then hath a doublet made of a beastes skinne or such other kinde of apparell the which with the verie shirt oftentimes wee haue seene by shot burned neyther then is it to be doubted but that the aire beeing on fire following and driuing the pellet into the wounded person but thereby the flesh may also be burned But what will they say then when the gunne is discharged euen close at the partâ—es bodie and the wound happeneth in an vncloathed and naked place doth euerie souldier weare gauntlets and helmets yea oftentimes it happeneth the gunne to be discharged at the verie face necke handes and open mouth as they which are dayly conuersant in the warres can beare me witnesse farre better then those which dispute of the matter in their closets and according to the prouerb without hazard of gunshot Surely I denie not but when one is wounded so nigh the Ordinance but that the wound may be burned and blasted in which case they are greatly deceaued which thinke that such woundes are alwaies without blasting and doe iudge the heate to come onely of the pellet and therby do make rules so general that they may haue many exceptions which easily may be gathered by that which we before haue spoken intreating of the venome and blasting happening to these woundes Thus much haue I thought it good to declare vnto you concerning the nature essence of wounds by shot and of the sundrie accidentes which may happen thereunto the which for the most part are woont to be solution of continuitie with brusing and rending of the partes which requireth two intentions curatiue that is consolidation and restoring of the brused and torne partes but if it be accompanied with burning as it may be then must we repaire to the third intention that is to the extinguishing of the fire and drawing out of the heate yea and last of all to the fourth that is to some wholesome remedie named of the Greekes Alexipharmacon as often as we shall thinke that there is some venom in the wound hauing speciall regard to the moste dangerous discommodities and to finde out so manie curatiue and conseruatiue and preseruatiue intentions as sundrie woundes ioyned with sundrie accidentes shall require CHAP. II. Of the differences tokens and sundrie signes of woundes by Gunshot THose which more heedily consider those partes which by shot are wounded and doe wisely weye their office necessarie substance situation sence and figure and likewise the essence or maner of the hurt and the proper differences thereof may presently see and iudge as well by reason as experience what and howe manie intentions are necessarie to the curation therof and so may prouide indications much able to sundrie accidentes and present griefes and thereby to preuent things which are as yet to come as Galen teacheth lib. Met. 4. 7. To which purpose it greatly auayleth a perfect knowledge of proper differences and a consideration of the greatnesse or smalenesse deepenesse or hollownesse of the wound the which differences are taken as of the cause efficient of the manifold figures substances shapes and kinde of mettall of the shot for some of them are long some plaine some great some litle some verie slender which causeth that the wound is of sundrie sortes some strike awaie the member other pearce through tearing and rending the sinewy parts and bursting the bones or sometime by onely brusing and not pearcing the flesh according to the sundrie â—nd vnlike kinde of shot or to the nighnesse or farre distance thereof or according to the state of the bodie being hurted that is eyther naked or couered yea sometimes so safe it is defended with so sure a corslet and as we may say so teÌ„pered that it cannot be pearred neyther the bodie by anie meanes be wounded And if it bee wounded it is verie little and without danger in that the violence of the shot is weakened by the hardnesse and strongnesse of the armour and especiallie being the shot of no great ordinance but of some small peece and all these differences without doubt may be referred to one kinde that is to the solution of continuitie which sometime is seene and somtimes is hidden that is manifest which is perceiued by handling and sight and when a plaine wound appeareth with wannesse of the fleshe as it were an Escare ioyned with great dolor and specially when the sinewes are hurt which doth plainly shew vnto vs beside the signes of a wound which doth not a litle auaile to this purpose that the same is made by gunshot A hidden or secret wound is without anie manifest breaking of the skinne which the Grecians call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and is knowen by shedding of the bloud betweene the flesh and the skinne and doe stayne the hurted part with a violet and wannie colour These are the common signes of such woundes wherein a consideration is had of onely brusing and solution of continuitie but insomuch as we haue taught in the former chapter that such woundes may sometimes be accompanied with venom and blastinâ— contrarie to the opinion of some it behoueth the Chirurgion to imploy all his studie and labour in this case to iudge and discerne euerie affection by the tokens and signes proper thereunto because such affections as we said before be often ioyned to such woundes and let him seeke out a proper remedie for ech of them and diligently consider which of them is most dangerous for that as Galen teacheth is not onely first but also chiefest to be cured that insomuch as sometimes wee are compelled by reason thereof not onely to let passe the other accidentes but also to make new that thereby we may remedie that which is most dangerous And this is the very cause why the knowledge of these wounds poisoned by shot are so necessarie as in the Chapter before we haue taught least that the sodaine death which many times comes thereby be imputed to the corruption of the aire and other first qualities when commonly the fault lieth in the wilfulnesse and vnskilfulnesse of the Phisition perswading themselues that these wounds by no meanes may be venemous therby they refuse the true kinde of healing And some no doubt will attribute it to the aboundance of blood and to the euill iuice of the bodies called by y e Greeks Cachochimia the which two verily I doe acknowledge with Galen confesse haue great force in hindering of al wounds and the chiefest causes of euill accidences notw estanding if the signes which signifieth venom hath in theÌ„ any thing coÌ„mon with these y t happen to gunshot where only coÌ„tusion is ioyned yet may they easily be discerned whether they be great or litle or waightie fearefull accidents and extraordinarie which oftentimes come to passe Therefore if the flesh be more wanner then it is wont to be in common wounds by shotte and as it were deade with an euill colour of all the whole member with intolorable and
Egshels Ê’ i. the sirope of drie Roses and of mirtils of ech â„¥ i. and with the water of the flowers of red popie make thereof a potion and minister it three houres before meate the which may be barly broth boyled with Rosewater and popie seede if it â—e toward bed Aboue all there cannot be found a worthier remedie both to stop bloud and case all paines and suppresse fluxes of humours then Laudanum Opiaticum if you minister a pill thereof as bigge as a Pepper come the vse wherof especially in these kind of wounds cannot to highly be commended that I haue more plenteously intreated of in my answer to y â— treatise of Aubertus vindonis do ortu causis Metal After these thinges being first done then apply medicins which quickly may suppurate and being come to maturation let it be mundified with exiccation that naturall fleshe may growe that is it be neither ouer hard or soft or proud and the scales of the bones if there be anie may come out from the sound bone Moreouer we hasten the suppuration of these wounds least the venome closed within and filthy saines doe some greater hurt for being throughly ripened feuers paines and almost al other passions will decay For this intention the common sorte are woont to vse at the second dressing digestiues as they tearme them made of the yeolke of an egge oyle of Roses and Turpentine which as I may say the trueth I cannot allow in that they soone putrifie and cause the wound to smell whiche thing is alwaies ill Others vse hydreleon warmed with butter and other thinges which haue nature to suppurate and some boyle the flower of wheate with a litle safron some againe there be which greatly commend Tetrapharmacon made of pitche rosin waxe and suit and Cor. Celsus esteemeth this aboue all others Also Macedonioum is made with the forenamed simples and frankencense and much commended of some Other greatly allowe Basilicon for it is a great suppuratiue and also readie at the Pothicaries and some commend Dialthea which they call Resumtiuum Others Emplas dia Chilo simplex and de mucilaginibus which they temper with oyle of lylies And with all these and other like medicines they out of hand doe suppur at the bruised flesh following the preceptes of Hâ—ppoc For he writeth that it is expedient that the brused flesh be supurated and by such meanes is the wound lesse subiect to impostumation and anguish and this is the iudgement of Hippoerates and all other antient Phisitions and I my selfe cannot but highly commend the vse of the supuratiues for they doe defend the nature and strength of naturall heate and do temperate the rage of rotten humours and verie quickly doe bring the corrupted bloud to matter and thereby doe bring the wound in a farre better estate But yet this one thing must be taken heede to that the vnorderly vse of them cause not the wound to rot which is remedied by putting to euerie ounce of the suppuratiue one dram of precipitate prepared after our order yea and more to if the wound shall smell and so shall the medicine pearce farther and worke his effeâ—t without danger and by this onely meanes you shall haue white matter and the affected member shalbe safâ— from Gaâ—grena and putrifaction whereunto in theâ—e kinde of woundes they are much subiect and this haue I oftentimes proued by sure experience Neyther haue I thought it amisse in the behalfe of the vnpractised chyrurgions to set downe some ensamples for this intention I would therefore that the tents Plegetes and whatsoeuer is put in the hollownesse of the wound be dipped in this oyntment following which is easie to be made Take vnguents Basilici maioris discrip Mesnae â„¥ ii fresh butter â„¥ i. Precipitate prepared after our manner â„¥ ii ss mingle them and annoint therewith the tents and plegets Another Take new Waxe Rosme ship Pitch of ech â„¥ iiii Goates sueâ— marrow of calues leggs of ech â„¥ ii aesypi humidae â„¥ i. oile of Oliue or of Linseed or of Visci pomorum one pound melt them straine them and make thereof an ointment An addition Take of that ointment â„¥ ii of our Precipitate Ê’ ii mixe them and so shalt thou haue a most excellent remedie which being vsed in emplasters without Precipitate is to bee annointed and put into the wound Or else thus Take venice turpentine and white hony of ech halfe a pounde the yelkes of twelue eggs and mixe them very well and boile them to the thicknesse of a pultise This ointment which the Paracelsians call Galcinatum magnum you may safely vse in sreede of a digestiue for being so prepared it resisteth putrifaction and is very good to bring such wounds to suppuration But in so much as it is the office of naturall heate to maturate and not of medicines we must therefore by all meanes possible increase such heate as is likest thereunto which is to be increased and nourished by wraping the member in bombase lana succida and linnen clothes or else with some Cataplasme by all which meanes as Celsus writeth daungerous wounds are cured and such things must be dipped in Hydraelion made of oyle of Rosâ—s and Rose-water wherunto you may put a little vineger but not too much in that it hindereth suppuration or else vse this fomentation following which I my selfe do often vse A fomentation to mollifie and ease paine Take of the leaues of Visci pomoruÌ„ smal shred with the berries m. iii. the rootes and leaues of Holihock Mallowes Violet leaues ana m ii of Fenigreke Linseed ana â„¥ ii the flowers of Camomell and melliâ—ote ana p ii seeth them in milke This medicine neuer failed me for it driueth away inflamation greatly easeth paine and strenthning the substance of the member it very quickly moueth good matter and of the foresaide substance pounded and driuen through a seeue is made a cataplasme by putting thereunto the meale of Lineseed Fenugreke ana â„¥ ii Oesepâ— humidae and marrow of calâ—â—es â—eete ana â„¥ i. ss the yelkes of foure eggs of saffroÌ„ sixe graines oile of Viscipomorum and rosarum as much as sufficeth let it be applied to the wound and parts nigh vnto it but round about it somewhat farther off let this ointment following be vsed to withstand the flux of humors An excellent defensiue Take the powder of red Roses and of Myrtils of ech Ê’ i. bole Armeny terrasigillata of ech Ê’ vi the iuice of Plantine and Dwaâ— of ech â„¥ i. vinegar of Roses â„¥ ii oile of Roses Omphacine and of Myrtils ana â„¥ ii ss Waxe â„¥ ii make thereof a defensatiue And such medicines so long you must vse as we saide before dressing it twise a day vntill the wound come to good matter and then must you vse clensing medicines wherwith you may always mix our Precipitate in greater dose which brauely clenseth wouÌ„ds from matter and also resisteth corruption An excellent mundificatiue easie to
a tale or rather a discourse as auailable to redresse the iniuries inferd by shot where the stripe is not mortall as the gun almost was to inforce the harmes wherein although diuers authors haue diuersly written euery one according to the model of his learning and experience as of the french Laurentius Iubertus and Botellus of the Italians Alfonsus Ferrius and Iohannes Vigo of the English Thomas Gale and William Clovves and sundry of other countries as euery man hath founde leisure and affâ—â—â—ion to trauell in a matter so needfull some laying open the nature of the wounds as well in concusion as dilaceration some deliuering the malignant and venomous qualitie proceeding from the mixture of the powder others leauing both these bestow their whole endeuour in the discouery of such medicines as to themselues or to such of whom they borowed their light might any way seeme fittest Among all which our Quercetanus as it werem a middle course betweene both lightly goeth ouer the causes and settles himselfe wholly vpon the cure in which as his method is exquisite so are his medicines singular the same for the most part agreeing in substance with those of Antiquitie but differing much in preparation for the which many condemne him as straying from the old beaten and knowne way but these men forget that artes which whilome were in their nonage haue grown in processe to a more ripe and perfite middle age and if they be not in time prouided for may easily decline as most things els do and fall into a dotage of such force and waight is and euer yet hath bene the due consideration of time and circumstance let vs shew our selues thankfull to such as pittying the imperfections of others seekes to furnish vs with better supplies And as Quercetanus with his owne countrimen and all that vnderstand the Latine tongue hath herein deserued wonderfull commendation so let me gentle reader that haue laid him as open to thee as he is to any other find thy friendly acceptacion and so much the rather because whatsoeuer I haue offended in the rudenesse of my translation in the diligent preparing of the medicines I heere promise to amende Many things not without great charge and painefull labour I haue already performed to these and diuers other hard cures not impertinent and if there be any thing else to make that to this Spagiricall art doth any way belong the learned or practitioned shall finde me ready vpon reasonable consideration to performe all and whatsoeuer my poore tallent can afford Iohn Hester A Sonet vpon the treatise of gunshot of the Lord of Morence and Liserable a Phisition and excellent Philosopher That Monk or Frier accurst may be that bent his wat so wickedly By salt peter and other stuffe through shot of Gun most cruelly To murther men at vnawares by sodaine stroke of bullet shot So as no force can now preuaile strength of men is quite forgot For where these engines come in place mens bodies there are rent and torne And many theÌ„ loose leg or arme bodies maimd are left forlorne But monsieur du Chesne we wel may blesse whose godly care and happie skill Hath found a mean to ease this grief how the rage of shot to stil Yea he the meane hath well set downe to heale all Gunshot with good speede Which was a worthy deed of his comfort yeelds to such as need Peter Enoc A Sonet to the Lord of Morence and Liserable Novv the hell and diuels all might him take Monke or Frier vvhat might he be That povvder and Gunshot did first make to torment men of euery degree Was not the force of svvord and fire and other engines vsde of olde Enough to fill vvarres bloodie desire but that nevv Esculape vnfolde This thundering torture nevv and strangc to spoile by chance and not by might Wovvorth that vvight that causde this change and altred so our kind of fight But monsieur du Chesne he may be said the helpe and succour of our age Who hath by medicines right assaid and easde of Gunshot all the rage Buttet To Monsiour du Chesne Baron and Lord of Morence and Lyserable VNgratefull should I be and void of nurtures lore If that I should neglect to make report Of vertues rare in you that beare such svvay As them to knovv may breed each mans comfort A Nurse the Muses haue you found and ye Proud ignorance haue striken such a blovv By your vvritings as learned graue and vvise And that your name for euer men shal knovv Not onely haue ye hereby done much good In shevving vvhatmen chiefly ought to shunne But medicines right ye haue set dovvne and hovv To cure all such as wounded are by Gunne F. Marchant groome of the kings chamber AD. LECTOREM QVOD QVERNEA CORONA A CLARISS IVRISC FR. Hotom optimo Iure authori sit posita Fortes fulmineis perituros glandibus istis Praesenti auxilio vis releuare viros Tot tibi quas Chiron tot quas Epidaurius herbas Monstrant ne tanto quaere labore proeul Nec Pergamem insignes Coiue medelas Arboris vnius sat tibi fructus erit Fertilis hoc fructu est pretiosas glandibus illis Quercus quae glandes obijcit ipso suas Quae tot frugiferas interfert nobilis arbor Et domino patriae munera tanta suae Quo nunc Naturae patriae cui iura coronam Decernunt quernam Zoile iure negas C L. Tex M. A TREATISE MADE BY THAT FAmous Phisitian Iosephus Quercetanus and intituled his Sclopetarie wherein is contained the perfect curation of such wounds which comes by shot of gun or by any other engine of warre CHAP. 1. Sundrie disputations of the essence of woundes by shot and of the venome and blasting ioyned therewith IT may be it will seeme superfluous to some that I haue thought it conuenient to set out this Treatise of curing woundes by gunshot of the which diuers and especially that excellent phisition Laurentius Iubertus hath verâ—e lately so diligently and fully written that there is not let passe anie thing that pertaineth to the essence or nature of such wounds The which being found out and knowne presently the chiefest and truest way of curing is shewed and that same did that learned man Iubertus moste excellently and orderly set out in his booke but y t causes why I was not withdrawn by the authoritie of this man from my pretended purpose chieflie was the burden of inconueniences of these woundes which we intend to treate of next a naturall desire from my birth placed in me of the immortall God to bring as much as in me â—teth some helpe to mankinde and especiallie to mine owne countrimen for whose sakes I haue also published this litle booke in the French toong wherein I doubt not but that I shall bring to light some excellent remedies neither knowne to those which wrote before me neither yet to the common people the vse of which I
haue learned both of excellent Phisitions and chyrurgions partly when I trauelled in sundry dominions of Europe and partly by the familiar companie which I had with most skilfull Phisitions abroad in the campes And first I will set downe my opinion concerning the essence and nature of such woundes the which question by the consent of all that haue written thereof is the mincipallest Batallus Iubertus and Paraeus haue deliuered to vs that the hurts by gunshot are accompained with two inconueniences that is they consist of solution of continuitie and brusing with rending oftentimes of the muscles vessels and flesh to the which manie accidentes dâ—o come the which beâ—ng diuers must needs haue diuers intentions of curation These are the two sortes of inconueniences of the which by disputation they haue agreed on woundes by gunshot to consist and therefore they haue set downe two kindes of remedies one wherewith the partes so torne and wanne are holpen that is the flesh sinewes lygamentes tendons ioyntes and bones and that by meanes of the bruse the which may come to passe without anie manifest wound at all and of the Erccians is called Ecchymoosis yet not without daunger but oftentimes subiect to great accidentes and manie times hath great effusion of bloud betweene the muscles which when it is shed out of the vaines presently putrifieth also great aches which are accompanied with great fiuxe of humours diuers swellinges inflamations and at the last Gangrena and mortification of the part affected The other sort which comes with a manifest wound is more daily seene and the deeper and greater it is so much it is thought the more dangerous because the shot whether of lead or brasse the more vehementer it goeth in so much the more it bruseth the parts in which it entreth by the which cause the bloud is congealed which falleth in the hollownes of the wounde and filleth the orofice of the veines and hollownes of the other partes then being destitute of his natur all heate the which being quenched and mortified by the resolution of the spirits by reasoÌ„ of the paine tearing of so many parts it goeth againe to the spring heade that is to the heart by reason of the feare which is takeÌ„ with the deadly hurt it becomes of a wannish leady colour like to that which the common sort calleth Asure the which is easily rotted and easily doth rot the parts adioyning and especially the Spermatical the which according to the opinion of our auncesters is easily turned to quitture and that the easier and speedier this fleshe being brused and dead may be separated from the quicke and liuely flesh the Chyrurgions doe commonly vse remedia suppuâ—aâ—tia mollientia the vse of which althâ—ugh it bee 〈◊〉 vsed in common bruses yet in these hurts it may not be followed without graue waightie considerations and especially without consideration had of the body time and part for in so much as these woundes doe easily admit great store of putrifaction so that manie times wormes are ingendred with intollerable putrifaction it is not to be doubted but that by the vse of suche medicines which by nature moue putrifaction the griefe is increased and augmented through euil vapors wherewith the principall partes that is to say the heart the braine and liuer are molested whereof come crampes and phrensies with continuall feuers and so commonly death followeth But this happeneth for the moste parte in bodies filled with euill iuice whose flesh when it is agreeued through putrifaction of the bloud it is no maruell if the wound be verie dangerous and verie hard or not at all to be cured In this case the disposition of the aire and heauens is to bee considered and also the qualitie and state of the member hurted Who also doubteth but that through the entraÌ„ce of the South winde into the hollownesse of these wounds whereby naturall heate is weakened there is great occasion to increase the putrifaction and generation of wormes which is seen by dayly experience that I may ouerpasse the authoritie of Hipocrates lib. Apho. 3. and in his booke de Epid. which also he signifieth in another place where he teacheth that drith is more healthier then moisture and so all corruption to come of ouermuch moysture as it were of his proper matter And to this purpose also it shall greatly auaile vs to haue a perfect knowledge of the temperamentes of partes for wounds in the head bottome of the stomacke and other moyst partes and therefore more apt to putrifaction although they be bruised doe require of vs the vse of suppurantia but yet not without great iudgement and heede taking for because in this case great hurt doth often come through the vnskilfulnesse and rashnesse of the Phisition neyther at anie time shall the Phisition be excused although he see the wound verie muche stinking which is alwaies an euill signe or berayed with stincking matter and wormes which may come to passe in one day by reasons afore alledged yet I say he may not vse medicines called commonly Digestiues although he reason that it is a brused wound therefore must come to suppuration because these incommodities drawing on we must presently haue recourse to such medicines as resist putrifaction that the moste dangerous accidentes may be preuented which are threatned by that which is said before that is to say Gangrena Sphacelus and mortification of the whole members Such medicines are the salts both mettaline and meane minerall drawne out especially of copper iron mercurie vitriol sulphur arsnick and orpiment as we shall declare in such place where we shall intreate of curation for these saltes hauing the office of an exterior Baulme doo by their heate and subtlenesse cut and make thinne thicke humours which doo choake naturall heate and doo by their saltnesse and sharpnesse withstand putrifaction they doe defend the wound from Gangrena and mortification and doo prepare the way being mixed with meet medicines as hereafter shall be declared to an easie and short curing and that without paine Farre better medicines surely then simple precipitate commonly prepared or Egiptiacum that specially which hath arsnicke and sublymate in it or such like whose common and dayly vse I can scarslie allowe by reason of the great paine which they bring to the patient of whome we ought to haue a great and speciall regard the which incommodities may easily be auoyded by a true and apt spagiricall preparation which will be a great solace and comforte to the sound patient Hitherto concerning the first remedies which are appointed to the first intention that is to the restoring of members brused torne in which â—ase it â—ehoueth to be a wise warie phisition in altering the medicines and applie them as occasion do serue to sundrie affections and sodaine mutations that so it be foreseene in all the whole sickenesse as Galen also hath taught The second kinde of medicines which serue to a more
extraordinarie aches and also with inflamation and pricking and shooting paines especially about the wound with vnlustinesse and heauinesse of all the whole bodie and many times burning feuers with sounding and alienation of the minde all these doo testifie that there is some venemous qualitie ioyned with the wound especially when there can no manifest cause be found out by y e Phisition whereof all these euill accidents should proceede which sometimes I haue seene to happen in simple wounds yea without the tearing of any sinewes But more certainer signes of this matter may be if any tokens appeare outwardly which may bee learned at the mouth of the patient and by relation of his familiar friendes and companions considering also the manner the place and the person being wounded But the surest signe of all is learned by the bullet if it may be found for if you cut him in two parts you shall see him darke and mixed with a purple and violet colour vnlike to the colour of other shot being cut which is wont to haue a yealow colour Then maist thou surely affirme that the shot was poisoned whereby the very substance thereof was altered as plaincly is seene by his inward colour which is greatly altered wanne and darke as we said before Proofe thereof also may be made in the fire which was said not rashly to haue great force in purging of all poison Because such things which are strong poison in deede doe consist of a spirituall and ayriall substance and therefore by force of fire doe easily vanish into the aire yet not with a smal heate such as is felt in going out of y e shot as Ambrosius Pareus thought which rather in processe of time woulde fixe it and make it not volatle and so consequently vnhurtfull But by a most strong heate of fire such as they vse in subliming for in that force of fire y e mercurie is eleuated and vanished away so likewise is the Arsnicke orpigment and such other spirits and for that cause they cannot be purged except they be pressed in the cold necke of the subliming vessels and so the suspected bullet being melted and kept in great heate a sufficient time then a darke and stinking smoke ariseth couering the mettall of which smoke or fume you must heware which after the melting is found not onely vnpurged but also appeareth blacke wanne and darke which commeth through the venemous fume spreding it selfe about the mettall and this is an infallible signe that the shott was poysoned whereby the wound may be venomed as I said before and that according to the time as it remaineth in the wound These be the signes whereby a poysoned wound is knowne which are the more dangerous to be iudged the more they doe weaken the strength of the patient Likewise blistering bladdering pricking paine drinesse contraction and hardnesse of the skinne doth manifestly shewe that the wound is also burnt with powder the which may be learned more surely by relation of the wounded person which can commonly declare whether he ware wounded nigh or farre off which also may be gathered by the burning of the vesture and it behoueth the Phisition to take heede diligently of all these thinges because they are of great waight and may bring great hurt to the wound and hinder greatly the curation thereof and through aboundance of fiures and other grieuous accidents which commonly insue vnlesse timely with wholesome medicines they be preuented as Galen commandeth in 4. Met. cap. 5. where he teacheth the maner of curing of an vlcer ioyned or coupled with another griefe not as the curation of a simple vlcer but first that affection must be remoued and then the vlcer to be cured Of the iudgement Furthermore a sounder iudgement in this case may be giuen by a heedie consideration of the saying of Galen written in his method where he teacheth that diseases may be dangerous for three causes first by reason of the worthinesse of the part affected secondarily through the vehemencie and strength of the griefe lastly by the malignitie and euill qualitie of the disease Therefore if the spirituall parts or if the braine and especially the substance thereof be wounded it is deadly Likewise the lunges the midriffe the stomacke the splene and kidnie being wounded doth cōmonly bring death for they also by reason of their offices are reckoned among the principall partes of no lesse ieopardie are the wounds of the guts especially in the smaller where there is no fleshe also in the bladder which cannot be aglutinated because they are vnbloudie parts and likewise woundes wherein the head or stomacke is pearced through are counted verie dangerous and the more greater and deeper y e wounds be with tearing of the sinewes and brusing of the bones so much the more dangerous they are and especiallie those which happen in the head with fracture of Cranion and also suche as be nigh the ioyntes through great and vehement accidentes insuing hereon but woundes ioyned with venome although in shew they be but small yet are they moste dangerous because by the contrarie substance excessiue qualitie thereof not onely the naturall disposition but also the verie substance of the bodie is altered and changed and especially when the wound is with breaking of the skinne which by thicknesse thereof doth defend the flesh which otherwise it woulde so that the poyson be not subtill that the contagiousnesse thereof doth not infect the bloud spirites and humors and consequently the principall partes whereby death commonly insueth Moreouer all these woundes are to be counted the more dangerous in case they be accompanied with euill accidentes and great passions and also the passion filled with euill humours and so much the more if at that time anie common sicknesse doth raigne in the campe caused by the aire whose qualitie although it be simple and not subiect to putrifaction yet oftentimes it bringeth great alteration to the qualities being infected with noysome and stincking fumes which oftentimes comes to passe in great hostes and chiefly in that part which is molested with composts and dead carcases of beastes and men from whence arise the noysome stincking fumes whereby the souldiers are afflicted also vnstablenesse of the weather comming with tempestes doth greatly hurt these woundes and oftentimes put the partie in great hazard and chiefly when a drie winter goeth before with northen blastes and a wet spring insueth with southerly windes through which many grosse humours are ingendred which with that vnstablenesse of weather are stirred and corrupted and the euilenesse of the aire ioyning therewith bringeth forth pestilent and burning feuers with inflamacions Gangrena and mortification yea and at the last death it selfe as Hipoc witnesseth in the third Aphorisme in lib. Epid. Neyther may we ouerpasse the loose and vnorderly kinde of dyet vsed not onely among the common souldiers but also with the Captaines rulers legates and protectors Which oftentimes are inforced to take such
good iuice and light of digestion The poorer sort may eate broath made of Mutten and Veale and of a Chicken if they be able boiled with raisins and prunes or such like as their ability will extende and let them forbeare grosse meats of euill iuice and hard of digestion and all water fowles and beasts and especially pigge flesh and salt meates and others that be sharpe and all kinde of spices let them drink Prisan Hipoc water and such as are sanguine or cholericke may vse onely water filtred and boiled let others especially such as before were not vsed to drinke wine delaide with water haue thinne Claret delayd with water and that in the beginning if so be y â— there be no feuer or inflamation and as concerning labour or rest let this Italian prouerbe followed La gamba al'letto la man al pecto with the aduise of Hipoc lib. de vlcer which saith that rest is verie meete for all wounded persons and labour hurtfull and therefore the Phisitions doo very foolishly in in commanding exercise of bodie to them that haue neede of suche rest and quietnesse that oftentimes they cannot moue themselues for paine but in steede of exercise they may vse frication on the whole partes and contrarie side and then they shall doe the office of medicine hauing vertue of keeping backe and shall turne aside the fluxes of humours comming to the affected member and also drie vp superfluous moistures ingendred by rest as Hipocrates hath taught lib. de Diaeta And as for sleepe let it be granted when nature seemeth to require it for sleepe in all diseases is verie necessarie to concoction and doth reuiue y e strength lost and decaâ—ed by bleeding paine and other passions yet heede must be taken that if the wound be inwardly and venomous the sleepe be not to large least thereby plentie of humours flowe to the affected part for the bloud with sleeping is alwaies drawen into the bodie Moreouer all vexations of the minde are verie hurtfull and especially anger which troubleth the stomacke and causeth the humors to be more thinner and subtiller whereby more aboundance of fluxis comes to the affected part and manie other euill passions and accidentes I haue willingly passed ouer repletion and emptinesse in that I meane to intreate of them by themselues and so without repetition to declare my minde CHAP. IIII. Of the second intention that is of purging and euacuation of humors by bloodletting and purgation NOt rashly and without great cause did Galen in his Method call to remembrance and highly commend this noble saying of Hipp. Medicum opportere non modo naturae imitatorem esse verum etiam eoru mque cum sua sponte eueniunt conferunt For it is y â— office of the Phisition to supplie the wants of nature and to preuent such hurtfull accidentes as may happen thereunto and that by indications taken of the waightinesse of the griefe the which I find to be two that is bloudletting and purgation both of the which are very necessarie to the curing of wounds by shot which for three causes may iustly be reckoned among most dangerous and therefore it is verie necessarie to drawe bloud in the curation of these woundes that in the verie beginning that so thereby the fluxe of humours in the wounded part be stayd and impostumation kept backe neither must we stay for the digestion of the wound and deferre it till the beginning and state thereof be past as Auicen thought whose opinion is not onely against all reason but also contrarie to the authoritie of Hipocrates who teacheth that if any thing is to be moued it must be done in the verie beginning Moreouer this bloudletting must be done in y e contrarie or opposit part then especially when it is not doubted that the shot was venomous which if it should be then is reuulsion forbidden for the venome is to be drawen out by scarification of the wound it selfe or a little belowe and partes about it taking heede that it creepe not farre as his nature is to the noble and principall partes as more at large we will declare when we intreate of the curation thereof The fittest time for letting of bloud is the morning except we be forced otherwise eyther by ouermuch fluxe of bloud or anie other accident and before we doe it it shall not be amisse to minister a glister to lose the belly and also in letting of bloud we must not onely weigh the greatnesse of the wound but also the fulnesse of the whole body and according thereunto limit the quantitie of bloud eyther more or lesse neither must wee forget to consider the age of the patient the time of the yeare the nature of the place diuers other things which must be committed to y e iudgement of the skilfull Phisition which may wisely weigh y t which is written by Galen lib. De missione sanguinis Purgations are no lesse necessarie in the curing of these woundes then is bloudletting for two causes the one the greatnesse of the griefe the other the aboundance of ill iuice which may be gathered by these words of Galen writteÌ„ lib. 4. Meth medendi Purgatio non in sola cacochymia conuenienter suscipitur sed sicut missio sanguinis vel propter ipsius abundantiam vel propter morbi magnitudinem ita purgatio propter abundantiam alteruis cuiusdam succi propter vim morbi adhibetur Neyther are they blamelesse which contemne this way of curing as though it were little oâ— nothing pertaining to cure woundes by shot when as both reason and experience shew the contrarie to those which following Hipocrates and Galen as captaines haue set downe a methodicall and orderly curation of such woundes for purgation saith Hipocrates is profitable for diuers vlcers Preterea vulner ibus capitis item ventris tum inferioris tum superioris atque etiam articulorum And he addeth also quae exeduntur quae serpunt quae diuturna sunt etiam quaecunque obligandâ— sunt per aluum purganda esse The which remedie must by and by and at the verie beginning be vsed yea immediatly after the letting of bloud partly that we may auoyd the humors following to the afflicted part by the contrarie way which the Grecians call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 as if the wound be in the ouer part we must purge by the lower part and if in the lower part wee must purge by vomite and partly that thereby wee drawe away the humors imimpacted and sticking to the wounded part and sides thereof by deriuation as both Hipocrates and Galen hath taught But if anie will alleadge by the authoritie of ancient Phisitions that purgation is not necessarie to healthfull bodies and suche as abound not with excrementes as commonly the bodies of souldiers be otherwise they were not able to sustayne such great labour and that they verie greeuously abide purgations and therewith are brought into swoundinges and
for such keepe in and driue backe and not draw out the fire and doth driue it more into the parts and increase the griefe and especially vineger which they commonly vse for with his astringent vertue it stoppeth the pores and keepeth backe the fiuxe of blood as Aetius writeth For rather brine or salt-water dooth presently draw on the burning and fire of such wounds and doo aswage the great paine and keepe backe blisters if the burned part be presently couered with a fine cloth wette in salt water But Oribasius and Paulus haue thought good that burnings were to bee cured with clensing medicines and therefore they haue commended terram Chiam Cimoliam and Creticam and all other light earth being tempered with vineger being not sharpe The late writers commend an vnguent made of lime seuen times washed and tempered with oile of Roses and applied to the griefe Other haue recourse to Walwort boiled in wine and made as a Cataplasine and to all such medicines which by heate may draw out the burning from the slesh and by this reason the fire it selfe if the part burned bee holden thereunto becomes aremedie to cure his owne hurts for in opening the pores it draweth out hte fire and ceaseth paine but wehaue oftentimes to our great profite vsed these medicines following Anvnguent for common souldiers to quench the burning and keepe backe blisters Take oile of elders and of nuts ana â„¥ ii oile of egges â„¥ ss harts tallow and marrow of a bull ana â„¥ i. two Onions rosted a little Waxe make of these an vnguent and lay it to the part affected Another for the same of great vertue Take of oile of lard and oile of butter ana â„¥ ss the iuice of the berries and leaues of Iuie â„¥ ii the iuice of the middle rinde of Elders â„¥ i. oyle of elders â„¥ iiii salt peter zii boile them altogither till the water be consumed and with a little waxe make thereof alinament which is of great force to take away burnings Also this water following is most excellent for the same purpose A water against burning Take of the fieame of vitriol and allome ana lb. ss the flowers of tapsus barbatus leaues of blacke Iuie ana m. i. sâ—afles frogges and crafishes ana numerox distil them in a leaden limbeck with somewhat a strong fice and wash the burned place with this water fiue or sixe times a day Likewise the water of sperma ranarum mixed with the fieame of vitrioll is very good but there cannot be found a more excellent remedy to quench the burning heate of pouder theÌ„ this lynament following for it putteth away all inflamations and alâ—wageth pâ—ine and the rich may vse it An excellent lynament Take salis saturni saccharini â„¥ i. oyle of yolkes of egges â„¥ ii buttâ—r prepared â„¥ iiii mixe them and make alynament wherewith annoint the bin ned place thrise or foure times a day and lay this defensiue following to the parts about it to withstand the fluxe of homors and inflamation Nutritum Magistrale Take of the iuice of henbane housleeke and water lilies of ech â„¥ ii water of the sperm of frogges and flowers of Mullein ana â„¥ i. Wharge or his salt which is better â„¥ ii oâ—se of visci pomorum and Rosâ—omphac ana â„¥ ii ss vineger of Roses â„¥ i. teÌ„per them long in a leaden morter with a pestill of the same and make it in forme of Nutriti and vse it for a defensiue These are the locall medicines which are necessary for such burned woundes but in so much as these inconueniences are wont to happen to bodies being sicke and filled with euill iuice and weake of strength which are subiect to all mishaps as to great paine and inflamation whereof feuers may grow and so death follow For so old patched and rotten shippes doo soonest giue vp in a tempest In which case wee must haue a care that a good order of diet bee kept and also if neede require purgation and blood-setting all which things are to be committed to the iudgement of the skilfull and wise Phisition who may prudently presage what will be the ende of the griefe not to neglect that which is great neither to make that great which is little least it should seeme that he hath done more then neede and this thing according to Celsus minde must alwayes be looked to least that griefe which is of it selfe being small be made great by the negligâ—nce of the Phisition CHAP. 1. A perticular curation of these wounds and also of the accidents happening thereunto Of vvounds vvith fracture of the bones THe curation of such wounds is commonly iudged more difficult if so bee it bee ioyned with fracture of the bones and that not without great cause especially if the greater bone as of the leggs and armes bee so broken that the marrowe goeth out which cannot be without great perishing of the sinewes vaines Arteries the which bring life feeling and mouing to euery part and that being kept back the member must needs perish commonly death ensueth Whereunto the Phisition or Chyrurgion ought so much the more to looke by how much the more the number greatnes of accidents shall increase that he may let nothing passe which doth pertain to the perfite â—uratio therof And it is better to attempt that with excelleÌ„t medicines theÌ„ by vtter desparation by a heauy sorrowfull meanes â—o cut off the member and especially in the beginning when as yet Sphacelus is not growen and that I haue not spoken this without a cause the workes and myracles of nature may teach vs the which she oftentimes brings to passe being furthered with meete medicines and deceiueth the iudgement yea of the learned the which with these eyes I haue oftentimes seene to haue happened in the tentes at this last warres and among all the rest a certaine noble man named Brosseus whose arme was so torne by a great shot that it missed but litle of breaking of y â— head which is fastened on the bones named Omoplat which was the onely cause why the Chyrurgions did not cut it off but they meant shortly to doo it for feare of Sphacelus but it fell out that the pacient recouered whom they iudged past helpe in that the wound was accompanied with such euill and sundry accidents yea and his arme saued that he is able to doe any thing with it I haue thought it good to set out this ensample to the younger Chyrurgions that thereby they may indeuour themselues by all meanes rather to preserue the hurted member then to beginne their curation by taking it off which ought not to be done before it is plainly perceiued the member to be come to mortification and then let it be done by due warning and prediction some wil obiect that in the beginning the strength of the paâ—ient to be of more force also to sâ—â—â—er better the taking off the which by the greatnesse of the griefe dacayeth
is no inflamation or anie other euill accident that thereby the rest of the whole bodie may be saued But first let the Chyrurgion declare such daâ—gers as are requisite to be told of neither is it to be doubted that auie lesse diligence is required then danger appeareth especially when the bones of y e shoulders or hip be burst which neuer happenetâ— without great tearing of the muskles and â—lso of the vaines and other partes where hence commeth commonly sodaine coâ—ulsions inflamations Gangrena and at the last mortification for if there are to be found of the antient Phisitians which would in no case meddle with y e onely rupture of these bones yea some willed the wounded member to be cut off when the bones but hanged out of y â— flesh what would they say now I pray you if they saw these horrible ruptures which happen coÌ„monly through y â— violence of this deadly and diuelish tormentes the whiche dayly is so increased by the wicked and naughtie deuises of some that almost there cannot any medicines be found to cure it nor any harnesse sufficient to defend it but as concerning this heauie and sorrowful remedie which is y e disineÌ„bring the member we shal haue a fitter place to intreate of it in the chapter of Gangrena and Sphacelus For nowe we will goe to the other remedie which is more profitable and better and is done by manuell operation as they tearme it and must be assayed by all meanes as wee haue sayd in the beginning of this chapter To which purpose the Chyrurgions set downe two intentions whereof the one respecteth the rupture and willeth as nigh as may bee that all the broken bones be reduced to their naturall seates which being done she commandeth the whole ioynt to be rowled and pressed with linnen clothes wetted first in some conuenient liquor to keepe backe all accidentes the which some allowe at the first dressing that the vnetion may be the surer and woulde not haue it quite vndone till fortie dayes be expired but to lose it and binde it harder in the meane space as neede shall require except it be through intollerable itching inflamation paine or such like and to remedie suche they prescribe an orderly dyet or bloudletting or operation or suche locall medicines as shalbe thought meete The other intention respecteth the wound and forbiddeth that it be hid and rowled so fast as is vsed in fractures in that it requireth to be dressed oft that the filth and excrementes whiche nature expelleth may haue issue and for that cause some vse straightwayes setones as they tearme them if it may easily bee put in the wound which they annoint first with meete medicines And some vse onely tentes and if neede require they also amplifie and inlarge the orifice thereof and likewise the lower partes whereby all filth and baggage may issue out the better and so the parts are broughtin a better case easier to be cured Likewise they dayly diminish their tents making them shorter shorter whereby y e wound may heale the better and incarnate the faster to which purpose they vse medicines meete for wounds by shot of which we made relation in the former treatise Moreouer to finish this last intention they haue a great regard to charge the patient to vse meates that are iuicy and good and such as conglutinate till such time as Callus is growne and chiefly because the nature of those woundes is suche that they seeme to tarie for the consolidation of the bones This maner of curing is vsed nowe adayes of diuers Chyrurgions when y e bones are fractured whose iudgement I could not but highly commend because they haue of their sides the opinion of moste excellent men which haue and doe vse the same maner of curiyng were it not that the thing it selfe and also experience did plainely teache me and as it were set before my eyes the innumerable inconueniences which happen through these splintes and hard binding for they oftentimes bring accidentes as paine inflamation and Gangrena whereunto these kindes of woundes are greatly subiect also they hinder the exhallations of these humours which in these woundes abound and oftentimes choke naturall heate and do hinder the knowledge of manie greeuous accidentes and letts that remedie therefore cannot easiâ—y be ministred as it ought except it be when it is too late when they are compelled to loose these round and crosse bandes which is done then perhaps when these commodities haue so taken hold that they cannot wel be remedied as they might if in time they had bene looked to wherefore these vulgar and common ligatures meet only for fractures by my iudgement is no wayes to be vsed in woundes ioyned with fractures and especially in those which happen by shot and ioyned with fractures as may be gathered by reasons before alledged in whiche case it behoueth the Chyrurgion to be carefull least he do any thing wilfullie and rashly which after too late he may repent Nowe in my iudgement I thinke it best that the bones by and by before inflamation be ingendred be brought in their seate and naturall forme with as little paine as may be to the patient and then to vse such medicines as are profitable to both inteÌ„ctions that is for the wound fracture and because I haue seene the verie same order vsed of most learned and skilfull Phisitions being of mine acquaintance aswel in Germany as in diuers other places I thought it not good to passe ouer this order whiche they are woont to holde and followe in curing wounds with fracture especially because I iudge y â— it is most meet for woundes by shotte in that they discommend this common and hard ligaturs or binding for no other cause but for the paine inflamations and Gangrena whiche commonly comes thereby whereunto those woundes by shoâ—t aboue all other as we sayd before are most subiect therefore so soone as the bones bee brought in their due places and the member rightly placed as it ought and the wound dressed spred this Cerote following on a linnen cloth first wet with oxyrhodino and lay it about the wound for it is very good for all fractures Take Rosen waxe ana lb. i. pul cort tilia â„¥ iii. succi geranij â„¥ iiii boyle them to the thicknesse of a cerote and vse it Another vvhich I alvvaies vse my selfe Take the gumme of the rotes of Comphery and vsci pomar and popul ana â„¥ iiii suc ci geranij â„¥ vi lapid sabulos Rhenes or Argill rub or els bole armeny â„¥ iii. pul cort tiliae â„¥ ii xx yeolkes of egges turpentine lb. ss oyle of wormes â„¥ iii. boyle them all together to y â— thicknesse of a cerote it is an excellent remedie for all wounds with fracturs and to asswage paine inflamations and other accidentes let it be changed euery xxiiii houres at the beginning and in a fewe dayes you shall see miraculous effectes in consolidating the bones In