastily whereby great pains would be occasioned unto him as the Gout Falling Sickness Feaver Cramp Inflammation and such like are caused by such violent motions chiefly let wounded parties not practise Venereous lusts whereby the worst accidents are caused A Surgeon observing all these things carefully then there is hope by Gods help of good success in his Art for the good of his Patient and the Patient also ought to behave himself accordingly For all dorh not lie in the teaching but in the learning also For if a Patient be unruly not caring for the Surgeons instruction but fall on gourmandizing and drunkning then no good is to be looked for because the Patient refusing all natural helps like a Swine trampling on Pearls cannot expect any cure and the Surgeon looseth his credit and reputation and all his pains he bestowed will be in vain CHAP. IV. Of three accidents commonly befalling wounded men a weak stomack a stoppage in the urine and not going to stool how these are to be remedied WOunded men are subject unto many Diseases as Experience sheweth among the rest there are three things which commonly befall wounded men First a Patient that hath lost much bloud hath a weak stomack which keeps not his meat nor digesteth it but vomiteth it up whereby he falls into great danger and the Wound shuts not nor is it fed naturally and the healing is put back Besides this his urine also is stopt and can hardly make any water whereby inflammations and other mischiefs are occasioned Lastly the wounded are bound in their body cannot go to stool and this usually befals wounded men whereby gripings in the belly are caused these three accidents must be helped in the following manner Touching the stomack to help him to right that he may To help the vomiting keep his meat make use of this following Receipt Take Mint Wormwood ana M 1. Ginger Calmus and Nutmegs cut small anaÊ’ ss boyl these in Wine and Water for an hour together then take a great sponge or in want of it a four doubled cloth dip it in the foresaid boyled liquor press it out again and apply it hot to the stomack his vomiting will be stayed this must be iterated twelve times a day and will cause an appetite Vomiting is not very dangerous and is stayed sometimes of its own accord and is not much to be regarded unless it hold the Patient vehemently then is it time to help him Touching the stopping of the urine
the following Receipt To help the stopping in the urine I made use of with good success Take Annise seed â„¥ 2. put it in a pewter bottle pour Water to it lb 1. keep it stopt and boyl it in a Kettle full of Water in this Annise seed water dip a sponge apply it to the Patients privy members as hot as he is able to endure it this provoketh urine And if this be too weak and doth not prevail then the Receipt must be made stronger thus â„ž Annise seed and parsley seed ana â„¥ 1. Maiden-hair M 1. Berberries Ê’ 1. boil these in Vinegar and Water to one pint of Vinegar put three quarts of Water boil away a third part of it and use it as you heard above And if these outward means will not help and the Patient is pained in his Urine then inward meanes must be used Viz. Maiden-hair Alkekengi oculi cancrorum take a sufficient quantity of these as of Maiden-hair â„¥ ss of Alkekengi or Winter-cherries â„¥ 1. lay it in the Patients drink and let him eat the Oculi Cancrorum doubtless it will provoke his Urine in case outward means be used also Touching his going to stool this is not much to be set by To help him to stool especially when the wounded ought to lie on bed but if he hath no stool in three or four dayes then is it time to look to his back dore Some think to remedy this with purging but in my judgement it is not good it is alwayes accompanied with danger especially in head-wounds it is better to make Suppositories of Honey and Mice turds mingled with Salt and if that will not help then make a Glister of Mallows oyl of Cammomil and flesh-broth and put Salt to it and minister it and if that be two weak then â„ž Electuarium Diaphenicum â„¥ ss oyl of Cammomil â„¥ 3. Mallows â„¥ ss beaten pour on these a quart of Water Flesh-broth were better or Goats Milk stir it well about apply it neither too hot nor too cold you will soon see the effect of it you may put Salt to it if need But in case the wounded should be purged then the safest way is to make a Potion of Sene leaves and Rubarb and minister it Thus much of those three accidents usually befalling wounded men sometimes other Diseases are incident also which are to be remedied as there is occasion for Of other Simptoms which happen unto Wounds shall be treated in the next part of this Book where I intend to write of them CHAP. V. How a Surgeon 〈…〉 himself about his Swathing-bands and other Manuals ALL manner of Arts being invented through experimental knowledge and exact observations and even till now dies diem docet one day teacheth another I hold it a thing impossible considering the brevity of mans life that an Art can be so exactly learned but the after-comers find somewhat more in their practical part and so it is impossible to set all down what belongeth to Surgery As much as is known to me I will communicate in the following Chapter Note the dressing of a Wound is of great concernment to handle it well and to use and take notice of advantages which some little regard and dress their Wounds without any difference or distinction whereby they effect this that they lame those which could be set upright if they had been honestly look'd too Sometimes it happeneth that neither the Wound nor the Medicine applied is in fault but the fault was committed at the dressing A Wound may be furthered in the healing if well drest and bound and a Wound may be spoiled in the dressing and a lameness caused as when a wounded member is bound too hard then is a swelling caused the Wound is choaked having left no vent to help it self and to receive any life yea I say this that if a Wound were onely kept clean and duly dressed it would sooner heal than if all the Art of Medicine had been used and all the Poultesses applied to it Seeing that binding is of great consequence therefore Take notice of the binding take good notice of all the parts of the body and chiefly of those that are dangerous in some Wounds there is great danger in some there is less and that according to their places And observe exactly the Wounds on the Shinns Knees Cartilages Armes Hands and where there is any joynt for those are dangerous require great care by reason of unhappy Simptoms which easily fall i◠〈◊〉 Touching other Wounds in the point of â—â—ck Sides Neck Throat and Head those also must 〈◊〉 looked to but require not such exactness in the dressing and are for the most part dressed so that the Medicine applied may not fall off There are some Wounds also with a flap hanging down which require a careful dressing Those that have undertaken Surgery must have a care to be ready and have in readiness Salves Plaisters and other Surgeons must be ready at all times necessary Medicines well prepared that at what time soever any Patient be brought to them he may find good counsel and present help and not to tarry for their readiness or stay till they make and prepare something which tarrying would prove hurtful and prejudicial to the wounded by reason of his bleeding and other disturbations for the readier you are to dress him the better the healing prospereth and the more credit it will be for you And when any comes to be dressed you ought to endeavour to be ready with your Medicines Plaisters Salves Lints Roulers that the Wound be not kept long undressed and be speedily covered and closed And that must be observed for that reason that the air be Air hurtful to Wounds kept out as much as possible it may for air doth hurt to the Wound especially air is contrary to veins sinews and joynts usually causing cramps and stitches and the room in which the Patient is dressed ought to be kept shut and closed to keep out the air and wind A Surgeon ought to be careful that he breath not into the Not to breath into Wounds Wound especially when he is yet fasting and is to turn away his mouth from the Wound or ought to put a cloth before his mouth if need for such breathing may cause that a water may stick to the Wound and incline it to a rottenness But this is chiefly noted in Head-wounds when the Pan or the Dura mater is wounded for then it is dangerous Some Surgeons have that custom at the dressing of The blood in the Wound is to be let alone Wounds that they wash the bloud out they find in the Wound thinking it to be done very well freeing it from uncleanness and this they do at the first dressing But it is an abuse and a thing contrary no bloud should be washed out of the Wound but let it be there if settled for a congealed bloud in the Wound is no hurt unto it
and is rather beneficial by keeping out the air which otherwise would hurt the sinews and it hinders the bleeding of the veins which they would do if the congealed bloud be wiped out it takes away the flesh for it is a right flesh-glue exceeding a Sarcocolla and it healeth other Wounds if used much more that where it lieth and it furthereth the matter in the Wound and hasteneth the healing and though it were not so yet it breaketh forth gently without any pain and that of its own accord from beneath upward therefore in that particular molest and trouble the Wound no further as to wipe out the bloud An honest Surgeon ought to have care of wounded joynts be the Wounds great or small and observe a distinction in their dressings and bind them not too hard a small joynt must not be bound so hard as a great one it cannot brook with it A Surgeon for the general ought to endeavour to order his bindings so that the Wound be kept together and the joynts in the hands ought to be dressed and bound commodiously whereby lamenesses are prevented Touching the binding it self how it must be performed Note the manner of binding note thus No joynt neither from above nor from below must be bound in the beginning but let it alone otherwise the bloud is driven inward or down which would cause a putrefaction and an inflammation but that binding must begin in a convenient place either higher or lower then the joynt and that very gently thus dangers will be avoided and swellings prevented which in Wounds commonly appear The Swathing-bands must be made choice of also for all What swadling-bands they must use do not fit nor are good for it For a Wound that is to be dressed requireth that the swathing-bands be soft and keep asunder that they may lie on the closer such swathing-bands are best made of old and worn linnen because they are very soft yeeld the sooner being retched and pulled lie close on keep the Medicine the better to the Wound and cause no trouble nor molestation But such Swathing-bands which purposely are woven with two selfedges or such that are hemmed on both sides and ends these are altogether unfit for Wounds because such hems cut deep prints into the flesh Thus much of the Swathing-bands more could be said in that behalf but to bring in all what could be said would be too great a labour He that desireth more let him advise with Experience which is able to put a Knighthood upon him CHAP. VI. Of Head-wounds what behaviour the Surgeon is to be of both toward himself and toward the Cure NOw it is time to come to the Wound it self and to describe As the Wound lieth so it must be cured the cure thereof as it ought to be hitherto I swarved round about Here great care ought to be had about the condition and distinction of it For as the Wounds lie distinctly so they must be cured distinctly and as the one part of the body is stronger than the other so the Medicines must be prepared accordingly For a Head-wound cannot brook with such strong Medicines as a Wound may in the leg and a Wound in a joynt cannot endure such great clotter as that which is in the flesh these things ought to be observed and more shall be spoken of in the following Chapters And I will begin with the Wounds in the head I know what order I ought to keep in their description namely first of the slighter Wounds afterward of the broken Skull and then of others also and to speak of their several cures But this order I do not observe for that reason because they are cured almost one way Therefore I will write onely of dangerous Wounds of the head where not onely the skin is broken but the Skull also and such like For he that can cure such a dangerous Wound truly he will be able to cure a slighter Wound This used order serves to shew how dangerous Wounds are For to say they appear clear and clean but afterward they cast up loose and shattered pieces of flesh or bone and one thing or other appeareth and so I regulate my self accordingly in the doctrinals touching the Head-wounds and shew the meanest and safest way to heal them as Nature alloweth and Experience bears witness All Wounds in the head are dangerous commonly they bring death along by reason of the many and heavy simptoms they are subject unto as there is the Cramp arthritick or Palsie Apoplexie and many more and especially are they dangerous when the pan or scull is broken and more dangerous are they when the skin of the brain is hurt and wounded and most dangerous it is when the brain is toucht as it fals out sometimes Therefore a Surgeon ought to be the more careful and the wounded also must not be wanting to himself For where wood and field as they say hold together commonly a good year comes after Therefore the Patient must be ruled by the Surgeon and though the meanes used are somewhat rough yet he ought to consider that Malus nodus malum requirit caneum The Surgeon is to observe that he govern the Patient with a good diet as the condition of the Wound requireth as you heard in the precedent Chapter Touching his speaking the Patient ought to be as sparing in it as possibly may be and if he speaks let him speak softly and the room he lieth in must be kept quiet and still And the Surgeon must place the Patient orderly in his lying especially when the Wound is dangerous then the Patient must be ruled and lie still in his bed lie high even as if he were sitting the higher the better and that for reasons well known and the chamber must be kept dark for quietness sake If a wounded party be brought unto you dress him quickly thus Cut off the hair round about the Wound in case the Wound bleedeth much that the bloud may the sooner be stenched and danger of death be prevented the hair being cut off stench the bloud with Cotten-wool or with lints as you shall hear hereafter and then dress and bind him as it is the fashion But in case the Wound doth not bleed as it fals out sometimes or onely weepeth then there is no need of bloud-stenching but lay a Head-plaister to it after the manner of an Opodeldoch so that the Wound be covered broad and well every way and then lay a soft bolster upon and bind it that it do not fall off All this must be done quick and nimbly that not much of the air come whereby inconvenience soon is caused if the dressing of the Wound be delayed And the Surgeon ought to dress the party in a close chamber especially at the second dressing to keep out the air because air endangers the Wound as you heard already the chamber also must be warm according to the years season for cold is hurtful to the
are dressed And if there any bone be loose then take it out but in case it hangeth yet and sticketh inward then raise it outward again with an Instrument into his former place Let it stand so use convenient means and let Nature provide for the rest I know she will not be wanting unto her self CHAP. VIII Of the Head-ach after the Cure and how that is to be helped How to make the subtile Head ointment with remarkable examples of Head-wounds cured Head-ach after the cure of a Head-wound IT happeneth sometimes after that a Wound hath been fully cured that the Patient after two three or more dayes or after so many weeks feeleth pains in his head and the same pains do increase more and more and many die of it for all Surgeons do not understand the cause thereof and how the same were to be helped of the which I will inform you here First when a Head-wound is healed and riseth after the When a Wound doth swell after healing healing and swelleth and is very painful then lance the Wound presently for it signifieth that some splinter would fain be out and if you do not open it then the matter would make a mighty great hole and break out in another place which would cause many simptoms and troubles and the blow would come on a fresh therefore look you give vent to that matter and when such things are opened then the plaister will draw out the splinter together with the matter bloud and water and if you think it good you may let him use an expulsive vulnerary potion then the Wound will be cleansed and cured Secondly look well to these following signes if the Patient complaineth of great pains feels great prickings in the head and these smarting pains increase more and more and cannot endure to be toucht in that place where the Wound formerly was yet no swelling nor rising of the skin appeareth as you heard formerly then is it a sign that within the scull there is a splinter which hangeth inward and causeth these prickings in this case that place must be lanced instantly and the splinter must be taken out as hath been said Thirdly In case the Patient complaineth more and more after the Cure not onely of the place where he was cured but all his head is panting and broyling accompanied with extream pains This is a sign that congealed bloud is gathered under the scull and is turned to an Imposthume And if his eyes be swelled and some bloud and matter runs out of his nostrils then is it a more sign of it This infirmity may with Gods help be cured easily as hath been said already Viz. Cut off the hairs in the place where the pains are lance the skin cross way to the scull in the breadth of half a Crown and put back the four pieces that the scull be naked then cut with a Raisor or other Knife a Wound into the scull open it that you may look into it then the matter will start out against ye and the Patient will be eased and if there be any splinter at hand you may easily see it and take it out as you have heard before This is the onely way to help such a Patient Such Wounds now made are soon healed again onely govern the Patient well as is fitting and as I have informed you before You must lay nothing to his brains as I told you afore for the brains will expel the things of their own accord when they have a vent for it without any further help and suffer not any strange matter to stay or abide there Touching the cutting up of the scull note that there is Note the cutting up of the scull no difficulty in it and is done easily and quickly For the scull gapeth and openeth if there be any splinters or little bones there therefore with a little help those small bones may be taken out onely look narrowly to it whether there be any fracture at hand for you may easily discern whether a splinter within goeth down and inwards or whether there be any more of congealed bloud there But if you find after the opening of the skin neither fracture nor scissure a hundred to one but there is and however you are sure that the scull must be opened be it either by reason of the congealed bloud or by reason of an Imposthume take a well turn'd sharp borer and bore thorough the scull at the place where the pain is then the matter will startle out and when the place is almost thorough bored then work gently and look well to it that you cause no small bones with the boring to fall into the hollow of the head for if so then you will find somewhat to do and not without danger In this case some will have though I never had need Another way to open the scull of that when the matter at the first opening doth not appear then another hole a fingers bredth from the first is to be bored and then to cut both these holes into one and so to make a Wound into the scull into that made hole you may see with a lighted candle in a dark place and understand the cause if you find then either congealed bloud or a swelling then touch it onely a little with an Instrument as soon as it feeleth vent it will soon come forth at the Wound I should like this way well enough in case any splinter or loose bones be there But it is your duty to study in what manner it may be done most fitly and conveniently as the condition of the case requireth and to regulate your self accordingly For it is impossible to set all down in writing onely be mindful of the vulnerary potion as you shall hereafter hear of Before the close of this matter I will tell you how you shall prepare the Head-plaisters and the thin ointment so To make Head-plaisters often mentioned hitherto Make the Head plaister thus â„ž Of Wax â„¥ 8. of washed Turpentine Ê’ 4. of oyl of Roses â„¥ 2. of the juyce of Bettony â„¥ 6. put all these into a pan let it boil let all the joyce boil away when the other are melted then take it off the fire and put thereto pulverized Colophonium â„¥ ss Mastix Frankincense Myrrh of each half a drachm this must be continually stirred till it be so cold that you may touch it with your hands then work among it Oleum Storacis CalamitaeÊ’ ss make it up into rouls and keep it clean for use This plaister cleanseth Wounds leaves no unclean thing in them and is pleasant and proper for the brains and the whole head Therefore use it as it ought it will not deceive you and doth better than Oyls Aqua vitae Waters Salves as you heard above I will teach you another Head plaister which is yet better â„ž Wax lb 1 Turpentine â„¥ 6. melt these together being well heated pour it into Rose water let it
as the strongest onely taken lb 3. boil these together for half an hour and then set it in a warm place for three or four dayes then put it in a coated Retort set it in the open fire let your first fire be gentle and draw all the Vinegar into a Receiver which being done then increase the fire so long till you see red drops coming which must be received a part and still increase the fire so long till nothing comes It s true you will get little enough but as little as it is as great vertue and efficacy it hath not onely in the Eye simptoms but also in other things which in its due place shall be spoken of I know these things according to this process may not be had every where and in case these things could not be had timely enough then other things as good as they may be had must be used for in case of necessity means present are not to be refused and I allow of them if so be the Eyes be not killed or otherwise spoiled In the last place note in case the eye-lids hang over they must be stitched A certain Merchant was cut over the Nose and one of his Eye apples was hurt also that Wound was cross the starre That party next God was helped onely with this red oil of Lead or Lethargir Another party received a splinter of wood in his Eye where it stuck two grains deep in this oil onely recovered his Eye Another party spoiled his Eye unawares with a sharp wood a Surgeon made experiment on him with the white of Eggs and Bole whereby the Eye was killed and when there was no more hope left half the Eye was loosened and the skin of it wrinkled To the party I being called used my Medicine you heard of and put of the red oil into the Eye he presently felt ease and the eye was perfectly cured but onely it was not so clear and a spot staid in it and I am perswaded if I had been with him at first I could have cured his Eye without defect For good men and womens sake I will teach you how To heal Wounds not leaving a scarr behind Wounds are healed and leave no scar to be seen in the face or any where or else they shall hardly be discerned Here I except such Wounds that were stitched and where the bones were shattered and where veins and sinews are hurt I speak onely of such either great or small Wounds in the face or elsewhere that are not very deep and where the skin onely is broken â„ž Good Aqua vitae drawn twice or thrice lb 1. put it in a glass body put thereto bean-floures â„¥ 4. which must be dried a little cover it with a smooth parchment lute a head to it set it in luke-warm Water or in Balneum Mariae as deep as the glass is filled lute a Receiver to it let it stand there so long till you see drops of water lie on the parchment then open it that which is in the Receiver keep in a glass apart well stopped that nothing exhale Whilst the body standeth in Balneo apply cold wet clouts to the head and another clout on the Receiver that the spirits of Wine may cool and resolve into drops At the using of it take the single threeds or ravellings of linne wet them in this Water cleanse the Wounds with them let it lie in the Wounds lay a fine soft boulster on it and bind the Wound close that no air come into it thus the Wound must be drest twice a day at the healing no scarr will be seen Use no other Salve nor Plaister else this Secret will do no good you need not fear that the spirit of Wine will burn much in the Wound you may safely use it CHAP. X. Of Wounds in the Throat and Neck how a Surgeon ought to deal with them AFter the Wounds in the Head and Face follow the Wounds in the Neck and Throat of them I will treat now Here as I have told you before I do not speak of slight and small Wounds but of dangerous ones where partly the great bloud veins are hurt when the sinews of the Neck and the Wind-pipe or the like is wounded my information shall be according to these hoping that he who can heal such Wounds may heal also those which are less dangerous Now to speak of these two sorts of Wounds first note Neck and Throat-wounds are dangerous that these are very perillous and subject to all manner of simptoms by reason of the exceeding great pain and such things are incident viz. Cramp Palsie Apoplexie Wound-consumption and such like and so they must the more wisely be dealt withal and I will give a particular instruction of each Wound because there is some distinction to be observed and in the first place I will speak of the Neck-wounds As I have informed you formerly that as I do not mean Neck-woudds here any slight Wound so on the other side you must understand that I mean not such Wounds where all the Neck is in pieces for such Wounds surely bring death along and are incurable But here I speak of all such Wounds when the Neck is hurt grievously Note also that the Neck dependeth from the Back bone and hath great affinity with the Brains out of whose hinder part runneth a marrow along like a rivelet through the Neck and Back bone Therefore all what I tell you here of the Wounds of the Neck the same you must take also for the Wounds of the Back bone for these are cured all one way Therefore the things spoken of above may be drawn hither Therefore as you have heard above you ought not to Neck-wounds ought not to be stitched nor tented stitch Wounds in the Neck nor to put a tent into much less ought you to search and to sound them with any Instruments how deep and how large these Wounds are whether stabb'd or cut do not sound them let the depth be what it will never trouble them else you cause all manner of sorrows and dangerous simptoms and so you make the last worse than the first was Proceed thus First stench the bloud as you shall hear The true proceeding and having removed the Bloud-stencher then take a good Wound-ointment which you shall find described in its due place in the Chapter of Wound-salves make it luke-warm and pour it into the Wound then apply a good plaister upon be it a stiptick one or an Opodeldoch and cover it with a defensive Plaister made of Beans which must guard the Wound round about This Plaister when there is great pain at hand must be applied fresh several times Have a care that the lowermost Medicaments which lay next the wound do not cling and stick to the defensive plaister therefore betwixt the lowermost and the other lay a cloth on which do ye rest the defensive Plaister But in case the Wound be not pained
condition of the Wound be what it will you must note first a party being wounded at the Breast commonly there cometh a wind out of the Wound which is like unto mans breathing here you must have a care for that is from thence observed viz. In case an internal part is wounded then there is a remarkable sign accompanied withit For if the Lungs or the Signs of internal parts wounded Midriffe which distinguisheth the Lungs from the Breast is wounded then is the Patient troubled with a continual cough and there appeareth a scum in the Wound and the Patient is full of pains and can hardly fetch breath if the heart be wounded then no remedy expected of which I say nothing more for the party dieth presently for no Art nor care will avail here however be not wanting on your side dress his Wound as Wounds of Lungs usually are drest Of the same conditions are other internal wounded parts And in case the party be quite run thorough without hurt to the internal parts yet that Wound is to be judged and undertaken as perillous and mortal For though none of Back-wounds are a cause of lame members the inward parts be hurt yet it may be that that thrust hath hit some of the white veins or sinews on the back which is dangerous by reason of the affinity they have with the Heart It happeneth many times that when a party is wounded in the Back that he fals lame either in his hand arme or elsewhere where no defect at all was which is caused onely by those white veins that are hurt Touching the cure of such Breast-wounds I intend not Breast-wounds â—â—red to give any other doctrinals herein but what hath been made known at the dressing of Throat-wounds Onely concerning the defensive Plaister that may here be omitted unless the Back bone be run thorough also and great pains are felt caused by the hurt sinews Therefore as I have informed you in Wounds of the Throat what you should do touching stitching so you must Stitching is permitted note here also that Breast-wounds are to be stitched and the stitches drawn strongly together cross-way yea you may use twisted stitches because they go easily asunder by reason of the breathing which constantly is against it whereby they are forced asunder And whereas breathing hinders the vapours and the air the healing therefore the Wound must be stitched as close as possible may be After that use no more but the green Salve which enforceth the healing then lay the Magnetick plaister upon and bind it quickly care not what course the matter taketh or which way the bloud runneth for it ought not to have any vent and may get perhaps more vent than the Surgeon shall well like of Bind it well with warm clothes but not too hot else it would incline to a fistulo neither use any Tents and above all search not with the Iron in the Wound which is a cursed custom In case the Wound be so great and so wide that it cannot be drawn together and stitched but it will keep some vent Stltching when disproved of then omit stitching altogether because such stitches would break out and burst asunder by reason of the breath which if it hath but a little passage it presseth more vehemently against the stitches as when the Wound were more narrowly closed In such Wounds use neither flat nor round tents but onely put in your Tent-ointment and then lay your plaister upon Take heed of flat and round tents on for the wounded parties breath being drawn would strongly draw also the Tent into the body and the Patient would bring great misery upon himself and cause his own utter ruine because that indrawn Tent must lie on the Midriffe or Diaphragma and rot there and indeed no wick or tent is fit to be used in these Wounds Note also that cold and warm dressing is dangerous and Cold and hot dressings are dangerous hot dressing is more dangerous because it causeth infallibly a putrefaction as experience sheweth For many suppose that hot dressings and hot Medicaments were best but the contrary ensued upon as hath been known Therefore a medium is best in all things let it be neither too hot nor too cold If you undertake to cure a Wound which cannot be stitched then use a strong Bloud-stencher unto as you heard How to dress breast wounds that cannot be stitched above and more of it followeth after and at the taking off the Bloud-stencher and at the dressing again all necessary things you ought to have in readiness as I told you above that the Wound be drest nimbly that the parties breath may not pass much thorough which would be very hurtful All this must be done in a dark place and sharp rough air be kept off Have a great burning Candle by the hand you shall Air hurtful to the Wound see that the breath that cometh forth out of the Wound will blow out the Candle Hence you may gather that such Wounds are endangered if not quickly dressed and a care must be had that the Lungs draw not into the body the rough air for if you suffer this to be done the Patient will never be recovered Breath if it gets but a little passage and is warm it causeth moist vapours whereby are caused internal Fistuloes and hot feavers Internal sistuloes hot feavers with the loss of understanding and sense and so all natural means lost Therefore use such Plaisters which stick and cling easily and suffer not air to come by and use such stiptick Plaisters in manner of an Opodeldoch or use an Opodeldoch which is very useful in such cases By these things may easily be gathered that Cataplasmes Cataplasms of no use which in such cases are too much used are useless altogether for they are too weak and have no power to oppose the air and breath and besides they are too moist and so they further putrefactions I know that there are many which will not like my manner of dressing no more than I like other mens dressing for some may object saying if a Wound in the said manneâ— be stitched and closed whither runs the bloud Doth it not run into the hollow of the body where it may doubtless cause great troubles and miseries Answer For the taking off of this doubt note Dayly experience witnesseth that Breast-wounds which can be thus stitched have no where such danger as those which cannot be stitched and it is known that that which is inwardly hurt sooner healeth because no air troubleth it than that where the air cometh to it For the air in the hollow of the body is judged mortall and deadly Touching the bloud which you say runs into the body troubleth me little For Nature which alwayes endeavoureth to help her self turneth that bloud into water which if good and fit means are used may be expelled by sweat and urine It may further be objected Whether runs
member keeps very warm under that plaister and counted it Gods blessing For I shew you hereafter how I used it and did much good with it For it was my Fracture-plaister to all beaten broken and swelled members When I name my Plaister then you must understand this Plaister or mine unknown Plaister that you may know also what Plaister it was I used to such Wounds and hurts The swelling and pain being gone and the member able to endure the annointing then with all speed annoint it with Dialthaea I alwayes carefully used my Ointment against shrinking which I wiâ—l shew when I speak of shrinking For though no shrinking appeared yet I still feared and prevented it with the Ointment before any exiccation came and whilst the member was yet swelled I did use no cooling Ointments but warming ones I had made a Populeon which I kept twenty five years not that I contemned the Ointment but I never used it I alwayes used Vnguentum Dialthoea to wounded Members understand me well I do not write now of imposthumes sores and other inflamed hurts but of all manner of heats in Wounds for I alwayes supposed that such heats do not come from the heat of the Member but from an accident which ought to be prevented then the heat goeth soon out of the Member wounded For I have often seen that when they thought to resist the heat outward as with Goats milk in which is boyled Vinegar Leth argyre Salt and Water some took also Sallade oyl and Lie some took Nightshade and Housleek and others what they pleased I am not against it but I never used it for I supposed still things outward may not hurt the Wounds your care must be onely first to bring the Wound to right then other means may be used for the rest and I thought still also it may be the Member hath bled too much and wanteth warmth and if there be any heat it comes from the pain of sinews and other accidents For that reason I used no warming things for I thought if I use warm things then the bloud is gone and warming things will bring other bloud into which causeth runnings and usually Imposthumes which I know experimently and these Imposthumations have done much hurt to the Members and caused great pains which terrified me so much that I would never use any warming things as usually Cataplasmes are used of Lin seed Fenugreek Walwort c. and applied warm and dipping of Bolsters in warm Wine and Balsam oyl poured into the Wound I must confess I used such things also three years together but I gave them over and took my other things in hand and used neither hot nor cold onely made use of Dialthaea and used it onely luke-warm There were many times found about the Wound Blisters Blisters Wharts about Wounds and Wharts which were caused by the hot dressings and sometimes the salt Flegm of the Patient hath been the cause of it in such a case I took onely my Vnguentum which I will describe moistning it with a little Vinegar which soon healed it And when any proud flesh appeared and one place grew Proud flesh sooner and higher then I used burnt Allom let it be there till it fell off of its own accord and if need I used it once more if not I let it alone To comprehend all in one about Joynt-wounds consider these things Viz. Fill the Joynt-wound with Vnguentum dress and bind it well let no air come into bind it nimbly neither too hot nor too cold nor too hard keep it quiet seek and search not in it keep it pretty well open thrust nothing between onely one vent above for a passage of the Ointment and another below let not the Patient drink much Wine prepare and make all things ready before you undress it and let not the Member hang down Neither take out any shattered piece unless it be quite loose and in case a bone be cut thorough in a Joynt-wound and yet it sticketh to the sinew it must not be cut or digged out as some use to do but rather set it into its right place let the work be done by the Lords blessing and the Medicine Therefore pull out nothing unless there be great cause for it for these will not be obstructive unto the healing nor cause pains consider the things well at first feel not in the Wound like a blind man especially if you go about to cut or loosen any thing in the Wound and stay for the occasion some dayes as long as nothing is yet neglected and though healing goeth on the more slowly yet is it the more convenient and safer I was called once to a Patient whose knee-pan was cloven Example whom another Surgeon undertook to cure and would needs shew his skill on him he loosened the knee-pan thinking he had done well But what happened after the pan was taken out The pan feel asunder and looked most ugly for he could look into it afore well enough and gaped so farre asunder that two fingers could be put in not touching either side This Knee put me and that Shaver to great troubles before we could fill up the place with flesh for the Joynt-water gushed in so fast that all Medicines were thrusted out thereby at last it was stayed by the brown Ointment and a good Opodeldoch the place was filled out with flesh and the Patient by Gods help cured But he was halting on that leg and I am confident if the knee-pan had not been taken out he would have been more perfectly cured without any defect I will quote another example In my travels which I undertook Another Example for to get knowledge I came to a Surgeon who was famous and expert man who undertook to cure one in whose Hand a bone was dislocated and seemed to be quite loose and the Surgeon held it to be so and went to take it out but it stuck so fast yet to the sinew that it came not so easily off as he first supposed and so he thought to loosen it quite but the Surgeon lost almost all his credit by it because he could do so little good upon him For when he cut off the sinew he caused such lamentable pains to the Patient that he was not able to have it handled any more and so the Surgeon was fain to let the bone alone and dressed the Wound and cured it but that bone was not healed to the first place of it for after healing it was moveable however it was no hinderance to his hand That Surgeon afterward told often that he could not have gotten out that bone without cutting of the sinew which would have caused a lameness to the Hand which in this way was avoided By these examples you may see how perillous it is to take any small bones out of a Wound that are not quite loose Note by these Joynt-wounds a Joynt being in the said manner wounded then the Joynts stand loose
the mindlemost I made the first knot then I could see how it would fit whether there be too many of the splinters or two few and placed them as I saw it fitting then I laid the uppermost band where I could see the better whether it would be too much or too little that knot I pulled hard together because it will still yeild and slacken at last I laid the lowermost band then commonly the middlemost was tied too slack which I opened and pulled it as hard as I thought it would hold the Fracture without hurting the Joynt and the Fracture be kept from stirring These three bands hold the Fracture and if dressed and bound otherwise it doth no good Thus much of splinters A Surgeon ought to have two roulers or at least one Of the Roulers though there be no need of them yet they must be had in store and great pieces of spread plaisters seven or eight and a number of all sorts of splinters short long crooked and plain ones for to flap-Wounds you must have several sorts according as they are made Roulers must be made not too broad and must run with the threed or Wool and cut with the threed or tear them after the threed which is best and cut off the ravelings for some of them have hindered me much in the same manner you must cut even the plaisters and the splinters all the sides along for the smoother and plainer a thing is the better is it handled nor let the linnen be wrinkled or plated nor the plaisters neither and apply them plain and smooth and apply the plaisters straight for they will slacken fast enough when the splinters are pulled together wet your finger either with Water or with a little of the Ointment then the Plaister will not cling to your finger Then have a long Rouler at hand with two other ordinary Roulers as also five smal pieces cut from one end of the piece to the other and have your Surgeons box filled with necessaries viz. Raisor Spatule Sheers keep the box clean that you may in nothing be hindered have in readiness also a good piece of plaister in a box of Tin or Copper which being hard you may fling it into hot Water to soften it Have a good Knife also about you in case you have need to cut the splinters to a fitness also a Sponge and a threeded Needle and a piece of lint Besides the great Plaister which must be spread broad and thick you must have many smaller pieces whereby you may fill up places if need Therefore spread alwayes more Plaisters than you think you shall have use for Item Be provided with Stitch-plaisters bolsters or bags filled with chaffe Provide also Fracture plaisters of the which hereafter is spoken and spread it on a strong cloath broad and long according to the bigness of the Fracture and you must be provided also with ordinary Plaisters made of two parts of Wax one part of Turpentine and one part of Suet and spread them thick and broad as the first Plaisters are lastly you must have in readiness also broad linnen as you shall hear all these things named are necessary for to dress a Fracture The above-mentioned Fracture-plaisters make thus How to make Fracture-plaisters â„ž Clear white Resine no hard glass Resine lb 2. Cyprus Turpentine lb ss melt these together gently and not boil it put to it of Barba hirci four ounces which Hearb must be pulverised stir it so long together till it be almost cold Thus is the Salve made if you will spread it on a cloath then pour on it boyling hot Water then is it plyable to be spread I like this Plaister better than the before-named ordinary The vertue of this plaister Cataplasmes or Drier For it sticketh close to the skin stirs not in haste even as splinters also applied to the Fracture must not stir This Plaister draweth forth the moisture from broken bones and ligaments and maketh their gluten stiffe and strong through the vertue of the Resine which is the true external Balsam unto bones and ligaments For this Resine draweth forth the superfluous moisture which the bones cast up and coagulateth the on-growing the sooner and maketh it come together and then the said Hearb Barbahirci is an extraordinary healer far beyond other Wound-hearbs Indeed Comfrey Walwort Sanicle Bistorta have their vertues also in the joyning the bones together but not comparable to this Resine true they draw forth the filth from flesh and bloud but to get out the matter out of the bones they are not strong enough much less is Terra sigillata and Bolus of that vertue true all these are great driers but have no power to extract things that lie deep To heal with greasie things is nought I will say nothing here of those which use to broken bones several fat and greasie things there is no reason to defend what they do whose actions I reject as nought for many reasons Oyls Waters Lies c. are not to be used For no man that is swelled ought to be wetted drying things are good for him I disswade here the use of Oyls and Ointments though they be more pleasant to Mans body than Lies or Waters Before I come to the handling of the Fracture I will first inform the courteous Reader how many sorts of Fractures there may happen unto Mans body then will I speak of them in particular where you shall faithfully be informed in things that I have found in my practise to the good and comfort of poor Patients and Surgeons It happeneth many times that the foremost part of the Arms bones are broken sometimes the uppermost great bone or Shin and sometimes the lesser bone and sometimes both these are broken and sometimes the upper part of the Shin hath a Scissure and sometimes the Arm or Hand is bowed or dislocated and may be set right again even as a stick bowed may be made straight sometime their Fracture breaks through the skin at the end of it and are apparent to the eye In brief there are several sorts of Fractures in these places all which are known by the practise as that part above the Elbow and those below the Knee and who can remember all such accidents sometimes a bone in the Finger is broken and another in the Shoulder or the Shoulder blade or the Neck bone or a Toe or the Knee-pan which sometime is split and broken I have had Patients whose Knee-pan was thorough cloven sometimes the Elbows-knockle is broken sometimes the gibbous part of the Hip as it befell mine own Child and grew halting of it sometimes the Ankles is off from the bone sometimes the bone of the Foot 's wrist is broken or that upon the Hand and sometimes the bones go asunder or raise yet are unbroken sometimes the Skull is broken and the bones and crissels of the Nose c. If the Patient hath a bowed Arm or Bone then
long till the hurt breaketh out and counting it ignorantly to be a Belly-flux or humour in the upshut they call it a Sprain Of these I quote some examples that you may know what I do call a crackt Fracture and what the condition of it is 1. A Maid coming home ward loaden with bought Wares fell on a stone in the street after she rose she went on her way though with pain and coming home she annointed the place to disperse the bloud and this annointing she continued for half a year at last it broke out with great pain and stink it was held to be a humour of the body which they dawbed with Plaisters for a whole year but it would not come to any healing This Maid was brought to me perceiving the cause of it I desired her to let me open it there I found a Fracture with a cut and the bone began to be scaled and black I took it out cleansed the sore and cured it as a cracked bone and she was healed 2. A Maid gathering Apples under a tree taking up a load of them on her head going along she stept into a hole broke her shin in pieces she sate down staying for her Father to lead or carry her home her Father coming chid her bidding her to rise telling her that some vein or other she did sprain she went on that Fracture some hundred paces and made it thereby worse and worse at last she could not tread upon it I was sent for I told that her bone was broke I was laughed at they saying it were not possible a body should tread on it if the bone were broken much less to go so farre as she did after her fall Their beleif was brought to experience upon their own peril For the bones went asunder and the Fracture began to grow too big for her to endure and for me to heal 3. A Man servant carrying a bundle of grass perceived he cracked his Leg yet he went on and in pains he carried home the grass with much ado This fellows Fracture was of so great difficulty to be set and healed as ever I had any for when I lanced it it was found to be enough for one Fracture 4. A young man taking down from a Horse a sack of salt broke his bone for all that he went about for some dayes but at last the bones broken appeared in good earnest many Surgeons had him in cure before I came to him and it proved a real Fracture which at first it would not be taken to be one 5. A Barber riding along came among Horses which fought among themselves by their kicking his Leg was broken he felt it well enough that it was so but he knew not whether it was broken in two lighting from his Horse he went into his house and in his going it was not seen by the boot whether he was hurt or no the boot being pulled off he tried whether he could go but could not for the two bones of the Leg were beaten in pieces I had to do enough to cure them and were healed without limping 6. A Girl carrying a basket full of chips and stepping over a block heard her bone give a snap she flings in the chips at the door sits down on the next block but her Parents being hard to her made her go for all that this Fracture was lanced afterward and was long under the cure 7. A Servant had a Fracture which I judged to be a lame one I was laughed at because I called it a Fracture but it was past laughing when I took out the bone from the gartering place to the Ankle For those Surgeons which saw him thought it a thing impossible that he should be able to go when his bone was in pieces and many agreed with these Surgeons it was so But the Patient said my bone is broken I presently opened the place opened the flesh to the bone which was black because the marrow prest thorough the Fracture but he was healed could leap and jump without halting at all Many more examples I could quote but forbear it and rather tell the cause why any one can go for all his bone be broken viz. if a bone be broken so that the Fracture hath branches and splinters these hold the bones still together because it stands together yet and beareth up the Patient as when ones bone be not well healed he goeth but in pains and with much ado more than one whose bone is but broken lately A Servant broke the bone next to the hand complained much his Mistress applied to it Vinegar and Bran I coming to dress the old Womans Sore on her Leg I looked on the Lad knew what he ailed but would say nothing for fear they should give me the lie the Lad complained more and more at last I was bid to see what he ailed I told that the Medicine applied could do no good for the Lads Arm is broken and it was so as I said and the Lad had no rest and it was worse with him every day then my words were found true The Lads Hand being grown crooked then they gave leave that he should be drest I set his bone right drest him he felt ease and his Hands swelling was allayed How cracked Fractures may be learned or discerned in old and young Folks If you have a Patient whose Arm or Leg is red accompanied with a swelling and the redness doth not alwayes appear at first but after when it beginneth to swell and will break out if such a thing appeareth then ask the Patient how long that sign was there if he can tell then you may the better discern the hurt but if he cannot tell either by reason of his young age not able to speak being a Child then feel it hard and try whether you feel any unevenness or any thing broken ask again where he doth feel any pain if he be able to answer you But if a Child take notice where it shrinketh at if toucht whether there be a hollowness or a bump or any other crookedness and at the feeling of the place take notice whether it doth stir if you find it to do so and giveth a snap or you can feel the hollowness or it yeilds to bowing then is it surely a Fracture and if it should not yeild to bowing and yet the other signs are at hand which you felt with your Signs of a crack-fracture hands then is it surely a crack which holdeth stiffely yet and the party can stand upon it and go and can work and no body could think that he ailed any thing In case you are not yet sure by feeling bowing c. then take notice of â—â—e Patients words whether he heard any thing crack or snap and what work he had done whether it came by a jump lift fall thrust blow or slipping into a pit or by striding over ditches or climbing up the Ladder or hurting himself against the bedsted For I
and the joint water runs strongly Joint water join'd with a swelling and the more the more it swelleth it is a sign that the Surgeons medicines are not proper for it therefore let him use better in case he intends not to spoil the joint quite and by too much running it cost the patients life let him learn to make better Salves than he hath in his Dispensatory If a party be wounded on a joint and complaineth of pains on the extream part of that joint as being wounded Pains in a wound in the arm and his pains are worse in the finger than in the wound it self then is it a sign that the member will dye and that the cold fire is coming into then is it high time to Cold fire prevent that evill and do not neglect the patient A wound made into the body and prickings are in the side signifieth death if so be the wound is in that place A wound made into the hollow of the body and is at a stand in healing signifieth death but if a wound be at such A wound at a stand a stand on an outward member and the wound waters a little it signifieth Cancer Prunella Inflamation Wound-disease or death if they be not prevented it may be that some imparity was in the wound Ointments and Balsoms which set the healing backward for such slovens are found which care not whether their medicines be made clean or no and that fault is committed in medicaments that are both for inward and outward use If a cough is incident which Cough a sign of congealed bloud is not cansed by the lungs it is a sign of congealed bloud in the body if he brings up any bloud with his cough then is it the surer sign of it but if that bloud brought up by coughing is red and fresh then is it a sign that a bloud vein is wounded which is still a bleeding If a wounded party begins to stammer in his tongue looks gastly turns his eyes is deaf it signifieth madness and death if he be snoaring at the noistrils knoweth no body hath a Stammering great droughth yet drinketh little his sleep is gone and still will be gone all these are ill signes and easily judged If a hard knot or callus groweth on a wound which is painful and increaseth yet the wound healeth it is a signe Collossities that the veins and sinewes which are there about are dying and rotting death ensueth upon of such heavy examples I know too many which have thus been neglected and such collossities grown there must be looked to These few signes I hold forth to you thereby to learn to discern other Symptoms it is not possible to rehearse all the defect hereof may be supplyed in those that follow for to discern such Symptoms CHAP. II. Of the Sleep of a wounded party what a Surgeon ought to judge of it REader marvel not that I keep no method in describing of Symptoms I took these Simptoms in hand to write of as they fell out in my practick Touching Sleep sound peoples sleep is not alike some snoar in their sleep others without a noise in these it matters not much but it is another matter with those that are wounded because Surgeons ought to take notice of such signes in their patients sleep If a patient puls in his sleep his wounded To judge the signs by the sleep member and is thereby awakned it is a sign that the Cramp or Wound disease is coming but if he is frightned in his sleep and awakneth of it if his vvound be in the head a Cramp or Palsie ensueth upon If a wounded party awakneth knoweth not where he is and talks idely it is a sign that he is in a great heat which soon will cause a disease in the wound A head wound which suffereth not the party to sleep accompanied with a heat it signifieth a mortal Symptome in such a case phlebotomy is very needfull if he cannot sleep after that then death ensueth A patient that sleepeth much and is idle withal in his sleep is hot in his body yet sweats not it is a sign that the wound disease is predominant for such there is no remedy and dyeth but if he sweateh all the body over then there is better hopes of him but if he sweateh onely on his brest it is a deadly sign If a patient le ts go his stool in his sleep it signifieth death A patient who at first is in a good posture unto healing but grows worse afterward and looseth his sleep it is a sign of a mortal Symptome If a patients sleep be thick and short but sweet it is a good sign and if he be in a good temper not too hot and his pulse beats orderly it is a good sigâ—â—â— but where no such signes are there is it dangerous Touching medicines to cause sleep withall when they are good and when not you will find them in the Receipt described of Anodin or Laudanum CHAP. III. Of pains in Wounds what doth cause them how judged and how remedied PAins in wounds are natural and in there cure they will Paines in wounds are usual be caused one way or other and pains will be felt as long as nature separateth the bad from the good and is done when the wound matters thereby cleansing it self pains caused in that way are of no consequent in case the patient be not otherwise disturbed and is kept in a good dyet but it is another case when the wound brings not out the matter in due time and the patient in his dyet or by the Surgeons carelesness is neglected out of such pains a Surgeon which is expert will look to the circumstances must be considered and for that reason I thought good to write one Chapter of it to know from what the pain is caused how it is to be judged and to fit the remedy against it Here I will not speak of ordinary and natural pains but of extraordinary ones which are caused either by the patient The patient causeth paines or by the Surgeon or by both A patient causeth pains to himself with disorderly eating and drinking pretending they must have a recruit for their bloud some spoil themselves by eating of Cabbages slimie Fish Pork c. by sour or strong Wine stinking and sour Beer c. some by being too much in the Sun shine or being too much in the Ayre or stirring too much in Leachery c. whereby pains are caused in wounds if not quite spoyled A Surgeon cannot exactly judge of the causes thereof nor to allay them unless the patient be better governed in such wayes The Surgeon oughâ—â—â— warn the patient of the danger which such disorders do breed if he will take no warning then let him take what falls Surgeons also may cause such unnatural pains as first with stitching with tents by forcing them into Wounds c. Surgeons in fault of which
this past on three weeks at last I being called with some others we consulted and resolv'd to launce the place which I performed there run out above half a pint of matter after that by Gods blessing he was cured Another party being a Gentleman had a fall with his horse was shrewdly bruised on his left side all manner of means were used but to no purpose the party was much troubled with prickings and a cough little sign was seen neither swelling nor redness and where the bloud should be gathered it could not be discern'd Physitians Surgeons and my self also were called some would have it launced but the major vote was for the negative what hapned the third day after the blood and matter come out at his mouth and not long after he dyed CHAP. X. Of bleeding Wounds what it signifieth what Surgeons ought to do for it A Wound which was thought to be well beginning to bleed then the following signes are to be taken notice of The Surgeon trying with his Seeker finding some What the bleeding in wounds meaneth bleeding in a small quantity is not be troubled much at it because the sound flesh may be that searching be caused to bleed But if the bloud comes abundantly then surely by that needless searching a bloud vein is hurt and turn'd out of its place which caused such vehement bleeding But the wound not being hurt by that searching yet bleedeth it signifieth that some shatter'd splinter is loosned which being desirous to get out sticks in the new flesh and makes it bleed this is best known to be so if the party toucht at the wound is mightily prickt and that bloud be clear and fresh The manual to be used herein in this to keep open that wound with a small tent which is to be covered with unguentum What the Surgeon ought to do in this case Egiptiacum and to dresse that wound but once a day so that that loose splinter may come nearer the mouth of the wound and be pluckt out And if it hangeth yet on a panicle it must be let alone till it loosneth of its own accord In that intrim search not with the instrument in the wound for fear that splinter be prest into a sinew whereby great mischief would be caused If a wound bleedeth abundantly it is a sign that a bloud vein closing is opened again in which case you must do thus If the wound be yet wide open then use an ordinary bloud stencher and put into it dayly the wound Ointment then it will soon overgrow with flesh and be stenched of its own accord And in case there be any bloud in the Wound as it often hapneth then that bloud must not be wiped or washt out which Surgeons ordinarily do but leave it there because that stoppeth the bloud vein and then the wound Ointment and the stitch Plaister keeps off other hurtful things unto the Wound and that bloud which stayeth in the wound will soon come out in the ulcerating But if the Wound be very narrow then the case of it is otherwise for if it be very narrow then make a tent prepared with a corosive that corosive is it which lyeth settled in the bottom of unguentum Egiptiacum and fill up the wound with it so that no bloud may get out this tent must not be put too deep into the wound onely half way leave it their for thirty hours applying a Plaister to it At the taking off the Plaister the tent not sticking to the Plaister and goeth out easily then let it stay there and apply the Plaister again for ten hours longer then open it take out the tent apply a smaller tent covered with the wound Ointment and a stitch Plaister upon and thus proceed to the end of that cure Squeeze no blood out of the Wound because the Opodeldoch will do it without any other means beware you No blood to be sqeezed out of the wound Example do not search in the wound with the seeker for fear you do stir a bloud vein and cause it to bleed afresh For I knew a Surgeon who was still graping with his instrument into the parties Wound causing thereby a vehement bleeding and spoyling the patient At a certain time a patient was brought to me whose wound did bleed so much that he grew very faint thereby The Surgeons who had him first in hand tryed several conclusions using long sharp tents for the Wound whereby they toucht the bloud vein causing vehement bleeding I took out the tent flung it away using none and cured the party in short time In some Wounds there is found much blood yet none runs out at the opening or undressing of it and no sign appeareth either of pricking or any other this is a sign that that that Wound was tyed to hard and the party is full of blood For with hard binding the flesh is prest together and is forced to cleansing and weeping and if it hath vent it bleeds no more This Symptom is thus remedied to bind the wound slackly and let the party not put on too straight clothes Surgeons ought to take good notice and care when the bleeding Wound will not be stenched especially when that Wound bleedeth not but after when it is drest or else it bleedeth before and after dressing and at the dressing the cause hereof is that the veins at the dressing be too much forced and prest the same is seen at phlebotomising when the veins are tyed too hard the blood doth not spin out so freely however pretty things help the bleeding of the vein This ought to be known at the bleeding of a Wound in the foot to have it stenched The dressing is of as great sequel and concernment as applyed medicines to Wounds which I know experimentally If a parties Wound bleedeth when he goeth or sleepeth then bind it slack and meerly apply the Plaister then you may the sooner perceive from whence that bleeding comes and take notice of the following sign for that is caused when there is no tent put in else it is a false sign When a spongious flesh appeareth out of the Wound looking like coam'd wool and that without any pain may be put in this signifieth that a splinter is loose or a piece of arteries is coming forth for such a thing closeth nigh with the bloud vein which is hurt with touching here you must search without delay else the party and you will have work enough because the bleeding may be increased and the vein be shut a great deal behind that and no way left for you to come near it and bring you to sorrowes Therefore strow onely burnt Allum into it this is strong enough if you should use a stronger it would soon run and eat through the Wound which in a long time you would hardly be able to cure again Let the Allum lay there till the next day it will come forth of its own accord if not then put more of the
death if that paroxisme comes above three times then is the sign of death the surer This is that simptom whereof so many dye For it is an usual saying if the patient outliveth five seven or nine dayes then he escapeth with his life Some set that time further off to the thirtieth or thirty fifth day which is not very uncertain neither For if a simptom cometh not into the wound within twelve or fifteen daies then it will not come at all or very seldom unless the Surgeon or patient hasten it on But if the wound be not so dangerous then no great carefulness is need unless the Pia Mater under the skull be wounded for then strange simptoms must be expected which happen when they dream least of it as you heard above about Head wounds Touching this cold or ague in the wound Note how it may be discerned before its coming For my meaning is not that Surgeons should stay for the seventh or ninth day when its full fore is come already into it Experience teacheth that an enemy is with less opposition kept off from invasion than beaten out when invaded already The original of this Wound Ague which causeth great mischief is variously discoursed of even among those which do not understand it My intent is not to be large in the writing of it only for Novices sake in Surgery and the good of patients I will shew how this simptom is known and how it is to be healed If you desire to know exactly from whence a Wound The original of the wound dis disease hath its original let them take notice of the following things It s commonly caused by anger frights fears great pains and disorderly life in eating drinking uncleanness I forbear to speak here of bad medicines in a word according as the wound is in a dangerous place and in a dangerous joint or member the one being nobler than the other especially the Head is the noblest and according as the blow cut stab is made and in what years season so simptomes will be accordingly Nothing bringeth so soon on such simptomes than when a party is wounded in a dangerous place and the wound bleedeth vehemently French Italians and other Nations observe this custom that if a patient hath bled nere so much they will plebotomize him further which is an ill and refusable way For a patient which looseth too much bloud looseth also much of his natural colour whereby he groweth cold and faint And if the wound be on a dangerous place then pains are caused these pains cause anger anger causeth heat upon which the foresaid paroxisme followeth infallibly heat and cold striving and fighting one against another at last the cold being conquered heat got the predominancy whereby all is set on a flame This heat and venom lyeth in man like a smoak or fume and must by force be expelled because otherwise it cannot be extinguished and coolers can do little in this particular Syrups Juleps Conserves of Buglosse and Borrage will avail here nothing and with these Surgeons commit grosse errours I have been present sometimes when the Physitian felt the patients pulse which is not so improper neither then viewed or cast his water finding him to be in a strong feaver and it was so Then presently some Syrups must be mixed and with Cordials the patient must be upheld with Goat milk Syrup Conserves c. but none of these men knew where that Ague did lye nor where the fault was the one judged it to be a continual Ague the other judged it to be somewhat else every one had his own judgement of it the one contradicting the other But what was the patient the better for their jarring I never saw any patient cured with disputing my self differed sometimes in my judgement concerning such simptoms but Experience shewed me the better way This Wound Ague to come to the point according To discern the wound ague to my promise made afore to discern well before its coming you are to note that when that Wound simptom is coming the patient is unquiet stares up and down lost his sleep and if he slumbereth be starteth awakneth and is unquiet If the Wound be on a joint then he doth not hold still striveth continually to shift this or that way and then it is commonly angered But the patient must first be well observed whether he sweateth in his sleep as you heard above also they do not usually sweat though they are hot enough and are much gready for drink Moreover this also ought to be noted if a wounded party hath a deep red color in his face more than he had formerly before he was wounded or he looketh paler yet is hot in his body which he was not so before he was wounded then is it a sure sign of this simptoms coming which we speak of now These and such like signs are to be observed in the outside of the patient But the knowledge of the wound is of chiefest concernment if the wound be in such a condition as I shall speak of the like about the Prunella or Inflamation thither I commit the Reader then is it a sign of the coming of the Wound simptome For if Nature be so strong as to keep the Prunella in the said joint and not to let it run into the body then the cold fire comes into and nothing else but if that heat in that joint presseth backward into the body then it causeth a Wound simptom These two simptoms meeting are a sure messenger of death These following signs which concern not the Inflamation and Prunella are to be observed also If a Wound be fresh and new not much touchy so that the patient may suffer to be toucht well and being toucht hard he feeleth it smart this is the first sign of all especially if the patient speaketh quick and looketh agazed it is a sign that such a party is mightily infected and is to look for that paroxisme accompanied with perril of death Observe also these signs which the coming of the wound disease giveth you to understand If a Wound look pale and a dead colour about the corners and lips but the wound within looks brown red and the patient is over-run in his body with a strong continued heat and keepeth in that strong heat groweth not cold or clammy as it usually hapneth in other sorts of wound diseases which must be observed for distinction sake and that strong heat and feaver goeth on to the coming of a paroxisme after which there followeth yet a strong heat and inflamation which may soon make an end of the patient One thing more I must relate touching the increase or Signes from the Moon decrease of the Moon according to which commonly wounds are affected When a patient groweth still weaker at the decrease of the Moon then you may expect at the new Moon a heavy and dangerous paroxisme if the patient continueth in a strong heat at
flegm and slyme then this Electuary is not good for him neither must it be used to such on whose breast or lungs is fallen a rheum There are more Anodynes which are made by distilling and are subtiller pleasanter and of more use than these that are set down above but because every one doth not understand that excellent Art of Chymistrie therefore I do not speak of them here and so let it rest at this time CHAP. IV. Of Blood stenching in Wounds and Noistrils how the things requisite thereunto must be prepared and used ABove have I rejected some Blood-stenchings understand it thus I do not thereby reject or refuse all Bood-stenchings which ordinarily are used I rejected only such Blood stenching performed through Cauteries otherwise I hold all Blood stenching good except Cauteries and Corrosives if used without danger and prejudice to the party be they made of what they will viz. of Rye meal of Mill dust Pulmonaria c. in brief all things imbibed and turned to a pap are good to stench Bloud provided it be not a hot matter These following may lawfully be used viz. a Carniol stone Haematites Agat stone Crocus Martis Bole Armoniack sealed Earth Earth of Vitriol in which there is no Alcool left the sweet red liquor of Vitriol in like manner Gum Arabick Gummi Tragant the white hair of Hairs Cotton-wool Mullipuff and the like of Hearbs and Roots tending to that purpose provided they be not of a biting and corroding quality whereby inflamations in Wounds may be caused Expect not many Receipts about Blood stenching I will set down only these which I made use of and found them to be best he that understandeth me well will easily provide for himself the like Blood stenchers leaving every one to his own discretion To Bloud-stenching I use first a Plaister which is made thus Take of Amber half an ounce of white soft Rosin The Authors plaister to stench blood one pound the dark Turpentine four ounces of Mastick a quarter of an ounce of Crocus Martis made in a Reverberatorie three ounces Of these make a Plaister in the following manner Take a fourth part of Turpentine make it very hot strain the pulverised Mastick and Amber into by degrees these two being melted therein then put the rest of the Turpentine to it and then the Rosin which in another pot must be melting gently after all that you put in the Crocus Martis and then you let it cool so is it ready This is the first and chiefest Bloud stencher not so much by reason of the Ingrediences but by reason of the singular Manuals which fall out here as you shall have more of it hereafter 2. The other piece which is here to be used is this Take Mullipuff cut great and small pieces of it of a fingers thickness or thicker some as big as an Egg and of a fingers length shorter and longer of all sorts tye these several pieces in a paper as hard as you can and tye them close together then bind them more harder together with tape so that one piece which was of the bigness of an egg in the binding be no bigger than the little finger this being done presse it together with heavy weights or screw it into a presse where you must let it lye for some daies that they may be yet closer prest together then take them forth lye them yet more together and keep them for use 3. Thirdly you must be provided also with this Powder Blood stenching powder Take Sheeps blood let it stand till the blood separateth from the water which is done in one day and night pour off the water and put the congealed blood into a pot set it in a circular fire like unto a little cement fire let it stand so till it be quite dry it neither stinketh nor is of any rank sent and being turned to a powder then is it ready Take of this prepared blood four ounces of purely pulverised Gum Traganth half an ounce of Blood wort pulverised half an ounce mingle all these and keep it for use Now if you have any patient whose blood you are to stench then first note and observe carefully whether when he is angry the blood will not be staid unless his anger be over The like case is when the party hath a paroxisme on him otherwise you are to do thus take a little of that powder and cast it into the wound and take a piece of the prepared Mullipuff apply it to the wound the bigness of the Mullipuff must be answerable to the wideness of the wound yet so that it easily go into the wound and not be forced into therefore ought you be provided with all sorts of such pieces then another broad and thin piece must be laid on the wound or else Cotton wool mingled with a little of stenching powder and hold it a little with your hand Make the place dry with a sponge round about the wound and apply the afore written plaister to it spread on a bladder pritty broad and great so that the wound every where be well covered then take a boulster presse the plaister close to the wound and with the binding be made cling unto the skin then it will receive no more moisture and closeth the bloud in the wound and can presse forth no where neither at the sides nor below nor above so that the blood is as it were forced to stay and run together and congeal within Hereby the Reader may easily understand that it is a matter of consequence when you are about the applying of a plaister that you must be careful to put away the bloud about the wound and that the skin be well dryed for the dryer the place is the sooner the plaister clingeth and the plaister sticking to it then is the thing for the most part holp Have a care that the plaister do not get loose again and in case the wound bleedeth too vehemently then is it requisite that you apply a greater plaister upon the first that it may stick on a dry place This Blood stenching is very natural as judicious men may easily understand and it is very convenient for a wound for whither can the blood run being kept in by that on sticking Plaister neither can it press above through the bladder and so it is forced to stay and be stenched Besides the abovesaid powder hath a marvailous quality because it turneth glutinous and uniteth with the blood by reason of the Gum Tragacanth and the prepared blood for that blood also uniteth with mans blood the matter swells in the wound and turns to a slyme as you heard above and the blood also groweth thereby glutinous and so cannot run much The same thing is it also with the prepared Mullipuff when it is laid into the wound it goeth asunder swelleth to the bigness it was at first of stoppeth the wound thereby and that swelling is gentle not forcible without any danger and prejudice
to the wound that may be used to all wounds even to head wounds so the powder also may be used provided it do not come too nigh to the naked inflamation It is not alwaies needful that such great earnest be used in Blood stenchings neither is it necessary to use such prest When Mullipuff is to be used Mullipuffs understand it onely of such wounds which bleed extreamly where no ordinary means will prevail the Mullipuff may be used per se also but you must use a good deal of it apply it loose to the wound and then to keep it on with a plaister many do use it so and they do well therein There is no man compelled or tyed to the foresaid powder nor to the Mullipuff you may make a composition of your own head of the foresaid Ingrediences as you think it best Mingle that powder among pure Cotton wool use it duely but then I counsell you not to forget the plaister which is the chiefest thing herein I made use of this way in Blood stenching hitherto and was ready to impart faithfully the same unto others hoping that if you understand me aright and handle these thingâ— rightly you will doubtless have good success onely let me intreat you not to use any Corrosives that are burning and biting for reasons alleadged above Touching spells over wounds and characters which are greatly used of some to stench bleeding thereby I know Spells nothing to say of them and I leave it in its worth They are meer words and signs which are not understood of him neither which maketh use of them and what they are like to effect thereby the same I commit to your consideration Sometimes things fall out strangely when the wound is in such a place where the said plaister cannot be applied conveniently as a party being wounded in the mouth or throat as ones nose falleth a bleeding vehemently then other means must be thought upon as I shall tell you afterward If one be wounded in a place where a plaister cannot How to stench the blood in the mouth conveniently be applyed then stench that blood thus Take of the red liquor of Vitriol which hath no corrosive quality one part and of Gum Arabick a third part to its quantity mingle these spread it on Cotton wool and endeavour to bring it to the wounded place it will make the wound draw together the blood veins will shrink and the blood will be quenched and all without biting or corroding but you must have a care to let the Cotton wool with the matter lay a while on the wounded place that it may work upon it and if it doth not work sufficiently at the first time then iterate it once more that the blood may be stenched Of the same nature is the vehement bleeding at the nose Bleeding at the nose here it is not alwaies good to have that bleeding stenched preâ—â—â—tly especially in cephalical diseases because thereby other diseases are spent and consume away by that bleeding but if that bleeding be so violent that it must needs be stenched then proceed thus Take instead of Cotton wool of which I made mention above a little piece of How to stay it the soft dryed and prest Mullipuff pull a needle and strong twisted thred through it with a great knot on the end of it the Mullipuff must be of that bigness that it may just go in at the noistrils cover it with the foresaid liquor of Vitriol mingle it with Gum Arabick thrust it up with an instrument into the noistril to the hole which goeth down to the throat if you do not so you will do but little good for fear the blood should take its course into the throat therefore the Mullipuff must be straight thrust upward being it is soft and causeth no pain Have a care that the thred stuck thorough the Mullipuff hang a good deal out of the nose that you may pull it out when you have need Thus a bleeding nose may easily be stenched For such kind of bleeding other means may also be used as Saltpeters clothes laid to the neck inwardly you may help much as you shall here hereafter If you see that the patient hath need to be plebotomized Phlebotomie and hath need of other medicaments then let him have them my intent is here onely how the bleeding of the nose is to be stenched though this my process seemeth mean and poor yet I found it still to be best and most useful for the Mullipuff swelleth in the nose and Mullipuff obstructeth the bloods course and the liquor of Vitriol by its constipating vertue draweth things together without any danger and prejudice I am not ignorant of that many remedies were sought The working of Vitrriols liquor after for to stench the bleeding at the nose but they never did much good with it insomuch that many bled to death without help or before they could be helped I speak no more of it than what I have found true by experience There are many good means which ought not to be rejected as precious Stones hanged about the neck or put into the mouth or hand or they scrath the party with them or there is a singular experiment made of Saltpeter â—â—und in old rotten walls take this Saltpeter of the wall put it Use of Salt-peter in a melting pot make a circular fire about it make it very hot then pulverise it in a morter put white Wine Vinegar to it to dissolve it dip clothes in it apply them cold to the wound This powder may be used also among other Blood stenchers and used to wounds where great anger is for it quencheth the heat coagulateth the blood in the wound Another secret piece which is not common and is this if you cannot well stay the blood of a wound then take one dram or one dram and a half of well prepared Saltpeter which we set down in the third Part in the Chapter of Wound diseases dissolve it in a convenient water as Chervil water c. if you cannot have such then take Well water let the patient drink it you will soon see the blood stay'd it is no hurt to the patient but doth him good Thus I close this Chapter also CHAP. V. Of Vulnerarie Potions in general and particular how these are to be made and in what different manner they are to be used TO make Vulnerarie Potions and to use them is a common thing and every Surgeon hath his own way which he thinks best which indeed is tollerible for these drinks cannot be rejected as if they were good for nothing but are rather to be praised as without which Surgeons sometimes cannot be the which I had eâ—perience of But I met with indiscreet dealings in such potions that thereby some did more hurt than good whereas if well handled and made more good can be done by them than otherwise which moveth me to bring to light that
is would have them sleep and others rock them when they cry others there are which will not use their Children to it at all as one a Clergy Mans Wife did who set her Child every night into a Cellar because nothing should disquiet him in his sleep not thinking on any other things the Child might befall but no honest Woman I hope will imitate that fashion In my judgement I hold it to be best that if a Child be laid down in Gods Name c. to rock it gently and not too hard then let it rest But if a Child sleepeth unquietty being as it were frighted as it can be perceaved when it snorteth snuffeth or when frightned or cryeth then rock it gently again then the melancholly blood which opprest the Child and frightned it is by rocking brought to right again out of its fear and anguish and are dispersed or expelled It falls out sometimes that a Mother meaneth to quiet her Child with rocking whereby the Child is the more unquieter and with crying inflames his head so vehemently that in many daies he cannot be brought to right again sometimes such a Child aileth that which a Mother doth not think of supposing to be the Childs frowardness which is not so but it feeleth something to be amiss in the bed which doth hurt it or its hand lyeth hard or a prick straw or hard feather doth prick it or a pin which eareless Nurses left in the linnen or a flea or louse tormenteth the Child therefore my advice is that if a Child will not be quieted to take it up and see what doth ail it Little Children are tormented also sometimes with the Cramp when they are taken up then their blood runs To help Children of the Cramp up and down and by that means are they quieted few people take notice of the cause of it and is remedied when the bloud getteth its course again and come to that place which was bereaved of it it warmeth that part again which warmth driveth the Cramp away and the pains which are caused thereby A Cramp will hold a Child strongly if once it takes possession in a Child causeth great pains below and above as these pains are to the Children continue in their crying and commonly the Gout doth accompany it Therefore these things must be taken good notice of when the Child cryeth much either half sleeping or awakened then take it up and wrap it in warm clothes This misery is caused by the following things viz. when Children are kept cold in the Nurses or Mothers lap or in the bed bath or lye in wet clouts bepissed by Children or such Children sit naked on the flower or stone I have seen that the sitting so naked on cold places hath proved so dangerous unto Children that in short time they were creepled with whom I had great toyle before I could recover them to their former health for if once they take cold in that way they are hardly recovered again This befalls old people also some whereof I have seen dye of in great anguish and misery and lay long by it before they dyed Therefore tender Children must by all means be kept warm not to shake stir and dally them too much If a new skin in old people be tender what is it you think in a new born Babe Doth a small thing pain you so much on a finger how painfull is it then to a Child which is tormented all the body over which hath but a tender new grown flesh if such a perfect Child is tormented so soon what shall we think of a Child which stayed not in the wombe its full time surely it is twice worse with him Touching Baths of Children it is known that they are Childs Bath bathed sometimes so hot that the heat thereof is scarcely sufferable to an old bodies hand whose skin is strong we must not here that if a water bath be made for any one which seemeth to him to be not very hot at that time when he was scabby and went in the first time so the skin of a Child is so thin and tender as his who is full of scabbs A hand which is usually naked can endure more cold heat air c. than that strong sound body which usually is not naked c. This every one doth or may conceive easily if he taketh notice of some Women are so careless that they take no notice nor observe what pains they do or may cause unto others and make Baths for Children so hot as if Children were able to brook with not considering that Children are weak in their little bodies and not so strong as aged people are in theirs The bodies of such little Children may be compared to a young and tender root or twigg of a Tree which in the fouch is not so grosse as an old root or branch of a Tree take heed you cause no paines unto little Children that they may not be filled with pains in their joints whereby they are made unfit ever to follow closely or well any mechanick calling And it is a most certain thing that those which are bathed too hot get a more tany skin than those which are not bathed so hot neither must they be bathed too cold else there will be caused to them pains in the Pains in the belly and the Cramp how caused belly and the cramp and is then most of all caused when Children are naked in the water are not covered in their body or else when the bath is made too thin or when such a bath is made but once and no more used a long time after and no order is observed herein or when the Child is taken out of the bath and they care not how long they keep it in the lap Some use to lye the Children bathed behind the hot oven whereby the Child may soon be Children are hurt if after bathing are laid behind a hot Oven stiffled or choaked not regarding whether that heat doth not cause a pain in the body or head supposing onely if the Child be but laid behind the oven then is it well cared for Some have that custome when they have bathed their children then they rub them with Wine and the whites of Eggs saying now I think I washed my Child neatly and rub it so strongly as if they had an old bodyes skin in hand which is grown hard thereby to soften it they do not consider that if an old bodyes skin after bath should be so rubbed and the party were scabbed how he would be affected with it or if a sound bodyes skin should be thus stretched or reacht what pain would it cause to it little do they consider what great wrongs are done thereby unto little Children All honest Mothers and Nurses will be cautious and carefull Children must not be kept loug naked or wet that their Children be not uncovered too long be it either at their taking up or their carrying
it which will be good thereby the matter will take its course and let the first little Wound be healed up as fast as you can and bind it strongly And the neathermost hole must have vent and be kept open till to the last of the healing Let the Knee not lie still and rest but stretch and bow it as much as you can that it grow not lame For if you stay till all be healed then will it be too late for the Knee to be stirred Therefore do it betimes what you ought to do that the Knee be not healed stiffe For if you stay too long and neither bow nor out-stretch the Knee then you will hardly help it afterward and it will be a great difficulty to bring it to right For if you deal rightly and heal it well in the joyning of it then the party will be of a sound and strong body for all the dangerous humidity which was in all the body was expelled through this strong humour I have seen that all those which were cured of such humours grew strong and sound men There are other humours which fall into the Knee even A humor like the Rose but worse as the Rose or Anthonies Fire useth to fall and with such a cold as the Plague doth and looks like unto this Rose or Anthonies Fire but is somewhat worse having blew spots as the Rose hath red ones but the blew ones are not so big but are of that bigness as the black blisters are and this redness is altogether nought for it is a flour of the cold Fire But if that Member hath great help from the body then it doth not so much hurt for there fall little holes into those blisters and when their skins are pulled off their matter looks black and fals out and these are easily healed but are worse than the Anthonies Fire is and ought not to be made wet neither must they be annointed but kept onely warm and dry as long as the redness and the black blisters hold then plaisters are applied unto them as other little holes usually are healed There are also Dogs blisters very like unto the above named Dogs blisters but not so dangerous and they make the Knees swell these also ought not to be made wet There are also on the Knees laming humours which are of a difficult healing make deep impressions cause a great deal Laming Humours of trouble and are not easily turned or diverted and do not shew from whence their original is the pain they cause is just in the middle of the Knee with a little swelling and stand on the Knee-pan there seemeth to be store of filth in it but is not onely the pain is apparent there is a sinew and lame water which can neither be softened nor ripened even like the water which is in a Joynt as we heard above much pain usually creepleth and maketh the Knee crooked or shrinks it especially toward the day My constant practise was to dress and bind them dry strongly and warm to keep the Pores open No greasie things no Ointments no wet things I used thereunto after I had well learned the simptom but my red Plaister I still applied and warm clothes And as I shewed at the great Bands to keep things there in a sweat so these lame biles also will steal away for if Patients sweat well under the Plaister they will doubtlese be healed and tie the places hard though it makes the foot swell it matters not for that soon allayeth and goeth away if kept warm with clothes even as other humours are expelled by keeping open the Pores CHAP. XXII Of Wounds made by Gun-shot of the abuses committed with the thorough pullings and Ointments what a Surgeon ought to note here ANy shot that went thorough Mans body is held mortal Wounds made with shot because the internal parts are spoiled and hurt by that heat such Wounds are not easily cured of these I intend not to treat nor of such where the shot hath carried all away which things can neither be filled nor set on We will speak here how to quench such burnings and how such inflammations are to be prevented so that that burning cause no further mischief than the shot hath made and then how Surgeons in such particulars are to regulate themselves The condition of one that is shot is this some bullets Bullets stay or penetrate the Body stay in the Wound or else go quite through if gone quite through then the cure is this that the burning be quenched because if that prevaileth it causeth more hurt than the shot hath done But if the bullet staid in the Wound then it must be taken When a bullet stayes out but how that is done is not well possible to set down every particular for shots are made several wayes the one is not like the other a whole book could be written of it Experience must shew the way how they are to be dealt withal and so here you must go to school and learn The Antients indeed have used hereunto many strange Screws and Instruments and were very careful herein But these are either of no use or of very little For if the bullet cannot be laid hold on by the Instrument how shall it be gotten out The bullet will strive to get out at the Wound if the Patient be laid downward with the Wound or else by its sinking it will come to a place where it may be cut out if none of these can be Experience must shew you another way Touching Wounds where the bullet went through here I must shew the dangerous abuses which Surgeons commit if they have a Patient that is shot through a Member they take hempen threed or some twisted hair which rotteth less and draw it through the Wound let it hang out on both ends they put their cooling Ointments to it before they draw it thorough and when they come to dress the Patient again then they pull the threeds forth and besmear it afresh with their cooling Ointment and then they draw it through again that part of the threed which staid in the Wound they make very clean from that it gathered in the Wound then they apply their Plaisters to the Wound as they think they are fitting With these thorough-drawings as they call it they Thorough-drawings do more hurt than good suppose to have done great good Nay some are of opinion that this is the onely way to dress and heal Wounds made with shots But it is otherwise For they do not effect so much with these thorough drwaings as they think for the hurt weighed with the good that is done thereby it will be apparent that more hurt is done than good and ought to be omitted altogether For such a cord or line drawn through the Wound must Hurts done with the thorough-drawings needs cause great pains and that not onely at the first but at the several dressings This way