incommodi quam commodi adferunt Huc accidit quod Cathartica hujusmodi Medicamenta quae fortia acuta sunt per se venenosa censentur non est autem venenum veneno apponendum omne enim tale addituns suo tali ut est communis Regula facit illud magis tale Major probatur ex Joh. Mesue de consolatione Medicinarum â—bi inquit Omnis Medicina laxativa est de genere venenosarum rerum cujus excessum Natura non patitur nullo propterea Cathartico Pestis tempore corpora vacuanda sunt Quandoquidem Medicus pro suo officio doctrina quam profitetur minister custos imitator Naturae dicitur Natura autâ—m in Peste à Centro ad superficiem conatur veâ—â—num pellere ergo Medicus riâ—e imitatur Naturae ductum juxtâ— Aphorism Hippocrat Libr. 21. Aphorism 1. Quo Naturae vergit ad loca conferentia eo ducere oportet c. Et quia Cathartica innata sua vi crudelitate Naturam regetivam totius corporis prosternunt qua ob Pest is quoque acuitatem impetum languida infirma est virtus vero hoc tâ—mpore conservanda qua prestrata periclitatur aeger ergo nullum Pharmacum dandum est The precedent Caveat touching purging Medicines Englished is in effect as followeth ONe Petrus Sibyllenius a learned Physician of his time in his Treatise De Peste doth write touching the use of Catharticke or purging Medicines in the case of the Plague as followeth and reciteth his reasons and authority for the same in these words Solutives forbidden in the cure of the Plague Concerning the opinion which some Physicians hold that solutive and purging Medicaments are convenient in the beginning of this most sharp sicknesse the Plague and that the venemous humour is to be driven out of the bodies infected with the Plague by their force and heat The censures of Galen and Avicen by strong arguments are repugnant to their opinions And Hippocrates confirmeth their anthorities in his L b. 4. de Dieta or of Diet which is to be used in sharp sicknesses where he saith when in any sharp sicknesse the opening of a Vein or solutive Medicaments are necessary the Vein is first to be opened And Avensoar in the Lib. 3. de Theisir saith before But in our Climate that Rule is not in gâ—â—â—ral gâ—od but is list to fit occasion and due time any purgation be he would advise that a general evacuation might be made meaning that letting blood is fit to be done And because saith he the use of laxative and purging Medicaments are ill hurtfull and dangerous to the body by reason of many evident cases therefore he likewise condemneth the errour of the unlearned and barbarous Physicians and Mountebanks of his times which would drive away the cause of the disease by violent purging Medicines as namely with Mercurius praecipitate which red powder they call falsly a precious Cathartick or purging Medicine which having a great force of heat in them they do draw forcibly and swiftly both the blood and humours which are in the Veines and do drive them out to the prejudice of Nature by which commission Nature which governeth the body is disabled stupified and beaten down in her endeavour touching her Crisis her working and contending with the poysonous vapours so as for the most part it hapneth that thereupon proceedeth a symptomatical expulsion which is not far from death it self And therefore such Medicines are not fit to be used in the beginning of the sicknesse namely the Plague Moreover all purging Medicaments draw the humours to the inward parts that is from the superficies or outward parts to the centre of the body which is the heart and the effects follow deadly for in venemous diseases the venomeought to be driven from the centre to the outwards therefore Cathartick or purging Medicines being ministred in the beginning of this sicknesse do more hurt then good And in this further is to be added that such purging Medicines as are so strong and sharp are esteemed to be venemous of themselves and there is no venome or poyson to be put to poyson for every such thing as is added to his like as the general Rule saith maketh that more such The Major is proved by Joh. Mesues de consolatione Medicinarum where he saith that all laxative Medicines are of the sort of venemous things whose excesse nature cannot endure therefore in time of the Plague the diseased bodies are not to be made empty by purgations The Office of a Physician seeing that a Physician is called by reason of his office and Learning which he professeth a Minister a keeper and an imitator of Nature The help of Nature in the Plague Nature in the Plague endeavours as much as in her is to expel the venome to the superficies of the body Therefore a Physician ought to follow the tract of Nature according to the Aphorisme of Hippocrates 21. Lib. 1. Aphoris Where Nature aymes his course thither it behoves the Physician to intend his Artificial help A reason of the danger of laxative Medicines And because Cathartick means by their innate force and cruelty do overthrow Nature the ruler of the whole body which also is made weak by reason of the sharpnesse and force of the Plague Nature is to be preserved and no laxative Medicine to be given Of variety of particulars for Brothes to be made for the sick according to mens several abilities or necessities and as the time and place hath to be added more or in part forborn upon each just occasion Of herbs convenient for Brothes ANd first for herbs fittest to be used in Brothes in this disease they are Buglosse Borage Endive Succory Strawberry leaves Marigolds Parsely Betony Violet leaves Sorrel Wood-Sorrel Plantane any of these are very good and so is Rosemary and Tyme so that you take not too much of any of them remembring also for the seasoning and relishing of Brothes as also for Sawce you may safely make use of Sugar Cynamon Currants Citrons Oranges Limons juice of Limons ripe and unripe Grapes preserved Barberries Cherries and Prunes Wine Vineger Verjuice Mace Cloves Nutmegs Saffron and Wine if occasion be to refresh the spirits for as I have said I esteem it far above any the simple waters of hearbs for a Vehicle in the disease of the Plague Necessary meats to be boyled in Broth. Also you may make your Brothes either of a Cock orrather of a Cock Chicken or of Mutton or Veal or for the meaner sort of what else their means will reach unto for many things that be held unsavoury nauseous yea and dangerous to the dainty are found to be very conveniene wholesome comfortable and precious to the poorer sort as Garlick Leekes Onions Chyves Wormwood Centory Angelica Bay-berries Gentian and divers others whose tastes are harsh A Cordial Drink to cool and contemperate the blood being a China broth if the Patient please to be
the facility thereof and for the saving of blood and spirits I have thought fit to commend to your consideration this new method as to the discretion of the Artist shall be esteemed fit Also I have observed that in surfeited delicate bodies of great personages such as are over-pomper'd with pleasure ease and fulnesse if by any way or accidents such happen to have a Gangrene seldome one of them escapeth death especially if they be ancient and have the dropsie or Scorbute and on the contrary amongst those which are weak poor indigent and miserable people which have bin by long continued ulcers fistulaes or other grievous maladies spent to extream weaknesse although seeming half dead before the work begin scarce two of ten dye amongst them upon amputation if the work be judiciously and in a fit way and time performed for I by practice have often observed that where an infirmity hath pulled down a Patient low and almost past hope of recovery especially if the disease proceeded by any outward violence that such bodies have bin by my experience found to be generally most hopeful of recovery either by amputation in the one or the other kind as the occasion will most fittest bear and on the contrary persons that are to be dismembred in full strength if it be to be acted in the sound part bear a far greater venture of their lives then the miserable dejected wretches do as aforesaid except it can be effected in the putrid part And one observation more to be by all men had in regard namely that our God in Naturehath created in mans body such a strong antipathie betwixt the living and the dead parts thereof that when by any violence in Nature either by distemperature from within testified by Feavours Pestilential or others or by the outward violence of Engines of Warre or other incident mischances as by Fractures Contusions c. whereby one part or limb of mans body becommeth sphacelated and dead before the other it is manifest that the living parts do as it were either in fear or disdain of the dead parts or for some other secret cause in Nature though not without great pain and grief notably withdraw themselves each from the other as in disdain leaving neither warmth not at all any comfort motion nor sense either by blood or spirits or ought else moving in the dead Veines Nerves nor Arteries neither any sense in the Periostcon that sensible Panicle that covereth the bones but as by a comparison of a Snail may in part be explained they wholly withdraw themselves for the Snail having by the vertue of natural warmth stretched her self out of her shell either for her necessity nourishment or delight in a moment apprehending cold or danger retyres into her shell and with all her force by her own slime shuts her self close up again and so rests her self in a supposed safety with her no doubt content even so all the living instruments faculties or vessels of Nature as in a nauseous disdain contempt or fear of the dead parts forsake the sphacelated parts and leave them utterly desperate and impotent and by vertue of the Radical Balsam of Nature contracts and shrowds her relict living parts as Artists may judge by the mortified toes of children but much the better where Art is at hand to aid Nature so that thereby the dead parts become as a noysome and heavy burthen to the living parts so as if you wound the sphacelated part it is not onely senselesse but also it is without blood or spirits at all neither doth blood or humours run any more nor so much as move in the sphacelated or putrid Veines at all and whilest lively Nature is as aforesaid shutting her dead enemy out of her living doores by stopping up all the breaches that she may hold the relict of her own if animal Art have not the charity to take her dead enemy from her yet vital agility assisted by natural motion and will in his due time doth efficiate what fairly can be expected for the assisting of Nature and supplying all defects proceeding ex intemperie all which excellent offices in Nature no question proceed de praesciencia Dei Here followeth a brief relation of amputation or of dismembring in general but more particularly being for the taking off of members in the rotten or mortified places which haâ—h in many cases been approved by the Authour thereof by his own long experience FOr brevity sake in this place I will not spend time to write of the general diseases causes or reasons that might urge the amputation of any member having elsewhere written somewhat thereof onely my intent for the present is to aquaint the younger sort with my long experienced practice for the manner of dismembring in a mortified part where just cause is offered having undertakeen it meerly for the publique good by informing the younger sort of Surgeons as well for their incouragements in the safe and warrantable putting in practice my pactical Method therein as also to shew and fore warn them from being over-much mis-led in the insisting upon old errours and traditions of their Masters Patrons and Predecessours too punctually As for example A Chirurgical â—ase put betwixt two Surgeons Suppose the younger Surgeon in consultation with his Friend or Brother Surgeon by way of asking advice should put the case and say I have a Patient that hath the toes of his feet putrefied fistulated and many wayes perforated with foul bones therein so that it is unsound even almost to the joynts of the ankle or the like and I have endeavoured by Art and with advice the best I can to heal him and cannot prevail in the Cure Wherefore since the toes of the foot cannot be cured the rest of the foot as unprofitable were as I suppose best to be taken away and no lesse of the legge also for it will be but a hinderance to the Patient considering that he cannot stand thereon and is full of grievous pain I will therefore conclude according to custome to take all off a little below the Gartering place leaving a fit room for the stilt to rest the body upon The which his said friend admitteth of as good practice and so he proceedeth to the work as being a rational and fair course and warrantable If the rest of his suggestion or indications be answerable The Chirurgical case answered and admitted unto the aforesaid allegation the work is doubtlesse good and so I my self would heretofore have done untill my practice taught me better things but now by my own practice which I much rather would ground on then upon ipse dixit I take a shorter course For if the bones of the toes of the feet onely were foul fistulated c. as is suggested yea and therefore incurable for so stands the suggestion as being so by reason of some great contusion wound or ulcer or otherwise as aforesaid with divers fragments of foul bones in them or the
themselves and let them avoid slothfulnesse avarice envie fear pride or what else may hinder these duties that God may give a blessing to their labours and then the praise and comfort shall return to themselves which God grant And for the elder sort of grave Artists I crave their charitable censures of my weake or undigested instructions which I no way mean to them but to babes in Chirurgery and so I conclude to the honour of the Almightie concerning the Scurvie for this time Concerning the Fluxes of the Belly THe principal Fluxes of the belly by a common consent of divers ancient Writers are chiefly referred to three kinds namely Leienteria Diarrhoea Dysenteria What Leienteria is Leientaria is distinguished to be that Fluxe which either passeth the sustenance taken wholly digested and that without any blood at all and without great pain or as it were half digested The true causes of Leienteria proceed chiefly through imbecillitie and weaknesse of The causes of Leienteria the stomack which may be occasioned many wayes whereby the vertue retentive is weakned yea and sometimes the stomack by some Crudity a cause Apostumation is either wholly weakned and cold or broken or otherwise by crude humidities is oppressed and must be strengthned both inwardly and outwardly by things that corroborate and warm the same as is Syrupe de absinthio or oleanâ— absinthii Chimice 3 or 4 drops thereof in wine or beere for need and I have found it good to a strong body at first namely in the beginning of the disease to give him a vomit of the infusion of stibium or rather of A vomit at first Salvitrioli ten grains if it may be had or of Aquila vitae four grains or of Cambogia twelve grains and so the medicine having done working To corroborate let him presently sleep fasting if he can if not give him a little Cinamon-water or a little sanguis prunellorum if you have it or a draught of good Aligant or conserve of Sloes or Quinces and shortly after namely three houres if he cannot take his rest give him An opiate three grains of Laudanum in a pill and so appoint him to rest but if you conceive or feare the disease to proceed of Apostumation in the stomack then beware of giving any vomit before perfect suppuration of the same for it is deanly but outwardly you may apply then Stomack comforted to the stomack a bag with Worm-wood Mints or sweet Majoram nd warm being sprinkled with Rose water and Vineger or else a Bisket bedued well with Rose water and Vineger being steeped must Pecteral unguent be applied to the stomack or anoint the stomack with unguentum pectorale or with oyl of Nutmegs made by expression also Theriaca andromachi or theriaca LondiniÊ’i ss is very good given him upon the Coâ—â—â—als point of a knife or Marmalad of Quinces is also good Mithridate is very fit and approved or grated Nutmegs is very good and Cinamon in powder taken in meats or drinks is good likewise if these things answer not thy desire thou maist proceed to medicines more astringent Astringent medicines such as follow in the cure of Dysenterie one verie familiar and good Medicine is sanguis prunellorum aforesaid the dose is â„¥ j. or â„¥ ij with Mint or Worm-wood or Carduus water taken going to rest or taken of it self But your mentioned Laudanum in all Fluxes judiciously Cordial water administred is the onely sure help neverthelesse in this grief trie other good things first all Aromatized strong waters are convenient in this case moderately used as well to avoid further fluxes as also in these fluxes to comfort the stomack stiptike wines serve well for it likewise Theriace diatesseron â„¥ j. now and then also electuarium diatrion piperion â„¥ ss on a knifes point given is very good for it mightily Diatrion piperion warmeth and strengthneth the stomack But sometimes it happeneth that not onely the meat passeth away by stoole but also other undigested matter with it in which case Petrus Bayrus in his Veni mecum folio 273. adviseth to use things sowre with meat as Verjuice or the juice of sowre Pomgranats and the like in want whereof the juice of Lemmons is good or rather syrup of Lemmons or syrup de Agrestis or oyle or spirit of Vitriol taken in some fitting drink as Cardâ—us water or fair water wine or Barly water the oyle of Vitriol 3. Syrupe of Lemons Oyl of Vitriol drops taken with conserve of Roses is also good in this disease also keep warm the region of the stomack and Liver and inwardly as is said it is good to use all good comfortable helps that warm Of Diarrhoea DIarrhoea is a flux of the belly which is either merely watrish or with humors and with slime mixed for the signes of the disease are manifest the causes too many for my leisure to note unto you concerning the cure of Diarrhoea if you see that the Patient be strong there is no great hast of stopping this disease for that it is many times a benefit of Nature whereby she avoideth superfluous or venemous or Stop not at the first otherwise vicious and offensive humours but when you shal perceive that it hath continued certain dayes and that the partie is weakned thereby then begin the cure as followeth First give him ℈ ij of Rubarb dried as they use to drie Tobacco and poudered either in wine or Carduus or fair water or the infusion thereof without the substance A purge and after the working thereof a gentle glister will doe well which may likewise leave a stiptick qualitie in the guts but not too strong such as hereafter shall be mentioned and let the partie be laid to rest very warm covered and warm clothes applied to the belly and fundament of the partie and if that helpeth not you may give him Warmth is very good within three houres three or foure grains of Laudanum and let him again incline himself to rest and by Gods help he shall be cured but if he have a Fever give him an opiate first I mean the Laudanum Good helps to the cure of this disease and all Fluxes of the belly are Laudanum these following first to refrain and resist as much as is possible the motions of going to stool not to strain or force the body being at stool not to sit long being at stool in rising to remember to put up worth the observing the fundament with a clout and that if it may be with a warm soft clout to sit as hot as the partie can namely if it may be often to sit upon an oaken board hot is very good hot trenches or pieces of boards heated and applied to the belly are very good and to take the fume of wine vineger sprinkled on a hot brick or iron and sit over it on a close stoole is approved very good and to
have ready a band and bolster to make it up again that Of the Launces points Of the veine opened his launcets be not too spear pointed I mean small pointed for the broadest pointed Launcets make the best work likewise that orifice be large not deep yet not overlarge for it is overlarge when the blood tumbleth out without a stream for that spendeth too much the spirits and it is also too narrow when the stream is small and the veine is puffed up with wind Note also that if your Patient incline to faintnesse Of faintnisse in blood-letting with a remedy or swounding you cause him betimes to thrust his longest finger of the other hand into his throat and a little provoke himself to casting it helpeth presently let him reiterate the same work if occasion be But if he chance on a suddain as oft it happeneth to be gone in a swound beware you lay him not on his back with his head too low as it is usual Of sweunding in blood letting the remedy approved with some to do for so you may chance to lose him I have seen the like once done by an ignorant blood-letter wherefore remember it but rather bend him with one arme forewards and with your other hand stop very close his mouth and nostrels and in very short time you shall perceive wind to come and it will gather to his mouth and he will strive for breath then let go your hand and all is well and as often as he fainteth do so This is a safe course which with good successe I have used from my youth to this day The quantity of blood to be taken away at sea Further note that at sea especially where fresh food or good nourishment is not at hand it is good to be sparing in the quantity of blood to be taken away and rather often take blood away then too much at once except blood abound too much which is not easily judged by every young Artist For sometimes the party is idle-headed by distemper of the blood which by cooling broths and julips ought rather to be tempered providing also that he have the benefit of nature I mean a loose body Remedies for idlenesse in the head through distemperature of blood Phlebotomie not ealwayes to be used or be provoked thereto by art and by this means rather seek to cure then by rash Pplebotomy for you must consider that in the blood consisteth the life of man wherefore be not rash in that work and as is said hold ever this rule that if the Patient neither on the day thou wouldest open a vain nor on the day before we have had a stoole that thou attempt not to let him blood before first he hath had one stoole procured Observe well Of the vains to be opened him at the least if not more which is soonest and safest done by a suppository the next safest and better way is by a glister The veines commonly opened are six in number namely one in the forehead one under the tongue three in the arm and one in the foot The three in the arm are most in use whose names are Cephalica the uppermost or head vain so called of the Greek word Cephale which signifieth a head and is commonly opened in all griefs of the head where it can be taken in want whereof it is almost as good to take the middle veine The next is the median or the middle veine it is the second principall vein which is generally taken as indifferent for the whole body Aspecial observation concerning the liver vein The third is the Basilica or the liver vein being the lowest in the arm and more respecteth the liver then the two former But hold this general rule that if thou intend the opening of a vein to help the liver and that the liver vein will not be well taken then take the median vein for thou must know that all veins have their original in the liver Some arms have but one fair vein appearing then it followeth of necessity thou must take that for many learned Physicians are of opinion that generally the fullest vein in the arm is best and fittest to be taken except some special cause alter their minds for their words are often quae majus turget majus urget which may be englished the vein which sheweth most is most faulty Causes of bâ—ood letting in the forehead Under the tongue In the saphane vein The vein in the fore-head is also often taken for pains in the head as rheumes distillations of humours and the like The veins under the tongue in the squinancie or angine imflammations and swellings of the Amygdals of the throat or of the root of the tongue the liver vein called saphane chiefly is taken for womans sicknesses not often seen at sea though some necessary occasions chance of the taking thereof in men at sea for diverting and sometimes for curing of some special diseases which for brevity having spent my limited time I omit Incision knife THis Instrument is mentioned in the beginning of the uses of Instruments under the title Incision knife The Burras Pipe From whence it hath its original The use of the Burras Pipe THis Instrument thus named doubtlesse was by a Surgeon borrowed at first from some Gold or Silver-smith and never paid him again for the Gold smiths use it daily and cannot perform their works without a Burras Pipe but the Surgeons make other use thereof namely for the most part to retain corroding powders in as Vitrioll burnt Allom praecipitate and such other caustick medicines which well used perform very much in healing So also their abuse bringeth The danger of the abuse of it shame to the Artist and often unrecoverable damage to the Patient For it is common with many Artists in the healing of new wounds to mix praecipitate either with a digestive Unguent or with Basilicâ—n and Dorsell or plegents laid on tents according to the form of the wound and An errour in healing of a new wound observed to put it in as they say either to enlarge the wound or to help digestion to take away proud flesh to mundifie and the like and if not praecipitate then must they be busie with Vitrioll or Allom burned or with Directions for the cure of a new wound some caustick medicine in that kind But I would advise the Surgeons Mate not to use any corroding medicine at all in new or fresh wounds but let the flesh grow as proud as it will the ground being clear from whence it groweth namely if it be from a wound wherein is no putrified bones and if so be that the wound be full of flesh and then will not cicatrize a little burned Allom or Vitrioll will doe well and then to your former dressing again remembring that each third or fourth dressing be merely drie lint you shall find good therein and if you onely take lint and wet it
lenifieth the hardnesse of the sinewes and maketh the face and hands fair c. Balsamum Naturale NAtural Balsamum or Opobalsamum is very good for them that are short winded for the obstructions of the liver and for griefs of the stomack it helpeth the consumption of the lungs and causeth an appetite besides the excellent vertue sanative it hath both inwardly and outwardly in the cure of wounds it hath also many other good vertues Oleum Vitrioli OYl of Vitrial is exceeding hot and cold mixed in waters decoctions sirrupes or conserves maketh them in tast tart or sowrish and in colour purple-like delighting them that are sick of fevers freeth obstructions recreateth the bowels and is very effectual in the pestilence falling sicknesse palsie and stopping of urine See more hereof in the treatise of Salt Oleum sulphuris per Campanam OYl of Sulphur made from the humide vapours thereof is good to make the teeth white to take away the morphew cureth venereal ulcers expelleth diseases arising from wind or cold is good against the falling sicknesse shortnesse of breath evil affections of the lungs easeth the tooth-ach and is being well prepared a true cordial medicine Oleum Garyophilorum OYl of Cloves not unlike to Opobalsamum in strength doth sweeten the breath driveth away putrede humours discusseth wind openeth the pores of the liver digesteth cold humours dissipateth the melancholick humours healeth old and new ulcers stayeth the putrefaction of the bones and asswageth the pain of the teeth proceeding from a cold cause Oleum Macis OYl of Mace doth calefie and digest cold humours roborate the stomack helpeth concoction raiseth an appetite aud procureth many other benefits to him that useth it Oleum Philosophorum OYl of Philosophers or of tile-stones or brick-bats the eldest is the best very like it is to Oleum Petreoleum in vertue it doth attenuate and penetrate upward digesteth and consumeth all excremental matter and is profitable for cold affections of the spleen reins bladder nerves womb and joynts for the Lethargie Apoplexie and falling sicknesse and many other the like griefs Oleum Anisi OYl of Anise-seeds prevaileth against the collick arising from wind and cold against the Tympany inflation and crudity of the stomack against the gripings and the crying of the intestines c. Oleum Terebinthinae OYl of Turpentine is taken inwardly for shortnesse of breath the ptysick against the stone the collick cold and windy affections of the breast it is outwardly used for to heal sinews wounded or troubled with any intemperature also to fill ulcers with flesh and knit them up leaving no cicatrice in them Oleum Juniperiunm OYl of Juniper is commended for the cure of the morphew of the skin it provoketh urine and agreeth with the cure of diseases of the reins it is good to be taken certain drops thereof against any pestilential vapours for the stone it is also good and to be drunk certain drops against penetrating wounds Oleum Spicae OYl of Spike doth calefie attenuate discusse and is very profitable to them that have the Gout proceeding of a cold cause or to comfort any member benummed also it is good against the falling sicknesse and convulsions the temples nape of the neck yea and the whole head to be anointed therewith is very profitable Oleum Antimonii OYl of Antimony or Stibium is good for them that have convulsions or any astonishing disease and other evil affections of the brain four grains thereof drunk it asswageth the pain of the gout and collick cureth fevers helpeth the bladder ulcerated and wonderfully helpeth the Canker Fistula phagedena the fretting or eating pockes the wolfe and all other sorts of ulcers Oleum Succini Chimice OYl of Amber helpeth the pain in the head resolution of the sinews and falling evil if one dop or two be taken with water of Betony or Lavender or in fair water it preserveth also from poyson and mixed with parsley water or Malmesey is a singular remedy in discussing diseases of the reins and bladder bringing forth the stone and opening the passages of the urine it profiteth in the collick and strangullion Four drops put into a little Angelica water and so given to a woman in travel refresheth all the weak faculties of the body confirmeth and openeth the brain Oleum Absinthii Chimice OYl of wormwood is good for the stomack to strengthen it to stay vomiting to kill worms asswageth the pain of the teeth and is used in agues Oleum Origani OYl of Origanum cureth malancholy helpeth the dropsie and cureth the cough the quartane fever and the tooth ach Syrupus Absinthii SIrupe of wormwood is said to corroborate the stomack help concoction cause an appetite discusse wind open the veins and to move urine kill worms c. Syrupus Limonum SIrupe of Limons is Cordial and refrigerating and I may say calefying too it doth please and profit the appetite and comforteth all that are sick of the pestilence continual and contagious fevers as also all diseases on which exceeding great heat attendeth cheareth up the heavy heart and dispelleth sorrow therefrom and against all obstructions of the spleen it is a good help and also well approved in the cure of the Scurvy Syrupus Papaverum SIrupe of white Poppies hath an astringent quality it procureth fleep helpeth the cough hindereth the humours which distill from the head into the throat tickling and is of precious use against the Palsie if it be used in the beginning thereof Syrupus Cinamomi SIrupe of Cynamon is commended to be very good to old men that are cold and weak and to them whose vigour humidity and natural heat diminisheth it nourisheth much begetteth blood and quickneth all the vitall parts Syrupus Rosarum simplex SIrupe of Roses simple doth quench thirst especially in fevers mitigateth their heat refrigerateth the stomack and liver being very hot Syrupus Rosarum solutivarum SIrupe of Roses solutive is used as a gentle and safe purge both to old and young when they are molested either with burning or pestilent fevers or any hot distemperature of the body Syrupus Violarum SIrupe of Violets doth break the acrimony of melancholy tempereth the heat of the bowels bringeth down the belly by purging it helpeth the diseases of the throat as hoarsenesse and the dry cough and is a chief aide to the curing inflammations of the breast against the pleurisic and quencheth thirst in fevers and is cordial Oximel simplex OXimel simple is in great use for the cure of inflammations of the lungs and throat helpeth expectoration and difficult breathing cutteth and attenuateth thick and slimy humours purgeth the entrails without trouble and is good both in cold an hot affections Mel Rosarum OR Honey of Roses strengtheneth and cleanseth the stomack purgeth clammy humours helpeth concoction with the temperate heat thereof allayeth and stoppeth hot fluxes the phlegmon of the mouth gums and jawes is singular good with oyl of Roses for wounds in the head These two with Aqua
price should be resonable for the poorer sort the ingredients thereof being neverthelesse Cordial and yet such as are easie to get It may be used well in place of Mithridate and in truth I had rather put my self upon it as a good Cordial being fresh made then upon the Mithridate we buy from beyond the Seas for it is by the Hollanders so uncharitably sophisticated that a man may fear to take it in his need my self chanced in Holland into the house of a Bore as they term him to lodge who lived by making of Mithridate and Treakel he confessed to me his Mithridate had but nine simples in it he had also pewter boxes marked so artificially as no man could discover them to be other then right Venice ones I have appointed to the Surgeons Chest some of the Species of the London Treakel ready powdered and dry that the diligent Surgeon at his will may compose a London Treakel at Sea namely by taking hony ℥ iii. and of this powder ℥ i. and heat them together stirring them well till all be incorporated and give it as need shall require Confectio Alkermis COnfectio Alkermis preserveth from Apoplexies arising from cold and melancholy humors doth very much comfort the brain and heart and is sometimes used very profitably for them that languish away through long sicknesse and are subject to swoundings Electuarium deovo Electuarium de ovo is very much commended for prevention and cure of the plague and all pestilential diseases in expelling the infection from the heart Mithridatum Damocratis MIthridate of Damocratis is in quality and vertue like to Treakel but more hot and forcible against the poyson of Serpents mad Dogs wilde Beasts creeping things being used as a plaster or drunk it cureth all the cold affections of the head helpeth the melancholick or those that are fearful of waters them also that have the falling sicknesse Megrum pain in the bowels ears tooth-ach and weeping eyes healeth the evils of the mouth and jawes being plasterwise laid to the temples by discussion giveth ease to the troubled with the Squinancie Apoplexie cough spitting of blood Impostumes or inflammations of the lungs or any griefs within the body and is good against the bloody flix flux of the stomack obstruction of the guts and against wringing and tortions in them being taken with aqua vitae and the decoction of baulastians it remedieth convulsions and palsie helpeth the middriffe flatus Hypocondria the pains of the reins and bladder breaketh the stone provoketh urine and monthly flowers expelleth other vices of the matrix yeeldeth a singular benefit for the Gout profiteth not a little in quotidians and quartanes or a quantity drunk in wine being first warmed and then taken an hour before the fit Theriaca Andromachi ANdromachus Treakel doth the effects of Mithridatum Damocratis and is also good against the hoarsnesse of the voyce against the Jaundise Dropsie for wounds of the intestines to bring forth the young birth dead to expell and take away the Leprosie and measles to revive every decayed sense to confirm wounds healed to kill all kinds of worms to dissipate wind to comfort the heart and stomack and to keep the body uncorrupt and sound Theriaca Diatesseron Mesuis THis Diatesseron is an ancient composition devised by the ancient Grecians and had beginning from Avicen and Mesues or one of them and according to the Greek word so named for that it is made of four simples viz. Gentian roots Bay-berries Myrrha and Aristolachia rotanda four precious and very Cordial simples full of medicinable vertues And for that I would have it kept in time of need I have thought meet to have ready powdred the said 4. simples together to be composed into a Treakel as occasion shall move thee Onely note this that to one ounce of the said species ℥ 3. of hony is to be added and well mixed on the fire and so it is ready for use By some Writers this composition is called Theriaca ad pauperem the poor mans Treakel The vertues of Diatesseron are said to be as follow It is good against poyson drunken and against the bitings of venemous beasts or worms It is also good against all the cold affects of the brain as convulsions resolutions of the sinews morbum Comitialem the Spasme or Cramp the inflation of the ventricle or stomack against defect of concoction therein and against venemous wounds both inwardly drunk and outwardly applied Also it openeth the obstructions of the liver and spleen thereby preserveth the body from the disease called Cachexia or stomacace which is the Scurvy Teste Pharmacopoeia Augustana aliis Dentes Elephantini DEns Elephantinus or Elephants tooth hath an astringent force healeth fellons and is good for white fluxes of women the Icteritia Flava or the yellow Jaundise Morbus Regius worms and continual obstructions Laudanum Paracelsi Opiatum IN the Treatise of the fluxes of the belly it is handled at large to which I refer the friendly Reader Diascordium DIascordium is helpful in fevers as well contagious as penstilential good for the head-ach and universal plague whose dose is from half a dram to one dram and a half according to the occasion or strength of the Patient Diacodion DIacodion removeth subtle Catarrhes which distill from the head to the breast helpeth the cough and procureth rest the dose is from ℈ i. to ʒ i. Pbilonium Romanum PHilonium Rom. magnum is given for the Pleurisie Collick and any internal pain or grief it causeth sleep stayeth Haimorraea or the flux of blood in the inward parts and sneesing allayeth the griefs of the belly spleen liver and reins caused by cold wind and crude humours and taketh away the hicket the quantity of ℈ i. is the usual dose and it is augmented or decreased as the years and strength of the Patient is Philonium Persicum PHilonium Persicum is invented against the abundance of blood of womens monthly terms of the hemorrhoides and for the overmuch flux of their courses the flux of the belly against vomiting and spitting of blood it doth also consolidate ulcers and veins Philonium Tarsense PHilonium Tarsense is of the same facultie as Pbilonium Romanum Aurea Alexandrina AUrea Alexandrina is effectual against the cold defluxions of the head good for weeping eyes the tooth-ach and head-ach consumption collick cough and spitting of blood it easeth the pain in the reins and profiteth intermitting fevers But the cause why I have not appointed this good composion nor any of the three last mentioned Philoniums to the Surgeons Chest though I know them to be good medicines is because they will not keep an East-India voyage and Laudanum opiale Paracelsi is sufficient for ought the other can do Wherefore I rest satisfied therewith Succus Absintbii SUccus Absinthii juice of wormwood is good for digestion killeth the worms benefiteth the stomack and differeth much from the vertues of the herb this being astringent the other abstersive
of maturation or no also by depressing the cutis a little with your finger When an Apostume will suppurâ—â—e Hâ—ppocrat cap. 2. lib. 47. Mark also out of the words of the Ancients to know when an Apostume will proceed to suppuration Hippocrates lib. 47. cap. 2. hath these words that whilest Pus is in making paines and feavers do afflict but Pus being made paines and feavers do decline And to Tagalt Instit confirm the former words Tagaltius in his Institutions cap. 3. hath these following verses Duritia longa pulsus dolor calor aucti Signant pus fieri sed facto dicta remissa Sub digito undans albescens pars acuta The fourth time of an Apostume The declination of Apostumes I cannot stand to amplifie but I refer you as before to Mr. Galles Institution of a Chirurgion as also to Johannes Vigo and other good writers for a more ample doctrine in that point onely note that when the tumour or apostume is ripe mine opinion is rather it be opened by a potential caustick medicine then by actual incision when it may be as conveniently effected and that for many good reasons and one sufficient reason in mine opinion is if you use incision you must needs put in tents dossels or the like with medicines to keep open the orifice and also to enlarge it which doing you stop the passage of natures true evacuation twixt each dressing offending the parts adjacent and hinder the unition of the disjoyned parts against conscience detracting good healing yea and thereby hazard divers evil accidents to follow as fistulaes c. from Caustick incision commended all which by caustick incision you are freed and fear not at all the application of a convenient potential caustick medicine in due time and place especially the impostume being ripe and the skin thin for you can pierce no further then thorow the cutis though you would for being onely thorow the skin the matter will choak your caustick or corrasive medicine neither doubt at all that your work shall succeed otherwise then well for nature will provide remedy speedily easily and safely to heal your patient provided you be also careful to use your endeavour with good warm medicines duly applyed and with also the use of good ligature which is one principall good help good diet and other reasonable means likewise had for I have ever observed in my practise that a hot tumour in any outward part of the body growing either by repletion obstruction fever or by the evil disposition of the bloud for the most part yea even in pestilential and venemous Fevers in good bodies not being pocky nor too too old are easily healed by any understanding Artist that can joyn reason and experience together many several wayes namely for one if you perceive a beginning or 〈◊〉 of humours together in any part of the body consider what might be the cause thereof as near as you can if you find it to be fulnesse of the body or costivenesse you have divers present remedies that way to flye unto Laxative Medicines fitting viz. at the first make the Patient a suppository then give him a glyster if need be and a Laxative medicine also according as you shall see cause regarding the quality and quantity of the humour abounding but remember where the body is costive you were best to begin as is said with a suppository first and that having caused one stoole proceed with a purge if you see further cause or a glyster for often onely one suppository doth what you require also good fomentations that may by the pores of the skin help to breathe some part of the matter will do well and so the rest by discussing and mollifying medicines the easier be cured If the grief begin in the head or throat you may use phlebotomy either under the tongue on the forehead or on the arm in the head vein or median vein but if you perceive that by emptying the body artificially and cooling the blood with convenient medicines as also answerable slender diet and opening a vein that the collected peccant humours will not be discussed nor put back then may you proceed to attraction and suppuration as you see cause for it were most grosse to seek to detain that which Nature hath resolved to cast forth wherefore if you see cause to bring forward any Apostume you may then consider by the quality thereof what course to take namely by attractive alterative or suppurative Medicines as touching attractive medicines good attractives at Sea to be had are Gum Elemni of it self spread on lether and 〈◊〉 applied and Galbanum also is very good provided it be dissolved in wine and not in vineger Mellilot plaister will well bring forward an Apostume hot or cold and helpeth suppuration Commonpitch is a good attractive Burgundy pitch is also good Of these the discreet Chirurgions Mate may use the fittest in his discretion and if he desire violent attraction of any slothful cold tumour let him set a large cupping glasse thereon Maturatives or alterative Medicines in the 〈◊〉 Chest and Ship to be had are very many yea more then I can call to mind at this time wherefore to be brief Emplastrum Diachylon cum Gummis I put for the principal for it is for that purpose only Paraâ—elsus Plaisters applyed thick spread the place first anointed with oyl of Lillies will do well But where time and place is convenient in my opinion a mean Cataplasme warm and thick applyed suppurateth best and easiest viz. make a decoction of Althaea roots or Line seeds and the cause being cold add Fenigreek a little to this decoction adde Bean or Barley meal oyl of Camomil Dill and Lillies of each a small quantity Dialthaea a little or Axungia porcina and apply it warm and shift it twice in 24 houres Or â„ž flowers of Camomil Mellilote and of Elders an a M. ss Wormwood M. ss Althaea roots bruised â„¥ ss make a decoction thereof in fair water a sufficient quantity adding of Bean meal or Barley meal M. j. and being boyled into a due form of a Cataplasme adde oyl of Camomil or Dill â„¥ iiij Axungia porcina â„¥ ij In want of some one of these flowers another for need will serve and if none of them were to be had yet there is many other meaner helps to bring forward an Apostume which time will not now permit me to rehearse When you have an intent to bring any tumour to suppuration you must neither purge nor bleed your Patient neither appoint him a thin dyet When you would an Apostume should go back if it be above the navil in the breast back or head then let your purging Medicines be such as purge downward onely but if it be below the navil or in the arms or legs vomitive Medicines do best except some especial hinderances as Asthma or the like And to those uses none are so effectual as those
put in practise as preparing the humours by evacuation remission and resolution all which require some long time and therefore other meanes are first to be used to take away the paine or at least to mitigate the same with Anodines first Anodine medicines and the due application of convenient helps of warme and moist temperatures which not helping you must againe Necrotical medicines if need have recourse to Necroticall and Stupifying things which indeed are not to be used but in great extremities to give the patient some present ease Anodine medicines are to be adminstred so well inwardly as outwardly as first inwardly namely in glysters consisting of moist and fat substance as the decoction of Camomill Dill Linseed Mellilot Mallowes Hollihock Fenigreek Bayberies or some of these with one ounce of the new extract of Cassia and some suger with Linseed oyle and butter administred Outwardly these are to be applyed either Unctions Cataplasmes Fomentations Baths or some such like convenient medicines as time and place best fitteth But if these should not help then in great extremities you are to flie yet againe to Necroticall or stupifying medicines as namely Landanum Paracelsi which exceedeth all Necroticis or Philonium Romanum is also a good medicine these are onely to be used in causes proceeding of heat and never of cold causes for in cold causes that were rather to confirm the disease and yet in the judging whether the cause be hot or cold sometimes a good Artist deceives himself If the Collick come of winde then you must apply warm resolving medicines I mean dissolving and dispersing medicines Notes to be considered of by the Chirurgion in the beginning tf the Cure of the Collick FIrst whilst the meat is yet in the crude gut I mean before it be digested A caveat and turned into excrement no loosing medicines are to be administred but rather a small and spare dyet and in the beginning to begin with mollifying glysters and then afterwards to proceed with more sharp and stronger But before all things if the Patient have a full stomack and withal queasie after a glyster then a vomit is principally Glysters and vomits to be administred Secondly Repletion or overfulnesse as well as too much fasting is to be avoided Thirdly no Agarick is to be used in any of your medicines for the Collick because that cleaveth to the guts and most bringeth terrible pain and tortions yet Stokinus a learned Germane Writer doth Beware of Agaricum highly extol the same to be put in Glysters to give it present ease Fourthly you must by cordials have a care to preserve the Liver Heart and Head least they be hurt or offended by the vapours and A caveat over-much heat of the oyntments cataplasms and fomentations which are usually applyed to the parts agrieved Fifthly in the beginning over vehement warmings are to be avoided A second caveat especially if the Collick proceed of the dry feces for thereby they be the more dryed Sixthly cold water is to be avoided and not any waies to be permitted to be used to quench thirst withal but rather let the patient use some stewed prunes Julip of Violets conserves and such like or a barly water with a few drops of oyl of Vitriol and some licoras are good Specifical remedies Specifical things that cure the collick are very many as horse-dung drunk in wine hares-dung or hen-dung drunk in Oxicratium where such may be had Also the powder of Harts-horn corral cockel-shels burnt or swines hoofs burnt or Calcined till they be white and such like according to the diversity of the causes Further in the particular cures of this disease there are very many things observed by the learned Physitians according to the diversity of the causes which were too much to trouble the Chirurgions Mate withal at this present as the ayre dyet and divers other good helps to the cure of this grief which cannot be observed at sea onely fish and water-fouls are to be avoided as much as may be The Cure To cure the Collick which cometh by means of the feces remaining and being dried up which happeneth most commonly at the sea in long voyages and especially in hot countries there are three sundry intentions to be observed The first to mollifie the feces and supple the guts Secondly in Evacuating to discharge the belly Thirdly to remove or take away the cause of exsiccation or drying up of the feces or excrements The first is performed with glysters made of common oyl or butter with the decoction of Mallows Violets Beets c and by drinking oyl of sweet almonds or a decoction of Polypodium The second thing which doth bring forth the mollified feces or excrements is Cassia fistula or Manna or Diaphenicon or Hiera or sharp glysters The third intention curative if it could be attained to at Sea were to remove first the external causes of the disease as over-warm ayre over-salted dry meats and small quantity of food fasting watching melancholy and the like inwardly to help the weaknesse of the expulsive faculty with Treakle Mithridate Conserva rosarum or the like cordial helps helping also the expulsive faculty with glysters and such like good things For further inward remedies you may use the aforesaid glysters or half a drachme or Ê’j of Sulphur vivum drunk in warm wine and the belly well covered with warm clothes helpeth somewhat Item Carraway seeds made warm in wine but not boyled therein being drunk helpeth Item a glyster made of Sope and Honey is a present remedy Item a bag stuffed with bran and made very warm sprinkled a little with vineger and applyed to the belly is good Item Goats milk or other milk boyled with honey and applyed to the belly with a spunge or cloth warm in manner of a foment healeth the Collick and driveth away worms and ceaseth the pain Item the gall of a bullock Salgem Aloes common oyl ana partes equales mingle them and make an oyntment thereof wherewith annoint the fundament before the fire that looseth the belly and bringeth forth the hard feces Tenasmus The definition of Tenasmus TEnasmus or Tenasmus as Hippocrates calleth in his sixth Aphorisme and in the seventh book is a disease of extention or straining out of the right gut called intestinum rectum being oppilate or stopped and of some English writers it is called Costivenesse This disease as Galen saith in his second book De methodo medendi is when a man hath an extraordinary provocation lust or desire and a vehement straining to go to the stool but cannot void any thing at all except sometimes some small quantity of slymy matter which now and then is mixed with blood or a bloody substance and the extraordinary desire of emptying or going to the stool ceasing The causes of Tenasmus outward and inward Outward as Cold. Heat Drought A corrupt asire Bathing in cold wâ—ter Necrotical ointments Inwardly as salt humours
the principall members of the body as the Heart Brain or Liver causing Convulsions Palsies Dropsies Scorbutes or the like which oft-times termine in Gangrena and after a further time they conclude in Sphacelus Also Gangrenes proceed by great incâ—sed wounds and namely amongst other wounds contused wounds chiefly I mean those of Gunshot also sometimes by fractures and dislocations also by Fistulaes and inveterate Ulcers by unreasonable stripes as with a Buls Pisle or a thong cut from an Elephants skin much used for correction in Poland Hungary and the Turkish Dominions finally from all interceptions intersections or interruptions of the spirits what or wheresoever may produce a Gangrena De Gangrena A third Definition gathered from learned Authours The third Definition of Gangrena A Gangrene is a partial mortification of a member commonly by reason of a phlegmon it may be said to be partial in that the part affected so long as the member is not throughly dead but hath in it self still a sense and feeling of pain and therefore not altogether desperate although yet it be tending to mortification and so unlesse there be some sudden help in the staying thereof it will soon turn to a total and perfect mortification after which it may no more be tearmed a Gangrene but is called of the Grecians Sphacelus 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 because of the extinction of Sphacelus the natural heat therein and of the Latines it is called Sideratio Sideratio a totall and perfect putrefaction and moreover of the later Writers Esthiomenon in that it is so sudden piercing and penetrating unto Esthiomenon the bone and doth as it were overcome the whole man so as again it may be concluded that the difference between a Gangrene and Sphacelus as is said is a Gangrene is truly tearmed an unperfect Dif in Gang. Sphacel mortification in the fleshy parts onely but Sphacelus is a perfect and total privation of sense being a mortification not only of the fleshy parts but also of the nervous parts even unto the very bone yea and of the bone it self also The causes of a Gangrene Causx Gangr by some learned Writers are reduced to three the first is when as a member cannot receive the vital spirits proper or natural due to it from the heart by the Arteries by reason of a dissolution in the mixture or harmony of the member caused externally by extreame frigidity as sometimes it chanceth to be in a very cold and sharp Winter also by the inconsiderate and too too immoderate and rash refrigeration of a Phlegmon as also extreame calidity as by scalding Liquor or through some poysonous disposition in nature invested in the parts affected all or any of which do or may sufficiently extinguish the natural heat thereof if wholesome remedies in time be not applyed a Gangrene may justly be expected to follow Another cause is when as the vitall spirits in any member are obstructed suffocated and finally extinguished by reason of some obdurate schirrous hardnesse and constipation of the Veines arteries or pores of the skin as in venemous or pestilential Apostumes or Carbuncles is often seen so that little or none of the venemous matter conteined in the Apostume or venemous tumour can be digested or receive discussion nor be brought to suppuration by apt Medicines whereby Nature being above her strength oppressed and Art not sufficiently succouring a Gangrene is produced Another cause may be by extreame strong ligature through the indiscretion of unworthily termed Artists or of unexpert Artists as too often is manifest and sometimes by compressions or other interceptions of blood or spirits by which the vital spirits should be transported to the member grieved The signes of a Gangrene are these an extinction of the lively Sign of Gangr colour which was in the precedent Phlegmon grievous pain and continual pulsation in the diseased part apparent by the Arteries being at the first very sensible but afterwards declining their due force the part agrieved seeming for the most part in colour to be blackish blewish or of a duskie or livid colour yea sometime putrid and being opened a filthy Ichor and of an unsavoury smell proceeding from it Thus much of the signs Of the Cure of Gangrena Cure TO the performance of the cure of this disease there must be first a due consideration had of the cause Secondly of the part affected Thirdly of the fitting apt remedies for the Cure and how to proceed in the curing that disease and of the Symptomes thereof and lastly of the removing the cause which if that may be effected health doubtlesse will follow according to that Axiome of the Philosopher Ablaâ—a causa tollitur effectus but that must be expected in his due time in which there must be first considered What to be considered in the cure of a Gangrene Diet to be used for a Gangrene whether the disease proceed of repletion and if so then a general evacuation with a cooling and spare dyet must be prescribed the Patient Viz. Water with the milk of Almonds and thin brothes with cooling herbs as Lactuca Spinachia Portulaca Sorrâ—l or the like as also advising with the learned Physician where time and place serveth Barley waters also are good and the sick must be forbidden all wine and strong drink and must be contented with posset-drink Barley water and small Beer it were also fitting that there were prescribed to the patient some preparative medicaments as these Syrup Acetos Preparatives necessaâ—y Simp. Syrup Endiviae Syrup Citri Violar any of these mixed with waters as may be convenient in such a disease and after these preparatives may be used such purgatives as may purge and cleanse the blood viz. Confect Hamech Caria costrirum Diacatholicon Cassia fistula or some one of them being according to Art performed Phlebotomy usefull And if you perceive further occasion you may reiterate the use of any of them and further you may not omit the use of Phlebotomy scarrification and application of Ventoses Leeches or Vesicatories upon or nigh the part affected and according to the Patient his strength let him blood moderately and observe that in scarrification regard is to be had concerning the gangrenated part whether it penetrate or be superficial and so accordingly is scarrification to be used as for the application of Leeches it may be done upon any part thereto adjoyning or upon the part affected it self and further note that if a Gangrene follow a contusion for the most part it proceeds either by the vehemency of the contusion whereby eruption of the capillar veins yea and the larger veins also blood is forced into the Muscles confusedly as by the Echymosis may appear of the evil disposition of the Patient or it may also proceed for want of a Surgeon to apply fit and artificial applications in due time not seldome under favour by over-hard ligature But if the Gangrene appear to have
proceeded by inanition that case is pitiful and the cure very doubtful but neverthelesse where it so falleth out all nutritive and comfortative remedies are to be appointed as namely if it proceed of cold either in frost or by want of due and sufficient food consideration is to be had by adding warmth of food and rayment with cordial and comfortive remedies also the Artist must truly inform himself whether this disease be a Gangrene or a Sphacelus whether a partial or a total privation and mortification with the utter losse of the sense of the fleshy and nervous parts and if he find sense in the parts there is life and hope Rulis to be observed if the Gangrene is caused by venomous diseases But suppose a Gangrene proceeds of a venomous cause as many times it doth and namely in time of contagion as of Carbuncles in the Plague the small Pox or by other malignant Feavers when as the Artist may neither purge his Patient nor open a vein safely but with fear except he may be well warranted either by good and grave advice of the expert where such may be had in want of which the Artist ought to search by authority of the most ancient Writers that he can come at for the avoiding of the eminent danger of death to ensue upon his Patient and to go warily in the want of better advice What to be observed if it be caused by fulnessâ— viz. If the grief proceed of fulnesse which seldome it doth at Sea or in Camps then his first rule in Art must be as is said that a thin dyet and cooling be prescribed his Patient and that he be admitted no wine nor strong drink also that he may be appointed some cooling Julep to be made him namely if the Patient be in Ship or Camp he is there confined and constrained to the Surgeons Chest and then let the Surgeon examine his provisions and if he find he have any cooling waters and Syrups fitting thereunto he may proceed to take as followeth A receit to be administred to the Gangrenated â„ž Aq. Lactuc Acetos Endiviae Buglos Borag Frag. Plantag Lujulae or some one or more of the most fitting aforesaid waters viz. â„ž Aq. Lujula 2 l. Syr. Limon vel Violar â„¥ ij Ol. Vuriâ—l gut 12. The Dose of it Misce give the Patient every two or three hours two or three spoonfuls hereof the glasse being ever shaken when it is poured out and if he hath not been at stool that day in which he is to take the Julep you may give him a Supposiâ—ory and having had one stool give him a The Receit of a Diaphoretick Diaphoretick viz. â„ž Aurum vitae gr 8. or Mithridat Ê’ 1. Elect. de Ovo ℈ 1. Confect Alcherm ℈ ss Ol. Vitriol gut 4. in Aq. Borag Lujulae Acetes vel Buglos viz. of any one of these â„¥ 4. with Syr. Limon Citri Lujulae The order of the applying of it Violar or some of them Misce fiat haustus give it the Patient being laid warm in bed and cover him warm and provoke him to sweat gently and as you find his strength continue his sweating for an hour two hours or more which done keep him in a moysture one other hour at the least which ended let him cool and dry paulatim and warily and having so done and refreshed himself till four or five hours ended then you may if you see cause give him the like Cordial again and proceed again as before to sweat him the second time and give him 8. grains of Aurum vitae â—or a Diaphoretick which done you may then admit him rest and respite again for a fitting time wherein you may advise what further is requâ—site to be done in which time not omitting in any case both before his laying down to sweat and after as also betwixt his sweating ever to apply all fitting topical helps viz. by scarifications and hot fomentations of some good lixivium such as aftrr the taking off members in the mortified place hereafter are described Thus much in brief of the Gangrena A Definition of Sphacelus and the cure thereof from some ancient Writers to shew the Reader their opinions and judgments thereof for that some Artists have grounded their judgments that their relations are according to good practice and therefore are to be imitated A Sphacelus saith Falopius and likewise Fabritius is an affect of a part already utterly mortified and therefore not to be cured but by amputation that the whole body come not to corruption thereby Extremum genus morbi requirit extrema remedia and this abscission is not done without great danger of death for often even in the instant act of amputation the Patient dyeth by the profusion of blood and spirits wherefore the strength of the sick is to be considered and Cornelius Celsus alledgeth Cap. 25. The opinion of Celsus concerning Sphacelus lib. 5. that in his time they used to take off the Sphacelated member by cutting the flesh round about unto the bone in the whole part near the rotten or sphacelated part and cutting ever in the live flesh not leaving any of the mortified flesh untaken away further Celsus say Another way of amputation they doth admonish us in this work that the skin and also the flesh be brought and drawn upwards that the bone may be the better covered by some of the said part in the healing of the stump but the same Authour confesseth also that by such abscission causing exceeding pain with over-large effusion of blood and spirits death usually followeth therefore to avoid hemorrage they must presently use actual Cauteries to burn the parts adjacent in which may be conjectured how cruel that course is to the Patient and uncomfortable and prepare the upper part thick enough to be a firm cover to the vessels But after himself not approving that course he saith that he took another way of curing which as he said happily succeeded by which work no profusion of blood hapned because no blood floweth from a mortified part neither is grief moved therein but lest the corruption should spread it self further saith the said Authour I burned the putrefied part remaining every where with red-hot Irons that were heavy and well burnt untill the Patient did feel the heat of the fire and that he suffered some small pain and the rather they did it they write because the same operation is very profitable and therefore burned ever some of the sound flesh also because the putrefaction is best to be drawn out by a red-hot Iron as I suppose saith he which is apparent to the eye for the humours are apparently seen to boyl about the Iron and likewise the weaknesse of the parts considered by burning it is fortified the adjacent parts being freed from many noxious humours thereby so that the weak part receiveth strength and within a few dayes begins to separate the living from the dead part and
in a Coperas water and let it dry again and lay that lint drie upon the proud flesh sometimes for a dressing or two and then againe to your former method doubt not but it will without pain verie well cicatrize any new wound I write this for that by the unskillfulness yea Surgeons wilfulness as well as unskilfulnes blame-worthy and sometimes by the idleness of evill minded and base Empericks I have seen men lamed by the needless use of caustick medicines even in slight wounds to which if an old wife had openly applied her one salve for all sores no such thing had happened yet I am not so simple to denie the just use of such noble medicines in wounds ulcers and fistulaes or otherwise where need is but I onely here advise the young Artist Note that he may not be too rash in the use of them and likewise doe advise him that having used them once he first pause again at the least eight dayes namely till the first Esker be fallen and certain daies after ere he use any caustick powder again for with the use of corroding medicines Two evils to be avoided one immediately after another many Ulcers are made more painfull and rebellious then they were and the bones sometimes made foule which were otherwise clean which fault is too frequent now adaies and amongst many grosse faults daily committed by unexpert Empericks this one is to be lamented namely the use of keeping open penetrating wounds too forcibly and too long by the use of hard tents armed with caustick powders whereby nature can make no true unition but is forced into much disorder which I wish young men to make a conscience of and to be carefull not to erre in that kind The Lavatorie This Instrument is set down else where Of the Uvula spoone THis Instrument is made to put pepper and salt in or fine bole pepper or salt or some other the like medicine and to hold the same right under the Uvula which is for to blow up into the concavitie behinde the same and no other great or especiall use I know it hath in Surgerie except it may be used to warm a medicine in Thus much of those necessaries which properly deserve the names of instruments in the Surgeons Chest Now a word or two of such other Appendixes which in their kind are as necessarie as the former The Cupping-glasses or Ventoses The use is divers THere are many necessarie works in Surgery performed by Cupping-glasses namely sometimes they are used to set upon a Bubo or botch to bring it forward and therein they are very good Sometimes also to set in the nodell and on the upper part of the shoulder-blades to draw back humours which oppresse the head the eyes or teeth or against Lethargie or on the thighes against aches or pains there or for the cure of the Sciatica they are very good or sometimes to draw bloud and spirits to The end why they are set without scarifying Why with scarifying a member withered or benummed in all these and divers more griefs the Cupping-glasses are very needfull Sometimes also they are set without scarifying onely to attract humours to the place Another time it may be in other cases they are used with scarifying to take away bloud and choler which offendeth the part Some set them on with The divers setting of them The best manner of setting them towe some with a small wax light set under them some onely with the flame of a great candle which my self use and is not offensive nor painfull at all whereas the other waies the flame excoriateth often the part and maketh new unseemly work for the better doing whereof I use to place my candle close to the place where the Cups should be set the place being first wet and rubbed well with hot water and a spunge and Note the Cupping-glasses also wet Hold your Cupping-glasses over the flame a little and then clap it quickly on the place whilest yet the steame of the light is in it and it will be fast and draw hard but you must have your Cups fit and not too wide for the place you would set them on or else they will not take any hold Further when you perceive they have drawn well which by the blackness and rising of the skin you may sasily Scarification must be light and sudden and with a Lanncet see then if you hold it fitting you may lightly and quickly scarifie it with a fine Launcet which truely is the best and profitablest instrument for that use and then wetting your Cupping-glasses againe with the flame onely of the candle set them on where they stood before setting When to take the cupping-glasses away What to be done after they be taken away Deep scarifying evil as many cups and drawing as much bloud as you see good and when no more bloud will come and that you thinke it time to take them away which is known by a yellow water which cometh at the last then I say it is time to wash the places with faire water where the cups stood and drie them with a spunge or cloth and onely anoint them with Ung. Album once and they will bee whole The overdeep scarifying it is not onely dangerous but also painfull and not art-like for if you note well the cutis it hath many capillar veines in it yea and some great veines and is porous so that the Artist may by force draw humiditie sufficient from farre if so occasion bee to use their utmost force Large and with cups are fittest on the thighes lesser on the arms and the least for the hands or feet Of tho Brasse Bason Friend learn good by ill I Have nothing to write concerning it but that at the least the Surgeons Mate have one if not two and if he finde no use for it let him sell it for good liquor at Bantham as a Surgeons Mate lately did one of mine Of the Blood Poringers The quantity of blood Imitation with out discretion is idle Blood poringers necessary BLood Poringers are necessary at Sea to be the more certain of the quantity of blood which is let for since the blood of man is so precious it is to be well weighed what quantity is taken And although the German Surgeons do ever let blood into a bason yet I hold it not good for the Surgeons Mate to imitate first except he be of good judgement indeed to judge of the quantity The blood Poringers which are made for that purpose being full hold just three ounces and The constitution of the body is to be regarded in Phlebotomy somewhat more For my own practice I hold this course if one chance to come to me of himself or by advice of a Physician to be let blood though he have a strong body I never take from him more then two poringers and a half at the most but often lesse If
the party be not strong except it be in case of a Pleurisie or some like urgent cause I take lesse For in that work except my reason give me good satisfaction to do the contrary I will rather offeud in too little then in too much Too little rather then too much blood is to be taken away taking of blood away for I have seen much hurt to have ensued by great quantity of blood taken away at one time 7. or 8. ounces I hold a strong body may bear to lose having good nourishment to recover it again and that without harm but if you grow to ten ounces you may many wayes do harm in the body except your warrant be good I speak not this to discourage young Surgeons from a work so behovefull but admonish them to warinesse in a point so dangerous Of the Dyet Pot. The use THe Dyet Pot is not alone to be used in cases of dyet drink seething for the pox and not otherwise for as a learned Doctor upon occasion lately reasoned there is difference betwixt the Dyet and a Dyet though in both kinds there is even Quot homines tot sententiae so many men so many minds Wherefore concerning descriptions of several Dyet drinks for the pox I will refer the Surgeons Mate to other Authors for in truth I must defer that point till fitter oppertunity I mean till I write touching the cure of that disease And yet methinks to speak somewhat A docoction for the Calenture of a drink is the case of the Calenture or any other unnatural hot fever to be made at Sea to qualifie the heat of the blood were not amisse which may be done as followeth â„ž French barley â„¥ iiij Fresh water 2. gallons Licorice â„¥ i. Cloves n o. 12. In want of Licorice tak juice of Licorice half an ounce In want of french barley take other barley or for a need wheat flower boyle this gently to 4. or 5. quarts then clear it and if it may be keep it not in How to keep it The composition of this drink if the heat be over great causeth head-ach The colour and taste of the drink is to be observed the brasse pot but in some earthen or glasse vessel and if the party his heat be great and have pain in his head add thereto so many drops of oyl or spirit of Vitriol as will a little change the tast and make it sowerish but not too tart in any wise and if into all his drink you put of Rose-water of wine-vinegar or Rose vinegar and Cinamon-water of each onely one spoonful if you have it it will do well to mend the tast if not the matter is not great let the Patient drink often hereof Further you The drink composed for a Laske may if you think good add surrupe or juice of Limons Ê’ 4. If it be for one which is loose in his belly you may infuse of your succus Acatiae herein some 2. or 3. Ê’ and being cleared let him drink of the drink plentifully as he hath thirst but you must cut your Acatiae first and dissolve it in a little of the drink warmed and so put it into the rest Also in want of Acatia if you put therein Galls in powder a little it will do well Of other necessaries THe next instruments in order to be remembred are these following viz. Skillet Chafing dish Glister pot Funnel Cups to give potions in One Board knife to spread plasters Morter and peâ—tel Weights and Scales Sives Searces Strayners Splents Junks Tape Towe Spunges Clouts Rowlers Gray paper White paper Empty pots and glasses Thred and Needles Wax Candles Lanthorne Tinder box furnished Inke and quills One close-stoole One bed pan One brasse paile 20 Well burned bricks Pipkins Empty baggs I shall not need to spend much time to set down the uses of all these necessary implements only two or three of the most needful to be noted I will remember and then to the uses of the medicines within the Chest Of Weight and Scales VVEights and Scales are necessary things often times lightly regarded and yet how many mens lives hang in the ballance it is plain enough For Sea-Surgeons familiarly give Stibium by the grain The use is divers namely from 4. to 8. grains yea and to 12. grains by your leave when in truth few of them have waights and Scales which can weigh one grain A great fault in weights and scales It is a dangerous thing for a Surgeon at Sea to be unprovided of neat weights and Scales which will turn with half a grain for how can they give either Laudanum Paracelsi Stibium or other Chimical medicines safely or almost any medicine inward without small weights and Scales Wherefore two pair of weights and Scales are very needful for the Surgeons Chest namely one for ounces and another for grains for larger Scales the ship is furnished It is also to be understood here for instruction of children in Art that xvi ounces make a A direction iâ— weights pound each ounce 8. drams each dram 3. scruples each scruple 20. grains for the grain a full barley corne will well serve or a good wheat corne though a large wheat corne be somewhat too big an ordinary pepper corn will also serve for a grain Of the Close-stoole with the Paile of Brasse and the Bricks ALthough I know before hand that I am to undergo many witty and Eloquent flouts from young gallants of my own profession for mentioning so base an instrument to belong to the Surgeons charge as this last mentioned Close-stoole with his appurtenances yet let them Mean things sometimes are of great moment know that neither can my book blush neither shall my self I hope have cause for I nothing doubt to yeeld each honest young Artist a sufficient reason for to satisfie him herein and in a word my reason for appointing to each ship bound for the East-Indies at the least one of these is because the bloody or other flixes are so dangerous diseases and so deadly amongst our men that I hold it my duty to advise even the good None worthy to be reputed â—rtists who disdain the meanest office of their profession use of a Close-stoole and I have caused the stoole to have one door on the one side that thereby either things to foment fumigate or otherwise to comfort the weak part might be the better applied the Patient sitting at his ease thereon The use of the Close-stool The need of it is great Also one especial reason why I have appointed it is that a poor weak man in his extremities should not continually go to the shrouds or beak-head to ease himself nor by noysome to his fellowes but might by the help of his Mate through this mean instrument find comfort in his most pitiful distresse whose miseries I heartily compassionate Wherefore I admonish the Surgeons Mate in general in the fear of God