be of very good use in Surgery as at the off-cutting of a member at the thickest part in the thigh and in two or three places more as when an Excrescence is to be cut off or other things well known to judicious Surgeons But that it should be of any use in wounds there I deny it absolutely and am fully perswaded that nothing but misery thereby is caused For as soon as the little white veines feel the heat of the fire they shrink presently grow shorter and may never be brought to their former length all judicious Surgeons must confess so much Unto which misery this is incident also or rather will ensue thereupon that a Wound thus burnt will never heal so soon and so well as those will which never had such things supplied the reason of it is known to many And ah how many Wounds are thereby inflamed and the parties lame when doubtless they might have done better In my youthful dayes I have been an eye witness how one received a Wound about his temple of four fingers Example breadth oh how was this poor man tortured with Corrosives with lighted cotten Wooll with nealed Iron and the like being thrust into his Wound and all to no purpose for the bleeding of it could not be quenched All these Surgeons being in a despair about their Patient whom they thus unmercifully tormented not knowing what to do any further in this case they wish'd the Patient to commit himself to God Almighty which however ought to be done without their grave advise when all their applied meanes would neither take nor work there came forth an old Woman laid some kind of haires on a leather and laid into the Wound a piece of lint or quilt and then she applied her plaister it stenched the blood and the Party was healed was not this old Woman more skilful and surer in her Art than all these Surgeons Barbers Doctors that were then present My self at that time being very young and unexperienced was ashamed for their sake though I had very little judgement that they professing that Art had so little judgement in it Some sixteen yeares ago there was a young man at B. Sharp oil of Marcasts is said to stanch bleeding which received hurt in his buttocks which did bleed very much which a Barber-Surgeon could not stench with his sharp bloud-stencher which in that place was held a Master-piece to stench it What do you think this Barber-Surgeon had done He took that biting oil of Antimony prepared with Sublimed Mercury dipt cotten Wool in it thrust it to the Wounds bottom this was such a rarity and secret skill that this young man out-breathed his last within few houres after for it most miserably tormented him who might have been very well saved if this Barber had not medled with him If I should rehearse all what miseries I have seen committed Intolerable miseries caused by burning by burning of wounds that did bleed though I have seen but little and have but small experience yet time would fall short with me to rehearse all and it would prove tedious unto the Reader to hear and read such a long tale besides I should but pull an old house about my eares if I should put them to the publick view and the rather because some antient Surgeons find some of the above named blood stenchings very necessary Therefore I let it rest hoping that judicious Surgeons will take my writing in good part and gather from thence that among the Antients there was great ignorance by misunderstanding as well as there is now adayes or rather more To prevent these abuses in my judgement there is nothing better to be used in blood stenching then quilts lints or mulli puffs cotten Wool or the like As for example if a Wound bleedeth and the cause of it is unknown then do not feel nor stir in the Wound nor apply any ointment but onely use a plaister but in case the bleeding would not cease then such said things may be used or any other fitting thing but if the Wound doth bleed but little in time when the Patient either walketh or sleepeth then bind it gently and apply the plaister where it bleedeth then you may soonest know from whence the blood cometh and if there be any loose or shatterd piece in it which causeth the bleeding being bound slack it casts up a ball or soft flesh like coam'd wool let it be gently press'd in again it is a sure token that there is a shatterd piece in it which is not altogether loose yet striveth to come forth where lieth a blood-vein which that loose piece doth hurt when stirred Now such like things being at hand no haste at all must be made with nor search made into the Wound for that search would put the Surgeon and Patient upon more work and increase the bleeding and the vein being deeply hid out of sight and no coming unto it would produce new troubles Therefore onely burnt Allom very subtilly pulverised clapped in and upon which is strong enough for it for if stronger or sharper things should be used they would through-run the Wound insomuch that the cure would be delayed where it had been almost performed That Allum must be let alone till it drops away or comes off by melting and in case it should not come out the next day then stray more Allum upon it then it will soon take away that flesh which hangeth on that splinter but in case that splinter should follow also and the flesh about it all consumed then that splinter hangeth yet on a panick which must come out also However proceed in the healing as if there were no such splinter therein it will loosen of its own accord the healing will put that aside even as an old tooth must give way to a young one even so the new flesh driveth out that piece at the wound easily insomuch that it may be taken away without danger Search not with any Iron or Silver Instruments into the Wound for if you touch any bone or crisle especially in such members that are full of them then that joynt will never take any flesh I give warning to all I have found it so desire no more to search it is a common saying amongst them because there are more such loose pieces in the Wound they will have them all out and feel and search in the Wound like a blind man It is a great foolishness to feel and groap about Wounds touch them with hard fingers without and search their inside with Instruments You Novices in Surgery when three five or more are called together to such a Patient suffer not the Patients Wound so rudely to be toucht for I speak by knowledge and not out of other mens opinions and know what hurt is done thereby CHAP. V. Of the Abuses in Phlebotomy how some supposed to stench bleeding with an example illustrated HAving begun to treat of blood stenching I could
not Abuses in Phlebotomy chuse but to declare some abuses committed by some Nations as in Italy and France in phlebotomy where they make many Experiments upon wounded men in stenching of blood and in doing other great feats For if any be wounded among them falling into their hands then the next day they open a vein and that without measure and knowledge not regarding how much the Patient hath bled already but what good they effect thereby may be seen out of this ensuing example where I was an eye witness In a certain place which for some reason shall go nameless I saw a wounded party which had bled very much and was brought very low thereby the next day came the Doctor which undertook to cure him who brought a Barber with him to open a vein of the Patient who had already lost too much blood that opened vein could not bleed because there was but little of blood in it and that little Nature reserved in store for to help her self withall This Doctor would needs have blood and seeing that that vein would not yeild so much as he expected he caused another vein to be opened whether that would satisfie his thirst after blood but little came out of it and the poor Patient died under his hand This is related here not to that end as if I would condemn Phlebotomy altogether for the defence of the wounds Phlebotomy not wholly condemned for I have seen more than once that Phlebotomy hath done much good to wounded men and fell out very well for their healing I onely related it to that end because it is used by some very indiscreetly whereby they did all manner of mischeif true they give some reason why they do so as namely in respect of a rheum which fals down from the head as they call it so will I call it also that it may not altogether fall upon the wounded side but may be diverted that the wounded party may be in the lesse perill Whether this be so I cannot tell nor can I agree with them herein for the symptoms of wounds take for the most part their cause from the place where the wound is and not from the head as I shall make further declaration of it neither are these symptoms caused by the blood but rather by the abuses that are committed amongst which this abuse also of the which I now treat may be numbered It is true Phlebotomy is used with great utility in all such wounds where the wounded have either gotten a Paroxisme of a Feaver or they fear one which may be caused either by frights or by anger Phlebotomy is used also with advantage when a party hath received a stab in the body and it is feared that there is congealed blood in the body in such a case Phlebotomy is not onely advantagious but also necessary when the blow given was done either by force or with a fall and the party bled but little especially in head Wounds which bleed but little Such Wounds are dangerous by reason of congealed blood which by this meanes may be driven out Here I must needs relate a custom which some have to expel congealed blood For when they have a wounded man in cure especially if his wound be in the body or belly and if they suppose that there is congealed blood there then they lay him on the ground with the wound downwards shake him to and fro even as a Butcher useth to do with a Swine in this manner they suppose to get the congealed blood out of the body all which is little to the purpose And if there be at hand a hot Feaver or other inflammation which is known by some signes of the which shall be treated hereafter there Phlebotomy may safely be used but it must be done upon mature advise for it is not good in all cases in some accidents it is good and in some it is dangerous therefore care must be had to be sure when it is necessary and when needless Many use Phlebotomy in all wounds without distinction little regarding the scituation and condition of the wound whether in legs armes joynts supposing to prevent hereby the Prunellain wounds known unto few but they effect nothing at all thereby for this rash and indiscreet Phlebotomy used keeps off none of these fore-named symptoms if the Wound be in a dangerous place then you must deal with it in another manner of way if so be you will be honest and get credit in the cure This also must be made account of that the lesse the wounded hath bled in the lesse perill his life standeth But this is considered little by many which are bluntly for blood Many do advise if a bleeding Wound cannot be stenched Many use Phlebotomy to stench blood easily then the Patient is to be phlebotomized in the opposite side and to let him bleed well for thereby the bloud as they perswade themselves will take another course and be drawn away from the Wound be the Wound never so big or wide and never so many veines wounded and the blood turned to the little and narrow mouthed veines opened But let them tell me what reason they have for this and whether this was ever done that a bleeding Wound was ever stenched in this manner Some reasons were produced in their answer but without any truth because experience sheweth the clean contrary This is true when the blood is thus inflamed and in this Phlebotomize when the blood is in an angry course his anger it taketh an unconstant course then through Phlebotomy this angry and impetuous course is in some sort allayed But without this anger I know not to what end Phlebotomy should be used unless it were to bring the Patient the sooner to the Church-yard For if a party were wounded in the four outer joynts and at each did bleed vehemently on what side must he be phlebotomized to divert the blood from the Wound In this case much more could be alledged and I rest to make any further relation of it of this I intended onely to give a hint that when in the next part of this Book I treat of the stenching of blood through easie mean and honest wayes and meanes thereby to overthrow these Imposters so the courteous Reader may the better understand upon what occasion I undertook the writing hereof CHAP. VI. What grosse abuses are crept in in binding up fresh Wounds with searching groaping grabling BEing already noted more than once how through the carelesness of Surgeons often evil and perillous symptoms are caused whereby afterwards are caused lameness-fistulaes cankers and such like therefore is it needful to shew what manner of abuses these are intimated by the word carelesness Having cleared the two head points as stitching and stenching of blood and shewed how grosse abuses are therein committed I will touch also other abuses which are as usually committed as the other The next unto stitching and blood stenching is
the following Receipt To help the stopping in the urine I made use of with good success Take Annise seed â„¥ 2. put it in a pewter bottle pour Water to it lb 1. keep it stopt and boyl it in a Kettle full of Water in this Annise seed water dip a sponge apply it to the Patients privy members as hot as he is able to endure it this provoketh urine And if this be too weak and doth not prevail then the Receipt must be made stronger thus â„ž Annise seed and parsley seed ana â„¥ 1. Maiden-hair M 1. Berberries Ê’ 1. boil these in Vinegar and Water to one pint of Vinegar put three quarts of Water boil away a third part of it and use it as you heard above And if these outward means will not help and the Patient is pained in his Urine then inward meanes must be used Viz. Maiden-hair Alkekengi oculi cancrorum take a sufficient quantity of these as of Maiden-hair â„¥ ss of Alkekengi or Winter-cherries â„¥ 1. lay it in the Patients drink and let him eat the Oculi Cancrorum doubtless it will provoke his Urine in case outward means be used also Touching his going to stool this is not much to be set by To help him to stool especially when the wounded ought to lie on bed but if he hath no stool in three or four dayes then is it time to look to his back dore Some think to remedy this with purging but in my judgement it is not good it is alwayes accompanied with danger especially in head-wounds it is better to make Suppositories of Honey and Mice turds mingled with Salt and if that will not help then make a Glister of Mallows oyl of Cammomil and flesh-broth and put Salt to it and minister it and if that be two weak then â„ž Electuarium Diaphenicum â„¥ ss oyl of Cammomil â„¥ 3. Mallows â„¥ ss beaten pour on these a quart of Water Flesh-broth were better or Goats Milk stir it well about apply it neither too hot nor too cold you will soon see the effect of it you may put Salt to it if need But in case the wounded should be purged then the safest way is to make a Potion of Sene leaves and Rubarb and minister it Thus much of those three accidents usually befalling wounded men sometimes other Diseases are incident also which are to be remedied as there is occasion for Of other Simptoms which happen unto Wounds shall be treated in the next part of this Book where I intend to write of them CHAP. V. How a Surgeon 〈…〉 himself about his Swathing-bands and other Manuals ALL manner of Arts being invented through experimental knowledge and exact observations and even till now dies diem docet one day teacheth another I hold it a thing impossible considering the brevity of mans life that an Art can be so exactly learned but the after-comers find somewhat more in their practical part and so it is impossible to set all down what belongeth to Surgery As much as is known to me I will communicate in the following Chapter Note the dressing of a Wound is of great concernment to handle it well and to use and take notice of advantages which some little regard and dress their Wounds without any difference or distinction whereby they effect this that they lame those which could be set upright if they had been honestly look'd too Sometimes it happeneth that neither the Wound nor the Medicine applied is in fault but the fault was committed at the dressing A Wound may be furthered in the healing if well drest and bound and a Wound may be spoiled in the dressing and a lameness caused as when a wounded member is bound too hard then is a swelling caused the Wound is choaked having left no vent to help it self and to receive any life yea I say this that if a Wound were onely kept clean and duly dressed it would sooner heal than if all the Art of Medicine had been used and all the Poultesses applied to it Seeing that binding is of great consequence therefore Take notice of the binding take good notice of all the parts of the body and chiefly of those that are dangerous in some Wounds there is great danger in some there is less and that according to their places And observe exactly the Wounds on the Shinns Knees Cartilages Armes Hands and where there is any joynt for those are dangerous require great care by reason of unhappy Simptoms which easily fall i◠〈◊〉 Touching other Wounds in the point of â—â—ck Sides Neck Throat and Head those also must 〈◊〉 looked to but require not such exactness in the dressing and are for the most part dressed so that the Medicine applied may not fall off There are some Wounds also with a flap hanging down which require a careful dressing Those that have undertaken Surgery must have a care to be ready and have in readiness Salves Plaisters and other Surgeons must be ready at all times necessary Medicines well prepared that at what time soever any Patient be brought to them he may find good counsel and present help and not to tarry for their readiness or stay till they make and prepare something which tarrying would prove hurtful and prejudicial to the wounded by reason of his bleeding and other disturbations for the readier you are to dress him the better the healing prospereth and the more credit it will be for you And when any comes to be dressed you ought to endeavour to be ready with your Medicines Plaisters Salves Lints Roulers that the Wound be not kept long undressed and be speedily covered and closed And that must be observed for that reason that the air be Air hurtful to Wounds kept out as much as possible it may for air doth hurt to the Wound especially air is contrary to veins sinews and joynts usually causing cramps and stitches and the room in which the Patient is dressed ought to be kept shut and closed to keep out the air and wind A Surgeon ought to be careful that he breath not into the Not to breath into Wounds Wound especially when he is yet fasting and is to turn away his mouth from the Wound or ought to put a cloth before his mouth if need for such breathing may cause that a water may stick to the Wound and incline it to a rottenness But this is chiefly noted in head-Head-wounds when the Pan or the Dura mater is wounded for then it is dangerous Some Surgeons have that custom at the dressing of The blood in the Wound is to be let alone Wounds that they wash the bloud out they find in the Wound thinking it to be done very well freeing it from uncleanness and this they do at the first dressing But it is an abuse and a thing contrary no bloud should be washed out of the Wound but let it be there if settled for a congealed bloud in the Wound is no hurt unto it
hurt which these are good for and that the matter and bloud which sticks and stayes in these places may be the better expelled by stool and urine therefore it is good to steep Rhubarb and Sene leaves in this drink that it may work the better and in case heat and sharp humours are at hand then use the seeds of Cucumbers and Melons and if need you may use also Gum Galban and Ammoniack inwardly and outwardly because these are commonly used in such cases And in case the Lungs are fallen into a rottenness which you may know by the Patients breath if stinking and his Corrupted Lungs daily undisposedness if it be so then it is a sure sign that the Patient is in deadly danger and all remedies will hardly help In this case I know this Secret to be good against internal Imposthumes and putrefaction of the Lungs â„ž Pure Balsam for putrâ—fied Lungs Turpentine lb 1. put Well water to it lb 6. put it in a glass body lute a fitting Helmet to it distil it in ashes when lb 1 ss of the water is come over into the Receiver then leave At the taking off of the Receiver you will see the spirit of Turpentine on the water which separate from the water â„ž Of this spirit â„¥ 3. and well prepared floures of Sulpher â„¥ 1. put these into a glass body lute it well with Hermes his Seal set it in water not too hot else the spirits break the glass and set it no deeper than the glass is full let it stand in a constant warmth eight or nine dayes you will see these spirits turn bloud-red Then open the glass pour this red Turpentine into a less glass body pour to it of the best Aqua vitae â„¥ 1. fit a Helmet to it set it in Balneum distil off the humidity there remains a bloud red oyle or Balsam in the bottom for the spirit comes over in the Balneo Keep this Balsam for use it is pretious it is an effectual The balsams use remedy against all putrefaction none like it minister gutt 3. in Rosewater or other convenient Vehicle it is of a good scent and rare vertue is used inwardly and outwardly and is of no corrosive quality In this manner Juniper oyle may be prepared which expels all rottenness and stinks is a rare Secret also but requireth Juniper oil a longer process and its needless to set it down here Floures of Brimstone are prepared thus â„ž Pure yellow To make floures of Sulpher Sulpher very well beaten lb 1. calcined Vitriol and white Salt ana lb 1. mingle these put it in a glass body fit a Helmet to it encrease the fire under it by degrees and make the Sulpher rise into the Helmet then let it cool take out the sublimed Sulpher mingle it with fresh calcined Vitriol and Salt and sublime it again take out the floures and weigh them put to its quantity as much of red Myrrh and as much of Aloes hepatick and a fourth part of oriental Saffron mingle these with the floures of Sulphur put it in a glass body and sublime it once more this sublimate hath an admirable vertue and if it be dissolved in spirit of Turpentine then is it more penetrative CHAP. XIII Of Belly-wounds and the inward parts thereof how Surgeons must deal with them VVOunds in the belly if not quite through are not dangerous Here I comprehend all Wounds from the breast to the privy parts Of slight Wounds in the belly I speak little onely of the great Muscles which are about the Navil if these be hurt then they must be well looked unto because they are dangerous they easily putrifie by reason of the abundant humor of the belly anger and inflammation soon getting into and thereby great miseries are caused if not prevented I intend not to speak of all the circumstances but briefly of the chiefest The Belly being stabb'd or cut thorough then the inward Signs of inward parts hurt parts are hurt thereby which is known by some signes For if the Patients food comes to the Wound then is it a sign that the stomack is hurt and if the excrements come into Wounds of the stomack and guts the Wound then is it a sign that the guts are wounded and so of the rest Whatsoever inward part is hurt it is dangerous for the Wounds of the Liver and Milt are perillous as also the Wounds of the Liver Milt Reins Gall Bladder Wounds in the Guts the Wounds of the Gall Reines and Bladder are counted mortal and those also of the Stomack Surgeons must deal here as they heard partly about the Breast-wounds Wounds of the Lungs are held mortal by reason of their constant motion more than the Wounds of the Liver and Milt These Wounds must not be stitched but ought to be healed with stiptick Plaisters neither must these Wounds be troubled with the Seeker or iron Instrument for if the Belly be run quite thorough how can you sound the Wound with the Instrument And if any bloud vein was hurt and stenched again how soon may it be made bleed again with the Seeker and make the thing worse than it was Heal the Wound outwardly is inward cure chiefly depends from a good diet and phlebotomy you may if you please make for such a Patient a vulnerary Potion made of Walwort Stellaria Starwort and Liquorice Touching the Wounds of the Entrals the old custom may Wounds of Guts here be followed viz. to stitch the wounded Entrals and cleanse them with Milk in which Annise seed is boyled However these Wounds are counted mortal and it is a hard matter if ever they recover because inflammation soon gets in This following is a rare Master-piece If a Patient be wounded in the side or body and you fear the Milt or Liver is hurt whereby commonly great swelling is caused then take this oyle and annoint the Wound about two hand-breadths it will allay all hardness of the Wound be it in the Belly Liver or Milt and that in a short time it is the rarest Remedy for such Wounds as experienced Surgeons know For such hardnesses cause inflammations and feavers This Oyl is made thus â„ž Of distilled oyl of Gum Oil for a wounded Milt Ammoniack â„¥ 2 of common Annise seed oyl â„¥ 4. mingle these together if the Wound is near the Liver then use of Populeon â„¥ 2. and leave out of the Annise seed oyl â„¥ 2. enough of this at this time I will quote here a notable example of one whose urine run out at the Wound and was recovered Anno 1618. in Urine run out of a Patients Wound September not farre off from Hamborough called on the Geys a Marriner born at Gripswald was stabbed with a knife a hand-breadth above his privy members at the right side his urine run out at the Wound all day long and was cured by Gods help in this manner First of all I stenched the bloud then
I applied to the Wound an Opodeldoch and a Bean-plaister in this manner I dressed him but once a day to give no cause to the urine to pass onely at the Wound I used no tent neither did I sound the Wound with the instrument for fear I should touch any bloud vein and so cause a fresh bleeding I ministred to him wâ—rm Beer in which was steeped Clophium wood Purslane I let him drink no other and kept him in his diet as a Patient ought By these means I reduced the urine to its right place in three dayes and the Patient recovered in a short time How could any one tell what had been hurt here inwardly but onely by the urines coming to that way whither the fleshy part of the bladders neck was hurt or no troubled not me nor stayed me in the healing of him for my chiefest care was to reduce the urine to its natural course and not to run through the Wound and to cause a great deal of pains CHAP. XIV Of the Wounds of the four outer Joynts and of Joynts contused all comprehended in one Chapter where you may find several good manuals and examples quoted THe Wounds of the four outer Joynts I comprehend in one Chapter because their cure is all one onely in the handling of them there fals in some difference Here I speak not of slight Wounds as hath been often said but such which deserve the name which are subject unto simptoms For slight Wounds be they in the Head Neck Belly or any where which ought not to be too much slighted neither because from a little hurt great matter may come of it may easily be cured with pure Cloath or lint Wine Water Salt c. for the natural balsam in Man doth much and applied Medicines perform not the cure alone Wounds subject unto simptoms where the natural Balsam is disturbed must have other meanes ordained because every simptom requireth a particular expulsive Medicine I could divide these Wounds into several sorts as into Wounds of the legs flesh sinews and veins it happeneth sometimes that all these four parts are hurt at once and yet onely one of them wounded this is the reason why I put them together into one Note that you ought not to stitch any such Wound unless Joynt-wounds not to be stitched unless it have a flap there hang down a great flap of it and chiefly have a care you stitch none of them that went into the great Muscle or joynt as in the Shoulder Elbow Hands Knees Knockles or Ankles for if you stitch them with needle and threed as the fashion is you will cause onely great pains which would prove a fore-runner of many simptoms Rather stitch them To stitch with plaisters and bands with a twisted stitch or twisted Silk for these must be stitched strongly more strongly than other Wounds or else they break out again For if you should stitch a Wound on the Shoulder like one on the Belly that stitch would not hold a day and a night Therefore I advise you to use a very strong one especially one upon the Wound as strong as you can yet stitch not too deep for fear you hurt the sinews or veins for too much is nought be moderate prospective and cautious in stitching and not too hasty Then apply the stitching plaister on the stitches it will help to keep together pull them even and well together with the plaister and roulers holding them together as long as you can for it is good for the members and sinews and very good to further the healing Though the Wound for all that doth keep asunder let it not trouble you but go on and press the Wound together as it ought at the several dressings If you have in hand a flap-wound then do not cut off Flap-wounds the flap as many do for Nature may strangely recover that and close it in a short time therefore proceed thus Stitch on the flap but not over-stitch it for fear you kill all the life in it and after the stitching apply a Stitch-plaister to it trouble it not with any feeling in and sounding and trying whether the stitch hold and let the stitches not eat thorough these else will cause scarrs neither must you put any tent be it flat or round betwixt the flap and the body nor suffer any water to come betwixt but press the flesh side of the flap close to the body Bind the Wound not too hard but close and gently as the flap requireth and cause as little pains to the Patient as you can choak not the flap else inflammation is caused and make it thus that the stitches do not hold all but the band also must help as you heard If you take off the Plaister then pull it off not against To take off the plaister the flap which would cause great pains but take it off with the flap or by that side where it hung on a little and by no meanes against the flap and apply not any strong clinging plaister else at the taking it off you stir the flap and disturbe the cure the flap must be bound gently one manner of way and not to day so and to morrow another way else the flap is hindered in its closing with the other flesh If you have made two or three stitches let the Silk not hang down into the Wound else it causeth matter and slime in it and hinders the flap in closing Have a care also you do it not too hard nor pull against the flap and apply alwayes a bolster to the middle of the flap that it grow not hollow underneath that you may do it the better make vent with a tent thrusting it under the flap that the matter do not run upward but downward and the tent must not be so long as to reach from one end to the other else the flap will be raised and stirred Do not search a Wound in a joynt with tents or the iron Instrument for reasons above quoted do not put the Tent-ointment to a flat tent to apply it to the Wound and then to lay a plaister upon no but let the Ointment run into the Wound to the bottom and it must run every where in the Wound and fill up the Wound with it and the Brawn-ointment must sometimes be let run into it it preventeth the running of the joynt water cleanseth the Wound furthereth the healing and suffereth no simptoms to be incident if the flap be so great and broad that of its own accord it separateth Flap separateth then make vent for it with a little tent which must be very thin that it stop not the matter neither must it be too long as to reach to both ends which would increase the Wound and loosen the flap Let the Wound have vent that the Ointment may the better run to all the places of it let the vent be in two or three places it will close at the vent holes as
much pains as ever it did before Physitians were much perplexed at not knowing what to do At that time it fell out that I went to dresse a Gentlemans child which had a hurt on the ancle wherein a callus was grown being neglected by Surgeons The other party hearing of my being there sent for me I beheld and viewed the wound and found that that humor was no joint water I presently asked the Gentlewoman about her monethly courses she replied she had them not since she was wounded then I perceived what humor that was for I had several such cases under hand their cure I learned strangely I proceeded thus first of all I opened on her foot the Saphena then I made a pessary of Hellebore niger to be put into the matrix thereby the humor was brought to its natural channel she found ease instantly all pains were gone and was cured which the party thankfully acknowledged Others marvailed at the cure some whereof held it impossible that according to my direction such a cure should be performed but they could say nothing against the thing being as clear as the Sun The like must be judged of a Cancer on Womens breasts bellies or privy places which sores or ulcers are mortal if their courses be obstructed all your medicines will not prevail unless their courses be first reduced The like in Men may be observed if troubled with Cancers which are uncurable unless their Hemorrhoydes be orderly in such it is true that usually have them One thing more I must tell if you have such a Woman No inward medicins to be used in hand to cure her of a wound then beware you trouble her not with any internal medicaments for such humors are not so soon stayed and though you suppose to reduce such humors by inward medicaments it will availe nothing for in that case that humor will not keep its natural course but comes forth at the wound and the stronger that inward medicine is the more it will spoile the wound Therefore make use onely of the above named Pessarie or other fomentations perfumes bathings c. according as experience shall minister occasion Thus much Reader I thought good to impart unto you ahout such Symptomes hoping you will learn so much therâ—by as to regulate your selves in the rest agreeably CHAP. XVII Of three sorts of Wound-diseases and first of the Wound-Feaver how that is to be discerned prevented and cured HItherto I have made mention often about the Wound-disease and Wound-feaver or Ague my intention here is to speak more largely of it the rather because there is not a worse Symptome and these are not alone by themselves when they come but Apoplexie Palsie Convulsion c. do accompany them of these I shall speak no more then my practick hath revealed unto me I cannot chuse here but must speak of a mistake about the wound disease because they talk of it as if there were no more but one sort of Wound disease and make no distinction herein and because that distinction is not observed comprehending it all under one cure is the cause why so many patients are neglected There are three sorts of diseases which befall Wounds A threefold wound disease the one is not cured like the other and what is good for the one is naught for the other and the one disease is more dangerous than the other Therefore it is a dangerous and foul abuse when some pretend saying if one is understood and cured the rest also may be cured in the same manner The first sort is called a Wound Ague or Feaver or the Wounds fire because at its first coming it Wound Ague is exceeding cold shaking the whole body like a strong Ague then a strong heat followeth upon and a mighty inflamation of the whole body ensueth The second sort is called the Shaking or the Wound-gall Wound gall it comes with a shivering cold no heat followeth but a great pain in the Wound commonly there is seen within the wound a little clear blister or in the outside there is a brown one which is full of bloud The third sort of the Wound disease is called the beating or unquietness within which is onely within without Beating in the wound any shaking Ague when it comes but it comes with extream smarting pains with heat and cold joined the patient hath no rest neither by day nor by night continually turning and winding this or that way These are the three distinct and several sorts of Wound-simptomes of these I intend to write yea rather because I nere saw any thing written of it fundamentally It is strange that so little is exstant in writing of the signs hitherto mentioned about the Wound diseases being a thing of such high concernment and ought to be timely prevented Most Surgeons regard them not watching onely for their end yet know not what to do or how to handle these things When such a Symptom is come to the wound and the patient in great anguish and the thing is come to extreamity then they conceive of a simptom in the wound but know not what it is But experience sheweth what the event is of such simptoms These men not understanding the sorts of these simptoms in the wound and perceiving a great heat about the patient yet cannot discern that it is a Wound disease then they are busie to cure that Wound disease as an ordinary Ague hoping with their coolers to expell that heat using Nenupharine Poppy seeds Solatrum c. and thereby they use things contrary unto it But doth not experience tell that such Paroxismes cannot be allayed and kept off by their coolers true the great dryness and thirst they quench but it was not seen that they ever cured the disease Though such a patient be plebotomised yet is the disease not expelled thereby as every one may judge though plebotomie is of good use in such cases and that is the reason why so many dye of it because such diseases are not rightly opposed and if any recovereth of it they have the more cause to be thankful unto God that granted them so much strength when neither plebotomy nor purges would help them To speak of the first sort of the Wound disease Note that Cold. Of the chilliness in the wound that is commonly the most dangerous wound if that simptom befalls the wound especially a head wound commonly it bringeth death and many patients loose their lives in that kind This simptom is the worst among the rest and its effect is as bad as the plague it self It comes first with a chilliness whereupon there followeth a mighty cold and then smarting pains in the head if that wound be in a place where there is a concurrence of great muscles sinewes white veins then the patient groweth somewhat out of his wit and talketh idely and if he recovereth not his right senses in tow or three daies then is it a sign of
death if that paroxisme comes above three times then is the sign of death the surer This is that simptom whereof so many dye For it is an usual saying if the patient outliveth five seven or nine dayes then he escapeth with his life Some set that time further off to the thirtieth or thirty fifth day which is not very uncertain neither For if a simptom cometh not into the wound within twelve or fifteen daies then it will not come at all or very seldom unless the Surgeon or patient hasten it on But if the wound be not so dangerous then no great carefulness is need unless the Pia Mater under the skull be wounded for then strange simptoms must be expected which happen when they dream least of it as you heard above about Head wounds Touching this cold or ague in the wound Note how it may be discerned before its coming For my meaning is not that Surgeons should stay for the seventh or ninth day when its full fore is come already into it Experience teacheth that an enemy is with less opposition kept off from invasion than beaten out when invaded already The original of this Wound Ague which causeth great mischief is variously discoursed of even among those which do not understand it My intent is not to be large in the writing of it only for Novices sake in Surgery and the good of patients I will shew how this simptom is known and how it is to be healed If you desire to know exactly from whence a Wound The original of the wound dis disease hath its original let them take notice of the following things It s commonly caused by anger frights fears great pains and disorderly life in eating drinking uncleanness I forbear to speak here of bad medicines in a word according as the wound is in a dangerous place and in a dangerous joint or member the one being nobler than the other especially the Head is the noblest and according as the blow cut stab is made and in what years season so simptomes will be accordingly Nothing bringeth so soon on such simptomes than when a party is wounded in a dangerous place and the wound bleedeth vehemently French Italians and other Nations observe this custom that if a patient hath bled nere so much they will plebotomize him further which is an ill and refusable way For a patient which looseth too much bloud looseth also much of his natural colour whereby he groweth cold and faint And if the wound be on a dangerous place then pains are caused these pains cause anger anger causeth heat upon which the foresaid paroxisme followeth infallibly heat and cold striving and fighting one against another at last the cold being conquered heat got the predominancy whereby all is set on a flame This heat and venom lyeth in man like a smoak or fume and must by force be expelled because otherwise it cannot be extinguished and coolers can do little in this particular Syrups Juleps Conserves of Buglosse and Borrage will avail here nothing and with these Surgeons commit grosse errours I have been present sometimes when the Physitian felt the patients pulse which is not so improper neither then viewed or cast his water finding him to be in a strong feaver and it was so Then presently some Syrups must be mixed and with Cordials the patient must be upheld with Goat milk Syrup Conserves c. but none of these men knew where that Ague did lye nor where the fault was the one judged it to be a continual Ague the other judged it to be somewhat else every one had his own judgement of it the one contradicting the other But what was the patient the better for their jarring I never saw any patient cured with disputing my self differed sometimes in my judgement concerning such simptoms but Experience shewed me the better way This Wound Ague to come to the point according To discern the wound ague to my promise made afore to discern well before its coming you are to note that when that Wound simptom is coming the patient is unquiet stares up and down lost his sleep and if he slumbereth be starteth awakneth and is unquiet If the Wound be on a joint then he doth not hold still striveth continually to shift this or that way and then it is commonly angered But the patient must first be well observed whether he sweateth in his sleep as you heard above also they do not usually sweat though they are hot enough and are much gready for drink Moreover this also ought to be noted if a wounded party hath a deep red color in his face more than he had formerly before he was wounded or he looketh paler yet is hot in his body which he was not so before he was wounded then is it a sure sign of this simptoms coming which we speak of now These and such like signs are to be observed in the outside of the patient But the knowledge of the wound is of chiefest concernment if the wound be in such a condition as I shall speak of the like about the Prunella or Inflamation thither I commit the Reader then is it a sign of the coming of the Wound simptome For if Nature be so strong as to keep the Prunella in the said joint and not to let it run into the body then the cold fire comes into and nothing else but if that heat in that joint presseth backward into the body then it causeth a Wound simptom These two simptoms meeting are a sure messenger of death These following signs which concern not the Inflamation and Prunella are to be observed also If a Wound be fresh and new not much touchy so that the patient may suffer to be toucht well and being toucht hard he feeleth it smart this is the first sign of all especially if the patient speaketh quick and looketh agazed it is a sign that such a party is mightily infected and is to look for that paroxisme accompanied with perril of death Observe also these signs which the coming of the wound disease giveth you to understand If a Wound look pale and a dead colour about the corners and lips but the wound within looks brown red and the patient is over-run in his body with a strong continued heat and keepeth in that strong heat groweth not cold or clammy as it usually hapneth in other sorts of wound diseases which must be observed for distinction sake and that strong heat and feaver goeth on to the coming of a paroxisme after which there followeth yet a strong heat and inflamation which may soon make an end of the patient One thing more I must relate touching the increase or Signes from the Moon decrease of the Moon according to which commonly wounds are affected When a patient groweth still weaker at the decrease of the Moon then you may expect at the new Moon a heavy and dangerous paroxisme if the patient continueth in a strong heat at
no effect Have a care that the stitches break not else they will cause scarrs but supply them with stitching-plaisters CHAP. IV. Of abuses committed in blood-stenching with Corrosives nealed Irons and the like and the dangers or hurts which ensue upon it illustrated with some examples BLood-stenching in Surgery is a very necessary point insomuch Stenching of blood is necessary that without it little is effected For Patients loose their lives if they bleed too much neither are the medicaments effectual if by a continual running of blood they be hindered in their operation and where there is a necessity of blood-stenching there it ought to be used and applyed according to Art And God be thanked Surgeons are found which have reasonable judgement in it and know how to stench blood and use it without any prejudice but rather to the great benefit of their Patients But the ruder sort goes to work basely whose number alwayes overtops the better sort and refuse better instructions Blood-stenching abused keeping and sticking to their old wayes obstinately observing their abuses even as when they intended nothing else but the ruine of their Patients I speak of such onely which use Corrosives supposing the stenching of blood must be effected onely with nealed Irons and other burning meanes among others they use sublimed Mercury crude or sublimed Arsenick calcined Vitriol Alumen Plumosum Caput mort of Aqua fort Euphorbium and such like things whereby they suppose to stench the blood Some there are found which to mend the matter take one or two of the mentioned things put them together and mingle other medicaments among it as Bole Armoniack Terra sigillata Millers dust Crocus Martis and such like This they hold for a rare Secret and Master-piece calling it a sharp Blood-stenching not without a cause for it is sharp enough nay too sharp It is a great pitty that these and such like things must be Abuses condemned cried up for rarities and master-pieces whereas they are nothing else but heavy and dangerous abuses and errors whereby infinite wrongs are done For all those above mentioned things one or more of them being used to a fresh wound for to stench the blood withall effect or do little or no good at all which were tollerable yet but they cause thereby infinite wrongs and do no lesse therewith as if they had strayed the wounds full of venom Tell me I pray if a wound bleedeth vehemently and you will stench it with one of the above named materials or corrosives when you stray that pouder into doth the wound cease to bleed presently Whoever affirms it I deny it For these materials in and outside I know very well and understand whither they have any efficacy in them to stench blood presently yea or no Must not the Wound being straid full be bound up with cotton Wool plaisters and the like that the blood may not issue forth Now vvhen you have thus bound up the wound and stench'd the blood so that it can run out no more could you not procure also that the in-strayed pouder should not work in the wound and that the corrosive which pulleth the running veins together cannot effect that because the running blood driveth it back and washeth it away For if a wound be carefully bound so that no blood can run out then of necessity the blood is stench'd and congealeth in the Wound This being done then the corrosive incorporates with it and begins then to work that is to say to rage to eat and to burn I would fain know here of what use Corrosives are in Corrosives are hurtful extreamly blood stenching as long as the blood congealeth without such fretting things and may be stayed onely by a careful binding of the Wound Perhaps you think the Patient is not sufficiently tormented unless you put more affliction and plagues upon him you immagine the Patient is not weak enough and so with your sharp Corrosives you must make him a Martyr Ah how many veins ah how many sinews which are not hurt at all by the blow nor toucht are eaten through by your sharp corrosiive blood-stenchers and are forcibly torn in pieces or at least benummed or mortified which would not have been so if you had not medled with them Are not lamenesses caused thereby and much wrong and evill inflicted upon Patients whose Wounds might have been easily cured if they had been dealt honestly withall I knew one who professed Surgery he was to stench a Example of one whose blood was stenched bleeding wound He took his pouder of the which he boasted much thrust the pouder into the Wound with some cotten wooll bound it up supposing he had done enough at it a little while after the Patient cried out extreamly complaining of his paines by reason of the raging and burning he felt in the Wound I asked the said Surgeon what he had put into the Patients Wound He was loath to reveal it because he held it for a great Secret and Master-piece however upon my importuning he said it was calcined Vitriol and Gummi Euphorbium sublimed Mercury mingled with Bole and Terra sigillata and a little quantity of Vinegar among it which he called quenching This was his great Skill and Secret wherewith he usually bound up Wounds But what happened He did more hurt then a wound twice as big would have done For though this mans Wound was not such where a lameness might be feared yet was he made a Cripple because this corrosive pouder hath corroded and eaten off his sinnews which were not hurt at all I pray what simpathy have these said simples one with the other especially Terra sigillata Gummi Euphorbium In like manner many Receipts are screwed together with a company of simples which do fit as much as a piece of new cloth a Beggar-patch'd coat of severall sorts of old rags all this is no sport or pastime to the poor Patient whose skin must reach for it These abuses hitherto shewed about blood stenching are great and grosse ones whereby incurable hurts are caused Abuse of hot Irons in blood-stenching which cause great hurt A horrible Skill and yet are they not comparable unto those which are committed with hot Irons whereby the Patients wounded veins sinews and other parts are drawn and shrunk together and haled as if pulled by a horse And this is held a great Skill amongst many but it is in my opinion such a terrible Skill which meerly belongeth to murthers and I am easily perswaded that Hangmen have taught this way at first Others that will outstrip their fellows in their Skill take cotten wool thrust it lighted into the Wound whereby they suppose to have done well for the good of the Patient But as I have said in general that I reject nor condemn blood stenching but rather hold it necessary and allowable as occasion serveth neither do I wholly condemn hot Irons to stench bloud withal and hold it to
that which is committed with the small iron instruments which by reason of seeking are called the seekers or searchers wherewith some do so seek and groap as if they had lost somewhat there and desire to know exactly of what largeness the Wound is and of what depth the stab is what vein be stabb'd which bone be broken and which be whole this they do onely at the first time of binding it which might be pardoned and excused but as often as they dress it so often do they search the Wound And if there be three or more Surgeons together then is it not enough that one with his searching iron shew his judgement and cruelty but also after the first the second after the second the third must seek for his lost penny in the Wound and thrust up and down in it the one more rudely than the other beyond all the rules of justice But how think you that the poor Patient is thereby mortified and tormented But to what end is it to groap and to grable so much in Wounds Ah! how little do they consider that with that A dangerous custom to search in the wounds poaking and searching they break and destroy that natural Gluten or Balsom which settleth for the healing and is the healing it self and spoil it altogether Pray tell me what else do they to a Wound which in the said manner they search and sound but to make another I see no other thing used but that they constantly play all upon one string and still keep the old Ditty and they alwayes use but one sort of salves and ointment one sort of oyle and one sort of plaister the Wound fareth a great deal the worse by reason of that cunning seeker Seeing there is but one thing used to Wounds let there be found in it whatsoever it will why should the Patients be much tormented which are troubled enough already with their wounds But it must be so that their gross ignorance and palpable rudeness may be brought to light because they know nothing else to use be the Wound in what shape and form it will There are some Surgeons found who meerly for customs sake make use of that little iron because they have seen it used though they know little what they seek for or why they seek but onely to make men beleive that it is a thing of great consequence and that men should hold them to be great Masters whereas all is but useless nay often very hurtful Being there is no defect in the Wound why do they then Searching doth great hurt molest the Patient with seeking pressing griping grobling and moiling in the Wound and tormenting him thus immeasurably for thereby not onely extream pains are caused by touching his quick flesh and veines with the iron but the time also is prolonged to make him indure the more misery and then the Wound also is kept open the longer and cannot so soon close as Nature could desire it nay they undo that also which hath been healed partly as you shall hear more afterward In case the Wound should not be in a right posture surely that instrument will never set it righter nor find its defect There are better wayes belonging hereunto as signes How to judge of a wound whereby the Wound is judged viz. by the viewing of it by the smell by the matter by the pain by the form colour plaisters their working and such like by these signes we must know the Wounds condition and into what symptoms it is like to fall Touching the form and colour of Wounds take good notice of these signs for they ought to be lookt to if the brims or outsides of a Wound look red it is no good sign and shews that there is a fault in the Wound but if the borders of it look blewish and light it is a sign that the Wound healeth but if the skin about the Wound is dark blew that is no good sign then the blood maketh the healed skin come off again and now you must make vent with sisers and cut that blewish part to let the blood run out else the new healing fals quite away and by giving vent then the new healing holdeth in part if the Wound round about in the outside feeleth hard is swell'd and looketh red then is it a sign that the Patient is pained and Imposthumations are like to ensue which is dangerous if there be a swelling with a whitish skin and feeleth to be full of water and the Patient feeling a droughth at night then good care must be had for fear the cold fire should grow on him and if there be a stink in it then the cold fire is already in it and smels like a thing putrified but is not so full of paines as the hot fire would cause and in case he complains not or feeleth no pains then his death draweth on especially if that cold stayeth long then he soon dieth or else fals into great danger by reason of the wounded joynt Touching the smell and its sign if a Wound smelleth strongly then the veines and sinews are dying and purge for as soon as a Wound is drest then alwayes the flesh separateth and so do the veines also Concerning the corruption in Wounds take notice of these ensuing signes if there be white matter in a Wound like sour milk then a conflux of ill humours comes to it and look from what side these humours come for the Wound is now setled to a bad end if a Wound be full of white matter then it is not in a full healing way but is at a stay and delaying posture if there is red matter in a Wound then some loose piece is in it or some other hinderance if there is in a Wound ruddy and thick moisture inclining more to a flesh and carnation colour than red then that Wound is in a healing posture Touching the pain take notice of that sign if the wound be moist and waterish then there are pains at hand and the joynt-sponge is like to grow These are the true signs whereby you may have a fundamental information of a wounds condition without these it is impossible to learn things aright about Wounds and in this manner all may be known without putting the Patient to any further pain much better then with seeking groaping and the like which is not onely useless but very hurtful and painful As often as a vein or sinew is toucht as often is a new Note pain caused for they are very touchy and full of sense which sense by that touch runs all the body over and as often as you stir in a naked wound as often ought it to be again cleansed for there is nothing toâ—cht in a naked wound be it as little as it will or as gently there separateth something and thrusts by the healing For it causeth a flame that is the humidity of the naturall balsum which alwayes like a chrystal lyeth on the
opened vein which was not quite healed let that neither fright nor trouble you much but do thus make use of the Wound salve with the brown ointment mingled that the Wound salve run the better into the Wound and annoint therewith a lint for tents of linnen cloth cause bleeding not so much as those that are made of flax for linnen is of a sanative quality in some veines but they close not so well as the wicks do made of flax Make this linnen wick very soft and that it fill out the Wound from whence the blood comes and let it be thick at the upper end that the blood may be kept in Even as usually Cotton wool is applied to the vein phlebotomized lay here also Cotton wool to it Briefly close and keep the blood in the Wound as well as possible you may and keep the ointment also in the Wound and thirty houres after dress his Wound again and if the plaister and the wick comes off together then make a softer wick for the place and proceed as formerly and if it doth keep on let it settle or lie there and ten houres after dress him again and do not take-out the tent unless it be very loose then dress him again for it healeth by degrees at every dressing and the flesh groweth as well so as if dressed every hour This I speak of to the end that better care may be had about the wicks or tents for theâ—e are not to be used to all Wounds indifferently especially not to such where blood veines and sinews are cut and dangers are feared as you have heard hitherto CHAP. VIII Of the abuses committed in plaisters papps â—â—â—ltisses and 〈◊〉 such like aâ— the dressing of Wounds and what hurt is canâ—â—sed thereby IF Wounds in the dressing be abused â—s hitherto we 〈◊〉 of and the natuâ—â—l balsum disturb d what can be expecâ—â—d but Naturâ— unâ—â—llingness and refractoriness because she is hiâ—â—ered in â—own free working despâ—â—ng to help her self if it be so then surely one symptom or other will be incident and if it hapneth best â—swelling will ensue to saâ—â—â—â—hing of other accidents Beâ—â—â—es these things you heard many other faults are committe◠〈◊〉 when some think that all may be performed Abuses in Cataplasms and effect◠〈…〉 â—atâ—plasmes and thereby to bring all to right 〈…〉 make such â—atâ—plasmes of Roâ—â— cakes others of 〈◊〉 maâ—low◠〈…〉 Millers dust Fâ—ni greek Milk yolks of Egâ— and such like of â—hese they make a poultâ—â— pouring some oyles amongst it and apply 〈◊〉 the Wouâ—â— as hot as the Patiâ—◠〈…〉 it â—â—re is no need of such a Poultess 〈…〉 uprightly because these are râ—ther hurâ—◠〈…〉 and if sucâ—â—â—in 〈…〉 â—lied then 〈◊〉 against 〈◊〉 and ought no 〈…〉 applyed hot it will not keep long thuâ— but grow◠〈…〉 before it worketh aâ— all moist thâ—â—â—sually do â—â—plasmes I do not condemn if â—â—ed in 〈…〉 â—sure Cataplasms are good if not abused season and place â— my self make somâ—â—â— use◠〈…〉 But that they shâ—â—â—â—be good to fresh Wounds as som◠〈…〉 I canâ—◠〈◊〉 beleive it For experieâ—◠〈…〉 convâ—â—â— it thâ—s Lay such a Poulâ—◠〈…〉 place let it lie there two or three houres you 〈◊〉 a stiâ—â—ing caused in that place 〈◊〉 doth so to a souâ—◠〈◊〉 what do you think it will do in â—â— unâ—â—nd place which is moved and stirred enough already and become raging in its course The several hurts done to Patients thereby I pass over A Cataplasme choaks the wound and relate onely this such Poultesses do choak and stop the Wound in her course for when such a Poultess is taken off the wound you see how it smoaketh and what signifieth that smoak Nothing else but putrefaction For Nature promoteth putrefaction even as a Mother that breedeth a Child and brings it to light Now if these Cataplasmes cause more hurt in wounds than good as that smoak is an evident sign thereof why are they not omitted but applied to places where they should not for in such places there is moisture enough without these I have known some Surgeons who held it for a good sign when they saw wounds smoak but the good that comes of Vapours in Wounds an ill sign it they may keep to themselves for I will have no share in it And to say it once more if a wound doth smoak it is an infallible sign of putrefaction for if such a wound after dressing be not opened in two or three dayes then a stink is at hand which putrefaction thrusteth forth as her first fruit and a wound which begins to putrifie whether it be so soon healed as when it was fresh let them tell it me And to say nothing of the chiefest thing which is the healing thereof is it not hindered and kept back For before you can come to the healing of it you must first remove the putrefaction and spend some time in it Besides the troubles and paines which this putrefaction causeth it is most certain that any wound whose vent is taken away by the said Poultess is forced to smoak as you heard above And what is this smoaking else but a moisture which moisture gathering together turnes into a water as we see it in such wounds which are thus papp'd up for at their opening there is found a water round about like drops of sweat which come meerly from that smoaking Now I ask whether the water signifieth any good and I ask further whether any Medicine doth effectually work on such wounds thus forced to sweat and to water if dressed as they ought In my judgement wounds that are thus compelled to dew will hardly come to healing And at the closing of this Chapter let me tell you thus much any wound in a joint be it in the hand foot or elsewhere being choaked up in the said manner it keepeth a foul and angry bird in the nest and the Patient will be A soul bird in the nest pained in that place as often as the weather doth change because of that moisture shut up in the wound and Nature will hardly rectifie that unsound moisture in a long time That up-shut moisture will stir at the changing of weathers and at the encrease and decrease of the Moon for the Celestial Lights do doubtless work upon the things below according to Gods singular Ordinance Enough of these let us proceed CHAP. IX Of all such Surgeons which dwell in abuses and errors which know neither their weakness nor own Medicines nor are able to judge of their operation together of two Examples which shew the chiefest abuses THe highest and principal'st thing in a Surgeon and It is dangerous when men know neither the Medicine nor the hurt Physitian is this that he be a knowing and experienced man not onely in wounds hurts sores but also in the Medicines he intends to use to them if not then little good will be done if a Doctor or Surgeon knoweth not the disease or
distinction is to be had of a Summer and of a Winter Season touching heat and cold And I mentioned it onely for that end that every one may see that it is fit Surgeons should observe such distinctions about persons and still be regulated after the form and condition of things as well in the diet as elsewhere Touching the said diet some have that custom as soon Abuses in diet forbidden and commanded as they have got a Patient into their hands presently forbid him Wine Beer and all good Meats and make Decoctions for him which are very unsavoury and would make a sound body sick however some meats are forbidden as Cabbage Coleworts Pork and Bacon all manner of water Fowls and Fishes because these are of hard digestion and give no good nourishment to the body and such food is allowed which nourisheth well A certain Physitian forbidding all meats to his Patient was asked what his Patient should eat then He said young boyled Cocks he was laughed at What diet is good for a wounded party Use him like a Woman that lies in according to the custome of the several Countries and I declare it further not onely in general but in particular also as much as concerns eating and drinking Concerning the meats let the wounded suffer no hunger and what he hath a mind too let him have it in case it be not hurtful to him observing the sex age and climate of the Land as you heard above Neither ought the Patient to be forced to eat this and that which goeth and is against his stomack that Nature may not be opprest whereby danger would be caused And this must be observed when the Patient hath a stomack to eat For sometimes Patients have lost their stomack in such a case what is to be done Then endeavour to give him some Cordials to corroborate his stomack But in case the Patient will take none Then apply stomack-plaisters and use the oil of Nutmegs Mace I will set down how to make good broth for the wounded to strengthen his stomack withal Take a Hen or in want of that a piece of lean Flesh cut Good Pottage for the wounded it in pieces put it in a pot put Calmus Cinnamon and Salt to it as much as will season it lute the pot and let it boyl for three hours in a sufficient quantity of water at the opening of it you will have good broth pleasant to the Patients stomack or boil and roast such things as you shall think fitting for him Touching his drink wounded men being alwayes more His drink dry than hungry having lost much blood their Liver striveth to have that want supplied besides bloud is like a food to the Wound and drink generates bloud and the more bloud the drink breeds the sooner the Wound healeth Hence you may note that the wounded must have drink sufficient and let him not suffer thirst or keep him not too dry as some usually do for thereby mischiefs are caused as daily experience witnesseth But the distinction mentioned at the beginning of this Chapter ought to be well observed and let the drink be neither too hot nor too cold and not too much Salt to be used ye may permit him small Wine to drink which is very good for such parties especially when the party hath lost much bloud but no Wine is to be permitted if the Wound be mortal and in the head or any great Wound of the body be it inward or outward The same rule is to be kept in such Countries which affordeth but Beer Let the drink be what it will the Patient ought to be kept in a cool temper rather than in a hot in which case Barly water is of good use I advise no wounded party to drink great draughts at a No great draught good for them time for such hasty drinking oppresseth the Liver which is hot and dry and would prove no better then when oyl is poured into fire to quench it withall and thereby the Liver would be obstructed and hindered in her sending forth nourishment to the rest of the members as being opprest and hindered in her operation which would cause great inconveniences and a slime would settle about the Liver and choak her and being thus obstructed how can the veins receive any bloud and you may easily guess what the issue would be Touching other things the Surgeon ought to observe Hasty motion hurtful that the Patient do not stir and move too hastily whereby great pains would be occasioned unto him as the Gout Falling Sickness Feaver Cramp Inflammation and such like are caused by such violent motions chiefly let wounded parties not practise Venereous lusts whereby the worst accidents are caused A Surgeon observing all these things carefully then there is hope by Gods help of good success in his Art for the good of his Patient and the Patient also ought to behave himself accordingly For all dorh not lie in the teaching but in the learning also For if a Patient be unruly not caring for the Surgeons instruction but fall on gourmandizing and drunkning then no good is to be looked for because the Patient refusing all natural helps like a Swine trampling on Pearls cannot expect any cure and the Surgeon looseth his credit and reputation and all his pains he bestowed will be in vain CHAP. IV. Of three accidents commonly befalling wounded men a weak stomack a stoppage in the urine and not going to stool how these are to be remedied WOunded men are subject unto many Diseases as Experience sheweth among the rest there are three things which commonly befall wounded men First a Patient that hath lost much bloud hath a weak stomack which keeps not his meat nor digesteth it but vomiteth it up whereby he falls into great danger and the Wound shuts not nor is it fed naturally and the healing is put back Besides this his urine also is stopt and can hardly make any water whereby inflammations and other mischiefs are occasioned Lastly the wounded are bound in their body cannot go to stool and this usually befals wounded men whereby gripings in the belly are caused these three accidents must be helped in the following manner Touching the stomack to help him to right that he may To help the vomiting keep his meat make use of this following Receipt Take Mint Wormwood ana M 1. Ginger Calmus and Nutmegs cut small anaÊ’ ss boyl these in Wine and Water for an hour together then take a great sponge or in want of it a four doubled cloth dip it in the foresaid boyled liquor press it out again and apply it hot to the stomack his vomiting will be stayed this must be iterated twelve times a day and will cause an appetite Vomiting is not very dangerous and is stayed sometimes of its own accord and is not much to be regarded unless it hold the Patient vehemently then is it time to help him Touching the stopping of the urine
and is rather beneficial by keeping out the air which otherwise would hurt the sinews and it hinders the bleeding of the veins which they would do if the congealed bloud be wiped out it takes away the flesh for it is a right flesh-glue exceeding a Sarcocolla and it healeth other Wounds if used much more that where it lieth and it furthereth the matter in the Wound and hasteneth the healing and though it were not so yet it breaketh forth gently without any pain and that of its own accord from beneath upward therefore in that particular molest and trouble the Wound no further as to wipe out the bloud An honest Surgeon ought to have care of wounded joynts be the Wounds great or small and observe a distinction in their dressings and bind them not too hard a small joynt must not be bound so hard as a great one it cannot brook with it A Surgeon for the general ought to endeavour to order his bindings so that the Wound be kept together and the joynts in the hands ought to be dressed and bound commodiously whereby lamenesses are prevented Touching the binding it self how it must be performed Note the manner of binding note thus No joynt neither from above nor from below must be bound in the beginning but let it alone otherwise the bloud is driven inward or down which would cause a putrefaction and an inflammation but that binding must begin in a convenient place either higher or lower then the joynt and that very gently thus dangers will be avoided and swellings prevented which in Wounds commonly appear The Swathing-bands must be made choice of also for all What swadling-bands they must use do not fit nor are good for it For a Wound that is to be dressed requireth that the swathing-bands be soft and keep asunder that they may lie on the closer such swathing-bands are best made of old and worn linnen because they are very soft yeeld the sooner being retched and pulled lie close on keep the Medicine the better to the Wound and cause no trouble nor molestation But such Swathing-bands which purposely are woven with two selfedges or such that are hemmed on both sides and ends these are altogether unfit for Wounds because such hems cut deep prints into the flesh Thus much of the Swathing-bands more could be said in that behalf but to bring in all what could be said would be too great a labour He that desireth more let him advise with Experience which is able to put a Knighthood upon him CHAP. VI. Of Head-wounds what behaviour the Surgeon is to be of both toward himself and toward the Cure NOw it is time to come to the Wound it self and to describe As the Wound lieth so it must be cured the cure thereof as it ought to be hitherto I swarved round about Here great care ought to be had about the condition and distinction of it For as the Wounds lie distinctly so they must be cured distinctly and as the one part of the body is stronger than the other so the Medicines must be prepared accordingly For a Head-wound cannot brook with such strong Medicines as a Wound may in the leg and a Wound in a joynt cannot endure such great clotter as that which is in the flesh these things ought to be observed and more shall be spoken of in the following Chapters And I will begin with the Wounds in the head I know what order I ought to keep in their description namely first of the slighter Wounds afterward of the broken Skull and then of others also and to speak of their several cures But this order I do not observe for that reason because they are cured almost one way Therefore I will write onely of dangerous Wounds of the head where not onely the skin is broken but the Skull also and such like For he that can cure such a dangerous Wound truly he will be able to cure a slighter Wound This used order serves to shew how dangerous Wounds are For to say they appear clear and clean but afterward they cast up loose and shattered pieces of flesh or bone and one thing or other appeareth and so I regulate my self accordingly in the doctrinals touching the Head-wounds and shew the meanest and safest way to heal them as Nature alloweth and Experience bears witness All Wounds in the head are dangerous commonly they bring death along by reason of the many and heavy simptoms they are subject unto as there is the Cramp arthritick or Palsie Apoplexie and many more and especially are they dangerous when the pan or scull is broken and more dangerous are they when the skin of the brain is hurt and wounded and most dangerous it is when the brain is toucht as it fals out sometimes Therefore a Surgeon ought to be the more careful and the wounded also must not be wanting to himself For where wood and field as they say hold together commonly a good year comes after Therefore the Patient must be ruled by the Surgeon and though the meanes used are somewhat rough yet he ought to consider that Malus nodus malum requirit caneum The Surgeon is to observe that he govern the Patient with a good diet as the condition of the Wound requireth as you heard in the precedent Chapter Touching his speaking the Patient ought to be as sparing in it as possibly may be and if he speaks let him speak softly and the room he lieth in must be kept quiet and still And the Surgeon must place the Patient orderly in his lying especially when the Wound is dangerous then the Patient must be ruled and lie still in his bed lie high even as if he were sitting the higher the better and that for reasons well known and the chamber must be kept dark for quietness sake If a wounded party be brought unto you dress him quickly thus Cut off the hair round about the Wound in case the Wound bleedeth much that the bloud may the sooner be stenched and danger of death be prevented the hair being cut off stench the bloud with Cotten-wool or with lints as you shall hear hereafter and then dress and bind him as it is the fashion But in case the Wound doth not bleed as it fals out sometimes or onely weepeth then there is no need of bloud-stenching but lay a Head-plaister to it after the manner of an Opodeldoch so that the Wound be covered broad and well every way and then lay a soft bolster upon and bind it that it do not fall off All this must be done quick and nimbly that not much of the air come whereby inconvenience soon is caused if the dressing of the Wound be delayed And the Surgeon ought to dress the party in a close chamber especially at the second dressing to keep out the air because air endangers the Wound as you heard already the chamber also must be warm according to the years season for cold is hurtful to the
Patient causing Cramps the which to prevent let his neck and back bone be annointed with warm oyl as with Cammomil oyl and such like at the several dressings Touching the bands bind it not too hard and keep measure herein as you ought in all other things But if it be a very dangerous Wound it needs be dressed but once a day the two first dayes after that you may dress it twice a day But I approve but of one dressing a day unless the matter come too much then two dressings a day will serve Have a care you use not much the Seeker to search in the Wound withall to find out its depth breadth and length the Wound doth not brook with it but desireth a good and a short work for the reason alledged in its due place You ought not to stitch any Head-wound because it is Seeking and stitching in Head-wounds is forbidden dangerous whereby an inflammation and anger soon is caused which will be of an ill consequence Having dressed the Wound and observed every thing well then is it adviseable that in case the Wound did not bleed the Patient be phlebotomized the next day But if his Wound hath sufficiently bled then Phlebotomy may be forborn and delayed for a fitter time The bloud being stenched and the Wound dressed and stayed there its due time then at the taking off the blood-stencher go as neatly and gently about it as possibly you may that you move not the Wound to bleeding again which a rough dealing would cause when the bloud-stencher is taken out by force which puts the healing by and causeth worse things Therefore be careful tender and gentle in the opening of the Wound And in case the scull and the brain is opened then at the taking off the bloud-stencher be careful that nothing fall Brain opened upon the brain for that cannot brook the least thing to lie upon it Therefore if any thing be fallen in be it but the smallest hair it presently fals on cleansing it self and striveth to cast it out But what pains beatings pantings it causeth to the Patients head may easily be judged for I am not able to express his misery You must not use greasie things to such a Wound also oyles ointments because they do no good for the reason quoted above Therefore my advise is not to use any Pouders Waters Oyles Salves which some do make and apply them to the Scull and the Dura mater for I marvelled much that in this particular Nature was not better regarded whereas neither the scull nor the brain can endure any thing For the most were of opinion that things good for the head may be useful also for Head-wounds if applied like the Bore who thought the Plaister that should be applied to the stomack without would do better within and so he swallowed it and by his good beleif he was healed Others would mend the matter and mixed other things with Aqua vitae and poured it into the Wound and dipt lint in it and laid it to the Scull or Pia mater all which in Head wounds where the braines Dura mater is opened are meer poyson whereby apparent dangers are caused Therefore let none be deceived that whether Pia mater be hurt or no to use such like things and have a care that nothing fall upon it And if you intend to make use of an Ointment besides Ointments Salves and Plaisters used the Plaister hoping it will do better and dispatch the cure the sooner then do thus First make ready fine clean white lint and lay it into the Wound gently not roughly as they usually do nor to thrust it in nor deeper than the scull is that the ends of such lints do hang over the Wound that they may with more ease be taken out again upon these lints others may be laid of the same stuffe which with the Ointment must be made wet which is set down hereafter but not too much that nothing drop from it upon the Pia mater then apply the Head-plaister upon and dress the Patient warm covering him with a soft bolster and observe all things well which hither to have been spoken of then doubtless with Gods help all will be well And being it happeneth commonly in Head-wounds How to deal wiâ—h these splinters in Head-wounds that the Scull is wounded and some bones are shattered some whereof are quite loose and some do hang by a little and some of them stick downwards on the Pia mater and some of them are beaten quite into the brain Here a Surgeon hath need to regulate himself accordingly no such small bone or splinter ought to be taken out unless it be free and loose and are to be taken out very gently and cautiously be not afraid though they hang by a little and are not quite loose then go on in your Art as well as you learned it Nature her self will in time loosen those splinters and expel them in good time and Nature must be assisted here with vulnerary Potions as you shall here of them hereafter In case a splinter hangeth within the Cranium downwards which may be known by a certain sign then you must Splinters hanging inwards look to it by reason of the difficulty which is at hand For when the brain raiseth as commonly it doth then the brain toucheth such down-hanging splinters with raging and pricking and maketh a short time seem to be very long to the Patient with this raging beating and panting Pia mater is often broke thorough and the brain it self hurt upon which nothing so sure as death doth ensue or at least a mortal Chronical Imposthume Therefore if by a sign you can observe that from within such a shattered splinter hangeth downward then take it out with an Instrument as well as ye can though some force be used In case you cannot come to the splinter then you must make room to it and expel evil with evil thereupon cut the In case the splinter cannot be come by hair close round about the Wound yet so that none fall into the Wound then cut that skin and scull cross way where that splinter lieth loosen the skin off the scull and then see whether you can get it out without any further trouble And if you cannot come near it that way then you must use a very sharp incision knife and take out that piece with the on-hanging splinter But if you could see that little bone then cut it off even with a sharp knife This is the shortest safest and best way to deal upon such like dangerous Wounds from hence we observe that the scull being broken may easily be dealt withall with carving and cutting because in such cases there are alwayes certain rents at hand so that the cutting goeth off easily from the hand otherwise where these rents are not then is it hard to deal with And when you observe that from the scull some little bones are fallen
upon the brains and that the vulnerary potion and the plaister cannot drive it out which is not done in haste neither then they may be taken out with the Core-tongues and have a care that the Piamater be not laid hold on and pull'd asunder which would cause a Palsie or Apoplexie CHAP. VII Of other Simptoms which are incident in head-Head-wounds and how they are dealt withall IT falleth out in head-Head-wounds that Biles appear round head- Biles in head-Head-wounds about which in time must be opposed before it come to any simptom For the bloud and the matter is settled under them and soon cause pains to the Patient if not remedied in time This to prevent as often as the Patient is dressed to stroak them gently and press that matter out at the Wound with your Swathing-bands and Bolsters you must be so careful that the matter be forced to come forth at the Wound It usually fals out also in head-Head-wounds that the skin looseneth The skin loosened from the bone off from the bone and such Biles grow there as you heard of now where the bloud and matter gathereth and puts the Patient to miserable pains and that is easily discerned for then the Patients eye-lids do swell especially when their rising appeareth which feeleth soft here and there in the head This must in time be remedied else the bloud would settle into the eyes which hardly or never will be gotten from thence yea the Patient would be in a deadly perill if it should be delayed Therefore remove these gathered matters in time and drive them out at the Wound And in case this matter would not yeeld unto this then lance these Biles and let the matter out and heal them again without delay that you cause no other trouble It happeneth sometimes that the scull by a heavy blow is bowed inward and there happeneth a great Bile in that How to help a bowed scul place and that sometimes is done without hurting or breaking the skin and is congealed bloud beneath it some have an open Wound and some have the scull onely bowed without the skin broken and sometimes not without splinters In such dangerous cases a Surgeon may well look about him For if the brains be crusht then all remedies are used in vain nothing will help though the scull could and should be put to the right place unless God miraculously strengthen or put new strengths into the Patient Therefore I will be silentin such cases and shew how others are to be dealt withal In this particular most of the Surgeons say that when such a hollow and bowed scull comes to be cured the same must be raised with a Screw but of this Screw I cannot approve because it causeth splinters and more troubles and I never found any good was done with it which in this particular gave occasion to me to study upon a better way unto which next God I took Nature for my help If such a case is brought to you to be cured then carefully feel with your finger whether there be any fraction or congealed bloud at hand and ask the Patient whether he be prickt or how he feeleth himself if you find congealed bloud then presently lance the place let the matter run out For this must be a common rule unto you as soon as you suspect any thing under such an inbow'd hole be it bloud a fracture a little bone a splinter then with one cut you must lance it to press out the matter and to make vent For such holes are sooner brought to right when they have vent and are cleansed then when they are shut up and for that reason you must lance it that you be the surer of the thing else you will be forced to cut off such hurts by reason of the splinters or little bones which come to the innermost part of the scull and so cause Imposthumations which at last must be cut up together with a piece of the scull as hath been said In such cases as generally hath been said in the precedent Chapter where the scull is bowed Phlebotomy must not be neglected and that in both armes as occasion shall serve use no greasie things as Oyles Waters Ointments Coolers c. but the Wound must be kept dry neither must the in-bowed scull be opprest with Cataplasmes or such like Compounds as some use to do Onely stick to your Head-plaisters and apply them the thicker that no air may get in use no tents into such open hurts neither thrust any thing into with the Seeker or any other Instrument For besides other incommodities which are caused thereby as was shewed in the first part the Scull is brought by that meanes to that pass that it will receive nothing and must of necessity be shaved which may well be omitted if rightly proceeded in other things However not regarding the mis-handling it happeneth in some fals and blowes that the skin goeth off from the bone and will imbrace no more one another Here of necessity you are forced with a sharp knife to shave or to scrape the bones that you may get unto a fresh bottom But in case by feeling no more can be found or felt but onely the hole or fall then omitlancing and use onely the Head-plaister together with the vulnerary Potion it will do well enough and by the help of Nature which is ready to help her self it will come to a good end Touching the Trepan make no use of it and let it not trouble you though the scull be bowed for the head is able to bear with that hollowness without any hurt or prejudice because a great hollowness and emptiness is below it and not filled Onely good care must be had that no ill simptoms may fall into Therefore Phlebotomize the party and in the rest follow the government of the curing the Wound But in case the scull be in bowed very much then open it with a sharp knife and at the hollowest part where it is deepest raise it again with a convenient Instrument and bring it into its due place as well as possible it may be done In case the pan of the head or scull be forcibly bowed inwards which the sword at the bâ—ow could not rise and made a pit or hole as you heard above and the bloud settleth there in this case the skin which rose thus must be instantly lanced and let the bloud run out then it will sit down again and sink then you may easily feel whether there be any fracture in the scull or any splinter It happeneth also at the lancing of such deep pits or holes that the skin doth not sink but remains as it is cast up In this case cut it with Sisers cross way then the heads skin will sink again and in a short time after will heal to it In case at such a blow or fall where the scull is in-bowed there be a Wound then dress it as hitherto you have heard how Head-wounds
are dressed And if there any bone be loose then take it out but in case it hangeth yet and sticketh inward then raise it outward again with an Instrument into his former place Let it stand so use convenient means and let Nature provide for the rest I know she will not be wanting unto her self CHAP. VIII Of the Head-ach after the Cure and how that is to be helped How to make the subtile Head ointment with remarkable examples of Head-wounds cured Head-ach after the cure of a Head-wound IT happeneth sometimes after that a Wound hath been fully cured that the Patient after two three or more dayes or after so many weeks feeleth pains in his head and the same pains do increase more and more and many die of it for all Surgeons do not understand the cause thereof and how the same were to be helped of the which I will inform you here First when a Head-wound is healed and riseth after the When a Wound doth swell after healing healing and swelleth and is very painful then lance the Wound presently for it signifieth that some splinter would fain be out and if you do not open it then the matter would make a mighty great hole and break out in another place which would cause many simptoms and troubles and the blow would come on a fresh therefore look you give vent to that matter and when such things are opened then the plaister will draw out the splinter together with the matter bloud and water and if you think it good you may let him use an expulsive vulnerary potion then the Wound will be cleansed and cured Secondly look well to these following signes if the Patient complaineth of great pains feels great prickings in the head and these smarting pains increase more and more and cannot endure to be toucht in that place where the Wound formerly was yet no swelling nor rising of the skin appeareth as you heard formerly then is it a sign that within the scull there is a splinter which hangeth inward and causeth these prickings in this case that place must be lanced instantly and the splinter must be taken out as hath been said Thirdly In case the Patient complaineth more and more after the Cure not onely of the place where he was cured but all his head is panting and broyling accompanied with extream pains This is a sign that congealed bloud is gathered under the scull and is turned to an Imposthume And if his eyes be swelled and some bloud and matter runs out of his nostrils then is it a more sign of it This infirmity may with Gods help be cured easily as hath been said already Viz. Cut off the hairs in the place where the pains are lance the skin cross way to the scull in the breadth of half a Crown and put back the four pieces that the scull be naked then cut with a Raisor or other Knife a Wound into the scull open it that you may look into it then the matter will start out against ye and the Patient will be eased and if there be any splinter at hand you may easily see it and take it out as you have heard before This is the onely way to help such a Patient Such Wounds now made are soon healed again onely govern the Patient well as is fitting and as I have informed you before You must lay nothing to his brains as I told you afore for the brains will expel the things of their own accord when they have a vent for it without any further help and suffer not any strange matter to stay or abide there Touching the cutting up of the scull note that there is Note the cutting up of the scull no difficulty in it and is done easily and quickly For the scull gapeth and openeth if there be any splinters or little bones there therefore with a little help those small bones may be taken out onely look narrowly to it whether there be any fracture at hand for you may easily discern whether a splinter within goeth down and inwards or whether there be any more of congealed bloud there But if you find after the opening of the skin neither fracture nor scissure a hundred to one but there is and however you are sure that the scull must be opened be it either by reason of the congealed bloud or by reason of an Imposthume take a well turn'd sharp borer and bore thorough the scull at the place where the pain is then the matter will startle out and when the place is almost thorough bored then work gently and look well to it that you cause no small bones with the boring to fall into the hollow of the head for if so then you will find somewhat to do and not without danger In this case some will have though I never had need Another way to open the scull of that when the matter at the first opening doth not appear then another hole a fingers bredth from the first is to be bored and then to cut both these holes into one and so to make a Wound into the scull into that made hole you may see with a lighted candle in a dark place and understand the cause if you find then either congealed bloud or a swelling then touch it onely a little with an Instrument as soon as it feeleth vent it will soon come forth at the Wound I should like this way well enough in case any splinter or loose bones be there But it is your duty to study in what manner it may be done most fitly and conveniently as the condition of the case requireth and to regulate your self accordingly For it is impossible to set all down in writing onely be mindful of the vulnerary potion as you shall hereafter hear of Before the close of this matter I will tell you how you shall prepare the Head-plaisters and the thin ointment so To make Head-plaisters often mentioned hitherto Make the Head plaister thus â„ž Of Wax â„¥ 8. of washed Turpentine Ê’ 4. of oyl of Roses â„¥ 2. of the juyce of Bettony â„¥ 6. put all these into a pan let it boil let all the joyce boil away when the other are melted then take it off the fire and put thereto pulverized Colophonium â„¥ ss Mastix Frankincense Myrrh of each half a drachm this must be continually stirred till it be so cold that you may touch it with your hands then work among it Oleum Storacis CalamitaeÊ’ ss make it up into rouls and keep it clean for use This plaister cleanseth Wounds leaves no unclean thing in them and is pleasant and proper for the brains and the whole head Therefore use it as it ought it will not deceive you and doth better than Oyls Aqua vitae Waters Salves as you heard above I will teach you another Head plaister which is yet better â„ž Wax lb 1 Turpentine â„¥ 6. melt these together being well heated pour it into Rose water let it
cool take it Another Head-plaister out and melt it again and look that the Rose water come all away afterward take of pulverized Sanicle ℥ 1. and stray it into the melted Wax and then all these following pieces Frankincense Mastix Myrrh ana ℈ 1. prepared Calmystone ℥ 2. Terra sigillata or prepared Bole armoniack ℥ ss all which must be purely beaten and strayed into take it off the fire and stir it continually till it be cold then take it out of the pan and work it with Cammomil oyle make it into roules and then into cakes and keep them for use Touching the thin Head salve make it thus ℞ Hart Suet ℥ ss purely skimm'd Honey ℥ ss Aloes hepatick Head-ointment or salve purely beaten ʒ 1. melt the Suet stir the Honey and Aloes among it till it be cold then you have a pure subtile Salve for the head at the using of it spread a little of it on a linnen and apply it to the Wound take heed that nothing of it fall on the brain which can endure nothing at all These are the Receipts I impart unto you Let it not be strange unto you that I set down no more Many Receipts cause errors Receipts which I could easily do But to what end are pluralities of Receipts good for but to confound him that is to make use of them insomuch that he knoweth not which to chuse or which to trust most unto A Receipt which is approved is better than a thousand which prove false He that is well grounded in Surgery will find Receipts enough in his daily practise For the Art consisteth as well in the knowledge of Simptoms as in the knowledge of Simples He that well knoweth these two will soon compose Receipts either to weaken or to strengthen them in their vertue and all according to the condition of the Wound Thus much be said of the Head-wounds Touching the Cramp and other accidents in Head-wounds the same shall be shewed unto the Reader in its due place Now I will set down some examples of Head-wounds which through Gods help have been strangely cured as I have copied them out of my Fathers writing after his death I have saith he had occasion to dress one by night in all haste because he did bleed so much that I was afraid he would die under my hands before I could dress him For from his scull was cut off a great part hair skin bone and all clean away and then on the left side by the temple a great piece was cut off skin bone and all was gone this Wound looked so ghastly that I was amazed at it for it did bleed so vehemently and it was so great that I could not cover it with my hand I dressed it in haste thus I covered the Wound with Mullipuffs and bound it with broad Swathing-bands and did no more to it for I thought no other but the Patient would die under my hands I was forced to make all the haste I could and had no time to cut the hair away about the Wound The next day taking off the uppermost rouler there I found the lint mullipuff stick close to the Wound which I let alone and poured round about warmed oyl of Roses with some of that oyl also I annointed the Patient his neck and back bone and so I dressed him again At the next dressing I took off no more of that Wool but that which easily came off and daily I annointed his back with Cammomil oyl warm'd I dressed him still in a dark still chamber where no air should fall on his brain and I had a care also that none of my breath came into the Wound and the things I intended to use to the Wound I had in readiness that he in the dressing might not be delayed The Patient was well governed in his diet and quiet according to order The lint together with the bloud came purely off from the Wound but the brain began to swell and in the outside the scull opened where the brain pressed thorough all along which a knife might have taken off and it did pant and work as if it would come forth and change his place which it did more in the neather Wound than in the upper where the brain was not touched To all which I did nothing but dressed the Wound with the wound-plaister three doubled so that no air might come to it At the tenth day the upper Wound inclined to healing and the brains began to settle by little and little and grew so little that I could have laid a finger betwixt the scull and the brain thus empty grew the head And the brain sinking thus I spied a little thing lying on the brain which was not quite separated in the rest it was wholly pure on the Pia mater there began to grow flesh which grew bigger and bigger I wondered that in few dayes there could grow so much flesh but where that said impure splinter did lie there it stunk extreamly and would not come to any healing at last the said splinter began to stir to and fro in the Wound with a subtile linnen I took off nimbly as much as would stick to the cloth the rest which clung not to the cloth I left there for I still was afraid that he would die under my hands though the twenty eight day was past already At last I thrust that little splinter away also so that I could see what was beneath it There I found there were present many honourable persons that the brain was hurt very little of the breadth of half a fingers joynt in that place there was alwayes a moisture as often as it was wiped away presently another came into the place and the flesh in it round about looked no other than like a raw Wound in which there lieth a splinter which hinders the healing of it it grew thicker and thicker and soft that I marvelled at it yet it would never cover that place where the brain was hurt At last when the flesh encreased in one night it covered that place wholly so that I saw no more moistness onely some matter lay there And thus the whole head grew up with flesh and I suffered the flesh above the scull to grow out and hindered it not for here his scull could not be metled withal Now suffering this flesh to overgrow then I straid in that flesh round about burnt Allum but none into the middle for there he could endure none Afterward the flesh pressed forth at the Wound and scul so fast that it drove out some little bones that were loose in the Wound at which I wondered not a little that so many small bones should come forth out at the Wound At last he was cured of this dangerous Wound and the flesh was good and sound and not soft as commonly it is for the which he owed thanks to God without whose gracious help such remarkable cures cannot be performed and not
as the strongest onely taken lb 3. boil these together for half an hour and then set it in a warm place for three or four dayes then put it in a coated Retort set it in the open fire let your first fire be gentle and draw all the Vinegar into a Receiver which being done then increase the fire so long till you see red drops coming which must be received a part and still increase the fire so long till nothing comes It s true you will get little enough but as little as it is as great vertue and efficacy it hath not onely in the Eye simptoms but also in other things which in its due place shall be spoken of I know these things according to this process may not be had every where and in case these things could not be had timely enough then other things as good as they may be had must be used for in case of necessity means present are not to be refused and I allow of them if so be the Eyes be not killed or otherwise spoiled In the last place note in case the eye-lids hang over they must be stitched A certain Merchant was cut over the Nose and one of his Eye apples was hurt also that Wound was cross the starre That party next God was helped onely with this red oil of Lead or Lethargir Another party received a splinter of wood in his Eye where it stuck two grains deep in this oil onely recovered his Eye Another party spoiled his Eye unawares with a sharp wood a Surgeon made experiment on him with the white of Eggs and Bole whereby the Eye was killed and when there was no more hope left half the Eye was loosened and the skin of it wrinkled To the party I being called used my Medicine you heard of and put of the red oil into the Eye he presently felt ease and the eye was perfectly cured but onely it was not so clear and a spot staid in it and I am perswaded if I had been with him at first I could have cured his Eye without defect For good men and womens sake I will teach you how To heal Wounds not leaving a scarr behind Wounds are healed and leave no scar to be seen in the face or any where or else they shall hardly be discerned Here I except such Wounds that were stitched and where the bones were shattered and where veins and sinews are hurt I speak onely of such either great or small Wounds in the face or elsewhere that are not very deep and where the skin onely is broken â„ž Good Aqua vitae drawn twice or thrice lb 1. put it in a glass body put thereto bean-floures â„¥ 4. which must be dried a little cover it with a smooth parchment lute a head to it set it in luke-warm Water or in Balneum Mariae as deep as the glass is filled lute a Receiver to it let it stand there so long till you see drops of water lie on the parchment then open it that which is in the Receiver keep in a glass apart well stopped that nothing exhale Whilst the body standeth in Balneo apply cold wet clouts to the head and another clout on the Receiver that the spirits of Wine may cool and resolve into drops At the using of it take the single threeds or ravellings of linne wet them in this Water cleanse the Wounds with them let it lie in the Wounds lay a fine soft boulster on it and bind the Wound close that no air come into it thus the Wound must be drest twice a day at the healing no scarr will be seen Use no other Salve nor Plaister else this Secret will do no good you need not fear that the spirit of Wine will burn much in the Wound you may safely use it CHAP. X. Of Wounds in the Throat and Neck how a Surgeon ought to deal with them AFter the Wounds in the Head and Face follow the Wounds in the Neck and Throat of them I will treat now Here as I have told you before I do not speak of slight and small Wounds but of dangerous ones where partly the great bloud veins are hurt when the sinews of the Neck and the Wind-pipe or the like is wounded my information shall be according to these hoping that he who can heal such Wounds may heal also those which are less dangerous Now to speak of these two sorts of Wounds first note Neck and Throat-wounds are dangerous that these are very perillous and subject to all manner of simptoms by reason of the exceeding great pain and such things are incident viz. Cramp Palsie Apoplexie Wound-consumption and such like and so they must the more wisely be dealt withal and I will give a particular instruction of each Wound because there is some distinction to be observed and in the first place I will speak of the Neck-wounds As I have informed you formerly that as I do not mean Neck-woudds here any slight Wound so on the other side you must understand that I mean not such Wounds where all the Neck is in pieces for such Wounds surely bring death along and are incurable But here I speak of all such Wounds when the Neck is hurt grievously Note also that the Neck dependeth from the Back bone and hath great affinity with the Brains out of whose hinder part runneth a marrow along like a rivelet through the Neck and Back bone Therefore all what I tell you here of the Wounds of the Neck the same you must take also for the Wounds of the Back bone for these are cured all one way Therefore the things spoken of above may be drawn hither Therefore as you have heard above you ought not to Neck-wounds ought not to be stitched nor tented stitch Wounds in the Neck nor to put a tent into much less ought you to search and to sound them with any Instruments how deep and how large these Wounds are whether stabb'd or cut do not sound them let the depth be what it will never trouble them else you cause all manner of sorrows and dangerous simptoms and so you make the last worse than the first was Proceed thus First stench the bloud as you shall hear The true proceeding and having removed the Bloud-stencher then take a good Wound-ointment which you shall find described in its due place in the Chapter of Wound-salves make it luke-warm and pour it into the Wound then apply a good plaister upon be it a stiptick one or an Opodeldoch and cover it with a defensive Plaister made of Beans which must guard the Wound round about This Plaister when there is great pain at hand must be applied fresh several times Have a care that the lowermost Medicaments which lay next the wound do not cling and stick to the defensive plaister therefore betwixt the lowermost and the other lay a cloth on which do ye rest the defensive Plaister But in case the Wound be not pained
then there is no need of the Defensive Plaister because it doth not alwayes good Annoint then the Patient with warmed oyls of Cammomil of Rose oyl mixed with a little Saffron or annoint the Patient round with Gray s grease his Neck and Back bone and the Wound also and look carefully to the business Govern the party in his diet as you were told at the Head-wounds Keep him from cold and air and let him be quiet and not stir much and be temperate in eating and drinking You may apply also to his Wound a Sandel plaister which I call the red Sandel plaister with these things you proceed in the cure till you come to a perfect healing These wounds being very subject to simptoms and among Note the signs by reason of dangerous simptomes as Cramp joynt water the rest to the joynt-water which in the whole body is no where so dangerous as it is about the Neck and Throat especially when a Cramp fals into therefore you have cause to look the better to it and to prevent such accidents But how you must behave your self touching the joynt and sinew water and against the Cramp also with the brown Ointment you shall find direction for it in the third part of this Book or else in some other place Touching throat-Throat-wounds these you must trouble as little throat- throat-Throat-wounds with Tents and with the Seeker as the other in the Neck Proceed thus If you have a throat-Throat-wound in cure True proceeding where the bloud issueth forth mainly so that there is fear that a bloud vein hath been hurt or that the swallow and Throat be cut then note if the Wound or Stab be deep or shallow neer the Ear then you may stitch it but not slightly as commonly is done but must be drawn strongly together cross-way so that neither breath nor bloud can get out then apply to the Wound an Opodeldoch with a defensive plaister upon which is described also in its due place this do so long till the anger be past Having drawn the Wound together with that stitching then is it requisite that you have a good Medicine which penetrate with its vertue and that is the Magnetick plaister which is described in Books of Decoctions truly that will draw all matter you need not to use any other thing to the Wound but onely apply this plaister great and thick Let it not trouble you which way the matter in these wounds goeth for Throat-wounds afford not much corruption and the Opodeldoch is of that quality that it leaveth not much uncleanness behind If the Wound be great and wide so that you fear it may not be stitch'd that way then let it alone for common stitches will not hold in this case and keep in the bloud from issuing forth therefore make use of a Bloud-stencher and proceed further as you did with other perillous Wounds and if you use any plaisters hereto then spread it thick that the air may press the less thorough for the swallow is a substance which can endure no air at all But if the throat be hurt at the side then do not stitch it especially if the Wind-pipe or swallow be in pieces for if a swelling should be incident the patient will be choaked or perish in his food And if the Wound be not great or deep then do not stitch it and draw much flesh into it would cause an ugly upcast scarr For at the Throat usually happen gross scarrs and therefore take heed of many stitches there and of too much flesh and if-you can endeavour to heal it up to a scurfe for if you suffer the flesh to grow freely and high then the scarr will be as big as a great nut therefore be not neglective in the preventing the simptom betimes else it may be too late to undertake the opposing of it you ought not to put into the Wound any Salve oyl or Tent for it may as little endure any Tent as the Back bone by reason of the variety of sinews which are in the Throat It being a thing more usual in Throat-wounds that swellings Gargarism are incident whereby soon great sorrows and troubles are caused therefore is it requisite that there be used besides the defensive Plaister a Gargarism not onely the sooner to further the healing of the Wound but to asswage also the pains And if there be not heat at hand then take Wine else do you take Water lb 3. put one hand of Mallow seed boil a third part away which being done then strain it through a clean cloth put thereto of Honey â„¥ 2. boyl it again after you scummed it put it in a pewter dish put to it of Storax Calamintha â„¥ ¼ and so let it stand for your use Some add a little Cinnamon which cannot be amiss Let the Patient use this water several times a day it will not onely further the healing but ease him of his pain and keep off rheumes This Gargarism may safely be used also in Head-wounds and is effectual alwayes Touching the joynt-water when that commeth then carry If the joint-water comâ—â— with pain your self as you shall be instructed in the Chapter about the joint-water And if accompanied with great pains then take notice of the causes and signs thereof that you may know whether the Prunella or inflammation be either at hand or coming on and if it doth signifie the Wound sickness or any other thing then proceed as you shall be informed All such that are troubled with such deep Neck and If a heat comes Throat-wounds and endure great pains then use smarting plaisters it will ease them One thing more in case the Patient feeleth great heat either in the Head or in the Face and by reason of it feareth the Prunella the Wound-sickness or other such like then phlebotomize the Patient chiefly under the Tongue if it may conveniently be for such phlebotomy cooleth much both Head and Throat taking away all the heat quencheth thirst opposeth many simptoms and maketh the Wound forward unto healing therefore neglect not Phlebotomy in these Wounds if need not else These veins you may safely open in Head-wounds where any heat is felt surely it will not be fruitless CHAP. XI Of Wounds at the Breast how a Surgeon ought to behave himself there TO speak of Breast-wounds I mean not small slight Wounds which require no singular great cure being Of Breast-wounds without danger By Breast-wounds I understand the first part of the Ribs If a party be wounded there and the Wound is not gone through the body then no great danger to be feared and upon that you ought to deal as usually is done to common Wounds For those Wounds which deeply run into the body are very dangerous It fals out in such wounds that the stab doth not go deep into the wound and yet one of the inner members is wounded Sometimes a party is run quite thorough and yet no internal part wounded Let the
condition of the Wound be what it will you must note first a party being wounded at the Breast commonly there cometh a wind out of the Wound which is like unto mans breathing here you must have a care for that is from thence observed viz. In case an internal part is wounded then there is a remarkable sign accompanied withit For if the Lungs or the Signs of internal parts wounded Midriffe which distinguisheth the Lungs from the Breast is wounded then is the Patient troubled with a continual cough and there appeareth a scum in the Wound and the Patient is full of pains and can hardly fetch breath if the heart be wounded then no remedy expected of which I say nothing more for the party dieth presently for no Art nor care will avail here however be not wanting on your side dress his Wound as Wounds of Lungs usually are drest Of the same conditions are other internal wounded parts And in case the party be quite run thorough without hurt to the internal parts yet that Wound is to be judged and undertaken as perillous and mortal For though none of Back-wounds are a cause of lame members the inward parts be hurt yet it may be that that thrust hath hit some of the white veins or sinews on the back which is dangerous by reason of the affinity they have with the Heart It happeneth many times that when a party is wounded in the Back that he fals lame either in his hand arme or elsewhere where no defect at all was which is caused onely by those white veins that are hurt Touching the cure of such Breast-wounds I intend not Breast-wounds â—â—red to give any other doctrinals herein but what hath been made known at the dressing of Throat-wounds Onely concerning the defensive Plaister that may here be omitted unless the Back bone be run thorough also and great pains are felt caused by the hurt sinews Therefore as I have informed you in Wounds of the Throat what you should do touching stitching so you must Stitching is permitted note here also that Breast-wounds are to be stitched and the stitches drawn strongly together cross-way yea you may use twisted stitches because they go easily asunder by reason of the breathing which constantly is against it whereby they are forced asunder And whereas breathing hinders the vapours and the air the healing therefore the Wound must be stitched as close as possible may be After that use no more but the green Salve which enforceth the healing then lay the Magnetick plaister upon and bind it quickly care not what course the matter taketh or which way the bloud runneth for it ought not to have any vent and may get perhaps more vent than the Surgeon shall well like of Bind it well with warm clothes but not too hot else it would incline to a fistulo neither use any Tents and above all search not with the Iron in the Wound which is a cursed custom In case the Wound be so great and so wide that it cannot be drawn together and stitched but it will keep some vent Stltching when disproved of then omit stitching altogether because such stitches would break out and burst asunder by reason of the breath which if it hath but a little passage it presseth more vehemently against the stitches as when the Wound were more narrowly closed In such Wounds use neither flat nor round tents but onely put in your Tent-ointment and then lay your plaister upon Take heed of flat and round tents on for the wounded parties breath being drawn would strongly draw also the Tent into the body and the Patient would bring great misery upon himself and cause his own utter ruine because that indrawn Tent must lie on the Midriffe or Diaphragma and rot there and indeed no wick or tent is fit to be used in these Wounds Note also that cold and warm dressing is dangerous and Cold and hot dressings are dangerous hot dressing is more dangerous because it causeth infallibly a putrefaction as experience sheweth For many suppose that hot dressings and hot Medicaments were best but the contrary ensued upon as hath been known Therefore a medium is best in all things let it be neither too hot nor too cold If you undertake to cure a Wound which cannot be stitched then use a strong Bloud-stencher unto as you heard How to dress breast wounds that cannot be stitched above and more of it followeth after and at the taking off the Bloud-stencher and at the dressing again all necessary things you ought to have in readiness as I told you above that the Wound be drest nimbly that the parties breath may not pass much thorough which would be very hurtful All this must be done in a dark place and sharp rough air be kept off Have a great burning Candle by the hand you shall Air hurtful to the Wound see that the breath that cometh forth out of the Wound will blow out the Candle Hence you may gather that such Wounds are endangered if not quickly dressed and a care must be had that the Lungs draw not into the body the rough air for if you suffer this to be done the Patient will never be recovered Breath if it gets but a little passage and is warm it causeth moist vapours whereby are caused internal Fistuloes and hot feavers Internal sistuloes hot feavers with the loss of understanding and sense and so all natural means lost Therefore use such Plaisters which stick and cling easily and suffer not air to come by and use such stiptick Plaisters in manner of an Opodeldoch or use an Opodeldoch which is very useful in such cases By these things may easily be gathered that Cataplasmes Cataplasms of no use which in such cases are too much used are useless altogether for they are too weak and have no power to oppose the air and breath and besides they are too moist and so they further putrefactions I know that there are many which will not like my manner of dressing no more than I like other mens dressing for some may object saying if a Wound in the said manneâ— be stitched and closed whither runs the bloud Doth it not run into the hollow of the body where it may doubtless cause great troubles and miseries Answer For the taking off of this doubt note Dayly experience witnesseth that Breast-wounds which can be thus stitched have no where such danger as those which cannot be stitched and it is known that that which is inwardly hurt sooner healeth because no air troubleth it than that where the air cometh to it For the air in the hollow of the body is judged mortall and deadly Touching the bloud which you say runs into the body troubleth me little For Nature which alwayes endeavoureth to help her self turneth that bloud into water which if good and fit means are used may be expelled by sweat and urine It may further be objected Whether runs
more as I saw need for it and when I laid any such bands to it I took heed that I toucht not the Plaister The use will teach you more how these laths and splinters must be laid they must not cover the Wound but it must be as in a bone-fracture it is used Above the bolster and band you lay them to the Wound at last lay on lath and so bind it to as you think fit And doing thus be it the Finger Hand Arm Leg then you may look to it twice or oftner in a day that the Joynt doth not move and is at better rest then if it were every day stirred and taken out of the case or lifted you need not fear any Imposthumations to fall into the Wound In case such laths and splinters are not used because no Joint or bone was in pieces nevertheless I applied the red unknown Plaister by reason of Imposthumes and Swellings of the Joynt alwayes leaving vent for the Wound as there was need of When you lay clothes over the Plaister then first lay a bolster upon the Plaister then the other clothes will not stick to the Plaister thus the easier you may open and bind it I let this Plaister lie sometimes ten dayes long in case it was not washed much On a Fracture I let it lie somewhat longer and on the Knee it must lie longer as I shall shew it in Fractures of bones and Knees when you place the Patient into the plaister and bands you may lift him immoveably as you please CHAP. XVII Of Cracks in Members caused by great and heavy liftings or when men work so strongly that their Hands crack as if broken SUrgeons many times undertake a cure which is of no great weight or consequence sometimes the Hand is swelled and sometimes it is not but the great sinews of the Arm is crackt and the party is not able to lift any thing and it paineth him when he worketh he aileth nothing but that his sinews are crackt If you dress him with the red Plaister as a Fracture is dressed then the crackt sinews joyn again even as a Fracture in a bone doth but if you onely annoint and not bind him he will not be cured in haste such like Patients I had many But you need not dress him with many laths or such like one lath or splinter will serve the turn here And apply that lath either above or below the great sinew on the Arm another within the Arm and better is it to appply one above than below the sinew and so tie it stiffely then the great sinew joyneth and the sinew water is consumed without any danger If a party was beaten or had a fall without a Wound or Fracture I dressed him in this manner as you heard of the crackt Joynts then the congealed bloud could not gather nor putrifie and the blew and yellow colour was gone I annointed them sometimes with Dialthaea that it should be the more supple and used no laths or splinters but onely drest the Hand with the red Plaister and needed no further toil some I drest but once some twice and at the most three times CHAP. XVIII Of Knees that are full of pains and how they are cured I Will write now of Knees that are much pained do look like other found Knees yet are full of pains continually without ceasing day and night and grow untoward and unshaped Of these there are several sorts some are with a fall blow thrust casts and other wayes thus lamed others were sound at day time and at night they fell lame swelled and greatly pained in their Knees Of these I should write severally of such Patients I had enough had great care and toil with them I have lanced more than a hundred of such Knees besides those I had cured otherwise and not opened them I call my Journymen and Apprentices to witness which dwelt a long time with me that I still was troubled to cure such Knees two or three Patients in one day whose Knees were so full of matter that it was to be wondered at And God hath given a great blessing unto such cures whose Name be praised for ever If any one was lamed in his Knee either by a throw fall blow c. and it was swelled which swelling was not long there but even newly come on these I cured so first I applied my red Plaister in a great and broad way onely leaving free the tendons or hamstrings and bound it well with roulers to keep off swellings and the Sinew water from gathering and from festering I did not undress the party in four or five dayes neither did I much annoint the party onely kept the Joynt free from simptoms thus all ill humours were exsiccated Thus simply I drest the Knees which order I do keep even to this present time neither did I hitherto here of any better way Sure I am I have drest above a hundred such Knees at the taking off of the one Plaister I applied another not troubling the Patients with any other things and so cured them The same process I used to Elbows Shoulders Hands Ankles Fingers Briefly all parts wounded and hurt by a fall blow throw thrust c. Fractures and Wounds never altered the cure Further if any had ugly Knees full of hardness and pains I proceeded in the same manner with them and with coagulated Sinews and other stiffe parts I never could hear of any better thing these seven and thirty yeares and as long as I followed this Profession and if I should continue it as long again I do not beleive that ever I should change it and as many Knees as I have lanced I still applied that same Plaister healing it toward the Body up and down to the Leg and bound it well above and below the Knee with a broad rouler somewhat I left open about the Wound like an open Fracture which I undrest and drest again as necessity required a lanced Wound should be drest I let lie the applied Plaisters as they use to do on a Rupture and drest them twice a day even as I thought good and the Joynt could not rise by reason of the applied Plaister because the Plaister would not suffer any thing to press or thrust upward and the hollowness and swelling never rose higher I had also many Knees in cure which were very hard and would not be stirred having a lameness biles and other simptoms and Joynt-sponges grew therein and exiccations of the Joynts All these I drest with the said Plaister tied them strongly and prest the hardness downward below the Knee driving it down to the Leg then the Knee began to lessen onely the Shin and Foot swelled for the which I applied warm clothes and sometimes I perfumed these warm clothes with Frankincense then the Legs swelling was gone also and that internal moisture was exiccated without any danger These parties were so cured that they needed not any other Medicines Moreover
some Knees came to my cure full of lameness biles and joynt-sponges such I cured in the following manner When the Knee was hard and ugly then I bound it strongly all the Joynt over and mollified it and was careful to see where the joyntwater would appear and having found it in a ripeness being gathered under the band and there also where it appeared first and there also where it never was then I took care where it might be best to open it and took hold on the matter where I was sure it was which I let run out as clear as water not mingled with matter or bloud and that water looked as clear as Well water In case I could not come so nigh as to get the water out at one cut lying yet under the knee-pan then I cut onely through the skin making a little hole putting in a Wick rould in Allom or other Corrosive and still eat a deeper and broader Wound with Corrosives till I came to the water For it is sure enough if you hit and meet with the water it gusheth forth as the bloud doth out of a breathed vein It often happened to me that I was fain to set the bason farther off when it gushed forth in this manner one time it gushed into my Mans face scarce able to hold the bason so fiercely came it running Having let out this water then I drest him with a Tent and Ointment every day thrice like an open Fracture Once I lanced a young Mans Knee the water gushed out so vehemently that none of it run down his Legs till at the end when they were empty I know not one but he was healed if any water was found therein and I had good success also upon those which I drest with bands and roulers and when I was about the lancing of any Knee I did it so that the Patient was no where endangered thereby I never opened any with a Knife or other instruments but onely with that Lancet I used to phlebotomize withal making no great incision onely of such a bigness that I might get in a Tent. Further I did so I dropped one drop of Ointment on the place where I meant to cut and was sure that in that hollowness the water did lie and having thus marked it with a drop then I took a long rouler and bound the place beneath it and then I struck upward above the marked place then I laid another band tied it strongly so that the skin rose on high and made it insensible with the stiffe and hard binding and raised it so high that I knew I could not hurt him and to come onely to the hollowness with the iron and it hurt the Patient not so much as it would if the place had not been tied neither could it slide away under the Lancet it must stand to it and it could not but be hit and surely found Now is it time here to consider what sores I mean to be opened on the Knees and Elbows Note I mean not such Knees or other Members which are full of matter or other swellings filled up with scirrosities but onely such that are full of water and are soft and by that water are brought to a lameness of such I had a great many neither are they marked with any weakness or defect onely they complain of it when they go or stand still and at mornings near the breaking of the day they are most pained neither do they feel any great pain when touched onely there they are pained where the water lieth and is swelled a little no other sign to be seen It is hardly beleived how it gusheth out at the cutting but if tied it spinneth out as when a vein is breathed but no bloud cometh with it Many such Knees would not yeild to any softness under the Plaister though they were much annointed and troubled with Cataplasms of Althea Malva Grease c. hot Wines Oyls Sweatings Fomentations Coolings and chiefly Water-baths all which were hurtful and rather caused the growing of a Joynt-sponge When they were so hard and shapless and unmoveable for the abovesaid Medicines make them stiffe tough hanging and clingling then I was forced to do what I was loath to do and seeing that the thing must be opened namely the top and the highest part of the bile and put some Corrosive into the Wound and made it angry every day more and more till the hardness was consumed and then I drest him as any other Wound of the Knee ought to be dressed after it was somewhat healed I applied the red Plaister also and so exiccated the rest as I usually did to Knees not lanced I often bowed out-stretched and moved them fitting them for motion for the flesh sticketh so close to the healing that it will hardly admit any stirring therefore by force they must be stretched bowed and bound as hereafter shall be spoken of at crooked joynts Note also that a Mercurial Ointment is good for lameness and pocky biles if his foot be annointed with it or it is better if laid into it for the Pox and lame blains come sometimes onely into the Knee though no where else but men are loath to hear that these are caused by that Morbus There are other strange hurts on the Knees more than to the whole Body may come and differ so much that no body can tell what they are and I beleive there is no man who knoweth them all There are also some humours of the Body which stink and fall down upon the Knees of which many perish and die and I say not that these may be cured for besides the misery pains stink putrefaction of the bones and sinews there grow Worms therein which fall from thence and to speak truly these ought to be cut off and the Patient be ready for death And my counsel is to you Novices in Surgery not to undertake alone to cure Knees unless you know first what accident there is in it whether it come by a hurt or whether it accrue to it for an accrued hurt is worse than one that is made and an accrued simptom hath a root which if it be stirred and roused a dangerours excrescence may be caused and the root not known But things proceeding from the Pox which are running are bad enough to be cured especially when they break forth of their own accord for then they are worse than when they are opened for when corruptions seek to come forth they search then many places betwixt the veins and sinews and stay there and have many passages and wayes and when a Surgeon thinks he is almost at his journeys end then is he onely at the beginning and can hardly come near it and fals out many times that the true ground can never be had and then bodily humours come also which come from ill Lungs and fall down from the Diaphragme Moreover take care and understand me right that you will have perhaps cause in sore
several and different so their Cures also Difference in Wounds must be according Some Wounds are cured onely with outward means if timely and orderly used other Wounds require also inward Medicaments without which they are not cured Therefore vulnerary Potions which I shall teach you are not to be rejected to expel the filth from the bloud and flesh Touching the Patients diet you heard of it before which I will not repeat here onely let me tell of the Medicaments I made mention of formerly how they ought to be prepared To make Coolers To make the Cooler do thus â„ž Honey lb 2. the juice of Housleek lb ss juice of Crefishes five ounces Rose Vinegar six ounces phlegm of Vitriol five ounces mingle all these scum it well in the boyling let it be a little thinner then Honey thus is it right The juice of Crefishes is made thus â„ž Oflive Crefishes lb 1. beat them in a morter press out the sap Phlegm of Vitriol is the distilled water from Vitriol at the drawing off the spirit of it Of these in the Chapter of Cramp and Palsie c. more shall be spoken This is a good Cooler it quencheth the fire presently it must stand and go no further and the fire must separate the sooner from the sound part It is not onely good against the fire the Gun-powder left in the Wound but other burnings also caused by Wood Water Oyl Iron Tin Lead Gold c. if the burnt place be annointed with it then a stiptick Plaister applied to it will do very well This fire being quenched and the pain allayed then milder Medicines must be used which mitigate the Wound and help to expel the rest I will teach you one or two I made use of my self â„ž Wax four ounces melt it on a gentle fire add to it of fresh Butter one ounce of Lin seed oyl two ounces all these being well melted then pour it forth into a pewter dish in which be water of plantain or Roses stir it well about make it hot again consume away the Water pour it again into the dish stir it well about then set the dish on a place to warm stir it still then all the water will be gone stir among it of Bole half an ounce then is the Ointment prepared for to get out the fire let it lie as deep as it will the Wound must be often drest with it at the beginning and the Plaister before spoken of applied to it Another cooling Ointment which quencheth not onely the fire but draweth it out also but it is not so good against Another Cooler the burning caused by Gun-powder as that which is prepared with Honey Make it thus â„ž Lin seed and Hemp seed-oyl ana lb ss Oyl of Poppy seed four ounces mingle these Oyls beat them put a spoonful of Vinegar to it let it cool some feces will settle to the bottom which cleanly must be separated from the Oyls Then â„ž of Wax three ounces melt and mingle it with a quarter of an ounce of white Amber put these among the Oyls then is your Ointment prepared Thus much of cooling Ointments because it is known enough how cooling Ointments are made It happeneth sometimes that though the fire be quenched and expelled yet the Wound doth not heal and is at a stand In such a case use the following remedy In case the Wound healeth not â„ž Gray Calmy stone and Tutia Alexandrina or a Calmy cake ana one ounce grind them small put it in a Crucible let it stand in a glowing heat for an hour then pour it into good Vinegar let it cool there which being done then take it out set it again into a glowing heat and then let it cool then take the juyce of Nightshade two ounces of Litharge of Silver a quarter of an ounce oyl of Roses half a pound of Wax four ounces of Frankincense one drachm mingle all these and make an Ointment of it There are many Simples found also which take out the Simples that are good also in that case fire and are of a sanatife quality viz red and white Colewort Soladel and many more of that kind And some Animals also are good viz. Frogs Geese c. of these I speak no more here Surgery being of a greater concernment with the Manuals and Experience in it more than great prating come too An expert Surgeon according to skill and Experience will Manuals Experience is best in Surgeons find more things than conveniently may be set down in writing when where and how is to order and alter his Medicines and to make them milder or stronger This I will teach you how the aforesaid Saltpeter is to be To prepare Saltpeter for Wounds made by shot prepared for Wounds made with shot and how Tents are to be made and used because the preparation is not known to every one First touching the Saltpeter its preparation is thus its naughty humidity is to be taken from it and a better restored to it that it may safely be used for the good of the Patient it is of a good scent it quencheth thirst it allayeth heat provoketh urine and is endowed with many good qualities not known to every one It s preparation is thus â„ž Of the purest clarified Peter two ounces put it in a pot and make a circular fire about let it be melted it being melted put a little quantity of purified Sulpher to it that being flamed away then cast more into till a quarter of an ounce be burnt in it the Sulpher clarifieth the Peter and when it is purified enough cast it forth and pulverise it and put it into a Bag or Manica Hypocratis put Rose water to it and make a Lixivium this Lie boyl away half let it cool and shoot into Cristals which you keep for use boil away the moiety of the remaining water let it cool and shoot again pulverise the Cristals keep them from the air in a glass for use The Tents formerly mentioned are made thus â„ž The juyce of Speedwel rectified through Wooll two ounces Gum Tragacanth purely beaten half an ounce mingle and reduce it to a pap let it stand in a warm place it will be like dough then take lint of Silk roul it in this pap on a pewter plate and keep these Wicks for use Note these must be made of a pretty bigness because in their drying they grow less when they are dry and you have need to use them then take one cover it with your cooling Ointment ' and put it into the Wound the Wick will swell in it and the Tragacanth attracteth all the moist filth which at one time with such a Wick you may get out of the Wound The lint the Wick is made of must hang out of the Wound to be pulled out thereby else it may be lost in the Wound Use the Wicks so long till the Wounds are cleansed and the heat and anger of it be past Some
Leg or Arm c. cross way cover not with the rouler the marked raising pull the rouler strongly together pressing down the veins and sinews that the red marked place may raise the better make that place raise high where you intend to make the incision then you may be sure that the matter will disperse it self no whether else and your incision will be made the surer you need not fear to hit an unright place nor the Patient shrink under you the incision will cause no great pain if bound hard which would not be so if tied slack I tied many times on the roulers two fillettins one above the other below fearing the marrow would slip away Be not timorous in the incision because there is no danger in it neither in the bleeding in case you should hit a vein For when I hit a vein in such a case I let it bleed but a little and stopped it again neither is it any small advantage for it maketh good breathing to the Patient the Leg groweth the lighter and the pains are lessened Sometimes such an incision cannot be made without the hitting of a vein especially below the Knee unless the veins be rotten having no bloud but matter in them I speak of such where neither corruption nor ulceration is but of fresh skin and flesh and where a redness is apparent you must make the incision upon the redness if you will open it right else the incision will be in vain When I held the Patient thus and marked the highest place of the redness then I took a strong Lancet laid it on close to the place where it held hard against thrusting it deeply into the crack turning the Lancet a little in my hand that the incision should fall the bigger till to the Fracture or crack if you do not so then the incision will soon close no other as when a hole is made with a bodkin into a four doubled cloath where hardly a tent may be thrusted into therefore have a care that the incision close not let it bleed well having done bleeding then apply to it Cotton wool or Mullipuffe on the tent with a clinging plaister you may allay the bleeding with a wet Sponge if you think the panicle is not cut thorough then make a strong tent well turned cover it with a sharp Unguent thrust it in that the panicle may be toucht with it that tent will make vent enough you need not to apply any Corrosive and it will heal like a fresh Wound Sometimes thinking that I had not hit it right yet I took a board tent which might best go into the Wound and covered it with Aegyptiacum straying some burnt Allom upon it to keep open the incision and to make it wider if you do so then you cause no long continuing pains it keeps open the Wound if you put it in loose Having given him a little rest and no bloud comes out not so much as to stain the cloath then you may dress him with a Fracture band leave the Wound open that you may come at it without any stirring like a thorough Fracture or Flap-fracture Dress him so as is said then you need not so many plaisters roulers nor splinters nor so much toils That Wound must not be so scoured as usually they deal with a Flap-fracture onely let the Wound have vent and let it stand free Apply the Plaister to it that no air get into and prevent putrefaction therein that it run not betwixt the band the Patient must not lie still as he doth at a Flap-fracture neither ought he to stay so long at it if you can dress well such a cracked bone it will be a great advantage to you in dressing other Flap-fractures and will be a great help unto you Some usefull and remarkable Rules comprehending briefly all necessaries belonging to cracked bones Let no ulceration come into a cracked bone as much as possible you may else the Patient will be endangered Keep it open not too long let it close as fast as it can and use in four dayes not any tents Do not press it too hard that you hurt not the new flesh and make it not fall off else the flesh is hindered Use no Corrosive where there is no need which would make the bone black which cannot brook with any corroding things Use no swelling Tents they for the most part are hurtful here Search not with the little Instrument for any splinters if you do so you make the bone rugged and shattered which healeth unwillingly Keep out the air that you make not black the white bone for the air that fals on such bones maketh them black which proveth incurable Make a small Wound and not a large or wide one Make the incision the long way along the Leg holding the Knife not the twhart way Thus I close this part of the cures of all sorts of Wounds and Fractures and Cracks Finis of the second Part. The Third Part. Of the Symptoms of Wounds how they are discerned and known before they appear what they foretel how to prevent them and how to cure them when apparent c. COurteous Reader hitherto I have shewed to you plainly what I have found in my practick part how you are to cure all sorts of Wounds from the Head to the extreamest parts the several fractures and confusions also hoping you will not begrudge your pains if you have followed the rule of my instructions You must take these things into serâ—ous consideration and be not wanting in your carefulness and industrie because all particulars cannot be set down in writing In this third Part I will Inform you in the best and most Knowledg of Symtoms is necessary faithful way of Symptoms befalling the wounded and the wounds which is one of the chiefest points belonging to Surgerie for without the knowledge of Symptoms in wounds little good can be effected nay irrecoverable hurts are caused if Surgeons are ignorant of them as woful experience testifieth And in my opinion those are no Surgeons which have no judgement in these Symptoms for wounds healed not according to the fundamentals of the Art falls out accidentally which good luck old women may have also and some Matrones there are found which would be too hard for such Surgeons These I count for good Surgeons which have a sound judgement not of Symptoms that are at hand already but such that discern by infallible signes there comming for these Symptoms have alwayes there forerunners which foretell of their comming There is nere a raine without clouds thundrings and lightnings accompany each other and great cold bringeth frost Man is taken from earth and hath the qualities of earth about him Earth is the mother of all fruits yet hath it many miscreance of the same condition is Man for which cause Antiquity put the title of Microcosme upon him For Man being wounded is no more in his right tune is like a mother of all diseases which
and the joint water runs strongly Joint water join'd with a swelling and the more the more it swelleth it is a sign that the Surgeons medicines are not proper for it therefore let him use better in case he intends not to spoil the joint quite and by too much running it cost the patients life let him learn to make better Salves than he hath in his Dispensatory If a party be wounded on a joint and complaineth of pains on the extream part of that joint as being wounded Pains in a wound in the arm and his pains are worse in the finger than in the wound it self then is it a sign that the member will dye and that the cold fire is coming into then is it high time to Cold fire prevent that evill and do not neglect the patient A wound made into the body and prickings are in the side signifieth death if so be the wound is in that place A wound made into the hollow of the body and is at a stand in healing signifieth death but if a wound be at such A wound at a stand a stand on an outward member and the wound waters a little it signifieth Cancer Prunella Inflamation Wound-disease or death if they be not prevented it may be that some imparity was in the wound Ointments and Balsoms which set the healing backward for such slovens are found which care not whether their medicines be made clean or no and that fault is committed in medicaments that are both for inward and outward use If a cough is incident which Cough a sign of congealed bloud is not cansed by the lungs it is a sign of congealed bloud in the body if he brings up any bloud with his cough then is it the surer sign of it but if that bloud brought up by coughing is red and fresh then is it a sign that a bloud vein is wounded which is still a bleeding If a wounded party begins to stammer in his tongue looks gastly turns his eyes is deaf it signifieth madness and death if he be snoaring at the noistrils knoweth no body hath a Stammering great droughth yet drinketh little his sleep is gone and still will be gone all these are ill signes and easily judged If a hard knot or callus groweth on a wound which is painful and increaseth yet the wound healeth it is a signe Collossities that the veins and sinewes which are there about are dying and rotting death ensueth upon of such heavy examples I know too many which have thus been neglected and such collossities grown there must be looked to These few signes I hold forth to you thereby to learn to discern other Symptoms it is not possible to rehearse all the defect hereof may be supplyed in those that follow for to discern such Symptoms CHAP. II. Of the Sleep of a wounded party what a Surgeon ought to judge of it REader marvel not that I keep no method in describing of Symptoms I took these Simptoms in hand to write of as they fell out in my practick Touching Sleep sound peoples sleep is not alike some snoar in their sleep others without a noise in these it matters not much but it is another matter with those that are wounded because Surgeons ought to take notice of such signes in their patients sleep If a patient puls in his sleep his wounded To judge the signs by the sleep member and is thereby awakned it is a sign that the Cramp or Wound disease is coming but if he is frightned in his sleep and awakneth of it if his vvound be in the head a Cramp or Palsie ensueth upon If a wounded party awakneth knoweth not where he is and talks idely it is a sign that he is in a great heat which soon will cause a disease in the wound A head wound which suffereth not the party to sleep accompanied with a heat it signifieth a mortal Symptome in such a case phlebotomy is very needfull if he cannot sleep after that then death ensueth A patient that sleepeth much and is idle withal in his sleep is hot in his body yet sweats not it is a sign that the wound disease is predominant for such there is no remedy and dyeth but if he sweateh all the body over then there is better hopes of him but if he sweateh onely on his brest it is a deadly sign If a patient le ts go his stool in his sleep it signifieth death A patient who at first is in a good posture unto healing but grows worse afterward and looseth his sleep it is a sign of a mortal Symptome If a patients sleep be thick and short but sweet it is a good sign and if he be in a good temper not too hot and his pulse beats orderly it is a good sigâ—â—â— but where no such signes are there is it dangerous Touching medicines to cause sleep withall when they are good and when not you will find them in the Receipt described of Anodin or Laudanum CHAP. III. Of pains in Wounds what doth cause them how judged and how remedied PAins in wounds are natural and in there cure they will Paines in wounds are usual be caused one way or other and pains will be felt as long as nature separateth the bad from the good and is done when the wound matters thereby cleansing it self pains caused in that way are of no consequent in case the patient be not otherwise disturbed and is kept in a good dyet but it is another case when the wound brings not out the matter in due time and the patient in his dyet or by the Surgeons carelesness is neglected out of such pains a Surgeon which is expert will look to the circumstances must be considered and for that reason I thought good to write one Chapter of it to know from what the pain is caused how it is to be judged and to fit the remedy against it Here I will not speak of ordinary and natural pains but of extraordinary ones which are caused either by the patient The patient causeth paines or by the Surgeon or by both A patient causeth pains to himself with disorderly eating and drinking pretending they must have a recruit for their bloud some spoil themselves by eating of Cabbages slimie Fish Pork c. by sour or strong Wine stinking and sour Beer c. some by being too much in the Sun shine or being too much in the Ayre or stirring too much in Leachery c. whereby pains are caused in wounds if not quite spoyled A Surgeon cannot exactly judge of the causes thereof nor to allay them unless the patient be better governed in such wayes The Surgeon oughâ—â—â— warn the patient of the danger which such disorders do breed if he will take no warning then let him take what falls Surgeons also may cause such unnatural pains as first with stitching with tents by forcing them into Wounds c. Surgeons in fault of which
casts forth the matter the better in such a manner Good Medicine maks good Matter as it ought to be But if the medicine be contrary unto the natural Balsam then the wound cannot digest it well and the matter also comes short in its form and sent if so then that medicine is nought and a better is to be applyed for the matter is altered according to the medicines goodness Therefore learn to know the Matter that you may be sure whether its form be from the wound or no or from any other Symptom or whether the medicine causeth it to be of such a shape Surgeons ought to know that every wound affords Matter be it much or little and the one Matter doth not look like the other Flesh and blood have their singular matter A twofold Matter the white veins have their proper matter and another matter affords the bones the same must be understood also of the internal members Bones at there healing yeild a white slime and somewhat thick but if they are not in a right tune they give a clear water without any smell and looks greasie which is seen by the linnen that are put into White veins afford a clear water somewhat tuff and slimie but if they be out of order then the water runs out yellowish abundantly and tuff like the white of an Egg or raw indigested blood Flesh affords its matter somewhat thick white gray or of a carnation colour with its due sent and willingly separateth from the wound If the matter be tuff clinging to the Wound and must be forcibly taken off and is cloddy it is a sign that the body Full and cloddy matter decayeth in strength And when there appeare any streaks therein it intimateth that the sinevvs are going all hastneth tovvard death And if the original be not toucht and found there is neither help nor hope for to recover such a party If the matter be tuff sticking to the vvound then is the vvound in no good case and inclineth to turn to another Symptome as to a Gangrene Cancer Fistula and the like If the matter be thin looks white like milk it signifieth naughty blood and the marrow in the bone is consumed Thin matter if this matter comes in any quantity then it is yet joint water and intimateth a terrible Symptom like to a palsie unto which you must look well that the wound be kept dry and no greasiness come into else it will befall you as you heard about the wounds in the back bone If there be but little matter the wound sinks and turns blew and hastily shutteh it signifieth death no help Little matter for it But if the matter be thick and yellow runs abundantly out of the wound if onely squezed a little it intimateth a thick matter great hollowness and if that wound be bone-chattar'd then it is a sign that a loose bone would fain break out If such a party come to your cure then tarry not but begin in time to cure it as a Fistula if there be a small bone at hand it will come out nere the sooner That Patient must be put to the smallest and not to the greatest cure If a Wound that is soft being squezed yeilds a foam or A froth in the wound froth mingled with blood it intimates a spongie flesh in the wound and it will turn to a Fistula therefore cure it as a Fistula that soft flesh will soon settle to a better ground-work of the cure A wound that beareth no matter is at a stand it intimates that an Inflamation is coming into whose Wound without matter forerunner is Prunella Stinking corruption in wounds prognostick ill Here the Surgeon must well know the matter and to judge by the Stinking matter form sent coluor c. how his Patient must be cured Thus much of corruptions in wounds more could be spoken of in that particular shuning prolixity I let it rest so neither is it well possible to write more exactly of it for every matters form is a working to the applyed medicine every Surgeon useth his own medicines which is the reason why these signes differ so much The signes mentioned here are set upon mine own Wound Ointments stiptick Plaisters those that use other things must find other signes Surgeons ought to know their medicines and observe their operations chiefly how they appear in the making of the matter then may they judge what medicines are good and which are nought for the wounds they have in hand CHAP. V. Of the Joint Water the difference of it how to allay it THe Symptoms of the Joint water are so well known that I believe it a thing superfluous that I should write Joint water is dangerous of it However confidering that the Symptoms herein terrifie Surgeons more than all others therefore I could not forbear I have seen many which understand as little herein as nothing which occasioned so many abuses in surgerie committed at the stenching of the Joint water against which many receipts were invented even as if in surgery nothing vvere known of it Note this about the Joint water there is a moisture in joints called by Surgeons a Gluten because it maketh the Joint water is no gluten joints slibberie without which no joint is in its right tune this moisture is but little in quantity Some Surgeons suppose that the joint water is that which lyeth in the joint these are mistaken and deceave others to their great damage For sometimes there runs out of one wound more joint water than there is of the Gluten in mans body and when that Gluten hath done running in that joint then that joint withereth and is no more flexible No art can restore that gluten if once gone and lost For the joint water called Synonia which usually runs out at the wound is properly a moisture of sinews and veins whereby every joint receiveth its strength without which no joint can subsist What is joint water For if in a wound the sinews tendons muscles c. be hurt then they let their moisture go which runs out at the wound and is then called the joint water and continueth running so long till the sinew is fed by the digestion then it begins by degrees to cease and the wound inclineth unto healing If a wound be hindred in its healing by the running of the joint the ioint water is hurtful to the whole body water because it was not drest with proper medicaments and the joint water getting its full course it will bereave all the parts of the body of their natural moisture or radical humidity and cause them to dye For the joint water getting the praedominancie and runs too long then that joint falls into an irrecoverable Consumption whithereth quite away as being wholly bereaved of its food It happeneth Salt spirit by the joint water some times that the joint water is accompanied with a salt
ought with the brown Ointment wound-Ointments stiptick Plaisters applyed in the manner of an Opodeldoch or the Opodeldoch it self to be used Let the Patients dyet be answerable to the heads infirmities It is fit that a contrary vein to the wound be breathed as the parties condition requireth If the Red joint mater joint water runs of a ruddy colour then use Diureticks to open the obstructions of the Liver and Milt Viz. Annise Fennel Maidenhair Tamarisks winter Cherries Plantain Liverwort c. Of these you may make a drink for the Patient and go on in the applying of external medicines so long till this red colour is changed Yellow joint water The yellow joint water burneth exceedingly usually spoyleth the wound and this is incident to such parties that are subject or troubled with the yellow Jaundice and is known by these signes The parties looks yellowish in and about the Eyes the Breast where that disease begins and sends it further to other parts and the party then feeleth some ease about the heart and stomack Such a party must be spedily lookt to before this hot humor eateth off the veins and sinews and bring him unto deaths door if the party be not holp the wound will farre the worse Therefore delay no time in diverting these humors and expel them by stool For these parties are good such things which usually are ministred against the yellow Jaundice Let the party obstaine from Wine but he may drink Barly water wherein are boiled Raisins and Melons seed Order him also right in his dyet use no sour nor hot things no Spice Let him use much of Borage Buglosse Succory Plantain c. This ensuing purge also may be used â„ž of the best Manna â„¥ 3 of Rubarb Ê’ 2 small beaten of Raisins â„¥ 2 of the best Prunes the number of twenty of Rose water â„¥ 1 ss fresh well Water and white Wine ana lib. 1. Boil these till the Prunes be enough ad to it pulverised Cinnamon The Patient is to eat every morning of these Prunes the number of six and of the liquor he is to take cochl 4 it will purge him gently and expell the sharp gall by stool This purge may be will be too costly for poor people let them take instead of Manna and Rubarb of Polopodium â„¥ 1. small chopt and beaten and of Rhapontick Ê’ 3 and make the rest as you heard These must be used as long as these humors are apparent these being gone your medicaments are to cease also else too much moisture will be drawn to the wound which would prove obstructive unto the healing of it Touching outward things to be used for the wound apply the brown Ointment Wound-ointments stiptict Plaisters c. as you heard above which are used so long as any of these Symptomes are apparent CHAP. VII Of congealed Blood winthin or without of the Body Remedies for such Parties though otherwise they are well THe things that I do write now touching congealed Blood have been told by those which lived long before me and found them very good for such purposes to their large writings I direct the Reader I have made use of them and found them to do very well and durst confide in them I mean not here congealed Blood which is in the head betwixt the scull and the skin of these I have spoken enough above about head-Head-wounds I speak now of such congealed Bloud which lurketh about other places of the body caused by a blow push fall strain c. There are two sorts of this Bloud inwardly such congealed Bloud comes to the hollow body outwardly it congealeth between the skin and flesh Surgeons must be careful Congealed blood is of two sorts herein to deal rationally for such parties come dayly to their hands which by ignorant Surgeons are spoyled Touching congealed Bloud in the hollowness of the body Note if it be there then be sure that a Feaver will be caused Blood in the hollow of the body and a mortal Imposthumation Therefore in the first place phlebotomize the party observing the Patients condition and the place Jest not in these things which concerne mans life and advise with a good Physitian Then use means which are diuretick diaphoretick purgative and extenuating that it may not turn to a Feaver or mortal Imposthume or Ulceration To this purpose are commonly used Rhubarb Rhapontick Maiden-hair Fennel and Annise seed hearb and root Parsley root all manner of diureticals and aperitives of the liver Here is used also Terra sigillata Bole armoniack Ocula cancorum Sperma cetae prepared red Corals calcined Harts horn c. In such cases are used also some distilled waters of Night-shade Alkekengi Cassia c. as Art and Experience shall supply you herein There is Unguentum populeon found in shops which is very good against congealed Bloud within the body mornings and evenings â„¥ 1 taken in Wine or the like vehicle You may use also this following Pouder â„ž Sperma cetae Powder â„¥ ss Mumia Terra sigillata Linch cakes coales of the wood of Tamarisk ana â„¥ ss Polipodium the root of it â„¥ 1 pulverise all these minister Ê’ 1 of it to the party mornings evenings and at noons This doubltless will disperse and expel the congealed Bloud You may observe when ever you intend to disperse and Note to expel congealed Bloud within then put a purgative ingredient among the rest as Folia senae Rhubarb Polipodie c. Above there was set down some pectoral Potions which may serve for this purpose also if you please Touching external congealed Bloud caused by falls Blood in Wounds throws blowes c. whereby the bloud burst out of the veins and lurketh between the flesh and skin and appeareth with blew streaks in such cases my advice is this Let the party be phlebotomised instantly where you think it fittest then apply a Plaister to the place where the bloud appeared Viz. Emplastrum exiccans of Terra sigillata Bole Armoniack Dragons bloud Ceruss Pitch Rosin Amber Calmey Sloe-moss unripe sloes buttons and leavs of Roses Mirtles c. out of these make a Plaister called a Dryer and apply it in form of a Poultesse In this manner you may order your medicines as you think good observing the conditions of the party and place I give you one instance â„ž Bole armoniack â„¥ 3 Chalk â„¥ 1 evaporated exiccated juice of Sloes â„¥ 1 pulverise these and boil them in strong Vinegar ad to it some beaten Walwort and stir among it Oat meal or Millers dust make it thick like a Poultesse ad some oil of Mirtles among it the oil of Sloes were better apply this Cataplasme wet to the place affected I must needs speak of some abuse which some Surgeons commit in such cases using greasie things to little purpose Abuse take heed of snotty greasie Ointments because in such cases no moist but exiccating things are to be used For all sorts of
coated glass body pour on it of Aquafort â„¥ 5 made of one part of Vitriol and one part of Saltpeter abstract the Aquafort and pour it again on the Mercury which stay'd on the bottom abstract it again and iterate the abstracting the third time then take the Mercury which stay'd on the bottom looks yellow like brass grind it well on a marble put it into a glass body and pour on it of oyl of Vitriol â„¥ 1 let these stand in a warm place for 24 hours let the oyl of Vitriol evaporate in hot ashes then the spirits of the Aquafort together with the oyl will evaporate and the yellow Mercury will stay on the bottom take it out that on the sides let alone grind it again pour upon it good Aquavitae that it stand two fingers breadth over it let it stand in a warm place for two dayes and two nights then cant of the Aquavitae cleanly and pour fresh on it let that also stand so long in a warm place and then cant off that also and when you have done so a third time then is the Mercury prepared and perfect in his operation Thus much of congealed blood within the body to be expelled by means used inwardly now followes how congealed blood is dipersed by outward means CHAP. IX Of congealed Blood to be expelled and healed by outward Medicines IT hapneth sometimes that by a fall throw thrust push c. congealed bloud settleth to the side or back and turns to an Imposthume which can neither by inward nor outward means be help'd This may befal also external or outward parts through carelesness of Surgeons or the Patients slieghtness keeping it concealed so long till the bloud turns to coâ—â—â—ption and causeth many pains Let the case be as difficult as it wil yet through Gods help we wil undertake to cure it And first we wil speak of such bloud which is come to the outer parts If a party be hurt either by a fal thrust push c. and the place be swelled a little and is soft and paineth the party if Signes toucht it is a sign there is congealed bloud under it be the place of a yellow blew or any other colour and if there be panting and beating in it then you are the snrer that it is so as hath been said Here you need not tarry till it come to corruption as Surgeons usually do toyling much about the molifying of it That place is to be launced instantly and to be tented the tent be covered with Unguentum Aegiptiacum and calcined Allum strained on it apply to it a stiptick Plaister and a defensive Plaister upon or else you may apply a fracture Plaister to cover the whole place withal in the middle of it leave a hole of the bigness of the Wound at which place you apply a little Plaister which you take off in time of dressing without removing the great Plaister if the tent stay'd a day and night in it and at the taking out of it the matter wil soon make shew and begin to run the pains wil cease and the swelling asswageth also proceed in this way so long til all anger and swelling be gone and the hollowness be filled up this being done leave off the tent and heal the rest as usually Wounds are healed in the mean while inward medicaments as Vulnerasie potions must be used also Some may wonder that I bid such hurts to be launced before thâ—â— be ripe or come to corrupion But he that understands Objection answered the business will easily concur with my saying For what needs one to let it have time unto corruption being it must come out why not in time before it causeth greater troubles for it will have a long while before it can break through the skin before it comes to do to what pains and sorrows may it cause as Feavers Inflamation and an anger joining with it may suffocate the sinews inflame the bones and cause them to grow black which may turn to Fistula c. they should the rather be launced that it may turn to matter for any blood if it gets vent will turn to corruption in one night the which is seen in Wounds where the blood in it turneth quickly to matter so other congealed bloud will the sooner turn to matter if it once hath gotten air Being it is so why should it be kept lock'd up there to prolong pains besides as you heard it is sure that the blood which is removed from its natural place turneth to matter why should it not be better then to let that water run out of such places and the hurt may the sooner be healed to which rational men will condescend Reader by these you may know that lenitives are to be avoided here Viz. Diachylon or other Gums and Cataplasmes for all softning things are hurtful here because these Symptomes are of another condition then other putrified swellings thus much of these touching the outer parts But if Symptomes are iucident to the side belly back shoulder with these you must proceed thus here the Surgeon ought to take notice whether after the fall blow c. the place did swell four or five dayes after and whether any pains be joined with it as pantings beatings pullings and whether the party can fetch his breath easily and without pains and whether he feel any great heat it matters not of what colour the hurted place be If that swelling doth pain the party being toucht and looks ruddy then launce the place with any instrument do it undauntedly doubtless you will hit the congealed blood then dresse the party after launcing as you heard above minister to the party good vulnerarie potions then things â—ill soon mend Remember to phlebotomize the party on that side where the hurt is let it bleed well be it on the arm or legg considering the condition of the patient and the place in the rest you proceed as you were informed about blood congealed Formerly I condemned Cataplasmes to be used much more now do I forbid them For there is no maturative of that vertue as to do the feat here to force the matter the sooner to eat thorough the skin but rather will make the matter eat inward and if it eateth through into the hollow body then the party dyeth and suppose that some recover in that kind yet will they be unfit for work and are crazy to their dying day I have seen many neglected in this kind I quote onely two examples for to inform you the better the one sheweth how the party after launcing did well and the other party whose hurt was not launced dyed miserably Some years agoe a party was hurt by a Bull which hurt grew worse every day at last he fell bed rid no purges no phlebotomy no diaphoretick would avail on the out side there was little sign onely the place the Bull pushed him at was red and a very little swelled but he could not endure to be toucht
this past on three weeks at last I being called with some others we consulted and resolv'd to launce the place which I performed there run out above half a pint of matter after that by Gods blessing he was cured Another party being a Gentleman had a fall with his horse was shrewdly bruised on his left side all manner of means were used but to no purpose the party was much troubled with prickings and a cough little sign was seen neither swelling nor redness and where the bloud should be gathered it could not be discern'd Physitians Surgeons and my self also were called some would have it launced but the major vote was for the negative what hapned the third day after the blood and matter come out at his mouth and not long after he dyed CHAP. X. Of bleeding Wounds what it signifieth what Surgeons ought to do for it A Wound which was thought to be well beginning to bleed then the following signes are to be taken notice of The Surgeon trying with his Seeker finding some What the bleeding in wounds meaneth bleeding in a small quantity is not be troubled much at it because the sound flesh may be that searching be caused to bleed But if the bloud comes abundantly then surely by that needless searching a bloud vein is hurt and turn'd out of its place which caused such vehement bleeding But the wound not being hurt by that searching yet bleedeth it signifieth that some shatter'd splinter is loosned which being desirous to get out sticks in the new flesh and makes it bleed this is best known to be so if the party toucht at the wound is mightily prickt and that bloud be clear and fresh The manual to be used herein in this to keep open that wound with a small tent which is to be covered with unguentum What the Surgeon ought to do in this case Egiptiacum and to dresse that wound but once a day so that that loose splinter may come nearer the mouth of the wound and be pluckt out And if it hangeth yet on a panicle it must be let alone till it loosneth of its own accord In that intrim search not with the instrument in the wound for fear that splinter be prest into a sinew whereby great mischief would be caused If a wound bleedeth abundantly it is a sign that a bloud vein closing is opened again in which case you must do thus If the wound be yet wide open then use an ordinary bloud stencher and put into it dayly the wound Ointment then it will soon overgrow with flesh and be stenched of its own accord And in case there be any bloud in the Wound as it often hapneth then that bloud must not be wiped or washt out which Surgeons ordinarily do but leave it there because that stoppeth the bloud vein and then the wound Ointment and the stitch Plaister keeps off other hurtful things unto the Wound and that bloud which stayeth in the wound will soon come out in the ulcerating But if the Wound be very narrow then the case of it is otherwise for if it be very narrow then make a tent prepared with a corosive that corosive is it which lyeth settled in the bottom of unguentum Egiptiacum and fill up the wound with it so that no bloud may get out this tent must not be put too deep into the wound onely half way leave it their for thirty hours applying a Plaister to it At the taking off the Plaister the tent not sticking to the Plaister and goeth out easily then let it stay there and apply the Plaister again for ten hours longer then open it take out the tent apply a smaller tent covered with the wound Ointment and a stitch Plaister upon and thus proceed to the end of that cure Squeeze no blood out of the Wound because the Opodeldoch will do it without any other means beware you No blood to be sqeezed out of the wound Example do not search in the wound with the seeker for fear you do stir a bloud vein and cause it to bleed afresh For I knew a Surgeon who was still graping with his instrument into the parties Wound causing thereby a vehement bleeding and spoyling the patient At a certain time a patient was brought to me whose wound did bleed so much that he grew very faint thereby The Surgeons who had him first in hand tryed several conclusions using long sharp tents for the Wound whereby they toucht the bloud vein causing vehement bleeding I took out the tent flung it away using none and cured the party in short time In some Wounds there is found much blood yet none runs out at the opening or undressing of it and no sign appeareth either of pricking or any other this is a sign that that that Wound was tyed to hard and the party is full of blood For with hard binding the flesh is prest together and is forced to cleansing and weeping and if it hath vent it bleeds no more This Symptom is thus remedied to bind the wound slackly and let the party not put on too straight clothes Surgeons ought to take good notice and care when the bleeding Wound will not be stenched especially when that Wound bleedeth not but after when it is drest or else it bleedeth before and after dressing and at the dressing the cause hereof is that the veins at the dressing be too much forced and prest the same is seen at phlebotomising when the veins are tyed too hard the blood doth not spin out so freely however pretty things help the bleeding of the vein This ought to be known at the bleeding of a Wound in the foot to have it stenched The dressing is of as great sequel and concernment as applyed medicines to Wounds which I know experimentally If a parties Wound bleedeth when he goeth or sleepeth then bind it slack and meerly apply the Plaister then you may the sooner perceive from whence that bleeding comes and take notice of the following sign for that is caused when there is no tent put in else it is a false sign When a spongious flesh appeareth out of the Wound looking like coam'd wool and that without any pain may be put in this signifieth that a splinter is loose or a piece of arteries is coming forth for such a thing closeth nigh with the bloud vein which is hurt with touching here you must search without delay else the party and you will have work enough because the bleeding may be increased and the vein be shut a great deal behind that and no way left for you to come near it and bring you to sorrowes Therefore strow onely burnt Allum into it this is strong enough if you should use a stronger it would soon run and eat through the Wound which in a long time you would hardly be able to cure again Let the Allum lay there till the next day it will come forth of its own accord if not then put more of the
of distilled oil of Bayes one part and of gum Amoniack one part mingle these annoint the wound about it will penetrate and warm the sinews Then apply a defensive plaister and so proceed in that cure use no greasie ointments or poultesses Keep the patient warm dresse him twice or thrice a day and phlebotomize him if his strength will allow it The next day I usully minstred to the patient this following drink â„ž Radic Turmentil and Angelic purely beaten Potion anaÊ’ 1 of Mumia â„¥ 1 Mitridate Ê’ 2 Aquapimpinelle â„¥ 4 mingle these let the patient take two spoonfuls of it and an hour after let him take two spoonfuls more mix with it ℈ 1 or Ê’ ss of Oculi cancrorum more or lesse as you shall see occasion Endeavour to perswade the patient unto sweating which if you proceed in the patient will be soon the better and Sweating in the time of sweating if he be very dry then let him drink of boiled Barly water let him not be opprest with thirst as I told you above also it is indiscreetly done to suffer such patients to be thirsty overmuch because great inconvenience is caused thereby it would do well if after such sweating the party might be phlebotomised but Surgeons must be regulated herein as they see occasion if the party by reason of his faintness is not able to endure sweating then press him not thereto and proceed with the rest in that cure All these said things being done then look to the wound whether the part spoiled in it inclineth to separate which is known thus when the wound is waterish and mingled with some matter the which hapneth not within thirty or forty hours if that sign be at hand then cease to use any further the above named ointment and take good wound ointment put that into the wound and apply an Opodeldoch or stiptick Plaister upon make use also of a defensive Plaister In case you dare not trust to all these then let him sweat twice more for more security sake and proceed in the rest as you heard above The Cramp is usually joined hereunto what you are to do in that case you shal find in its due place I must needs speak of abuses committed in these whereby patients are bereaved of their joints and sometimes of their lives also This abuse is partly committed by stitching which is stark nought to be used here because that flesh in the wound exiccated and spoiled by air or cold the same assimilateth no more but is to separate off and how can it well separate if pull'd together with stitching besides these stitches will not tarry but tear out because the lips of the wound are turn'd outward and in case such a wound should be thus stitched the cold fire would soon get into the stitch Some Surgeons committed great faults herein causing great hurts to the parties Viz. Assoon as such a party fals into their hands then they presently use their Wound ointment or Balsam to the Wound which is improper hereto because such Wounds admit of no healing unless the spoiled flesh be separated and be out of the Wound which exiccated and cooled flesh comes not out of the vvound of its ovvn accord but must be aided Therefore sharp ointments are to be put into such Wounds vvhich cease on the corrupted flesh and eat it off and thereby to prevent that the sound flesh and veins be not infected Which cannot be done if onely wound Oiles and Ointments be used because these cannot rectifie that corrupted and spoyled flesh but rather make it worse which to prove I could quote many examâ—â—es upon good reasons whereby illeterate men of an ordinary capacity may be perswaded unto And if it should happen that a party was cured by such oiles and ointment surely a great many to that one have miscarryed I have known such Surgeons which replyed that such Wounds had not their due excretions onely watered a little yet they went on in their salving annointing to the utter ruine of their patients though that the patient felt that the pains of the utter parts of the joints encreased more and more inclining to an Imposthume by reason of the continual beating and pulling heowever they continued in their course obstinately supposing their way to be the best Those indeed that know no other and do their best endeavours may partly be excused Thus much of this of the rest the Reader may think and mend it CHAP. XIV Of a Callus on the Hand or Foot causing great miserable pains SOme receave a hurt on their hand or foot on which places many bones and sinews concur where one or other may be hurt which is taken no heed or notice of neiany Collosities orâ—ginal care had to remedy the same Hence it fals out that Synonia begins to run into that joint and groweth to a collositie and whereas to that place a swelling is joined then is it supposed to be nothing else but it Hereby the patient is put into great extreamity This being an ordinary Symptome enforceth me to speak something of it the rather because this cure agreeth with the cure of the Callus or Nodus of the which mention hath been made above This Symptome befals not onely the hand or foot but all other joint wounds and stabs where there is a concurrence of sinews and muscles which being wounded are by Surgeoâ—â—lso often times neglected To make it more plain if a sinew or muscle be wounded then usually they begin to weep and yeild a moisture which moisture as you heard above never comes to any corruption and the skin being closed on that part and that water hath no issue it filleth up that place in a short time wherby that place is enforced to an up-swelling The sinews having a fellow feeling herein may soon be set on a heat which in time turning to a sharp humor may make the thing worse For the joint water or radical humor running from the sinews joining with a sharp humor how soon may that humor inflame and corrode the sinews and veins and may easily be suffocated if no vent made for it Though this hapneth also to other places as you heard yet usually it befals hands and feet betwixt the toes and ancles because there is a meeting of many small bones veins and sinews and little flesh joined to them and in such places such wounds may the sooner be inflicted And because no congealed blood nor spots appear there therefore some silly Surgeons suppose the place to be in the lesse peril and all is well to their seeming and ignorantly they let it run on so long till all be past help If any such party comes to your hand being hurted by a blow fling fall on his hand foot knee elbow and within few daies it begun to raise swelleth its pains encreaseth more and more yet no sign appearing of congealed blood or other fracture nor any sinews or veins seems to be hurt
gravel or gout and in that respect such sort of swellings we take to partake of he same infirmity Such swellings cannot be allayed with annointing fomenting bathing c. For the matter which lyeth in the joint must be reduced again to water and so be drawn forth to which end this ensuing is allowed Take of Goats pisse lb 6 you may mingle Cowes pisse among it if you cannot have a sufficient quantity of the other distil it in sand through a Helmet the faeces staying in the bottom must be calcined in a Pot let it be cool pour the abstracted water from it upon the Calx make a lixivium of it evaporate that a salt you will find take this salt ad to it of kitchin salt ℥ 1 of the distilled pisse lb 3 and a sufficient quantity of well Water for to dissolve the salt to clear water all these must be boiled again so long that an Egg may swim in it then let it cool so much that you may endure to put your hand into Into this water let the party put the said swelled member or joint it will dissolve and allay those tartarous humors in a short time The same may be used to other parts also as to knees ancles elbowes where any such swelling appeareth after they have been healed CHAP. XVI Of Vulnerary Symptomes caused by bodily insirmities chiefly by the Pox or supprest Menstruum how these are to be dealt withal IT old formerly that Surgeons must observe what diseases their patients are subject unto or troubled withal that their medicines might be applyed adcordingly for these humors coincident to the wound require answerable cures I intend not to speak of all such Symptomes but will give onely a hint of one or other whereby the rest may be judged how they ought to be observed Some pocky people happily are wounded these do not love te hear much of that infirmity however they cannot Wounds of pocky folks be cured in their wounds as those which were not defiled with them for such pocky humors will take their course to wounds settle there and are usually obstructive to healing Surgeons have reason here to look to themselves how to cure such they may know there by the matter and the persons they have in hand First of all to cure such wounds things above said must be known and in case these will not be cured by ordinary dressings then other means must be taken in hand Note no Mercury is to be used to the symtomes of such wounds be it prepared for fixation or otherwise because Mercuries quality is to take away all impurities and if Mercury should be used to a wound of a pockyfied party that morbus would be rowzed and the party would be brought to deaths door The cure of such wounds is thus ℞ Flos aeris ʒ 1 crocus Martis ℥ ¼ Aloes Hepatick ℥ ss Myrrh Frankincense anaʒ ss Sallat oyle ℥ 4 Wax Terpentine ana ℥ ¼ melt the Wax Turpentine and Oyl with Vernice ℥ ½ then put the rest to it stir it well so long till it be cold Use this Ointment to the wounds apply a stiptick Plaister upon it it will heal the wound In case this said ointment should not prevail then use the red liquor of Vitriol to it which will inforce the wound unto healing and make it thus ℞ of Vitriol lb 2 purified with fresh rain water let it dry then calcine it to a yellowish colour then pour on it again fresh water lb 8 exiccate it again then set it into a Reverberatory to bring it to some rubification then put it in a glass pour on it rectified Aquavitae that it stand two fingers breadth over it which will tinge the Aquavitae to a redness Cant off this Aquavitae and pour other on it to be ting'd which put to the first This ting'd Aquavitae is to be extracted per Balneum a spissitude of honey remaining on the bottom on this must be poured fresh Alcool vinj to take out the tincture Cant of that purely and abstract the Alcool again in Balneo to a liquid form then is it prepared This liquor is of an attractive or to get her drawing quality is not corrosive and is a principal soveraign thing for spoiled wounds where bodily humors are like to be incident this may be safely used for spraines and other wounds received in warlick services A Gentleman not long agoe received a wound in his face who was pockified but would not hear of it the pocky humor faling into the wound did burn much and eat into some Surgeons being sent for they went about to use precipitated Mercury thereby to cleanse and keep the wound clean But what happened Morbus Gallicus was thereby rowzed and that humor was forced to come abundantly to the wound and the mouth was full of it also I being called thereunto soon found what was done and the patient was fain to yield to a pocky cure This example I quote to that end because some Surgeons Mercury not useful in many things suppose they can prepare Mercury so that he can be fitted like a Saddle for any horse little considering that Mercury is naught for fresh wounds be it as artificially prepared as ever it may because he is too searching which is not alwaies good in these waies Many other Symptomes do concur in patients one example I will quote which is very remarkable whereby A notable example of a woman others may be judged Anno 1590. not farre from Basell an honest Gentlewoman which shall go nameless was cutting a stick one time with a sharp knife but the stick breaking at her hard laying on she cut her hand near the joint flesh skin sinews veins all in pieces A Barbar Surgeon being sent for drest her and that cure went on well unto healing for twenty daies together as both the Surgeon and the Gentlewoman affirmed it now which of these two was faulty I cannot tell one night a humor fell into that wound running out of the wound like waterish bloud causing smarting paines The Barbar holding it to be the joint water used all the means he supposed to be good against it but did no good A Physitian and two other Surgeons were called these also counted it a joint water advising their remedies to be used to oppose it Here was affliction upon affliction and no ease or help the Gentlewoman had no rest neither by day nor by night and that continued for a whole week then the humor stayd and the party had some ease But that humor had corroded all that which was healed these twenty dayes her whole arm was much swelled and inflamed and with much adoe that wound was hardly brought to that state it was in in fourteen dayes so much was it come out of order They supposing now that all things were brought again into a good posture and that all dangers were past Behold four weeks after the said humor fell again into that wound causing as
some call it the shaking or quaking doubtless because it seizeth on the patient with a quaking as if it were an ague For my part I know not what other name to give it nor why I should hold it for any other should I call it an Anthrax or no it may assoon and as easie be Anthrax cured as an Anthrax a futher discourse of it I commit to the learned let them dispute of it so long till they find a true and proper name for it if my opinion herein should be required I should say that it is a special sort of Wound disease because its cure is almost like the great Wound disease only it requireth no such great toyling To know and to discern this simptom note I know as yet not any fundamental or reall sign of it whereby to discern Signes its coming not unless it be come For that reason I will not speak here what others do think of doubtless it hath its signes whereby it may be discerned every one is to have his own observations about it if I meet with any I shall be ready to let the Reader know it Where ever this simptom is fallen in it appeareth and is conditioned in the following manner First the patient feeleth a shivering no other as if it were an Ague But upon this shaking there doth not follow neither heat nor head ach as it is usual in the ordinary great Wound disease unless the wound be in the head which distinction or difference ought to be carefully observed as being of great consequence An extream misery and pain befals the wound with panting and beating making the wound extreamly out of order Within the wound where the greatest pain is there appeareth a bright blister but somewhat darkish if the wound be deep and it being made with a thrust then the blister cannot alwaies be seen therefore the judgement of it must be taken from the cold pain caused by the chilliness But in case the foresaid blister be not in the wound but without or beside it then is it brown of the bigness of a pea is full of blood and feeleth hard with a hard swelling round about the wound having no ill colour If these be let alone then the said blister falls again inwards gets a hole leaving a scarre after it very white with a darkish ring presently after there appears black spots and look like the cold fire by and by there followeth upon a great heat and vehement head ach then ensueth a palsie next is death There is exactly to be observed also that if a patient is Note taken with a Wound gall so I name it now he hath no desire to turn this and that way and as they say to hop up and down as those do which are troubled with the great Wound disease but he lyeth still and stands out his time not without great complaining by reason of the continued increasing pain For if he stirreth then his pain increaseth and is forced to be quiet against his will Touching the cure of this simptom it is thus Take of the prescribed Aquavitae â„¥ 1 Oculi cancrorum Ê’ 1 which Cure must be well grinded mingle these let the patient drink it cover him well cause him to sweat in his bed for this sweat is of great concernment if the patient be loth to sweat or is difficult for him to do yet however you must keep him to it for no sooner the sweat cometh then he will be at ease About the wound apply the Anodyne ointment and let some of it be put into it in case you do not see the blister within apply to the wound a stiytick plaister in which must be no Rasom or any such thing which is of an attractive quality for the patient would thereby be put to more smarting pains which would prejudice the party Assoon as he hath done sweating then plebotomize him next to the place where he is wounded and let the vein run reasonable well doubtless the pains in the wound will be allayed after which you may cure the party with more facility Let him forbear meats hot of spices And because the blister being broken by sweating and is no more mortall maketh still the wound disformed so that it groweth brown and weeping then it will be requisite that you use the brown ointment for one or two daies till the wound be well cleansed then go on with the cure according to Art CHAP. XIX Of the third sort of Wound disease called the pulling and unquietness in the wound THis Symptom is known unto expert Surgeons and it hath its name answerable unto its deed I should have written of it afore before I had told of the other sorts and that the rather because the great wound disease which I have described at first commonly is caused from thence but I purposely delayed it to this place for some reasons For though the great wound disease thus I call the first sort for distinction sake and others also call it by that name is caused sometimes of or by this last sort which for some reasons I call the unquiet yet this also is true that the wound disease for the most part cometh into the wound whereas the unquietness hath not yet been felt in the wound This unquietness though it be bad and dangerous enough yet is it no so perrilous as the great wound disease therefore it requireth the less care than the other in respect of the pains which are not so grievous Touching other things together with the cure there is found also a great difference easie to be discerned by him which taketh notice of From whence that unquietness cometh into the wound From whence that Unquiet in the wound is needless to make any further discourse of it Even the same cause which causeth the great wound disease causeth also the unquietness in the wound and that sooner and suddainly therefore the unquietness cometh sooner into the wound than the great or first sort of wound disease which usually cometh then when the patients wound beginneth wholly to come off at the end When that unquietness is coming into the wound then Signes shieverings and chlilliness runneth over the patient which are not so vehement with quaking as other sorts of wound diseases usually do This cold shaking runneth about a long time in the body afterward it setleth to the wounded member or joint from thence into the wound where it causeth horrible pains with heat cold insomuch that the patient doth not know what ayleth him The wounded member he is not able to rest it any where Why it is called unquietness still shifting from place to place hoping to find ease in one place or other Therefore this wound disease is called unquietness because the patient still moveth the wounded joint like the jack of a watch doth move If the wound be on the body it s not the better because the patient will stir himself to and fro
long time then it comes to an updrying because that sick member cannot digest that food which Nature afforded and causeth an oppilation in that member no marvail then if it withereth It falls out also when a member is wounded very deeply there may be incident there such an Ariditie because the natural balsam hath not its true course and it is impossible for Nature to skip over the wound and that which runs amisse doth not go well There may also fall a humor to a member which though it be not wounded yet it may be obstructed and so causeth an exiccation More causes could be quoted of such updryings but it is needless to do it because their cures differ very little for Acidities caused either by a fall blow thrust or by any other occasion all these are comprehended under one cure Those cold witherings by a shot fall c. whereby great pains and consequently a consumption of that member is caused that hath a peculiar cure differing but a little from the other it may be said of the rest also Touching such cures we will first of all speak of that which Surgeons call Aridum membrum caused by the running out of the joint water you must conceave that I do Cure of Arudum membrum not speak here of an aridity which is come unto an extreamity for that which one neither knoweth nor is able to cure why should he write of it I will speak here only of a consumed member which is not gone too far where there is yet great hope of its recovery Do it thus Take head feet lungs and liver of a Goat or of a sheep or Calfes gather cleanse the head and feet well from hairs wool c. put these together into a great pot put alike quantity to it of water and white wine let it boil that all the bones fall off from the flesh throw away the bones the rest cut small put it into that liquor it was boiled in boil it again to a mash with this liquor the patient must be fomented as hot as he can endure it But in case the withered member could not conveniently be bathed then spread that mash on a thick cloth apply it like a Cataplasm as hot as the patient can endure it assoon as that groweth cold then apply another of the same as warm as he can endure it That which was used must still be put into the pot that you may not want materials for Cataplasmes This must be continued so long till the patient confesseth that it hath warmed his member very well this warmth may hold half an hour or more which being done then take the following Ointment annoint the withered member at a coal fire do it downward still warming one hand after the other so long till the said member be warmed wel throughly then lay on it a plain plaister made of Wax and Hoggs grease that member and the patient must be kept warm forbear to use any Oxycroceum or other hot plaisters Go on with the former so long till you see and perceave that the member is at a mending hand and getteth strength When you perceave that all the pain is gone and that member beginneth to prove again then use other Ointments against shrinkings and updryings which are found at the Receipt for ordinary Consumptions and witherings all the skill lyeth herein to stay the consuming and to get to the member its natural nourishment which being brought to pass then you may easily go on with the rest The Ointmunt above named against withered members is thus Take Cranes grease Foxes grease ana â„¥ 2 grease of a young Hogg â„¥ 1 ss mingle these together make an Ointment and use it as you have heard Reader out of these you may gather what the fundamentals are of my cure about exiccated members which exiccation though it be a withering yet it differs from other exiccations in the cure For the medicines used here are not of hot qualities as those are which they use to other withered members Now this difference not being understood of those which undertake such cures how can it be otherwise but that many patients are spoiled and utterly und one I have much read seen and heard of withered members and made use also of such medicines that were usual then but afteward finding better I left the other some used to whip the dryed member with Juniper twigs or Horse tayles or with Nettles others rubbed the place with Sackcloth c. others annointed the party at a good fire others used Cupping glasses others used Fomentations c. all these wayes I do not condemn because my self made use of some of them I will inpart unto you my way with the reason thereof I hold the flesh of every sound body hath its growth from abundance of blood and natural humidity my chiefest endeavour was to imitate Nature herein and to restore flesh to a withered member and to convey blood and food to it by rarifying the same by stirring and monving it now by the lifting up the hand then by hanging it down in which way the blood is made to come forward and backward and by stroaking it may be lead further To which end I took in hand such a withered member and stroaked it downward not upward annointing each part thereof with Wound Ointment all downward and stroaked the blood and humidity down to the member in the manner of milking afterward rubbing the member so long till the very marrow in the bone was warmed thereby at which work my hands also were heated This stroaking downward to the hand or feet I continued for an hour bringing the blood into the fingers or toes and forced the blood to the extream parts as much as I could insomuch that the toes or fingers began to swell from the abundance of blood After this stroaking I applyed a warmed Oxycroceum well and thick spread laid it on gently only to keep to the part and let it have ayr and room enough for the blood and natural humidity to come unto That member I bid the patient alwaies to hang it down not upward that the blood may the easier get into I annointed the party twice a day which saveth toyling to the party when the member begins to grow again then the party felt no pain when annointed That witheredness caused by a fall and not by a fracture I have annointed twice a day if a member did consume away by reason of a cold or other simptom then I annointed it four times more than if it had been caused by a fracture If a hand or foot was swelled but the part above was not swelled I liked it well then I knew my labour would not be ill bestowed when that member felt a tickling or tingling it was a sign of healing and when that member at the undressings grew warm and the veins looked blew then I proceeded in the cure It fell out often that a great pain was come into
flegm and slyme then this Electuary is not good for him neither must it be used to such on whose breast or lungs is fallen a rheum There are more Anodynes which are made by distilling and are subtiller pleasanter and of more use than these that are set down above but because every one doth not understand that excellent Art of Chymistrie therefore I do not speak of them here and so let it rest at this time CHAP. IV. Of Blood stenching in Wounds and Noistrils how the things requisite thereunto must be prepared and used ABove have I rejected some Blood-stenchings understand it thus I do not thereby reject or refuse all Bood-stenchings which ordinarily are used I rejected only such Blood stenching performed through Cauteries otherwise I hold all Blood stenching good except Cauteries and Corrosives if used without danger and prejudice to the party be they made of what they will viz. of Rye meal of Mill dust Pulmonaria c. in brief all things imbibed and turned to a pap are good to stench Bloud provided it be not a hot matter These following may lawfully be used viz. a Carniol stone Haematites Agat stone Crocus Martis Bole Armoniack sealed Earth Earth of Vitriol in which there is no Alcool left the sweet red liquor of Vitriol in like manner Gum Arabick Gummi Tragant the white hair of Hairs Cotton-wool Mullipuff and the like of Hearbs and Roots tending to that purpose provided they be not of a biting and corroding quality whereby inflamations in Wounds may be caused Expect not many Receipts about Blood stenching I will set down only these which I made use of and found them to be best he that understandeth me well will easily provide for himself the like Blood stenchers leaving every one to his own discretion To Bloud-stenching I use first a Plaister which is made thus Take of Amber half an ounce of white soft Rosin The Authors plaister to stench blood one pound the dark Turpentine four ounces of Mastick a quarter of an ounce of Crocus Martis made in a Reverberatorie three ounces Of these make a Plaister in the following manner Take a fourth part of Turpentine make it very hot strain the pulverised Mastick and Amber into by degrees these two being melted therein then put the rest of the Turpentine to it and then the Rosin which in another pot must be melting gently after all that you put in the Crocus Martis and then you let it cool so is it ready This is the first and chiefest Bloud stencher not so much by reason of the Ingrediences but by reason of the singular Manuals which fall out here as you shall have more of it hereafter 2. The other piece which is here to be used is this Take Mullipuff cut great and small pieces of it of a fingers thickness or thicker some as big as an Egg and of a fingers length shorter and longer of all sorts tye these several pieces in a paper as hard as you can and tye them close together then bind them more harder together with tape so that one piece which was of the bigness of an egg in the binding be no bigger than the little finger this being done presse it together with heavy weights or screw it into a presse where you must let it lye for some daies that they may be yet closer prest together then take them forth lye them yet more together and keep them for use 3. Thirdly you must be provided also with this Powder Blood stenching powder Take Sheeps blood let it stand till the blood separateth from the water which is done in one day and night pour off the water and put the congealed blood into a pot set it in a circular fire like unto a little cement fire let it stand so till it be quite dry it neither stinketh nor is of any rank sent and being turned to a powder then is it ready Take of this prepared blood four ounces of purely pulverised Gum Traganth half an ounce of Blood wort pulverised half an ounce mingle all these and keep it for use Now if you have any patient whose blood you are to stench then first note and observe carefully whether when he is angry the blood will not be staid unless his anger be over The like case is when the party hath a paroxisme on him otherwise you are to do thus take a little of that powder and cast it into the wound and take a piece of the prepared Mullipuff apply it to the wound the bigness of the Mullipuff must be answerable to the wideness of the wound yet so that it easily go into the wound and not be forced into therefore ought you be provided with all sorts of such pieces then another broad and thin piece must be laid on the wound or else Cotton wool mingled with a little of stenching powder and hold it a little with your hand Make the place dry with a sponge round about the wound and apply the afore written plaister to it spread on a bladder pritty broad and great so that the wound every where be well covered then take a boulster presse the plaister close to the wound and with the binding be made cling unto the skin then it will receive no more moisture and closeth the bloud in the wound and can presse forth no where neither at the sides nor below nor above so that the blood is as it were forced to stay and run together and congeal within Hereby the Reader may easily understand that it is a matter of consequence when you are about the applying of a plaister that you must be careful to put away the bloud about the wound and that the skin be well dryed for the dryer the place is the sooner the plaister clingeth and the plaister sticking to it then is the thing for the most part holp Have a care that the plaister do not get loose again and in case the wound bleedeth too vehemently then is it requisite that you apply a greater plaister upon the first that it may stick on a dry place This Blood stenching is very natural as judicious men may easily understand and it is very convenient for a wound for whither can the blood run being kept in by that on sticking Plaister neither can it press above through the bladder and so it is forced to stay and be stenched Besides the abovesaid powder hath a marvailous quality because it turneth glutinous and uniteth with the blood by reason of the Gum Tragacanth and the prepared blood for that blood also uniteth with mans blood the matter swells in the wound and turns to a slyme as you heard above and the blood also groweth thereby glutinous and so cannot run much The same thing is it also with the prepared Mullipuff when it is laid into the wound it goeth asunder swelleth to the bigness it was at first of stoppeth the wound thereby and that swelling is gentle not forcible without any danger and prejudice
to the wound that may be used to all wounds even to head wounds so the powder also may be used provided it do not come too nigh to the naked inflamation It is not alwaies needful that such great earnest be used in Blood stenchings neither is it necessary to use such prest When Mullipuff is to be used Mullipuffs understand it onely of such wounds which bleed extreamly where no ordinary means will prevail the Mullipuff may be used per se also but you must use a good deal of it apply it loose to the wound and then to keep it on with a plaister many do use it so and they do well therein There is no man compelled or tyed to the foresaid powder nor to the Mullipuff you may make a composition of your own head of the foresaid Ingrediences as you think it best Mingle that powder among pure Cotton wool use it duely but then I counsell you not to forget the plaister which is the chiefest thing herein I made use of this way in Blood stenching hitherto and was ready to impart faithfully the same unto others hoping that if you understand me aright and handle these thingâ— rightly you will doubtless have good success onely let me intreat you not to use any Corrosives that are burning and biting for reasons alleadged above Touching spells over wounds and characters which are greatly used of some to stench bleeding thereby I know Spells nothing to say of them and I leave it in its worth They are meer words and signs which are not understood of him neither which maketh use of them and what they are like to effect thereby the same I commit to your consideration Sometimes things fall out strangely when the wound is in such a place where the said plaister cannot be applied conveniently as a party being wounded in the mouth or throat as ones nose falleth a bleeding vehemently then other means must be thought upon as I shall tell you afterward If one be wounded in a place where a plaister cannot How to stench the blood in the mouth conveniently be applyed then stench that blood thus Take of the red liquor of Vitriol which hath no corrosive quality one part and of Gum Arabick a third part to its quantity mingle these spread it on Cotton wool and endeavour to bring it to the wounded place it will make the wound draw together the blood veins will shrink and the blood will be quenched and all without biting or corroding but you must have a care to let the Cotton wool with the matter lay a while on the wounded place that it may work upon it and if it doth not work sufficiently at the first time then iterate it once more that the blood may be stenched Of the same nature is the vehement bleeding at the nose Bleeding at the nose here it is not alwaies good to have that bleeding stenched preâ—â—â—tly especially in cephalical diseases because thereby other diseases are spent and consume away by that bleeding but if that bleeding be so violent that it must needs be stenched then proceed thus Take instead of Cotton wool of which I made mention above a little piece of How to stay it the soft dryed and prest Mullipuff pull a needle and strong twisted thred through it with a great knot on the end of it the Mullipuff must be of that bigness that it may just go in at the noistrils cover it with the foresaid liquor of Vitriol mingle it with Gum Arabick thrust it up with an instrument into the noistril to the hole which goeth down to the throat if you do not so you will do but little good for fear the blood should take its course into the throat therefore the Mullipuff must be straight thrust upward being it is soft and causeth no pain Have a care that the thred stuck thorough the Mullipuff hang a good deal out of the nose that you may pull it out when you have need Thus a bleeding nose may easily be stenched For such kind of bleeding other means may also be used as Saltpeters clothes laid to the neck inwardly you may help much as you shall here hereafter If you see that the patient hath need to be plebotomized Phlebotomie and hath need of other medicaments then let him have them my intent is here onely how the bleeding of the nose is to be stenched though this my process seemeth mean and poor yet I found it still to be best and most useful for the Mullipuff swelleth in the nose and Mullipuff obstructeth the bloods course and the liquor of Vitriol by its constipating vertue draweth things together without any danger and prejudice I am not ignorant of that many remedies were sought The working of Vitrriols liquor after for to stench the bleeding at the nose but they never did much good with it insomuch that many bled to death without help or before they could be helped I speak no more of it than what I have found true by experience There are many good means which ought not to be rejected as precious Stones hanged about the neck or put into the mouth or hand or they scrath the party with them or there is a singular experiment made of Saltpeter â—â—und in old rotten walls take this Saltpeter of the wall put it Use of Salt-peter in a melting pot make a circular fire about it make it very hot then pulverise it in a morter put white Wine Vinegar to it to dissolve it dip clothes in it apply them cold to the wound This powder may be used also among other Blood stenchers and used to wounds where great anger is for it quencheth the heat coagulateth the blood in the wound Another secret piece which is not common and is this if you cannot well stay the blood of a wound then take one dram or one dram and a half of well prepared Saltpeter which we set down in the third Part in the Chapter of Wound diseases dissolve it in a convenient water as Chervil water c. if you cannot have such then take Well water let the patient drink it you will soon see the blood stay'd it is no hurt to the patient but doth him good Thus I close this Chapter also CHAP. V. Of Vulnerarie Potions in general and particular how these are to be made and in what different manner they are to be used TO make Vulnerarie Potions and to use them is a common thing and every Surgeon hath his own way which he thinks best which indeed is tollerible for these drinks cannot be rejected as if they were good for nothing but are rather to be praised as without which Surgeons sometimes cannot be the which I had eâ—perience of But I met with indiscreet dealings in such potions that thereby some did more hurt than good whereas if well handled and made more good can be done by them than otherwise which moveth me to bring to light that
see fitting but still look to that what the condition of the patient and the necessity of the wound requireth To speak of their quantity weight or measure cannot be well set down because one Patient is of a stronger nature than another the one a man the other a woman these parties ought to be considered and the Vulnerarie potions regulated answerably And to come nearer to the description of Vulnerarie Potions first you must note and it is known unto others also that Vulnerarie potions increase the blood more than meats therefore the better that Potions the better blood it will make now every wound receiveth its food from the blood hence easily it may be gathered if that Potion be prepared of good wound Hearbs that the wound also will the better and sooner be healed preserverh and defendeth them from several malignant enemies if so be that good order and dyet be kept with moderateness therefore endeavour to use to such Potions not the meanest but the best however all must be ordered as the occasion of the thing requireth Touching the cooking and boiling of Vulnerarie Potions Boiling of Vulnerarie potions therein not one alone but several waies are used the one boileth them in Wine simply another boils it in Wine in an upshut vessel which is more fit but not much better others use Waters to it distilled of Hearbs these are not much to be regarded because the salts are not therein which operate most others take these Hearbs green without any other addition putting them in a closed Pewter vessel setting it in a kettle full of water boile the Hearbs so long till the juice be out of the Hearbs and that drink they use but such Potions are too strong and but a little of it must be used at a time It can be made pleasant with Cinnamon and Sugar to please the patients pallat all which is left free to every ones disposing however discretion ought to be used herein There remaineth now that I set down some Receipts for Vulnerarie Potions It must not be understood here that thereby I reject all other Vulnerarie Potions the Ancients also have left behind them several good Vulnerarie Potions and they set them down so upon sure reasons I am onely against abuses as you often heard me speak of therefore you have leave not only to make use of my Vulnerarie Potions but also of other mens Potions and all discreetly and considerately If you will make a Vulnerarie potion for to use it then No red Wine to be used to wound potions take no red Wine to it for reasons known and such potions are to be used mornings fasting and the party fast two hours upon or evenings two hours after supper A good Wound Drink ordinarily used 1. Take Sanicle Stellaria Pyrola Mugwort of each ℥ 1 The Authors ordinary wound drink of ground Ivy ℥ ss boile these in two quarts of Wine to the boiling away of the one moyty minister to the patient of it twice a day mornings and evenings Another ordinary Drink which is good also 2. Take Adder tongue Bistorta Serpentaria of each ℥ ss of Tormentil ℥ ¼ boile these in a quart of Wine and use it as the former Another which is plesant to be used 3. Take Adder tongue and our water Bloodwort Barbula hirci of each ℥ 1 of May flowers ℥ ss of Stellaria ℥ ss of Cariophyllata ℥ ss of good white Wine lb 5 put these in a glass body and set a blind helmet upon close it well let it boil in sand for four hours gently according to Art open it and ad to it of Cinnamon ℥ ¼ close it again and let it cool thus you have a very good wound Drink Let the patient drink of it twice or thrice about four ounces more or less considering the parties condition Another Wound Drink for one in which there is is a loose bone fowl corruption or the like 4. Take of Sanicle of red Mugwort of Speedwell of Virga Aurea of Pyrola of each ℥ 1 of Savine ℥ 1 ss of Nipp ℥ ss boil these in two quarts of Wine or Beer and use it as the rest if you will have this Drink yet stronger then put to it a little of Oculi Cancrorum or of Sperma Cetae the impuritie will be expelled thereby out of the wound A Vulnerarie Potion for Stabs or Wounds 5. Take of Adder tongue of our water Bloodwort or Goats beard of each ℥ 1 note it is not the Goats beard Dr. Foxl and Dr. Taberna Montanus saith that it is but that noble Wound Hearb which is used inward and outwardly of Stellaria ℥ ss of Sage Matrisylva red Mugwort of each ℥ 1 ss mingle these together and pour on it lb 3 of Water or Wine which you please boile it in a closed glass body as you heard above of this let the patient drink twice a day ℥ 4 at a time more or less according to the parties condition But if you will cleanse the wound or stab then take of Oculi Cancrorum of Mumia of Sperma Cetae of each ʒ 1 mingle them purely Of this powder let the party take every morning ʒ 1 mingled with the wound Potion and let him drink it warm and fast two hours after A rare Master piece for a Wound or Stab where you suspect there is a bone proud flesh broken veins or other impurities 6. This Composition is not known to many which moved me to impart it and it is thus If you fear that there is in a wound or stab a loose piece of bone proud flesh pieces of broken veins fowl matter or such like which usually hapneth to deep wounds or stabs then take your wound Hearbs which you intend to use mingle among them a sixt part of Savine to all the other Ingrediences and thus prepare your wound drink And when you minister any of it to the patient then mingle with it of pulverised Oculi Cancrorum ℈ ss and let Expulsive potion them drink it This Potion will expel at the wound all loose bones blood corruption and the like and cleanse it without this cleansing no wound can be perfectly healed The wound being thus cleansed then leave off this expelling wound drink and make use of others as you think fit and leave no danger behind and use your Unguents and Plaisters according to Art Though there are not used any wound potions but they are expulsive because Oculi Cancrorum Savine c. are driving yea almost all wound Hearbs are of that quality therefore I would have you to conceive aright of it though the red Mugwort Polopodie Rhubarb c. are expulsive yet they do not expel so well fowl blood and naughty flesh together with the loose spinters out of the wound as the Savine Azarum and Oculi Cancrorum doth Besides there is not any of the Difference in driving wound Hearbs forenamed Hearbs which so effectually expels the onset hard clinging slymie matter as
the Helleboras niger doth but must alwaies be used with Carduus Benedictus Neither is there any of the foresaid Simples which sooner taketh away the sharp humors from the gall and dulcifies more their corroding condition than polypodie doth used with Liquorice and Mallowes so it may be said of the rest of which a hint hath been given above A Vulnerarie Potion for spoyled Wounds which yeildeth a tuff and slimie matter environed with a swelling and are deep and hollow underneath are like to turn to a Cancer 7. Take of Virga Aurea Sanicle Speedwell of each ℥ 1 of Vervain ℥ 1 of Carioplyllata ℥ ¼ of Carduus Benedictus ℥ 1 ¼ of Ellebore niger ¼ boil these in four quarts of Wine to the consumption of its moyty the rest you strain through a clean cloth let the patient drink mornings of it ℥ 3 use it so long till you see the wound yeilds lo external medicines applyed if it doth then leave off your Vulnerarie potion and use convenient means But if any pains are incident then stay for it is turned already to a Cancer outward medicines must be applyed answerably that its eating may be killed which is done Sweet Cauteries with the sweet Cauteries which are mighty helpful in such Vulnerarie Potions A Vulnerarie Potion for the Joint Water 8. True there is no such great necessity to use Vulnerarie Potions against the Joint Water for if a Surgeon understandeth himself and is diligent in his dealing he may stay it without such Potions as you heard of it above sufficiently But in case a Surgeon doubts that he will not be able to stay it with external medicines and is defective in his waies then let him make use of the following Potion Take Strawberry leaves Knotgrass red Rose leaves of Vulnerarie potion to stay the joint water each ℥ 1 of Consolida ℥ ss of Speedwell ℥ 1 ss of Cariophillata ℥ ¼ of Wine lb 3 of Water lb 2 boil away the moity of it let the patient drink of it consider the parties condition it were good if Centorie were added to the rest by reason of its bitterness but maketh the Potion unpleasant I leave it to your discretion whether you will use it or no. A Vulnerarie Potion against Gun-shots 9. Take of Speedwell and the hearb of Alkekengi or red Mugwort of each one handful of the root of Tormentil ℥ 1 ss of Adderwort ℥ 1 boil these in Water or Wine as the patients condition may brook withall to the moity of it let the patient drink of it twice or thrice a day And in case there be much corruption in the wound then Expulsive powder for wounds made by Gun-shot let the patient have of the following Powder among his drink dayly one dram and that for three times then all blood matter bullet if it be in it will be expelled at the wound Make it thus of Mumia ℥ ss of Sperma Cetae ¼ Oculi Cancrorumʒ 3 Liquorice ℥ 2 pulverise these very purely if you will have it yet better then ad of Rhubarb ¼ of Cinnamon ℥ ss it driveth strongly so and is more pleasant is safely used causeth no pain Note one thing more when Sperma Cetae is stale it To prepare Sperma Cetae stinks then it ought not to be used making the medicine very unpleasant however if you must needs use it make a separation with Vinegar distilled and fling away that which is stinking and that which is clean keep for use Of this you must not take so much as usually is taken because its vertue now is made better and stronger which is to be understood of other things also where Sperma Cetae is used And this is all what I intended to write of Vulnerarie Potions hoping that the Reader hath sufficiencie of iustructions from thence according to which he may order all other sorts of Vulnerarie Potions And thus I let it rest and having made one relation more then have I done with it Many may think when they have perused the things I have written concerning Vulnerarie Potions and say this man useth in his Surgerie none but plain Plaisters and Unguents if any one should perswade himself so he may be deceaved For besides these Vulnerarie Potions I use alwaies Wound Unguents Stiptick Plaisters Opodeldoch c. as good as they may be and occasion requireth However it is true that if Vulnerarie Potions are used then the wound needs not so much of Unguents as when none were used Neither do I advise that such Vulnerarie Potions are to be used to all wounds for where I have no need of them there I omit them and where they are needful there I make use of them And I used them discreetly not because I was accustomed to it if I should have done onely according to my custome I should never have been without sorrowes CHAP. VI. Of spouting and sprinkling into Wounds of Tents and of Corrosives I Cannot chose but to speak something about syringing and that briefly without any Receipt spouting is much Spouting or Sprinkling used with Lavaments I describe none of them because I see there is more hurt than good done with them and so I hold their use to be unadvisable and this must be understood about fresh wounds And if any wound precisely be for the use of them he ought not to siringe strongly into any wound or stab be it as deep as it will else the wound within will be driven asunder or enlarged and made wider spout so gently that the medicine may only droppingly fall out of the Syringe into the wound But in spoiled wounds which are fistulated to these siringing may very well be used unto which in some place I gave my advise These Syringes must be either crooked or straight as the condition of the wound is whereby you may come to the bottom of wounds and to bring the medicines thither also To sore throats for pains in the mouth a strong siringing is necessary because through that strong spouting is better washed off the slyme and filth from teeth and from the holes of the throat than when meerly gargarismes are used Of Wicks or Tents When Wicks are to be used ye heard it above viz. to wounds where spinters are to flap wounds to vehement Swelling tents are naught bleeding wounds for other places I do not advise them it being a dangerous abuse I hold less of swelling Tents unless they be made of Juniper Gum of the root of Gentiana dry Sponges c. I do not see what good they can do either in fresh or in dryed wounds true they keep a wound asunder but close again quickly leaving the wound in her old condition if a swelling Tent be put into a Wound stops the hole lets no matter come forth keeps it in forcibly till it be pulled out again and vent be given to the wound If Tents needs must be used to keep open wounds then How to make tents to
keep wounds oopen thereby make them of linnen cloth cover them with an Unguent mingled with burnt Allum c. then they will bite round about and make an open place My advise is that medicins should be conveyed to the bottom of the wound and not onely to dawb the Tents therewith and Tents used to spoiled wounds are such which of themselves melt within the wound These are thrust home to the bottom of it Melting tents and to the upper place of the wound there is laid another made of linnen to keep in the first Tent that it come not forth before it is melted of such Tents I have made mention afore hoping to speak more largely of it in another place when I shall publish my Cures about wound Fistula's and the like Sores Of Corrosives To use Cauteries to fresh wounds is needless and hurtful and spoils a fresh wound wholly and does no good Cauteries are not good to be used at all neither in Blood stenching or other occasions Corrosives have poisoned many wounds turning them to a Fistula Cancer Noli me tangeri Corrosives do wound bones and are the cause why such a wound cannot be healed and turns to a Fistula they inflame sinews and cause many other mischiefs Surgeons usually corrode with sublimed mercury which Sublimed Mercury is a great abuse and misunderstanding for Mercury doth not bite the salts do it which he received in the subliming these corrode the broad way causing smarting pains Mercury ought not to be used at all to fresh wounds Others use crude Arsenick and some do sublime it but it is as hurtful to fresh wounds as Mercury is some use the caput mort of Aquafort and otheres use the red calcined Vitriol all these are naught to wounds Nature desires quietness will not be disquieted by such evil medicines sweet and gentle things are to be used here and not to press Nature with sharp Corrosives I never used any stronger Corrosive to wounds but quenched Allum true I hold that Extinguisht Allum Arsenick is to be used to spoiled wounds but my way of preparing of it is that it deserves no more the name of a Corrosive or venome it separates the ill from good not Arsenicks operation causing any pain The Brown Unguent performs all what is to be done about wounds as you heard above in want Brown Unguent of this Unguent you may use Vnguentum Egyptiacum provided there be no Allum in it or a very little as some use it But this Egyptiack Unguent is not to be compared in any degree with the Brown Unguent How to prepare Arsenick that it may safely be used Arsenick ought not to be used crude being a meer venome Arsenick how prepared its operation is answerable to its preparation usually it is prepared thus Take of Christallin Arsenick â„¥ 2 of Saltpeter â„¥ 2 grind them well together put it in a melting pot make a circular fire about it let it melt and let the smoak and fume go away increase the fire that it be red hot let it stand thus two or three hours then cast into it of yellow Sulphur Ê’ 1 this being done cast it forth on a marble set it in the Cellar it dissolves in few dayes that liquor keep in a glass for use Thus I close this Fourth Part true I could have quoted many other things but I purposely avoided prolixity being Conclusion this Book is already grown bigger than I inrended it should Reader I hope these will be an occasion to you to regulate your self in other things intreating you to accept in good part this my labour which was to be servicible to others The bad things in it must be ascribed to Man for the good things in it God is to be thanked and praised FINIS Of the Fourth and Last Part of this Book of Surgerie The Childrens Book OF FELIX WVRTZ A famous and expert Surgeon This Book was never published till now Treating of infirmities and defects of new born Children and of the faults and abuses which wet or dry Nurses commit among and against little Children and of Medicins and Cures of such Children which receaved hurt in that way Written for young Surgeons wet and dry Nurses Maid Servants and other parties to whose trust and overlooking little Children are committed MY purpose is to communicate an usual little Treatise concerning the infirmities of new born Babes and sucking Children which are befallen them by the neglect of wet and dry Nurses or else brought them into the world from their mothers wombe In the first place I will speak something how Midwives wet and dry Nurses ought to be conditioned that they may the better deal with such little Children or Babes even as it becomes an understanding sober godly Woman Such Women to whose trust little Babes are committed Duties of such Women ought to be pious honest modest and civil in words works and manners she must be one that hath been a Mother of Children and is expert in those waies for experience is the Mistriss of things and there is more credit to be given to experienced Women than to such which know things by hearsay Therefore if a Midwife be a Woman of credit and fidelitie and hath endured in her own body anguish miseries and pains which others neither can nor will beleeve because they never endured any torments in their own bodyes neither may they hear nor have heard of the like those that had such things befallen them know what they are neither is there any need to tell unto such what miseries pains and torments mean and those that were never in such perrilous cases may hold their tongues and not speak of it jeeringly or contemptibly It falls out often that in such dangerous travails one three or two loose their lives besides the loss a good Husband hath in his Wife and poor Children in their Mother c. And in case such parties may escape with their lives in hard travails yet are they so pulled and torn that they are made unfit for any work which otherwise might have better been preserved if honestly and faithfully they had been dealt withal This I speak not as an invective against others let every one look to it what they are instrusted withal and make a conscience in their waies remembring also that they must be accountable unto God for it then they need not to be put in mind of it by my words I beseech every pious Matron not to take ill the things I speak of for what I intend here is for the good of little Children which cannot complain of their griefs but by crying For it is most certain that Children will not cry unless How Babes reveal their griefs they ail somewhat because it is more ease for them when quiet and they are not able to make their complaints any other way but by crying Hence we are to note that assoon as man is born into the
I would lay violent hands on my self by reason of the great pains I was in Thus making pittiful mourn to Surgeons and all my friends on whom I called for help intreating them to cut the pulse vein on my left temple which crying and calling I continued for ten dayes those that heard my outcries suposed I did out of impatience for the which none would hearken unto my cries but I continued still with my lamentation hoping one or other would take pitty on me At last my friends considered of my cries and promised in case any one would undertake the cutting of the pulse vein they would then consent unto my demand I thanked God that my cries were heard and my pulse vein to be cut then came that famous and conscionable Dr. Cennad Gesner comforted me and my familie and advised Dr. Gesner adviseth for an incision that my pulse vein should be opened then returned I thanks to God again who put this councill into his heart then was I asked what means should be used for the stenching of that blood and incision I gave directions to the Surgeons then present that my friend and Brother in Law John Waser should make the incision he took it in John Waser makes the incision hand and by my leave and all the Master Surgeons then present placed me on the beds side and made the incision at twice cutting the wound bleeded vehemently before he laid down the incision knife I found my self better for the which the Lord be praised for ever thereby was I delivered from all my pains and being drest according to the direction I gave I lost nere another drop of blood after that I felt my self better in my head than ever I was in my life as long as I could remember To the Lord be Praise Honour and Glory for evermore Amen Some Country fashion about the winding their Children into clouts and to lay them down in the Cradle It is the fashion in some Countries that when they intend to lie their Children to sleep they lay them on a Table on a great pillow and have their woven or hemmed linnen swadling clothes whereby they bind the Child into the clouts from the arms downwards but others begin from below and bind along upward and on the Cradle they are lain whereby the inlaid Child is packed up like a pack of Wares this I do not much mislike provided the Child be not tyed or pack'd too hard In other places Nurses or Mothers take Children into their lap wrap the Child into a woolen cloth after they have wrapped them first into small linnen clouts binding arms and hands down and begin in their tying from above downward but this I approve not so well of as of the former way because these clouts fall thicker cause unquietness to Children of the which more shall be said afterward how Children are hurt thereby having bound and wrapped the Child thus then they lay it in the Cradle and tye it once more Others lay their Children only in clouts into the Cradle over that a piece of woolen cloth or a piece of a ragg and so tye it to the Cradle from hole to hole in the Cradle which they tye very hard for if they should not do so they beleeve their Child would not stay in the Cradle even as the former too which tye their Children once before they put it into the Cradle and when it is put into then tie it once more however let these things be done so that with their strong binding they do no hurt to the Child for such hard binding any aged body would hardly endure about his breast or heart I am assured that by such hard binding great and anguishing pain is caused in their sleep as you heard also above about the sleeping on the back Of crooked and lame Children coming thus into the World It hapneth that a Child is born with crooked feet placed and pressed one upon another and must go on the ancles if they can they usually say that such lame births are caused by frights strange sights or by carelesness which also Nurses have to answer for These defects they say usually are incurable it agreeth with that saying no body maketh himself crooked These idle pratings causeth careless and lazy people pretending if my lame Child cannot be cured why should I be at expences or taking of pains It is a base and false excuse because experience proveth it to be otherwise To liken this to an example many have eaten from that Trees fruit which they nursed by putting the kernell into the ground my self have eaten the fruit of a Tree six yeers after I put the kernel thereof into the ground Even so is it with lame Children some whereof I cured so that after some yeers I saw them go straight Let no man be neglective if his Child be thus crooked as not to ask counsel about it though all be not recovered which are in such cases yet many are cured and if not perfectly yet may they be mended in some sort the which I do demonstrate with examples I have dressed a new born Child and ordered it with splinters as I thought fitting whose feet from his Mothers wombe stood so that the Child stood on the outside ancle which with splinters I brought to right and that Child went as straight as any other I have cured Children whose thumbs and other fingers No crooked joint ought to be broken but plainly to be set right have lain in their hands for many years tyed them outward but did not break the joints as they usually say that they must be broken again wich is false and he that saith so discovereth his silliness in Surgerie they ought not to be broken but gently and steedily be placed right for if a Child be put to pains in that kind the joint will be inflamed thereby and the case made worse and more painfull than it was formerly My advice is that none should attempt to break nor permit any to do or undertake the doing of it rashly and if you meet with one that give reasons the thing might be done without pains and that in such a way the cure might be performed then follow his advice but he that saith that first of all such joints must be fomented bathed annointed he goeth the contrary way to work for thereby the joint is not made soft but stiffer But if Childrens ancles kees feet fingers c. are so hard and ugly that they must be first of all mollifyed then such medicines may do something And so I speak here not of all but of such which are curable Therefore observe whether that joint doth bow and turn easily to the place where it should be then bind it that way and cure it Some of such joints will easily turn and bow but that is not enough binding is for such a joint the better the growing whereof bringeth forward the cure and not the bowing or setting
it which will be good thereby the matter will take its course and let the first little Wound be healed up as fast as you can and bind it strongly And the neathermost hole must have vent and be kept open till to the last of the healing Let the Knee not lie still and rest but stretch and bow it as much as you can that it grow not lame For if you stay till all be healed then will it be too late for the Knee to be stirred Therefore do it betimes what you ought to do that the Knee be not healed stiffe For if you stay too long and neither bow nor out-stretch the Knee then you will hardly help it afterward and it will be a great difficulty to bring it to right For if you deal rightly and heal it well in the joyning of it then the party will be of a sound and strong body for all the dangerous humidity which was in all the body was expelled through this strong humour I have seen that all those which were cured of such humours grew strong and sound men There are other humours which fall into the Knee even A humor like the Rose but worse as the Rose or Anthonies Fire useth to fall and with such a cold as the Plague doth and looks like unto this Rose or Anthonies Fire but is somewhat worse having blew spots as the Rose hath red ones but the blew ones are not so big but are of that bigness as the black blisters are and this redness is altogether nought for it is a flour of the cold Fire But if that Member hath great help from the body then it doth not so much hurt for there fall little holes into those blisters and when their skins are pulled off their matter looks black and fals out and these are easily healed but are worse than the Anthonies Fire is and ought not to be made wet neither must they be annointed but kept onely warm and dry as long as the redness and the black blisters hold then plaisters are applied unto them as other little holes usually are healed There are also Dogs blisters very like unto the above named Dogs blisters but not so dangerous and they make the Knees swell these also ought not to be made wet There are also on the Knees laming humours which are of a difficult healing make deep impressions cause a great deal Laming Humours of trouble and are not easily turned or diverted and do not shew from whence their original is the pain they cause is just in the middle of the Knee with a little swelling and stand on the Knee-pan there seemeth to be store of filth in it but is not onely the pain is apparent there is a sinew and lame water which can neither be softened nor ripened even like the water which is in a Joynt as we heard above much pain usually creepleth and maketh the Knee crooked or shrinks it especially toward the day My constant practise was to dress and bind them dry strongly and warm to keep the Pores open No greasie things no Ointments no wet things I used thereunto after I had well learned the simptom but my red Plaister I still applied and warm clothes And as I shewed at the great Bands to keep things there in a sweat so these lame biles also will steal away for if Patients sweat well under the Plaister they will doubtlese be healed and tie the places hard though it makes the foot swell it matters not for that soon allayeth and goeth away if kept warm with clothes even as other humours are expelled by keeping open the Pores CHAP. XXII Of Wounds made by Gun-shot of the abuses committed with the thorough pullings and Ointments what a Surgeon ought to note here ANy shot that went thorough Mans body is held mortal Wounds made with shot because the internal parts are spoiled and hurt by that heat such Wounds are not easily cured of these I intend not to treat nor of such where the shot hath carried all away which things can neither be filled nor set on We will speak here how to quench such burnings and how such inflammations are to be prevented so that that burning cause no further mischief than the shot hath made and then how Surgeons in such particulars are to regulate themselves The condition of one that is shot is this some bullets Bullets stay or penetrate the Body stay in the Wound or else go quite through if gone quite through then the cure is this that the burning be quenched because if that prevaileth it causeth more hurt than the shot hath done But if the bullet staid in the Wound then it must be taken When a bullet stayes out but how that is done is not well possible to set down every particular for shots are made several wayes the one is not like the other a whole book could be written of it Experience must shew the way how they are to be dealt withal and so here you must go to school and learn The Antients indeed have used hereunto many strange Screws and Instruments and were very careful herein But these are either of no use or of very little For if the bullet cannot be laid hold on by the Instrument how shall it be gotten out The bullet will strive to get out at the Wound if the Patient be laid downward with the Wound or else by its sinking it will come to a place where it may be cut out if none of these can be Experience must shew you another way Touching Wounds where the bullet went through here I must shew the dangerous abuses which Surgeons commit if they have a Patient that is shot through a Member they take hempen threed or some twisted hair which rotteth less and draw it through the Wound let it hang out on both ends they put their cooling Ointments to it before they draw it thorough and when they come to dress the Patient again then they pull the threeds forth and besmear it afresh with their cooling Ointment and then they draw it through again that part of the threed which staid in the Wound they make very clean from that it gathered in the Wound then they apply their Plaisters to the Wound as they think they are fitting With these thorough-drawings as they call it they Thorough-drawings do more hurt than good suppose to have done great good Nay some are of opinion that this is the onely way to dress and heal Wounds made with shots But it is otherwise For they do not effect so much with these thorough drwaings as they think for the hurt weighed with the good that is done thereby it will be apparent that more hurt is done than good and ought to be omitted altogether For such a cord or line drawn through the Wound must Hurts done with the thorough-drawings needs cause great pains and that not onely at the first but at the several dressings This way
were less dangerous and the less refuseable if the shot had hurt no sinews and bloud veines but this being very seldom I hold this scouring should be omitted For it often fals out when a bloud vein is hurt and hath stencht her self this thorough pulling causeth in her a fresh bleeding which bloud stayeth within and causeth no good And in case a sinew be hurt-in that Wound then this line must needs hurt the wounded sinew at the several dressings and stir it at this pulling or drawing which doubtless is not done without causing of great pains and thereby the worst simptoms are occasioned For these and many other reasons which I could alledge here I hold this thorough-drawings to be a very dangerous abuse and count the following way which I made use of far better as being an easier and slighter way causing less pains anâ— dangers in respect of simptoms Object It may be objected here that such cords draw out the filth which the fire hath left in the Wound and the Wound is throughly cleansed within It may do so but in respect of other inconveniences pains dangers whereby some Patients are quite spoiled I hold it for nought For Nature is her own best Physitian and desires to be aided in these things which are not contrary unto her and the matter burnt flesh bloud c. through Natures help separateth of its own accord and Nature ought to be helped herein with convenient meanes as you shall here hereafter Therefore the burning or fire being quenched then there is no more need but that Nature be assisted and that be expelled which the fire in the Wound hath spoiled the which is easier and sooner done through the following Medicines better than with all their thorough-drawings I must needs give a hint here of the cooling Ointments Abuses in the Coolers committed which some Surgeons prepare of Oyle and other shorty and greasie things Though indeed they do no hurt and in that respect I reject them not But there is one thing in the way at which I am offended and must needs speak of All fat things be they what they will grow hot suddenly and cool slowly Must now such a cooling Ointment be â—ut and forced into the Wound where the bullet sticks either in the bone or in the flesh whilst it is yet hot Surely that Wound must needs be more inflamed thereby Besides this will ensue also when such Ointments are poured into the Wound the Patient must endure the more smarting paines especially when the bullet is still hot warm in the Wound Therefore I hold it to be better to use means which cause less pains for it is usual that to pained places worse things are incident But where there is no pain there the Wound settleth the sooner unto rest As for the healing of such Wounds I will tell you what I found to be good not that there should not be other cures for them but onely that the courteous Reader may see that I and others have endeavoured to the utmost that hurts and dangers might be prevented and the good of all Patients promoted CHAP. XXIII How to cure Wounds made with Shot and how the Coolers are made and how the Saltpeter is prepared thereto THe first thing belonging to such Cures is that the bullet be taken out and I gave a hint of my meaning for it in the precedent Chapter and let it rest thereby Touching the burning and fire in the Wound to quench it you may note the following things First when the fire in the Wound is at the highest prepare an Ointment of Honey and not of Oyl or other greasie things spout it into the Wound three or four times or any other way you can best get it in and moisten all places within even the bullet also if it be in it Then take a Tent of Gum Tragadanth annoint it with the said Wound-ointment and thrust it into the Wound But if the Wound be shot quite thorough then you must use two of these Tents be they short or long as the occasion of the Wound requireth let the Tentâ— be thin and not thick that they may the easier be put in at last apply a good stiptick Plaister upon and take notice of its operation Then minister to the Patient of prepared Saltpeter Ê’ ss which follows hereafter in fresh Well water or according unto occasion sirrup of Violets or of Sloe-thorn floures minister to the Patient without delay of this you may give before you dress him the fire within will the sooner be allayed and quenched for outward means do not alwayes quench such fire inward things must be used In case the pain of this burning will not cease in two or three hours then undress the Wound and dress it again and let him have one drachm more of the prepared Saltpeter surely that burning will cease in a short time If it be not yet quenched then try the third time and be provided with a better thing In the mean while let the Patient drink Water let him not be opprest with thirst the raw Water is better than if boyled but things cannot alwayes be had in readiness If inwardly a Joynt or Principal part be hurt in the Wound at which you cannot come with the Medicine of such Wounds I will not speak here because they are usually mortal The greatest pain being gone then another Cooler may After burning be used made of Oyls or fat things as you shall find hereafter and that may be done safely onely my advise is not to meddle with oyly things at first for reasons spoken of before Note also that when all the fieriness and burning is gone Phlebotomy will be of good use in such places as the Wound will permit and that is to be done when the fire is quenched but if you do it before that then you do nothing but make the fire to prevail the more and get the predominancy for I found it so by experience In case the great pain and burning holdeth still and is not quite ceased and the Wound also doth not purge out its When a Wound it poysoned filth and groweth redder and redder round about the brim and the Patient be thereby the more weakened from thence you may argue that the Wound is fallen into a venomous simptom Now is it necessary to let the Patient have a draught of Aqua vitae described in the Chapter of Wound-diseases and let him sweat being well covered For what is such a Wound thus burned by Gun-powder but a venomous Wound And in case you cannot have the aforesaid Aqua vitae in lieu thereof take good Mithridate or Treacle and let the Patient sweat upon For I found it by experience that with such sweating the heat was taken off and quenched more than with the best Medicines outwardly applied the Patient may be thus sweated twice or thrice In the interim neglect not the Wound and dress it as it ought As Wounds are