can for two or three hours in his bed when he wakes let him take some Ptisan or some such like thing and then repeat his bath after the foresaid manner Things strengthening the ventricle He shal use this bath thrice in ten days But if the Patient be subject to crudities of the stomach so that he cannot sit in the bath without fear of swooning and such symptoms his stomach must be strengthened with oyl of quinces wormwood and mastich or else with a crust of bread toasted and steeped in muskadine and strewed over with the powders of roses sanders and so laid to the stomach or behind neer to â—e 13. verteâ—ra of the back under which place Anatomy teaches that the mouth of the stomach lies Epithems shall be applyed to the liver and heart to temper the too acrid heat of these parts Epithems and correct the immoderate dryness by their moderate humidity Now they shal be made of refrigerating and humecting things but chiefly humecting for too great coldness would hinder the penetration of the humidity into the part lying within The waters of bugloss and violets of each a quartern with a little white wine is convenient for this purpose But that which is made of French barly the seeds of gourds pompious or cowcumbers of each three drams in the decoction mixed with much tempering with oyl of Violets or of sweet Almonds is most excellent of all other Let cloaths be dipped and steeped in such epithems and laid upon the part and renewed as oft as they become hot by the heat of the part And because in hectick bodies by reason of the weakness of the digestive faculty many excrements are usually heaped up and dryed in the guts it will be convenient all the time of the disease to use frequently clysters made of the decoction of cooling and humecting herbs flowers and seeds wherein you shall dissolve Cassia with Sugar and Oyl of Violets or Water-lillies What a flux happening in a hect ck feaver indicates But because there often happen very dangerous fluxes in a confirmed hectick Feaver which shew the decay of all the faculties of the body and wasting of the corporeal substance you shall resist them with refrigerating and assisting medicins and meats of grosser nourishment as Rice and Cicers and application of astringent and strengthening remedies and using the decoction of Oats or parched Barly for drink Let the Patient be kept quiet and sleeping as much as may be especially if he be a child For this Feaver frequently invades children by anger great and long fear or the too hot milk of the nurse over-heating in the Sun the use of wine and other such like causes they shall be kept in a hot and moist air have another Nurse and be anointed with oyl of violets to conclude you shal apply medicins which are contrary to the morbifick cause CHAP. XXXIII Of the Wounds of the Epigastrium and of the whole lower Belly How children be cured THe wounds of the lower Belly are sometimes before sometimes behind some only touch the surface thereof others enter in some pass quite through the body so that they often leave the weapon therein some happen without hurting the contained parts others grievously offend these parts the Liver Spleen Stomach Guts Kidneys Womb Bladder Ureters and great Vessels Their differences so that oft-times a great portion of the Kall falls forth We know the Liver is wounded when a great quantity of bloud comes forth of the wound when a pricking pain reaches even to the Sword-like gristle Signs of a wounded liver Signs that the stomach and smaller guts are wounded Signs to know when the greater Guts are wounded Signs that the Kidneys are hurt Signs that the Bladder is wounded Signs that the womb is wounded to which the Liver adheres Oft-times more choler is cast up by vomit and the Patient lyes on his Belly with more ease and content When the Stomach or any of the small Guts are wounded the meat and drink break out at the wound the Ilia or flanks swell and become hard the Hicket troubles the Patient and oft-times he casts up more choler and grievous pain wrings his Belly and he is taken with cold sweats and his extream parts wax cold If any of the greater Guts shall be hurt the excrements come forth at the wound When the Spleen is wounded there flows out thick and black bloud the Patient is oppressed with thirst and there are also the other signs which we said use to accompany the wounded Liver A difficulty of making water troubles the Patient whose reins are wounded bloud is pissed forth with the Urin and he hath a pain stretched to his groins and the regions of the Bladder and Testicles The Bladder or Ureters being wounded the flanks are pained and there is a Tension of the Pecten or Share Bloud is made instead of Urin or else the Urin is very bloudy which also divers times comes forth at the wound When the Womb is wounded the Bloud breaks forth by the Privities and the symptoms are like those of the Bladder The wounds of the Liver are deadly for this part is the work-house of the bloud wherefore necessary for life besides by wounds of the Liver the branches of the Gate or Hollow-veins are cut whence ensues a great flux of bloud not only inwardly but also outwardly and consequently a dissipation of the spirits and strength Prognosticks Lib. 6. cap. 88. But the bloud which is shed inwardly amongst the Bowels putrefies and corrupts whence follows pain a feaver inflammation and lastly death Yet Paulus Aegineta writes that the lobe of the Liver may be cut away without necessary consequence of death Also the wounds of the Ventricle and of the small Guts but chiefly of the Jejunum are deadly for many vessels run to the Jejunum or empty Gut and it is of a very nervous and slender substance and besides it receives the cholerick humor from the Bladder of the Gall. So also the wounds of the Spleen Kidneys Ureters Bladder Womb and Gall are commonly deadly but alwayes ill for that the actions of such parts are necessary for life besides divers of these are without bloud and nervous others of them receive the moist excrements of the whole body and lye in the innermost part of the body so that they do not easily admit of medicins Furthermore all wounds which penetrate into the capacity of the Belly are judged very dangerous though they do not touch the contained Bowels for the encompassing and new air entring in amongst the Bowels greatly hurts them as never used to the feeling thereof add hereto the dissipation of the spirits which much weakens the strength Neither can the filth of such wounds be wasted away according to the mind of the Chirurgeon whereby it happens they divers times turn into Fistula's as we said of wounds of the Chest and so at length by collection of matter cause death
with a cap stuffed with cotton on that side CHAP. XXIX Of the Wounds of the Neck and Throat THe Wounds of the Neck and Throat are somewhiles simple The differences of wounds of the neck and throat as those which only use the continuity of the muscles otherwhiles compound such as those which have conjoyned with them a fracture of the Bones as of the Vertebrae or hurt of the internal and external jugular Veins or sleepy Arteries sometimes the Trachea Arteria or Weazon and the oesophagus or gullet are wounded sometimes wholly cut off whence present death ensues Wherefore let not the Chirurgeon meddle with such wounds unless he first foretel the danger of death or the loss of some motion to those that are present The Palsie follows upon wounds of the neck For it often happens that some notable nerve or tendon is violated by a wound in the neck whence a Palsie ensues and that absolutely incurable if the wound shall penetrate to the spinal marrow also hurt therewith Wounds of the Gullet and Weazon are difficultly cured because they are in perpetual motion and chiefly of the latter by reason it is gristly and without bloud The wounds of the gullet are known by spitting of bloud Signs that the gullet is wounded by the breaking forth of meat and drink by the wound but if the Gullet be quite cut asunder the Patient cannot swallow at all For the cut parts are both contracted in themselves the one upwards and the other downwards But we know the weazon is hurt by casting up bloud at the mouth with a continual cough and by the coming forth of the breath or wind by the Wound The wounds of the jugular veins and sleepy Arteries are deadly by accident The Wounds of the jugular Veins and sleepy Arteries if they be great are usually deadly because they cannot be straitly bound up for you cannot bind the throat hard without danger of choaking or strangling the Patient But for defect of a strait ligature in this case the flux of bloud proves deadly If the recurrent Nerve of either side be cut it makes the voyce hoarse if cut on both sides it takes away the use of speech by hurting those instruments which impart motion to the muscles of the Larinx For the cure if the wound be small and not associated with the hurt of any notable vessel By hurting the recurrent Nerve the voyce is hurt nor of the Weazon and Gullet it is speedily and easily cured and if there shall be need you shall use a Suture then you shall put therein a sufficient quantity of Venice-Turpentine mixed with Bole-Armenick or else some of my Balsam of which this the Receipt â„ž Terebinth venetae lb ss gum elemi â„¥ iiij olei hypericonis â„¥ iij. boli armen sang draconis an â„¥ j. aqua vitae â„¥ ij The description of the Author's Balsom liquefiant simul omnia lento igne fiat Balsamum ut artis est ad dendo pulveris ireos florent aloes mastiches myrrhae an Ê’ j. I have done wonders with this Balsom in the agglutination of simple wounds wherein no strange body hath been Now when you have put it in The faculty of Diacalcitheos lay upon it a plaister of Diacalcitheos dissolved in Oyl of Roses and Vinegar as that which hath power to repress the flowing down of humors and hinder inflammation or in stead thereof you may apply Emp. de Gratia Dei or Emp. de Janua But if the jugular Veins and sleepy Arteries be cut let the bleeding be stayed as we have shewed in a chapter treating thereof When the Weazon or Gullet are wounded The cure of the wounded Weazon and Gullet the Chirurgeon shall sow them up as neatly as he can and the Patient shall not endeavour to swallow any hard thing but be content to be fed with gellies and broths When a gargarism is needful this following is very good â„ž hordei M. j. florum rosar p. j. passul mund juâ—ubarum an â„¥ ss glycyrhizae â„¥ j. bulliant omnia simul addendo mellis ros Julep ros an â„¥ ij fiat gargarisma ut artis est A Gargarism With which being warm the Patient shall moisten his mouth and throat for it will mitigate the harshness of the part asswage pain cleanse and agglutinate and make him breathe more freely But that the Chirurgeon may not despair of or leave any thing unattempted in such like wounds The manifold use thereof I have thought good to demonstrate by some examples how wonderful the works of Nature are if they be assisted by Art A certain servant of Monsieur de Champaigne a gentleman of Anjou was wounded in the throat with a sword whereby one of the Jugular-veins was cut together with his Weazon A History He bled much and could not speak and these symptoms remained until such time as the wound was sowed up and covered with medicines But if medicines at any time were more liquid he as it were sucked them by the wound and spaces between the stitches and presently put forth at his mouth that which he had sucked or drawn in Wherefore more exactly considering with my self the greatness of the wound the spermatick and therefore dry and bloudless nature unapt to agglutination of the affected part but chiefly of the Weazon and Jugular-vein as also for that the rough Artery is obnoxious to those motions which the gullet performs in swallowing by reason of the inner coat which is continued to the coat of the gullet by which means these parts mutually serve each other with a reciprocal motion even as the ropes which run to the wheel of a pulley furthermore weighing that the Artery was necessary for the breathing and tempering the heat of the heart as the Jugular-veins served for the nourishment of the upper parts and lastly weighing with my self the great quantity of bloud he had lost which is as it were the treasure of Nature I told those which were present that death was near and certainly at hand And yet beyond exceptation rather by divine favour then our Art he recovered his health A strange History Equally admirable is this History following Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne but one of them lying in wait to rob the other of his money and a massie chain of gold which he wore set upon him at unawares cut his throat and robbed him and so left him amongst the Vines which were in the way supposing he had kill'd him having with his dagger câ—t the Weazon and Gullet This murderer came back to the City the other half-dead crawled with much ado to a certain Peasant's house and being dressed with such medicines as were present and at hand he was brought to the City and by his acquaintants committed to my care to be cured I at the first as diligently as I could sowed up the Weazon
which was cut quite asunder and put the lips of the wound as close together as I could I could not get hold of the Gullet because it was fallen down into the Stomach then I bound up the wound with medicines pledgets and fit ligatures After he was thus drest he begun to speak and tell the name of the villain the author of this fact so that he was taken and fastened to the wheel and having his limbs broken lost his wretched life for the life of the innocent wounded man who dyed the fourth day after he was hurt Another History The like hurt befel a certain German who lay at the house of one Perots in the street of Nuts he being frantick in the night cut his throat with a sword I being called in the morning by his friends who went to see him drest him just after the same manner as I dressed the Englishman Wherefore he presently recovered his speech which before could not utter one syllable freed from suspition of the crime and prison the servant who lying in the same chamber with him was upon suspition committed to Prison and confessing the thing as it was done lived four days after the wound being nourished with Broths put into his Fundament like Clysters and with the grateful vapour of comfortable things as Bread newly drawn out of the Oven and soaked in strong Wine I having thus by Art of Chirurgery made the dumb speak for the space of four days CHAP. XXX Of the Wounds of the Chest The differences of wounds of the Chest SOme wounds of the Chest are on the fore-side some behind some penetrate more deep others enter not into the capacity thereof othersome pierce even to the parts contained therein as the Mediastinum Lungs Heart Midriffe hollow Vein and ascendent Artery Othersome pass quite through the body whereby it happens that some are deadly some not The signs You shall thus know that the wound penetrates into the capacity of the Chest if that when the Patients mouth and nose be shut the breath or wind break through the wound with a noise so that it may dissipate or blow out a lighted candle being held near it If the Patient can scarse either draw or put forth his breath this also is a sign that there is some bloud fallen down upon the Diaphragma Signs that the heart is wounded By these signs you may know that the heart is wounded If a great quantity of bloud gush out if a trembling possess all the members of the body if the pulse be little and faint if the colour become pale if a cold sweat and frequent swooning assail him and the extream parts become cold then death 's at hand A History Yet when I was at Turin I saw a certain Gentleman who fighting a duel with another received a wound under his left brest which pierced into the substance of his heart yet for all that he struck some blows afterwards and followed his flying enemy some two hundred paces until he fell down dead upon the ground having opened his body I found a wound in the substance of the heart so large as would contain ones finger there was only much bloud poured forth upon the midriffe Signs that the Lungs are wounded These are the signs that the Lungs are wounded if the bloud comes foamy or froathy out of the wounds the Patient is troubled with a cough he is also troubled with a great difficulty of breathing and a pain in his side which he formerly had not he lies most at ease when he lies upon the wound and sometimes it comes so to pass that lying so he speaks more freely and easily but turned on the contrary side he presently cannot speak Signs that the midriffe is wounded When the Diaphragma or Midriffe is wounded the party affected is troubled with a weight or heaviness in that place he is taken with a Delirium or Raving by reason of the sympathy of the Nerves of the sixth conjugation which are spread over the midriffe difficulty of breathing a cough and sharp pain troubles the Patient the Guts are drawn upwards so that it sometimes happens by the vehemency of breathing that the Stomach and Guts are drawn through the wound into the capacity of the Chest which thing I observed in two The one of these was a Mason who was thrust through the midst of the Midriffe where it is nervous and dyed the third day following I opening his lower belly and not finding his stomach A History thought it a monstrous thing but at length searching diligently I found it was drawn into the Chest through the wound which was scarse an inch broad But the stomach was full of wind but little humidity in it The other was called captain Francis d' Alon a Native of Xantoigne Another History who before Rochell was shot with a Musket Bullet entring by the breast-bone near to the sword-like Gristle and passing through the fleshy part of the midriffe went out at the space between the fifth and sixth bastard ribs The wound was healed up on the outside yet for all that there remained a weakness of the stomach whereupon a pain of the guts like to the colick took him especially in the Evening and on the night for which cause he durst not sup but very sparingly But on the eighth month after the pain raging more violently in his belly then it was accustomed he dyed though for the mitigating of the vehemency thereof Simon Malmâ—dy and Anthony du Val both learned Physitians omitted no kind of Remedy The body of the diseased was opened by the skilful Chirurgeon James Guillemeau who found a great portion of the Colick-gut swelled with much wind gotten into the Chest through the wound of the Diaphragma for all it was so small that you could scarse put your little finger in thereat But now let us return from whence we digressed We understand that there is blood poured forth into the capacity of the Chest by the difficulty of breathing the vehemency of the increasing feaver the stinking of the breath Signs that there is blood pouted into the capacity of the Chest the casting up of blood at the mouth and other symptoms which usually happen to those who have putrefied and clotted blood poured out of the vessels into the belly infecting with the filthy vapour of the corrupt substance the parts to which it shall come But also unless the Patient cannot lye upon his back he is troubled with a desire to vomit and covets now and then to rise whence he often falls into a swound the vitall faculty which sustains the body being broken and debilitated both by reason of the wound and concreat or clotted blood for so putting on the quality of poyson it greatly dissipates and dissolves the strength of the heart It is a sign the spinal marrow is hurt when a Convulsion or Palsie that is a sodain loss of sense and motion
Yet I have dressed many who by Gods assistance and favour have recovered of wounds passing quite through their bodies A History I can bring as a witness the Steward of the Portingal Embassadour whom I cured at Melun of a wound made with a Sword so running through the body that a great quantity of excrements came forth of the wounded Guts as he was a dressing yet he recovered Another History Not long ago Giles le Maistre a Gentleman of Paris was run quite through the body with a Rapier so that he voided much bloud at his mouth and fundament divers dayes together whereby you know the Guts were wounded and yet he was healed in twenty days In like sort the wounds of the greater vessels are mortal by reason of the great effusion of bloud and spirits which ensues thereupon CHAP. XXXIV The cure of wounds of the lower Belly THe first cogitation in curing of these wounds ought to be Whether they pierce into the capacity of the Belly for those which pass no further than the Peritonaeum shall be cured like simple wounds which only require union But those which enter into the capacity must be cured after another manner For oft-times the Kall or Guts or both fall forth at them A Gut which is wounded must be sowed up with such a seam as Furriers or Glovers use The cure of a wounded Gut as we formerly told you and then you must put upon it a powder made of Mastich Myrrh Aloes and Bole. Being sowed up it must not be put up boysterously together and at once into its place but by little and little the Patient lying on the side opposite to the wound As for example the right side of the Guts being wounded and falling out by the wound the Patient shall lye on his left side for the more easie restoring of the faln-down Gut and so on the contrary If the lower part of the Guts being wounded slide through the wound then the Patient shall lye with his head low down and his buttocks raised up by putting a pillow under them If the upper part be hurt then must he lye quite contrary that the Guts falling downwards by such a site may give way to those which are faln out through the wound But often in this case the Guts having taken cold by the encompassing air swell up and are distended with wind the which you must discuss before you put them into their place with a fomentation of the decoction of Camomil Mellilot Aniseeds and Fennel applyed with a Spunge or contained in a Bladder or else with Chickens or Whelps cut alive in the midst and laid upon the swelling for thus they do not only discuss the flatulency but also comfort the afflicted part But if the inflation cannot thus be discussed the wound shall be dilated that so the Guts may return the more freely to their place If the Kall shall fall out it must be speedily restored to its place for it is very subject to putrefie The cure when the Kal falls out for the fat whereof for the most part it consists being exposed to the air easily loses its native heat which is small and weak whence a mortification ensues Hence is that of Hippocrates If the Kall fall out it necessarily putrefies The Chirurgeon shall know whether it putrefie or not Hip. Aph. 58. sect 6. by the blackness and the coldness you may perceive by touching it neither must you when it putrefies presently restore it to its place for so the contagion of the putrefaction would spread to the rest of the parts but whatsoever thereof is putrefied shall be twitched and bound hard with a string and so cut off and the rest restored to his proper place but it 's good after cutting of it away to leave the string still hanging thereat that so you may pluck and draw forth whatsoever thereof may by being too strait bound fall away into the capacity of the belly Some think it to be better to let the Kall thus bound to hang forth until that portion thereof which is putrefied fall away of it self and not to cut it off But they are much deceived for it hanging thus would not cover the Guts which is the proper place The Guts and Kall being put up if the wound be great and worth speaking of it must be sowed with that suture which is termed Gastroraphia but this kind of suture is thus made The Needle at the first putting in must only take hold of the Peritonaum and then on the opposite side only of the flesh letting the Peritonaeum alone and so go along putting the Needle from without inwards and from within outwards but so that you only take the musculous flesh and skin over it and then only the Peritonaeum until you have sowed up all the wound He which doth otherwise shall undergo this danger that whereas the coat Peritonaeum is of it self without bloud it being divided or wounded cannot of it self be united to it self therefore it requires an intercourse of flesh otherwise unless it be thus united by the benefit of the flesh intermixed therewith there would remain an uncurable tumor after the wound is cicatrized on the outside But that which we said before according to Galen's mind that al the wounds must be sowed Lib. 6. Math. cap. 4. it is not so to be taken as if that the wound must be sowed up to the very end for in the lower part of the wound there must be left a certain small vent by which the quitture may pass forth which being wholly cleansed and exhausted the wound must be quite healed up But the wounds which shall penetrate into the substance of the liver spleen ventricles and other bowels the Chirurgeon shall not suffer them to be without medicines as if they were desperate but he shall spare neither labour nor care to dress them diligently For doubtful hope is better than certain despair The bladder womb and right gut being wounded detergent and agglutinative injections shall be put up by their proper passages I have read nothing as yet in any Author of the wounds of the fat for all of them refer the cure thereof to the wounds of the Muscles The cure of the wounded fat Yet I will say this by the way that wounds of the fat how deep soever they be if they be only simple may be dressed without putting in of any Tent but only dropping in some of my Balsam and then saying upon it a plaister of Gratia Dei or some such like for so they will heal in a short time CHAP. XXXV Of the Wounds of the Groins Yard and Testicles WHen the Groins and neighbouring parts are wounded we must first consider whether they pierce to within and if they do penetrate to what inward parts they come whether to the bladder the womb or right gut for these parts are such neer neighbours that oft-times they are all wounded with one blow
incompassing air under which also is comprehended that which is taken from the season of the yeer region the state of the air and soil and the particular condition of the present and lately by-past time Hence it is we read in Guido Why wounds of the head at Paris and of the legs at Avignion are hard to be cured that Wounds of the head are cured with far more difficulty at Paris than at Avignion where notwithstanding on the contrary the Wounds of the legs are cured with more trouble than at Paris the cause is the air is cold and moist at Paris which constitution seeing it is hurtfull to the brain and head it cannot but must be offensive to the Wounds of these parts But the heat of the ambient air at Avignion attenuates and dissolves the humors and makes them flow from above downwards But if any object that experience contradicts this opinion of Guido and say that wounds of the head are more frequently deadly in hot countries let him understand that this must not be attributed to the manifest and natural heat of the air but to a certain malign and venenate humor or vapor dispersed through the air and raised out of the Seas as you may easily observe in those places of France and Italy which border upon the Mediterranean Sea An indication may also be drawn from the peculiar temper of the wounded parts for the musculous parts must be dressed after one and the bony parts after another manner The different sense of the parts indicates and requires the like variety of remedies for you shall not apply so acrid medicins to the Nerves and Tendons An indication to be drawn from the quick and dull sense of the wounded part as to the ligaments which are destitute of sense The like reason also for the dignity and function of the parts needfull for the preservation of life for oft-times wounds of the brain or of some other of the naturall and vitall parts for this very reason that they are defixed in these parts divert the whole manner of the cure which is usually and generally performed in wounds Neither that without good cause for oft-times from the condition of the parts we may certainly pronounce the whole success of the disease for wounds which penetrate into the ventricles of the brain into the heart the large vessels the chest the nervous parts of the midriffe the liver ventricles small guts bladder if somewhat large are deadly as also those which light upon a joynt in a body repleat with ill humors as we have formerly noted Neither must you neglect that indication which is drawn from the situation of the part and the commerce it hath with the adjacent parts or from the figure thereof seeing that Galen himself would not have it neglected Gal. lib. 7. Meth 2. ad Glauc But we must consider in taking these forementioned Indications whether there be a composition or complication of the diseases for as there is one and that a simple indication of one and that a simple disease so must the indication be various of a compound and complicate disease But there is observed to be a triple composition or complication of affects besides nature for either a disease is compounded with a disease as a wound or a plegmon with a fracture of a bone or a disease with a cause as an ulcer with a defluxion or a disease with a symptome as a wound with pain or bleeding It sometimes comes to pass that these three the disease cause and symptome concur in one case or affect In artificially handling of which we must follow Galens counsell Gal. lib. 7. Meth. who wishes in complicated and compounded affects that we resist the more urgent then let us withstand the cause of the disease and lastly that affect without which the rest cannot be cured Which counsell must well be observed for in this composure of affects which distracts the Emperick on the contrary the rational Physitian hath a way prescribed in a few and these excellent words which if he follow in his order of cure he can scarse miss to heal the Patient Symptomes truly as they are symptomes yeeld no indication of curing neither change the order of the cure for when the disease is healed the symptome vanishes as that which follows the disease as a shadow follows the body But symptomes do oftentimes so urge and press How and when we must take indication of curing from a symptome that perverting the whole order of the cure we are forced to resist them in the first place as those which would otherwise increase the disease Now all the formerly mentioned indications may be drawn to two heads the first is to restore the parts to its native temper the other is that the blood offend not either in quantity or quality for when those two are present there is nothing which may hinder the repletion or union of wounds nor ulcers CHAP. IX What remains for the Chirurgeon to do in this kind of Wounds THe Chirurgeon must first of all be skilfull and labour to asswage pain hinder defluxions prescribe a diet in those six things we call not-natural forbidding the use of hot and acrid things as also of Wine for such attenuate humors and make them more apt for defluxion Why such as are wounded must keep a slender diet Therefore at the first let his diet be slender that so the course of the humors may be diverted from the affected part for the stomach being empty and not well filled draws from the parts about it whereby it consequently follows that the utmost and remotest parts are at the length evacuated which is the cause that such as are wounded must keep so spare a diet for the next dayes following Venery is very pernicious for that it inflames the spirits and humors far beyond other motions whereby it happens that the humors waxing hot are too plentifully carried to the wounded and over heated part The bleeding must not be stanched presently upon receiving of the wound for by the more plentiful efflux thereof the part is freed from danger of inflammation and fulness Why we must open a vein in such as are wounded by Gunshot Wherefore if the wound bleed not sufficiently at the first you shall the next day open a vein and take blood according to the strength and plenitude of the Patient for there usually flows no great store of blood from wounds of this nature for that by the greatness of the contusion and vehemency of the moved air the spirits are forced in as also I have observed in those who have one of their limbs taken away with a Cannon bullet For in the time when the wound is received there flows no great quantity of blood although there be large veins and arteries torn in sunder thereby But on the 4 5 6. or some more dayes after the blood flows in greater abundance and with more violence the native
into the bowels All things that resist poison must be given any way whatsoever as lemons oranges angelica-roots gentian tormentil burnet vervain cardus benedictus borage bugloss and the like Let all things that are afterwards set before the patient be meats of good juice such as ate veal kid mutton patridg pullets capons and the like CHAP. XVI Of the biting of a Viper or Adder and the symptoms and cure thereof THe remedies that were formerly mentioned against the bitings of mad dogs the same may be used against all venomous bites and stings yet nevertheless each poison hath his peculiar antidote Vipers or Adders as we vulgarly term them have in their gums The bites of vipers how virulent or the spaces between their teeth little bladders filled with a virulent sanies which is pressed out into the part that they bite with their teeth There forthwith ariseth a pricking pain The symptoâ— the part at the first is much swollen and then the whole body unless it be hindred gross and bloody filth sweats out of the wound little blisters rise round about it as if it were burnt the wound gnaws and as it were feeds upon the flesh great inflammation possesseth the liver and the guts and the whole body becomes very dry becoming of a pale or yellowish colour with thirst unquenchable the belly is griped by fits a cholerick vomiting molesteth them the stomach is troubled with a hicketting the patients are taken with often swoundings with cold sweat the fore-runner of death unless you provide by fit medicines for the noble parts before the poison shall invade them Matthiolus tells that he saw a country-man who as he was mowing a meadow An history by chance cut an Adder in two with his sithe which when he thought it was dead he took the one half whereon the head remained without any fear in his hand but the enraged creature turning about her head cruelly bit him by one of his fingers which finger as men usually do especially when as they think of no such thing he put into his mouth and sucked out the blood and poison and presently fell down dead When as Charls the ninth was at Montpelier An history I went into the shop of one Farges an Apothecary who then made a solemn dispensation of Treacle where not satisfying my self with the looking upon the Vipers which were there in a glass ready for the composition I thought to take one of them in my hands but whilst that I too curiously and securely handled her teeth which were in her upper jaw covered with a skin as it were a case to keep the poison in the beast catched hold of the very end of my fore-finger and bit me in the space which is between the nail and the flesh whence presently there arose great pain both by reason of the part endued with most exquisite sense as also by the malignity of the poison forthwith I exceeding straitly bound my finger above the wound that so I might press forth the blood and poison lest they should diffuse themselves further over the body Remedies for the bite of a viper I dissolved old Treacle in aqua vitae wherein I dipped and moistned cotton and so put it to the wound and within a few daies I throwly recovered by this only medicine You may use in stead of Treacle Mithridate and sundry other things which by reason of their heat are powerful drawers as a quill rosted in hot embers garlick and leeks beaten and applied barly-flowr tempered with vinegar hony and goats-dung and so applied like a pult is Some think it sufficient forthwith to wash and foment the wound with vinegar salt and a little honey Galen writes that the poison inflicted by the bite of a viper Lib. de theriac may be drawn forth by applying to the wound the head of a viper but othersome apply the whole viper beaten to mash CHAP. XVII Of the Serpent called Haemorrhous The Haemorrhous why so called THe Serpent Haemorrhous is so called because by biting he causeth blood to drop out of all the passages of the wounded body he is of a small body of the bigness of a viper with eies burning with a certain fiery brightness and a most beautiful skin The back of him as Avicen writes is spotted with many black spots his neck little and his tail very small the part which he bites forthwith grows blackish by reason of the extinction of the native heat which is extinguished by such poison which is contrary thereto in its whole substance Then follows a pain of the stomach and heart these parts being touched with the pestiferous quality of the poison These pains are seconded by vomiting the orifice of the ventricle being relaxed by a Diarrhaea the retentive faculty of all the parts of the belly being weakned and the veins which aâ—e spread through the guts Wonderful bleedings not being able to retain the blood contained in them For the blood is seen to slow out as in streams from the nose mouth ears fundament privities corners of the eies roots of the nails and gums which putrefie the teeth falling out of them Moreover there happens a difficulty of breathing and stoppage of the urine with a deadly convulsion The cure is forthwith to scarisie and burn the bitten part or else to cut it quite off if that it may be done without danger of life and then to use powerfully drawing Antidotes The figure of the Serpent Haemorrhous CHAP. XVIIII Of the Serpent called Seps The reason of the name and description of the Seps THe Serpent Seps is so called because it causeth the part which it bites forthwith to putrefie by reason of the cruel malignity of its poison It is not much unlike the Haemorrhous but that it curls or twines up the tail in divers circles Pausanias writes that this serpent is of an ash colour a broad head small neck big belly writhen tail and as he goes he runs aside like a crab But his skin is variegated and spotted with several colours like to Tapistry By the cruelty of his caustick and putrefying venom he burns the part which he hath bit with most bitter pain he causeth the shedding of the hairs and as Aetius addeth the wound at the first casteth forth manifest blood The symptoms but within a little while after stinking filth The putrefied affected parts wax white and the body all over becomes of the colour of that scurf which is termed Alphos so that by the wickedness of this putrefactive poison not only the spirits are resolved but also the whole body consumed as by fire a pestilent carbuncle and other putrid tumors arising from an hot and humid or suffocating constitution of the air Now for the remedies they must be such as are formerly prescribed against the bitings of a viper The figure of the Serpent Seps CHAP. XIX Of the Basiliske or Cockatrice THe Basilisk far exceeds all kinds
concavity of the body Signs that a wound hath pierced in the concavity of the chest if the air come forth at the wound making a certain whizzing noise if the patient breathe with great difficulty if he feel a great heaviness or weight on or about the midriff whereby it may be gathered that a great quantity of blood lieth upon the place or midriff and so causeth him to feel a weight or heaviness which by little and little will be cast up by vomiting But a little after a fever commeth and the breath is unsavory and stinking by reason that the putrifying blood is turned into sanies the patient cannot lye but on his back and he hath an often desire to vomit but if he escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting Signs that the Lungs are wounded That the Heart is wounded he is vexed with a grievous shortness of breath and with pain in his sides We may perceive the heart to be wounded by the abundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse paleness of the face cold sweat with often swooning coldness of the extreme parts and sudden death When the midriff which the Latins call Diaphragma is wounded The Midriff the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortness of winde a cough and fit of grievous pain and drawing of the intrals upwards Wherefore when all these accidents appear we may certainly pronounce that death is at hand Death appeareth suddenly by a wound of the hollow Vein or the great Artery The Vena Cava and great Artery by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindered The marrow of the back bone being pierced The spinal marrow the patient is assaulted with a palsie or convulsion very suddenly and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood cometh out at the wound The Liver and pricking-pain disperseth it self even unto the sword-like gristle which hath its situation at the lower end of the breast-bone called Sternon the blood that followeth from thence down into the intestines doth oft-times infer most malign accidents yea and sometimes death When the stomach is wounded the meat and drink come out at the wound The Stomach there followeth a vomiting of pure choler then commeth swearing and coldness of the extreme parts and therefore we ought to prognosticate death to follow such a wound When the Milt or Splene is wounded black and gross blood cometh out at the wound The spleen the patient will be very thirsty with pain on the left side and the blood breaks forth into the belly and there purrifying causeth most malign and grievous accidents and often-times death to follow When the guts are wounded the whole body is griped and pained The Guts the excrements come out at the wound whereat also oft-times the guts break forth with great violence When the reins of Kidnies are wounded the patient will have great pain in making his urine The Kidnies and the blood commeth out together therewith the pain commeth down even unto the groin and yard and testicles When the Bladder and Ureters are wounded the pain goeth even unto the entrails The Bladder the parts all about and belonging to the groin are d stended the urine is bloody that is made and the same also commeth oftentimes out of the wound When the womb is wounded the blood commeth out at the privities The womb and all other accidents appear like as when the bladder is wounded The nerves When the sinews are pricked or cut half asunder there is great pain in the affected place and there followeth a sudden inflammation flux abscess fever convulsion and oftentimes a gangrene or mortification of the part whereof commeth death unless it be speedily prevented Having declared the signs and tokens of wounded parts it now remaineth that we set down other signs of certain kindes of death that are not common or natural whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgment of the descreet Physician or Surgeon Signs that an infant is smothered or over-laid Therefore if it chance that a nurse either through drunkenness or negligence lies upon the infant lying in bed with her and so stifles or smothers it to death If your judgment be required whether the infant died through the default or negligence of the nurse or through some violent or sudden disease that lay hidden and lurking in the body thereof you shall finde out the truth of the matter by these signs following For if the infant were in good health before if he were not froward or crying if his mouth and nostrils now being dead be moistened or bedewed with a certain foam if his face be not pale but of a Violet or Purple colour if when the body is opened the Lungs be found swoln and puffed up as it were with a certain vaporous foam and all other intrails sound it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corps of a man be found lying in a field or house alone and you be called by a Magistrate to deliver your opinion whether the man were slain by lightning or some other violent death you may by the following signs finde out the certainty hereof Signs of such as are slain by lightning For every body that is blasted or stricken with lightning doth cast forth or breathe out an unwholsome stinking or sulphureous smell so that the birds and sowls of the air or dogs will not once touch it much less prey or feed upon it the part that was stricken oftentimes sound and without a wound but if you search it well you shall finde the bones under the skin to be bruised broken or shivered in pieces Lib. 2. cap. 54. But if the lightning hath pierced into the body with making a wound therein according to the judgment of Pliny the wounded part is far colder then all the rest of the body For lightning driveth the most thin and fiery air before it and striketh it into the body with great violence by the force whereof the heat that was in the part is soon dispersed wasted and consumed Lightning doth alwaies leave some impression or sign of some fire either by ustion or blackness for no Lightning is without fire Moreover whereas all other living creatures when they are
was contained in that little close chamber was partly consumed by the fire of coals no otherwise then the air that is contained in a cupping-glass is consumed in a moment by the flame so soon as it is kindled Furthermore it was neither cold nor temperate but as as it were inflamed with the burning fire of coals Thirdly it was more gross in consistence then it should be by reason of the admixtion of the grosser vapor of the coals for the nature of the air is so that it may be soon altered and will very quickly receive the forms and impressions of those substances that are about it Lastly it was noisome and hurtful in substance and altogether offensive to the aiery substance of our bodies For Charcoals are made of green wood burnt in pits under ground and then extinguisht with their own fume or smoak as all Colliers can tell These were the opinions of most learned men although they were not altogether agreeable one unto another yet both of them depended on their proper reasons For this at least is manifest that those passages which are common to the brest and brain were then stopped with the grossness of the vapors of the coals whereby it appeareth that both these parts were in fault for as much as the consent and connexion of them with the other parts of the body is so great that they cannot long abide sound and perfect without their mutual help by reason of the loving and friendly sympathy and affinity that is between all the parts of the body one with another Wherefore the ventricles of the brain the passages of the Lungs and the sleepy Arteries being stopped the vital spirit was prohibited from entring into the brain and consequently the animal spirit retained and kept in so that it could not come or disperse it self thorough the whole body whence happeneth the defect of two of the faculties necessary for life It many times happeneth and is a question too frequently handled concerning womens maiden-heads whereof the judgment is very difficult Of the signs of virginity Yet some antient women and Midwives will brag that they assuredly know it by certain and infallible signs For say they in such as are virgins there is a certain membrane of parchment like skin in the neck of the womb which will hinder the thrusting in of the finger if it be put in any thing deep which membrane is broken when first they have carnal copulation as may afterwards be perceived by the free entrace of the finger Besides such as are defloured have the neck of their womb more large and wide as on the contrary it is more contract strait and narrow in virgins But how deceitful and untrue these signs and tokens are shall appear by that which followeth for this membrane is a thing preternatural and which is scarce found to be in one of a thousand from the first conformation Now the neck of the womb will be more open or strait according to the bigness and age of the party For all the parts of the body have a certain mutual proportion and commensuration in a well-made body Joubertus hath written that at Lectaure in Gascony Lib. de error popul a woman was delivered of a childe in the ninth year of her age and that she is yet alive and called Joan de Parie being wife to Videau Bechâ— the receiver of the amercements of the King of Navare which is a most evident argument that there are some women more able to accompany with a man at nine years old then many other at fifteen by reason of the ample capacity of their womb and the neck thereof besides also this passage is enlarged in many by some accident as by thrusting their own fingers more strong thereinto by reason of some itching or by the putting up of a Nodule or Pessary of the bigness of a mans yard for to bring down the courses Aph. 39. sect 5. Neither to have milk in their brests is any certain sign of lost virginity For Hippocrates thus writes But if a woman which is neither with childe nor hath had one have milk in her brests then her courses have failed her Moreover Aristotle reports that there be men who have such plenty of milk in their breasts that it may be sucked or milked out Cardan writes that he saw at Venice one Antony Bussey some 30. years old Lib. 4. de hist animal c. 20. Lib 12 de subtilitate who had milk in his brest in such plenty as sufficient to suckle a childe so that it did not only drop but spring out with violence like to a womans milk Wherefore let Magistrates beware lest thus admonished they too rashly assent to the reports of women Let Physicians and Chirurgions have a care lest they do too impudently bring Magistrates into an error which will not redound so much to the judges disgrace as to theirs But if any desire to know whether one be poysoned let him search for the symptoms and signs in the foregoing and particular treatise of poysons But that this doctrine of making reports may be the easier I think it fit to give presidents in imitation whereof the young Chirurgion may frame others The first president shall be of death to ensue a second of a doubtful judgement of life and death the third of a impotency of member the fourth of the hurting of many members I A. P. Chirurgion of Paris A certificatâ— of death this twentyeth day of May by the command of the Counsel entred into the house of one John Brossey whom I found lying in bed wounded on his head with a wound in his left temple piercing the bone with a fracture and effracture or depression of the broken bone scales and meninges into the substance of the brain by means whereof his pulse was weak he was troubled with raving convulsion cold sweat and his appetite was dejected Whereby may be gathered that certain and speedy death is at hand In witness whereof I have signed this Report with my own hand By the Coroners command I have visited Peter Lucey whom I found sick in bed Another in a doubtful case being wounded with a Hilbert on his right thigh Now the wound is of the bredth of three fingers and so deep that it pierces quite through his thigh with the cutting also of the vein and artery whence ensued much effusion of blood which hath exceedingly weakned him and caused him to swound often now all his thigh is swoln livid and gives occasion to fear worse symptoms which is the cause that the health and safety of the party is to be doubted of By the Justices command I entred into the house of James Bertey to visit his own brother In the loss of a member I found him wounded in his right arm with a wound of some four fingers bigness with the cutting of the tendons bending the leg and of the veins arteries and Nerves Wherefore I
the Varices and the inâ—â—ion of the temporal Arteries as after the amputation of a member Now you your self command that in cutting the Varices the flux of blood be stopped by the ligature of the vessels In the book 2 chap. of Angealogy leaf 176. you command the same in the book of stitches 1. chap. speaking of the stitch with the amputation and section of the Call changed by the outward air see here your own words After that must be considered concerning the Câ—lâ— for if there be any part corrupted putrified withered or blackish first having tyed for fear of a flux of blood you do not bid afterward to have it cauterised but to say the truth you have your eyes shâ—t and all your sences dulled when you would speak against so sure a method and that it is not but through anger and an ill will For there is nothing which hath more power to drive reason from her seat then cholet and anger Moreover when one comes to canterize and dismemper the parts oftentimes when the 〈◊〉 comes to fall off there happens a new flux of blood As I have seen divers times not having been yet inspired by God with so suâ—e a means then when I used the heat of fire Which if you have not found or understood this method in the books of the Antients you ought not thus to â—â—ead it under your feet and speak unluâ—kily of one who all his life hath preferred the profit oâ— the Common-wealth before his own particular It is not more then reasonable to be found upon the saying of Hippocrates in the chapter of burning 2. book leaf 206. upon whose authority you serve your self which is thus That what the medicament cureth not the iron doth and what the iron doth not amend the fire exterminateth Galen in 4. book of the Meth. and in the book of Art of Hippocratâ—s Apho. the 2. book 1. In the book of arte panva It is a thing which savors not of a Christian to fall to burning at the first dash withoâ—t staying for any more gentle remedies As you your self write in the first book leaf 5. speaking of the conditions required in a Chirurgion to cure well which passages you borrow from some other place for that which may be done gently without fire is much more commended then otherwise Is it not a thing which all schools hold as a Maxiâ—â— that we must alwayes begin with most easie remedies which if they be not sufficient we must then come to extreme following the doctrine of Hippocrates Galen commands in the place before alledged to treat or dress the diseased quickly safely and with the least pain that is possible Let us come to Reason NOw so it is that one cannot apply hot irons but with extreme and vehement pain in a sensible part void of a Gangrene which would be cause of a Convulsion Fever yea oft-times of Death Moreover it would be a long while afteâ—wards before the poor patient were cured because that by the actions of there is made an either Of what the eâ—coar is made which proceeds from the subject flesh which being fallen nature must regenarate a new flesh in stead of that which hath been burned as also the bone remains discovered and bare and by this means for the most part there remains an ulcer incurable Moreover there is yet another accident It happeneth that oftentimes the crust being faln off the flesh not being well renewed the blood issueth out as it did before But when they shall be tied the ligature falls not off until the first flesh have very well covered them again which is proved by Galen in the 5. book of his Math. saying that escharotick medicines which cause a crust or eschar whensoever they fall off leave the part more baâ—e then the natural habit requires For the generation of a crust proceeds from the parts subject and which are situate â—ound about it being also burned as I may say wherefore by how much the part is burnt by so much it loseth the natural heat Words of the adversary Then tell me when it is necessary to use escarotick medicines or cautering irons T is when the flux of blood is caused by erosion or some Gâ—ngrene or putrefaction Now is it thus in fresh bleeding wounds there is neither Gangrene nor putrefaction Therefore the cauteries ought not to be there applied And when the Antients commanded to apply hot irons to the mouths of the vessels it hath not been only to stay the flux of blood but chiefly to correct the malignity or gangâ—enous putrefaction which might spoil the neighboring parts And it must be here noted that if I had known such accidents to happen which you have declared in your book in drawing and tying the vessels I had never been twice deceived nor would I ever have left by my writings to posterity such a way of stopping a flux of blood But I writ it after I had seen it done and did it very often with happy success See then what may happen through your inconsiderate counsel Propositions of the Adversary without examining or standing upon the facility of tying the said vessels For see here 's your scope and proposition to tie the vessels after amputation is a new remedy say you then it must not be used it is an ill argument for a Doctor But as for that say you one must use fire after the amputation of members to consume and dry the putrefaction which is a common thing in Gangrenes and mortifications that indeed hath no place here because the practice is to amputate the part above that which is mortified and corrupted as Celsus writes and commands to make the amputation upon the second part rather then to leave any whit of the corrupted I 5. book c. 26. and 7. book c. 33. I would willingly ask you if when a vein is cut transverse and that it is very much retracted towards the original whether you would make no conscience to burn till that you had found the orifice of the vein or artery and if it be not more easie only with a Crow-bill to pinch and draw the vessel and so tie it In which you may openly shew your ignorance In the ch of cutting Book the 2. and that you have your mind seized with much rancor and choler We daily see the ligature of the vessels practised with happy success after the amputation of a part which I will now verifie by experiences and histories of those to whom the said ligature hath been made and persons yet living Experiences A â—oâ—â—ble history The 16. of June 1582. in the presence of Mr. John Lieâ—aud doctor in the faculty of Physick at Paris Claud Viard sworn Surgeon Mr. Mathurin Hurâ—n Surgeon of Mounsieur de Sâ—uvâ—â—y and I Jâ—hn Charbonel M. Barber-Surgeon of Paris well understanding the Theorick and Fractick of Surgerie did with good dexterity amputate the left leg of a woman tormented
of an ulcerated Phlegmon Pag. 183 Chap. XI Of feavers and the cure of the feavers which accompany a Phlegmon Pag. 185 Chap. XII Of an Erysipelas or inflammation Pag. 187 Chap. XIII Of the cure of an Erysipelas ib. Chap. XIV Of the Herpes that is tetters or ringworms or such like Pag. 188 Chap. XV. Of feavers which happen upon erysipelous tumors Pag. 189 Chap. XVI Of an Oedema or cold phlegmatick tumor Pag. 190 Chap. XVII Of the cure of flatulent and waterish tumors Pag. 191 Chap. XVIII Of the cure of a flatulent and waterish tumor Pag. 192 Chap. XIX Of an Atheroma Steatomae and Meliceris Pag. 193 Chap. XX. Of the cure of Lupiae that is wens or ganglions ib. Chap. XXI Of a Ganglion more particularly so called Pag. 195 Chap. XXII Of the Strumae or Scrophulae that is the Kings evil ib. Chap. XXIII Of the feaver which happens upon an oedematous tumor Pag. 196 Chap. XXIV Of Scirrbus or an hard tumor proceeding of melancholy Pag. 197 Chap. XXV Of the cure of a Schirrhus Pag. 198 Chap. XXVII Of the causes kinds and prognosticks of a cancer Pag. 199 Chap. XXVIII Of the cure of a cancer beginning and not yet ulcerated ib. Chap. XXIX Of the cure of an ulcerated cancer Pag. 200 Chap. XXX Of the topick medicines to be applyed to an ulcerated and not ulcerated cancer ib. Chap. XXXI Of the fever which happeneth in Scirrhous tumors Pag. 202 Chap. XXXII Of an Aneurisma that is the dilation or springing of an artery vein or sinew Pag. 203 The eighth Book Of the particular tumors against Nature Chap. I Of an Hydrocephalos or watery tumor which commonly affects the heads of infants Pag. 205 Chap. II. Of a Polypus being an eating disease in the nose Pag. 206 Chap. III. Of the Parotides that is certain swellings about the ears ib. Chap. IV. Of the Epulis or overgrowing of the flesh of the Gums Pag. 207 Chap. V. Of the Ravula ib. Chap. VI. Of the swelling of the glandules or almonds of the throat Pag. 208 Chap. VII Of the inflammation and relaxation in the Uvula or Columella Pag. 209 Chap. VIII Of the Angina or squinzy Pag. 240 Chap. IX Of the Bronchocele or rupture of the throat Pag. 212 Chap. X. Of the Plurisie ib. Chap. XI Of the Dropsie Pag. 213 Chap. XII Of the cure of the dropsie Pag. 214 Chap. XIII Of the tumor and relaxation of the navil Pag. 216 Chap. XIV Of the tumors of the groins and cods called Hermae that is Ruptures ib. Chap. XV Of the cure of ruptures Pag. 217 Chap. XVI Of the golden ligature or the Punctus Aureus as they call it Pag. 219 Chap. XVII Of the cure of other kindes of ruptures Pag. 221 Chap. XVIII Of the falling down of the fundament Pag. 223 Chap. XIX Of the Paronychiae ib. Chap. XX. Of the swelling of the knees Pag. 224 Chap. XXI Of the Dracunculus ib. The ninth Book Of wounds in general Chap. I. What a wound is what the kindes and differences thereof are and from whence they may be drawn or derived Pag. 227 Chap. II. Of the causes of wounds Pag. 228 Chap. III. Of the signs of wounds Pag. 229 Chap. IV. Of prognosticks to be made in wounds ib. Chap. V. Of the cure of wounds in general Pag. 230 Chap. VI. Of sutures Pag. 231 Chap. VII Oâ— the Flux of blood which usually happens in wounds Pag. 232 Chap. VIII Of the pain which happens upon wounds Pag. 233 Chap. IX Of convulsion by reason of a wound ib. Chap. X. The cure of a convulsion Pag. 234 Chap. XI Of the cure of a convulsion by sympathy and pain Pag. 235 Chap. XII Of the Palsie Pag. 236 Chap. XIII Of the cure of the Palsie ib. Chap. XIV Of swouning Pag. 237 Chap. XV. Of Delirium i. raving talking idly or doting ib. The tenth Book Of the green and bloody wounds of each part Chap. I. Of the kindes and differences of a broken skull Pag. 238 Chap. II. Of the causes and signs of a broken skull Pag. 240 Chap. III. Of the signs of a broken skull which are manifest to our sense Pag. 241 Chap. IV. Of a fissure being the first kinde of a broken skull ib. Chap. V. Of a concusion which is the second part of a fracture Pag. 243 Chap. VI. Of an effracture depression of the bone being the third kinde of a fracture Pag. 245 Chap. VII Of a seat being the fourth kinde of a broken skull Pag. 247 Chap. VIII Of a Resonitus or counterfissure being the fifrh kinde of fracture ib. Chap. IX Of the moving or concussion of the brain Pag. 248 Chap. X. Of prognosticks to be made in fractures of the skull Pag. 250 Chap. XI Why when the brain is hurt by a wound of the head there may follow a convulsion of the opposite part Pag. 251 Chap. XII A convulsion of the deadly signs in the wounds of the head Pag. 252 Chap. XIII Of salutary signs in wounds of the head Pag. 253 Chap. XIV Of the general cure of a broken skull and of the symâ—toms usually happening thereupon ib. Chap. XV. Of the particular cure of wounds of the head and of the musculous skin Pag. 555 Chap. XVI Of the particular cure of a fracture or broken sukll Pag. 257 Chap. XVII Why we use trepaning in the fractures of the skull Pag. 258 Chap. XVIII A description of trepans Pag. 259 Chap. XIX Of the places of the skull whereto you may not apply a trepan Pag. 262 Chap. XX. Of the corruption and Ca ies or rottenness of the bones of the head Pag. 263 Chap. XXI Of the discommodities which happen to the Crassa meninx by fractures of he skull Pag. 264 Chap. XXII Of the cure of the brain being shaken or moved Pag. 266 Chap. XXIII Of the wounds of the face Pag. 267 Chap. XXIV Of the wounds of the eyes Pag. 268 Chap. XXV Of the wounds of the cheeks Pag. 270 Chap. XXVI Of the wounds of the nose Pag. 272 Chap. XXVII Of the wounds of the tongue ib. Chap. XXVIII Of the wounds of the ears Pag. 273 Chap. XXIX Of the wounds of the neck and throat ib. Chap. XXX Of the wounds of the chest Pag. 274 Chap. XXXI Of the cure of the wounds of the che chest Pag. 279 Chap. XXXII Of differences causes signs and cure of an Hectick fever Pag. 277 Chap. XXXIII Of the wounds of the Epigastrium and of the whole lower belly Pag. 280 Chap. XXXIV Of the cure of wounds of the lower belly Pag. 281 Chap. XXXV Of the wounds of the groins yard and testicles ib. Chap. XXXVI Of the wounds of the thigh and legs Pag. 282 Chap. XXXVII Of the wounds of the nerves and nervous parts ib. Chap. XXXVIII Of the cure of the wounds of the nervous parts ib. Chap. XXXIX Of the wounds of the joints Pag. 284 Chap. XL. Of the wounds of the Ligaments Pag. 286 Of wounds made by Gunshot other fiery Engines and of all
which abounds Examples of taking away that which iâ— superfluousâ—â— in the Amputation or cutting off a finger if any have six on one hand or any other monstrous member that may grow out in the lopping off a putrefied part inwardly corrupted in the extraction of a dead child the secondine mole or such like bodies out of a womans womb In taking down of all Tumors as Wens Warts Polypus Cancers and fleshy excrescences of the like nature in the pulling forth of bullets of pieces of mail of darts arrows shells splinters and of all kind of weapons in what part of the body soever they be And he taketh away that which redounds which plucks away the hairs of the eye-lids which trouble the eye by their turning in towards it who cuts away the web possessing all the * Two tunicles of the eyes Alaska and the part of the * Two tunicles of the eyes Cornâ—a who letteth forth suppurated matter who taketh out stones in what part soever of the body they grow who puls out a rotten or otherwise hurtful tooth or cuts a nail that runs into the flesh who cuts away part of the Uvula or hairs that grow on the ey-lids who taketh off a Cataract who cuts the navil or foreskin of a child newly born or the skinny caruncles of womens Privities Examples of placing those things which are out of their natural site are manifest in restoring dislocated bones Examples of replacing in re-placing of the guts and gall fallen into the cods or out of the navil or belly by a wound or of the falling down of the womb fundament or great gut or the eye hanging out of its circle or proper place Example of separating things joyned together But we may take examples of disjoyning those things which are continued from the fingers growing together either by some chance as burning or by the imbecillity of the forming faculty by the disjunction of the membrane called Hymen or any other troubling the neck of the womb by dissection of the ligament of the tongue which hinders children from sucking and speaking and of that which hinders the Glans from being uncovered of the foreskin by the division of a various vein or of a half cut nerve or tendon causing Convulsion by the division of the membrance stopping the auditory passage the nose mouth or fundament or the stubborn sticking together of the hairs of the ey-lids Refer to this place all the works done by Causticks the Saw Trepan Lancet Cupping-glasses Incision-knife Leeches either for evacuation derivation or revulsion sake Examples of uniting things disjoyned The Chirurgeon draws together things separated which healeth wounds by stitching them by bolstring binding giving rest to and fit placing the part which repairs fractures restoring luxated parts who by binding the vessel stayeth the violent effusion of blood who cicatriceth cloven lips commonly called Hare-lips who reduceth to equality the cavities of Ulcers and Fistula's Examples of supplying defects But he repairs those things which are defective either from the infancy or afterwards by accident as much as Art and Nature will suffer who set on an ear an ey a nose one or more teeth who fills the hollowness of the palat eaten by the Pox with a thin plate of gold or silver or such like who supplies the defect of the tongue in part cut off by some new addition who fastens to a hand an arm or leg with fit ligaments workman-like who fits a doublet bumbasted or made with iron plates to make the body straight who fils a shoo too big with cork or fastens a stockin or sock to a lame mans girdle to help his gate We will treat more fully of all these in our following Work But in performing those things with the hands we cannot but cause pain for who can without pain cut off an arm or leg divide and tear asunder the neck of the bladder restore bones put out of their places open Ulcers bind up wounds and apply cauteries and do such like notwithstanding the matter often comes to that pass that unless we use a judicious hand we must either die or lead the remnant of our lives in perpetual misery Who therefore can justly abhor a Chirurgeon for this or accuse him of cruelty or desire they may be served as in ancient times the Romans served Archagatus Archagatus the Chirurgeon who at the first made him free of the City but presently after because he did somewhat too cruelly burn cut and perform the other works of a good Chirurgeon they drew him from his house into the Campus Martius and there stoned him to death as we read it recorded by Sextus Cheronaeus Plutarch's nephew by his Daughter Truly it was an inhumane kind of ingratitude so cruelly to murder a man intent to the works of so necessary an Art But the Senate could not approve the act wherefore to expiate the crime as well as then they could they made his Statue in Gold placed it in Aesculapius his Temple and dedicated it to his perpetual memory For my part I very well like that saying of Celsus A Chirurgeon must have a strong In praefat lib. 7. The properties of a good Chirurgeon stable and intrepid hand and a mind resolute and merciless so that to heal him he taketh in hand he be not moved to make more haste than the thing requires or to cut less than is needful but which doth all things as if he were nothing affected with their cries not giving heed to the judgment of the vain common people who speak il of Chirurgeons because of their ignorance CHAP. III. Of things Natural THat the Chirurgeon may rightly and according to Art perform the foresaid works he must set before is eys certain Indications of working Otherwise he is like to become an Emperick whom no Art no certain reason but only a blind temerity of fortune moves to boldness and action From whence we must draw Indications These Indications of actions are drawn from things as they call them natural not-natural and besides-nature and their adjuncts as it is singularly delivered of the Ancients being men of an excellent understanding Wherefore we will prosecute according to that order all the speculations of this Art of ours First therefore things Natural are so termed because they constitute and contain the nature of mans body What things are called natural which wholly depends of the mixture and temperament of the four first bodies as it is shewed by Hippocrates in his Book de Natura humana wherefore the consideration thereof belongs to that part of Physick which is named Physiologia as the examination of things not natural to Diaetetice To what part of physick things not nacuraly pertain or Diet because by the use of such things it endevours to retain and keep health but Therapeutice or the part which cures the Diseases and all the affects besides nature challenges the contemplation of
The present state of the Air one while for some small time is like the Spring that is temperate otherwhiles like the Summer Aphor. 4. sect 2. The force of the Winds that is hot and dry otherwhiles like the Winter that is cold and moist and sometimes like the Autumn which is unequal and this last constitution of the Air is the cause of many diseases When upon the same day it is one while hot another cold we must expect Autumnal diseases These tempers and varieties of constitutions of the Air are chiefly and principally stirred up by the winds as which being diffused over all the Air shew no small force by their sudden change Wherefore we will briefly touch their natures That which blows from the East is the East-wind and is of a hot and dry nature and therefore healthful But the Western wind is cold and moist and therefore sickly The South-wind is hot and moist the Author of putrefaction and putrid diseases The North-wind is cold and dry therefore healthy wherefore it is thought if it happen to blow in the Dog-days that it makes the whole year healthful and purges and takes away the seeds of putrefaction if any chance to be in the Air. But this description of the four Winds is then only thought to be true if we consider the Winds in their own proper nature which they borrow from those Regions from which they first proceed For otherwise they affect the Air quite contrary How the winds acquire other â—ies than they naturally have according to the disposition of the places over which they came as Snowie places Sea Lakes Rivers Woods or sandy Plains from whence they may borrow new qualities with which they may afterwards possess the Air and so consequently our bodies The Westwind oâ— it self unwholsome Hence it is we have noted the Western-wind unwholsom and breeding diseases by reason of the proper condition of the Region from whence it came and such that is cold and moist the Gascâ—ins find it truly to their so great harm that it seldom blows with them but it brings some manifest and great harm What force stars have upon the Air. either to their bodies or fruits of the earth And yet the Greeks and Latins are wont to commend it for healthfulness more than the rest But also the rising and setting of some more eminent Stars do often cause such cold winds that the whole Air is cooled or infected with some other malign quality For vapors and exhalations are often raised by the force of the Stars from whence winds clouds storms whirlwinds lightnings thunders hail snow rain earthquakes inundations and violent raging of the sea have their original The exact contemplation of which things although it be proper to Astronomers Cosmographers and Geographers yet Hippocrates could not omit it but that he must speak something in his book De Aere Aquis where he touches by the way the description of the neighbouring Regions and such as he knew From this force of the Air either hurtful or helping in diseases came that famous observation of Guido of Cauâ—ias That wounds of the head are more difficult to cure at Paris than at Avignion and the plain contrary of wounds of the legs How the air of Paris comes to be ill for wounds of the head and good for those of the leggs for the air of Paris compared to that of Avignion is cold and moist wherefore hurtful and offensive to the wounds of the head On the contrary the same air because it obscures the spirits incrassates the blood condensates the humors and makes them less fit for defluxions makes the wounds of the legs more easie to be healed by reason it hinders the course of humors by whose defluxion the cure is hindred But it is manifest that hot and dry places make a greater dissipation of the natural heat from whence the weakness of the powers by which same reason the Inhabitants of such places do not so well endure blood-letting but more easily suffer purgations though vehement by reason of the contumacy of the humor By what means the air changes our bodies caused by driness To conclude the Air changes the constitutions of our bodies either by its qualities as if it be hotter colder moister or drier or by its matter as if it be grosser or more subtil than is fit or corrupted by exhalations from the earth or by a sudden and unaccustomed alteratâ—on which any man may prove who makes a sudden change out of a quiet air into a stormy and troubled with many winds But because next to the Air nothing is so necessary to nourish mans body as Meat and Drink I will now begin to speak of them both CHAP. XIV Of Meat and Drink THat this our Treatise of Meat and Drink may be more brief and plain I have thought good to part it into these heads as to consider the goodness and illness of both of them their quantity quality custom delight order time and to accommodate them all to the ages and seasons of the year We judge of the goodness and pravity of meats and drinks The goodness of nourishments from the condition of the good or vicious humours or juyce which they beget in us For evil juyce causeth many diseases As on the contrary good juyce drives away all diseases from the body except the fault happen from some other occasion as from quantity or too much excess Wherefore it is principally necessary that those who will preserve their present health and hinder the access of diseases feed upon things of good nourishment and digestion as are good wine the yolks of eggs good milk wheaten bread well baked the flesh of Capons Partridge Thrushes Larks Veal Mutton Kid and such like other which you may find mentioned in the Books which Galen writ De Alimentâ—rum facultatibus where also he examins those which are of evil juyce by their manifest qualities as acrimony bitterness saltness acidity harshness and such like But unless we use a convenient quantity and measure in our meats howsover laudable they be Their quantity we shall never reap these fruits of health we hoped for For they yield matter of diseases by the only excess of their quantity but we may by this know the force of quantity on both parts because often the poisonous quality of meats of ill nourishment doth not hurt by reason they were not taken into the body into a great quantity That measure of quantity is chiefly to be regarded in diseases for as Hippocrates saith If any give meat to one sick of a Feaver The quantity of meats must be esteemed according to the nature of the disease and strength of the Patient he gives strength to the well and increases the disease to the sick especially if he do not use a mean Wherefore it is a thing of no small consequence to know what diseases require a slender and what a large diet
the evacuation of the conjunct matter Galen by a dream cures the Sciatica by the artery the Anckle of the same side being opened yet because it was not cut for this purpose but happened only by chance I judged it was not much dissenting from this argument Pliny writes that there was one named Phalereus which casting up blood at his mouth and at the length medicines nothing availing being weary of his life went unarmed in the front of the battel against the Enemy and there receiving a wound in his breast shed a great quantity of blood which gave an end to his spitting of blood the wound being healed and the vein which could not contain the blood being condensate At Paris Anno 1572. in July a certain Gentleman being of a modest and curteous cariage fell into a continual Feaver and by that means became Frantick moved with the violence of which he cast himself headlong out of a window two stories high and fell first upon the shoulder of Valterra the Duke of Alenzons Physitian and then upon the pavement with which fall he cruelly bruised his ribs and hip but was restored to his former judgment and reason There were present with the Patient besides Valterra witnesses of this accident these Physitians Alexis Magnus Duretus and Martinus The same happened in the like disease and by the like chance to a certain Gascoyn lying at the house of Agrippa in the Paved street Othomannus Doctor of Physick of Monpelier and the King's Professor told me that a certain Carpenter at Broquer a village in Switzerland being frantick cast himself headlong out of an high window into a river and being taken out of the water was presently restored to his understanding The cause of the last recited cures But if we may convert casualties into counsel and Art I would not cast the Patients headlong out of a window But would rather cast them sodainly and thinking of no such thing into a great cistern filled with cold water with their heads foremost neither would I take them out until they had drunk a good quantity of water that by that sodain fall and strong fear the matter causing the Frenzy might be carryed from above downwards from the noble parts to the ignoble the possibility of which is manifest by the forecited examples as also by the example of such as bit by a mad Dog fearing the water are often ducked into it to cure them CHAP. XXIV Of certain juggling and deceitful ways of Curing HEre I determin to treat of those Impostors who taking upon them the person of a Chirurgeon do by any means either right or wrong put themselves upon the works of the Art but they principally boast themselves amongst the ignorant common sort of setting bones which are out of joynt and broken Sciences are not hereditary affirming as falsly as impudently that they have knowledg of those things from their Ancestors as by a certain hereditary right which is a most ridiculous fiction for our minds when we are born is as a smooth table upon which nothing is painted Otherwise what need we take such labour and pains to acquire and exercise Sciences God hath endued all brute beasts with an inbred knowledge of certain things necessary for to preserve their life more than man But on the contrary he hath enriched him with a wit furnished with incredible celerity and judgment by whose diligent and laborious fatigation he subjects all things to his knowledg For it is no more likely that any man should have skill in Chirurgery because his father was a Chirurgeon than that one who never endured sweat dust nor Sun in the field should know how to ride and govern a great Horse and know how to carry away the credit in tilting only because he was begot by a Gentleman and one famous in the Art of War A most impudent sort of Impostors There is another sort of Impostors far more pernicious and less sufferable boldly and insolently promising to restore to their proper unity and seat bones which are broken and out of joynt by the only murmuring of some conceited charms so that they may but have the Patients name and his girdle In which thing I cannot sufficiently admire the idleness of our Countreymen so easily crediting so great and pernicious an error not observing the inviolable law of the ancient Physitians and principally of Divine Hippocrates by which it is determined that three things are necessary to the setting of bones dislocated and out of joynt to draw the bones asunder to hold the bone receiving firmly immoveable with a strong and steddy hand to put the bone to be received into the cavity of the receiving For which purpose the diligence of the Ancients hath invented so many Engines Three things necessary for the cure of a Luxation Glossocomies and Bands lest that the hand should not be sufficient for that laborious work What therefore is the madness of such Impostors to undertake to do that by words which can scarse be done by the strong hands of so many Servants and by many artificial Engines Of late years another kind of Imposture hath sprung up in Germany they beat into fine powder a stone which in their mother tongue they call Bemâ—ruch and give it in drink to any who have a bone broken or dislocated and affirm that it is sufficient to cure them Through the same Germany there wander other Impostors who bid to bring to them the Weapon with which any is hurt they lay it up in a secret place and free from noise and put and apply medicines to it as if they had the patient to dress and in the mean time they suffer him to go about his business and impudently affirm that the wound heals by little and little by reason of the medicine applyed to the weapon But it is not likely that a thing in animate which is destitute of all manner of sense should feel the effect of any medicine and less probable by much that the wounded party should receive any benefit from thence Neither if any should let me see the truth of such juggling by the events themselves and my own eyes would I therefore believe that it were done naturally and by reason but rather by Charms and Magick In the last assault of the Castle of Hisâ—in the Lord of Martigues the elder was shot through the breast with a Musket bullet I had him in cure together with the Physitians and Chrirurgeons of the Emperour Charles the fifth and Emanuel Phiâ—rt the Duke of Savoy who because he entirely loved the wounded prisoner caused an Assembly of Physitians and Chirurgeons to consult of the best means for his cure They all were of one opinion that the wound was deadly and incurable because it passed through the midst of his lungs and besides had cast forth a great quantitv of knotted blood into the hollowness of his breast There was found at that time a certain Spaniard
Exspiration in the contraction of the Heart Whereby we may gather this that there is but one third part of that air we draw into the Heart in breathing sent forth again in the form of vapor in exspiration because Nature would have but one third part of the Orifice to lye open for its passage out Therefore the exspiration or breathing out and the Systole of the Heart and Arteries is shorter than the inspiration so that we may truly say that the inspiration or drawing the breath in is equally so long as the exspiration is together with the rest which is in the midst between the two motions CHAP. XII Of the distribution of the Vena arteriosa and the Arteria venosa HAving hitherto shewed the original of the vessels of the Heart we must now speak of their distribution The Vena arteriosa or the Arterious vein and the Arteria venosa or the Veinous Artery each proceeding out of his proper ventricle that is the right and left are divided into two large branches one of which goes to the right and the other to the left hand the one lying cross-ways over the other the Vein always riding over the Artery as you may understand better by the sight of your eys The Artery always lies under the vein than by reading of Books These branches at their entrance of the Lungs are divided into two other large branches and each of them go to his peculiar Lobe of the Lungs and these again run almost into infinite other branches dispersed in three places over the Lungs These Vessels have acquired their names by reason of that transmutation of consistence whereby the composure of a vein degnerates into an Artery A twofold reason why the Vein was made arterious or like an artery and that of an Artery into a Vein for the commodity of life For this is a miracle of prudent Nature to change the Coats of the vessels of the Lungs producing a Vein which in its Body should imitate an Artery and an Artery which should represent a Vein for if the Vena arteriosa should have retained its proper consistence the arterious blood which is carryed by it from the Heart to nourish the Lungs might by reason of its subtilty penetrate through and flow away by reason of the rarity of the veinous texture and so nature should never have attained her conceived end that is to nourish the Lungs by reason of the continual motion of their contraction and dilatation For nourishment cannot be assimilated to the part unless it be put and cleave to it Wherefore it was fit that nature should make the Body of this vein solid that it might be immoveable unshaken and stubborn in respect of a vein which by its softness would have been too obsequious and yielding to the agitation of the Lungs that so it might have nourishment which might be diffused into all parts thereof and which might neither be drawn by its Diastole Why the Artery was made like a Vein nor driven back into the heart by its Systole But the artery hath the consistence of a vein that by that veinous softness according to the necessity of Nature it might be the more readily contracted and dilated to bring the air in and carry the vapours forth of the heart Here we meet with a difficulty which is By what way the Blood is carried out of the right and left ventricle of the heart Galen thinks that there be certain holes in the partition made for that purpose By what way blood may pass out of the right into the left ventricle and verily there are such but they are not perforated Wherefore Columbus hath found out a new way which is that the Blood is carried to the lungs by the Vena Arteriosa and there attenuated and carried from thence together with the air by the Arteria venosa to the left ventricle of the heart this he writes truly very probably Botallus in his Treatise de Catarrho hath found out a third way to wit a vein which he cals Arteriarum nutrix that is The nurse of the arteries The vein called the Nurse of the arteries Fallop initio obser Arteriarum Gal. lib. 15. de usu partium cap. 6. which creeps a little above the Coronal to the right ear of the Heart and then goes into the left ear thereof But yet I am very much afraid that this vein observed by Botallus is that vessel observed by Fallopius whereby the Vena Arterialis is joyned to the Aorta and by which the all vital Blood is carried for the forming and nourishment of the Lungs whilst the infant is yet in the womb Of which also Galen makes mention but it had lain hid from his time to this day but that Fallopius raised up the memory of it again CHAP. XIII The Distribution of the ascendent Hollow-Vein THe Hollow Vein rising out of the gibbous part of the Liver Gal. lib. de form foetus The greater descendent branch of the hollow vein and resembling according to Galen the Body of a Tree is divided into two notable Branches but not of a like bigness For the greater by the hind-part of the Liver upon the Back-bone and by the way receives certain other Branches from the substance of the Liver which enter not into the great trunck with the rest You may often see this descendent Branch even to the Back-bone upon which it lies in this its descent covered with the substance of the Liver so that it may seem that branch proceeds not from that common trunk together with the ascendent The upper branch of the hollow vein is the less although indeed it always doth But the lesser Branch ascends to the upper parts and is distributed after this manner following For first arising into the Midriff it bestows two small veins upon it on each side one which from that part are called Phrenicae But from thence when it arrives at the right Ear of the Heart it makes the Coronales the Coronal or Crown-veins Venae phrenica Coronales which compass the basis of the heart in manner of a Crown Thirdly entring somewhat more deeply into its right Ear in its greater part it produces the vena arteriosa Fourthly lifted up above the heart Vena Arteriosa on the right side it produces the vein Azygos or sine pari that is without a fellow which descending to the fourth rib reckoning from above downwards nourisheth the intercostal muscles and also the membranes of the eight lower ribs on both sides sending a Branch into each of the muscles at the lower part of the rib which may be sufficient for their nourishment Besides also oftentimes Vena Azygos or sine pari especially in little men this vein Azygos nourishes all the spaces between all the ribs by the like Branches which it sends in the same manner to the four upper ribs Moreover also this Azygos sometimes The Azygos sometimes two How the matter
transpiration or by the moisture of the skin The unputrid Synochus or by a sweat natural gentle and not ill smelling to this Diary we may refer the unputrid Synochus generated of bloud not putrid but only heated beyond measure For usually there arises a great heat over all the body by means of the bloud immoderately heated whence the veins become more tâ—mid the face appears fiery the Eyes red and burning the breath hot and to conclude the whole habit of the body more full by reason of that ebullition of the bloud and the diffusion of the vapours thence arising over all the body Whence it is that this kind of Synochus may be called a vaporous Feaver To this Children are incident as also all sanguine bodies which have no ill humors The cure of this and the Ephemera or Diary is the same because it may scarse seem different from the Ephemera in any other thing than that it may be prolonged for three or four dayes Wherefore whatsoever we shall say for the cure of the Ephemera may be applyed to the Synochus bloud-letting excepted which in an unputrid Synochus is very necessary Now the cure of a Diary-Feaver consists in the decent use of things not natural The cure of a Diary Feaver contrary to the the cause of a disease wherefore bathes of warm and natural water are very profitable so that the Patient be not Plethorick nor stuft with excrements nor obnoxious to Catarrhs and defluxions because a Catarrh is easily caused and augmented by the humors diffused and dissolved by the heat of a Bath therefore in this case we must eschew frictions and anointing with warm Oil which things notwithstanding are thought very useful in these kinds of Feavers especially when they have their original from extreme labour by astriction of the skin or a Bubo Let this be a general rule that to every cause whence this Feaver proceeded you oppose the contrary for a remedy as to labour rest to watching sleep to anger and sorrow grateful society of friends and all things replenished with pleasant good will and to a Bubo the proper cure thereof The use of Wine in a Diary Wine moderately tempered with water according to the custom of the sick Patient is good and profitable in all causes of this Feaver except he be pained in his head or that the Feaver drew its original from anger or a Bubo for in this last case especially the patient must abstain wholly from Wine until the inflammation come to the state and begins to decline This kind of Feaver often troubles Infants and then you must prescribe such medicines to their Nurses as if they were sick that so by this means their milk may become medicinable Also it will be good to put the Infant himself into a Bath of natural and warm water and presently after the Bath to anoint the ridg of the Back and Brest with Oyl of Violets But if a Phlegmon possess any inward part or otherwise by its nature be great or seated near any principal Bowel so that it may continually send from it either a putrid matter or exhalation to the heart and not only affect it by a quality of preternatural heat by the continuity of the parts thence will arise the putrid Synochus if the blood by contagion putrefying in the greater vessels consists of one equal mixture of the four humors This Feaver is thus chiefly known How a putrid Synochus is caused it hath no exacerbations or remissions but much less intermissions it is extended beyond the space of twenty four hours neither doth it then end in vomit sweat moisture or by little and little insensible transpiration after the manner of intermitting Feavers or Agues but remains constant until it leaves the Patient for altogether it commonly happens not unless to those of a good temper and complexion which abound with much bloud and that tempered by an equal mixture of the four humors It commonly indures not long because the bloud by some peculiar putrefaction degenerating into Choler or Melancholy will presently bring forth another kind of Feaver to wit a Tertian or continued Quartain Phlebotomy necessary in a putrid Synochus The cure of this Feaver as I have heard of most learned Physitians chiefly consists in blood-letting For by letting of bloud the fulness is diminished and therefore the obstruction is taken away and lastly the putrefaction And seeing that in this kind of Feaver there is not only a fault of the matter by the putrefaction of the bloud but also of the Temper by excess of heat certainly Phlebotomy helps not only as we said the putrefaction but also the hot distemper For the bloud in which all the heat of the creature is contained whilst it is taken away the acrid and fuliginous excrements exhale and vanish away with it which kept in encrease the Feaverish heat Moreover the veins to shun emptiness which Nature abhors are filled with much cold air in stead of the hot bloud which was drawn away which follows a cooling of the habit of the whole body yea and many by means of Phlebotomy have their Bellies loosed and sweat both which are much to be desired in this kind of Feaver What benefit we may reap by drawing bloud even to fainting This moved the ancient Physitians to write that we must draw bloud in this disease even to the fainting of the Patient Yet because thus not a few have poured out their lives together with their bloud it will be better and safer to divide the evacuations and draw so much bloud at several times as the greatness of the disease shall require and the strength of the Patient may bear Why we must give a Clyster presently after bloud-letting When you have drawn bloud forthwith inject an emollient and refngerative Clyster lest that the veins emptied by Phlebotomy may draw into them the impurity of the Guts but these Clysters which cool too much rather bind the belly than loose it The following day the Morbisick matter must be partly evacuated by a gentle Purge as a bole of Cassia or Catholicon then must you appoint Syrups which have not only a refrigerative quality When Syrrups profitable in this case but also to resist putrefaction such as the Syrup of Limmons Berberries of the Juyce of Citrons of Pomgranates Sorrel and Vinegar Why a slender Diet must be used after letting much bloud let his diet be absolutely cooling and humecting and also slender for the native heat much debilitated by drawing of great quantity of bloud cannot equal a full diet Therefore it shall suffice to feed the Patient with Chicken and Veal Broths made with cooling Herbs as Sorrel Lettice and Purslin Let his drink be Barly-water Syrrup of Violets mixed with some pretty quantity of boyled water Julepum Alexandrium especially if he be troubled with scouring or lask But the Physitian must chiefly have regard to the fourth day for if then
by amputation or cutting it away but you must diligently observe that the flesh be not grown too high and have already seized upon the groin for so nothing can be attempted without the danger of life But if any man think that he in such a case may somewhat ease the Patient by the cutting away of some portion of this same soft flesh The Cure he is deceived For a Fungus will grow if the least portion thereof be but left being an evil far worse than the former but if the Tumor be either small or indifferent the Chirurgeon taking the whole tumor that is the testicle tumified through the whole substance with the process incompassing it and adhering thereto on every side and make an Incision in the Cod even to the tumor then separate all the tumid body that is the Testicle from the Cod then let him thrust a needle with a strong thred in it through the midst of the process above the region of the swoln testicle and then presently let him thrust it the second time through the same part of the process then shall both the ends of the Thred be tied on a knot the other middle portion of the Peritonaeum being comprehended in the same knot This being done he must cut away the whole process with the testicle comprehended therein But the ends of the thred with which the upper part of the process was bound must be suffered to hang some length out of the wound or Incision of the Cod. Then a repercussive medicine shall be applyed to the wound and the neighbouring parts with a convenient ligature And the cure must be performed as we have formerly mentioned What a Cirsocele is The Cirsocele is a tumor of veins dilated and woven with a various and mutual implication about the Testicle and Cod and swelling with a gross and melancholy bloud The causes are the same as those of the Varices But the signs are manifest The Cure To heal this Tumor you must make an Incision in the Cod the bredth of two fingers to the Varix Then put under the Varicous vein a Needle having a double thred in it as high as you can that you may bind the roots thereof then let the Needle be again put after the same manner about the lower part of the same vein leaving the space of two fingers between the ligatures But before you bind the thred of this lowest ligature the Varix must be opened in the midst almost after the same manner as you open a vein in the arm to let bloud That so this gross Bloud causing a Tumor in the Cod may be evacuated as is usually done in the cure of the Varices The wound that remains shall be cured by the rules of Art after the manner of other wounds leaving the threds in it which presently fall away of themselves To conclude then it being grown callous especially in the upper part thereof where the vein was bound it must be cicatrized for so afterwards Bloud cannot be strained or run that way Hernia Humoralis Hernia Humoralis is a tumor generated by the confused mixture of many humors in the Cod or between the Tunicles which involve the Testicles often also in the proper substance of the Testicles It hath like causes signs and cures as other Tumors While the cure is in hand Rest Trusses and fit Rowlers to sustain and bear up the Testicles are to be used CHAP. XVIII Of the falling down of the Fundament WHen the Muscle called the Sphincter which ingirts the Fundament is relaxed The causes then it comes to pass that it cannot sustain the right gut This disease is very frequent to Children by reason of the too much humidity of the Belly which falling down upon that Muscle mollifieth and relaxeth it or presseth it down by an unaccustomed weight so that the Muscles called Levatores Ani or the lifters up of the Fundament are not sufficient to bear up any longer A great Bloudy-flux gives occasion to this effect A strong endevour to expel hard excrements the Haemorrhoids which suppressed do over-load the right gut but flowing relax it Cold as in those which go without Breeches in Winter or sit a long time upon a cold Stone a stroak or fall upon the Holy-bone a Palsie of Nerves which go from the Holy-bone to the Muscles the lifters up of the Fundament the weight of the Stone being in the Bladder That this Disease may be healed we must forbid the Patient too much drinking The cure too often eating of Broth and from feeding on cold Fruits For local medicines the part must be fomented with an astringent decoction made of the rinds of Pomegranats Galls Myrtles Knotgrass Shepherds-purse Cypress Nuts Alum and common Salt boyled in Smiths-water or Red-wine After the fomentation let the Gut be anointed with Oyl of Roses or Myrtles and then let it be gently put by little and little into its place charging the Child if he can understand your meaning to hold his breath When the Gut shall be resotred the part must be diligently wiped lest the Gut fall down again by reason of the slipperiness of the unction Then let the powder prescribed for the falling down of the Womb be put into the Fundament as far as you can Then you must straitly bind the Loins with a swathe to the midst whereof behind let another be fastned which may be tied at the Pubes coming along the Peritonaeum so to hold up the Fundament the better to contain it in its place a Spunge dipt in the astringent decoction The Patient if he be of sufficient age to have care of himself shall be wished when he goes to Stool that he sit upon two pieces of wood being set some inch a sunder lest by his straining he thrust forth the Gut together with the excrement but if he can do it standing he shall never by straining thrust forth the Gut But if the Gut cannot by the prescribed means be restored to its place Hippocrates hiâ— cure Hippocrates bids that the Patient hanging by the heels be shaken for so the Gut by that shaking will return to his place but the same Hippocrates wisheth to anoint the Fundament because that remedy having a drying faculty hath also power to resolve the flatulent humors without any acrimony by reason of which the Gut was the less able to be contained in his place CHAP. XIX Of the Paronychia THe Paronychia or Panaris is a tumor in the ends of the fingers with great inflammation What the Paronychia is coming of a malign and venemous humor which from the Bones by the Periosteum is communicated to the Tendons and Nerves of that part which it affecteth whereof cruel symptoms do follow as pulsifique pain a Feaver restlesness so that the affected through impatiency of the pain are variously agitated like those tormented with Carbuncles for which cause Guido and Johannes de Vigo judge this disease to be
all means for the quick recovery of the Patient lest that which was of its own nature small may by his negligence become great Therefore it is expedient he should know what wounds are to be accounted great This as Galen saith is three ways to be known The first is by the magnitude and principality of the part affected for thus the wounds of the Brain Heart and of the greater vessels Lib. 4. Meth. cap. 6.1 though small of themselves yet are thought great Wounds are called Great out of three respects Then from the greatness of the solution of continuity for which cause wounds may be judged great in which much of the substance of the part is lost in every dimension though the part be one of these which are accounted servile Then from the malignity through which occasion the wounds of the joynts are accounted great because for the most part they are ill conditioned CHAP. IV. Of Prognosticks to be made in Wounds THose Wounds are thought dangerous wherein any large Nerve vein or Artery are hurt What wounds are dangerous From the first there is fear of Convulsion but from the other large effusion of the veinous or arterious bloud whence the powers are debilitated also these are judged evil which are upon the Arm-pits groins leggs joynts and between the fingers and likewise those which hurt the head or tail of a Muscle They are lest dangerous of all other which wound only the fleshy substance But they are deadly which are inflicted upon the Bladder Brain Heart Liver Lungs Stomach and small guts But if any Bone Gristle Nerve or portion of the cheek What least dangerous What deadly Hip. aphor 19. Lib. 6. or prepuce shall be cut away they cannot be restored Contused wounds are more difficult to cure than those which are from a simple solution of continuity for before you must think to heal them up you must suppurate and cleanse them which cannot be done in a short time Wounds which are round and circular are so much the worse for there can be no unity unless by an angle that is a meeting together of two lines which can have no place in round wounds because a circular figure consists of one oblique line Besides wounds are by so much thought the greater by how much their extreams and lips are the further disjoyned which happens to round wounds Why round Wounds are difficult to heal Contrary to these are cornered wounds or such as are made alongst the fibers as such as may be healed Wounds may be more easily healed in young men than in old because in them Nature is more vigorous and there is a greater plenty of fruitful or good bloud by which the loss of the flesh may be the better and more readily restored which is slowlier done in old bodies by reason their bloud is smaller in quantity and more dry and the strength of nature more languid Wounds received in the Spring Hip. lib. de ulcer Hip. aph 66. lib. 5. are not altogether so difficult to heal as those taken in Winter or Summer For all excess of heat and cold is hurtful to them it is ill for a Convulsion to happen upon a Wound for it is a sign that some Nervous body is hurt the Brain suffering together therewith as that which is the original of the Nerves A Tumor coming upon great wounds is good for it shews the force of nature is able to expel that which is harmful and to ease the wounded part The organical parts wholly cut off cannot again be united because a vital part once severed and plucked from the trunk of the body cannot any more receive influence from the heart as from a root without which there can be no life The loosed continuity of the Nerves Veins Arteries and also the Bones is sometimes restor'd not truly and as they say according to the first intention but by the second that is by reposition of the like but not of the same substance The first intention takes place in the fleshy parts by converting the Alimentary bloud into the proper substance of the wounded part But the second in the spermatique in which the lost substance may be repaired by interposition of some heterogeneous body which nature diligent for its own preservation substitutes in place of that which is lost for thus the body which restores and agglutinates What a Callus is and whence it proceeds is no Bone but a Callus whose original matter is from an humor somewhat grosser than that from whence the Bones have their original and beginning This humor when it shall come to the place of the fracture agglutinateth the ends of the Bones together which otherwise could never be so knit by reason of their hardness The Bones of Children are more easily and speedily united by reason of the pliantness of their soft and tender substance Small and contemptible Wounds often prove mortal Aphor. 1. sect 1. Lastly we must here admonish the Chirurgeon that small Wounds and such as no Artisan will judg deadly do divers times kill by reason of a certain occult and ill disposition of the wounded and incompassing Bodies for which cause we read it observed by Hippocrates that it is not sufficient for the Physitian to perform his duty but also external things must be rightly prepared and fitted CHAP. V. Of the Cure of Wounds in general The general Indication of Wounds THe Chirurgeon ought for the right cure of wounds to propose unto himself the common and general indication that is the uniting of the divided parts which indication in such a case is thought upon and known even by the vulgar for that which is dis-joyned desires to be united because union is contrary to division But by what means such union may be procured is only known to the skilful Artisan Therefore we attain unto this chief and principal Indication by the benefit of Nature as it were the chief Agent and the work of the Chirurgeon as the servant of Nature And unless Nature shall be strong the Chirurgeon shall never attain to his conceived and wished for end therefore that he may attain hereto he must perform five things Five things necessary for uniting wounds the first is that if there be any strange Bodies as pieces of Wood Iron Bones bruised Flesh congealed Bloud or the like whether they have come from without or from within the Body and shall be by accident fastened or stuck in the wound he must take them away for otherwise there is no union to be expected Another is that he joyn together the lips of the Wound for they cannot otherwise be agglutinated and united The third is that he keep close together the joyned lips The fourth that he preserve the temper of the wounded part for the distemper remaining it is impossible to restore it to its unity The fifth is that he correct the accidents if any shall happen because these urging
the Physitian is often forced to change the order of the cure All strange and external Bodies must be taken away as speedily as is possible because they hinder the action of Nature intending unity especially if they press or prick any Nervous Body or Tendon whence pain or an Abscess may breed in any principal part or other serving the principal Yet if by the quick and too hasty taking forth of such like Bodies there be fear of cruel pain or great effusion of Bloud it will be far better to commit the whole work to Nature than to exasperate the Wound by too violent hastening For Nature by little and little will exclude as contrary to it or else together with the Pus what strange body soever shall be contained in the wounded part But if there shall be danger in delay it will be fit the Chirurgeon fall to work quickly safely and as mildly as the thing will suffer for effusion of Bloud swooning convulsion and other horrid symptoms follow upon the too rough and boystrous handling of Wounds whereby the Patient shall be brought into greater danger than by the Wound it self Therefore he may pull out the strange Bodies either with his fingers or with instruments fit for that purpose but they are sometimes more easily and sometimes more hardly pulled forth according as the Body infixed is either hard or easie to be found or pulled out Which thing happens according to the variety of the figure of such like Bodies according to the condition of the part it self soft hard or deep in which these Bodies are fastned more straitly or more loosly and then for fear of inferring any worse harm as the breaking of some Vessel but how we may perform this first intention and also the expression of the instruments necessary for this purpose shall be shown in the particular Treaties of Wounds made by Gun-shot Arrows and the like Ligatures and Sutures for to conjoyn and hold together the lips of wounds But the Surgeon shall attain to the second and third scope of curing Wounds by two and the same means that is by Ligatures and Sutures which notwithstanding before he use he must well observe whether there be any great flux of Bloud present for he shall stop it if it he too violent but provoke it if too slow unless by chance it shall be poured out into any capacity or belly that so the part freed from the superfluous quantity of Bloud may be less subject to inflammation Therefore the lips of the Wound shall be put together and shall be kept so joyned by suture and ligatures Not truly of all but only of those which both by their nature and magnitude as also by the condition of the parts in which they are are worthy and capable of both the remedies For a simple and small solution of continuity stands only in need of the Ligature which we call incarnative especially if it be in the Arms or Legs but that which divides the Muscles transversly stands in need of both Suture and Ligature that so the lips which are somewhat far distant from each other and as it were drawn towards their beginning and ends may be conjoyned If any portion of a fleshy substance by reason of some great Cut shall hang down it must necessarily be adjoyned and kept in the place by Suture The more notable and large Wounds of all the parts stand in need of Suture which do not easily admit a Ligature by reason of the figure and site of the part in which they are as the Ears Nose Hairy-scalp Eye-lids Lips Belly and Throat There are three sorts of Ligatures by the joynt consent of all the Ancients Three sorts of Ligatures They commonly call the first a Glutinative or Incarnative the second Expulsive the third Retentive The Glutinative or Incarnative is fit for simple green and yet bloudy Wounds What an incarnative Ligature is This consists of two ends and must so be drawn that beginning on the contrary part of the Wound we may so go upwards partly crossing it and going downwards again we may closely joyn together the Lips of the Wound But let the Ligature be neither too strait lest it may cause inflammation or pain nor too loose lest it be of no use and may not well contain it The Expulsive Ligature is fit for sanious and fistulous Ulcers to press out the filth contained in them This is performed with one Rowler having one simple head What an expulsive the beginning of binding must be taken from the bottom of the Sinus or bosom thereof and there it must be bound more straightly and so by little and little going higher you must remit something of that rigour even to the mouth of the Ulcer that so as we have said the sanious matter may be pressed forth The Retentive Ligature is fit for such parts as cannot suffer strait binding such are the Throat What the retentive What the rowlers must be made of Belly as also all parts oppressed with pain For the part vexed with pain abhorreth binding The use thereof is to hold to local Medicines It is performed with a Rowler which consists somewhiles of one some whiles of more heads All these Rowlers ought to be of linnen and such as is neither too new nor too old neither too coorse nor too fine Their breadth must be proportionable to the parts to which they shall be applyed the indication of their largeness being taken from their magnitude figure and site As we shall shew more at large in our Tractates of Fractures and Dislocations The Chirurgeon shall perform the first scope of curing Wounds Why and how the temper of the wounded part must be preserved which is of preserving the temper of the Wounded part by appointing a good order of diet by the Prescript of a Physitian by using universal and local Medicines A slender cold and moist Diet must be observed until that time be passed wherein the Patient may be safe and free from accidents which are usually feared Therefore let him be fed sparingly especially if he be plethorick he shall abstain from Salt and spiced flesh and also from Wine if he shall be of a cholerick or sanguine nature in stead of Wine he shall use the Decoction of Barly or Liquorice or Water and Sugar He shall keep himself quiet for Rest is in Celsus opinion the very best Medicine He shall avoid Venery Contentions Brawls Anger and other perturbations of the mind When he shall seem to be past danger it will be time to fall by little and little to his accustomed manner and diet of life Universal remedies are Phlebotomies and Purging which have force to divert and hinder the defluxion whereby the temper of the part might be in danger of change For Phlebotomy it is not alwayes necessary as in small Wounds and Bodies In what wounds blood-letting is not necessary which are neither troubled with ill humors or Plethorick
But it is only required in great Wounds where there is fear of defluxion pain Delirium Raving and unquietness and lastly in a Body that is Plethorick and when the joynts tendons or nerves are wounded Gentle purgations must be appointed because the humors are moved and inraged by stronger whence there is danger of defluxion and inflammation wherefore nothing is to be attempted in this case without the advice of a Physitian The Topick and particular Medicines are Agglutinative What medicines are to be judged agglutinative which ought to be indued with a drying and astrictive quality whereby they may hold together the lips of the wound and drive away defluxion having always regard to the nature of the part and the greatness of the disease The Simple Medicines are Olibanum Aloes Sarcocolla Bole-Armenick Terra sigillata Sanguis Draconis Common Venice Turpentine Gum Elemni Plantane Horse-tail the greater Comfry Parina Volatilis many other things of this kind which we shall speak of hereafter in our Antidotary The fifth scope of healing Wounds is the correction of those Symptoms or Accidents which are accustomed to follow Wounds which thing verily makes the Chirurgeon have much to do For as he is often forced to omit the proper cure of the disease so to resist the accidents and symptoms as Bleeding Pain Inflammation a Feaver Convulsion Palsie talking Idly or distraction and the like Of which we shall treat briefly and particularly after we have first spoken of Sutures as much as we shall think sitting for this place CHAP. VI. Of Sutures WHen Wounds are made alongst the Thighs Legs and Arms they may easily want Sutures because the Solution of continuity is easily restored by Ligatures What wounds stand in no need of a Suture but when they are made overthwart they require a Suture because the flesh and all such like parts being cut are drawn towards the sound parts whereby it comes to pass that they part the further each from other wherefore that they may be joyned and so kept they must be sewed and if the Wound be deep you must take up much flesh with your Needle for if you only take hold of the upper part the wound is only superficially healed but the matter shut up and gathered together in bottom of the wound will cause abscesses and hollow Ulcers Wherefore now we must treat of making of Sutures The first called Interpunctus leaves the distance of a fingers breadth The first manner of Suture and therefore is fit for the green wounds of the fleshy parts which cannot be cured with a Ligature and in which no heterogeneous or strange body remains The form of your Needle It is performed after this manner You must have a smooth Needle with a thred in it having a three-square point that so it may the better enter the skin with the head of it somewhat hollowed that the thred amy lie therein for so the Needle will the better go through The form of the pipe with a window in it You must also have a little Pipe with a hole or window in the end which you must hold and thrust against the lip of the wound that it be not moved to the one side or other whilst you thrust through the Needle And that we may see through that window when the Needle is thrust through and also draw it together with the thread and withal hold the lip of the Wound in more firmly that it follow not at the drawing forth of the Needle and thred Having thus pierced the lips of the Wound tie a knot near to which cut off the thread lest that if any of it be left below the knot it may so stick to the Emplasters that it cannot be plucked and separated from them without pain when they are taken off But you must note the first stitch must be thrust through the midst of the Wound and then the second must be in that space which is between the midst and one of the ends but when you have made your stitches the lips of the Wound must not be too closely joyned but a little space must be left open between them that the matter may have free passage forth and inflammation and pain may be avoided otherwise if they shall be closely joyned together without any distance between a tumor after arising when the matter shall come to suppuration the lips will be so much distended that they may easily be broken by the stifness of the thred But you must neither take hold of too much nor too little flesh with your Needle for too little will not hold and too much causeth pain and inflammation And besides leaves an ill favoured scar Yet in deep wounds such as are those which are made in the thicker Muscles the Needle must be thrust home that so it may comprehend more of the fleshy substance lest the thred drawn away by the weight of the flesh not taken hold of may be broken But oft-times wounds are seen made in such places as it would be needful the Chirurgeon should have a crooked Needle and Pipe otherwise the Suture will not succeed according to his desire Wherefore I have thought good to set forth both their figures that you may use either as occasion shall serve The Figures of Pipes with Fenestels in them and Needles fit for Sutures The second means of Suture The second Suture is made just after the same manner as the Skinner sows their fels or furs And the guts must be sowed with this kind of Suture if they shall be at any time wounded that the excrements come not forth by the wound The third manner of Suture The third Suture is made by one or more Needles having thred in them thrust through the wound the thred being wrapped to and again at the head and the point of the Needle as Boys use to fasten their Needle for fear of losing it in their caps or clothes This kind of Suture is fit in the curing and healing of Hare-lips as we shall shew you hereafter expressed by a Figure The fourth kind of Suture termed Gastroraphia The fourth kind of Suture is termed Gastroraphia invented for the restoring and uniting the great Muscles of the Epigastrium or lower Belly cut with a great wound together with the Peritonaeum lying under them The manner whereof we shall shew in due place The fift kind called the Dry Suture The fifth kind is called the dry Suture which we use only in the wounds of the face which also we will describe in its proper place CHAP. VII Of the Flux of Blood which usually happens in Wounds The signs of bloud flowing from an artery OFt-times great bleeding follows upon wounds by reason of some vessel cut broken or torn which there is need to heal and help diligently because the Bloud is the treasure of Nature without which life cannot consist The Bloud which floweth from an Artery is thus known
It is more subtile it runs forth as it were leaping by reason of the vital spirit contained together with it in the Arteries On the contrary that which floweth from a Vein is more gross black and slow Now there many wayes of stanching Bloud The first way of staying bleeding The first and most usual is that by which the lips of the Wound are closed and unless it be somewhat deep are contained by Medicines which have an astringent cooling drying and glutinous faculty As terrae sigill Boli Armeni ana â„¥ ss Thuris Mastichis Myrrhae Aloes anaÊ’ ij Farinae volat molend â„¥ j Fiat pulvis qui albumine ovi excipiatur Or â„ž Thuris Aloes ana partes aequales Let them be mixt with the white of an Egge and the down of a Hare and let the pledgets be dipped in these Medicines as well those which are put unto the Wound as those which are applyed about it Then let the Wound be bound up with a double cloth and fit Ligature and the part be so seated as may seem the least troublesome and most free from pain But if the blood cannot be stayed by this means when you have taken off all that covereth it The 2. manner of stanching it you shall press the Wound and the orifice of the Vessel with your thumb so long untill the blood shall be concrete about it into so thick a clot as may stop the passage But if it cannot be thus stayed then the Suture if any be must be opened The 3. way by binding of the vessels and the mouth of the Vessell towards the originall or root must be taken hold of and bound with your needle and thred with as great a portion of the flesh as the condition of the part will permit For thus I have staid great bleedings even in the amputation of members as I shall shew in fit place To perform this work we are often forced to divide the skin which covereth the wounded vessell For if the Jugular vein or Artery be cut it will contract and withdraw it self upwards and downwards Then the skin it self must be laid open under which it lyeth and thrusting a needle and thred under it it must be bound as I have often done But before you loose the knot it is fit the flesh should be grown up that it may stop the mouth of the vessel An admonition lest it should then bleed But if the condition of the part shall be such as may forbid this comprehension The 4. way by Eschatoricks and binding of the vessel we must come to Escharoticks such as are the powder of burnt Vitriol the powder of Mercury with a small quantity of burnt Allum and Causticks which cause an Escar The falling away of which must be left to nature and not procured by art lest it should fall away before that the orifice of the vessel shall be stopt with the flesh or clotted blood But sometimes it happens that the Chirurgeon is forced wholly to cut off the vessel it self The 5. way by cutting off the vessels that thus the ends of the cut vessel withdrawing themselves and shrinking upwards and downwards being hidden by the quantity of the adjacent and incompassing parts the flux of the blood which was before not to be staid may be stopped with lesse labour Yet this is an extream remedy and not to be used unlesse you have in vain attempted the former CHAP. VIII Of the pain which happens upon Wounds THe pains which follow upon wounds ought to be quickly asswaged Pain weakens the body and causes deffluxions because nothing so quickly dejects the powers and it alwaies causes a defluxion of how good soever a habit and temper the body be of for Nature ready to yeeld assistance to the wounded part alwaies sends more humors to it than are needful for the nourishment thereof whereby it comes to passe that the defluxion is easily increased either by the quantity or quality or by both Therefore to take away this pain the author of deflux on Divers Anodynes or medicins to asswage pain let such medicines be applyed to the part as have a repelling and mitigating faculty as â„ž Olei Myrtili Rosarum ana â„¥ ij Cerae alb â„¥ i Farinae hordei â„¥ ss Boli armeni terrae sigillat ana Ê’ vj. Melt the Wax in the oyls then incorporate all the rest and according to Art make a medicine to be applyed about the part or â„ž Emplast Diacalcith â„¥ iv Ole Rosar aceti ana â„¥ ss liquefiant simul and let a medicine be made for the fore-mentioned use Irrigations of oyl of Roses and Myrtiles with the white of an Egge or a whole Egge added thereto may serve for lenitives if there be no great inflammation Rowlers and double cloaths moystened in Oxcycrate will be also convenient for the same purpose But the force of such medicines must be often renewed for when they are dryed they augment the pain But if the pain yeeld not to these we must come to narcotick Medicines such as are the Oyl of Poppy of Mandrake a cataplasm of Henbane and Sorrel adding thereto Mallows and Marsh-mallows of which we spoke formerly in treating of a Phlegmon Lastly we must give heed to the cause of the pain to the kind and nature of the humor that flows down and to the way which nature affects for according to the variety of these things the Medicines must be varied as if heat cause pain it will be asswaged by application of cooling things and the like reason observed in the contrary If Nature intend suppuration you must help forwards its indeavours with suppurating medicines CHAP. IX Of Convulsion by reason of a Wound A Convulsion is an unvoluntary contraction of the Muscles as of parts movable at our pleasure towards their original that is the Brain and Spinall Marrow What a Convulsion is for by this the convulsed member or the whole body if the convulsion be universal cannot be moved at our pleasure Yet motion is not lost in a Convulsion as it is in a Palsie but it is only depraved and because sometimes the Convulsion possesseth the whole Body otherwhiles some part thereof you must note that there are three kinds of Convulsions in general The first is called by the Greeks Tetanos Three kinds of an universal Convulsion when as the whole body grows stiffe like a stake that it cannot be moved any way The second is called Opisthotonos which is when the whole body is drawn backwards The third is termed Emphrosthotonos which is when the whole body is bended or crooked forwards A particular Convulsion is when as the Muscle of the Eye Tongue and the like parts which is furnished with a Nerve Three causes of a Convulsion Causes of Repletion is taken with a Convulsion Repletion or Inanition Sympathy or consent of pain cause a Convulsion Aboundance of humors cause Repletion dulling the body by
that the broken cleft or cut Bone can neither be perceived by your sight nor Instrument wherefore if you think there is any such thing by the rational signs above-mentioned anoynt the place with writing Ink and Oyl and so you shall find the crack or clift by the means we shall shew you hereafter When you are certain of the fracture Lib. 5. Epid. in Aaâ—onomus of Omilum Hippocrates was deceived by the sutures then you must diligently consider the greatness of the disease and apply medicines speedily Verily when a fracture chances to light upon any suture the disease is hard to be known unless the fracture be very great because the sutures by their clifts and roughness resemble fractures wherefore Hippocrates saith that he was deceived by them Now having briefly delivered the differences and signs of a broken Skull it is time to come to the several kinds thereof with a Fissure CHAP. IV. Of a Fissure being the first kind of a broken Skull IF the Chirurgeon by the fore-mentioned signs shall know that the Skull is broken or crakt Upon what occasion the hairy scalâ— must be câ—â— and if the wound made in the musculous skin shall not be thought sufficient for ordering the Fissure thâ—â— must he shave off the hair and cut with a razour or Incision-knife the musculous skin with the Pericranium lying under it in a triangular or quadrangular figure to a proportionable bigness alwayes shunning as much as in him lyes the sutures and temples neither must he fear any harm to ensue hereof Celsus for it is farr better to bare the Bone by cutting the skin than to suffer the kind and nature of the fracture to remain unknown by a too rel gious preservation of the skin for the skin is cured without any great ado though pluckt off to no purpose For it is much more expedient in Hippocrates opinion to cure diseases safely and securely Hippocrates though not speedily than to do it in a shorter time with fear of relapse and greater inconveniencies Let this dissection be made with a razour or sharp knife and if there be any wound made in the skin by the weapon let one of your Incisions be made agreeable thereto A Razour or Incision-Knife Now therefore the Musculous skin together with the Pericranium must be divided and cut with a sharp razour pressed and guided with a strong and steddy hand then it must be so pluckt from the Bone The manner how to pull the hairy scalp from the broken Skull or Skull lying under it that none thereof remain upon the Bone for if it should be rent or torn with the Trepan it would cause vehement pain with inflammations You must begin to pull it back at the corners of the lines crossing each other with right angles with this Chissel whose figure you see here expressed A Chissel or Instrument to pull back or separate the Pericranium from the Skull Then you must fill all the wound with boulsters of fine soft lint that so the lips may be kept further a-sunder But you shall apply upon it medicines fit to stanch bloud But if it come so to pass that the bloud flows forth so violently that it can be stayed by no means the vessel it self must be bound after this manner The manner to bind a vessel in case of too much bleeding First thrust through the musculous skin on the outside with a needle and thred then thrust the Needle back again then tye the thred on a knot on the outside but first put some lint rolled up to the bigness of a Goose-quill between the thred and the hairy scalp on both sides thereof lest the strait twitching of the thred which may serve to stay the bleeding may cut and tear the skin or cause pain then must you raise his head somewhat higher A History I have lately tryed and performed this upon a certain Coach-man who thrown from the Coach upon his Head on a pavement of free-stone exceedingly bruised the hind-part of the Bregma for which cause it was fit to open the musculous skin with a cross Incision both that the congealed bloud might be pressed out as also that the fracture if there were any might be observed But an Artery being cut in performance hereof when as the Chirurgeon who was there present could not stay the bloud leaping out with violence and the Coachman already had lost so great a quantity thereof that his strength was so much decayed that he could not stir himself in his Bed or scarse speak I being called shewed them by experience that whereas astringent medicines were used before to no purpose it was better to stay the bleeding by binding the vessel than to let the Patient dye for a childish fear of pricking him But that we may return to our former matter the Chirurgeon shall the next day consider with what kind of fracture the Bone is hurt and if no signs of hurt appear to the eyes nor be perceived with your fingers and probe yet some of the rational signs may cause one to have a conjecture that there is a fracture A way to find a fracture in the skull when it presents not it self to the view at the first Then you must anoint as we told you before the bared Bone with writing Ink and a little Oyle of Roses that the cleft or crack may be dyed or coloure therewith if that there be any there Then the next dressing you must dry the Bone with a linnen cloth and scrape off the Ink and Oyl with scraping Instruments made for the purpose if any part thereof shall be sunk into the Bone for if there be any crack it will be black Wherefore you must continue scraping until no sign of the fissure remain or else until you come even to the Dura Mater But that he may be more certain whether the Fissure pierce through both the Tables of the Skull he must bid the Patient that stopping his Nose and Mouth he strive to breathe with a great indeavour A sign that both the Tables are broken For then bloudy matter or sanies will sweat through the Fissure For the breath driven forth of the Chest and prohibited passage forth swells and lifts up the substance of the Brain and the Meninges whereupon that frothy humidity and Sanies sweats forth Therefore then the Bone must be cut even to the Dura Mater with a Radula and other scraping Instruments fit for that purpose yet so as you hurt not the Membrane but if the Fissure shall be somewhat long it will not be convenient to follow it all the extent thereof for Nature will repair and restore the remnant of the Fissure by generating a Callus besides also the Chirurgeon according to Celsus opinion must take away as little of the Bone as he can because there is nothing so fit to cover the Brain as the Skull Therefore it shall suffice to make a passage whereby the bloud
and Sanies may pass and be drawn forth lest that matter being suppressed may corrupt the Bone and cause an inflammation in the Brain But the broken Bone must be taken forth within three days You may use the Trepan after the tenth day if it be possible especially in Summer for fear of inflammation Yet I have often taken forth with a Trepan and with Scrapers the Bones of the Skull after the seventeenth day both in Winter and Summer and that with happy success Which I have the rather noted lest any should at any time suffer the wounded to be left destitute of remedy for it is better to try a doubtful remedy than none Yet the By-standers shall be admonished and told of the danger for many more dye who have not the broken bones of the Skull taken out than those that have But the Instruments with which the wounded or cleft Bones may be cut out are called Scalpri or Radulae of which I have caused divers sorts to be here decyphered that every one might take his choyce according to his mind and as shall be best for his purpose But all of them may be scrued into one handle the figure whereof I have exhibited Radulae or Scalpri i. Shavers or Scrapers Radulae of another form for the better cutting of the greater Bones To conclude When the Skull shall be wounded or broken with a simple Fissure It is sufficient in a simpâ—e fissure to dilate it with your Scalpri only and not to Trepan it the Chirurgeon must think he hath done sufficient to the Patient and in his Art if he shall divide the Bone and dilate the Fissure or cleft with the described Instruments though he have used no Trepan although the Fissure pierce through both the Tables But if it doth not exceed the first Table you must stay your scrapers assoon as you come to the second according to the opinion of Paulus but if the bone shall be broken and shivered into many pieces they shall be taken forth with fit Instruments using also a Trepan if need shall require after the same manner as we shall shew you hereafter CHAP. V. Of a Contusion which is the second sort of Fracture AN Ecchymosis that is effusion of bloud What an Ecchymosis is presently concreting under the musculous skin without any wound is oft caused by a violent contusion This Contusion if it shall be great so that the skin be divided from the Skull it is expedient that you may make an Incision whereby the bloud may be evacuated and emptied How a contusion of the skull must be cured For in this case you must wholly desist from suppurative medicines which otherwise would be of good use in a fleshy part by reason that all the moist things are hurtful to the Bones as shall be shown hereafter But if the Bone shall bee too strong thick and dense so that this Instrument will not serve to pluck it forth then you must perforate the Skull in the very center of the depression and with this threefold Instrument or Levatory put into the hole lift up and restore the Bone to its natural site for this same Instrument is of strength sufficient for that purpose It is made with three feet that so it may be applyed to any part of the head which is round but divers heads may be fitted to the end thereof according as the business shall require as the figure here placed doth shew A three-footed Levatory But if at any time it comes to pass that the Bone is not totally broken or deprest but only on one side it will be fit so to lift it up as also to make a vent for the issuing out of the filth to divide the Skull with little Saws like these which ye see here expressed for thus so much of the Bone as shall be thought needful may be cut off without compression neither will there be any danger of hurting the Brain or Membrane with the broken Bone The figures of Saws fit to divide the Skull But if by such signs as are present and shall appear we perceive or judg that the contusion goes but to the second Table or scarse so far the baring or taking away of the Bone must go no further than the contusion reaches for that will be sufficient to eschew and divert inflammations and divers other symptoms And this shall be done with a scaling or Desquamatory Trepan as they term it with which you may easily take up as much of the Bone as you shall think expedient And I have here given you the figure thereof A Desquamatory or Scaling Trepan A Delineation of other Levatories A A. Shews the point or tongue of the Levatory which must be somewhat dull that so it may be the more gently and easily put between the Dura Mater and the Skull and this part thereof may be lifted up so much by the head or handle taken in your hand as the necessity of the present operation shall require B. Intimates the body of the Levatory which must be four square lest the point or tongue put thereon should not stand fast but the end of this Body must rest upon the sound bone as on a sure foundation The use thereof is thus put the point or tongue under the broken or depressed Bone then lift the handle up with your hand that so the deprâ—ssed bone may be elevated C. Shews the first Arm of the other Levatory whose crooked end must be gently put under the depressed Bone D. Shews the other Arm which must rest on the sound Bone that by the firm standing thereof it may lift up the depressed Bone CHAP. VI. Of an Effracture or depression of the Bone being the third kind of Fracture BEfore I come to speak of an Effracture I think it not amiss to crave pardon of the curteous and understanding Reader for this reason especially that as in the former Chapter when I had determined and appointed to speak of a Contusion I inserted many things of a Depression so also in this Chapter of an Effracture What a Consion is I intend to intermix something of a Contusion we do not this through any ignorance of the thing it self for we know that it is called a Contusion when the Bone is deprest and crusht but falls not down But an Effracture is What an Effracture is when the Bone falls down and is broken by a most violent blow But it can scarse come to pass but that the things themselves must be confounded and mixt both as they are done and also when they are spoken of so that you shall scarse see a Contusion without an Effracture or this without that Therefore the Bones are often broken off and driven down with great and forcible blows The cause of Effractures with clubs whether round or square or by falling from a high place directly down more or less according to the force of the blow kind of weapon and condition of the
opposite to that which received the blow What a Resonitus is as if the right side be struck the left is cloven this kind of Fracture is very dangerous because we cannot find it out by any certain sign as it is written by Hippocrates Lib. de vuln Capitis Wherefore if at any time the Patient dye of such a Fracture the Chirurgeon must be pardoned And although Paulus Aegineta laugh at this kind of Fracture and thinks that it cannot happen to a mans head as that which is hard and full as it happens in empty glass Bottles Lib. 6. cap 90. yet I have sometimes seen and observed it Neither is their reason of any vailidity who think Nature therefore to have framed the head of many bones knit together by sutures lest the fracture of the one side In whom this fracturâ— may take place in diverâ— bones of the Skull should be stretched to the other For peradventure this may take place in such as have express Sutures seated and framed according to Nature But it takes no place in such as either want them or have them not seated according to Nature or have them very close and so defaced that it may seem one Bone grown together of many This shall be made manifest by recital of the following History A servant of Massus the Post-master had a grievous blow with a stone upon the right Bregma A History which made but a small wound yet a great Contusion and Tumor Wherefore that it might more plainly appear whether the Bone had received any harm and also that the congealed bloud might be pressed forth the wound was dilated the skin being opened by Theodore Hereus the Chirurgeon who as he was a skilful workman and an honest man omitted nothing which Art might do for his cure When he had divided the skin the bone was found whole although it was much to be feared that it was broken because he fell presently to the ground with the blow vomited and shewed other signs of a fractured Skull so it happened that he dyed on the one and twentieth day of his sickness But I being called to learn and search how he came by his death dividing the Skull with a Saw found in the part opposite to the blow a great quantity of Sanies or bloudy matter and an Abscess in the Crossa Meninx and also in the substance of the very Brain but no Sutures but the two scaly ones Therefore that is certain which is now confirmed by the authority of Hippocrates as also by reason and experience that a blow may be received on the one side and the bone may be fractured on the opposite especially in such as have either no Sutures or else so firmly united and closed that they are scarse apparent The Resonitus may be in the same bone of the Skull Neither is it absurd that the part opposite to that which received the stroak of the same bone and not of divers bones may be cloven and in those men who have their Skulls well made and naturally distinguished and composed with Sutures and this both was and is the true meaning of Hippocrates That this may be the better understood we must note that the opposite part of the same bone may be understood two manner of ways First when the fracture is in the same surface of the smitten bone as if that part of one of the bones of the Bregma which is next to the Lambdal suture be smitten and the other part next to the Coronal suture be cloven Secondly when as not the same superficies and table which receives the blow but that which lyes under it is cleft which kind of fracture I observed in a certain Gentleman a Horseman of Captain Stempans Troop He in defending the breach of the wall of the Castle of Hisdin A History was struck with a Musket bullet upon the Bregma but had his helmet on his head the bullet dented in the helmet but did not break it no nor the musculous skin nor skull for as much as could be discerned yet notwithstanding he died apoplectick upon the sixt day after But I being very desirous to know what might be the true cause of his death dividing his Skull observed that the second Table was broken and cast off scales and splinters wherewith as with Needles the substance of the Brain was continually pricked the first and upper Table being whole for all this I afterwards shewed the like example to Capellanus and Castellanus the King and Queens cheif Physitians in the expedition of Roane But Hippocrates prescribes no method of curing this fifth kind of fracture by reason he thinks it cannot be found out by any circumstance whence it happens that it is for the most part deadly Yet must we endeavour to have some knowledge and conjecture of such a fracture Why Hippocrates set down no way to cure a Resoritus if it shall at any time happen Wherefore having first diligently shaven away the hair we must apply an Emplaister of Pitch Tar Wax Turpentine the Powder of Iris or Flower-deluce roots and Mastich now if any place of the head shall appear more moist The manner to know when the Skull is fractured by a Resonitus soft and swoln it is somewhat likely that the bone is cleft in that place so that the Patient though thinking of no such thing is now and then forc'd to put his hand to that part of the Skull Confirmed with these and other signs formerly mentioned let him call a counsel of learned Physitians and foretell the danger to the Patients friends which are there present that there may no occasion of calumny remain then let him boldly perforate the Skull for that is far better than forsake the Patient ready to yield to the greatness of the hidden disease so consequently to dye within a short while after There are four sorts or conditions of fractures by which the Chirurgeon may be so deceived that when the Skull is broken indeed yet he may think there is no fracture The first is when the bone is so depressed that it presently rises up into its true place and native equability The second is when the fissure is only capillary The third is when the bone is shaken on the inside the utter surface nevertheless remaining whole forasmuch as can be discerned The fourth is when the bone is stricken on the one side and cleft on the other CHAP. IX Of the moving or Concussion of the Brain Gal. lib. 2. de comp m dic cap 6. Com. ad Aph. 58. sect 7. BEsides the mentioned kinds of fractures by which the Brain also suffers there is another kind of affect besides Nature which also assails it by the violent Incursion of a cause in l ke manner external they call it the Commotion or shaking of the Brain whence Symptomes like those of a broken Skull ensue Falling from aloft upon a solid and hard body dull and heavy
within by the stroak may cast forth some bloud upon the Membranes of the Brain which being there concrete may cause great pain by reason whereof it blinds the Eyes if soâ—e that the place can be found against which the pain is and when the skin is opened the bone look pale it must presently be cut out as Celsus hath written Now it remains that we tell you how to make your Prognosticks in all the fore-mentioned fractures of the Skull CHAP. X. Of Prognosticks to be made in fractures of the Skull Hip. de vul cap. WE must not neglect any Wounds in the Head no not those which cut or bruise but only the hairy scalp but certainly much less those which are accompanyed by a fracture in the skull for oft-times all horrid symptoms follow upon them consequently death it self especially in bodies full of ill humors or of an ill habit such as are these which are affected with the Lues venerea Leprosie Dropsie Pthysick Consumption for in these simple wounds are hardly or never cured for union is the cure of wounds but this is not performed unless by the strength of nature and sufficient store of laudable bloud but those which are sick of hectick Feavers and Consumptions want store of bloud and those bodies which are repleat with ill humors and of an ill habit have no afflux or plenty of laudable bloud but all of them want the strength of nature the reason is almost the same in those also which are lately recovered of some disease Whether the wounds of children or old people are better to heal Those wounds which are bruised are more difficult to cure than those which are cut When the Skull is broken then the continuity of the flesh lying over it must necessarily be hurt and broken unless it be in a Resonitus The bones of children are more soft thin and replenished with a sanguine humidity than those of old men and therefore more subject to putrefaction Wherefore the wounds which happen to the bones of children though of themselves and their own nature they may be more easily healed because they are more soft wherby it comes to pass that they may be more easily agglutinated neither is there fit matter wanting for their agglutination by reason of the plenty of bloud laudable both in consistence and quality than in old men whose Bones are dryer and harder and so resist union which comes by mixture and their bloud is serous and consequently a more unfit bond of unity and agglutination yet oft-times through occasion of the symptoms which follow upon them that is putrefaction and corruption which sooner arise in a hot and moist body and are more speedily encreased in a soft and tender they usually are more suspected and difficult to heal The Patient lives longer of a deadly fracture in the Skull in Winter than in Summer for that the native heat is more vigorous in that time than in this besides also the humors putrefie sooner in Summer because then unnatural heat is then easily inflamed and more predominant as many have observed out of Hippocrates Aph. 15. sect 1. The wounds of the Brain and of the Meninges or Membranes thereof are most commonly deadly because the action of the Muscles of the Chest and others serving for respiration is divers times disturbed and intercepted whence death insues If a swelling happening upon a wound of the head presently vanish away it is an ill sign unless there be some good reason therefore as bloud-letting Aph. 65. sect 5. purging or the use of resolving local medicines as may be gathered by Hippocrates in his Aphorisms If a Feaver ensue presently after the beginning of a wound of the head that is upon the fourth or seventh day which usually happens you must judg it to be occasioned by the generating of Pus Aph. 47. sect 2. or Matter as it is recited by Hippocrates Neither is such a Feaver so much to be feared as that which happens after the seventh day in which time it ought to be terminated but if it happen upon the tenth or fourteenth day with cold or shaking it is dangerous because it makes us conjecture that there is putrefaction in the Brain the Meninges or Skull through which occasion it may arise chiefly if other signs shall also concurr which may shew any putrefaction as if the wound shall be pallid and of a faint yellowish colour as flesh looks after it is washed Wounds which are dry rough livid and black are evil For as it is in Hippocrates Aphoris 2. Sect. 7. It is an ill sign if the flesh look livid when the Bone is affected for that colour portends the extinction of the heat through which occasion the lively or indifferently red colour of the part faints and dyes and the flesh thereabout is dissolved into a viscid Pus or filth Commonly another worse affect follows hereon wherein the wound becoming withered and dry looks like salted flesh sends forth no matter is livid and black whence you may conjecture that the Bone is corrupted especially if it become rough whereas it was formerly smooth and plain for it is made rough when Caries or corruption invades it but as the Caries increases it becomes livid and black sanious matter with all sweating out of the Diploe as I have observed in many all which are signs that the native heat is decayed and therefore death at hand but if such a Feaver be occasioned from an Erysipelas which is either present or at hand it is usually less terrible The signs of a Feaver caused by an Erysipelas But you shall know by these signs that the Feaver is caused by an Erysipelas and conflux of cholerick matter if it keep the form of a Tertian if the fit take them with coldness and end in a sweat if it be not terminated before the cholerick matter is either converted into Pus or else resolved if the lips of the wound be somewhat swoln as also all the face if the eyes be red and fiery if the neck and chaps be so stiffe that he can scarse bend the one or open the other if there be great excess of biting and pricking pain and heat and that far greater than in a Phlegmon Why an Erysipâ—las chiâ—fly assâ—ils the face For such an Erysipelous disposition generated of thin and hot bloud chiefly assails the face and that for two causes The first is by reason of the natural levity of the cholerick humor the other because of the rarity of the skin of these parts The cure of an Erysipelas on the â—â—ce The cure of such an affect must be performed by two means that is evacuation and cooling with humectation If choler alone cause this tumor we must easily be induced to let bloud but we must purge him with medicines evacuating choler If it be an Erysipelas Phlegmonodes you must draw bloud from the Cephalick-vein of that side which is most affected
inflammation of the brain and Meninges Galen wishes to wash besmear and anoint the head nose temples and ears with refrigerating and humecting things for these stupefie and make drowsie the brain and membranes thereof being more hot then they ought to be Medicines procuring sleep Wherefore for this purpose let the temples be anointed with Unguentum populeon or Unguentum Rosatum with a little Rose-vinegar or Oxycrate let a spunge moistned in the decoction of white or black Poppy-seed of the rinds of the roots of Mandrages of the Seeds of Henbane Lettuce Purslane Plantain Night-shade and the like He may also have a Broath or Barly-cream into which you may put an emulsion made of the Seeds of white Poppy The commodities of sleep or let him have a potion made with â„¥ i or â„¥ i ss of the syrup of Poppy with â„¥ ij of Lettuce-water Let the Patient use these things four hours after meat to procure sleep For sleep doth much help concoction it repairs the efflux of the triple substance caused by watching asswageth pain refresheth the weary mitigates anger and sorrow restores the depraved reason so that for these respects it is absolutely necessary that the Patient take his natural rest If the Patient shall be plethorick let the plenitude be lessened by bloud-letting purging and a slender diet according to the discretion of the Physitian who shall over-see the cure But we must take heed of strong purgations in these kinds of wounds especially at the beginning lest the feaver inflammation pain and other such like symptoms be increased by stirring up the humors Lib. 4. meth Phlebotomy according to Galen's opinion must not only be made respectively to the plenty of bloud but also agreeable to the greatness of the present disease or that which is to come to divert and draw back that humor which flows down by a way contrary to that which is impact in the part and which must be there evacuated or drawn to the next Wherefore for example if the right side of the head be wounded the Cephalick-vein of the right arm shall be opened unless a great Plethora or plenitude cause us to open the Basilica or Median yet if neither of them can be fitly opened the Basilica may be opened although the body be not plethorick The like course must be observed in wounds of the left side of the head for that is far better by reason of the straitness of the fibers than to draw bloud on the opposite side in performance whereof you must have diligent care of the strength of the Patient still feeling his pulse unless the Physitian be present to whose judgment you must then commit all that business For the pulse is in Galen's opinion the certainest shewer of the strength Lib. de cur per sanguinis miss Wherefore we must consider the changes and inequalities thereof for as soon as we find it to become lesser and more slow when the forehead begins to sweat a little when he feels a pain at his heart when he is taken with a desire to vomit or to go to stool or with yawning and when he shall change his colour and his lips look pale then you must stop the bloud as speedily as you can otherwise there will be danger lest he pour forth his life together with his bloud Then he must be refreshed with bread steeped in wine and put into his mouth and by rubbing his temples and nostrils with strong vinegar and by lying upon his back But the part shall be eased freed from some portion of the impact and conjunct humor by gently scarifying the lips of the wound or applying of leeches But it shal be diverted by opening those veins which are nighest to the wounded part as the Vena puppis or that in the midst of the forehead or of the temples or those which are under the tongue besides also cupping-glasses shal also be applyed to the shoulder sometimes with scarification The use of Frictions sometimes without neither must strong long frictions with coarse clothes of all the whole body the head excepted be omitted during the whole time of the cure for these will be available though but for this that is to draw back and dissipate by insensible transpiration the vapours which otherwise would ascend into the head which matters certainly in a body that lyes still and wants both the use and benefit of accustomed exercise are much increased But it shall be made manifest by this following and notable example A History how powerful Bloud-letting is to lessen and mitigate the inflammation of the Brain or the membranes thereof in wounds of the head I was lately called into the suburbs of Saint German there to visit a young man twenty eight years old who lodged there in the house of John Martial at the sign of Saint Michael This young man was one of the houshold-servants of Master Doucador the steward of the Lady Admiral of Brion He fell down head-long upon the left Bregma upon a marble-pavement whence he received a contused wound without any fracture of the skull and being he was of a sanguine temperature by occasion of this wound a Feaver took him on the seventh day with a continual delirium and inflammation of phlegmonous tumor of the wounded Pericranium This same tumor possessing his whole head and neck by continuation and sympathy of the parts was grown to such a bigness that his visage was so much altered that his friends knew him not neither could he speak hear or swallow any thing but what was very liquid Which I observing although I knew that the day past which was the eighth day of his disease he had four sawcers of bloud taken from him by Germain Agace Barber-surgeon of the same Suburbs yet considering the integrity and constancy of the strength of the Patient I thought good to bleed him again wherefore I drew from him fourteen Saucers at that one time when I came to him the day after and saw that neither the Feaver nor any of the fore-mentioned symptoms were any whit remitted or asswaged I forthwith took from him four Saucers more which in all made two and twenty the day following when I had observed that the symptoms were no whit lessened I durst not presume by my own only advice to let him the fourth time bloud as I desired Wherefore I brought unto him that most famous Physitian Doctor Violene who assoon as he felt his pulse knowing by the vehemency thereof the strength of the Patient and moreover considering the greatness of the inflammation and tumor which offered it self to his sight he bid me presently take out my Lancet and open a vein But I lingered on set purpose and told him that he had already twenty two Saucers of bloud taken from him Then said he grant it be so and though more have been drawn yet must we not therefore desist from our enterprise especially seeing the two chief Indications
of bloud-letting yet remain that is the greatness of the disease and the constant strength of the Patient The two chief Indications in bloud-letting I being glad of this took three Saucers more of bloud he standing by and was ready to take more but that he wished me to defer it until the afternoon wherefore returning after dinner I filled two Saucers more so that in all this young man to his great benefit lost twenty seaven Saucers of bloud at five times within the space of four days Now the ensuing night was very pleasing to him the Feaver left him about noon the tumor grew much less the heat of the inflammation was asswaged in all parts except in his eye-lids and the laps of his ears which being ulcerated cast forth a great quantity of Pus or matter I have recited this history purposely to take away the childish fear which many have to draw bloud in the constant strength of the Patient and that it might appear how speedy and certain a remedy it is in inflammations of the head and brain Now to return from whence we digressed The discommodity of venery in wounds of the head you must note that nothing is so hurtful in fractures and wounds of the head as venery not only at that time the disease is present but also long after the cure thereof For great plenty of spirits are contained in a small quantity of seed and the greatest part thereof flows from the Brain hence therefore all the faculties but chiefly the Animal are resolved whence I have divers times observed death to ensue in small wounds of the head yea when they have been agglutinated and united How hurtful noyse is to the fractures of the skull All passions of the mind must in like sort be avoided because they by contraction and dissipation of the spirits cause great trouble in the body and mind Let a place be chosen for the Patient as far from noise as can be as from the ringing of Bells beatings and knocking 's of Smiths Coopers and Carpenters and from high-ways through which they use to drive Coaches for noise encreases pain causes a Feaver and brings many other symptoms I remember when I was at Hisdin at the time that it was besiged by the forces of Charles the fifth A History that when the wall was beaten with the Cannon the noise of the Ordnance caused grievous torment to all those which were sick but especially those that were wounded on their heads so that they would say that they thought at the discharging of every Cannon that they were cruelly strucken with staves on that part which was wounded and verily their wounds were so angered herewith that they bled much and by their pain and Feavers encreased were forced with much sighing to breathe their last Thus much may serve to be spoken of the cure in general now we will out of the monuments of Ancients treat of the particular CHAP. XV. Of the particular cure of wounds of the head and of the musculous skin LEt us begin with a simple wound Of a simple wound of the flesh and the skin for whose cure the Chirurgeon must propose one only scope to wit Union for unless the wound pierce to the skull it is cured like other wounds of the fleshy parts of our bodies But if it be compound as many wayes as it is complicate so many Indications shew themselves In these the chiefest care must be had of the more urgent order and cause Therefore if the wound shall be simple and superficiary then the hair must first be shaven away then a plaister applyed made of the white of an Egge Bole Armenic and Aloes The following day you must apply Emplastrum de Janua or else de gratia Dei until the wound be perfectly healed But if it be deeper and penetrate even to the Pericranium the Chirurgeon shall not do amiss if at the second dressing he apply a digestive medicine as they call it which may be made of Venice-Turpentine A digestive medicine the yolks of Egges Oyl of Roses and a little Saffron and that shall be used so long until the wound come to maturation for then you must add Honey of Roses and Barly flour to the digestive Hence must we pass to these medicines into whose composition no oyly or unctuous body enters A sarcotick medicine such as this â„ž Terebinth venetae â„¥ ij syrupi rosar â„¥ j pul Aloes Myrrhae Mastich an Ê’ ss Let them all be incorporated and made into an unguent which shall be perfectly regenerated An Epulotick then it must be cicatrized with this following powder â„ž Aluminiis combusti corticis granatorum combust an Ê’ i. Misceantur simul fiat pulvis but if the wound be so large that it require a suture it shall have so many stitches with a Needle as need shall seem to require A H story Whilst I was at Hisdin a certain Souldier by falling of the earth whilst he undermined had the Hairy scalp so pressed down even to the Pericranium and so wholly separated from the beginning of the hind-part of his head even to his fore-head that it hung over his face I went about the cure in this manner I first washt all the wound with Wine a little warmed that so I might wash away the congealed bloud mixed with the earth then I dryed it with a soft linnen cloth and laid upon it Venice-Turpentine mixed with a little Aqua-vitae What things we must observe in sewing wherein I had dissolved some Sanguis Draconis Mastick and Aloes then I restored the hanging skin to its former place and there stayed it with some stitches being neither too strait nor too close together for fear of pain and inflammation which two chiefly happen whilst the wound comes to suppuration but only as much as should serve to stay it on every side and to keep forth the air which by it entrance doth much harm to wounds the lower sides of the wound I filled with somewhat long and broad tents that the matter might have passage forth Then I applyed this following cataplasm to all the head â„ž farinae hâ—rd falarum an â„¥ vi olei rosatiÊ’ iij aceti quantum sufficit fiat cataplasma ad formam pultis this hath a faculty to dry cool repel mitigate pain and inflammation and stay bleeding When we must not let bloud in wounds I did not let him blood because he had bled much especially at certain arteries which were broken neer his Temples he being dressed after this manner grew well in a short time But if the wound be made by the biting of a wild Beast it must be handled after another manner as shall appear by this following History As many people on a time stood looking upon the King's Lyons who were kept in the Tilt-yard at Paris A History for the delight of King Henry the second and at his charges it happened that one
of the fiercest of them broke the things wherein he was tyed and leaping amongst the company he with his paws threw to the ground a Girl of some twelve years old and taking her head in his mouth with his teeth wounded the musculous skin in many places yet hurt not the Skull She scarse at length delivered by the Master of the Lyons from the jaws of Death and the Lyon was committed to the cure of Rowland Claret Chirurgeon who was there present by chance at the same time some few days after I was called to visit her she was in a Feaver her head shoulders brest and all the places where the Lyon had set his teeth or nails were swoln all the edges of the wound were livid and did flow with a waterish acrid virulent cadaverous dark green and stinking matter so that I could scarse indure the smell thereof she was also opprest with pricking biting and very great pain which I observing that old saying came into my mind The bitings of man and beasts are venenate which is That all wounds made by the bitings of beasts or of men also do somewhat participate of poyson Wherefore there must principally great care be had of the venenate impression left in the wounds by the nails and teeth and therefore such things must be applyed as have power to overcome poyson Wherefore I scarified the lips of the wounds in divers places and applyed Leeches to suck out the venenate bloud and ease the inflammation of the parts then I made a Lotion of Aegyptiacum Treacle and Mithridate after the following manner Theriacal topick Medicines â„ž Mithrid â„¥ i theriac â„¥ ij aegyptiac â„¥ ss dissolvantur omnia cum aqua vitae Carduiben Let the wounds be fomented and washed with it warm besides also Treacle and Mithridate were put in all the medicines which were either applyed or put into the wound and also of the same with the conserves of Roses and Bugloss dissolved in the water of Sorrel and Carduus benedictus potions were made to strengthen the heart and vindicate it from malign vapours A Cordial Epithema For which purpose also this following Epithema was applyed to the region of her heart â„ž aquae rosar nenuphar an â„¥ iiij aceti scillitici â„¥ j corallorum santalorum alborum rubrorum rosar rub pulveris spodii an â„¥ j Mithridatii Theriacae an Ê’ ij flo cordial pulverifatorum p. ij crociÊ’ j dissolve them all together make an Epitheme and apply it to the heart with a scarlet cloth or spunge and let it be often renued Verily she drest after this manner and the former remedies but once used pain inflammation and all the malign symptoms were much lessened to conclude she recovered but lingred and was lean some two years after yet at length she was perfectly restored to her health and former nature By which you may understand that simple wounds must be handled after another manner than these which have any touch of poyson The cure of the hairy scalp when it is contused But now that we may prosecute the other affects of the hairy scalp say that it is contused with a blow without a wound that which must be first and alwayes done that so the affect may better appear and the remedies which are applyed may take more effect the hair must be shaven away and at the first dressing a repelling medicine applyed such as this following Oxyrhodinum â„ž ol ros â„¥ iij album ovorum nu ij pulveris nucum cypressi balaust alumin. rochae rosar rub anÊ’ j. Let them be all incorporated A repelling medicine and make a medicine for the former use or in stead thereof you may apply the catalpasm prescribed before consisting of Farina hordei fabarum aceto oleo rosaceo But such medicines must be often renued When the pain and defluxion are appeased we must use discussing medicines for dissipation of that humor which remains impacted in the part A discâ—ssing Fomentation â„ž Emplastri de mucilagin Ê’ ij oxicrocei emp. de meliloto an â„¥ i. olei chamaem anethi an â„¥ ss malaxentur simul fiat emplastrum ad usum dictum Such a fomentation will also be good â„ž vini rub lib. iiij lixivii com lib. ij nuces cupressi contus nu x. pul myrtillorum â„¥ i. rosar rub absinth fol. salviae majoranae staechados florum chamaem melil an M. ss aluminis rochae radicis cyperi calami aromatici an â„¥ ss bulliant omnia simul and make a decoction to foment the grieved part After somewhat a long fomenting it whereby it may the better discuss dry and exhaust the concrete humor the head must be dryed and more discussing things applyed such as the Cerate described by Vigo called de Minio Ceratum de Minio which hath an emollient and digestive faculty in this form â„ž Olei chamaem lilior an â„¥ x. olei mastich â„¥ ij pinguedinis vervecis lib. i. litharg auri â„¥ viij minii â„¥ ij vini boni cyathum unum bullianb omnia simul baculo agitando primum quidem lento igne mox verò luculentiore donec tota massa colorem nigrum vel subnigrum contrahat adde in fine cocturae Terebinth lib. s pulveris mastich â„¥ ij gum elemi â„¥ j. cerae quantum sufficit bulliant rursus una ebullitione fiat empl molle But if the humor be not thus discussed Detersive or cleansing medicines but only grow soft then the tumor must be quickly opened for when the flesh is inflamed and putrefied through occasion of the contained humor the bone under it putrefies also by the contagion of the inflammation and the acrimony of the matter falling upon the bone When you have opened it wash away the filth of the ulcer with this following deterâ—ive medicine â„ž syrupi ros absinth an â„¥ i. terebinth â„¥ ss pul ireos aloes mastichis myrrhae farinae hordei an Ê’ ss In stead hereof if there be great putrefaction Aegyptia either by it self or mixt with an equal quantity of Unguentum Apostolorum may be put into the Ulcer When the Ulcer is cleansed it will be time to use scarcotick and cicatrizing medicines CHAP. XVI Of the particular cure of a Fracture or broken Skull IF the Skull be broken so that it be needful to trepan it or to elevate and lift it up Why the Pericranium hath such exquisite sâ—nse or scrape it away the musculous skin being cut as we formerly noted the Pericranium shall be plucked from the Skull as we said before which because it can hardly be done without great pain by reason of its exquisite sense and connexion with the membranes of the brain we must labour to mitigate the pain for fear of inflammation and other accidents Therefore the first dressing ended and the corners of the wound drawn each from other at the second dressing put to the wound a digestive as they term it made of the yolk of an Egge and
in the parts thereunder an unvoluntary excretion of the Urine and other excrements Signs that the Spine is wounded or a totall suppression of them seises upon the Patient When the hollow vein and great Artery are wounded the Patient will dye in a short time by reason of the sodain and aboundant effusion of the blood and spirits which intercepts the motion of the Lungs and heart whence the party dies suffocated CHAP. XXX Of the cure of the Wounds of the Chest WE have read in John de Vigo that it is disputed amongst Chirurgeons concerning the consolidation of wounds of the Chest For some think that such wounds must be closed up Vigo tract de vuln thoraâ— cap. 10. and cicatrized with all possible speed lest the cold air come to the heart and the vitall spirits fly away and be dissipated Others on the contrary think that such wounds ought to be long kept open and also if they be not sufficiently large of themselves that then they must be inlarged by Chirurgery that so the blood poured forth into the capacity of the Chest may have passage forth which otherwise by delay would putrefie whence would ensue an increase of the feaver a fistulous ulcer and other pernicious accidents The first opinion is grounded upon reason and truth if so be that there is little or no blood poured forth into the capacity of the Chest But the latter takes place where there is much more blood contained in the empty spaces of the Chest Which lest I may seem rashly to determin I think it not amiss to ratifie each opinion with a history thereto agreeable Whilst I was at Turin Chirurgeon to the Marshall of Montejan the King of France his General A History I had in cure a Souldier of Paris whose name was Levesque he served under captain Renovart He had three wounds but one more grievous than the rest went under the right brest somewhat deep into the capacity of the Chest whence much blood was poured forth upon the midriff which caused such difficulty of breathing that it even took away the liberty of his speech besides through this occasion he had a vehement feaver coughed up blood and a sharp pain on the wounded side The Chirurgeon which first drest him had so bound up the wound with a strait and thick suture that nothing could flow out thereat But I being called the day after and weighing the present symptoms which threatned speedy death judged that the sowing of the wound must straight be loosed which being done there instantly appeared a clot of blood at the orifice thereof which made me to cause the Patient to lye half out of his bed with his head downwards and to stay his hands on a Settle which was lower than the bed and keeping himself in this posture to shut his mouth and nose that so his Lungs should swell the midriffe be stretched forth and the intercostal muscles and those of the Abdomen should be compressed that the blood poured into the Chest might be evacuated by the wound but also that this excretion might succeed more happily I thrust my finger somewhat deep into the wound that so I might open the orifice thereof being stopped up with the congealed blood and certainly I drew out some seven or eight ounces of putrefied and stinking blood by this means When he was laid in his bed I caused frequent injections to be made into the wound of a decoction of Barly with Honey of Roses and red Sugar which being injected I wisht him to turn first on the one and then on the other side and then again to lye out of his bed as before for thus he evacuated small but very many clots of blood together with the liquor lately injected which being done the symptomes were mitigated and left him by little and little The next day I made another more detergent injection adding thereto wormwood Why bitter things must not be cast into the Chest centaury and Aloes but such a bitterness did rise up to his mouth together with a desire to cast that he could no longer indure it Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris in one who had a fistulous ulcer in his Chest Therefore when I had considered with my self that such bitter things may easily pass into the Lungs and so may from thence rise into the Weazon and mouth I determined that thenceforwards I would never use such bitter things to my Patients for the use of them is much more troublesome than any way good and advantagious But at the length this Patient by this and the like means recovered his health beyond my expectation Read the History of Maryllus in Galen lib. 7. de Anaâ—om administra But on the contrary I was called on a time to a certain Germain gentleman who was run with a sword into the capacity of his Chest the neighbouring Chirurgeon had put a great tent into the wound at the first dressing which I made to be taken forth for that I certainly understood there was no blood powred forth into the capacity of the Chest because the Patient had no feaver no weight upon the Diâ—phrâ—gma nor spitted forth any blood Wherefore I cured him in few dayes by only dropping in some of my balsome and laying a plaister of Diacalcitheos upon the wound What harm ensues the too long use of Tents The like cure I have happily performed in many others To conclude this I dare boldly affirm that wounds of the Chest by the too long use of tents degenerate into Fistula's Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest you shall not presently shut them up at the first dressing No liniments must be used in wounds of the Chest but keep them open for two or three dayes but when you shall find that the Patient is troubled with none or very little pain and that the midriffe is pressed down with no weight and that he breathes freely then let the tent be taken forth and the wound healed up as speedily as you can by covering it only with lint dipped in some balsome which hath a glutinative faculty and laid somewhat broader than the wound never apply liniments to wounds of this kind lest the Patient by breathing draw them into the capacity of the Chest Wherefore also you must have a care that the tent put into those kinds of wounds may be fastned to the pledgets and also have somewhat a large head lest they should be drawn as we said into the capacity of the Chest for if they fall in they will cause putrefaction and death Let Emplast Diacalcitheos or some such like be applyed to the wound But if on the contrary you know by proper and certain signs that there is much blood fallen into the spaces of the Chest then let the orifice of
the wound be kept open with larger tents untill all the Sanies or bloody matter wherein the blood hath degenerated shall be exhausted But if it happen at any time as assuredly it sometimes doth that notwithstanding the Art and care of the Physitian the wound degenerates into a Fistula then the former evil is become much worse For Fistula's of the Chest are scarse cured at any time and that for divers causes The first is for that the muscles of the Chest are in perpetual motion Wounds of the Chest easily degenerate into a Fistula Another is because they on the contrary inside are covered only with the membrane investing the ribs which is without blood The third is for that the wound hath no stay by means whereof it may be compressed sowed and bound whereby the lips being joined together the wound may at length be replenished with flesh and cicatrized Why there flows such plenty of matter out of wounds of the Chest But the reason why wounds of the Chest do every day heap up and pour forth so great a quantity of matter seems to be their vicinity to the heart which being the fountain of blood there is a perpetual efflux thereof from thence to the part affected For this is Natures care in preserving the affected parts that continually and aboundantly without measure or mean it sends all its supplyes that is blood and spirits to their aid Add hereto that the affected parts by pain heat and continual motion of the Lungs and midriffe draw and allure much blood to themselves Such like blood defiled by the malignity and filth of the wound is speedily corrupted whence it is that from the perpetual afflux of blood there is a continual efflux of matter or filth which at the last brings a man to a consumption because the ulcerated part like a ravenous wolf consumes more blood by the pain heat and motion than can be ministred thereto by the heart Yet if there be any hope to cure and heal the Fistula it shall be performed after the use of diet and phlebotomy according to the prescript of the Physitian by a vulnerary potion which you shall find described when we treat of the Caries or rottenness of the bones The cure of a Fistula in the Chest When Aegyptiacum must be put into the injections Wherefore you shall make frequent injections therewith into the Fistula adding and mixing with it syrup de rosis siccis and mel rosarum Neither do I if the putrefaction be great fear to mix therewith Aegyptiacum But you must have a care to remember observe the quantity of the injected liquor that you may know whether it all come forth again after it hath performed its detergent office For if any thereof remain behind in the corners and crooked passages it hurts the part as corrupted with the contagion thereof The form of a Syringe fit to make injection when a great quantity of liquor is to be injected into any part After the injected liquor is come forth a pipe of gold silver or lead shall be put into the fistulous ulcer and it must have many holes in it that so the filth may pass forth at them it must be fast tyed with strings that it may not fall into the capacity of the Chest A great Spunge steeped in Aqua-vitae and wrung forth again shall be laid hot to the end or orifice thereof both to hinder the entrance of the air into the Fistulous ulcer as also to draw forth the filth there by its gentle heat the which thing the Patient shall much further if often times both day and night he hold his breath stopping his mouth and nose and lying upon the diseased side that so the Sanies may be the more forcibly evacuated neither must we leave the putting in the pipe before that this fistulous ulcer shall be almost dry that is whole as when it yields little or no matter at all then it must be cicatrized But if the orifice of this fistulous ulcer being in the upper part hinder the healing thereof then by a chirurgical Section a passage shall be made in the bottom as we said before in an Empyema The delineation of the Pipes with their Strings and Spunges The Reader must note that the Pipes which are fit for this use need not have so many holes as these here exprest but only two or three in their ends for the flesh growing and getting into the rest makes them that they cannot be plucked forth without much pain A wound made in the Lungs admits cure What wounds of the Lungs are curable unless it be very large if it it be without inflammation if it be on the skirts of the Lungs and not on their upper parts if the Patient contain himself from coughing much and contentious speaking and great breathing for the wound is inlarged by coughing and thence also arises inflammation the Pus and Sanies whereof The harm that insues upon coughing in wounds of the Lungs whilst the lungs again endeavour to expel by coughing by which means they are only able to expel that which is hurtful and troublesome to them the ulcer is dilated the inflammation augmented the Patient wastes away and the disease becomes incurable There have been many Eclegma's described by Physitians for to clense the ulcer How Eclegma's must be swallowed which when the Patient useth he shall lye on his back to keep them long in his mouth so to relax the muscles of the Larinx for thus the medicin will fall by little and little alongst the coats of the Weazon for if it should fall down in great quantity it would be in danger to cause coughing Cows Asses or Goats-milk with a little Hony lest they should corrupt in the Stomach are very fit remedies for this purpose but Womans milk exceeds the rest But Sugar of Roses is to be preferred before all other medicins in the opinion of Avicen The utility of Sugar of Roses in ulcerated or wounded Lungs for that it hath a detergent and also an astrictive and strengthening faculty than which nothing is more to be desired in curing of ulcers When you shall think it time to agglutinate the clensed ulcer you must command the Patient to use emplastick austere and astringent medicins such as are Terra sigillata bolus armenus hypocystis Plantain Knot-grass Sumach Acacia and the like which the Patient shall use in his Broaths and Eclegma's mixing therewith Hony of Roses which serving for a vehicle to the rest may carry away the impacted filth which hinders agglutination But seeing an hective Feaver easily follows upon these kinds of wounds and also upon the affects of the Chest and Lungs it will not be amiss to set down somewhat concerning the cure thereof that so the Chirurgeon may know to administer some help to his Patient whilst a Physitian is sent for to overcome this disease with more powerful and certain remedies CHAP. XXXII
well in a plethorick body or in a body replete with ill humors or indued with exquisite sense Therefore in such a case it will be safer to follow the course here set down For wounds of the nerves do not only differ from other wounds but also among themselves in manner of curing For although all medicines which draw from far and waste sanious humors may be reputed good for the wounds of the nerves yet those which must be applyed to punctures and to those nerves which are not wholly laid open ought to be far more powerful sharp and drying yet so that they be not without biting that so penetrating more deep they may draw forth the matter or else consume and discuss that which either lies about the nerves or moistens their substance On the contrary Medicines fit for wounds of the nerves when the sinews are bared from flesh and adjoyning particles they stand in need but of medicines which may only dry Here you may furnish your selves with sufficient store of medicines good for the nerves howsoever pricked As â„ž Terebinth vin olei veteris an â„¥ j. aquae vitae parum Or â„ž olei Terebinth â„¥ j. aqua vitaeÊ’ j. cuphor Ê’ ss Or â„ž radices Dracontiae Brioniae Valerianae Gentianae exsiccatas in pulverem redactas misce cum decocto centaurii aut oleo aut exungia veteri drop hereof warm into the wound as much as shall suffice Or else put some Hogs Goose Capons or Bears-grease old Oyl Oyl of Lillies or the like to Gall anum pure Rozin opopanax dissolved in Aqua-vitae and strong Vinegar Or â„ž olei hypericonis samâ—uti de cuphorâ—io an â„¥ j. suâ—phuris vivi subtiliter pulverisati â„¥ ss gummi ammoni bdellii an Ê’ ij aceti boni â„¥ ij vermium terrest praeparat â„¥ j. bulliant omnia simul ad consumptionem aceti Let as much hereof as shall suffice be dropped into the wound then apply this following Cerate which draws very powerfully â„ž olei supra-scripti â„¥ j. Terebinth venet â„¥ ss diachylonis albi cum gummi Ê’ x. ammoniac â—dellii in aceto dissoluterum an Ê’ ij resin pini gum clemi picis navalis an Ê’ v. cerae quod sufficit fiat ceratum satis molle We must use some whiles one some whiles another of these medicines in punctures of the Nerves with choice and judgment according to their conditions manner depth and the temperaments and habits of the wounded bodies But if the pain yield not to such remedies but rather increase What wounds of the N rves must be burnt with the inflammation of the affected part a swelling of the lips of the wound and sweating forth of a serous thin and virulent matter or filth then you shall pour into it scalding Oyl and shall touch three or four times not only the surface of the wound but the bottom thereof with a rag dipped therein and tyed to the end of a Spatula For this will take away the sense from the Nerve Tendon or Membrane A certain Anodyne in pain of the teeth like as if they were burnt with a cautery and so the pain will be eased So in the most grievous pains of rotten teeth the thrusting of an hot iron into their roots or stopping them with Cotton dipped in Oyl of Vitriol or Aqua-vitae gives most certain ease for by burning the Nerve which is inserted into their roots the sense and so consequently the pain is taken away So also in malignant Why Escharoticks must be used to spreading ulcers gnawing eating and spreading ulcers which are alwayes associated with much pain the pain ceases by applying an Escharotick the powder of Alum or Mercury or Aegyptiacum made somewhat more strong than usual That the young Chirurgeon may be more ready for this practise and the use of the former medicines I have thought good to insert the following History both for the lateness of the thing and the pleasing memory of the most laudable Prince Charles the ninth the French King being sick of a Feaver A famous History Monsieur Chapellan and Castellan his Physitians thought it fit he should be let bloud for the performance whereof there was called a Chirurgeon wondrous famous for that business but when as he by chance had pricked a nerve in stead of a vein the King cryed out that he felt a mighty pain in that place Then I bid that the ligature should straight-wayes be loosed otherwise the arm would presently be much swelled But he going slowly about it behold the arm began to swell with such contraction that he could not bend it nor put it forth and cruel pain molested not only the pricked particle but all the whole member besides I forthwith laid upon the wound a plaister of Basilicon to hinder the agglutination thereof and then I wrapped all the arm in a double linnen cloth dipped in Oxycrate putting upon it an expulsive ligature which beginning at the wrist and ending at the top of the shoulder might keep the bloud and spirits from fear of defluxion and inflammation This being thus performed we went aside to consult what was necessary to be done both to asswage the pain as also to divert the other symptoms which usually happen upon punctures of the nerves I being desired thus delivered my opinion that in my mind there were nothing better then presently to drop into the wound some Oyl of Turpentine warmed and mixed with a little Aqua-vitae And then all the arm should be covered with a plaister of Diacalcitheos dissolved in Vinegar and Oyl of Roses bound over and besides with the expulsive ligature which we formerly mentioned For the Oyl and Aqua-vitae have a faculty to penetrate into the bottom of the wound and to exhaust and dry up the serous and virulent humor which sweats from the substance of the pricked nerve and also to mitigate the pain by its actual heat Furthermore emplaister Diacalcitheos hath a faculty to dissolve the humor which hath already fallen down into the arm and to hinder the entrance and defluxion of any new matter And the ligature is such as by its moderate astriction would serve to strengthen the muscles and to press out and repel the humors which were fallen down into the upper part and to prohibit that which is ready to fall down Mine advice being approved of the Physitians both in word and deed the pain was mitigated But the humor stayed in the part A discussing and drying cataplasm for the dissolving and drying whereof this following remedy was used â„ž far hordei crobi an Ê’ ij flor chamaem melilot an p. ij butyr recentis siue sale â„¥ i ss lixivii â—arbitonsoris quod sufficit fiat cataplasma ad formam pultis By these remedies the King at last after three months space was perfectly healed so that there remained no sign of the depraved action in the part But if at any time there shall be so great contumacy that it will
putrefaction as you may learn by those Countries which are blown upon by a wind from Sea For in these flesh which is kept for food putrefies in the space of an hour Flesh quickly putrefies in maritine places and such ulcers as in other places are easily and quickly healed do there by the conflux and collection of matter become inveterate and contumacious Therefore as when the seasons of the year successively fall out agreeable to their nature and when each season is seasonable then either we are not sick at all or assuredly with less danger So on the contrary the perfect constitution and health of our Bodies becomes worse and decays when the seasons of the year are depraved perverted in time and temper Now seeing that these many years the four seasons of the year have wanted their seasonableness the Summer wanting his usual heat and the Winter its cold and all things by moisture and the dominion of the Southern winds have been humid and languid I think there is none so ignorant in natural Philosophy and Astrology who will not think but that the causes of the malignity and contumacy of those diseases which have so long afflicted all France are to be attributed to the Air and Heavens For otherwise whence have so many pestilent and contagious diseases tyrannized over so many people of every age sex and condition whence have so many Catarrhes Coughs and heavinesses of the head so many Pleurisies Tumors small Poxes Measles and Itches not admitting of digestion and remedies prescribed by Art Whence have we had so many venemous creatures as Toads Grashoppers Caterpillers Spiders Wasps Hornets Beetles Snails Vipers Snakes Lizards Scorpions and Efts or Nutes unless from excessive putrefaction which the humidity of the air our native heat being liquid and dull hath caused in us and the whole Kingdom of France Hence also proceeds the infirmity of our native heat and the corruption of the bloud and humors whereof we consist which the rainy Southwind hath caused with its sultry heat Wherefore in these last years I have drawn little bloud which hath not presently shewed the corruption of its substance by the black or greenish colour as I have diligently observed in all such as I have bled by the direction of the Physitians either for prevention of suture or cure of present diseases Whence it comes to pass that the fleshy substance of our bodies could not but be faulty both in temper and consistence seeing that the bloud whence it is generated had drawn the seeds of corruption from the defiled air In what bodies ulcers and wounds are not easily cured Whence it fell out that the wounds which happened with loss of substance could be scarse healed or united because of the depraved nature of the bloud For so the Wounds and Ulcers of those which are troubled with the Dropsie whose bloud is more cold or wholly waterish so of Leprous persons whose bloud is corrupt and lastly of all such as have their bodies replete with ill juyce or else are Cachectick will not easily admit of cure Yea assuredly if but the very part which is hurt swerve from its native temper the wound will not easily be cured Therefore seeing all these things both the putrefaction of the Air and depraved humors of the body and also the distemper of the affected parts conspired together to the destruction of the wounded what marvail was it if in these late civil wars the wounds which were for their quantity small for the condition of the wounded parts but little have caused so many and grievous accidents and lastly death it self Especially seeing that the Air which encompasseth us tainted with putrefaction corrupts and defiles the wounds by inspiration and exspiration the body and humors being already disposed or inclined to putrefaction Now there came such a stink which is a most assured sign of putrefaction from these Wounds when they were dressed that such as stood by could scarse endure it neither could this stink be attributed to the want of dressing or fault of the Chirurgeon for the wounds of the Princes and Nobility stunk as ill as those of the common Souldiers An argument of great putrefaction of the humors And the corruption was such that if any chanced to be undrest for one day which sometimes happened amongst such a multitude of wounded persons the next day the wound would be full of worms Besides also which furthermore argues a great putrefaction of humors many had abscesses in parts opposite to their wounds as in the left knee when as the right shoulder was wounded in the left arm when as the right leg was hurt Which I remember befel the King of Navarre the Duke of Nevers the Lord Reden and divers others For all men had nature so over-charged with abundance of vicious humors that if it expelled not part thereof by imposthumes to the habit of the Body it certainly otherwise disposed of it amongst the inner parts of the Body for in dissecting dead Bodies we observed that the Spleen Liver Lungs and other Bowels were purulent and hence it was that the Patients by reason of vapours sent from them to the heart were troubled with continual Feavers But the Liver and all the veinous parts being polluted and so the generation of the laudable Bloud hindered they languished for want of fitting nourishment But when the Brain by vapours was drawn in to sympathize with the rest they were molested with Ravenings Convulsions Wherefore if any thing succeeded unprosperously in so great malignancy of wounds the Chirurgeon was not to be blamed for that it were a crime to fight against God and the Air wherein the hidden scourges of the divine justice lye hid Therefore if according to the mind of the great Hippocrates who commands to bring all contused wounds to suppuration that so they may be healed we indeavoured to cure with such medicins wounds made with Gunshot and therefore contused who can rightly be angry with us if we performed it not so well by reason of those putrefactions gangrenes All contused wounds must be brought to suppuration and mortifications which proceeded from the corrupt Air for all that we used not only suppuratives but were oft-times forced to use other medecins so long turning aside from the cure of the disease until we had orecome the symptoms which much indanger the Patient and customarily happen upon such wounds as also upon those which are made with a sword or any other kind of weapon as shall plainly appear in the following Treatise to which it now seems high time that we betake our selves CHAP. I. A division of Wounds drawn from the variety of the wounded parts and the Bullets which wound A division of wounds from the variety of the wounded parts ALl Wounds which are made in mans Body by Gunshot whether simple or compound are accompanyed with contusion dilaceration distemper and swelling I say all these possess either the
suppurative medicine composed of Lard the yolk of an Egge Turpentine and a little Saffron In the year 1538. there was at Turin whilst I was Chirurgeon there to the Marshal of Montejan the Kings Lieutenant General in Piemont a certain Chirurgeon woundrous famous for curing these wounds and yet he used nothing else but the Oyl of Whelps the description whereof I at length obtained of him with much intreaty and expence and he used it not scalding hot as some have imagined but poured it scarse warm into their wounds and so did mitigate their pain and happily bring them to suppuration Which afterwards almost all Chirurgeons after they had got the description hereof when I first published this Work have used and daily do use with happy success But in contemning and condemning Aegyptiacum I think he hath no partaker The force of Aegyptiacum against putrefaction seeing there as yet hath been found no medicine more speedy and powerful to hinder putrefaction if beginning or correct it if present Now these wounds often degenerate into virulent eating spreading and malign ulcers which cast forth a stinking and carion-like filth whence the part gangrenates unless you withstand them with Aegytiacum and other acrid medicines being greatly approved by the formerly named Physitians and all Chirurgeons But saith he this Unguent is poysonous and therefore hath been the death of many who have been wounded by Gunshot Verily if any diligently inquire into the composition of this Ointment and consider the nature of all and every the ingredients thereof he shall understand that this kind of Unguent is far from poyson that on the contrary it directly opposes and resists all poyson and putrefaction which may happen to a fleshy part through occasion of any wound The force of the air in breeding and augmenting diseases It is most false and dissonant from the doctrin of Hippocrates to affirm that the seasons of the year swerving from the Law of Nature and the air not truly the simple and elementary but that which is defiled and polluted by the various mixture of putrid and pestilent vapours either raised from the earth or sent from above make not wounds more malign and hard to cure at some times than they are at othersome For the air either very hot or cold drawn into the body by inspiration or transpiration generates a condition in us like its qualites Therefore why may it not when defiled with the putredinous vapours of bodies lying unburyed after great battails and shipwracks of great Armadoes infect with the like quality our bodies and wounds A History In the year 1562. when the Civill Wars concerning Religion first begun in France at Pene a Castle lying upon the River Lot many slain Bodies were cast into a Well some hundred Cubits deep so stinking and pestilent a vapour arose from hence some two months after that many thousands of people dyed all over the Province of Ageneis as if the Plague had been amongst them the pernicious contagion being spread twenty miles in compass Which none ought to think strange especially seeing the putrid exhalations by the force of the winds may be driven and carryed into divers and most remote regions dispersed like the seeds of the Pestilence whence proceeds a deadly corruption of the spirits humors and wounds not to be attributed to the proper malignity or perverse cure of wounds but to be the fault of the air Therefore Francis Daleschampe in his French Chirurgery in reckoning up those things which hinder the healing of Ulcers hath not omitted that common cause which proceeds from the air defiled or tainted with the seeds of Pestilence Hip. Aph. 1. sect 3. For he had learnt from his Master Hippocrates that the mutations of times chiefly bring diseases and he had read in Guido that this was the chief occasion that wounds of the head at Paris and of the legs at Avignion were more difficultly healed Lastly even Barbers and such as have least skill in Chirurgery know that wounds easily turn into a Gangrene in hot and moist constitutions of the air Wherefore when the wind is southerly the Butchers will kill no more flesh than to serve them for one day In our second discourse I have formerly declared the malignity of the wounds occasioned by the air in the siege of Ronen which spared none no not the Princes of the bloud who had all things which were requisite for their health Which caused me made at length more skilful by experience to use Unguentum Aegyptiacum and medicines of the like faculty in stead of Suppuratives to wounds during all that season that so I might withstand the putrefaction and Gangrene which so commonly assailed them The power of the Stars upon the a r and our bodies But if the various motion of the Stars can by their influx send a Plague into the air why then may it not by depravation of their qualities infect and as by poysoning corrupt both wounds and wounded bodies obnoxious to their changes and that of the air We learnt long since by experience that all pains but principally of wounds grow worse in a rainy and moist season specially because in that southerly constitution the air replete with thick and foggy vapours causes the humors to abound in the body which forthwith easily fall upon the affected parts and cause increase of pain But saith our Adversary in the battel at Dreux and at S. Dâ—nais which were fought in winter there dyed a great number of men who were wounded by Gunshot This I confess is true but this I deny that it was occasioned by applying suppuratives or corrosives but rather the vehemency and largeness of their wounds and the spoil the Bullet made in their members but above all by reason of the cold For cold is most hurtful to wounds and ulcers Aphor. 40. sect 5. as Hippocrates testifies it hardens the skin and causes a Gangrene If this my Gentleman had been with me in the siege of Metz he might have seen the legs of many souldiers to have rotted and presently taken with a Gangrene to have faln away by the only extremity of cold if he will not believe me let him make tryal himself and go in winter to the Chappel at Mount Senis one of the Alpine-hills where the bodies of such as were frozen to death in passing that way are buryed and he shall learn and feel how true I speak In the mean time I think it fit to confute the last point of his reprehension The similitude between Thunder and great Ordnance maintained He cavils for that I compared Thunder and Lightning with Discharging of pieces of Ordnance First he cannot deny but that they are alike in effects For it is certain that the flame arising from Gunpowder set on fire resembles Lightning in this also that you may see it before you hear the crack or report I judg for that the eye almost in a moment perceives its
head and then take fast hold of the head with your Cranes-bill and so draw them forth all three together CHAP. XX. What to be done when an Arrow is left fastned or sticking in a Bone BUt if the weapon be so depart and fastned in a Bone that you cannot drive it forth on the other side neither get it forth by any other way than that it entred in by A Caution you must first gently move it up and down if it stick very fast in but have a special care that you do not break it and so leave some fragment thereof in the bone then take it forth with your Crows-bill or some other fit Instrument formerly described Then press forth the bloud The benefit of bleeding in wounds and suffer it to bleed somewhat largely yet according to the strength of the Patient and nature of the wounded part For thus the part shall be eased of the fulness and illness of humors and less molested with inflammation putrefaction and other symptoms which are customarily feared When the weapon is drawn forth and the wound once dressed handle it if simple as you do simple wounds if compound then according to the condition and manner of the complication of the effects Certainly the Oyl of Whelps formerly described is very good to asswage pain To conclude you shall cure the rest of the symptoms according to the method prescribed in our Treatise of wounds in general and to that we have formerly delivered concerning wounds made by Gunshot CHAP. XXI Of poysoned Wounds IF these Wounds at any time prove poysoned they have it from their Primitive cause to wit The signs of poysoned wounds the empoysoned Arrows or Darts of their enemies You may find it out both by the property of the pain if that it be great and pricking as if continually stung with Bees for such pain usually ensues in wounds poysoned with hot poyson as Arrows usually are Also you shall know it by the condition of the wounded flesh for it will become pale and grow livid with some signs of mortification To conclude there happen many and malign symptoms upon wounds which are empoysoned being such as happen not in the common nature of usual wounds Remedies in poysoned wounds Therefore presently after you have plucked forth the strange bodies encompass the wound with many and deep scarifications apply ventoses with much flame that so the poyson may be more powerfully drawn forth to which purpose the sucking of the wound performed by one whose mouth hath no soarness therein but is filled with Oyl that so the poyson which he sucks may not stick nor adhere to the part will much conduce Lastly it must be drawn forth by rubefying vesicatory and caustick medicines and assailed by Oyntments Cataplasms Emplaisters and all sorts of local medicines The End of the Eleventh Book The Twelfth BOOK Of CONTVSIONS and GANGRENES CHAP. I. Of Contusions A Contusion according to Galen is a solution of continuity in the flesh or bone Gal. Lib de artis c nstitut Sect. 2 lib. de fracturis caused by the stroak of some heavy and obtuse thing or a fall from on high The symptom of this disease is by Hippocrates called Peliosis and Melasma that is to say blackness and blewness the Latins term it Sugillatum There are divers sorts of these Sugillations or blacknesses Causes of Bruises and Sugillations according as the bloud is poured forth into the more inward or outward part of the body The bloud is poured forth into the body when any for example falls from an high or hath any heavy weight falls upon him as it often happens to such as work in Mines or are extreamly racked or tortured and sometimes by too loud and forcible exclamations Besides also by a Bullet shot through the body bloud is poured forth into the Belly and so often evacuated by the passages of the Guts and Bladder The same may happen by the more violent and obtuse blows of a hard Trunchion Club Stone and all things which may bruise and press the cloud out of the vessels either by extending or breaking them For which causes also the exteriour parts are contused or bruised sometimes with a wound sometimes without so that the skin being whole and as far as one can discern untoucht the bloud pours it self forth into the empty spaces of the muscles and between the skin and muscles which affect the Ancients have tearmed Ecchymosis Hippocrates calls it by a peculiar name Nausiosis Sect. 2. Lib. de fract for that in this affect the swoln veins seem as it were to vomit and verily do vomit or cast forth the superfluous blood which is contained in them From these differences of Contusions are drawn the indications of curing as shall appear by the ensuing discourse CHAP. II. Of the general cure of great and enormous Contusions THe blood poured forth into the body must be evacuated by visible and not-visible evacuation The visible evacuation may be performed by blood-letting Cupping-glasses horns scarrification horsleeches and fit purgative medicins if so be the patient have not a strong and continual feaver The not-visible evacuation is performed by resolving and sudorifick potions Ad sentent 62. sect 3. lib. de A ticulis baths and a slender diet Concerning Blood-letting Galens opinion is plain where he bids in a fall from an high place and generally for bruises upon what part soever they be to open a vein though the parties affected are not of a full constitution for that unless you draw blood by opening a vein there may inflammations arise from the concreat blood from whence without doubt evill accidents may ensue After you have drawn blood give him foure ounces of Oxycrate to drink for that by the tenuity of its substance hinders the coagulation of the blood in the belly A portion to disolve an evacuate clotted blood A hot sheeps skin or in stead thereof you may use this following Potion â„ž rad GentianaeÊ’iij bulliant in Oxycrato in cilaâ—ura dissolve rhei electiÊ’ j. fiat potio These medicins dissolve and cast forth by spitting and vomit the congealed blood if any thereof be contained in the ventricle or lungs it will be expedient to wrap the Patient presently in a sheeps skin being hot and newly taken from the sheep and sprinkled over with a little myrrhe cresses and salt and so to put him presently in his bed then cover him so that he may sweat plentifully The next day take away the sheeps-skin A discussing ointment and anoint the body with the following anodyne and resolving unguent â„ž unguent de althaea â„¥ vj. olei Lumbric chamaem anethi an â„¥ ij terebinth venetae â„¥ iiij farinae foenugrae rosar rub pulverisat pul myrtillorum an â„¥ j. fiat liâ—us ut dictum est Then give this potion which is sudorifick and dissolves the congealed blood A Sudorifick potion to dissolve congealed blood Syrups hindering putrefaction
and congealing of blood A drink for the same purpose â„ž Ligni guajaci â„¥ viij radicis enulae camp consolid majoris Ireos Florent polypod querni seminis coriandri anisi an â„¥ ss glycyrhiz â„¥ ij nepetae centaureae caryophyl cardui ben verbenae an m. s aquae fontanae lib. xij Let them be all beaten and infused for the space of twelve hours then let them boil over a gentle fire untill the one half be consumed let the Patient drink some halfe a pint of this drink in the morning and then sweat some hours upon it in his bed and do this for seven or eight dayes If any poor man light upon such a mischance who for want of means cannot be at such cost it will be good having wrapped him in a sheet to bury him up to the chin in Dung mixed with some hay or straw and there to keep him untill he have sweat sufficiently I have done thus to many with very good success You shall also give the Patient potions made with syrups which have power to hinder the coagulation and putrefaction of the blood such as syrup of Vinegar or Lemmons of the juice of Citrons and such others to the quantity of an ounce dissolved in scabius or Cardnus water You may also presently after the fall give this drink which hath power to hinder the coagulation of the blood and strengthen the bowells â„ž Rhei elect in pul redacti ℈ j aquae ruliae majoris plantagin an â„¥ j. theriacaÊ’ ss syrupide rosis siccis â„¥ ss fiat pâ—â—us Let him take it in the morning for four or five dayes In stead hereof you may make a potion of one dram of Sperma ceti d ssolved in bugloss or some other of the waters formerly mentioned and half an ounce of syrup of Maiden-hair if the disease yield not at all to these formerly prescribed medicins it will be good to give the Patient for nine dayes three or four hours before meat A powder for the same some of the following powder â„ž rhei torrefacti rad rub majoris centaurei gentianae aristoli rotundae an â„¥ ss give Ê’j hereof with syrup of Vinegar and Carduus water They say that the water of green Walnuts distilled by an Alembick is good to dissolve congealed and knotted blood Also you may use baths made of the decoction of the roots of Orris Elecampane Sorrel Fennel Marshmallows Water-fern or Osmund the waterman the greater Comfrey the seeds of Faenugreek the leaves of Sage Marjerum the flowres of Camomile Melilote and the like For a warm Bath hath power to rarifie the skin The distilled water of green Walnuts Baths to dissolve the clotted blood by cutting the tough and mitigating the acrid humors by calling them forth into the surface of the body and relaxing the passages thereof so that the rebellious qualities being orecome there ensues an easie evacuation of the matter by vomit or expectoration if it flote in the Stomach or be contained in the Chest but by stool and urin if it lye in the lower parts by sweats and transpiration if it lye next under the skin Wherefore bathes are good for those who have a Peripneumonia or inflammation of their Lungs Lib 3 de vict aâ—ut lib. 3. de de meth or a Plurisie according to the mind of Hippocrates if so be that they be used when the feaver begins to be asswaged for so they mitigate pain help forwards suppuration and hasten the spitting up of the purulent matter But we would not have the Patient enter into the bath unless he have first used general remedies as blood-letting and purging for otherwise there will be no small danger lest the humors diffused by the heat of the bath cause a new defluxion into the parts affected Wherefore do not thou by any means attempt to use this or the like remedy having not first had the advice of a Physitian CHAP. III. How we must handle Contusions when they are joyned with a Wound EVery great Contusion forthwith requires Bloud-letting or purging or both and these either for evacuation or revulsion For thus Hippocrates in a contusion of the heel Sect. lib. fract gives a vomitory portion the same day or else the next day after the heel is broken And then if the Contusion have a wound associating it the defluxion must be strayed at the beginning with an Ointment made of Bole-Armenick the white of Eggs and Oyl of Roses and Myrtles with the powders of red-Roses Alome and Mastich At the second dressing apply a digestive made of the yolk of an Egg Oyl of Violets and Turpentine A suppurative Cataplasm This following Cataplasm shall be applyed to the near parts to help forwards suppuration â„ž rad althaeae lilii an â„¥ iiij sal malâ— violar senecionis an M. ss coquantur complete passentur per setaceum addendo butyri recentis olei viol an â„¥ iij. farinae volatilis quant sufficit fiat cataplasma ad formam pultis liquidae A caution to be observed Yet have a care in using of Cataplasms that you do not too much exceed for too frequent and immoderate use of them makes wounds phlegmonous sordid and putrid Wherefore the wound after it is come to suppuration must be clensed filled with flesh and cicatrized unless happily the contused flesh shall be very much torn so that the native heat forsake it for then it must be cut away But if there be any hope to agglutinate it let it be sowed How contused wounds must be sowed and other things performed according to Art but the stitches must not be made so close together as when the wound is simple and without contusion for such wounds are easily inflamed and swell up which would occasion either the breaking of the thred or flesh or tearing of the skin CHAP. IV. Of these Contusions which are without a Wound IF the skin being whole and not hurt as far as can be discerned the flesh which lies under it be contused and the bloud poured forth under the skin make an Ecchymosis then the Patient must be governed according Art until the malign symptoms which commonly happen be no more to be feared Wherefore in the beginning draw bloud on the opposite side Phlebotomy both for evacuation and revulsion The contused part shall be scarified with equal scarifications Scarifying Cupping-glasses then shall you apply Cupping-glasses or horns both for evacuation of the bloud which causes the tumor and tension in the part as also to ventilate and refrigerate the heat of the part lest it turn into an Abscess Neither must we in the mean while omit gentle purging of the Belly Astrictives how good in Contusions The first Topick medicins ought to be astrictives which must lye some short while upon the part that so the Veins and Arteries may be as it were straitned and closed up and so the defluxion hindered as also that the part it self may be
according to the common rules of Art you cut it off close to that which is perished the Patient will be forced with trouble to use three Legs instead of two An observable Histâ—ry For I so knew Captain Francis Clerk when as his foot was stricken off with an iron bullet shot forth of a man of war and afterwards recovered and healed up he was much troubled and wearied with the heavy and unprofitable burden of the rest or his Leg wherefore though whole and sound he caused the rest thereof to be cut off some five fingers breadth below his knee and verily he used it with much more ease and facility than before in performance of any motion We must do otherwise if any such thing happen in the Arm that is you must cut off as little of the sound part as you can For the actions of the Legs much differ from those of the Arms and chiefly in this that the body rests not neither is carried upon the Arms as it is upon the Feet and Legs CHAP. XIX How the section or amputation must be performed THe first care must be of the Patients strength wherefore let him be nourished with meats of good nutriment easie digestion and such as generate many spirits as with the yolâ—s of Egs and bread tosted and dipped in Sack or Muskadine Then let him be placed as is fit and drawing the muscles upwards towards the sound parts let them be tyed with a strait ligature a little above that place of the member which is to be cut off with a strong and broad fillet like that which women usually bind up their hair withall The Ligature of the part This ligature hath a threefold use the first is that it hold the muscles drawn up together with the skin so that retiring back presently after the performance of the work they may cover the ends of the cut bones and serve them in stead of â—o â—isters or pillows when they are healed up and so suffer with lesse pain the compression in sustaiâ—ing the rest of the body besides also by this means the wounds are the sooner healed and cicatrized for by how much more flesh or skin is left upon the ends of the bones by so much they are the sooner healed and cicatrized The second is for that it prohibits the flux of bloud by pressing and shutting up the veins and arteries The third is for that it dulls the sense of the part by stupefying it the animal spirits by the strait compressing being hindred from passing in by the Nerves Wherefore when you have made your ligature cut the flesh even to the bone with a sharp and well-cutting incision-knife or with a crooked Knife such as is here expressed A crocked knife fit for dismembring or a dismembring knife The Figure of such a Saw A caution to be observed Now you must note that there usually lies beâ—ween the bones a portion of certain muscles which you cannot easily cut with a large incision or dismembring-knife wherefore you must carefully divide it and separate it wholly from the bone with an instrument made neatly like a crooked Incision-knife I thought good to advertise thee hereof for if thou shouldest leave any thing besides the bone to be divided by the Saw you would put the Patient to excessive pain in the performance thereof for soft things as flesh tendons and membranes cannot be easily cut with a Saw Therefore when you shall come to the bared bone all the other parts being wholly cut asunder and divided you shall nimbly divide it with a little Saw about some foot and three inches long and that as near to the sound flesh as you can And then you must smooth the front of the Bone which the Saw hath made rough CHAP. XX. How to stanch the bleeding when the member is taken off WHen you have cut off and taken away the member let it bleed a little according to the strength of the Patient that so the rest of the part may afterwards be lesse obnoxious to inflammation and other symptoms Then let the veins and arteries be bound up as speedily and straitly as you can that so the course of the flowing blood may be stopped and wholly stayed Which may be done by taking hold of the vessels with your Crows-beak whereof the figure follows The Crows-beak fit for to draw the vessels forth of the flesh wherein they lye hid that so they may be tyed or bound fast The ends of the vessels lying hid in the flesh How to draw forth the vessels and bind them must be taken hold of and drawn with this instrument forth of the muscles whereinto they presently after the amputation withdrew themselves as all parts are still used to withdraw themselves towards their originals In performance of this work you need take no great care if you together with the vessels comprehend some portion of the neighbouring parts as of the flesh for hereof will ensue no harm but the vessells will so be consolidated with more ease than if they being bloodlesse parts should grow together by themselves To conclude when you have so drawn them forth bind them with a strong double thred CHAP. XXI How after the blood is stanched you must dresse the wounded member WHen you have tyed the Vessels How the lips of the dismembred part are to be joined together loose your Ligature which you made above the place of amputation then draw together the lips of the wound with four stitches made across having taken good hold of the flesh for thus you shall draw over the bones that part of the skin and cut muscles drawn upwards before the amputation and cover them as close as you can that so the air may the lesse come at them and that so the wound may be the more speedily agglutinated But when we say draw together the lips of the wound with four stitches you must not so understand it as that you must endeavour to draw them so close as to touch each other for that is impossible for the stitches would sooner break out and so the part would lye bare Wherefore it will be sufficient to draw them indifferent close together that so you may suffer the skin and flesh thereunder to enjoy its former liberty which it possest before the drawing up and so in fine by nature's assistance the wound may be the more easily agglutinated CHAP. XXII How you must stop the bleeding if any of the bound-up vessels chance to get loose THe business hitherto being performed as we said if peradventure it happen that any bandage of any of the vessels be unloosed then must you again bind the member with that kind of Ligature which you did before the amputation thereof Or else which is better more easie and less painful let your servant take hold of the member with both his hands pressing his fingers strait stop the passage of the loosed vessell for so he may stanch the bleeding Then
Cathaereticks which is excellent in these kinds of Wounds whether by it self or mixed with others You shall use these and such like even unto the perfect agglutination and cicatrization of the wound and you may of your self devise other things such as these as occasion shall offer its self CHAP. XXIV What just occasion moved the Author to devise this new form of remedy to stanch the blood after the amputation of a member and to forsake the common way used almost by all Chirurgeons which is by application of actual Cauteries VErily I confess I formerly have used to stanch the bleeding of members after amputation Hot Irons not to be used after another manner than that I have a little before mentioned Whereof I am ashamed and agrieved But what should I do I have observed my masters whose method I intended to follow alwayes to doe the like who thought themselves singularly well appointed to stanch a flux of blood when they were furnished with various store of hot Irons and caustick medicins which they would use to the dismembred part now one then another as they themselves thoâ—ght meet Which thing cannot be spoken or but thought upon without great horror much less acted For this kind of remedy could not but bring great and tormenting pain to the Patient seeing such fresh wounds made in the quick and sound flesh are endured with exquisite sense Neither can any caustick be applyed to nervous bodies but that this horrid impression of the fire will be presently communicated to the inward parts whence horrid symptoms ensue and oft-times death it self And verily of such as were burnt the third part scarce ever recovered and that with much adoe for that combust wounds difficultly come to cicatrization for by this burning are caused cruel pains whence a Feaver Convulsion and oft-times other accidents worse than these Add hereunto that when the eschar fell away oft-times a new haemorrhage ensued for stanching whereof they were forced to use other caustick and burning Instruments Neither did these good men know any other course so by this repetition there was great loss and waste made of the fleshy and nervous substance of the part Through which occasion the bones were laid bare whence many were out of hope of cicatrization being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembred which also took away the opportunity of fitting or putting to of an artificial leg or arm instead of that which was taken off Wherefore I must earnestly entreat all Chirurgeons that leaving this old and too too cruel way of healing they would embrace this new which I think was taught me by the special favour of the sacred Deity for I learnt it not of my masters nor of any other neither have I at any time found it used by any Only I have read in Galen Lib. 5. Meth. that there was no speedier remedy for stanching of blood than to binde the Vessels through which it flowed towards their roots to wit the Liver and Heart This precept of Galen of binding and sowing the Veins and Arteries in the new wounds when as I thought it might be drawn to these which are made by the amputation of members I attempted it in many yet so that at first in my budding practice thereof I alwayes had my Cauteries and hot Irons in a readiness that if any thing hapned otherwise then I expected in this my new work I might fetch succour from the ancient practice untill at length confirmed by the happy experience of almost an infinite number of particulars I bid eternally adieu to all hot Irons and Cauteries which were commonly used in this work And I think it fit that Chirurgeons do the like For antiquity and custom in such things as are performed by Art ought not to have any sway authority or place contrary to reason as they oft-times have in civil affairs wherefore let no man say unto us that the Ancients have alwayes done thus CHAP. XXV The practice of the former precepts is declared together with a memorable history of a certain Souldier whose Arm was taken off at the Elbow I Think it fit to confirm by an example the prescribed method of curing a Gangrene and Mortification A History Whilest I was Chirurgeon to the Marshall of Montejan at Turin a certain common souldier received a wound on his wrist with a musket-bullet by which the bones and tendons being much broken and the nervous bodies cruelly torn there followed a Gangrene and at length a mortification even to the Elbow besides also an inflammation seised upon the middle part of his Chest and there was as it were a certain disposition to a Gangrene whereby it followed that he was painfully and dangerously troubled with belchings hicketings watchings unquietnesse and frequent swoundings which occasioned many Chirurgeons to leave him as desperate But it so fell out that I orecome by his friends intreaty undertook the cure of this wretched person destitute of all humane help Wherefore knowing the mortification by its signs I cut off the arm by the Elbow as speedily as I could making first the ligature whereof I made mention I say I took it off not with a saw Dismembring at a joynt but only with an incision-knife cutting in sunder the ligaments which held the bones together because the sphacell was not passed the joynt of the Elbow Neither ought this section to be counted strange which is made in a joint for Hippocrates much commends it Sect. 4. Lib. de Art and saith that it is easily healed and that there is nothing to be feared therein besides swounding by reason of the pain caused by cutting the common tendons and ligaments But such incision being made the former ligature could not hinder but much blood must flow from thence by reason of the large vessels that run that way Wherefore I let the blood to flow plentifully so to disburden the part and so afterwards to free it from the danger and fear of inflammation and a Gangrene then presently I stanched the blood with an hot Iron for as yet I knew no other course Then gently loosing the ligature I scarified that part of the brawn of the Arm which was gangrenated with many and deep incisions shunning and not touching the inner part by reason of the multitude of the large vessels and Nerves which run that way then I presently applyed a cautery to some of the incisions both to stanch the bleeding and draw forth the virulent sanies which remained in the part And then I assailed and overcame the spreading putrefaction by putting and applying the formerly prescribed medicins I used all sorts of restrictive medicins to stay the inflammation of the Chest I also applyed Epithemaes to the region of the heart and gave him cordiall potions and boles neither did I desist from using them untill such time as his belching hicketting and swoundings had left him
who have not halted during the rest of their lives Why those halt who have had this bone fractured The cause hereof is the knitting by the concretion of a Callus hinders the free bending of the knee going especially on even ground is more easie to the Patient but an ascent is far more difficult and absolutely painfull The Patient must necessarily for this kinde of fracture lye or keep his bed at the least for forty dayes CHAP. XXIII Of a broken Leg. Sent. 65. sect 2. de fract THis kind of fracture is cured after the same manner as that of the arm or cubit Hippocrates admonisheth us that the Tibia or leg-bone is more dangerous to be broken and more difficult and slow to be healed than the Fibula or shin-bone because that is the thicker and as it were the upholder of the whole bulk of the body but this other is but as it were a certain additament or assistant provided for the staying or bearing up of the muscles of the leg by which the foot is moved The leg-bone being only broken the signs thereof are perceived only in the inner part of the leg for that the shin-bone being whole suffers it not to throw or cast forth it self On the contrary when the shin-bone only is broken the signs thereof appear only in the external part of the leg because the leg-bone being opposed thereto Signs that both the bones are broken doth not suffer it to cast in its self and with its fragments to turn inwards But when both the bones are broken the signs of the fracture may equally appear both here and there But when only one of these bones are broken the fracture is far more easie to dress and heal because that which remains whole is a much more firm stay to that which is hurt than any splints can be But that I may the better instruct and make ready the Surgeon for the restoring of this fracture A History I will illustrate the matter by an example from my self John Nestor Doctor of Physick Richard Hubert and I went together to visit a Patient at the place of the Frier Minorites Wherefore intending to pass over the Sein within sight of the place I endeavoured to make my horse take boat and therefore switched him over the buttocks The Jade madded herewith so struck at me with his heels that he brake both the bones of my left leg some four fingers breadth above my ankle Then I fearing some worse mischief and lest the Jade should double his blow flew back and as I fled back the broken bones flew in sunder and breaking through the flesh stocking and boot shewed themselves whereby I felt as much pain as it is credible a man was able to endure Wherefore I was presently carried into the boat that so I might be carryed to the other side of the water to be dressed but the stirring of the boat as they rowed almost killed me with bitterness of pain for that the sharp fragments of the bones were rubbed against the flesh which lay next them Being ferried over as I was conveyed into the next houses my pain was much increased whilest lifted by the hands of divers persons one while up another down sometimes to the left side other whiles to the right with my whole body and all the parts thereof When at the length I was laid upon a bed I was somewhat freed from the bitterness of my pain A soon made medicine and had time to wipe off the sweat which ran down over all my body Then was I dressed with such a medicine as the time and place would afford we composed it of the white of an egge wheat-flour soot of a chimny and melted butter For the rest I entreated Richard Hubert that he would handle me as if he knew me not neither that moved for love of me he should remit any thing of the severity of art but chiefly that he would stretch my foot straight out What to doe when the leg 〈◊〉 broken and if the wound were not sufficiently wide that he would inlarge it with his incision-knife that so he might the more easily set the broken bones in their due place that he would with his fingers whose judgement is far more certain than the best made instruments search whether the splinters which were in the wound were quite severed from the bone and therefore to be taken forth that he would with his hand press forth the blood and the clods of blood which were in a great quantity concrete at the mouth of the wound that he would bind up and place my leg in that site and manner as he thought best which is that he would have three rowlers in a readiness the first whereof he should cast directly upon the wound so that he should begin his ligation at the wound also he should put splints about it some three but others two fingers breadth of the length of half a foot somewhat depressed and hollowed whereby they might be the more easily put about the leg more straitly at their ends and a fingers distance each from other which at the last he should bind with fillets like those wherewith women use to binde up their hair yet so that the binding might be more strait upon the wound and that he would fill the cavity of the ham and of the ancles with boulsters made of flax wrapped in linnen clothes that he would fortifie the sides of my leg with Junks made of bents or little sticks and lined with linnen cloth stretched from my heel to my groin and bound over in four places so that the straight figure of the leg might scarcely be perverted by any force that he would gently and smoothly lift up my leg to an indifferent The figure of a Leg fractured with a wound and bound up height and lastly that he should arm it from the violence of external injuries by putting it in a box or case But you must note that the fit placing or laying of the leg is a matter of such moment that â—f any error be here committed it will cause no less than lameness For if it be lifted up higher than is fit the Callus will be hollow on the foreside if lower then it will be gibbous or bunching forth Neither also do they commit a small error who do not fill up the cavities at the ancles after the afore-mentioned manner for hereupon the heel will be much afflicted whilest it is forced to sustain a tedious and painfull compression which at length brings a hot distemper because the spirits cannot freely flow thereto which I finding by experience not knowing the cause wished them ever now and then to lift up my heel whereby it might enjoy the benefit of perspiration and the spirits have free entrance thereinto and the contained vapours passing forth To conclude my hurt leg was laid upon a cushion after the manner you see here described CHAP. XXIV Of some
turpentine A detersive and a little wheat flower and I used it until it was opened then to cleanse it I used this following remedy ℞ syrupi rosati terebinth venetae an ℥ ii pulveris radicis ireos florentiae aloes mastiches farinae hordei an ʒ ss incorporentur omnia simul fiat mundificativum but I had a care that the place whereat I conjectured the quite severed scales of the bones must break forth should be filled with tents made of sponge or flax that so by this means I might keep the ulcer open at my pleasure Catagmatick powders have power to cast forth the scales of bones But I put into the bottom of the ulcer catagmatick and cephalick powders with a little burnt alum to procure the egress of the formerly mentioned scales These at length cast forth I cicatrized the ulcer with burnt alum For this having a drying and astringent faculry confirms and hardens the flesh which is loose and spongy and flowing with liquid sanies and helps forward natures endeavour in cicatrization For the fragments of the bones they by reason of their natural driness and hardness cannot be joyned and knit together by themselves without a medium but they need a certain substance which thickning and concreting at their ends doth at length glue them together The causes both efficient and material of a Callus and as it were fasten them with soder This substance hath its matter of the proper substance and marrow of the bones but the former from the native hear and emplastick medicines which moderately heat For on the contrary these medicines which by their too much heat do discuss and attenuate do as it were melt and dissolve the matter of the Callus and so hinder the knitting Wherefore for this purpose I would wish you to make use of the following emplasters of whose efficacie I have had experience for hence they are called knitting or consolidating plasters Medicines conducing to the generation of a Callus ℞ olei myrtil rosarum omphac an lb. ss rad altheae lb. ij rad fraxini fol. ejusdem rad consolidae majoris fol. ejusdem fol. salicis an m. j. fiat decoctio in sufficiente quantitate vini nigri aquae fabrorum ad medietatis consumptionem adde in colaturâ pulveris myrrhae thuris an ℥ ss adipis hirci lb. ss terebinth lotae ℥ iv mastichesʒ iij. lithargyri auri argenti an ℥ ij boli armeniae terrae sigillatae an ℥ i. ss miniiʒ vi cerae albae quantum sufficit fiat emplastrum ut artis est In stead hereof you may use the black emplaster whereof this is the description The black plaster ℞ lithargyri auri lb. j. olei aceti lb ij coquantur simul lento igne donec nigrum splendens reddatur emplastrum non adhaereat digitis Or else ℞ olei rosat myrtill an ℥ ij nucum cupressi boli armen sanguinis drac pulverisatorum an ℥ ss emplastri diachalcitheos ℥ iv liquefaciant simul fiat emplastrum secundum artem The Description of a Sparadrapum or Cere-cloth In defect of these you may use a Cere-cloth or tela Gualteri whereof this is the description ℞ pulveris thuris farinae volatilis mastiches boli arm resinae pini nucum cupressi rubiae tinctorum an ℥ ij sevi arietini cerae albae an lb ss fiat emplastrum into which whilest it is hot dip a warm linnen cloth for the forementioned use Emplastrum Diacalcitheos by the common consent of all the Ancients is much commended for fractures but it must undergo different preparations according to the condition of the time for in the Summer it must be dissolved in the juice of Plantain and Night-shade lest it should heat more than is fit It is convenient in the interim to have regard to the temper of the affected bodies for neither are the bodies of children to be so much dried as these of old men otherwise if such drying medicines should be applied to young bodies as to old the matter of the Callus would be dissolved it would be so far from concreting wherefore the Surgeon must take great heed in the choice of his medicines Medicins good of themselves not good by event For oftentimes remedies good of themselves are by use made not good because they are used and applyed without judgment which is the cause that oft-times pernicious accidents happen or else the Callus becomes more soft hard slender crooked or lastly concretes more slowly by the great error and to the great shame of the Surgeon CHAP. XXVIII By what means we may know the Callus is a breeding When the Callus is breeding the ulcer must be seldom drest THen I knew that my leg begun to knit when as less matter than was usual came from the ulcer when the pain slackned and lastly when as the convulsive twitchings ceased which caused me to judge it fit to dress it seldomer than I was used to do For by the frequent detersion in dressing an ulcer whilest a Callus is breeding the matters whereof it is to be made are drawn away and spent which are as they term them Ros Cambium and Gluten which are the proper and genuine nourishments both of the bony as also of the fleshy substance I by other signs also conjectured the breeding of the Callus to wit by the sweating of a certain dewie blood out of the edges and pores of the wound which gently died and bedewed the boulsters and ligatures Hipp. sent 43. sect 1. de fract proceeding from the efflux of the subtler and gentler portion of that matter which plenteously flowed down for the breeding of a Callus As also by a tickling and pleasing sense of a certain vapour continually creeping with a moderate and gentle heat from the upper parts even to the place of the wound Wherefore thenceforwards I somewhat loosened the ligation lest by keeping it too strait I should hinder from entring to the fragments of the bones the matter of the Callus which is a portion of the bloud temperate in quality and moderate in quantity Then therefore I thought good to use nourishments fit to generate more gross thick Meats fit for generating a Callus and tenacious bloud and sufficient for generating a Callus such as are the extremities tendinous and grisly parts of beasts as the heads feet legs and ears of Hogs Oxen Sheep Kids all which I boiled with Rice French Barley and the like using somewhiles one somewhiles another to please my stomach and palate I also sometimes fed upon frumity or wheat sodden in Capon broth with the yolks of eggs I drank red thick and astringent wine indifferently tempered with water For my second course I ate chesnuts and medlars neither do I without some reason thus particularize my diet for that gross nourishments especially if they be friable and fragil as Beef is are alike hurtful
horny coat being relaxed or thrust forth by the violence of the pustule generated beneath It in shape resembleth a grape whence the Greeks stile it Staphyloma This tumor is sometimes blackish otherwhiles whitish For if the horny coat be ulcerated and fretted in sunder so that the grapy coat shew it self fall through the ulcer then the Staphyloma will look black like a ripe grape for the utter part of the Vvea is blackish But if the Cornea be only relaxed not broken then the swelling appears of a whitish colour like an unripe grape Paulus and Aetius The Antients have made many kinds or differences thereof For if it be but a smal hole of the broken Cornea by which the Vvea sheweth or thrusteth forth it self then they termed it Myccephalon that is like the head of a flie But if the hole were large and also callous they called it Clavus Every Slaphiloma infers incurable blindness or a nail if it were yet larger then they termed it Acinus or a grape But in what shape or figure soever this disease shall happen it bringeth two discommodities the one of blindness the other of deformitie Wherefore here is no place for Surgerie to restore the sight which is already lost but onely to amend the deformitie of the eye which is by cutting off that which is prominent But you must take heed that you cut away no more then is fit for so there would be danger of pouring out the humours of the eye CHAP. XVII Of the Hypopyon that is the suppurate or putrified eye PVS or Quitture is sometimes gathered between the hornie and grapie coat from an internal or external cause From an internal as by a great defluxion The cause and oft-times after an inflamation but externally by a stroke through which occasion a vein being opened hath poured forth bloud thither which may presently be turned into Quitture For the cure universal remedies being premised cupping glasses shall be applied with scarifications and frictions used Anodine and digestive collyria shall be poured from above downwards Galen writes that he hath sometimes evacuated this matter Lib. 14. method cap. ult the Cornea being opened at the Iris in which all the coats meet concur and are terminated I have done the like and that with good success James Guillemeau the Kings Surgeon being present the Quitture being expressed and evacuated after the apertion The Ulcer shall be cleansed with Hydromel or some other such like medicine CHAP. XVIII Of the Mydriasis or dilatation of the Pupil of the Eye MYdriasis is the dilatation of the pupil of the eye The Cause and this happeneth either by nature or chance the former proceedeth from the default of the first conformation neither is it cureable but the other is of sorts for it is either from an internal cause the off-spring of an humour flowing down from the brain wherefore Physical means must be used for the cure thereof The cure Now that which cometh by any external occasion as a blow fall or contusion upon the eye must be cured by presently applying repercussive and anodine medicines the defluxion must be hindered by diet skilfully appointed phlebotomie cupping scarification frictions and other remedies which may seem convenient Then must you come to resolving medicines as the bloud of a Turtle-dove Pigeon or chicken reeking-hot out of the vein being poured upon the eye and the neighbouring parts Then this following cataplasm shall be applied thereto A digesting Cataplasm â„ž farinae fabar hordei an â„¥ iij. ol rosar myrtillor an â„¥ j. ss pul ireos flor Ê’ij cum sapa fiat cataplasm You may also use the following fomentation â„ž rosar rub myrtyl an m.j florum melil chamaem an p.j. nucum cupress â„¥ j. vini ansteri lb ss aq rosar plantag an â„¥ iij. make a decoction of them all for a fomentation to be used with a sponge CHAP. XIX Of a Cataract A Cataract is called also by the Greeks Hypochima by the Latines suffusio A Cataract Howsoever you term it it is nothing else but the concretion of an humour into a certain thin skin under the hornie coat just against the apple or pupil and as it were swimming upon the waterie humour and whereas the place ought to be emptie opposing it self to the internal faculty of seeing whereby it differeth from spots and scars growing upon the hornie coat and Adnata It sometimes covereth the whole pupil The differences otherwhiles but the one half thereof and somewhiles but a small portion thereof According to this varietie the sight is either quite lost weak or somewhat depraved because the animal visive spirit cannot in its entire substance pass through the densitie thereof Causes The defluxion of the humour whence it proceeds is either caused by an external occasion as a stroke fall or by the heat or coldness of the encompassing air troublesome both to the head and eyes or else it is by an internal means as the multitude or else the acrid hot and thin quality of the humours This disease also sometimes taketh its original from gross and fumid humours sent from a crude stomach or from vaporous meats or drinks up to the brain and so it falleth into the eyes where by the coldness straitness and tarrying in the place they turn into moisture and at length into that concretion or film which we see The signs may be easily drawn from that we have already delivered Signs For when the cataract is formed and ripe it resembleth a certain thin membrane spred over the pupil and appeareth of a different colour accorcing to the variety of the humor whereof it consisteth one while white another while black blue ash-coloured livid citrine green It sometimes resembleth quick-silver which is very trembling and fugitive more than the rest At the first when it beginneth to breed they seem to see many things as flyes flying up and down hares nets and the like as if they were carelesly tossed up and down before their eyes sometimes every thing appeareth two and somewhiles less than they are because the visive spirit is hindred from passing to the objects by the density of the skin like as a cloud shadowing the light of the Sun Whence it is that the patients are duller fighted about noon and surer and quicker sighted in the morning and evening for that the little visive spirit diffused through the air is dispersed by the greater light but contracted by the less Now if this film cover half the pupil then all things shew but by halfs but if the midst thereof be covered and as it were the centre of the chrystalline humor then they seem as if they had holes or windows but if it cover at all then can he see nothing it all but only the shadows of visible bodies and of the Sun Moon Stars lighted cancles and the like luminous things and that but confusedly and as
sit The figure of a Chair for a Semicupium A. Sheweth the whole frame of the Chair B. The hole wherein the patient must sit C. The Cistern that holds the water D. A Cock to empty the water when it groweth cold E. A Funnel whereby to pour in warm water There may also bee another decoction made for the bath as thus ℞ rad raph alib an lb. ii rad rusc petrosel asparag an lb. i. cumin foenicul ameos an ℥ iiii sem lini faenug anʒvi fol. marub parietar florum chamaem melil anethi an m. ii bulliant omnia secundum artem in aquae sufficienti vini albi odoriferi exigu â quantitate ad consumptionem tertiae partis pro Semicupio Also the same decoction may be used for glisters adding thereto two yolks of eggs and four ounces of oil of lillies with ʒi of oil of juniper which hath a certain force to asswage the pain of the stone and collick But a far less quantity of the decoction in a glyster must be used in these diseases than usually is appointed in other diseases otherwise there will be danger lest the guts being distended should more press upon the kidnies and ureters troubled in some sort with inflammation and so increase the pain and other symptoms This following cataplasm shall be profitably applyed to the grieved place to wit the loins or flanks and bottom of the belly for it is very powerful to asswage pain and help forwards the falling down of the stone An anodine Cataplasm ℞ rad alth raphani an ℥ iiii pariet foenic. senicionis nasture berul an m. i. herniariae m. ss omnibus in aquâ sufficienti decoctis deinde contritis adde clei aneth chamaem pingued cuniculi an ℥ ii farin cicer quantum sufficit-fiat cataplasma ad usum praedictum Signs of the stone fallen out of the ureter into the bladder After by these means the stone forced out of the ureter is fallen into the bladder the pain presently if there be but one stone for sometimes more with much gravel do again fall into the ureter is mitigated and then the patient is troubled with an itching and pricking at the end of his yard and fundament Therefore then unless he be very weak it is fit that he ride and walk a foot and take ʒiv of species Lithontribon in four doses with white wine or the broth of red Cicers three hours before dinner and supper Besides let him plentifully drink good wine and after he hath drunk let him hold in his urine as long as he can that so it being gathered in great plenty it may presently thrust the stone out of the bladder with the more force for which purpose you may also inject the following liquor into the bladder ℞ syrupi capill ven ℥ i. aquae alkekengi ℥ iii. oleo scorpionum ℥ ss Let it be injected into the bladder with a syringe CHAP. XXXIX What must be done the stone being fallen into the neck of the bladder or passage of the yard AFter the stone is fallen out of the capacity of the bladder and stops in the neck thereof or passage of the yard the Surgeon shall have a special care that he do not force or thrust back the stone from whence it came but rather that hee presse it gently with his fingers to the end of the yard the passage being first made slipperie by injecting some oil of sweet almonds But if it stop in the end of the Glans it must be plucked out with some crooked instrument to which if it will not yeeld a Gimlet with a pipe or case thereto shall bee put into the passage of the yard and so it shall bee gotten out or els broken to pieces by the turning or twining about of the Gimblet which I remember I have divers times attempted and don for such Gimblets are made with sharp scrues like ordinary gimblets The delineation of a Gimblet made to break the stones in the passage of the yard together with its pipe or case The effigies of another lesser Gimblet Verily what Gimblets soever are made for this business their bodie or poin◠must bee no thicker then a small probe least whil'st thay are forced or thrust into the Vrethra or urinarie passage they might hurt the bodies next unto them by ther violent entrance CHAP. XL. What cours must bee taken if the stone sticking in the Urethra or urinarie passage cannot bee gotten out by the fore-mentioned arts BUt if the stone bee more thieck hard rough and remote from the end of the yard than that it may bee gotten out by the means formerly mentioned in the precedent Chapter and if that the urine bee wholly supprest therewith then must you cut the yard upon the side with a straight wound When the yard may bee safely cut for you must not make incision on the upper part for fear of a flux of blood for a large vein and arterie lieth there-under nor in the lower part for so it would scarce ever heal again for that it is a bloodless part and besides the continual and acrid falling of the urine would hinder the agglutination wherefore the incision must bee made on the side on that part whereas the stone most resist's and swels out For that part is the more fleshie yet first the end of the skin of the prepuce must bee much drawn up so to cover the Glans which beeing don the Vrethra shall bee tied with a thred a little above the stone that so the stone may bee staied there and may not fall back again Therefore then incision beeing made the stone must bee taken forth and the skin which was drawn more violently to cover the Glans is to bee let go back again for so it will com to pass that a whole part of the skin may cover the cut-yard and so it may bee more the speedily united and the urine may naturally flow out I have by this means oft-times taken forth the stone with the instruments here delineated Instruments fit to take the stone forth of the opened Urethra or urinarie passage of the yard Then for the agglutination if need require it will bee requisit to sow up the lips of the wound An agglutinative medicine and applie this agglutinative medicine following ℞ tereb venet ℥ iiii gum elemi ℥ i. sang dracon mastic an ʒ ss fiat medicamentum ut dictum est then the whole yard must bee covered over with a repercussive medicine made of the whites of eggs with the pouder of bole armenick aloës farina volatilis and oil of roses Lastly if need so require a wax-candle How to hasten the agglutination or leaden string anointed with Venice turpentine shall bee thrust into the Vrethra to hasten the agglutination and retain the natural smoothness and straightness of the urinarie passage least peradventure a a caruncle grow therein CHAP. XLI What manner of section is to bee made when a
Therefore it must bee made the space of two fingers from the fundament Where to make the wound to take forth the stone That which is torn sooner healeth then that which is cut according to the straightness of the fibres that so it may bee the more easily restored afterwards Neither must the incision thus made exceed the bigness of ones thumb for that it is afterwards enlarged by putting in the Crow's beak and the dilater but more by the stone as it is plucked forth But that which is cut is neither so speedily nor easily healed up as that which is torn Then presently put into the wound som one of these silver instruments delineated here below and called by the name of Guiders for that thay serv as guides to the other instruments which are to bee put into the bladder these are made with a round and prominent head whereby it may bee put into the described cavitie of the probe and they are noted by these letters A. A. then there are others marked with the letters B. B and called by the like name and are to bee put under the former beeing made forked at the end that so it may as it were embrace the end of the former The figures of Guiders of two sorts Now the probe is to bee drawn forth and the guiders to bee thrust and turned up and down in the bladder and at length to bee staied there by putting in the pin yet such guiders as want a pin are fitter for the hand and are by som called spatbae Then must they bee held betwixt the Surgeon's fingers It will bee also necessarie for the Surgeon to put another instrument called the D cks-bill between the two guiders into the capacitie of the bladder hee must thrust it in somwhat violently and dilate it so thrust in with both his hands turning it everie way to enlarge the wound as much as shall bee sufficient for the admitting the other instruments which are to bee put into the bladder yet it is far better for the patiâ—nt if that the wound may with this one instrument bee sufficiently dilated and the stone pulled forth with the same without the help of anie other The effigies of an instrument called a Ducks-bill Which if you have not in a readiness and the largness of the stone require more dilatation then must you put in this dilater for beeing put into the bladder and the handle pressed together it will dilate the incision as much as you desire The figure of a Dilater shut and opened The wound by the help of this instrument beeing dilated as much as is sufficient then putt in the straight Ducks-bill before described or the crooked here exprest Crooked Forcipes's like a Ducks-bill The stone may bee sought and taken hould of with these instuments and beeing taken hold on the branches of the instrument shall bee tied together least they should suffer that to slide away which they have once taken hold of Neither shall the stone bee suddenly plucked out but easily shaken to and again and at length gently drawn forth Yet you must beware that you do not press it too straightly in the forceps least you should break it in pieces Som least it should slip away when they have once taken hold thereof put their two fingers into the fundament and put them about the stone that it may not fall out nor slip back again which I think conduceth much to the easie extraction of the stone There are others who strengthen this comprehension by putting in on each-side above and below these winged instruments so that the stone can slip forth on no side Winged instruments to hold the stone with the Duck's-beak The figure of another The figure of another winged instrument the end of whose handle is fastned by a scrue as also a bended iron-plate which is marked with this letter A. for the firmer holding thereof A note of more stones than one After the stone is by these means drawn forth observ diligently whether it beee worn on anie side and as it were levigated for that happeneth by the wearing or rubbing of one or more stones upon it yet there is no surer way to know this than by searching with a Catheter The one end of the following instrument may supplie the want of a Catheter or probe and the other may serv for a scoop or clenser A cleanser or scoop whereby you may search whether there bee anie more stones behinde as also clense or purge the bladder from gravel clots of blood and other such bodies as use to remain behinde after the drawing forth of the stone For if other stones remain behinde thay shall bee drawn forth as the former which beeing don the end oft the instrument which is crooked and hollowed like a scoop or spone How to clens the bladder shall bee thrust by the wound into the bladder and therewith you shall gather together and take out what gravel soever clotted blood and the like refuse as shall bee there for that they may yeeld matter for another stone How to break a stone that cannot bee taken out whole and at once But if you finde that the stone which is in the bladder bee too great so that it may not bee plucked forth without great and fearful rending of the bladder it will bee better to take hold thereof with this Crows bill and so break it to peeces The effigies of a toothed Crow's-bill made neatly to break greater stones with a screw to force it together This Crows-bill hath onely-three teeth and those sharp ons on the inside of which two are placed above and one below which is the middle-most so that it falleth between the two upper When the stone is broken all the peeces therof must bee taken forth and wee must have a special care lest any peece thereof lie hid for that in time increased by the access of a tough and viscuous matter or conjoined with other fragments by the intersition of the like matter as glew may rise to a stone of a large bigness CHAP. XLIII What cure must bee used to the wound when the stone is taken forth THe stone being drawn out if the greatness of the wound so require Of sewing the wound when the stone is taken forth it shall have one or two stitches with a needle and threed leaving only so much space as shall bee sufficient to put in a pipe for the use wee shall hereafter shew your threed must bee of crimson silk waxed and let it not bee too small least it by bindeing should cut asunder the fleshie lips of the wound or rot in a short time either by the moisture of the urine or matter flowing from the ulcer Therefore you shall take up much flesh with the skin in sewing it least the lips of the wound beeing torn your labor proov in vain and so you are forced to trouble the patient with makeing a new one Things beeing thus
performed a silver pipe shall bee put through the wound into the bladder whereof I have here given you divers forms that you may take your choice and so fit them to the wounds and not â—he wounds to them which oft-times in want of instruments the Surgeons are forced to do to the great harm of the patient Silver pipes to bee put in the bladder when the stone is drawn out These must have no holes in their sides as those here expressed but only in their ends that all the matter of the wound and the filth gathered and concrete in the bladder may flow and bee carried forth this way When cleer urine shall begin to flow out of the wound there shall bee no more need of a pipe therefore if you continue it and keâ—p it longer in the wound there is som danger least nature accustomed to that way may afterwards neglect to send the water through the Vrethra or urinarie passage Neither must you forget to defend the parts near to the wound with the following repercussive medicine to hinder the defluxion and inflammation which are incident by reason of the pain â„ž album ovorum an iii. pulboli armeni A repercussive medicine sanguinis dracon an â„¥ iii. olei ros â„¥ i. pilorum leporinorum quantum sufficit make a medicine of the consistence of honey CHAP. XLIV How to lay the patient after the stone is taken away ALl things which wee have recited beeing faithfully and diligently performed the patient shall be placed in his bed laying under him as it were a pillow filled with bran or oat chaff to drink up the urine which floweth from him You must have divers of these pillows Remedies for the Cod least it gangrenate that thay may bee changed as need shall require Somtimes after the drawing forth of the stone the blood in great quantity falleth into the Cod which unless you bee careful to provide against with discussing drying and consumeing medicines it is to bee feared that it may gangrenate Wherefore if anie accident happen in cureing these kinde of wounds you must diligently withstand them After som few daies a warm injection shall bee cast into the bladder by the wound consisting of the waters of plantain night shade and roses with a little syrup of dried roses It will help to temper the heat of the bladder caused both by the wound contusion as also by the violent thrusting in of the instruments Also it somtimes happen's that after the drawing forth of the stone clots of blood and other impuritie may fall into the urinarie passage and so stop the urine that it cannot flow forth Therefore you must in like sort put a hollow probe for som dais into the urethra that keeping the passage open all the grosser filth may flow out together with the urine CHAP. XLV How to cure the wound made by the incision What things hasten the union YOu must cure this wound after the manner of other bloodie wounds to wit by agglutination and cicatrization the filth or such things as may hinder beeing taken away by detergent medicines The patient shall hasten the agglutination if hee lie cross-legged keep a slender diet untill the seventh or ninth day bee past Hee must wholly abstain from wine unless it bee verse weak in stead thereof let him use a decoction of barly and licorish or mead or water and suger or boiled water mixed with syrrups of dried roses maidenhair and the like Let his meat bee panado raisons stewed prunes chickens boiled with the cold seeds purslain sorrel borage spinage and the like If hee bee bound in his belly a Physician shall bee called who may help it by appointing either Cassia a glyster or som other kinde of medicines as hee shall think good CHAP. LVI What cure is to bee used to Vlcers when as the urine flow's through them long after the stone is drawn out MAnie after the stone is drawn out cannot have the ulcer consolidated therefore the urine flow's out this way continually by little and little and against the patient's wil dureing the rest of his life unless the Surgeon help it How to make a fresh wound of an old ulcer Therefore the callous lips of the wound must bee amputated so to make a green wound of an old ulcer then must they bee tied up bound with the instrument wee term a Retinaculum or stay this must bee perforated with three holes answering to three other on the other side needles shall bee thrust through these holes taking hold of much flesh shall bee knit about it then glutinative medicines shall bee applied such as are Venice Turpentine gum Elemi sanguis draconis bole armenick and the like after five or six daies the needles shall bee taken out and also the stay taken away For then you shall finde the wound almost glewed and there will nothing remain but onely to cicatrize it The figure of a Retinaculum or stay A. shew's the greater B. the lesser that you may know that you must use divers according to the different bigness of the wound If a Retinaculum or stay bee wanting you may conjoin the lips of the wound What to do in want of a stay after this following manner Put two quills somwhat longer than the wound on each side one and then presently thrust them through with needles haveing thred in them takeing hold of the flesh between as often as need shall require then tying the thred upon them For thus the wound shall bee agglutinated and the fleshie lips of the wound kept from beeing torn which would bee in danger if the needle and thred were onely used CHAP. LVII How to take stones out of women's bladders WE know by the same signs that the stone is in a woman's bladder as wee do in a man's yet it is far more easily searched by a Catheter How to search for the stone in women for that the neck of the bladder is the shorter broader and the more straight Wherefore it may not onely bee found by a Catheter put into the bladder but also by the fingers thrust into the neck of the womb turning them up towards the inner side of the Os pubis and placeing the sick woman in the same posture as wee mentioned in the cure of men Yet you must observ that maids yonger then seven yeers old that are troubled with the stone cannot bee searched by the neck of the womb without great violence Therefore the stone must bee drawn from them by the same means as from boies to wit by thrusting the fingers into the fundament for thus the stone beeing found out and the lower bellie also pressed with the other hand it must bee brought to the neck of the bladder and then drawn forth by the forementioned means Yet if the riper yeers of the patient permit it to bee don without violence the whole work shall bee more easily and happily performed by putting the
Cauteries fit in all necessary cases of all parts Other Cauteries Other Cauteries for the same purpose The following figure of a Cautery is fit for virulent knots that arise in the scull when you desire to take away the flesh that covers the bone for this purpose it is made hollow and sharp in a triangular and quadrangular form divided as it were into three branches that you may so make use of which you please The figure of an hollow and cutting Cautery Actual Cauteries with their Pipes Great discommodities ensue upon too rash that is too frequently applyed Caureries or too long adhering to the bone for by this immoderate and fiery heat not only the excrementitious humidity of the rotten bone is consumed but also the radical and substantial moisture of the part is exhausted wherein alone nature endeavouring to cast off the corrupt scales and sever the sound from the rotten bone and to substitute flesh stands and consists Whereof Manner of applying of Cauteries the measure of applying of Cauteries ought to be taken from the greatness of the rottenness and the excrementitious or after a manner foming humidity sweating through the pores of the bone But before you press your Cautery into the rotten bone which lies very deep in as that which happens in the thigh-bone and upon other very fleshie parts you must diligently defend the neighbouring sound and fleshie part as it were with a covering for that the humor diffused by the touch of the fire burns the other places whereunto it diffuseth it self like scalding oyl After the cauterization you must help forwards the falling away of the scales by sometimes dropping in our oyl of Whelps being made scalding hot Oyl of Whelps helps forwards the casting off of scales This oyl though very fit for this purpose yet do I not judge it fit to use it too often it may suffice to have dropped it in some twice or thrice For at length it may violate the sound bone that lies under the rotten by the oyly subtil and moist substance Furthermore a bone is the most dry part of the body therefore unctuous and moist medicines are contrary to its temper and consistence But it conduceth often and gently to move the scales already beginning to seperate themselves and it hastens the slackness of nature in casting them off Yet may you not use force unless peradventure when as they hang as it were by a slender thread otherwise if the unwary Surgeon forcibly pluck away the scales before that nature hath put a cover upon the sound bone A caution in moving the scales of burnt bones he shall give way to a new alteration and fowlness by the appulse of the air Furthermore after the corrupt scale is falling off by the force of nature expelling it you must have a diligent heed that you put not eating or corroding medicines upon the bone that is under it for thus thou shalt consume or wast the flesh which nature hath generated thereupon which composed of newly concreted bloud is like in softness to newly curdled milk which otherwise in time would grow into a more solid and hard consistence This under-growing flesh by little and little thrusts the rotten bone above it out of its place and is the cause of the scaling thereof it is at the first gathered together like the grains of a pomgranate with a red smooth and equal sanies and not stinking and at length it casts forth a white matter Therefore then we must rather strew thereon Cephalick powder composed of such things as have a faculty to drie without biting such as are Orris-roots washed aloes Cephalick powders of what composed mastich myrrh barly-flower and the like Lastly it must be cicatrized it is better that scales of bones fall away of themselves by the only force of nature then to be plucked away by the force of medicines or instruments because such as are too violently and forcibly plucked away leave corners like to fistulous ulcers Neither ought the corrupted membranes when they are turned into pus to be plucked away too violently or to be touched by too acrid medicines for pain hereupon arising hath divers times caused inflammation convulsion and other pernicious symptoms Therefore it is better to commit this business to nature which in success of time by making use of the expulsive faculty will easily free it self from this rotten substance for that which is quick as far as it is able will still put away that which is dead from it CHAP. XXVIII Of a Vulnerary potion BUt if the contumacious rottenness of the bone and also a rebellious ulcer shall not yield to the described remedies it will be convenient to prescribe a vulnerary potion to the patient For nature helped by such a potion hath to my knowledge sundry times done wondrous things The use of vulnerary potions in amendment of corrupt bones and consolidation of ulcers For these potions though they do not purge the noxious humors away by stool yet are they wondrous effectual to cleanse ulcers and free them from the excess of excrementitious humours to cleanse the blood and purge it from all impurity to agglutinate broken bones and knit the sinews I have here thought good to speak of them and chiefly for that they were much commended by the Antients but neglected by the modern Physicians and Surgeons But if the cure of wounds and old ulcers be performed by detersion and the reposition of the lost substance what medicine can sooner or rather do it then that which by its admirable and almost divine force so purgeth the bloud that thereof as from a fit and laudable matter the flesh or any other lost substance may be fitly restored and the part recover its former union But if fistulous Ulcers Cancers Gouts and the like diseases be offended by the use of salt spiced acrid meats and others which are of subtil parts as mustard onions and garlick or any other excess in meat or drink why may they not become mild and gentle by medicated and contrary meats and drinks or at least be reduced to a more equal temper Therefore that Surgeons may know of what things such compositions may arise I have here thought good to reckon them up that you may learn what they are Scabious Sanicle Bugle Mous-ear Burnet Madder Tanfie Tops of hemp Tops of brambles Sow-bread Comfery the greater and lesser Vervaine Bistort Mug-wort Periwincle Centaury Adders-tongue Betony Carduus benedictus The cordial flowers Aristolochia or Birth-worts Speed-well Agrimony The Capillaries Herb-Robert Doves-foot Dogs-tongue Avens Prunella Osmund Clarie Gentian Herniaria Red Cole-wort or Cabbage Scordium Cats-mint Cinque-foil River-Crabs Mace Bole-armenick Petum or Tobacco Mead-sweet Colts-foot Dandelion Plantaine St. Johns-wort Of all these the Surgeon shall make choice according to the minde and judgment of the Physician such as he shall think fit and proper to every ulcer or wound or to each wounded and ulcerated part according to the
out by putting in of warm water made it credible that the plant was poysoned by their spittle and urine whereby you may understand how unwisely they do who devour herbs and fruits newly gathered without washing Also we must take heed lest falling asleep in the fields we lie not near the holes which toads or other venomous beasts of the same nature have made their habitation For thence a venomous or deadly air may be drawn into the lungs May frogs For the same cause we must abstain from eating of frogs in the month of May because then they engender with toads Oxen in feeding somtimes lick up smalltoads together with the grass which presently will breed their great harm for thereupon the Oxen swell so big that they often burst withall Neither is the venom of toads deadly only being taken inwardly but even sprinkled upon the skin unless they forthwith wipe the place and wash it with urine water and salt Such as are poysoned by a toad turn yellow swell over all their bodies are taken with an Asthmatick difficulty of breathing a Vertigo convulsion swounding and lastly by death it self These so horrid symptoms are judged inherent in the poyson of toads not only by reason of the elementary qualities thereof coldness and moisture which are chiefly predominant therein but much rather by the occult property which is apt to putrefie the humors of that body whereto it shall happen The cure Therefore it will be convenient to procure vomit especially if the poyson be taken by the mouth to give glysters and to weaken the strength of the poyson by hot and attenuating Antidotes as treacle and mithridate dissolved in good wine but in conclusion to digest it by baths stoves and much and great exercise Rondeletius in his book de piscibus affirms the same things of the cursed venom of toads as we have formerly delivered yet that they seldom bite but that they cast forth either their urine the which they gather in a great quantity in a large bladder or else their venomous spittle or breath against such as they meet withall or assail besides the herbs which are tainted by their poysonous breath but much more such as are sprinkled with their spittle or urine are sufficient to kill such as eat them Antidotes against the poyson of Toads The Antidotes are juice of betony plantane mug-wort as also the blood of Tortoises made with flower into pils and forthwith dissolved in wine and drunken Plinye writes that the hearts and spleens of Toads resist poyson The vulgar opinion is false who think that the Toad-stone is found in their heads which is good against poyson CHAP. XXV Of the Stinging of a Scorpion The description of a Scorpion His tail A Scorpion is a small creature with a round body in form of an egg with many feet and a long tail consisting of many joynts the last whereof is thicker and a little longer then the rest at the very end thereof is a sting it casts in some two hollow and replete with cold poyson the which by the sting it casts into the obvious body it hath five legs on each side forked with strong claws not unlike to a Crab or Lobster but the two foremost are bigger then the rest they are of a blackish or sooy colour they go aside aside and oft-times fasten themselves with their mouths and feet so fast to them Winged Scorpions that they can scarce be plucked there-hence There be some who have wings like the wings of Locusts wasting the corn and all green things with their biting and burning Such are unknown in France These flie in divers countries like winged Ants. This is likely to be true by that which Matthiolus writes that the husband-men in Castile in Spain in digging the earth oft-times finde a swarm of Scorpions which betake themselves thither against winter Plinie writes that Scorpions laid waste a certain part of Ethiopia by chasing away the inhabitants The Antients made divers kinds of Scorpions according to their variety or difference of colours some being yellow others brown reddish ash-coloured green whitish black dusky some have wings and some are without They are more or lesse deadly according to the countries they inhabit In Tuscany and Scithia they are absolutely deadly but at Trent and in the Iland Pharos their stinging is harmless Symptoms The place stung by a Scorpion presently begins to be inflamed it waxeth red grows hard and swells and the patient is again pained he is one while hot another while cold labour presently wearies him and his pain is some-whiles more and som-whiles less he sweats and shakes as if he had an Ague his hair stands upright paleness dis-colours his members and he feels a pain as if he were pricked with needles over all his skin winde flieth out backwards he strives to vomit and go to stool but doth nothing he is molested with a continual fever and swounding which at length proves deadly unless it be remedied Dioscorides writes Lib. 2. cap. 44. lib 6. ca. 10. that a Scorpion beaten and laid to the place where he is stung is a remedy thereto as also eaten rosted to the same purpose It is an usual but certain remedy to annoint the stung place with the oil of Scorpions There be some who drop into the wound the milky juice of figs others apply calamint beaten other-some use barly-meal mixed with a decoction of Rue Snails beaten together with their shells and laid thereon presently asswage pain Sulphur vivum mixed with Turpentine and applied plaster-wise is good as also the leaves of Rue beaten and laid thereto In like sort also the herb Scorpioides which thence took its name is convenient as also a briony-root boiled and mixed with a little sulphur and old oil Lib. 3. cap. 1. Dioscorides affirms Agarick in powder or taken in wine to be an Antidote against poysons verily it is exceeding good against the stingings or bitings of Serpents Yet the continual use of a bath stands in stead of all these as also sweat and drinking wine some-what allaid Now Scorpions may be chased away by a fumigation of Sulphur and Galbanum also oil of Scorpions dropped into their holes hinders then coming forth Juice of raddish doth the same For they will never touch one that is besmeared with the juice of radish or garlick yea verily they will not dare to come near him CHAP. XXVI Of the stinging of Bees Wasps c. BEes Wasps Hornets and such like cause great pain in the skin wounded by their stinging by reason of the curstness of the venom which they send into the body by the wound yet are they seldom deadly but yet if they set upon a man by multitudes they may come to kill him For thus they have sometimes been the death of horses Wherefore because such as are stung by these by reason of the cruelty of pain may think they are wounded by a more
it is written by Aelian and Nicander CHAP. XXXI Of the Draco-marinus or sea-Dragon THe sea-Dragon called by the French viva for his vivacity and by the English a Viver or as some say a Qua-viver because being taken in fishing and drawn out of the sea she is said long to survive Her pricks are poisonous but chiefly those that are at the edges of her gills Which is the reason that Cooks cut off their heads before they serve them up to the table and at Roven the fishermen lay them not upon their stalls to sell before they have cut off their head The wounded part of such as are hurt pains them much with inaflmmation Symptoms a fever swouning gangrene and deadly mortification unless it be quickly withstood Not very long ago the wife of Mounsieur Fromaget Secretary of the requests An history was wounded with a prick of this fish in her middle finger there followed a swelling and redness of the part without much pain but perceiving the swelling to encrease being made more wary by the mischance of her neighbor the wife of Mounsieur Bargelonne Lieutenant particular in the Chastelet of Paris who died not long before by the like accident being neglected sent for me I understanding the cause of her disease laid to her pained finger and her whole hand besides a pultis made of a great Onion rosted under the coles leaven and a little treacle The next day I wished her to dip her whole hand into warm water so to draw forth the poison then I divided the skin about it with much scarification but only superficiarily to the gashes I applied Leeches which by sucking drawing a sufficient quantity of blood I put thereto treacle dissolved in aqua vitae The cure The next day the swelling was asswaged and the pain eased and within a few daies she was perfectly well Dioscorides writes that this fish divided in the midst and applied to the wound will cure it CHAP. XXXII Of the Paffinaca marina or Sting-Ray which some call the Fierce-claw The symptoms SUch as are stung by a Sting-Ray as Aetius hath written the place of the wound doth manifestly appear there ensues thereon lasting pain and the numness of the whole body And seeing that it hath a sharp and firm sting whereby the nerves by the deepness of the stroke may be wounded it so happens that some die forthwith their whole bodies suffering convulsions Lib. 9. cap. 48. Moreover it will kill even the very trees into whose roots it is fastned Yet Pliny affirms that it is good against the pain of the teeth if the gums be scarified therewith yea and it being made into powder with white Hellebore or of it self will cause teeth to fall out without any pain or any violence offered to them This fish is good meat the head and tail excepted some of them have two stings other-some but one these stings are sharp like a saw with the teeth turned towards their heads The virulency of her sting Oppianns writes that their stings are more poisonous then the Persians arrows for the force of the poison remaineth the fish being dead which will kill not only living creatures but plants also Fisher-men when they catch this fish presently spoil him of his sting lest they should be hurt therewith But if by chance they be hurt therewith then take they forth his liver and lay it to the wound furthermore the fish being burnt and made into powder is the true Antidote of his wound The Sting-Ray lives in muddy places near the shoar upon the fishes that he hunteth and catcheth with his sting having the teeth thereof turned towards his head for the same purpose He is not unlike a Ray and I have here given you his figure The figure of a Sting-Ray CHAP. XXXIII Of the Lepus Marinus or Sea-hare The description of the Sea-hare PLiny calls the Sea-hare a mass or deformed piece of flesh Galen saith it is like a Snail taken forth of the shell It is exceedingly poisonous in the judgment of the Antients wherefore it is not amiss to set down the description of it lest we might eat it at unawares too earnestly view it or smell thereto as also that we may use it against the poison thereof it is an inhabitant not only of the sea but also of lakes of sea-water especially such as are muddy it is of the same colour as the hair of the land-hare is it hath a hole in the head out of which he putteth a certain piece of flesh The earnest beholding of a Sea-hare will cause abortion and plucks it back again when as he is seen Paulus Aetius Pliny Galen and Nicander are of one opinion and agree in this that if a woman big with child do too earnestly look upon one she will vomit and presently after abort They which have drunk this poison saith Dioscorides are troubled with pain in the belly and their urine is stopped If they do make water then is it bloody they run down with stinking sweat which smells of fish a cholerick vomiting sometimes mixed with blood ensues thereon The symptoms Aetius writes that all their bodies turn yellow their faces swell and their feet but chiefly their genital member which is the cause they cannot make water freely Galen writes that it is the property of the Sea-hare to exulcerate the lungs The antidote Their antidote is Asses-milk muskadine or honied-wine continually drunken or a decoction of the roots and leavs of Mallows It is good for the falling away of the hair I have here given you the figure thereof out of Rendeletius his book of Fishes The figure of a Sea-Hare CHAP. XXXIV Of the poyson of Cats NOt only the brain of a Cat being eaten is poysonous and deadly to man A Cats hair most subject to choak but also their hair their breath yea and their very presence to some prove deadly For although any hair devoured unawares may be enough to choak one by stopping the instruments or respiration yet the hairs of a Cat by a certain occult property are judged most dangerous in this case besides also their breath is infected with a certain hurtful malignity For Matthiolus saith that he knew some who being so delighted with Cats that they would never go to bed without them have by so often drawing in the air with their breath The breath of a Cat most hurtful to the lungs fallen into a consumption of the lungs which occasioned their death Moreover it is manifest that the very sight of their eies is hurtful which appears by this that some but seeing or hearing them presently fall down in a swound yet I would not judge that to happen by the malicious virulency of the Cat but also by the peculiar nature of the party and a quality generated with him and sent from heaven When as saith Matthiolus a certain German in winter-time An history came with us
emplasters and so applied it asswageth pain by stupefaction hindering the acrimony of pustles and cholerick inflammations But by its humidity it softneth scirrhous tumors dissolveth and dissipateth knots and tophous knobs besides it causeth the breath of such as are annointed therewith to stink by no other reason then that it putrefies the obvious humor by its great humidity Avicens experiment confirms this opinion who affirmeth that the blood of an Ape that drunk Quick-silver was found concrete about the heart the carcass being opened In l. 6 Dios c. 28 Matthiolus moved by these reasons writes that Quick-silver killeth men by the excessive cold and humid quality if taken in a large quantity because it congeals the blood and vital spirits and at length the very substance of the heart as may be understood by the history of a certain Apothecary An history set down by Conciliator who for to quench his severish heat in stead of water drunk of a glass of Quick-silver for that came first to his hands he died within a few hours after but first he evacuated a good quantity of the Quick-silver by stool the residue was found in his stomach being opened and that to the weight of one pound besides the blood was found concrete about his heart Others use another argument to prove it cold and that is drawn from the composition thereof because it consists of Lead and other cold metals But this argument is very weak For unquencht Lime is made of flints and stony matter which is cold yet nevertheless it exceeds in heat Lib. 4. de nat rerum Paracelsus affirmeth that Quick-silver is hot in the interior substance but cold in the exterior that is cold as it comes forth of the Mine But that coldness to be lost as it is prepared by art and heat only to appear and be left therein so that it may serve instead of a tincture in the trans-mutation of metals And verily it is taken for a Rule amongst Chymists that all metals are outwardly cold by reason of the watery substance that is predominant in them but that inwardly they are very hot which then appears when as the coldness together with the moisture is segregated for by calcination they become caustick Moreover many account quick-silver poison Tract de casu offen yet experience denies it For Marianus Sanctus Boralitanus tells that he saw a woman who for certain causes and effects would at several times drink one pound and a half of quicksilver which came from her again by stool without any harm Moreover he affirmeth that he hath known sundry who in a desperate Colick which they commonly call miserere mei have been freed from imminent death by drinking three pounds of quick-silver with water only For by the weight it opens and unfolds the twined or bound up gut nnd thrusts forth the hard and stopping excrements he addeth that others have found this medicine effectual against the colick drunk in the quantity of three ounces Antonius Musa writes that he usually giueth Quick-silver to children ready to die of the worms Avicen confirmeth this averring that many have drunk Quick-silver without any harm wherefore he mixeth it in his ointments against scales and scabs in little children whence came that common medicine amongst country people to kill lice by annointing the head with Quick-silver mixed with butter or axungia Quick-silver good for women in travel Matthiolus affirmeth that many think it the last and chiefest remedy to give to women in travel that cannot be delivered I protest to satisfie my self concerning this matter I gave to a whelp a pound of Quick-silver which being drunk down it voided without any harm by the belly Whereby you may understand that it is wholly without any venomous quality Verily it is the only and true Antidote of the Lues Venerea and also a very fit medicine for all malign ulcers as that which more powerfully impugns their malignity then any other medicines that work only by their first qualities For the disease called Malum sancti manis Besides against that contumacious scab which is vulgarly called Malum sancti manis there is not any more speedy or certain remedy Moreover Guido writes that if a plate of lead be besmeared or rubbed there with and then for some space laid upon an ulcer and conveniently fastned that it will soften the callous hardness of the lips thereof and bring it to cicatrization which thing I my self have often times found true by experience Lib. de comp med socurd loc Against malign ulcers Certainly before Guido Galen much commended Quick-silver against malign ulcers and cancers Neither doth Galen affirm that lead is poisonous which many affirm poisonous becaus it consists of much Quick-silver but he only saith thus much that water too long kept in leaden pipes cisterns by reason of the drossiness that it useth to gather in lead causeth bloody fluxes which also is familiar to brass and copper Otherwise many could not without danger bear in their bodies leaden bullets during the space of so many years as usually they do It is reported It is declared by Theodoret Herey in the following histories how powerful Quick-silver is to resolve and asswage pain and inflamations Not long since Against the Parotides saith he a certain Doctor of Physick his boy was troubled with parotides with great swelling heat pain and beating to him by the common consent of the Physicians there present I applied an Anodine medicine whose force was so great that the tumor manifestly subsided at the first dressing and the pain was much asswaged At the second dressing all the symptoms were more mitigated At the third dressing I wondring at the so great effect of an Anodine Cataplasm observed that there was Quick-silver mixed therewith and this happened through the negligence of the Apothecary who mixed the simple Anodine medicine prescribed by us in a mortar wherein but a while before he had mixed an ointment whereinto Quick-silver entred whose reliques and some part thereof yet remained therein This which once by chance succeeded well I afterwards wittingly and willingly used to a certain Gentlewoman troubled with the like disease possessing all the region behind the ears much of the throat and a great part of the cheek when as nature helped by common remedies could not evacuate neither by resolution nor suppuration the contained matter greatly vexing her with pain and pulsation I to the medicine formerly used by the consent of the Physicians put some Quick-silver so within a few daies the tumor was digested and resolved But some will say it resolves the strength of the nerves and limbs as you may see by such as have been anointed therewith for the Lues Venerea who tremble in all their limbs during the rest of their lives This is true if any use it too intemperately without measure and a disease that may require so great a remedy for thus we see the Gilders
conformation must be speedily amended as it often happeneth For if any such cover or stop the orifices of the ears nostrils mouth yard or womb it must be cut in sunder by the Chirurgian and the passage must be kept open by putting in of tents pessaries or dosels left otherwise they should joyn together again after they are cut If he have one finger more then he should naturally if his fingers do cleave close together like unto the feet of a Goose or Duck if the ligamental membrane that is under the tongue be more short and stiffer then it ought that the infant cannot suck nor in time to come speak by reason thereof and if there be any other thing contrary to nature it must be all amended by the industry of some expert Chirurgian Many times in children newly born there sticketh on the inner side of their mouth and on their tongue a certain chalky substance both in colour and in consistence this affect proceeding from the distemperature of the mouth the French-men call it the white Cancer Remedies for the Cancer in a childes mouth It will not permit the infant to suck and will shortly breed and degenerate into ulcers that will creep into the jawes and even unto the throat and unless it be cleansed speedily will be their death For remedy whereof it must be cleansed by Detersives as with a linnen cloth bound to a little stick and dippped in a medicine of an indifferent consistence made with oil or sweet almonds hony and sugar For by rubbing this gently on it the filth may be mollified and so cleansed or washed away Moreover it will be very meet and convenient to give the infant one spoonful of oil of almonds to make his belly loose and slippery to asswage the roughness of the weason and gul let and to dissolve the tough phlegm which causeth a cough and sometimes difficulty of breathing If the eye-lids cleave together or if they be joyned together or agglutinated to the coats cornea or adnata if the watery tumor called hydroccephalos affect the head then must they be cured by the proper remedies formerly prescribed against each disease Many from their birth have spots or markes which the common people of France call Signes that is marks or signs Some of these are plain and equal with the skin others are raised up in little tumors and like unto warts some have hairs upon them many times they are smooth black or pale yet for the most part red When they rise in the face they spread abroad thereon many times with great deformity Many think the cause thereof to be a certain portion of menstrual matter cleaving to the sides of the womb comming of a fresh flux if happily a man do yet use copulation with the woman or else distilling out of the veins into the womb mixed concorporated with the seeds at that time when they are congealed infecting this or that part of the issue being drawn out of the seminal body with their own colour Women referr the cause thereof unto their longing when they are with childe which may imprint the image of the thing they long for or desire in the childe or issue that is not as yet formed as the force and power of imagination in humane bodies is very great but when the childe is formed no imagination is able to leave the impression of any thing in it no more then it could cause horns to grow on the head of King Chypus as he slept presently after he was returned from attentively beholding Bulls fighting together Some of those spots be cureable others not as those that are great An old fable of King Chypus and those that are on the lips nostrils and eye-lids But those that are like unto warts because they are partakers of a certain malign quality and melancholick matter which may be irritated by endeavouring to cure them are not to be medled with at all for being troubled and angered Which uncureable Which and how they are cureable they soon turn into a Cancer which they call Noli me taugere Those that are curable are small and in such parts as they may be dealt withall without danger Therefore they must be pierced through by the roots with a needle and a thread and so being lifted up by the ends of the thread they most be cut away and the wound that remaineth must be cured according to the general method of wounds There are some that suppose the red spots that are raised up into little knobs and bunches may be washed away and consumed by rubbing and annointing them often with menstrual blood or the blood of the secundine or after-birth Those that are hairy and somewhat raised up like unto a Want oâ— Mouse must be pierced through the roots in three or four places and straitly bound so that at length being destitute of life and nutriment they may fall away after they are faln away the ulcer that remaineth must be cured as other ulcers are If thereby any superfluous flesh remain it must be taken away by applying Aegyptiacum or the powder of Mercury and such like but if it be doubted that it commeth from the root of the tumor that may haply remain it must be burned away by the root with oyl of vitriol or aqua fortis There is also another kinde or sort of spots of a livid or violet-colour comming especially in the face about the lips with a soft slack lax thin and unpainful tumor and the veins as if they were varicous round about it This kinde of tumor groweth greater when it ariseth on children that are wayward and crying and in men of riper years that are cholerick and angry and then it will be of a diverse colour like unto a lapper or flap of flesh that hangeth over the Turky-cocks bill When they have done crying or ceased their anger the tumor wil return to his own natural colour again But you must not attempt to cure it in people that are of these conditions CHAP. XVIII How to pull away the secundine or after-birth Why it is called the secundine I Suppose that they are called secundines because they do give the woman that is with châ—lde the second time as it were a second birth for if there be several children in the womb at once and of different sexes they then have every one their several secundines which thing is very necessary to be known by all Midwives For they do many times remain behinde in the womb when the childe is born The causes of the stâ—ying of the secundines either by reason of the weakness of the woman in travail which by contending and laboâ—ing for the birth of the childe hath spent all her strength or else by a tumor rising suddenly in the neck of the womb by reason of the long and difficult birth and the cold air unadvisedly permitted to strike into the orifice of the womb For so the liberties of
womb There are women that bear the childe in their womb ten or eleven whole moneths and such children have their conformation of much quantity of seed wherefore they will be more big great and strong and therefore they require more time to come to their perfection and maturity for those fruits that are great will not be so soon ripe as those that are small But children that are small and little of body do often come to their perfection and maturity in seven or nine moneths if all other things are correspondent in greatness and bigness of body it happeneth for the most part that the woman with childe is not delivered before the ninth moneth be done A male will be born soonner then a female or at the leastwise in the same moneth But a male childe will be commonly born at the beginnâ—ng or a little before the begining of the same moneth by reason of his engrafted heat which causeth maturity and ripeness Furthermore the infant is sooner come to maturity and perfection in a hot woman then in a cold for it is the property of heat to ripen CHAP. XXXI How to preserve the infant in the womb when the mother is dead IF all the signes of death appear in the woman that lieth in travel and cannot be delivered there must then be a Surgeon ready and at hand which may open her body so soon as she is dead whereby the infant may be preserved in safety neither can it be supposed sufficient if the mothers mouth and privie parts be held open for the infant being inclosed in his mothers womb Why it is not sufficient to preserve life in the childe to hold open the mouth and privie parts of the mother so soon as she is dead and the childe alive in her body and compassed with the membranes cannot take his breath but by contractions and dilatations of the artery of the navel But when the mother is dead the lungs do not execute their office function therefore they cannot gather in the air that compasseth the body by the mouth or aspera arteria into their own substance or into the arteries that are dispersed throughout the body thereof by reason whereof it cannot send it unto the heart by the veiny artery which is called arteria venalis for if the heart want air there cannot be any in the great artery which is called arteria aorta whose function it is to draw it from the heart as also by reason thereof it is wanting in the arteries of the womb which are as it were the little conduits of the great artery whereinto the air that is brought from the heart is derived and floweth in unto these little ones of all the body and likewise of the womb Wherefore it must of necessity follow that the air is wanting to the cotyledons of the secundines to the artery of the infants navel the iliack arteries also and therefore unto his heart and so unto his body for the air being drawn by the mothers lungs is accustomed to come to the infant by this continuation of passages How the bellie of the woman that dieth in travel must be cut open to save the childe Therefore because death maketh all the motions of the mothers body to cease it is far better to open her body so soon as she is dead beginning the incision at the cartilage Xiphoides or blade and making it in a form semicircular cutting the skin muscles and peritonaeum not touching the guts then the womb being lifted up must first be cut lest that otherwise he infant might perchance be touched or hurt with the knife You shall oftentimes finde the childe unmoveable as though he were dead but not because he is dead indeed but by reason that he being destitute of the accesse of the spirits by the death of the mother hath contracted a great weakness yet you may know whether he be dead indeed or not by handling the artery of the navel for it will beat and pant if he be alive otherwise not but if there be any life yet remaining in him How it may be known whether the infant be aâ—ive or not shortly after he hath taken in the air and is recreated with the access thereof he will move all his members and also all his whole body In so great a weakness or debility of the strength of the childe by cutting the navel string it must rather be laid close to the region of the belly thereof that thereby the heat if there be any jot remaining may be stirred up again But I cannot sufficiently marvel at the insolency of those that affirm that they have seen women whose bellies and womb have been more then once cut and the infant taken out when it could no otherwise be gotten forth and yet notwithstanding alive which thing there is no man can perswade me can be done without the death of the mother by reason of the necessary greatness of the wound that must be made in the muscles of the belly and substance of the womb for the womb of a woman that is great with childe by reason that it swelleth and is distended with much blood must needs yield a gread flux of blood which of necessity must be mortal And to conclude when that the wound or incision of the womb is cicatrized it will not peâ—mit or suffer the womb to be dilated or extended to receive or bear a new birth For these and such like other causes this kinde of cure as desperate and dangerous is not in mine opinion to be used CHAP. XXXII Of superfetation SUperfetation is when a woman doth bear two or more children at one time in her womb What superfetation is and they be enclosed each in his several secundine but those that are included in the same secundine are supposed to be conceived at one and the same time of copulation by reason of the great and copious abundance of seed and these have no number of daies between their conception and birth but all at once For as presently after meat the stomach which is naturally of a good temper is contracted or drawn together about the meat to comprehend it on every side though small in quantity as it were by both hands so that it cannot rowl neither unto this or that side so the womb is drawn together into the conception about the seeds assoon as they are brought into the capacity thereof and is so drawn in unto it on every side that it may come together into one body not permitting any portion thereof to go into any other region or side so that by one time of copulation the seed that is mixed together cannot engender more children then one which are divided by their secundines A womans womb is not distinguished into diverse cells And moreover because there are no such cells in the wombs of women as are supposed or rather known to be in the wombs of beasts which therefore bâ—ing forth many
descent Crucibiles and another such-Vessels for Calcination Hair-strainers Bags Earthen-platters Vessels for circulation as Pelicacanes Earthen-basins for filtring Fornaces The secret Fornaces of Philosophers The Philosophers egg Cacurbites Retorts Bolt-heads Urinals Receivers Vessels so fitted together that the lowermost receives the mouth of the uppermost whence they may be termed conjoined Vessels they are used in distilling per descensum Marbs exquisitely smooth for distillations to be made in Cellars Pots to dissolve calcined metalls in A Catalogue of the Surgeons Instruments mentioned in this whole work RIngs wherein little Lancets lye hid to open Impostumes Trunks or hollow instruments going with springs A vent or cooler for the womb made like a pessary Hollow tents Sundry Cauteries as flat round sharp-pointed cutting c. Constrictory rings to twitch or binde the Columella Speculum Otis Ocul Ani Vteri A trunk or pipe with an actual Cautery in it Crooked Knives A pipe in form of a quill Divers trusses with one or more bolsters A shoulder-band to be put about the neck to hold up a truss A needle to draw through a golden wier c. Pipes with fenestels and needls fit for futures Cutting Mâ—llets Mullets only to hold and not to cut Mullets to take forth splinters of bones Mullets to draw teeth An incision-knife Scrapers to plain or smooth the bones or else to cut them Cutting or hollow scrapers A leaden mallet to drive the Scrapers or Chizzels into the scull A Gimblet in shape and use resembling that which Coopers use to lift up the sunk staves of their cask withall Levatories of which kinde is the three-footed one Old Levatories which taken by their handles and their tongues put under the deprest bones lift them up Saws A desquamatory Trepan Pliers to take forth splinters of bones A Gimblet to perforate the scull A Trepan fit to divide the scull with the scrue point or piercer brace and cover or cap that keeps it from running in too far A plate to set one foot of the Compass upon A cutting pair of compasses both open and shut a fit instrument to depress the Dura mater without hurting thereof A syringe to make injection withall A pair of Pincers with holes through them to make up the skin for making a Seton Setons as well drye as moistened with ointments The Beaks of Crows Parats Swans Ducks Lizards Cranes are either strait crooked toothed or smooth Catch-bullets and Pliers to draw forth pieces of mail and splinters of bones that lye deep in Hollow and smoth Dilaters diversly made for the different wounds of the parts Probes fit for to put flamulas into wounds and these are either strait or crooked perforated or unperforated Scrued mullets to draw forth barbed heads of crrows and the like Lancets to let blood and scarifie as well strait as crooked A Pyulcos or Matter-drawer Ligatures bands swathes thongs of leather woollen linnen round slit sown together again some are upper binders other under-binders Again these are either expressing or else containing and that either the applied medicine or the lips of wounds or members put in a fit posture which therefore they call a sarcotick Ligature Thred Bottoms or clews of thred or yarn Pledgets compresses boulsters doubled cloaths Ferulae or Splints Casses Boxes Junks Glossocomies Ambi a kinde of Glossocomy A pully with its wheels and wooden and Iron-pins whereon the wheels may run Ropes as well to draw and extend as hold up the member c. Scruepins A hand-vice Hooks Buttons or staies to fasten to the skin to hold together the lips of the wounds Lint cussions pillows linnen-cloathes Files Dentiscalpia Dentifricia Dentispiscia Catheters guiders of the work Abathing chair or seat bathing-tubs half-rubs caldrons funnels with all other circumstances belonging to a bath Stoves or hot-houses to sweat in Cocks to turn and let out water A Gimblet to break the stone Hooks Hollow probes slit on the upper sides Winged instruments to draw forth stones An instrument to cleanse the bladder Spatulas straight and crooked Cupping-glasses Horns Pipes or Catheters to wear Caruncles Artificial members as eyes of gold enamelled c. An Urinal or case to save the water in An artificial yard Crutches Nipples or leaden covers for sore breasts Griffius talons to draw forth a mola out of the womb A sucking-glass to draw a breast withal Pessaries both long and oval Syringes to give glysters as also to make injection into the ears and womb The Effigies of HIPPOCRATES of Côos the Prince of Physicians INVICTUM Hippocrates quòd te potuere superbae Eoî numquam flectere Regis opes Cecropidae fronti ex auro fulgente coronam Promeriti memores imposuere tuae Gratia sed levis est Actaeis tantus Athenis Nec fuit hinc uni quám tibi partus honos Nam quòd quae recreent languentia corpora morbo Paeonias fueris promere largus opes Sed tua tam fundit quà m magni machina mundi Gratia insignis tam tua fama volat BON. GRA. PARIS MEDIC Select Aphorisms concerning Surgery collected out of the Aphorisms of the great HIPPOCRATES Aphor. 27. sect 6. WHosoever being suppurate or hydropical are burnt or cut therefore if all the matter or water flow forth at once they certainly dye 31. 6. The drinking of wine or a bath fomentation blood-letting or purging help the pains of the eyes 38. 6. Such as have hidden or not ulcerated Cancers had better not to cure them For healed they quickly dye not cured they live the longer 55. 6. Gouty-pains usually stirr in the Spring and Fall 28. 6. Eunuchs are not troubled with the Gout neither do they become bald 49. 6. Whosoever are troubled with the Gout have ease in forty daies the inflammation ceasing 66. 5. In great and dangerous wounds if no swelling appear it is ill 67. 5. Soft tumors are good but crude ones ill 25. 6. For an Erysipelas or inflammation to return from without inwards it is not good but to come from within outwards is very good 19. 7. An Erysipelas comming upon the bearing of a bone is evil 20. 7. Putrefaction or suppuration comming upon an Erysipelas is ill 21. 6. If Varices or Haemorrhoides happen to such as are mad their madness ceases 21. 7. A flux of blood ensuing upon a great pulsation in ulcers is ill 26. 2. It is better that a fever happen upon a convulsion then a convulsion upon a fever 4. 6. Those ulcers that have the skin smooth or shining about them are evil 18. 6. The wound is deadly whereby the bladder brain heart midriff any of the small guts stomach or liver are hurt 45. 6. Whatsoever ulcers are of a years continuance or more the bone must necessarily scale and the scars become hollow 2. 7. The bone being affected in the flesh be livid it is ill 14. 7. Stupidity and lack of reason upon a blow of the head is evil 24. 7. A Delirium happens if a bone to wit the scull be
memory I may work more certainly and surely when as I have any more curious operation to be performed the left side remain whole and the Lungs Heart Diaphragma stomach splene kidnies beard hairs yea and the nails which being pated I have often observed to grow again to their form and bigness And let this be the bound of this our immense labor and by Gods favor our rest to whom Almighty all-powerful immortal and invisible be ascribed all honor and glory for ever and ever Amen Labor improbus omnia vincit The end of the Treatise of reports and embalming the dead The NINE and TWENTIETH BOOK The Apology and Treatise containing the voyages made into divers places By Ambrose Pare of Laval in Maine Counsellor and chief Chirurgion to the King Of what the Adversary accuseth the Author TRuly I had not put my hand to the pen to write on such a thing were it not that some have impudently injured taxed and more through particular hatred disgraced me then for zeal or love they bear to the publick good which was concerning my manner of tying the Veins and Arteries writing thus as followeth The words of the Adversary Male igitur nimium arroganter inconsultus temerarius quidam vasorum ustionem post emortui membri rejectionem à veteribus omnibus plurimum commendatam semper probatam damnare ausus est novum quendam deligandi vasa modum contra veteres omnes medicos sine ratione experientà judicio docere cupiens nec animadverit majora multo pericula ex ipsa vasorum deligatione quam acu partem sanam profunde transfigendo adminâ—strari vult imminere quam ex ipsa ustione Nam fi acu nervosam aliquam partem vel nervum ipsum pupugerit dum it à novo inusitato modo venam absurde conatur constringere nova inflammatio necessario consequetur à qua Convulsio a convulsione cita mors Querum symptomatum metu Galenus non ante transversa vulnera suere audebat quod tamen minus erat periculosum quam musculorum aponeuroses denudasset Adde quod forcipes quibus post sectionem iterum carnem dilacerat cum retracta versus originem vasa se posse extrahere somniat non minorem adferant dolorem quam ignita ferramenta admota Quod si quis laniatum expertus incolumis evaserit is Deo optimo maximo cujus Beneficentia crudelitate ista carnificina liberatus est maximas gratias habere semperagere debet which is thus Ill then and too arrogantly a certain indiscreet and rash person would blame and condemn the cauterizing of vessels after the amputation of a rotten and corrupted member much praised and commended and alwayes approved by the Antienâ—s desiring to shew and teach us without reason judgment and experience a new way to tie the vessels against the opinion of the Antient Physicians taking no heed nor being well advised that there happens far greater perils and accidents through this new way of tying the vessels which he will have to be made with a needle piercing deeply the sound part then by the burning and ustion of the said vessels for if the needle shall prick any nervous part yea the nerve it self when he shall by this new and unaccustomed way absurdly constrain the vein by binding it there must necessarily follow a new inflammation from the inflammation a convulsion from a convulsion death for fear of which accidents Galen never durst stitch transversal wounds which notwithstanding were less dangerous before he had discovered the Aponeuroses of the muscles Moreover the pincers with which after the section the flesh is again dilacerated while he thinks to draw the vessels out which are drawn in toward their original bring no less pain then the cautering irons do And if any one having experimented this new manner of cruelty have escaped danger he ought to render thanks to Almighty God for ever through whose goodness he hath been freed from such tyranny feeling rathet his executioner then his methodical Chirurgion The Authors answer O what sweet words are here for one who is said to be a wise and learned Doctor he remembers not that his white beard admonisheth him not to speak any thing unworthy of his age and that he ought to put off and drive out of him all envy and rancor conceived against his neighbor So now I will prove by authority reason and experience that the said Veins and Arteries ought to be tyed Authorityes AS for Authorityes I will come to that of that worthy man Hippocrates who wils and commands the cure of Fistulaâ— in the fundament by ligature as well to consume the callosity as to avoid hemoâ—â—hagy In the book of Fistulas of the fundament chap. 3. book 5 leaâ— 4. Galen Treâ—ise 2 chap. 17. in his method speaking of a flux of blood made by an outward cause of whom see here the words It is saith he most sure to tye the root of the vessel which I understand to be that which is most near to the Liver or the heart Avicen Treatise 3. Doct. 1. chap. 3. commands to tye the vein and the Artery after it is discovered towards his original Guido of Canliac speaking of the wounds of the Veins and Arteries injoyneth the Chirurgion to make the ligature in the vessel Master Hollier in the 3. book chap. 4. of the matter of Chirutgery speaking of a flux of blood commands expresly to tye the vessels Calmethâ—us in 12. chap. of the wounds in the Veins and Arteries tels a most sure way to stay a flux of blood by ligature of the vessel Celsus chap. 26. book 5. from whom the said Physiâ—ian hath snatched the most part of his book chargeth expresly to tye the vessels in a flux of blood happening to wounds as a remedy most easie and most sure Vesalius in his Chirurgery chap. 4. book 3. willeth that the vessel be tied in a flux of blood John de Vigo book 1. treatise 1. treating of hemoâ—â—hagy in bleedâ—ng wounds commands to tye the Vein and the Artery Tegaultius chap 12. book 2. treating of the means to stay the flux of blood commands to pinch the Vein or Artery with a Crow or Parrats-bill â—â—en to â—yâ— it with a very strong thred Peter of Argillata of Bullonge tâ—eatise 4. chap. 11 book 1. discoursing of a flux of blood and the means to stop it giveth a fourth way expresly which is made by ligature of the vessels John Andreas a Cruce â— Venetian book 1. sect 3. chap. 16. page 5 upon the 8â— chap of the book of Paul makes mention of a method to stay a flux of blood by the ligature of the vessels D. Alechamp commands to tye the Veinâ— and Arteries See then my little good man the â—â—thorities which command you to tye the vessels As for the â—eaâ—ons I will debate of them The hemoâ—hagy say you iâ— not so much to be feared in the section of the Call as that of
the space of three years with extreme pain by reason of a great Caries which was in the bone Asiragal Cyboides great â—nd little â—â—cil and through all the nervous parts through which she felt extreme and intolerable pains night and day she is called Mary of Hostel aged 28 years or thereabouts wife of Peter Heâ—ve Esquire of the Kitchin to the Lady Ducheâ—s of Vzez dwelling in the meet of Verbois on the other side S. Martin in the fields dwelling at the sign of the S. John's-head where the said Charbâ—nel cut off the said leg The operation of Charbonel the bredth of 4 large fingers below the knee and after that he had inâ—â—ed the flesh and â—awed the bone he griped the vein with the Crow-bill then the Artery then tied them fâ—om whence I protest to God which the company that were there can witness that in all the operation that was suddenly done there was not spilt one porrenger of blood and I bid the said Charbonel to let it bleed more following the precept of Hippâ—crates that it is good in all wounds and also in inveterate ulcers to let the blood run by this means the part is less subject to inflammation In the â— Cent. of â—e bâ—ok of Ulcers The said Charbonel continued the dressing of her who was cured in two months without any flux of blood happening unto her or other ill accident and she went to see you at your lodging being perfectly cured Another History Another history of late memory of a singing-man of our Ladies Church named M. Colt who broke both the bones of his leg which were crusht in divers pieces insomuch that there was no hope of cure to withstand a gangrene and mortification and by consequence death Monsieur Helin Doctor Regent in the faculty of Physick a man of honor and good knowledge Claud. Viard and Simon Peter sworn Surgeons of Paris men well exercised in Surgery and Balthazar of Lestre and Leonard de Leschenal Operation done by Viaâ—d M. Barber-Surgeons weâ—l experimented in the operations of Surgery were all of opinion to withstand the accidents aforesaid to make entire amputation of the whole leg a little above the broken and shivered bones and the torn nerves veins arteries the operation was nimbly done by the said Viard and the blood stancht by the ligature of the vessels in the presence of the said Helin and M. Tousard great vicar of our Ladies Church and was continually drest by the said Leschenal and I went to see him otherwhiles he was happily cured without the applâ—cation of hot irons and walketh lustily on a woodden leg Another History In the year 1583. the 10. day of December Toussiant Posson born at Ronieville at this present dwelling at Beauvais near Dâ—urdan having his leg all ulcered and all the bones cariez'd and rotten prayed me for the honor of God to cut off his leg by reason of the great pain which he could no longer endure After his body was prepared I caused his leg to be cut off four fingers below the retula of the knee by Daniel Powlet one of my servants to teach him and to imbolden him in such works and there be readily tied the vessels to stay the bleeding without application of hot irons in the presence of James Guillemau ordinary Surgeon to the King and John Châ—â—bâ—nel Master-Surgeon of Paris and during the cure was visited by M. Laffile and M. Couâ—tin Doctor Regents in the faculty of medicine at Paris The said operation was made in the house of John â—â—hel Inn-keeper dwelling at the sign of the white-Horse in the Greve I will not heâ—e forget to say that the Lady Princess of Montpensier knowing that he was poor and in my hands gâ—ve him mony to pay for his chamber and diet He was well cured God be praised and is returned home to his house with a woodden-leg Another History A Gangreen happening by an Antecedent cause A Gangreen happened to half of the leg to one named Nicolas Mesnager aged 76. years dwelling in S. Honores street at the sign of the Basket which happened to him through an inward cause so that we were constrained to cut off his leg to save his life and it was taken off by Antony Renaud Master Barber-Surgeon of Paris the 16. day of December 1583. in the presence of M. Le Fort and M. La Nave sworn Surgeons of Paris and the blood was stanched by the Ligature of the Vessels and he is at this present cured and in health walking with a wooden-leg A water-man at the Port of Nesle dwelling near Monsieur de Mas Post-master Another History nâ—â—ed John Boussereau in whose hands a Musket brake asunder which broke the bones of his hâ—â—d 〈◊〉 â—ent â—nd tore the other parts in such sort that it was needful and necessary to make aâ—p◠〈…〉 the â—â—nd two fingers above the wrist Operation d nâ— by Gullâ—mâ—r which was done by James Guillemau then Surgâ—on 〈…〉 the King who dwelt at that time with me The operation likewise beiâ—â—â—ly â—one and the blood stanched by the Ligature of the vessels without burning â—ons he is 〈◊〉 this present living A Merchant Grocer dwelling in S. Denis-street at the sign of the 〈…〉 named the Judg who fell upon his head where was made a wound 〈…〉 â—poral muscle Another History Operation â— done by the Author where he had an artery opened from whence issued forth blood wâ—◠〈…〉 impeâ—â—oâ—â—y insomuch that common remedies would not serve the turn I was called tâ—â—â—her wâ—â—re I found Mr. Russe Mr. Câ—interet Mr. Viard sworn Surgeons of Paris to stay â— ood where presently I took a needle and thred and tied the artery and it bled no more after that and was quickly cured Mr. Rowssellet can witness it not long since Deacon of your Faculty who was in the cure with us A Sergaant of the Chastlet dwelling near S. Andrew des Aâ—ts Another History Another operation who had a stroak of a sword upon the throat in the Clacks medow which cut asunder the jugular vein extern as soon as he was hurt he put his hankeâ—â—her upon the wound and came to look me at my house and when he took away his hankercheâ— the blood leaped out with great impetuosity I suddenly tied the vein toward the root he by this this means was stanched and cured thanks be to God And if one had followed your manner of stanching blood by cauteries I leave it to be supposed whether he had been cured I think he had been dead in the hands of the operator If I would recite all those whose vessels were tied to stay the blood which have been cured I should not have ended this long time so that me thinks there are Histories enough recited to make you believe the blood of veins and arteries is surely stanched without applying any outward cauteries He that doth strive against experience Daigns not to talk of any learned science NOw my
Savoy with six other Surgeons following the Army to see the hurt of the said Lord of Martigues and to know of me how I had dressed him and with what medicines The Emperors Physician bid me declare the essence of the wound and how I had drest it Now all the assistants had a very attentive ear to know if the wound were mortal or not I began to make a discourse that Monsieur de Martigues looking over the wall to perceive them that did undermine it received a shot from an Arquebus quite through the body presently I was called to dress him I saw he cast out blood out of his mouth and his wounds Moreover he had a great difficulty of breathing and cast out winde by the said wounds with a whistling in so much that it would blow out a candle and he said he had a most sharp pricking pain at the entrance of the bullet I do beleive and think it might be some little pieces of bones which prickt the Lungs When they made their Systole and Diastole I put my finger into him where I found the entrance of the bullet to have broken the fourth Rib in the middle and scales of bones which the said bullet had thrust in and the out-going of it had likewise broken the fifth Rib with pieces of bones which had been driven from within outward I drew out some but not all because they were very deep and adherent I put in each wound a Tent having the head very large tied with a thred lest by the inspiration it might be drawn into the capacity of the Thorax which hath been known by experience to the detriment of the poor wounded for being faln in it cannot be taken out which is the cause that engenders putrefaction a thing contrary to nature The said Tents were annointed with a medicine composed of yelks of eggs Venice-turpentine with a little oyl of Roses My intention for putting the Tents was to stay the flux of blood and to hinder that the outward air did not enter into the brest which might have cooled the Lungs and by consequent the heart The said Tents were also put to the end that issue might be given for the blood that was spilt within the Thorax I put upon the wound great Emplasters of Di acolcitheos in which I had relented oyl of Roses and Vineger to the avoiding of the inflammation then I put great stupes of Oxycrate and bound him up but not too hard to the end he might have easie respiration that done I drew from him five porrengers of blood from the Basilisk vein of the right arm to the end to make revulsion of the blood which runs from the wounds into the Thorax having first taken indication from the wounded part and chiefly his forces considering his youth and sanguine temper He presently after went to stool and by his urine and sieg cast great quantity of blood And as for the pâ—â—n which he said he felt at the entrance of the bullet which was as if he had been pricked with a bodkinâ— that was because the Lungs by their motion beat against the splinters of the Broken Rib. Now the Lungs are covered with a coat comming from the membrane called Pleura interweâ—ved with nerves of the sixt Conjugation from the brain which was cause of the extreme pain â—e self likewise he had great difficulty of breathing which proceededd from the blood which was spilt in the capacity of the Thorax and upon the Diaphragm the principal instrument of respiration and from the dilaceration of the muscles which are between each Rib which help also to make the expiration and the inspiration and likewise because the Lungs were torn and wounded by the bâ—llet which hath caused him ever since to spit black and putrid blood in coughing The fever seised him soon after he was hurt with faintings and swoonings It seemed to me that the said fever proceeded from the putredinous vapors arising from the blood which is out of his proper vessels which hath falln down and will yet flow down The wound of the Lungs is grown great and will grow more great because it is in perpetual motion both sleeping and waking and is dilated and comprest to let the air to the heart and cast fuliginous vapors out by the unnatural heat is made inflammation then the expulsive vertue is constrained to cast out by cough whatsoever is obnoxious unto it for the Lungs cannot be purged but by coughing and by coughing the wound is dilated and grows greater from whence the blood issues out with great abundance which blood is drawn from the heart by the vein arterial to give them nourishment and to the heart by the vena cava his meat was barly broath stued prunes somtimes Panado his drink was Ptisan He could not lye but upon his baâ—k which shewed he had a great quantity of blood spilt within the capacity of the Thorax and being spread or spilled along the spondyls doth not so much press the Lungs as it doth being lain on the sides or â—itting What shall I say more but that the said Lord Martigues since the time he was hurt hath not reposed one hour only and hath alwaies cast out bloody urines and stools These things then Messieres considered one can make no other prognostick but that he will dye in a few dayes which is to my great grief Having ended my discourse I â—rest him as I was wont having discovered his wounds the Physicians and other assistants presently knew the truth of what I had said The said Physiciâ—ns having felt his pulse and known his forces to be almost spent and abolished they concluded with me that in a few dayes he would dye and at the same instant went all toward the Lord of Savoy where they all said that the said Lord Martigues would dye in a short time he answered it were possible if he were well drest he might escape Then they all with with one voice said he had been very well drest and sollicited with all things necessary for the curing of his wounds and could not be better and that it was impossible to cure him and that his wound was mortal of necessity The Monsieur de Savoy shewed himself to be very much discontented and wept and asked them again if for certain they all held him deplored and remediless they answered yes Then a certain Spanish impostor offered himself who promised on his life that he would cure him and if he failed to cure him they should cut him in an hundred pieces but he would not have any Physicians Surgeons or Apoâ—hecaries with him And at the same instant the said Lord of Savoy told the Physicians and Surgeons they should not in any wise go any more to see the said Lord of Martigues And he sent a Genâ—leman to me to forbiâ— me upon pain of life not to touch any more the said Lord of Martigues which I promised not to do wherefore I was very glad seeing he
should not dye in my hands and commanded the said Impostor to dress the said Lord of Martigues And that he should have no other Physicians nor Surgeons but him he came presently to the said Lord of Martigues who told him Senor Cavallero el senor Duge me ha mandadâ— que veniasse a curar vastra herida yo os juro a Dios que antes de achio dias yo os haga subir a Cavello con la lansa en puno contasque no ago que yo quos tâ—gâ—e Comeris y biberis to dis comidas que sueren de vastro gusto y yo hare la dieta pro V. M. y desto os de veu aâ—eguirar sobre de mi yo he sanaâ—o mun hos que tenian magores heridas que la vastra That is to say Lord Cavallere Monsieur the Duke of Savoy hath commanded me to come dress thy wound I swear to thee by God that before eight dayes I will make thee mount on hors-back with thy Lance in thy hand provided that no man may touch thee but my self thou shalt eat and drink any thing that thou hast a minde to I will perform thy diet for thee and of this thou mayest be assured upon my promise I have cured divers who have had greater wounds then thine and the Lord replied God give you grace to do it He demanded of the said Lord a shirt and tore it in little rags which he put across muttering and murmuring certain words over the wounds and having dress him permitted him to eat and drink what he would telling him he would observe a diet for him which he did eating but six prunes and six bits of breatd at a meal and drinking but beer Notwithstanding two dayes after the said Lord of Martigues died and my Spaniard seeing of him in the Agony eclipst himself and got away without bidding farewell to any body and I beleive if he had been taken he had been hangd for his false promises which he had made to monsieur the Duke of Savoy and to divers other Gentlemen He died about ten of the clock in the morning and after dinner the said Lord of Savoy sent Physicians and Surgeons and his Apothecary with a great quantity of Drogues to embalm him they came accompanied with divers Gentlemen and Captains of the Army The Emperors Surgeon came near tome and prayed me kindely to open the body which I refused telling him I was not worthy to carry his plaster-box after him he prayed me again which then I did for his sake if it so liked him I would yet again have excused my self that seeing he was not willing to embalm him that he would give this charge to another Surgeon of the company he made me yet answer that he would it should be I and if I would not do it I might here after repent it knowing this his affection for fear he should not do me any displeasure I took the razor and presented it to all in particular telling them I was not well practised to do such operations which they all refused The body being placed upon a Table truly I purposed to shew them that I was an Anatomist declaring to them divers things should be here too long to recite I began to tell all the company that I was sure the bullet had broken two ribs and that it had pass'd through the Lungs and that they should find the wound much enlarged became they are in perpetual motion sleeping or waking and by this motion the wound was the more dilacerated Also that there was great quantity of blood spilt in the capacity of the brest and upon the midriff and splinters of the broken ribs which were beaten in at the entrance of the bullet and the issuing forth of it had carried out Indeed all which I had told them was found true in the dead body One of the Physicians asked me which way the blood might pass to be cast out by urine being contained in the Thorax I answered him that there was a manifest conduit which is the Vena Azygos which having nourish'd the ribs the rest of the blood descends under the Diaphragm and on the left side is conjoined to the emulgent vein which is the way by which the matter in Pleurisies and in Empuema do manifestly empty themselves by urine and stool As it is likewise seen the pure milk of the brests of women newly brought to bed to descend by the Mammillarie veins and to be evacuated downwards by the neck of the womb without being mixt with the blood And such a thing is done as it were by a miracle of nature by her expulsive and sequestring virtue which is seen by experience of two glass-vessels called Mount-wine let the one be filled with water and the other with Claret-wine and let them be put the one upon the other that is to say that which shall be filled with water upon that which shall be filled with wine and you shall apparently see the wine mount up to the top of the vessel quite through the water and the water descend atraverse the wine and go to the bottom of the vessel without mixture of both and if such a thing be done so exteriorly and openly to the sence of our eye by things without life you must believe the same in our understanding That nature can make matter and blood to pass having been out of their vessels yea through the bones without being mingled with the good blood Our discourse ended I embalmed the body and put it into a coffin after that the Emperors Surgeon took me apart and told me if I would remain with him that he would use me very well and that he would cloath we anew also that I should ride on hors-back I thank'd him very kindly for the honor he did me and told him that I had no desire to do service to strangers and enemies to my country then he told me I was a fool and if he were Prisoner as I he would serve the devil to get his liberty In the end I told him flat that I would not dwell at all with him The Emperors Physician returned towards the said Lord of Savoy where he declared the cause of the death of the said Lord of Martigues and told him that it was impossible for all the men in the world to have cured him and confirmed again that I had done what was necessary to be done and prayed him to win me to his service and spake better of me then I deserved Having been perswaded to take me to his service he gave charge to one of his stewards named Monsieur dn Bouches to tell me if I would dwel in his service that he would use me kindly I answered him that I thanked him most humbly and that I had resolved not to dwell with any stranger This my answer being heard by the Duke of Savoy he was some what in choler and said he would send me to the Gallies Monsieur de
the marrow of the brain drawn out in length whilest it is yet contained within the limits of the skull that offers it self in the first place The first pair of the brain which makes the Optick Nerves that are so famous among all the Masters of Anatomy For these are not only the biggest if thou look upon their thickness but also without doubt the softest of all the nerves of the body But they arise out of the middle of the basis of the brain It s original on the forepart according to the opinion of the Antients but indeed if the head be turned upside down in the dissection wich is the proper way out of the beginning of the former trunks of the spinal marrow that their original is as it were in the back part of the head Progress and presently each of them by little and little making towards its mate they are united not only joyned as some would have it over the saddle of the wedg-bone and making one common square body the marrow within them being mixed together After that presently separating again each of them is carried obliquely into the eye of its own side Insertion entring the orb thereof through the first hole of the wedg-bone and entring at the very centre of the eye In this pair we may easily shew those two membranes which are derived to the nerves from the two Meninges of the brain as also the very inner marrowy substance which comes from the body of the brain Yet the nerve it self is not cleft into more branches as the other are but lying hid makes the coats of the eye and out of the thick membrane it forms that coat which is called Cornea the horney one out of the thin membrane that is called Vvea the grapy one but out of the substance of the marrow the Retina or coat like a net For as soon as it is arrived at the centre of the eye these membranes are displayed and making a sphere contain the humors in them Use These nerves convey the faculty of seeing to the eyes wherefore they being obstructed or comprest a blindeness ensues The holes of the optick nerves Galen hath ascribed holes to them and Herophilus for the same reason called them 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the passages of the sight teaching that there is a sensible hollowness plainly to be seen in them whom for all that almost all Anatomists do contradict But I have heretofore shewen in the University of Padua and in a great assembly of them that there are certain passages continuing from the beginning of these Nerves as far as to the place where they meet together and presently after that vanish away toward the eye And therefore I shewed that the Ancients may not only be excused but also that they writ the truth especially when none of them have said that these passages were great but only such as did not altogether escape the sight if one would make tryal thereof in a great living creature and by a cleer light and presently after it is killed For Galen himself requires these three conditions 7. placit 4 and lib. de oculis that one may see them But before we depart hence I will bring in some problemes that besides the history it self Problemes I may also shew the use of that which I say especially when in our time they only for the most part follow the study of Anatomy who imploy their industry in the behalf of Physick The first therefore shall be what is the cause that many upon sneesing often especially when they have povoked it for the nonce have of a sodain faln blind This happens either because the branches of the sleepy arteries which are so near to the optick nerves that they touch are filled and bring so press together those nerves or else because a copious and that a phlegmatick humor has faln out of the brain into the optick nerves and obstructed them I have seen those that have been bling through the first cause sometimes cured by a Seton but I never remember that any in whom this arose from phlegmatick humors have recovered except one having the French Pox who being annointed with quick-silver all the humors melting away was restored to health But it is not the part of a good and pious Physitian to make use of those things which being full of danger may do more harm if they prove hurtful then they can procure good if they be profitable And truly it is better not to cure blindeness then to cause death although oftentimes rashness helps them whom reason helps not as the most elegant of Physitians Celsus sayes elegantly In the mean time in diseases of the eyes they who practise Physick may learn rather to administer those thing which bring the phlegm out by the palat then to draw the noxious humors to the nostrils That I may conceal besides the danger which they avoid that more profit arises from the medicines that void the phlegm out of the head through the mouth which both long experience hath hitherto taught and Anatomy perswades when the optick nerves in their original are not far distant from the palat but farther from the spongy bone and it is a preternatural way by which the humors are carried as hath been already demonstrated by the learned Vesalius Then it is disputed by what means the eye can fall out of its orb the optick nerve not being broke whereof we may have very many histories But it is not hard to give an answer to wit that the nerves may be very much extended in length Whilest therefore this nerve receives much moisture in the inflammations of the eyes it easily comes to pass that it is slackned but the muscles themselves swelling very much when they can no longer be contained in the orb leap forth out of it For this falling forth of the eyes most commonly proceeds from inflammations such as are the stories the most learned Vega who cured a woman in this case by procuring the flux of her terms and a young man by digesting ointments But the question is very worthy to be made memtion of and that gives me an occasion to explain it which I have read in some Authors that such as were before blind upon receiving of a wound overthwart the forehead and some upon a great loosness of the belly arising on a sodain have received their sight and that presently The cause of their blindness was no other then the compression of these nerves proceeding from the neighbour-vessels to wit the veins and arteries being swoln with blood which such a wound presently emptyed Wherefore I also sometimes and not without success in that species of blindness with the Barbarians tall Gutta serena open the middle vein of the fore-head out of which I draw blood so long till it ceases to run of its one accord The second pair It s original The second pair arises as the ancient Anatomists say
venemous may kiâ—l a man 501. How it may be corrupted 529. Pent up it is apt to putrifie 540. change thereof conduces to the cure of the Plague ibid. Alae what 91 Alantoides tunica there is no such shewed by 3. several reasons 92 Alâ—ugineous humor the use thereof 129 Almonds of the throat or ears their history 208. their tumor with the causes and signs thereof the cure ibid. Almonds increase the pain of the head 253 Alopecia what the cause which curable and how and which not 399 Ammios tunica the substance and composure thereof 92 Amphiblistroides vel retiformis tunica 141 Amputation of a member when to be made 321. How to be performed ibid. to stanch bleeding ensuing thereon 322. how to dress the part ibid. To perform the rest of the cure 324. sometimes made at a joint 325 Anatomy the necessity of the knowledg thereof 53. A threefold method thereof ibid. The definition thereof 54 Anatomical administration of the lower belly 59. Of the Sternon 94. Axioms 106 129 150 Aneurisma what 203. how cured 204. which incurable ibid. Anger the effects thereof 26 Angina see Squinacy Anima how many wayes taken 4. see Soul Animal parts which 56. Their division ibid. Anodyne medicines 709. For the eyes 269. in pains of the teeth 283 Antidotes must be given in great quantities 604. No one against all poysons 520. To be used in cure of the Plague 544 Antipathy see Sympathy Antipathy between some Men and a Cat 517. Of poysons with poyson 530. Ants 39. their care ibid. Apâ—â— their imitation of mens actions 47 〈◊〉 risus the poysonous quality thereof with the cure 517 〈◊〉 concerning wounds made by Gun-shot 305. That such 〈◊〉 are not poysoned 307. Concerning binding of vessels c. Apophlegmatisms what and their use 715 Apophyses clinoides 121 122 Aphorisms concerning Surgery selected out of Hippocrates 548. of the Author 750 Apostumes see impostumes Apothecaries choise of such as shall have care of those sick of the plague 535 Apendices glandulosae 85 Aqua fortis the poysonous quality and the cure thereof 521 Aqua theriacalis the description and manner thereof 484 530. good against the Plague ibid. Aqua vitae how distilled Aqueus humor 129 Arcchnoides sive araneosa tunica 129 Araeotick medicines 695 Archagatus a Roman Surgeon slain by the people 2 Argentum vivum see Hydrargyrum Aristomachus the Philosopher a great observer of Bees 39 Arm or shoulder-bone the fracture thereof 151 Arm and the muscles thereof 151. The defect thereof how to be supplied 585 587 Arsenick the poysonous quality thereof and the cure 521 Arrows wounds made by them and their several formes 309. How to be drawn forth 310 Artery what 66. The division of the great descendent artery 78 84. Distribution of the left subclavian artery 107. the Axillary 149. Of the crural 159. Not dangerous to be opened 402. Rough Artery 109. Figure of the Arteries 107 Arteria venosa and the destruction thereof 102. Carotydes 10. Cervicalis ibid. Intercostalis ibid. Mammaria ibid. Musculosa ibid. Humeraria duplex 107. Thoracica duplex ibid. Aspera 109. Muscula 159 Arthrodia what 173 Articulation and the kindes thereof idid Ascaride how known 491 Ascires see Dropsie Aspe his bite and symptoms that happen thereon with their cure 510 Asses-milk how to be used in the cure of a Hectick 279 Astragaltus 165 Atheroma what 193. The cure thereof ibid. Atrophia how helped 5 Attractive medicines what 695 Auricula cordis 101 Auripigmentum the poysonous quality and the cure thereof 521 Autumn the condition thereof 64 Actioms anatomical 85. 106. 129 Philosophical 129 B BAck-bone and the use thereof 138 Bags the diversity and use 717 Ball-bellows 292 Balneum Mariae 727 Balsams fit to heal simple not contused wounds 307 Balsam of Vesalius's description 735. of Fallopius his descripton ibid. Anodyne and sarcotick one 284 Bandages their differences 343. What cloth best for them ibid. Indications how to fit them ibid. Three kindes necessary in fractures Common precepts for their use 354. uses whereto they serve ib. Bernard the Hermit 689 Barrenness the cause thereof in men 622. In women 623 Basilisk her description bite and the cure thereof 509 Battels where the author was present See voyages Baths good in pain of the eyes 406 Baths their faculties and differences 718 How to know whence they have their efficacie ibid. Their faculties and to whom hurtful 719 half baths ibid. Beautrol a beast of Florida 683 Bear-worms the bites and the cure thereof 513 Bears their craft 36 Beasts inventors of some remedies ibid. Their faculty in presaging ibid. Their love and care of their young 38. Most wilde ones may be tamed 39. They know one anothers voice 47 Bees their government 38. Care and justice ibid. Their stinging and the cure thereof 512 513 Beggars their cosenages and crafty tricks 664 Belly why not bone 547. The division of the lower belly ibid. Bezoar and Bezoartick medicines 550 Biceps musculus 154 Bindeing of the vessels for bleeding 242. An Apology therefore Authorities therefore Reason experience Histories to confirm it Birds their industry in building their nests 37. Ravenous birds counterfeit mans voice 48. they have taught men to sing ibid. Bird of Paradise 680 Birth See Childe-birth Bitings of man and beast virulent 502 Bitings of a Mad dog Adder c. See Dog Adder c. Bitter things not fit to be injected into wounds of the Chest 276 Bladder of the Gall 76 Bladder of urine 86. The substance figure c. ibid. Signs of the wounds thereof 280. Ulcers thereof and their cure 338 437 Blear-eyes their differences and cure 405 Bleeding in wounds how helped 232. How stopped by binding the vessels 266. Why devised by our Author 325. In amputation of members 322 Blood the temper thereof 7. The material and efficient causes thereof ibid. Where perfected ibid. All the four humors comprehended under that general name ibid. compared with new wine ibid. the nature consistence color taste and use 8 Blood letting whether necessary at the beginning of pestilent diseases 545 Blood-letting whether necessary in a synochus 186. When in an Erysipelas 187. When in a Tertian 189. In what wounds not necessary 231. The two chief indications thereof 255. Why necessary in the fracture of the Heel See Phlebotomy Bloody urine and the causes thereof c. 436 Boat-bone 167 Body how divided 56 58. The forepart thereof 59. The back-part ibid. The crookedness thereof how helped 568 Bolsters and their use 278 Bones how they feel 54. Their definition 95. Their differences ibid. How hurt by the trepan 259. What hastens their scaling ibid. Their corruption 283. How helped 263 Bones of the scul 113 124. of the face 138. of the nose ibid. of the auditory passage 133. of the arm 151. of the back 138. of the brest 94. of the cubit 153. of the wrist and fingers 155. Seed-bones 156. Of the thigh 162. of the leg 164. Of the foot 265. of the toes
c. ibid. Their muscles coats and humors 129. their wounds 130. to hide the loss or defect of them ibid. their ulcers 333. their cure 334. their effects 402. c. their inflammation 403 F FAce discloser of affections and passions 26. the wounds thereof 267. How to help the redness thereof 723 Faculties what 15. their division 14 Falling down of the Fundament the causes and cure thereof 223. Fat the substance and cause c. thereof 61. Why not generated under the skull 267. How to be distinguished from the brain ibid. the cure thereof being wounded 181 Fauces what 136 Faulcon her sight with the Hern. 47 Faults of conformation must be speedily helped 504. Of the first concoction nor helped in the after 451 Fear and the effects thereof 26 Fever sometimes a symptom otherwise a disease Fevers accompanying Flegmons and their cure 185 Happening upon Erysipelous tumors 208. Upon Oedematous tumors 189. Upon Schiâ—thous tumors 202. The cure of bastard intermitting Fevers 208 Feet and their bones 165. Their twofold use 168 Fierce Clare a fish 516 Females of what seed generated 591 Fiâ—ra curis what 132 Fibula 164 Figures in Anatomy and the first of the forepart of man 58. Of the backparts thereof 59. Of the lower belly and parts thereof 68 69. Of the stomach 71. of the vessels of seed and urine 81. Of the bladder and yard 86. Of the womb 89. Of some parts in women different from those of men 91. Of the hollow vein 104. Of the Arteries 105. Of the rough Artery or weazon 109. First and second of the brain 125. Third of the Cerebellum 130. Fourth and fifth of the brain 118. The sixth of the brain ibid. Seventh shewing the Nerves of the brain 120. The eighth of the brain 121. Of the spinal marrow 123 Of the eye 128. Of the chief muscles of the face 131. Of the lower jaw 132. Of the ears 133. Of the back-bone 139. Of the muscles in sundry parts of the body 140 141 142 143. 144 145. Of the nerves 119 Of the bones in the hands 155. Of the thigh bone 162. Of the bones in the feet 165. Of the Sceleton 171 172 Figures of instruments used in Surgery See Instruments Figures of divers sorts of javelins and arrow-heads 310 Figures of monsters 64. 643 c. Of divers beasts c. as of Succarath 39. Of the Elephant 47 685. Rhinoceros 43. Of the Camel 46. Of the Crocodile 51. Of the Crab 199. Of the Scorpion c. 488. Of the Serpent Hemorrhous 508. Of the Serpent Seps ibid. Of the Basilisk 509. Of the Salamander ibid. Torpedo 510. Of the Sting Ray 516. Of the Sea-hare ibid. Of the Monk and Bishop-fish 670. Of the Sea-devil 671. Of the Sea-Mors ibid. Of the Sea-Bore 672. Of the fish Hoga 674. Of a Monstrous flying-fish 675. Of Bernard the Hermit 676. Of the sailing-fish ibid. Of the Whale 677. Of an Estridg 678. Of the bird of Paradice 680. Of a Giraffa 681. Of a beast called Thanacth 687. Of the beast Haiit and a Monstrous African-beast 684. Of a Cameleon 686 Figures of Fornaces and other things fit for distillation 727 728 729 730 731 732 733 734 735. Figure of a fractured arm with a wound in a fit posture 358. Of a Leg fractured with a wound and bound up 363. Of Ligature for extention 372. How to restore the dislocated spine 377. Of putting the shoulder into joint 380 381 382 383 384 385. Of the Ambi and the use thereof 385. Of restoring the dislocated elbow 387. Of the thigh-bone dislocated inwards 393. Outwards 394. Of restoring a knee dislocated forwards 395 Figure of a Semicupium 424. Of a Barrel to be used in the cure of a Caruncle 476. Of the Helmet-flour 519. Of the situation of the Childe in the womb 600. Of leaden nipples 609. Of a glass to suck the breasts with 614 Figures of Artificial Eyes 562. Of noses 564. Of teeth 565. Palats ibid. How to supply the defect of the tongue 566. Of the Ears 567. Iron Breast-plates 568. Of an urin basin and Artificial-yard 583. Of an iron finger-stall ibid. Of an Erector of the hand 584. Of boots for such as are crook-legged 585. Of an artificial-hand 586. Of an arm and leg 587 588. Of a crutch 589 Filings of lead their harm taken inwardly and cure 521 Filtration the manner and use thereof Fingers and their parts c. 155. their dislocation why easily restored 156. how to take away such as be superfluous and help those that stick together 417. How to supply their defects 583 Fire and the qualities thereof 3. The force thereof against the Plague 529 Fishes their industry 44. They may be tamed 42 Fisherman a fish so called 45 Flatulent tumors their causes signs and cures 191 192 Flatulencies about the joints counterfeiting the Gout 59 Fistula lacrymosa see Aegilops Fistulas what their differences signs c. 340. Their cure 341. In the Fundament ibid. The cure ibid. Upon the wounds of the chest and the cure 276 Fleshly Pannicle the History thereof 61 Flesh quickly putrifies in maritime parts 293 Flexores musculi 163. Superior 618 Flux of blood in wounds how helped 232 Flux of the belly how to be stopped 559 560 Flying fish of a Monstrous shape 675 Focile what 164. How to cure the separation of the greater and lesser 627. The separation from the pastern-bone 628 Fomentations and their use 711. For broken bones 368. They hurt plethorick bodies ibid. What to be observed in their use ibid. Fornaces their matter and form 725 727 728 c. Fornix 117 Foxes and their crafts 44 Fracture what and the differences thereof 348. Their causes ibid. Signs and Prognosticks ibid. 349. Their general cure 350. How to help the symptoms 351 Why deadly in the joynt of the shoulder 354. why near a joint more dangerous 361. Fractures of the skull their differences 238 Of the causes and signs 240. Signs manifest to Sense 241. A fâ—â—ure the first kind of fracture ibid. How to finde it being less manifest ibid A contusion the second kinde of fracture 243. An estracture the third kinde 245 A Seat the fourth kinde 247 Resonitus the fifth kinde ibid. The prognosticks 250. general cure of them and their symptoms 353. They are hurt by Venery 255. By noise ibid. The particular cure 257. Why trepanned 258 Fractures more particularly and first of the nose 352. Of the lower jaw ibid. Of the Collar-bone 353. Of the shoulder-blade 354. Of the breast-bone ibid. Of the Ribs 355. Of the vertebrae or Rack-bones 356. Of the Holy-bone 357. Of the Rump ibid. Of the Hip ibid. Of the shoulder or arm-bone ibid. Of the cubit or Ell a Wand 358. Of the Hand 359. Of the Thigh ibid. Of the Thigh near the joynt 361. Of the patella or whirl-bone 362. Of the leg ibid. Of the bones of the feet 368 Fractures associated with wounds how to be bound up 345 363 French Pox see Lues Venerea
the Sanies or matter Or else â„ž Mellis rosar â„¥ ij farinae hord pulver aloes mastich Ireos florent an Ê’ ss aqua vitae parum let them be incorporated together and make a detersive medicine for the foresaid use Sometimes also the Crassa Meninx is inflamed after Trepaning and swoln by a Phlegmon that Paulus lib. 6. cap. 90. impatient of its place it rises out of the hole made by the Trepan and lifts it self much higher then the skull whence grievous symptoms follow Wherefore to prevent death of which then we ought to be afraid we must inlarge the former hole with our cutting mullets that the matter contained under the skull by reason of whose quantity the membrane swells may the more freely breathe and pass forth and then we must go about by the prescript of the Physitian to let him bleed again to purge and diet him The inflammation shall be resisted by the application of contrary remedies as this following fomentation â„ž Sem. lini althae fon psillii ros rub an â„¥ j. solani plantag an M. j. bulliant in aqua tepida communi ex qua fiat fotus Anodyne and repelling medicines shall be dropped into his ears when it is exceedingly swoln that the tumor may subside Remedies for the inflammation of the Crassa Meninx you shall cast upon it the meal or floure of lentils or vine leaves beaten with Goose grease With all which remedies if the tumor do not vanish and withall you conjecture that there is Pus or matter contained therein then you must open the Dura Mater with your incision-knife holding the point upwards and outwards for so the matter will be poured forth and the substance of the brain not hurt nor touched Many other Chirurgeons and I my self How we must open the Crassa Meninx when it is impostumate have done this in many patients with various success For it is better in desperate cases to try a doubtful remedy then none at all also it oft-times happens whether by the violence of the contusion and blow or concretion or clotting of the blood which is shed or the appulse of the cold ayre or the rash application of medicines agreeing neither in temper nor complexion with the Crassa Meninx or also by the putrefaction of the proper substance that the Dura Mater it self becomes black The causes and remedies of the blackness of the Dura Mater Remedies for contusion Of which symptome the Chirurgion must have a great and special care Therefore that thou mayst take away the blackness caused by the vehemency of the contusion you shall put upon it oyle of eggs with a little Aquae vitae and a small quantity of Saffron and Orris roots in fine powder you shall also make a fomentation of discussing and aromatick things boyled in water and wine and Vigoes Cerat formerly described shall be applyed But if the harm come from congealed blood you shall withstand it with this following remedie â„ž Aqua vitae â„¥ ij granor tinctorum in tenuem pulverem tritorumÊ’ijss croci ℈ 1. Mellis rosat â„¥ ijss sarcocol Ê’iij Leviter simul â—â—lliant omnia de colatura infundatur quousque nigrites fuerit obliterata For congealed blood If this affect come by the touch of the ayre it shall be helped with this following remedy â„ž Tereb ven â„¥ iij Mellis ros For the hurt received by the Ayre â„¥ ij Vitellum ov unum farin hordeiÊ’iij croci ℈ j. sarcocol Ê’ij aq vitaeÊ’ij Incorporentur simul â—ulliant paululum This remedy shall be used untill the blackness be taken away and the membrane recover its pristine colour What medicins make the Crassa Mâ—ninx black But if this affect proceed from the rash use of medicines it must be helped by application of things contrary For thus the offence caused by the too long use of moist and oyly medicines may be amended by using catagmatick and cephalick powders but the heat and biting of acrid medicines shall be mitigated by the contrary use of gentle things for both humid and acrid things somewhat long used make the part look black that truly by generating and heaping up filth but this Medicins against the putrefaction of the Meninx by the burning and hardening heat But when such blackness proceeds from putrefaction Iohn de Vigo commends the following remedy â„ž aqua vitae â„¥ ij mellis rosat â„¥ ss But if the affect be grown so contumacious that it will not yeeld to this gentle remedy then this following will be convenient â„ž Aq. vitae â„¥ iij. mellis ros â„¥ j. pulver Mercur. Ê’ij unica eâ—ullitione bulliant simul ad usum dictum Or â„ž aqua vit â„¥ jss syrup absinth mellis rosat an Ê’ij unguenti AegyptiaciÊ’jss sarcocol myrrhae aloes an.Ê’j. vini albi boni odoriferi â„¥ j. Bulliant leviter omnia simul colentur ad usum dictum But if the force of the putrefaction be so stubborn that it will not yeeld to these remedies it will be helped with Aegyptiacum made with plantain water instead of Vinegar used alone by it self or with the powder of Mercury alone by it self or mixt with the powder of Alome Neither must we be afraid to use such remedies especially in this extream disease of the Dura Mater for in Galens opinion the Crassa Meninx after the skull is trepaned delights in medicines that are acrid Why the Crassa Meninx easily endures acâ—id medicins that is strong and very drying especially if it have no Phlegmon and this for two reasons the first is for that hard and dry bodies such as membranous bodies are be not easily affected unless by strong medicines the other is which must be the chief and prime care of the Physitian to preserve and restore the native temper of the part by things of like temper to it But if the auditory passage not only reaching to the hard membranes of the Brain but also touching the Nerve which descends into it from the brain suffer most vehement medicines though it be placed so neer certainly the Crassa Meninx will endure them far more easily and without harm But if by these means the putrefaction be not restrained and the tumor be encreased so much that the Dura Mater rising far above the skull remains unmoveable black and dry and the patients eyes look fiery stand forth of his head and rowl up and down with unquietness and a phrensie Signs of death at hand and these so many ill accidents be not fugitive but constant then know that death is at hand both by reason of the corruption of the gangraen of a noble part as also by extinction of the native heat CHAP. XXII Of the cure of the Brain being shaken or moved What the concussion of the brain is WE have formerly declared the causes signs and symptoms of the concussion or shaking of the Brain without any wound of the musculous skin or fracture of the bone wherefore for
the present I will treat of the cure Therefore in this case for that there is fear that some vessel is broken under the skull it is fit presently to open the cephalick vein And let blood be plentifully taken according to the strength of the Patient as also respectively to the disease both which is present and like to ensue taking the advice of a Physitian Then when you have shaven away the hair you shall apply to the whole head and often renue the forementioned cataplasm Ex fâ—rinis oleo rosaceo oxymelite and other like cold and moist repelling medicines But you must eschew dry and too astringent medicins must be shunned such as are Unguentum de bolo and the like for they obstruct too vehemently and hinder the passage forth of the vapours both by the sutures and the hidden pores of the skull Wherefore they do not only not hinder the inflammation but fetch it when it is absent or encrease it when present The belly shall be loosed with a clyster and the acrid vapours drawn from the head for which purpose also it will be good to make frictions from above downwards to make straight ligatures on the extream parts to fasten large cupping-glasses with much flame to the shoulders and the original of the spinal marrow that so the revulsion of the blood running vioâ—ently upwards to the brain and ready to cause a phlegmon may be the greater The opening of the Vena Puppis The following day it will be convenient to open the Vena Puppis which is seated upon the Lambdall suture by reason of the community it hath with the veins of the brain and shutting the mouth and nose to strive powerfully to breathe For thus the membranes swell up and the blood gathered between them and the skull is thrust forth but not that which is shut up in the brain and membranes of which if there be any great quantity the case is almost desperate unless nature assisted with stronger force cast it forth turned into Pus But also after a few dayes the vena frontis or forehead-vein may be opened as also the Temporal Arteries and Veins under the tongue that the conjunct matter may be drawn forth by so many open passages In the mean space the Patient must keep a spare diet and abstain from wine especially until the 14th day for that until that time the fearful symptoms commonly reign But repelling medicins must be used untill the 14th day be past A discussing fomentation A caution in fomenting the head then we must come to discussing medicins beginning with the more milde such as is this following decoction â„ž rad Alth. â„¥ vj. ireos cypari calam arom an â„¥ ij fol. salviae majoran betonic flor chamaem melil ros rub stoechad an M. ss salis com â„¥ iij. bulliant omnia simul secundum artem cum vinâ— rub aqua fabrorum fiat decoctio Let the head be washt therewith twice a day with a spunge But yet when you do this see that the head be not too much heated by such a fomentation or any such like thing for fear of pain and inflammation A caution in fomenting the head Then you shall apply the cerate of Vigo which hath power to discuss indifferently to dry and draw forth the humors which are under the skull and by its Aromatick force and power to confirm and strengthen the Brain it thus described â„ž Furfuris bene triturati â„¥ iij. farin lentium â„¥ ij ros myrtillor foliorum granorum ejus an â„¥ j. calam A description of Vigo's Cerate aromat â„¥ i ss chamaemel melil M. ss nuces cupressi num vj. olei rosacei chamaem an Ê’ iij. cerae albae â„¥ ij ss thuris mastichis an Ê’ iij. myrrhaeÊ’ ij In pulverem quae redigi dâ—bent redactis liquefactis oleis cum cera omnia misceantur simul fiat mixtura quae erit inter formam emplastri ceroti Vigo saith that one of the Duke of Urbins Gentlemen found the Urine hereof to his great good A History He fell from his Horse with his head downwards upon hard Marble he lay as if he had been dead the bloud gusht out of his nose mouth and ears and all his face was swollen and of a livid colour he remained dumb twenty days taking no meat but dissolved Gellies and Chicken and Capon broths with Sugar yet he recovered but lost his memory and faultered in his speech all his life after To which purpose is that Aphorism in Hippocrates Aph. 58. sect 7. Those that have their Brain shaken by what cause soever mus of necessity become dumb yea also as Galen observes in his Commentary lose both their sense and motion That Cerot is not of small efficacy but of marvellous and admirable force which could hinder the generating of an abscess which was incident to the Brain by reason of the fall Yet there be many men so far from yielding to reason that they stifly deny That there may be an abcess in the brain Aph. 10. sect 6. that any impostumation can be in the Brain and augmenting this errour with another they deny that any who have a portion of the Brain cut off can recover or rise again but the authority of ancient Writers and Experience do abundantly refel the vanity of the reasons whereon they rely Now for the first in the opinion of Hippocrates If those which have great pain in their heads have either pus water or bloud flowing from their Nose Mouth or Ears it helps their disease But Galen Rhasis and Avicen Gal. lib. de inaequal intemp Rhas cap. 4. contineâ—t Avicen cap. de exit sen 3. lib. 4. cap. 20. A History affirm that Sanies generated in the Brain disburdens it self by the Nose Mouth or Ears and I my self have observed many who had the like happen to them I was told by Prothais Coulen Chirurgeon to Monsieur de Langey that he saw a certain young man in the Town of Mans who often used to ring a great Bell he once hanging in sport upon the rope was snatcht up therewith and fell with his head full upon the pavement he lay mâ—te was deprived of his senses and understanding and was besides hard bound in his Belly Wherefore presently a Feaver and Delirium with other horrid symptoms assayled him for he was not trepanned because there appeared no sign of fracture in the skull on the seventh day he fell into a great sweat with often sneesing by violence whereof a great quantity of matter and Pus flowed of forth his ears mouth and nose then he was eased of all his symptoms and recovered his health Now for the second Lib. 8. de usu part com ad Aph. 18. sect 6. Galen affirms that he saw a Boy in Smyrna of Ionia that recovered of a great wound of the brain but such an one as did not penetrate to any of the ventricles But Guido of Cauliac
of Serpents in the curstness of its poyson The efficacie of the poyson of the Basilisk Therefore it is affirmed by Nicander that into what place soever he comes other venomous creatures do forthwith flie thence for that none of them can so much as endure his hissing for he is thought to kill all things even with this and not with his biting and touch only besides if any of them hasten to get any meat or drink and perceive that the Basilisk is not far from thence he flies back and neglects the getting of nourishment necessary for life Galen writes Lib. de Theriac that the Basilisk is a yellowish Serpent with a sharp head and three risings distinguished with white spots and rising up in form of a Crown by reason whereof he is stilled the King of Serpents Why the Basilisk is thought to kill by his onely sight Certainly the violence of his poyson in killing men is so great that he is therefore thought to kill men and other creatures by his sight only Solinus affirms that the body of a Basilisk hath wondrous faculties Wherefore the inhabitants of Pergamum in ancient times gave a mighty price for one to hang upon the joists of the temple of Apollo so to drive away the Spiders and Birds lest they should weave their webs or the other build their nests in that sacred place Verily no ravenous creature will touch their carkcass but if constrained by hunger they do touch it then they forthwith fall down dead in the same place and this happens not only by eating their body Plin. lib. 8. c. 21. but also by devouring of the bodies of such beasts as are killed by their bitings They kill the trees and shrubs by which they pass not only by their touch but even with their breath Among the western Aethiopians is the fountain Nigris near which there is a Serpent called Catablepas The Catablepas small in body and slow having a great head which it scarce can carry but that it lies alwaies upon the ground otherwise it would kill abundance of people for it forthwith kills all that sees the eies thereof the Basilisk hath the same force he is bred in the province of Cyrene of the length of some twelve fingers with a white spot in his head resembling a crown he chaseth away all serpents with his hiss Weasels are the destruction of such monsters thâ—s it pleased nature Nothing in nature without its equal that nothing should be without its equal they assail them in their dens being easily known by the barrenness or consumption of the soil These kill them also by their sent and they die and the sight of nature is ended thus nature to the magnanimous Lion lest there should be nothing which he might fear hath opposed the weak creature the Cock by whose crowing only he is terrified and put to flight Erasistratus writes Symptoms that a golden yellowness affects the bitten part of such as are hurt by a Basilisk but a blackness and tumor possesseth the rest of the body all the flesh of the muscles within a while after falling away piece-meal Cure An antidote against this must be made of a dram of Castoreum dissolved in wine and drunken or in the juice of poppy But Aetius thinks it superflous to write remedies against the Basilisk when as the sight and hearing only kills such as either see or hear her The figure of a Basilisk CHAP. XX. Of the Salamander THe Salamander kills not only such as it bites by making a venomous impression The malignity of a Salamander but it also infects the fruits and herbs over which it creeps with a spittle or gross moisture which sweats out of all the body to the great danger of the health and life of such as eat these things at unawares wherefore it need not seem strange which is received by some late writers that some families have all died by drinking water out of the pits whereinto a Salamander by accident was fallen For if it shall creep upon a tree The temper of her it infects all the fruit with the qualities of cold and moist poison wherein it yields not to Aconite Aetius writes that such as are infected with the poison of a Salamander certain parts of their body grow livid so that they fall away often being putrefied At the first there appear white spots Symptoms over the body then red after wards black with putrefaction and the falling away of the hairs The cure is The cure to procure vomit to loose the belly with a glyster and to give them Treacle and Mithridate in potions Avicen prescribes the same things against this kind of poison as against opium Lib. 2 cap. 54. by reason of the cold nature of them both the proper antidote is turpentine styrax nettle seeds and cypress-leaves Dioscorides writes that the Salamander is a kind of Lizard dull variegated and which is falsly reputed not to be burnt by fire But Pliny saith she is so cold that she extinguisheth the fire by her touch only being laied upon hot coles On the contrary Matthiolus saith How a Salamander may be said to live in the fire that cast into a great flame they are quickly consumed It is easie out of Actiuâ— to reconcile these disagreeing opinions This creature saith he passeth through a burning flame and is not hurt the flame dividing it self and giving her way but if she continue any time in the fire the cold humor being consumed in her she is burnt Now the Salamander is black variegated with yellow spots star-fashion The figure of a Salamander CHAP. XXI Of the Torpedo The craft of the Torpedo THe Torpedo hath his name from the effect by reason that by his touch and power the members become torpid and numme in muddy shoars it lives upon fish which the catcheth by craft His stupefying force For lying in the mud she so stupefies those that are nigh her that she easily preys upon them she hath the same power over men for she sends a numness not only into the arm of the fisher-man but also over all his body although his fishers pole be between them The effigies of a Torpedo CHAP. XXII Of the bitings of Asps Symptoms THe wound which is made by an Asp is very small as if a needle were thrust into the part and without any swelling These symptoms follow upon her bite sudden darkness clouds their eies much agitation in all their bodies but gentle notwithstanding a moderate pain of the stomach troubles them their fore-heads are continually troubled with convulsive twitchings their cheeks tremble and their eie-lids fall gently to rest and sleep the blood which flows from the wound is little but black death no longer deserred then the third part of a day will take them away by convulsions unless you make resistance with fitting remedies The male Asp makes two wounds Cu cing the
female sour as it also happens in the bitings of vipers Now for that the poison of Asps congeals the blood in the veins and arteries therefore you must use against it such things as are hot and subtil of parts as mithridate or treacle dissolved in aqua vitae and the same powred into the wound the patient must be waâ—med by baths frictions walking and the like When as the hurt part becometh purple black or green it is a sign that the native heat is extinct and suffocated by the malignity of the venom Therefore then it is best to amputate the member if the patient be able to endure it and there be nothing which may hinder An history Vigo writes that he saw a Mountebank at Florence who that he might sell the more of his Antidotes and at the better rate let an Asp to bite him by the finger By what means Asps may be made less hurtful but he died thereof some four hours after To the same purpose you may read Matthiolus whereas he writes that those Impostors or Mountebanks to cozen the better and deceive the people use to hunt and take vipers and asps long after the spring that is Gal. lib. de Ther. ad pisonem then when as they have cast forth their most deadly poison then they feed them with meats formerly unusual to them so that by long keeping and care and at the length they bring it to pass that they put off a great part of their venomous nature neither being thus satisfied they make them oftentimes to bite upon pieces of flesh that so they may cast forth into them the venom which is contained in the membrane between their teeth and gums Lastly they force them to bite lick and swallow down an astringent medicine which they compose and carry about for the same purpose that so they may obstruct the passages by which the venom used to flow out for thus at length their bites will be harmless or without great danger This therefore is their art that so they may sell their counterfeit treacle to the people at a high rate as that which is a most safe remedy against all poisonous bites Against the bites of what serpents treacle doth no good Christopher Andrew in his book called Oicoiatria writes that the Islands of Spain are every where full and stored with serpents asps and all sorts of venomous beasts against whose bites they never observed or found any benefit in treacle But the efficacy of the following Antidote is so certain and excellent and approved by so manifold experience that in the confidence thereof they will not be affraid to let themselves be bitten by an Asp Now this medicine is composed of the leaves of Muller A certain remedy against the biting of Asps Avens and red-stock-gilliflowers in like quantity which they boil in sharp vinegar and the urine of a sound man and therewith foment the wounded part Yet if he have not taken nor used any thing of a good while after the wound it will be better and more certain if the patient drink three ounces of this decoction fasting two hours before meat CHAP. XXIII Of the biting of a Snake I Have thought good in a true history to deliver the virulent malignity of the bite of a Snake An history and the remedies thereof When as King Charls the ninth was at Moulins Mounsieur le Feure the Kings Physician and I were called to cure the Cook of the Lady of Castelophers Who gathering hops in a hedg to make a sallet was bit on the hand by a snake that there lay hid he putting his hand to his mouth sucked the wound to ease the pain by sucking forth the venom But his tongue forthwith swelled so big that he could not speak his mind besides his whole arm even to his shoulder was in like sort much swelled his pain was so vehement that it hath made him swound twice in my presence his face was wan and livid like to a dead body The cure and though I despaired of his recovery yet not suffering him to be quite forsaken I washed his mouth with Treacle dissolved in white wine and gave him some thereof to drink adding thereto some aqua vitae I opened his swoln arm with many and deep scarifications especially in the place where he was hurt I suffered the blood which was wholly serous and sanious to slow more plentifully I washed the wounds with treacle and mithridate dissolved in aqua vitae and then I put him exceeding warm in bed procuring sweat and making him to lie awake lest sleep should draw the poison inwards to the entrails I by these means so far prevailed that on the day after he was freed from all his malign symptoms Therefore I judged it only remained for a perfect cure that the wound should be long kept open and washed with treacle neither was I deceived for within a few daies he was perfectly recovered CHAP. XXIV Of the bitings of Toads THough Toads want teeth The bites of Toads how harmful yet with their hard and rough gums they so straitly press or pinch the part which they shall take hold on that they will force their poison thereinto and so over the whole body by the pores of the pressed part Moreover they cast forth their venom by urine spittle and vomit upon herbs but chiefly upon Strawberries the which they are reported greatly to affect Hence many suddenly and ignorantly catch their deaths I heard from a man of very good credit An history that there were two Merchants not far from the City Tholous who whilest dinner was providing walked into the Garden that belonged to the Inn where they gathered some sage leaves and unwashed as they were put them into their wine The symptoms occasioned by the poison of Toads They had not as yet dined when being taken with a sudden Vertigo the whole Inn seemed to run round then losing their sight they fell into a swound intermixed now and then with convulsions But they stamered with their lips and tongues becomming black a froward and horrid look with continual vomiting and a cold sweat the fore-runner of death which presently seized upon them their bodies becoming exceedingly much swoln But the Justices of the place suspecting that they were poisoned made the Inn-keeper and the Guests to be apprehended being examined they all constantly and with one voice answered That the dead parties ate of the same meat and drink which the rest did but only they put sage into their wine A Physician was asked the question whether sage might be poisoned he answered it might but to come to the purpose it must appear whether any venomous creature hath poisoned the plant with her spittle or venomous sanies This which was lightly pronounced and only by conjecture was by the eie found to be true For at the root thereof there was found a hole in the ground full of Toads who got