this sicknesse to come by the multitude of Melancholike humors gathered in Vena Porta by which it is said the Milt doth draw unto it Melancholly humors and so transporteth it from the Milt into the Ventricle But truly the causes of this disease are so infinite and unsearchable as they far pass my capacity to search them all out some men conceive this disease happeneth to Sea-men onely through long being at Sea without touch at land as it is seen in East India voyages our men have it betwixt England and the Cape de bon speraâ—ce as they term it and at their coming on the land there they presently grow Aire and fresh food helpeth well this disease in Sea-men strong again and are by the very fresh ayr and fresh food cured without much other help and likewise twixt the Cape and the Indies they are touched with it again and as aforesaid the fresh air of that land the next they come on and good dyet together cureth them with small physical helps and the same again home-ward bound The chief cause whereof is the continuance of salt diet either fish or flesh as pork and the like which is not to be avoided at sea as I suppose by the wit of man another cause is want of sufficient nourishing food and of sweet water and also for want of Aqua vita wine beer or other good water to comfort and warm their stomackes which by contrary winds men are two much incident unto in long voiages howsoever the Marchants are careful provident and bountiful in that point An other cause of this disease to the ordinary sort of poor men is want of fresh apparel to shift them with which indeed amongst poor Sailers especially a sort of them that are carelesse and lazy of disposition is too frequent partly also by the not keeping their apparel sweet and dry and the not cleansing and keeping their Cabins sweet this also ingendreth and increaseth the infection Some charge Bisket as a cause of the Scurvy but I am not of their opinion Some say inordinate watchings are cause therseof Some say extream labour wanting due nourishment Some also affirm cares and grief to be some cause thereof others affirm the very heat of the 〈◊〉 resolving the spirits but what shall I amplifie further for it is 〈◊〉 true that they which have all the helps which can be had for mony and take as much care as men can devise are even by the evil disposition of the aire and the course of nature strook with a Scurvy yea and die thereof at sea and land both yet this giveth no warrant to the Surgeon or his Mate to leave their duties unperformed for the bloods of those men which either by their wilfulnesse or slothfulnesse perish under their charge will surely be required at their hands But it is plain that this grief is a lazie foul disease with obstructions of the liver or spleen or of both as also it appeareth that the head is much diseased and that there is great obstructions in the brain for that the eyes not onely look evil coloured but also the gummes putrifie and the teeth grow loose and all the sinewy parts of the body bear their part in the disease for the shrinking and withering of the sinews with the great pains the party hath declareth no lesse Of the Scurvy or Scorbutum the signes THe signes of the Scurvy are many as namely a general laziness and evil disposition of all the faculties and parts of the body saving the stomack and the appetite which oftentimes is greater then ordinary with them a long time A discolouring of the skin as if it were fouler then ordinary with spots darker coloured then the rest and sometimes also darkish blew spots A fever at sea commonly ends in the Scurvy wherefore by the way beware of too large purging or phlebotomy which increase oft the grief and make it incurable I speak this because I have noted there is a fault in young Surgeons of forwardnesse in taking too much blood at Sea Also itching or aking of the limbs are signes of the grief Sometimes the legs falling away and drying the calves of the legs growing hard and dry as also immoderate swellings of the legs also the legs and thlghes discoloured into frekels or spots of a durty brown sad colour much like the colour of a gangrenated or mortified member Stinking of the breath Great obstructions of the liver or spleen or both and in the exercising of the bodyes their limbs and their spirit failing them Shortnesse and difficulty of breathing especially when they move themselves but lying still finde little grief or pain Their eyes of a leady colour or like dark violets Great swellings in the face legs and over all the body paleness or a foul pale colour in the face Swellings of the gums rottenness of the same with the issuing of much filthy blood and other stinking corruption thence looseness of the teeth Also some are troubled with an extream costivenesse that for 14. dayes together they go not to stool once wherefore the Chirurgion is constrained with an Instrument to take out the excrements to avoid death after which extreme costivenesse often followeth a great flux of blood and a painful also many have stoppings of the urine or at least making lesse water in two dayes then the party drinketh in one day A coldnesse and stiffenesse of the sinewy parts chiefly of the legs Some also have their Muscles yea and sinews of their thighes arms and legs so wasted away that there seemeth to be left only the Certain signes of the Scurvy by the dead opened discovered skin covering the bones Also it is manifest that divers of those which have been opened after death have had their Livers utterly rotted Others have had their Livers swoln to an exceeding greatnesse some the Spleen extreamly swoln others have been full of water others their Lungs putrified and stunk whilst they have lived these and divers other signs too many for to be mentioned here do afflict poor Sea-men which often are past mans help in such place and time as they happen the Cure whereof resteth only in the hands of the Almighty And yet to any man of judgement it may seem a wonder how a poor miserable man coming on Land from a long Voyage even at the point of death namely swoln sometimes to an unreasonable greatnesse not able to lift a leg over a straw nor scarce to breath by reason of strong obstruction yet in a few daies shall receive the fulnesse of former health yea with little or no medicine at all The Cure of this disease as a famous Writer named Johannes Echthius in a Treatise De Scorbuto affirmeth consisteth chiefly in four things namely in opening obstructions evacuating the offending humors in altering the property of them and in comforting and corroborating the parts late diseased Remedies touching the Scurvy Johannes Vierius another famous writer ascribeth the
Surgeon his preparation for the work and that heartily For it is no small presumption to Dismember the Image of God This done have thy other Instruments ready namely a good Dismembring-knife a small Incision-knife two great square stitching needles armed with very strong thred waxed which some use but may also be forborn and one needle also and thred of the ordinary sort to sow rowlers likewise have ready long clouts lesser clouts plegents of tow greater and smaller dorsels and buâ—toâ—s of tow three broad strong rowlers or four of four yards long each with also a form convenient for to place the Patient on with a large boul and some ashes therein to recieve the blood let it be set under the end of the form then wet your clouts I mean your beds or boulsters in water and vinegar and wring them out hard which done make ready your medicine I mean your restrictive powders of both sorts have also ready strong wine-veneger or other good vineger and the white and yolk of an egge together mixt if it may well be had or else vineger onely spread your plegents ready with the restrictive stuffe or Cataâ— lasme following have ready the stronger restrictive powder mentioned namely the ordinary restrictive â„¥ j. and of burn'd Allum Ê’j Vitriol burn'd and of Precipitate of each Ê’i ss all these mixed together This mixture I have termed the strong restrictive powder for that it forcibly restraineth Fluxes aud maketh an Eskar have ready also one plegent made no bigger then the end of the member let it be spread with this recited strong restrictive mixed with an egge and a little vineger which done strew it thick with some of the said strong powder mentioned having another plegent ready broader then the former spred with the ordinary restrictive mentioned and mixed with an egg as the former also take of the buttons of row some four or five wet them in the strong restrictive to be laid on the ends of the great veins and arteries when they are absized This done and ready place the Patient on the mentioned form with one strong man set behind him and another to stand before him bestriding his thigh close to his body compassing strongly with both his hands the member which is to be taken off and holding it exceeding fast some two fingers above the place where you intend to take it away and let another hold up his foot It were not amiss also to have ready a swines bladder which hath been somewhat wet and dryed off again which after the stuffes the first bed and first long rowler is spent draw on the Bladder and proceed to rowl again to the full end of the work in the name of the Almighty the sharp Instruments being as near as you can ever hidden from the eyes of the Patient the two ministers or helpers also being ready and having hold on the member one above another below and also one sitting behind as is said on whom the Patient may lean backward and rest on then take your dismembring knife and with a steddy hand and good speed cut off flesh sinews and all to the bone round about the member which done take a smaller incision knife and divide the panicle called the periosteâ—n from the bone it is a tough thin skin covering all the bones of the body also thrust your said incision knife betwixt the fossels or bones cutting away whatsoever is to be found there with the like expedition the party that holdeth the upper part of the legge with all his strength griping the memberâ— together to keep in the spirits and blood It were also very good that the said party holding the member the flesh and sinews being cut â—asunder should immediately draw or The use of the Saw strip upward the flesh so much as he could keeping his hold that thereby the Saw may come so much the nearer which would occasion a quicker and better healing the flesh being thereby made longer then the end of the bone then if you approve of that course of stitching The manner of stitching the stump as some good men do take the two strong square needle threds mentioned presently after the member is taken away stitch the skin thorow on the one side and just over on the other side and with the other needle do likewise as it were cross over the member the other way and draw the said threds so close as you think convenient the better to stop and choak the great veins arteries then tye them fast and presently put buttons to the heads of the veines and arteries then apply the restrictive Plegents together the lesser spred with the strong restrictive lying on the broder spred with the ordinary stuff this broder plegent must come at the least three fingers over the stump and a linnen bed with them presently following laying a flat hand close on the end of the stump and holding it so till another standing by draw up the said plegents with the saidbed smooth close then let a third mango on with the rowling till the first rowler be spent then if you will draw on a Swins bladder which is no evil course for being once dry you need not fear any flux of blood my self have used it and found it good but your rowling must be very Artificial in such a case or all will not serve forâ—it exceedeth all medicines And there is a second great care to be had in the holder that he hold wel also remember ever in rowling to keep a hand to the end of the stump thrusting up the medicines close and keeping them so excepting ever as the rowleâ— passeth by to make way warily for it and stay it again ever where you see the blood springing out there lay a slender dorsel of tow and rowl over it again continuing rowling till the blood appear no more The first dressing being ended lay the party to bed with the stump high and a pillow under it appoint him a slender diet namely no flesh let him have a comfortable Caudle for the first if you see him weak and afterwards Broths and Pannadons and light things and in small quantity It shall not be amiss to defer the second dressing until the fourth day and no longer only visit the Patient daily and ease or take away some one towler or as you shall see cause Moreover in dismem bring the leg you are to understand that though the foot only be corrupted it is best to take off the leg some four inches below the lower end of the rotule or round bone of the knee the pain is all one and it is most profitable to the Patient for a long stump were but troublesome This work of dismembring is best to be done in the morning do it not willingly the sign being in the place neither the day oâ— the full Moon never take off any member in the joynt yet A caution Petrus Pigâ—rius a late learned Writer
the teeth have taken good hold round then take up your Trapan again and take out the pin in the midst and set on the other part again as before piercing and turning still till you have pierced through both Tables which is easily to be felt by the piecer then gently take out the piece which commonly cometh away in the midst of the instrument not regarding that all the fractured part be taken out or all coming away Neither shall it alwayes be needful that the depressed part be presently elevated except it may very safely and easily be done for nature Nature much helpeth in this work will admirably bring to passe the elevating and scaling of the rest of fractured or depressed bone in due time if thou follow onely a good method of applying comforting and convenient medicines to the wound with apt Ligature Neither strive in setting the Trapan A caution in setting the Trapan without good reason to use the greatest head of the Trapan which hath commonly three or four heads for if nature onely have a breathing it will wonderfully help it self by purging the contused blood through the orifice by way of matter or excrement Many worthy Artists there are at this day living which have performed great cures in fractures of the Cranium and yet never knew the worthy use of this instrument I have my self with a short carving knife twise made as good a shift as if I had had a Trapan ready and thereby cured two dangerous fractures by cutting as much of the Cranium away as that the contused blood had only vent The Germane Surgeons use no Trapan that ever I could see in my eight years living among them though they both speak and write of it But forasmuch as it is apparent the work of a Trapan is very good I therefore would advise a young Artist to make some experience first upon a calves head or a sheeps head till he can well and easily take Special skill required in the operation out a piece of the bone so shall he the more safely do it to a man without error when occasion is Note also that where a fracture is accompanied with a wound it Note shall not be needfull to inlarge further then will serve to set the Trapan for as too litle breathing is dangerous so are too great wounds making the Artist to be esteemed Butcher-like and hatefull and is often also very dangerous and deadly Further note the good successe of the curing of the fractures in the Note wherein curation of Fractures consists Cranium as also in all other Fractures standeth very much in good Ligature and easie medicines which I wish each young learner with diligence to practise Thus much of the Trapan Of the Lavatorie THe Lavatory is a necessary instrument to elevate the depressed Cranium The use in which work as I have written in the former Chapter of the use of the Trapan I advise no young Artist to be too curious Cautions to be observed or hastie to force the depressed bone too much where there is no evil symptomes for a depressed bone will oftimes help it self by rising It is very necessary and scaling admirably and yet it is many times of very necessary use and a fit instrument in the Surgeons Chest Of the Head-saw The Vse THe Head-saw is an instrument with which a vent may be given sometimes through the Cranium and thereby the use of the Trapan may be happily forborn and for that reason this instrument may have a place in the Surgeons Chest sometimes also a small ragged piece of the Cranium may so hang that this instrument may be used to sawe it away But I wish young Artists not to be over-busie in Good heed required in sawing sawing plucking away or raising the fractured Cranium as is said more then of mere necessitie they are argued unto lest fearfull and suddain accidents follow not to be avoyded not stayed If ought be meerly loose and in sight take that away if not forbear to pluck much at first for nature is exceeding beneficiall in eiecting unnaturall things in that part and very froward if thou use force whilest she is weak her self Of the dismembring saw Instruments must be ready at hand and kept clean THis great and terrible instrument onely ordained for amputation or dismembring is fitting to be alwayes ready and clean kept in the Surgeons Chest with two blades thereunto though one good blade well used will serve an Artist for his whole life but forasmuch as it is onely appointed as is said for the work of dismembring I refer the Reader to a subsequent Chapter of dismembring where I shal at large recite the use thereof and having small leisure will now haste to the next Of the dismembring Nippers and of the Mallet and Chizel for dismembring THese instruments having coherence with the precedent namely the Sawe are meerly invented as the former for amputation The Vse chiefly and are appointed to the fingers and toes as the other is to the legs and armes I need say no more of them in this place but that they are good necessaries upon occasions in the Surgeons Chest being kept well Neverthelesse in want of such at Sea the Ship-Carpenter No great nâ—â—d of them for a need can alwayes furnish the Surgeon in a short warning and therefore they may as well be forborn as any other I know in the Chest if allowance grow scant Of the Speculum oris plain The use THis Speculum oris is that which taketh hold on the tongue and under the chin at once and is very necessary to hold open the mouth for the better applying medicines to the throat and this instrument This is very necessary is of no other use at all in the Surgeons Chest yet because the work is frequent at Sea there is much need of such an instrument in the Surgeons Chest Of the Speculum oris with a screw Frequent in use and very profitable THis Speculum serveth to screw open the mouth which is often very need full at Sea as well in the cure of Lethargie and Scurvie as in many other dangerous cases and namely sometime for conveying nourishment into the mouth of the Patient sometime also for the bringing in medicines of severall kindes too long to write of wherefore it may not well be missing in the Surgeons Chest Of the Speculum Linguae The form of Speculum linguae The use thereof THis Speculum Linguae is a small instrument which may be carried in a plaister box it is formed like a splatter or spatula at one end onely it is hollow and cut through and the other being formed for scraping the tongue is very fitting in Fevers and furring of the tongue The broad end is used to hold down the tongue at some times as you desire either to inject any liquor into the throat or to apply any other
it The divers maner of their use is to be armed with dry soft lint to cleanse a wound sometimes again as is aforesaid armed with dry lint and dipped into some lotion oyl or liquor therewith to mundifie corrode or heal the grief according The ends of their use to the due occasion thereof and will of the Artist sometime to enquire the depth of a wound ulcer or fistula in which work many times great wrong is done by unconscionable or ignorant Surgeons to their Great danger in the ill use of the Probe Patients by forcing too far the Probe thereby to make the grief appear deeper which I advise young Surgeons to make a conscience of for by such abuse the Patient is many times greatly indangered of his The use of a long Probe life Further some use the longer sort of Probes with eyes like needles in wounds that penetrate through a member yea some are so hardy To draw the Probe therow the body wounded is evil they will put them through the Trunk of the body the Patient being wounded through the body all which I hold to be very idle for certainly it must be both very painful fearful dangerous to the Patient the custome of such artists is to draw laune or a fine linnen cloth being put into the eye of the Probe or stamule as some term it and dipped in some artificial balm thorow the member yea and some are so wise in their own conceits that they leave the said laun or linnen cloth in the wound from one dressing to another which for my part I utterly mislike for I know in all wounds nature striveth to make unition of the parts divided whoso keepeth asunder the parts by such courses it shall repent him except he be gracelesse My self have had reasonable experience in piercing wounds both through the trunk of the body and through the outward members and have ever contented my self in putting in to each orifice a short and easie tent which I commonly make of emplastrum stipticum Paracelsi or some other good plaister spread on a clout and rolled gently tentwise and so applyed dipped in Balm the tent being but of half an inch or an inch long at the most of which I never yet repented me except a broken bone be to come out and then I alter my intention according as the occasion enforceth with other answering and methodical courses due to healing being observed which in their places as time will permit shall be touched God willing No more at this time of the use of Probes Of Spatulaes great and small SPatulaes or splatters as they commonly term them are most needful instruments to spread unguent and emplaisters withal and also Their use to stir about and the better to compound any medicine on the fire Splatters of wood as well as of Iron necessary and to this latter work the Artist may make wooden splatters which will be far fitter and cleaner then those of Iron The Surgeons Chest cannot well be without both sorts and variety will do well wherefore they cannot be forborn in the Chest Spathula mundani THis instrument is newly devised by my self to serve upon any occasion A new instrument of extreme costiveness which often hapneth to sea men so that no purging medicine neither upward nor downward administred or taken will work which my self have more then once seen in which The use case the fundament with the speculum ani aforesaid if occasion urge is to be opened and the spoon end of this instrument put in the hard excrements there with drawn out which in some bodies are so dry that they may be poudered This disease killeth many and may by Costiveness dangerous the diligent Artist be easily cured as aforesaid This recited instrument may be easily forced into the fundament without the speculum ani to conduct it being anointed or greased and first warmed a little This grief cometh now and then to men which have the scurvy and it often so inflameth and excoriateth yea and sometime putrifieth the Arse-gut or Longanum that the party either dyeth thereof or the sharp humidity proceeding by reason of the inflammation and excoriation thence mentioned maketh passage for the aforesaid hard excrement after which followeth a most extreme and painful flux of blood which for the most part killeth them and yet is it often seen that the party being in time diligently attended by God his mercy Great care to be had in the cure of this disease may have comfort and remedy for it These hard excrements taken away the body returneth to the natural former habit again c. Pacis Pullicans Punches or Forcers Crowes bils Phlegmes Gravers and Files for teeth ALl these recited instruments and each of them are needful in the The use Surgeons Chest and cannot be well forborn for the drawing of teeth forasmuch as the cleansing of the teeth and gums and the letting of the gums blood are often no smal things for keeping men in health at Sea and sometimes do save the lives of men both at Sea and Land For we see that from an Apostume begun under a rotten or hollow tooth for want of drawing the same sometimes proceedeth Skill in drawing of teeth required great swellings in the face or in the amygdals and throat and the party is suffocated and dyeth Likewise by indiscreet drawing of a tooth either the jaw is broken or some other had accident is provoked Wherefore I hold none worthy to go for a Surgeons Mateto sea who is ignorant of tooth drawing and I esteem him an unworthy Surgeon how high soever he bears his head that can draw a tooth well and will upon need at Sea scorn or deny to do it The maner how how to draw a tooth aright For drawing of teeth the true manner is first well to divide the gum from the tooth in which work if you be wary you need not launch or cut the gum at all but only with the round sharp pointed end of the The use of a Phlegme phlegme to compasse the tooth close piercing by little and little still somewhat deeper but ever keeping round and close to the tooth till you feel your phlegme be as low as the jaw bone in which time you may do well then to consider what kind of instrument you wiltake to draw it and if it be the furthest tooth of the jaw either above or below The use of the Pullican or that it be a stump except it be of the formost teeth the Pullicans are the fittest instruments to draw with if it be any other of the great grinders and that there be reasonable hold on the inner side be it on The use of the Pacis the upper or lower jaw it is best done with the pacis but you must be wary you draw not a large tooth with a narrow pacis for so you
in a Coperas water and let it dry again and lay that lint drie upon the proud flesh sometimes for a dressing or two and then againe to your former method doubt not but it will without pain verie well cicatrize any new wound I write this for that by the unskillfulness yea Surgeons wilfulness as well as unskilfulnes blame-worthy and sometimes by the idleness of evill minded and base Empericks I have seen men lamed by the needless use of caustick medicines even in slight wounds to which if an old wife had openly applied her one salve for all sores no such thing had happened yet I am not so simple to denie the just use of such noble medicines in wounds ulcers and fistulaes or otherwise where need is but I onely here advise the young Artist Note that he may not be too rash in the use of them and likewise doe advise him that having used them once he first pause again at the least eight dayes namely till the first Esker be fallen and certain daies after ere he use any caustick powder again for with the use of corroding medicines Two evils to be avoided one immediately after another many Ulcers are made more painfull and rebellious then they were and the bones sometimes made foule which were otherwise clean which fault is too frequent now adaies and amongst many grosse faults daily committed by unexpert Empericks this one is to be lamented namely the use of keeping open penetrating wounds too forcibly and too long by the use of hard tents armed with caustick powders whereby nature can make no true unition but is forced into much disorder which I wish young men to make a conscience of and to be carefull not to erre in that kind The Lavatorie This Instrument is set down else where Of the Uvula spoone THis Instrument is made to put pepper and salt in or fine bole pepper or salt or some other the like medicine and to hold the same right under the Uvula which is for to blow up into the concavitie behinde the same and no other great or especiall use I know it hath in Surgerie except it may be used to warm a medicine in Thus much of those necessaries which properly deserve the names of instruments in the Surgeons Chest Now a word or two of such other Appendixes which in their kind are as necessarie as the former The Cupping-glasses or Ventoses The use is divers THere are many necessarie works in Surgery performed by Cupping-glasses namely sometimes they are used to set upon a Bubo or botch to bring it forward and therein they are very good Sometimes also to set in the nodell and on the upper part of the shoulder-blades to draw back humours which oppresse the head the eyes or teeth or against Lethargie or on the thighes against aches or pains there or for the cure of the Sciatica they are very good or sometimes to draw bloud and spirits to The end why they are set without scarifying Why with scarifying a member withered or benummed in all these and divers more griefs the Cupping-glasses are very needfull Sometimes also they are set without scarifying onely to attract humours to the place Another time it may be in other cases they are used with scarifying to take away bloud and choler which offendeth the part Some set them on with The divers setting of them The best manner of setting them towe some with a small wax light set under them some onely with the flame of a great candle which my self use and is not offensive nor painfull at all whereas the other waies the flame excoriateth often the part and maketh new unseemly work for the better doing whereof I use to place my candle close to the place where the Cups should be set the place being first wet and rubbed well with hot water and a spunge and Note the Cupping-glasses also wet Hold your Cupping-glasses over the flame a little and then clap it quickly on the place whilest yet the steame of the light is in it and it will be fast and draw hard but you must have your Cups fit and not too wide for the place you would set them on or else they will not take any hold Further when you perceive they have drawn well which by the blackness and rising of the skin you may sasily Scarification must be light and sudden and with a Lanncet see then if you hold it fitting you may lightly and quickly scarifie it with a fine Launcet which truely is the best and profitablest instrument for that use and then wetting your Cupping-glasses againe with the flame onely of the candle set them on where they stood before setting When to take the cupping-glasses away What to be done after they be taken away Deep scarifying evil as many cups and drawing as much bloud as you see good and when no more bloud will come and that you thinke it time to take them away which is known by a yellow water which cometh at the last then I say it is time to wash the places with faire water where the cups stood and drie them with a spunge or cloth and onely anoint them with Ung. Album once and they will bee whole The overdeep scarifying it is not onely dangerous but also painfull and not art-like for if you note well the cutis it hath many capillar veines in it yea and some great veines and is porous so that the Artist may by force draw humiditie sufficient from farre if so occasion bee to use their utmost force Large and with cups are fittest on the thighes lesser on the arms and the least for the hands or feet Of tho Brasse Bason Friend learn good by ill I Have nothing to write concerning it but that at the least the Surgeons Mate have one if not two and if he finde no use for it let him sell it for good liquor at Bantham as a Surgeons Mate lately did one of mine Of the Blood Poringers The quantity of blood Imitation with out discretion is idle Blood poringers necessary BLood Poringers are necessary at Sea to be the more certain of the quantity of blood which is let for since the blood of man is so precious it is to be well weighed what quantity is taken And although the German Surgeons do ever let blood into a bason yet I hold it not good for the Surgeons Mate to imitate first except he be of good judgement indeed to judge of the quantity The blood Poringers which are made for that purpose being full hold just three ounces and The constitution of the body is to be regarded in Phlebotomy somewhat more For my own practice I hold this course if one chance to come to me of himself or by advice of a Physician to be let blood though he have a strong body I never take from him more then two poringers and a half at the most but often lesse If
the party be not strong except it be in case of a Pleurisie or some like urgent cause I take lesse For in that work except my reason give me good satisfaction to do the contrary I will rather offeud in too little then in too much Too little rather then too much blood is to be taken away taking of blood away for I have seen much hurt to have ensued by great quantity of blood taken away at one time 7. or 8. ounces I hold a strong body may bear to lose having good nourishment to recover it again and that without harm but if you grow to ten ounces you may many wayes do harm in the body except your warrant be good I speak not this to discourage young Surgeons from a work so behovefull but admonish them to warinesse in a point so dangerous Of the Dyet Pot. The use THe Dyet Pot is not alone to be used in cases of dyet drink seething for the pox and not otherwise for as a learned Doctor upon occasion lately reasoned there is difference betwixt the Dyet and a Dyet though in both kinds there is even Quot homines tot sententiae so many men so many minds Wherefore concerning descriptions of several Dyet drinks for the pox I will refer the Surgeons Mate to other Authors for in truth I must defer that point till fitter oppertunity I mean till I write touching the cure of that disease And yet methinks to speak somewhat A docoction for the Calenture of a drink is the case of the Calenture or any other unnatural hot fever to be made at Sea to qualifie the heat of the blood were not amisse which may be done as followeth â„ž French barley â„¥ iiij Fresh water 2. gallons Licorice â„¥ i. Cloves n o. 12. In want of Licorice tak juice of Licorice half an ounce In want of french barley take other barley or for a need wheat flower boyle this gently to 4. or 5. quarts then clear it and if it may be keep it not in How to keep it The composition of this drink if the heat be over great causeth head-ach The colour and taste of the drink is to be observed the brasse pot but in some earthen or glasse vessel and if the party his heat be great and have pain in his head add thereto so many drops of oyl or spirit of Vitriol as will a little change the tast and make it sowerish but not too tart in any wise and if into all his drink you put of Rose-water of wine-vinegar or Rose vinegar and Cinamon-water of each onely one spoonful if you have it it will do well to mend the tast if not the matter is not great let the Patient drink often hereof Further you The drink composed for a Laske may if you think good add surrupe or juice of Limons Ê’ 4. If it be for one which is loose in his belly you may infuse of your succus Acatiae herein some 2. or 3. Ê’ and being cleared let him drink of the drink plentifully as he hath thirst but you must cut your Acatiae first and dissolve it in a little of the drink warmed and so put it into the rest Also in want of Acatia if you put therein Galls in powder a little it will do well Of other necessaries THe next instruments in order to be remembred are these following viz. Skillet Chafing dish Glister pot Funnel Cups to give potions in One Board knife to spread plasters Morter and peâ—tel Weights and Scales Sives Searces Strayners Splents Junks Tape Towe Spunges Clouts Rowlers Gray paper White paper Empty pots and glasses Thred and Needles Wax Candles Lanthorne Tinder box furnished Inke and quills One close-stoole One bed pan One brasse paile 20 Well burned bricks Pipkins Empty baggs I shall not need to spend much time to set down the uses of all these necessary implements only two or three of the most needful to be noted I will remember and then to the uses of the medicines within the Chest Of Weight and Scales VVEights and Scales are necessary things often times lightly regarded and yet how many mens lives hang in the ballance it is plain enough For Sea-Surgeons familiarly give Stibium by the grain The use is divers namely from 4. to 8. grains yea and to 12. grains by your leave when in truth few of them have waights and Scales which can weigh one grain A great fault in weights and scales It is a dangerous thing for a Surgeon at Sea to be unprovided of neat weights and Scales which will turn with half a grain for how can they give either Laudanum Paracelsi Stibium or other Chimical medicines safely or almost any medicine inward without small weights and Scales Wherefore two pair of weights and Scales are very needful for the Surgeons Chest namely one for ounces and another for grains for larger Scales the ship is furnished It is also to be understood here for instruction of children in Art that xvi ounces make a A direction iâ— weights pound each ounce 8. drams each dram 3. scruples each scruple 20. grains for the grain a full barley corne will well serve or a good wheat corne though a large wheat corne be somewhat too big an ordinary pepper corn will also serve for a grain Of the Close-stoole with the Paile of Brasse and the Bricks ALthough I know before hand that I am to undergo many witty and Eloquent flouts from young gallants of my own profession for mentioning so base an instrument to belong to the Surgeons charge as this last mentioned Close-stoole with his appurtenances yet let them Mean things sometimes are of great moment know that neither can my book blush neither shall my self I hope have cause for I nothing doubt to yeeld each honest young Artist a sufficient reason for to satisfie him herein and in a word my reason for appointing to each ship bound for the East-Indies at the least one of these is because the bloody or other flixes are so dangerous diseases and so deadly amongst our men that I hold it my duty to advise even the good None worthy to be reputed â—rtists who disdain the meanest office of their profession use of a Close-stoole and I have caused the stoole to have one door on the one side that thereby either things to foment fumigate or otherwise to comfort the weak part might be the better applied the Patient sitting at his ease thereon The use of the Close-stool The need of it is great Also one especial reason why I have appointed it is that a poor weak man in his extremities should not continually go to the shrouds or beak-head to ease himself nor by noysome to his fellowes but might by the help of his Mate through this mean instrument find comfort in his most pitiful distresse whose miseries I heartily compassionate Wherefore I admonish the Surgeons Mate in general in the fear of God
laske weaknesse of the kidnies and stopping of the urine comforteth the heart and aromatizeth the stomack Zinziber ZInziber or Ginger is hot in the third degree helpeth concoction strengtheneth a cold and weak stomack breaketh wind and preventeth sowre eructation Gummi Guaici Gummi Guaici the gum of the Guacum hath the same vertue as the wood and bark aforesaid called Lignum Guaicum and drunk in powder is approved a good remedy in Gonorraea Opoponax OPoponax is a gum hot in the third degree and dry in the second if bitter white within or yellow fat tender easily dissolving and of a strong smell it is good it doth mollifie digest attenuate or asswage dissipate or disperse wind and is laxative Of Bdellium BDellium doth warm and mollifie hard tumors in the throat and discusseth Hernia's in their beginnings provoketh urine and is good aganst the cough Amoniacum AMoniacum a gumme so called is hot in the third degree hath the force of mollifying so effectual that it dissolveth Tophoes or hard stones grown in the flesh easily discusseth other pustles healeth the spleen hardned and being given in drink taketh away many obstructions provoketh the monethly courses and urine driveth out the stone dissolveth the Kings-evil is very profitable for aches occasioned by cold that which is pure thereof is formed like Thus and in tast like Castoreum Sagapenum SAgapenum or Serapinum is hot in the third degree dry in the second bringeth down womens courses is profitable against the suffocation of the Matrix resolveth attenuateth dissipateth moveth dissolveth and purgeth though slowly thick flegme and clammy humours it is esteemed excellent if clear yellow in colour without but white within quick in tast light in substance and easie in dissolving Galbanum GAlbanum is hot in the second degree it is good if it be full of drops pure like frankincense fat not full of sticks strong in smell neither moist nor dry in substance it extracteth discusseth bringeth away the courses stopt and the birth takes away biles hard kernels and knots in the body and helpeth the cough short breathing convulsions and ruptures Myrrha MYrrha chosen fragil or brittle light spendent of little drops bitter sharp which smelleth sweet full of whitish veins being broken is hot and dry in the second degree It openeth the womb procureth the courses bringeth forth speedily the birth and is good for the cough stitch flux and bloody flix it killeth worms amendeth the breath closeth up wounds confirmeth the teeth loose and stayeth the hair from shedding Mastick MAstick sweet in smell white spendent brittle old and very dry brought from the Isle Chio is hot in the second degree It helpeth concoction stoppeth vomiting confirmeth the power of reteining sustenance is abstersive it is profitable also to them that spit blood or that are troubled with a cough it attracteth flegme from the brain and is good for the breath Gum. Ladanum LAdanum is hot and dry in the second degree doth calefie and mollifie it opens the pores of the veins keepeth the hair from falling off the head stoppeth the laske provokes urine it is used seldome in the Surgeons Chest except in making a grateful odour as when a fume of Cinabrium is to be prepared for the cure of the pox Styrax STyrax Calamita liquidus are both hot in the second degree do mollifie concoct cure the cough distillations hoarsnesse pose or stuffing of the head matrix stopped are good to procure the monthly courses of women cordial exhilarating oppose to poyson and do discusse hard cold tumours the knots of the sinews and the struma The best commeth from Gyprus Sidon and Pisidia the Calamita Styrax is yellow fast rosen like in glistering fragments continuing its smell though old and being dissolved of a hony-like colour if commendable Belzoin BElzoin called vulgarly Benjamen is hot in the fourth degree comforteth the heart and all the faculties thereof and hath the same power as Styrax Calamita aforesaid the reddish cleer full of white drops like frankincense and of a sweat smell as Xiloaloes burned is chosen Tragacanthum TRagacanthum a temperament hot gum is good for the cough roughnes of the Artery or wind-pipe hoarsnesse and defluxions being taken with honey or with Sugar and is commended to be good for the eyes also it is good to be swallowed down whole or eaten in powder against the fluxe Pix Burgundiae of some Pix Graeca and Colophoniae COlophonia or Pix Graeca is all one thing and is a kind of Rosin of the Pine tree it is hot and dry cleansing and healing new wounds mollifying hard tumours or swellings and is very profitable against aches of the limbs proceeding of a cold cause Pix PIx Navalis or stone pitch is hot and dry in the second degree it discusseth conglutinateth mollifieth maturateth suppleth the hardnesse of the matrix and hard tumours cureth ulcers filleth them that are hollow up with good flesh and helpeth cold aches Resina REsina is hot mollifying discussing and cleansing and being taken inwardly is good against the cough mendeth the breast provoketh urine concocteth crude matters looseth the belly expelleth thē stone and gravel and is excellent for the cure of green and fresh wounds Succinum AMbra citrina seu succinum is hot and dry prevalent against the white flux of the wombe flux of blood running of the kidnies distillations of the head stopping of the matrix monethly terms difculty of urine being powdered and drunk helpeth immoderate cough and strengtheneth the intestines and is good to be cast on coals to receive the fume thereof to comfort the Arse-gut fallen as also to fume a ship or house in time of infectious aires as the plague or when general fluxes are to be feared Cera Citrina CEra Citrina or yellow wax doth mollifie and heat moistneth temperately it is good to amend the milk in the nurses breasts coagulated it asswageth pain healeth wounds and ulcers and hath commonly a place in all good unguents and plaisters It is a good medicine to be drunk or eaten and so swallowed down for to cure the exulcerations of tht stomack or intrails in fluxes where inward exulcerations are to be feared Mummia MUmmia is astringent helpeth fluxes of blood the bladder ulcerated and the inward distempers of the yard as also it provoketh urine and is very good to be drunk in powder against great contusions or coagulated blood within the body Sperma Ceti SPerma Ceti or Spuma maris or the spawn of the Whales is sowre in tast spungie and white in shew unsavoury in smell and weighty having a sharp quality It is of a cold faculty cleanseth and digesteth and is sometimes used of women to clear the skin from spots and morphew It is good also against bruises inwardly taken with the former namely Mummia and also outwardly warm to anoint the parts contused therewith and a Paracelsus emplaister or of Pix Grecum put thereon Sanguis Draconis SAnguis Draconis is cold and dry in the
but the choice of the day is not material as some suppose where there is apparant necessitie except on the day of the full of the Moon and then there is danger more then at other times but necessitie hath no rules The cure of wounds in the face would if it were possible be done without a cicatrice but that cannot be performed without a drie stitch with also a most artificial convenient binding the lips of the wound together with also a sure natural balm wherefore I will not stand to teach the drie stitch here for it is not proper at sea it fits the land bettet In the work of suture or stitching take heed that the skin and flesh be not overthick which you take up with your needle and let not your stitches be too close A true ligature of the face is somewhat difficult to be performed because of the cavities thereof which are to be filled with linnen clothes or tow or lint the better to keep the ligature to the wound Where ligature is needfull The Nose and Eare wounded require good and carefull ligature and Emplasters that will cleave fast to the grief The wounds of the eyes are dangerous by reason of their affinity as well with the Pericranium as the other Membranes of the brain so that they are for the most part full of bitter pain causing losse of sight wherefore by Glisters bloud letting cupping Glasses Purgations and sober diet the accidents are to be stayed The medicines outwardly which I have used ever with good successe are the artificial Balm with fine lint warm applied on the eye lids and a Paracelsus plaster over that and therewith I have done great cures in wounds of the eyes but I never dropt any medicine into the eye it self The wounds of the neck are healed as other are unlesse the hinder part thereof be hurt which hath like symptomes to the brain If the shoulder be wounded it is cured as other wounds except the wound be in the joint-bone ligaments and nerves which needeth a suture and if it be overthwart a convenient Fascia or Ligature for the sustentation of the arm is to be carefully provided for without good ligature those wounds do not well For ought else their cures are common to other wounds The cures of the arm are sometimes dangerous chiefly if the bone and ligaments or the muscles with veins and nervs be incised thwart let the remedies therefore be such as are proper and agreeable to the nerves as namely the artificiall Balm very warm applied and a Paracelsus plaster with ligature fitting But if the hands be wounded and the tendous ligaments and sinewie parts thereof offended divers abscesses in many places with Inflammations appear sometimes and exceeding sore Sometimes pains arise which may occasion the use of purgations blood-letting anodine medicaments and a spare wholsome diet In these cures the artificiall bearing up of the arm is a chief part of the cure thereof and keeping the hand in one even position The wounds of the Thorax external suffer to be covered with flesh and to be healed as other wounds but wounds that penetrate the inward patts are dangerous namely if any great quantitie of bloud lie in the capacitie of the Thorax which cannot be evacuated by the wound but if it can be evacuated there is hope otherwise it is desperate Also if the blood may be extracted and no internall part seem hurt heal up the wound and be careful the aire get not into it but if the external orifice be litle and the internal great and wide the Membrane being burst and a rib uncovered as it oft times falleth out it is to be judged incurable and a Fistula will remain their continually And if the former part of the Thorax be strook thorow even to the latter but not thorow both if the wound be little and slender there is some hope of cure otherwise not but it is commonly past cure yet neglect not thy duty nor despair for God is merciful Let thy cure be attempted with good diet as is said cly sters bleeding syrupe of Violets and Hysop and the like unguentum potabile drunk fasting Ê’ ii or 3 for a dose and such local Medicines as are mentioned but if pain or the like accident shall be in any part of the Thorax use anodine medicaments as well as sanative lest pain hinder rest and overthrow all The outward wounds of the belly do nothing differ from the generall method of other wounds touching local Medicines onely in stitching they differ much but the inward differ as the parts offended may be divers as namely when the Omentum commeth out with all hast put it into its place lest it corrupt and the aire alter it if it shall be put in cold it will putrifie and bring grievous Symptomes it were better to make a Ligature about so much as is out and cut it off being careful of the guts If the intestines passe out by a wound the wound being very little they will hardly be reduced unlesse they be pricked for they will swell with wind but if the substance of a gut be wounded sow it together and consolidate it and if the liver splene stomack kidneis or bladder be wounded let nature work its part for there is small hope by art to prevail The wounds of the Scrotum are cured as other wounds of the sinewie parts The cure of the Hyppe wounded agreeth with that of the shoulder afore mentioned The Knee wounds also are cured as other sinewie parts wounded are The ancle foot and sole thereof wounded are hard of cure because there are many bones ligaments tendons and finewie parts among them they are also placed in the lowest part of the body and therefore are subject to defluction of humours Of Gun-shot wounds VVOunds made by Gunshot are alwaies compound never simple and are the more difficult of cure by reason of a certain Wounds by Gunshot are compound humor without the veins found neer them inclining to coruption the quality thereof being changed by the sudden violence of the blow The composition of which wounds for the most part consists of loss of substance contusion fraction of many sinewie fibres veins arteries membranes and bones yea often shivered into divers pieces being in The divers form ofwounds by Gunshot form different as some round narrow and wide and in figure cuniculous triangular quadrangular fistulous c. at the first bringing with them no Hemorrhea or flux of blood although the veins be broken open the blood returning back through the fearful violence of the strok The first curative intention of these wounds is dilatation where by the enemy to nature may by an open orifice be expeld The symptoms of such wounds are Hemorrea furtive or a stealing flux of blood trickling out by little and little Gangrene unawares assaulting the part also apostumation dolour and the like Wherefore as an entrance to the cure let an universall
themselves and let them avoid slothfulnesse avarice envie fear pride or what else may hinder these duties that God may give a blessing to their labours and then the praise and comfort shall return to themselves which God grant And for the elder sort of grave Artists I crave their charitable censures of my weake or undigested instructions which I no way mean to them but to babes in Chirurgery and so I conclude to the honour of the Almightie concerning the Scurvie for this time Concerning the Fluxes of the Belly THe principal Fluxes of the belly by a common consent of divers ancient Writers are chiefly referred to three kinds namely Leienteria Diarrhoea Dysenteria What Leienteria is Leientaria is distinguished to be that Fluxe which either passeth the sustenance taken wholly digested and that without any blood at all and without great pain or as it were half digested The true causes of Leienteria proceed chiefly through imbecillitie and weaknesse of The causes of Leienteria the stomack which may be occasioned many wayes whereby the vertue retentive is weakned yea and sometimes the stomack by some Crudity a cause Apostumation is either wholly weakned and cold or broken or otherwise by crude humidities is oppressed and must be strengthned both inwardly and outwardly by things that corroborate and warm the same as is Syrupe de absinthio or oleanâ— absinthii Chimice 3 or 4 drops thereof in wine or beere for need and I have found it good to a strong body at first namely in the beginning of the disease to give him a vomit of the infusion of stibium or rather of A vomit at first Salvitrioli ten grains if it may be had or of Aquila vitae four grains or of Cambogia twelve grains and so the medicine having done working To corroborate let him presently sleep fasting if he can if not give him a little Cinamon-water or a little sanguis prunellorum if you have it or a draught of good Aligant or conserve of Sloes or Quinces and shortly after namely three houres if he cannot take his rest give him An opiate three grains of Laudanum in a pill and so appoint him to rest but if you conceive or feare the disease to proceed of Apostumation in the stomack then beware of giving any vomit before perfect suppuration of the same for it is deanly but outwardly you may apply then Stomack comforted to the stomack a bag with Worm-wood Mints or sweet Majoram nd warm being sprinkled with Rose water and Vineger or else a Bisket bedued well with Rose water and Vineger being steeped must Pecteral unguent be applied to the stomack or anoint the stomack with unguentum pectorale or with oyl of Nutmegs made by expression also Theriaca andromachi or theriaca LondiniÊ’i ss is very good given him upon the Coâ—â—â—als point of a knife or Marmalad of Quinces is also good Mithridate is very fit and approved or grated Nutmegs is very good and Cinamon in powder taken in meats or drinks is good likewise if these things answer not thy desire thou maist proceed to medicines more astringent Astringent medicines such as follow in the cure of Dysenterie one verie familiar and good Medicine is sanguis prunellorum aforesaid the dose is â„¥ j. or â„¥ ij with Mint or Worm-wood or Carduus water taken going to rest or taken of it self But your mentioned Laudanum in all Fluxes judiciously Cordial water administred is the onely sure help neverthelesse in this grief trie other good things first all Aromatized strong waters are convenient in this case moderately used as well to avoid further fluxes as also in these fluxes to comfort the stomack stiptike wines serve well for it likewise Theriace diatesseron â„¥ j. now and then also electuarium diatrion piperion â„¥ ss on a knifes point given is very good for it mightily Diatrion piperion warmeth and strengthneth the stomack But sometimes it happeneth that not onely the meat passeth away by stoole but also other undigested matter with it in which case Petrus Bayrus in his Veni mecum folio 273. adviseth to use things sowre with meat as Verjuice or the juice of sowre Pomgranats and the like in want whereof the juice of Lemmons is good or rather syrup of Lemmons or syrup de Agrestis or oyle or spirit of Vitriol taken in some fitting drink as Cardâ—us water or fair water wine or Barly water the oyle of Vitriol 3. Syrupe of Lemons Oyl of Vitriol drops taken with conserve of Roses is also good in this disease also keep warm the region of the stomack and Liver and inwardly as is said it is good to use all good comfortable helps that warm Of Diarrhoea DIarrhoea is a flux of the belly which is either merely watrish or with humors and with slime mixed for the signes of the disease are manifest the causes too many for my leisure to note unto you concerning the cure of Diarrhoea if you see that the Patient be strong there is no great hast of stopping this disease for that it is many times a benefit of Nature whereby she avoideth superfluous or venemous or Stop not at the first otherwise vicious and offensive humours but when you shal perceive that it hath continued certain dayes and that the partie is weakned thereby then begin the cure as followeth First give him ℈ ij of Rubarb dried as they use to drie Tobacco and poudered either in wine or Carduus or fair water or the infusion thereof without the substance A purge and after the working thereof a gentle glister will doe well which may likewise leave a stiptick qualitie in the guts but not too strong such as hereafter shall be mentioned and let the partie be laid to rest very warm covered and warm clothes applied to the belly and fundament of the partie and if that helpeth not you may give him Warmth is very good within three houres three or foure grains of Laudanum and let him again incline himself to rest and by Gods help he shall be cured but if he have a Fever give him an opiate first I mean the Laudanum Good helps to the cure of this disease and all Fluxes of the belly are Laudanum these following first to refrain and resist as much as is possible the motions of going to stool not to strain or force the body being at stool not to sit long being at stool in rising to remember to put up worth the observing the fundament with a clout and that if it may be with a warm soft clout to sit as hot as the partie can namely if it may be often to sit upon an oaken board hot is very good hot trenches or pieces of boards heated and applied to the belly are very good and to take the fume of wine vineger sprinkled on a hot brick or iron and sit over it on a close stoole is approved very good and to
Sect. 4. Another good sign In fluxes of the belly changes of the excrements is a principal good sign unlesse the change be made worser Aph. 14. Sect. 2. In perturbations of the belly and voluntary vomiting if such things are purged thereby that ought to be purged it is good but otherwise the contrary Aph. 25. Sect. Aph. 3 Sect. 4. A Dysentery which proceeds from yellow choler is not altogether mortal as Galen affirmeth in his second book of natural faculties that General rules for the cure of the flux many are cured of it Lientery after Dysentery is mortal these Canons following belong to the particular cure of any flux of the belly No flux of the belly before the fourth day if the Patient be strong is to be restrained The ulcers of the higher intestines are to be cured with medicines taken at the mouth but those of the lower with Glysters chiefly and if ulcers be in both then are they to be cured both waies To such as cure a Dysentery let astringent things be given before other meats that they may the better be retained Hot stiptick things are good in fluxes proceeding of a cold cause And on the contrary if the concocting faculty shall be weak the use of hot things is likewise good If there be a cough with flux of the belly the Patient shall abstain from all sharp stiptick things Sweating medicines and frications with oyl of Camomil and Dill by opening the pores and plucking back the matter to the opposite part are good in fluxes Cupping-glasses saith Avicene applyed four hours to the belly stay the fluxes of the belly All stiptick fruits by the counsel of Avicene are to be avoided in fluxes of the belly notwithstanding Chestnuts hurt not as the same Author affirmeth Sleep among other things is good for a flux and so is any quietnesse and rest good unlesse the flux proceed from some Catarrhe or rheume Touching the particular cure if the disease come of a hot cause let there be a lentive glyster administred before the fourth day which is this â„ž Aqua hordei â„¥ xij Mellis rosati â„¥ ij mingle it and let it be made a Glyster twice reiterating it afterwards let the cholerick matter be purged thus â„ž Rosarum ruâ—earum violarum â— â— â„¥ â— let them boile A glyste onely one walme and in the straining infuse them the space of six hours then add these things â„ž Cortiâ—es mirâ—bal cit â„¥ j. tragac Ê’ij A Purge strain the medicine and let it be so given notwithstanding warily for indeed many of our ancients did abstain altogether from purging medicines in fluxes whereupon Avicene 41 capite 3. saith that it is dangerous to loose the belly upon a former loosenesse If the matter be sanguine and the sick of reasonable strength you may let the lower vein be opened to represse the acrimony of the humour to pluck back and coole the boyling of the liver witnesse Avicena 4 â—rimi chap. 20. Phlebotomy doth bind the belly very much and amongst many is held for a great secret for a certain man of 70. years of age labouring with the Dysenterie the space of a moneth when no other means would help him he was cured by letting of blood yet I confesse my self should not easily do the like If the excrements begin to grow thicker and the gripings begin to cease the token is good if in the excrements scraping as it were of the guts seem to appear it is no token of death I read that the ancients used caustick Glysters of Arsenicum aes vestum Alumen Calx vivum but these later Pysitians use rather astringent and narcotick medicines as these Cortices Thâ—ris Mastiâ—ts Boli Armeniae Sarcocollae and the like The'ulcers of the small guts are worse to receive healing then those of the great guts for the greater are fleshie and therefore they receive consolidation so much the easier The ulcers of Jejunum or the hungry gut are of all the worst because it is smaller then the other and because sharpe choler doth suddenly happen into it iâ— hath more veins in it then the rest and is next to that noble part the liver and further one reason of doubt is for that medicines taken to bind and consolidate cannot long remain therein In the Dysentery what must be refused In the Tenasmus and the Dysentery coming after it the patient must abstain from all sharpe salt and bitter things because by using of such things the excrements become sharpe and cause excoriation Hot things restrain the flux of the belly because they make the meat digest penetrate cause urine and provoke sweat which is found in the drinking moderately of pure wine as Avicâ—ne witnesseth besides that it provokes sleep and helps digestion notwithstanding it is to be abstained from in fevers and when the flux proceeds from hot and cholerick humors A Dysentery proceeding from obstructions will never be cured with Astringent medicines but rather with penetrating medicines by adding a little vinegar which openeth more forcibly then wine and mollisieth obstructions for if Astringent medicines be mingled with deâ—icatives they increase the obstruction Although some say that in the Lienteria the meat taken in doth come forth in the same colour and quantity as it was when it was taken in this notwithstanding is to be understood that the form and colour of it is of necessity changed but it doth not wholly alter it for they are altered somewhat according to the majus minus because it is an impossible thing that the nourishment being conveighed thorow so many intestines should come forth without any alteration at all There are some also which judge the Dysenteria and the Tenasmus by motion of the pulse that the patient hath a fever if the pulse be moved swift yet it seems to me the contrary although there is an over heating or boyling in the blood by reason of the hot humors the great motion of the body want of sleep and abstinence yet with the flux onely stayed the fever hath an end It is formerly said that the ulcers of the great intestines are to be cured with Glysters and the ulcers of the small intestines to be cured with medicines taken at the mouth notwithstanding it profiteth to take fit medicines at the mouth for ulcers of the great intestines and Remedies for Vices in the intestines in ulcers of the small guts to inject glysters which sometimes ascend to both the ventricles as experience teacheth and so also are ulcers in the great guts sometimes cured by medicines taken at the mouth wherefore let no convenient helps be omitted in case of necessity And though Avicena saith it is dangerous to purge the belly upon a loosenesse thereof yet the same Avicena Gerardus Cremo Serapio Jordanus de Turra and other later Physicians of â—ound judgement prescribe in the cure of fluxes Purgative medicines therefore they appoint things according to the patients strength when a
the Chrystalline salt purified from grosse Salt-peeter knowne to be pure by that it doth contain no common salt therein being also wholly combustible of temperament it is either hot or cold as is The Nature plainly seen by his office and vertue do I say vertue yea and vice both I may say for in truth for wounding and killing salt goeth beyond Mercury this is the dangerous part of gun-powder which giveth it the force of piercing to the heart which God deliver all Christians from feeling it and accursed be that hellish Germane Monk Germane Monk Europs Doct rs Sal Nitriof two sorts which taught it first in Europe This Sal nitri is either animal or vegetable or both and may also not unfitly be tearmed mineral growing in mines and it is every where for every creature living may be said to have a part thereof man and beast I am sure hath a great part The spacious kingdome of Sal Nitri of it It is a most medicinable subiect as any is in the world and no man can live without it for our bloud and urine hath it in it yea and our very excrements are mixed therewith it is also in caves in mountains and plains and where not The inward vertue of Sal Nitri The dose for Hemoragie But to leave such discourse whereto I have not appointed this little time I say Sal nitri in the Chirurgions chest is a worthy medicine and the purer it is the better it is for all uses Touching the inward uses thereof it is good against Hemoragia or bleeding of a vein whether it be by the nose or any inward vein of the body taken Ê’ j. dissolved in plantane or fair water Helpeth the Calenture In the Calenture it is approved good to coole the boyling of the blood taken as aforefaid the dose for a need if the heat be great may be given every foure houres or the party may have a barley water rather made wherein two drachmes or more may be dissolved to drink at will it will not offend him onely if he take too great a The dose dose at once it may cause him to vomit but it will not hurt him It is the best thing I do know for the furring of the mouth and the throat in fevers the place gently washed therewith dissolved in water it presently bringeth away all the whitenesse and furring without offence Cleanseth the mouth furred used in water The mouth cleansed a Lotion needful It is not ungrateful of taste but so soon as you have taken such furring away I advise you that you have ready some gentle sanative lotion to inject to take away the acrimony thereof for it is abstergent and yet without violence or danger you may use therefore the ordinary lotion one part faire water two parts and so inject to cleanse the mouth after the use thereof I have expressed other uses of Sal Nitri proper in the cure of the Scurvy to which I referr the Reader Certain plain Verses for the use of Young Chirurgions by the Author gathered in praise of SALT SAlt with the world did begin whose end exceedeth time In it lie hidden secrets rare which no tongue can define Our Saviour his disciples deere to Salt did oft allude Who by their blessed voyces fill'd the earth with spiritual food Salt many jewels far exceeds salt guideth health and life Salt Author is of all increase ' gainst salt there is no strife Salt and his force his place his time his power in life and death His choice his change his actions strange admire we may on earth What living creature can want salt what plant or tree may grow What metal perfect doth endure if salt it do forgo His several kinds are infinite his vertues without number His quantity so large in all as to man seemes a wonder The aire the earth the Ocean deep with salt are seasoned so As wanting it fowl beast nor fish nor man could breath I know And for one instance do but note in blood what taste you finde Note urine eke how salt it is if it digresse not kinde Yea sweat and spittle though they be but excrements indeed Have store of salt which thing we finde by nature so decreed The earth produceth salt in all her creatures more and lesse Yet different each in some degree exeperience doth confesse Both hot and cold yea moist and dry is salt in temperament Yea volatile and fix also observing each intent Some sowre some sweet some sharp is sound some bitter eke in taste Yea liquid solid corrasive and purging salt thou hast All colours strange in salt are seen true healing therein stands And poyson strong abounds in salt salt loseth metals bands The spirit of salt makes liquid Sol and Luna at thy will That potable they may be wrought a work of worth and skill By salt are cured many griefs thongh hidden and profound Yet the exceeding use thereof is certainly unfound Salt doth preserve the food of men that travel far by sea And seasoneth well our meats at home which else would soon decay Of gain that doth thereby arise all people have a part It maketh barren land bear fruit which cheers the Plough-mans heart The Marchant is enricht thereby and all that fish in lakes Great store of food is gain'd by salt all things it savory makes In Physick and Chirurgery it hath the greatest part It doth contain an essence true which glads the fainting heart It causeth appetite at need it quencheth thirst at will It ceaseth pain of raging gowts it fevers hot doth still Thereby are bleeding wounds made well and that without delay Yea sordid Ulcers it makes sound and tumours takes away For meat and medicines there 's not ought with salt compar'd may be Wherefore I 'le cease to praise a thing above capacity God grant we all may seasoned be with salt devoid of strife That while we live we may do good and gain eternal life Sal metallorum est lapis Philosophorum OF SVLPHVR Sulphur is taken in general three manner of waies SUlphur is generaly taken for every fatty oylie or any way combustible part of any creature whether it be Animal Vegetable or Mineral namely in animal it comprehends Adeps Axungia Pinguedo and what else is combustible In Vegetables it includes Rosine Terebinthine Gum Oyl Wax Vinum Ardens or Aqua vitae Touching Minerals or Metals it includes all sorts of Bitumens with also the oyles of Metals as of Gold Silver Iron or any other together with all sorts of Brimstone Also it comprehends all sorts of Minral salts I mean their oyles as the oyl of Vitriol of A special observation Example A general rule Allom or of common salt c. And further it is to be considered that every Animal vegetable or Mineral substance whatsoever is said to contain his own pec liar and different Sulphur as for example in wine or beer or any other liquid
even Sol or gold it self to make it potable and after all the aforesaid strong spirits be drawn forth that will be forced out by the strength of the fire withdraw or decline the fire and all being cold gather your first liquor by it self then the spirit or rather the Oleum salis into a second glasse by it self the which is a most excellent medicine and in the bottom of the earthen Instrument you shall finde the true salt of salt though but light in substance and small in quantitie which having each part then if you please to make use of these medicines each per se not joyned for so it is the better for that each of these particulars have different vertues in the Art of healing as experience will teach And amongst the rest the spirit of Salt will dissolve Gold to make it potable it is also singular in Fevers for the quenching of thirst and refreshing the spirits and for the curing of many other diseases A PREFACE TO THE TREATISE OF THE CHARACTERS AND TEARMS OF ART FOLLOWING COurteous Reader considering with my self that young men in long Voyages are full of leisure I thought it not lost labour to adde these Treatises to the former for that they not onely contain profitable instructions for youth but by their novelty and varieties do partly refresh the minde of those Readers as delight themselves in that part of Practise It was part of my gleanings in the time of eight years travel by Land in forreign Regions If the matter and form thereof be not worth the acceptance yet I pray thee accept the good will of the Giver I. W. CHARACTERS AND THEIR INTERPRETATIONS And first of the seven Planets SaÌ„turnus Plumbum ♄ ♄ Lead Cold desiccative sweet discussing mollificative anodine sanative laxative mundificative and yet full of deadly vapors Jupiter Stannum ♃ ♃ Tin Diaphoretick laxative desiccative sanative c. Mars Ferrum ♂ Iron or Steel The greatest shedder of blood a sure medicine for fluxes of blood and a great opener of obstructions Sol. Aurum ☉ Gold A great and sure Cordial for it comforteth the heavy hearted and is reputed the best medicine Venus Cuperum ♀ ♀ Copper Maketh sundry needful medicines for mans health Physical and Chirurgical viz Oleum spiritus terra cum multis aliis Mercurius ☿ Quicksilver Is hot cold a friend a foe healing killing expelling attracting corroding quid non Luna Argentum ☾ ☽ Silver A medicine never too often taken a good restorative a comfortable and an anodine medicine c. Other Characters Alphabetically Acetum Vinegar of Beer Good against inflammation discussive defensative comfortable anodine c. Acetum Vini Wine Vineger A discusser a cooler a heater a piercer anodine a consumer a caustick and a vesicatory medicine c. Acetum Distillatum Distil'd Vineger Is a vehicle that openeth mineral bodies and extracteth tinctures c. Aer 🜠AR One of the 4 Elements Without the which no creature subsisteth Alumen â—‹ â—‹ Allum Crude Desiccative astringent corrosive mundificative sanative refrigerative c. Alumen Combustum Allum Burnt An easie and a good corrosive medicine which also induceth a good cicatrix Alumen Plumosum Allum Plume A secret in restoring a withered member by a certain hidden specifical vertue it hath Albumen Ovorum Whites of egges Cold defensative mollificative healing and good in restraining fluxes c. Amalgama ÄÄÄ Â A putting things together or a term of Art for putting together viz fiat Almagama but more particularly it is meant of Mercury with any other metal Antimonium {antimony} Antimony Vomitive laxative sanative diaphoretick diauretick anodine caustick and full of deadly vapours if it be not prevented yet exceeding precious in healing being discrectly used Antimonii Vitrum Glasse of Antimony or Stibium A forbidden medicine and yet in common used and praise-worthy if not abused Antimonii Regulus Antimony Precipitate This is but half a medicine which afterward is used to be converted to Flores Tincture or some other good medicine Annus One year From March the 25. till the return of the same Aqua 🜄 â™’ Water One of the four elements of quality coldd and moist Aqua Fortis Strong Water Made by Vulcans Art of Coppperas Allome and Saltpeeter and diversly other waies Aqua Regis A water to divide Gold This is made as the former adding common salt or rather Sal Armoniacke Aqua Vitae Aquavitae of Wine Aquavitae distilled out of Wine is of excellent use for healing and the chief cordial in cheering the heart of man Arsenicum Arsuick In taste not unpleasing in trial deadly yet a good outward healer many waies Auripigmentum Orpiment In taste deadly yet used of some inwardly for the cough by fume with amber mixt and outwardly used in many medicines profitable Autumnus Harvest Or as it were an entrance to the Winter quarter Auriculum A chalk that contains gold Also gold calcined into powder being an entrance to Aurum Potabile Aurum Potabile Potable Gold A Principal cordial medicine but very often adulterated which being true is precious Aestas Sommer This character is sometimes used for Sommer and sometimes for heat Aes Brasse This is but Copper mixed with Lapis Calaminaris and prepared by Vulcans Art Balneum Mariae MB BM Balnea Mariae Is an Artificiall distilling by a glasse Still set into a furnace in a Kettle of water by the boyling of which the subject contained in the glasse is distilled Bolus Armenus Fine bole Is cordial desiccative restringent sanative refrigerative c. Borus Communis Common Bole. Imitating the former but farre weaker Borax Venetiae Borax This is a great opener of obstructions of young women and is excellent to lute glasses and as a second hand to goldsmiths Calidus Or rather Wâ—rm Neither hot nor cold Calx Lime Is abstersive desiccative caustick sanative Calx Ovorum Lime of Eggesbâ—ls Is sometime used in strong restrictives c. Calx Vive Vnstaked Lime Chiefly used in Causticke medicines Chalybs Steele The most valiant sonne of Mars it openeth obstructions and stayeth the fluxes c. Calor Heat This Character serveth not only for fire but also for great heate Calcinare To Calcine Sometimes to burne to powder and sometimes to prepare by fire to a certain height and colour Cementare To Cement Is by a mixture corrosive to adde to any metal pure as Gold or silver a higher tincture and also to purifie the same yet further Cerussa Venetiae Venice Ceruce One of the off-spring of Saturn sanative cooling anodine desiccative c. Cera Waxe A blessed medicine outwards inwards of a temper neither exceedingly too hot nor too cold mollificative sanative c. Cinnabrium Cinnabar Found naturall and also compounded of Sulphur and Quicksilver and used in Fumes it spoyleth many and healeth by chance some one in killing ten Cineres Ligni Ashes of Wood. Hereof are prepared many different medicines of value in Physick and Chirurgery amongst which the caustick stone the ordinary
Lixivium c. Corallus Corallus Albus Coral white Is Cordial cooling drying and being prepared Chymically hath wonderfull vertues confortative Corallus Rubeus Red Coral This is as the former but in vertues it farre exceedeth it Paracelsus ascribeth vertues infinite and wonderful to red Coral if it be perfectly red Colcothar Burnt Vitriol or Colcoth A good causticke medicine and also cooling exsiccating sanative mundificative c. Crocus Martis Safron of Iron Good against dysenterium Gonorrer Diâ—rrhâ—â— and generally all fluxes Crocus Veneris Safron of Copper Or refined Verdigrease as some affirm but more truly is refined Aes Ustum it expelleth drieth mundifieth and healeth Decoctio Boyling Is the boyling or decocting any medicine Digestio Digesting Good digestion presageth good healing but Chymical digestion est gradus spagyricus similis ventriculo per quem gradum materia coquitur melius ut puri ab impuro separatio fieri posset Dies Et nox Day and Night Containing 24. houres Distillatio Distilling Is the separation of the pure from the unpure performed by sublimation and precipitation but after many kinds and fashions Elementa Not one of the four Elements But a pure medicine made by Chymical Art out of any good thing either animal vegetable or mineral Quere Laâ—avii lib. 2. Alchym cap. 49. Filtrum A felt This filtring with a felt is a kind of preparation of medicines liquid to purge them from their terrestrial parts Fimus Equinus Horse-dung Chymists use to set their medicines in Horsedung to putrifie and is an ancient and worthie work rightly used Vicarius ejus est BM Balnia Maria. Fixatio Fixing or perfecting This is that alâ— good Chymickes desire in their works but few truely attain it but in stead of fixatio they finde vexatio satis ultimo mendicatum ire Flos Aeris Verdigreas Called commonly viride â—s and Verdigrease being the rust of Copper it is a good astringent disiccative and corrosive medicament Gradus G1 G2 G3  A degree first second or third as you see them described with their severall figures Gummi Gumme Of any kinde is so described but the single Character is most used Hyems Winter This Character is also used for cold by some Writers Ignis 🜂 but the first is most in use Fire As well naturall asartificiall actuall as potentiall Lapis Magnetis The Loadstone A jewel precious for value far exceeding the Diamond of the Tribe of Mars in qualitie attractive and sanative Lues Venerea The venereall disease This is a Catholike plague containing almost all diseases in one being seldom perfectly healed Luna Crescens The Moone increasing Or the first and second quarter of the Moon Luna Decrescens The Moone decreasing Of the two last quarters of the Moon Lapis Prunella A stone made of Salniter This is good against tooth-ache and inflammations and for sores of the mouth and throat and also against â—ot fevers inwardly taken Lapis Calaminaris Calamint Stone Is a stone which changeth Copper into Brasse it is desiccative and excelleth in Lotions for the eyes c. Lapis Hematices Bloud stone This stone is used to stench bleeding inwardly and outwardly and hath many other vertues medicinable Lapis Sabulosus  This is a great secret in curing a fracture being daily given the party Ê’j and also mixed with the outward medicine and applyed to the grief Lapis Granutus The Granat Stone This is a Jewel precious in medicine but not commonly used Lateres Stones Or Bricks for farnasis or otherwaies Lateres Cribrati Powder of Bricks It is often used in preparing medicines as well to make good Lute as also for divers other needful uses Lucinium Lixivium Lye made of ashes This is many waies used very profitable in healing outwardly and inwardly and for caustick medicines it is the best Limatura Martis Filings of Horn Used for the making of Crocus Martis Lutum Sapientia Lute used of the Philosophers Some suppose that the pinching of glasses together is it but it is taken for a man and so meant by divers learned men Lutum Commune Lute Common Made of good Clay with flax of wooll and salt commonly but there is as many several Lutes as Chymicks Lythagirus Auri. Litharge of Gold One of the sons of Saturn and is partly so tearmed for that the tests that refine Gold through Lead after are made into Litharge I mean the Saturn into them Lythagirus Argenti Litharge of Silver One of the sons of Saturn supposed proceed of Luna to as aforesaid but indeed these and the first are sent daily from Holland made onely of Lead Lythargirus Plumbi Litharge of Lead One other of the sons of Saturn and is made by every Plumber out of that part of Saturn which wasteth to a hardnesse in melting Marchasita Vnprepared Minerals Of any kinde as we vulgarly say Silver oar or Lead Lead oar c. Mercurius ☿ ☿ Quicksilver The hottest the coldest a true healer a wicked murtherer a pretious medicine and a deadly poyson a friend that can flatter and lye Mercurius Sublimatus Quicksilver sublimed This fellow hath deserved much praise and dispraise as till more scope I omit for he hath done me both credit and shame Mercurius Praecipitatus Quicksilver precipitate A worthy medicine of true Artists with praise used of Empericks shamefully abused for healing and killing he is known Mercurius Solis ☿ ☉ ☿ ☉ Mercury of Gold Hic labor hoe opus quod supra me nibil ad me true Philophers onely are capable of this mystery Mercurius Lunae ☿ ☽ ☿ ☽ Mercury of Silver This and the former have one way of preparation or not greatly different but are past my reach Mercurius Veneris ☿ ♀ ☿ ♀ Mercury of Copper I have heard many brags of this medicine and to be precious but I never could see it c. Mercurius Martis ☿ ♂ ☿ ♂ Mercury of â—â—on It is said that with this medicine the vertue of the Loadstone is strengthened above measure Mercurius Jovis ☿ ♃ ☿ ♃ Mercury of Tinne This is reported able to make of Lead Tinne but I have not seen it Mercurius Saturni ☿ ♄ ☿ ♄ Mercury of Lead This is easily drawn from Lead in a good quantity per se onely by Art of fire as Writers affirm Mensis One moneâ—h Containing 28. daies and 28. nights or four whole weeks Minium Or red Lead Is one of the sons of Saturn cooling drying repelling healing mollifying discussing c. Minutum One Minute The sixtieth part of one hour Mel. ML ML Honey Honey is Laxative mundificative mollificative sanative c. Oleum 🆠Oyl of any kinde And sometimes taken for Sulphur is as if you would say take from Guaiacum his Sal Sulphur and Mercury by his Sulphur you must understand his oyly part c. Phlegma 🜄 A Plegma It is used for any distilled water which is void of Spirit as Rose-water Piger Henricus Slow Hemick An instrument for distilling so called for his exceeding slownesse Plumbum Philosophorum Philosophers Lead This
of Amputating or cutting off of putrid members in the mortified part I after considered with my self that I could not properly proceed therein except by the defining of a Gangrene in the first place because a Gangrene is ever the fore runner of a Sphacelus and the material cause of Amputation either in the general body of Man or in any the particular parts thereof and from the which no Animal creature no not Man himself can decline from Ab initio statutum est omnibus semel mori For from the beginning all men are constituted once to dye and yet there is an interim for each man of not being in health neither really dead but quafi moriens vel semi mortuus dying or half dying In the which iâ—terim or intermission of time a man may by an accident be said to be in such a distemper as he may be gangrenated or in a Gangrena as the Artist tearms it either in part or in all and yet by the permission of God and by the help of Art that supposed dying man or member of man may receive cure and be heaâ—d again although in mans judgment not well versed in the mystery of healing he be supposed to be at the gates of death Even so a Gangrene presaging a Sphacelus may in some cases be cured as daily experience sheweth that divers Gangrenes receive cure so that to conclude a man that hath a Gangrene in one or more parts of his body untill it be taken away that man is evâ—r as it were under the Shadow of Death Nam Mors sequitur ut umbra Death attendeth us as our shadow Thus much briefly by way of Preface touching the Gangrene A Treatise of Gangrena A Definition of a Gangrene and the several causes thereof A Gangrene in his progresse may justly be termed an effect destroying nature and therefore against nature it is a disease woful painful horrible and fearful to man-kind and justly so for that it often endeth in Sphacelus which is the destruction of the part affected if not of the whole body Causes The causes thereof are infinite for number but to speak in brief in one generall term for all how the dâ—sease commeth first to invade mâ—ns body it ever proceedeth ex intemperie which is of distemper ever by force invading nature this intemperies or distemper may be said generally two wayes to be taken either Externally or Internally Externally It may be tearmed external or from without as well when it proceedeth by externall violence of the ayr by thunder and lightning or otherwise by the mighty and immediate hand of God as it doth to many or by feavours violent contagious or pestilential as Anthrace the small Pox or the like whose secret causes with the reasons thereof are hidden in God and therefore â—y mans wisdome are not to be found out although some affirm the Conjunction or Opposition of the Planets have power or give cause hereunto according to the Poet Astra regunt homines sedregit Astra Dâ—us The Stars govern mans body and God governeth the starres or it proceedeth of outward violence namely sometime by mans hand his intention or invention as by great wounds whereof great hemorrage and so as by a just consequent a Gangerne followeth as also by a violent contusion given either by violence of weapons as by wounds made by Gun-shot Swords Speares knives c. And oftentimes by obstructions in the blood sometimes caused by stripes c. whereby fractures of bones distortions of joynts contusious inflammations Convulsions great and sudden fears and other distempers proceed among which great accidents Gangrena is to be feared will be one and not the least although it may be called one of the last and it may also happen by the fall of a house a tree any weighty thing yea by a tyle a stone by the bite of any venemous Beast of a Dog and innumerable other accidents according to Gods secret appointment or permission Nam Accidit in puncto quod non reparatur in anno That may happen in a moment that cannot be repaired in a year And further a distemper may fall out to be a disease of the similar parts deprived of their naturall and proper temperament this deprivation 1. What a distemper is Simple distemper Compound distemper is caused two wayes either by a simple distemper by reason of the excesse of one quality viz. of heat cold dry or moisture or by a compound distemper by reason of the extuberance or over bearing of the two qualities together hot and moist hot and dry cold and moist and cold and dry again a distemper is either a fault of the meer quality Phlogosis alone viz. an inflammation or it hath an adjuâ—ct fâ—ult of the humours as a Phlegmon again many times a Gangrene proceedeth Phlegmon from a surfeir or a distemper of fulnesse or inanition which may proceed Intemperies by starving or recessus of dew nutriment to satisfie nature A second definition of a Gangrene Second definition of the Gangrene A Gangrene is a beginning of putrefaction being a dreadful Symptome of a disease in any member of the body and sheweth it self for the most part by inflammation with great dolour the grieved How to know it part often appearing of a sad dusky reddish colour or livid though not alwaies and being for the most part tumifieed or swollen the pain being to the judgment of the Patient so intolerable as if there were a fire-coal burning therein or the like in effect and for that reason the German Writers call this by the violent heat of the disease the Heisbrant or the hot burning coal for in truth a Gangrene is of a burning sudden fierce destroying nature and therefore against nature being a disease dreadful to mankind as is said and justly so for that it menaceth to the part affected if not to the whole body eminent destruction yea death it self except speedy remedy by Gods mercy be at hand The causes of this disease as aforesaid are many for number whereof The causes of Gangrene I will set down but part viz. It may proceed either from great hemorrage mentioned that is exceeding effusion of blood and spirits or by a distemper of the four humours proceeding either by Repletion or Inanition Or by extream erosion or corrosion of caustick Medicines or corrosive humours By imbecillity of nature as by weaknesse of infants and old age by a venemous and poysoned blood as in contagious times and namely when the small Pox or Plague reigneth Small Pox or Plague may prâ—ducâ— Gangrena's causing sudden putrefaction of humours also it may proceed by great burnings and scaldings by over-much hunger and thirst by the pricking of a nerve or of nerves by a Feavour precedent by a Frost and also by extream cold by the bitings of venemous Beasts or Wormes or mad Dogs by want of good concoction or humours by obstructions of or from any
so afterwards the dead part falls off and the living part is conserved And this manner in my judgment saith Fabritius is best but this Authour conceiveth Fabritius to be but a relater not a true practiser of the aforesaid course in amputation for that that work is so terrible and cruel neverthelesse In this recited Chapter you have the opinions of some of the ancient The way of amputation made better by experienâ—â— and learned Writers touching Sphacelated members and the manner of the amputation of those times since which the Art hath been by Gods favour very much illustrated so that where the complaint formerly was that by reason of great hemorrage namely the large effusion of blood and spirits in the work of their amputations many of their Patients perished under the Surgeons hands in the very act of amputation I may to Gods glory and so justly do I affirm for a truth that for the space of near 24 years I have been a Surgeon in the Hospital of Saint Bartholomews where I have taken off and holpen to take off many more then one hundred of legs and arms besides very many hands and fingers amongst all which not one of them all hath dyed in the time of their dismembering nor afterwards through the exceeding effusion of blood in the operation that ever I could gather or conceive and furthermore I affirm that not above four of each twenty dismembred but lived to have been healed and have been delivered whole out of the Hospital notwithstanding whatsoever their diseases have been and for that horrid cruel course mentioned by the aforesaid recited Ancients of burning the ends of the stumps in the the tender living and most sensible parts since I have known the Art of Surgery which hath been by the space of 50 years that I have used it I never saw it used by any in England nor elsewhere and yet I will not deny but the best Artist that is in the first work of amputation or in the second dressing of the Patient after amputation may be so put to it that if he provide not himself of a cauterizing button he may heartily wish he had had a small button ready for fear of the losse of his Patient upon an unexpected flux and howsoever it is a good Art and safe to my knowledge both for the Patient and Surgeon and but fitting for him so to be provided for fear of need onely I advise it to be privately absconded for the reputation sake Thus much of the manner of amputation from the Ancients This precedent Dâ—finition I have takes out of some of the ancient Authours from their own words verbatim that the Reader may consider how far it differeth from the scope hereafter to be handled An Introduction to amputation but chiefly for the mortified place LOving Reader the general opinion of the most ancient as also of the modern Writers yea and of the best Artists with us at this present living as farre as I can gather or conceive is that the fafest and best way for the cure of sphacelated or putrid dead members is to amputate them in the sound part and not in the putrid and their general reasons are to prevent that none of the putrid venemous or gangrenated blood or spirits should remain untaken away Ense recidendum est ne pars sincera trahatur for fear it should infect the sound and so consequently confound the whole masse of the blood and spirits and to conclude kill the whole body but the horrid pain the patient thereby susteineth with also the great uncertainty of his life after his extream sufferings caused me ever to mislike my own works therein yea although the successe for the most part was answerable to my desire And I further confesse tradition tooke place with me in the Hospital of S. Bartholomews in part where I was as is said a Surgeon for many years yea and that in my whole practice there as also with the rest of the Surgeons my partners untill after reading some Frustrà fit per plura quod fieri potest per pauciora ancient Authors I conceived that I might in some cases save a mans life by amputating in the sphacelated part notwith standing the general vate and tenent aforesaid to the contrary whereupon by accident about the year 1617. having a fit Patient which had a mortified leg and was as feeble and weak as possible a living creature might be insomuch I was of opinion upon the first view of him that Natures third was at hand spun out in him so that it was even sinne and pitty for me to hinder natures course or to shorten her course in hasting it with violent Art and namely by dismembring him in the whole part who had not blood and spirits in such a case according to the word to keep life and soul together but by consequent he must dye in the very act and therefore I confesse I intended the Patient should dye by Nature rather then to be killed by Art ever esteeming it a great sin to take away a limb from any creature but with some good hope thereby to preserve his life But again considering Christian duty and that I was tyed to do my best to preserve life to the utmost in my power I conceived there might be peradventure yet some small hope of life if I could without pain to the weak Patient or losse of blood ridde away his rotten member so I in short concluded to take it off in the dead place which as all men may conceive I without pain quickly effected and by Gods mercy the next day I found that my poor Patient after the loathsome stinck of his putrid limb was removed from him he began to chear up and so after from day to day was refreshed more and more and nature as it were rejoyced even as a tree refresheth after the dead boughs are pruned off so my poor Patient grew more and more lusty and chearful and to conclude in the space of 10. weekes he was perfectly healed and being then sound and lusty gave thanks to the Governour of the Hospital in full payment of his cure and so departed from the Hospital upon a leg of wood he then being fair and fat and very formal the which blessing of health to the poor man and light of knowledge by that experience to me did put me in mind of my duty in just thankfulnesse to God and also it animated me further to proceed in the like practice upon many others which since that time I have with good successe to Gods glory in the same manner well healed I then also began with my self to consider and as it were to question the reason why this latter Age of ours consisting of more pregnant wits then former Ages and that by good reason their judgments should in Art farre exceed the former as having had the experience light knowledge and examples from all the precedent Ages I say I
the facility thereof and for the saving of blood and spirits I have thought fit to commend to your consideration this new method as to the discretion of the Artist shall be esteemed fit Also I have observed that in surfeited delicate bodies of great personages such as are over-pomper'd with pleasure ease and fulnesse if by any way or accidents such happen to have a Gangrene seldome one of them escapeth death especially if they be ancient and have the dropsie or Scorbute and on the contrary amongst those which are weak poor indigent and miserable people which have bin by long continued ulcers fistulaes or other grievous maladies spent to extream weaknesse although seeming half dead before the work begin scarce two of ten dye amongst them upon amputation if the work be judiciously and in a fit way and time performed for I by practice have often observed that where an infirmity hath pulled down a Patient low and almost past hope of recovery especially if the disease proceeded by any outward violence that such bodies have bin by my experience found to be generally most hopeful of recovery either by amputation in the one or the other kind as the occasion will most fittest bear and on the contrary persons that are to be dismembred in full strength if it be to be acted in the sound part bear a far greater venture of their lives then the miserable dejected wretches do as aforesaid except it can be effected in the putrid part And one observation more to be by all men had in regard namely that our God in Naturehath created in mans body such a strong antipathie betwixt the living and the dead parts thereof that when by any violence in Nature either by distemperature from within testified by Feavours Pestilential or others or by the outward violence of Engines of Warre or other incident mischances as by Fractures Contusions c. whereby one part or limb of mans body becommeth sphacelated and dead before the other it is manifest that the living parts do as it were either in fear or disdain of the dead parts or for some other secret cause in Nature though not without great pain and grief notably withdraw themselves each from the other as in disdain leaving neither warmth not at all any comfort motion nor sense either by blood or spirits or ought else moving in the dead Veines Nerves nor Arteries neither any sense in the Periostcon that sensible Panicle that covereth the bones but as by a comparison of a Snail may in part be explained they wholly withdraw themselves for the Snail having by the vertue of natural warmth stretched her self out of her shell either for her necessity nourishment or delight in a moment apprehending cold or danger retyres into her shell and with all her force by her own slime shuts her self close up again and so rests her self in a supposed safety with her no doubt content even so all the living instruments faculties or vessels of Nature as in a nauseous disdain contempt or fear of the dead parts forsake the sphacelated parts and leave them utterly desperate and impotent and by vertue of the Radical Balsam of Nature contracts and shrowds her relict living parts as Artists may judge by the mortified toes of children but much the better where Art is at hand to aid Nature so that thereby the dead parts become as a noysome and heavy burthen to the living parts so as if you wound the sphacelated part it is not onely senselesse but also it is without blood or spirits at all neither doth blood or humours run any more nor so much as move in the sphacelated or putrid Veines at all and whilest lively Nature is as aforesaid shutting her dead enemy out of her living doores by stopping up all the breaches that she may hold the relict of her own if animal Art have not the charity to take her dead enemy from her yet vital agility assisted by natural motion and will in his due time doth efficiate what fairly can be expected for the assisting of Nature and supplying all defects proceeding ex intemperie all which excellent offices in Nature no question proceed de praesciencia Dei Here followeth a brief relation of amputation or of dismembring in general but more particularly being for the taking off of members in the rotten or mortified places which haâ—h in many cases been approved by the Authour thereof by his own long experience FOr brevity sake in this place I will not spend time to write of the general diseases causes or reasons that might urge the amputation of any member having elsewhere written somewhat thereof onely my intent for the present is to aquaint the younger sort with my long experienced practice for the manner of dismembring in a mortified part where just cause is offered having undertakeen it meerly for the publique good by informing the younger sort of Surgeons as well for their incouragements in the safe and warrantable putting in practice my pactical Method therein as also to shew and fore warn them from being over-much mis-led in the insisting upon old errours and traditions of their Masters Patrons and Predecessours too punctually As for example A Chirurgical â—ase put betwixt two Surgeons Suppose the younger Surgeon in consultation with his Friend or Brother Surgeon by way of asking advice should put the case and say I have a Patient that hath the toes of his feet putrefied fistulated and many wayes perforated with foul bones therein so that it is unsound even almost to the joynts of the ankle or the like and I have endeavoured by Art and with advice the best I can to heal him and cannot prevail in the Cure Wherefore since the toes of the foot cannot be cured the rest of the foot as unprofitable were as I suppose best to be taken away and no lesse of the legge also for it will be but a hinderance to the Patient considering that he cannot stand thereon and is full of grievous pain I will therefore conclude according to custome to take all off a little below the Gartering place leaving a fit room for the stilt to rest the body upon The which his said friend admitteth of as good practice and so he proceedeth to the work as being a rational and fair course and warrantable If the rest of his suggestion or indications be answerable The Chirurgical case answered and admitted unto the aforesaid allegation the work is doubtlesse good and so I my self would heretofore have done untill my practice taught me better things but now by my own practice which I much rather would ground on then upon ipse dixit I take a shorter course For if the bones of the toes of the feet onely were foul fistulated c. as is suggested yea and therefore incurable for so stands the suggestion as being so by reason of some great contusion wound or ulcer or otherwise as aforesaid with divers fragments of foul bones in them or the
I observe by their method that they were rather narrators one from anothe then truly actors but be it as it will this one comfort the Surgeon shall be Comfort to the patient in ubscissing in the mortified part sure to find thereby he shall no way endanger his patient in that course either by losse of blood or spirits nor shall the Patient endure any pain at all in the act of amputation after that way and the practice is good and warrantable in divers yea in most cases as hereafter I shall explain and as my self of many yeares experience may boldly affirm and it is likewise beneficial for the Common-wealth and for a true instance of the truth thereof I have many of my Patients so dismembred at the writing hereof living and in perfect health I mean which were dismembred in the putrid part and that upon some Patients on both the legges at one instant performed amongst which tryals I made of one legge was in Anno Domini 1617. Secondly I had one Thomas Brown about Anno 1619. a Sayler who had received a great wound by Gun-shot at Sea upon the right legge the greater Fossels A bislory for an example thereof being broken in sunder so that the shot had carried away two inches of the said bone in length together with the lacerating the muscles nerves Artcries Veines c. whereby it was so contused lacerated and torn asunder with also so much losse of substance that nature could not bear to heat that member to be any way serviceable for ought besides there had followed upon the wound so great and intolerable hemorrage or expence of blood and spirits that the member mort fied by reason of the former great evacuations and contusions neither could nature in that Patient possibly have born a dismembring Losse of blood causeth Gangrena in a whole part without eminent danger of present death and so was the estate and case of this Patient before he came by me to be cured in Saint Bartholomews Hospital wherefore considering well his most desperate estate I resolved to make a second experience of him and did take off the wounded legge in the lacerated dead part wherein I conceive as afore-said all men of judgment will easily be of opinion that the Patient by that work was without danger of death or pain and without losse of any drop of blood and I healed this patient by Gods mercy in five moneths and he had been by the half sooner whole had not he lost so exceeding much blood and spirits by his wounds as afore-said and this Patient was living at the writing hereof being many yeares after the amputation the method of which cure with the manner of amputating thereof shall God assisting me hereafter be set down Another example The next I took off in the mortified place was one Thomas Hog a shippe-Carpenter a Scotchman who also was living at the writing hereof this man at his labour aboard the shippe standing stoutly at his work at the straining of a Cable as it was running out of the bits of the ship as the Sea-men terme it the Cable tooke hold of his legge close by the ankle and forceably bruised in peices not onely the veines arteries and nerves with the softer parts but brake also the bones in sunder with extream violence insomuch as by reason of the want of a Surgeon present to dresse him by great effusion of blood and spirits the legge mortified the next day and he after that fell unto my part in the Hospital to be cured the which being emboldened by the good successe of the two former I took off his legge also in the mortified part as I did the other and made a perfect cure thereof in three moneths and he followed the trade of a ship-Carpenter at the writing hereof Another example Also two yeares after I cured an Apprentice of one Master Goddard an Upholster at the sign of the Crown in the Poultry in London named John Harding in his Masters house who after a fierce pestilential Feavour had his right legge mortified in bed as he lay and I took it off in the mortified part at or near the gartering place which by the ancient use of Art of our times must have been taken off in a sound place notwithstanding the great feeblenesse of the Patient at that time and his eminent danger of death he being extream feeble and at the point of death in which case to have taken it off in the sound part he doubtlesse would have dyed under my hand but by Gods mercy he lived divers yeares after and went most neatly on an Artificial legge not easily discovered Another history Remarkable A history or a relation of a remarkable example of an amputation by me performed upon a woman in Saint Bartholomews Hospital of both her legges and part of seven of her fingers in one morning together all taken off in the mortified part without pain The amputation of both the legs and part of seven fingers of a woman in one morning or losse of blood or spirits at all and the woman was living at the writing hereof and the Patient was a certain poor maid or woman servant in London named Ellin French of whom there were made Bookes and Ballads that were sung about the streets of her namely that whereas the said maid or servant was given to pilfering and being accused thereof by her Mâ—ster and Mistresse used to curse and swear and with words of execration to wish that if she had committed the crime she stood accused of that then her legges and hands might rot off the which thing accordingly no doubt by the providence of God came to passe as a judgement upon her namely that both her legges almost to the gartering place with parts of seven of her fingers did rot off the which wretched woman neverthelesse being referred to me in Saint Bartholomews Hospital to be cured by Gods mercy and permission I healed her perfectly by cutting off both the Sphacelated legges in the mortified parts with also part of her seven fingers as is said all in one morning without pain terrour or of any losse of blood unto her in the taking them off and made her perfectly whole in a very short time namely within three moneths so merciful is our God unto us vile creatures when we are most unworthy of such his mercies she is at the instant writing hereof also living Now with your friendly patience onely one example more I will trouble you with namely of the cure of a mortification proceeding of a Carbuncle in a Feavour Pestilential by me performed and I A hisâ—â—ry will therein conclude my shewing of instances although I could declare many more of living persons and I will haste to shew forth the manner of my acting of such amputations The work was of a certain Stationer then dwelling in Pauls Church-yard whose name I conceal for that at the writing hereof