and if it be where there is a double Bone as in the Leg and below the Elbow the Flesh and Ligaments between them is to be divided which being performed let the Bone be separated with a very sharp Saw If the Flux of Blood be not great to apply only those Medicines that stop Blood will be sufficient but if great an actual Cautery is to be used which is only to be applied upon the great Vessels then let the Ligature be taken off and the Part be fitly bound up If either the Patient or Chirurgeon be averse to the use of a Cautery then as soon as the Member is taken off let the Skin together with the Flesh in four distinct places opposite one to the other be taken up with a Needle and waxed Thread and the Ligature being loosened above or drawn down that if possible they may meet So by this way is the Hemorage staid the Bone preserved from all danger and the Wound sooner cured But this way is painful and troublesom therefore ought it the seldomer to be used Aquapendens his way When the principal design of Art in this Operation is to put a stop to Putrefaction to cause as little pain as may be and to stay the Flux of Blood all which the above-quoted Author thinks may be done if the Member be amputated in the dead Part but near to the sound then the Bone being divided with burning-hot Irons let the remainder of the dead Part be cauterized till the Patient perceive the heat of the Fire So he writes that by this course a Flux of Blood is not to be feared less pain is caused and within the space of two or three days will appear a separation of the Mortified Part from the Sound but in my opinion we ought to consider well of the Cause For in a Spacelus sprung from an Internal Cause in a Body otherwise sound this way is the best but in a Spacelus caused from a defect of innate Heat the former is more profitable CHAP. XXV Of the Fleshy Rupture SArcocele which is a Fleshy Rupture is a Tumor besides Nature produced from impure Blood flowing in too great quantity itno the Testicles and there degenerated into Flesh In this Definition received by the best Physitians and Chirurgeons I note two things 1. The cause of this Tumor not to be impure Blood seeing the best may produce it not simply abounding in quantity because it also happens in wasted Bodies though 't is not so soon generated nor arrives to such a greatness in these as in those Bodies but the true cause is the Erosion Rupture or Dilatation of the Membranes which close the Mouths of the Capillary Vessels that the nutritious Blood may not flow too suddenly into the Part from whence more Blood flows into the Part than what is required for its nourishment and Nature changeth that Blood which otherwise would purifie into a fleshy Substance 2. This flesh sometimes grows to the second of the common Tunicles of the Scrotum and not to the Testicles in which case it may be taken aways without either hurting or cutting of them out Signs are the hardness and slow encrease of the Tumor which is rather more troublesome than painful except accompanied with sharp Humors no appearance of any Tumor in the Groin Prognosticks A Sarcocele is hardly cured by the help of Medicines and seldom by manual Operation without taking off the Testicle if it extends it self into the Groins for the most part incurable Cure In the beginning when the Membranes of the Vessels being eroded broke or dilated do give leave for too much leave to issue forth Bleeding and the use of Repelling and Restringent Medicines profit much but when it hath begun to augment then we may use these following means Let there be made a little Orifice into the Scrotum rather in its Superior then Inferior Part through which by the help of Plegets let Suppurating Medicines be applied so that if possible to waste the Flesh every dressing diligently wiping away the Matter but not at all that the remaining Flesh may be the better consumed If these things succeed not draw forth the Testicle and by Incision take off as much Flesh as may be done without injury to it then restore it again into its place and the remainder of the Flesh endeavor to consume by Suppuration But if there be no hope of curing this Rupture by the recited means draw forth the Hernious Testicle as far as you may then pass once or twice a Silken Thred above the Tumor by the Process of the Peritonaeum then pass both ends of the Silk through the Orifice it self so that which was on the right side may be on the left and that of the left on the right and having ordered that the process of the Peritonaeum may be tied with a knot then cut off the Testicle letting both the ends of the Silk hang out of the Scrotum and so cure it as another Wound I cannot here but friendly advise 1. The Chirurgeon ought to consider well of the Cause before he comes to the Operation it self for sometimes the Parastates are so swell'd especially the Testicles being Scirrhous that they may easily deceive a very curious Examiner 2. The Ligature ought to be made as near to the Tumor as possible for by how much the higher part of the Process of the Peritonaeum be perforated it is observed to be so much the thicker which thing will retard the Suppuration and the falling of the Thread in the mean time Convulsions coming on denounce death 3. The Spermatick Vessels detain'd in the Scrotum oftentimes by Natures variety exceed the Testicles themselves in greatness which causes no other inconvenience but only Fear which I have observed to be true in more than one CHAP. XXVI The Extraction of the Stone out of the Bladder THe Stone is a hard Body concreted from Slimy Salt or Earthy Matter by a peculiar Lapidifying quality causing Pain Obstruction and other Symptoms in the place where it is detained The Cause is a Pituitous Salt or Earthy Matter which neither by heat nor cold by a peculiar lapidifying quality is changed into a Stone Signs The Urine is white slimy crude and troubled suddenly adhering to the Urinal sometimes it is bloody sometimes sandy or gravelly sometimes full of little Threads and not seldom supprest a great thirst a frequent making of Urine but with pain and by drops The Patients place themselves with their Thighs across always holding their Privy-Parts in their hands pressing the bottom of their Belly the Privy-Part is always erected very painful to go or walk in the Region of the Belly a weight perceived the Patient seldom making Water without going to Stool the Intestine commonly falls out especially in young People Although all these Signs seem plain yet they may sometimes deceive a Phisician it was formerly the Custom with a Catheter passed through the Ureter into the Bladder then
set down to the which I refer the Reader The End of the first Part. BARBETTY'S CHIRURGERY The Second Part. Which treats of Tumors Wounds and Ulcers In three Books The First Book of the Second Part of Chirurgery Of Tumors CHAP. I. Of Tumors in general A Tumor besides Nature is a Disease in which the Parts of the Body are indecently inlarlarged and extended so that they are rendred unfit to perform its Actions The Differences of Tumors are taken 1. From the Part affected as an Inflammation of the Eyes Jaws c. 2. From the Causes The Causes are 1. The Parts of the Body removed out of their Natural place 2. The Four Humors as well Natural as Preternatural viz Blood Choler Phlegm Melancholy to which likewise we add Serum and Wind. Tumors for the most part are generated from the Humors and that either by Congestion or Fluxion They come by Congestion when the Natural heat of the Part being diminished the good Humors are ill concocted or the vicious are not sufficiently evacuated By Fluxion from a two-fold Cause External viz. a Fall Blow External Heat too great Motion c. Internal viz. Pain Superabundancy Thinness Acrimony of Humors c. The Signs of Tumors are an Extention of the Part Pain Redness Heat Hardness c. But these are better explained in particular Tumors than in general The times of Tumors for all curable Tumors have four are as followeth Beginning when the Part begins to swell Increase the swelling pain and other Symptoms are augmented State the Symptoms stand at a stay and grow not worser Declination when the Symptoms are diminished Prognostick Tumors produced from Phlegm or Melancholy are hard of Cure Those are dangerous which are generated from corrupt Blood or Choler which seizeth the Internal Parts which shew themselves about the greater Vessels Joynts Nerves and the Membranous or Noble Parts Those that are of great bigness and that happen in Cacochymick Bodies They are Terminated four ways 1. By Dissipation which the lessening of the Symptoms do declare 2. By Suppuration wherein the Pain and Pulsation is increased together with a Fever 3. By Induration which the too often and immoderate use of Repelling and Dissipating Medicines hath caused 4. Degenerating into a Gangrene from the defect of Natural Heat The Cure is performed two ways 1. By hindering any further Flux to the Part. 2. In removing that which is already gathered in the Part. We stay the Flux of Humors 1. By Intercepting 2. By Repelling 3. By Revelling 4. By Derivation 5. By Corroborating the Part it self The Matter already gathered is taken away 1. By Astringing and Repelling Medicines to wit when 't is thin and sticks not too firm to the Parts 2. By Resolvents when it is thick and adheres more firmly to the Part. 3. By Suppuratives when the other are too weak 4. By Fire and Cutting when other means effect nothing CHAP. II. Of Inflammation A Phlegmon or Inflammation is a Tumor besides Nature from Blood thrown forth into the Skin or Subjacent Muscles causing Heat Redness Pain Pulsation and Tension Difference 'T is Perfect when from Blood alone Imperfect when Choler Phlegm or Melancholy is mix'd with the Blood and then 't is called Phlegmone Erysipelatodes Oedematodes Schirrhodes The Cause is sometimes Blood alone sometimes mixt with other Humors Signs are Heat Redness Pain Pulsation Shining Tension Hardness Renitency Prognosticks An Inflammation of the External Parts frees the Internal from many Diseases always wholesome except from its too great Extention it produceth a Gangrene dangerous and of hard cure is that which seizeth on the Eyes Jaws Penis Pudendum Muliebre and Joynts In a young Person and in Summer soon cured longer of Cure in a fat than a lean Body The Cure hath four Indications The first of these respects a good Diet let him chuse a clear Air his Meat and Drink little and that cooling all hot sweet and fat things as Pepper and Ginger are hurtful as also the motion of the Body especially of the Part affected Sleep is very convenient All Costivenefs Anger and Venery are noxious Second that stops the further Flux of the Humor which may be performed by Revulsion Derivation Repelling and Interception therefore let a Vein be opened as soon as possible it being most necessary Revulsion is made in the Opposite and most Remote part Derivation in the nearest If you may not open a Vein you must use Leeches and Scarifications Whilst these things are done seeing the Body is seldom clean but that always there are ill Humors mixt with the Blood by Purging rightly used and often repeated as also Bleeding we effect much In the mean time the Part affected requires Repelling Medicines from which we must abstain Where 1. The Noble Parts send the Humors to convenient places and to the Glandules 2. Where the Humors are Malignant 3. When Critical 4. When the Body is very impure 5. When the part affected is very weak or painful 6. Where the Inflammation is about some Noble Part. Repelling Medicines The Roots of Bistort Tormentil the Leaves of Cyprus Mirtles Plantain and Oak the Flowers of Balaustians and Roses Quince-seeds Red Sanders Galls Acacia Dragons Blood Whites of Eggs Vinegar Red Wine Allum Bole Oyl of Roses Myrtles Empl. de Spermate Ranarum Take Rose-Vinegar two ounces Whites of Eggs beat together No. 2. Bole-Armenick three drams Lap. Hematitis a dram Mix them Take the Juice of Housleek Purslane and Plantane of each an ounce Rose-Vinegar sowr Red Wine of each an ounce and half Oyl of Myrtles an ounce Stir them together in a Leaden Morter adding to them of the Powder of Pomegranate Rinds and Bistort of each a dram Make it into a Linament 3. Indication requires the taking away the Humor already in the Part. Here Resolvents are first to be used but they not effectual then Suppuratives Resolvents or Discussives Roots of Galangal Orrise Dill Southernwood Rue Savin Flowers of Camomil Melilot Elder 2 Aniseeds Carraways and Cummin Ammoniacum Bdellium Sagapenum Tacamahac Oyl of Dill Nard Rue Bays Ointment of Agrippa Martiatum Emplaisters of Betony Oxicroceum Diachilon Leaven the Dung of Beasts Spirit and Lees of Wine Take Roots of Orrise Marsh-Mallows of each an ounce and half the tops of Wormwood Flowers of Camomile Melilot of each one Pugil Herbs of Pellitory of the Wall Mullein of each one handful Meal of Barley and Fenugreek as much as is sufficient Boil them in White Wine then being beaten together add of Oyl of Orrise and Camomile of each an ounce Make it into a Cataplasm Or Take Cows-dung three ounces Juice of Hemlock one ounce Oyl of Camomile half an ounce Castor two drams Bole-Armonick half a dram Red Myrrhe two drams Saffron one dram Meal of Lupines as much as sufficeth to make it into a Poultice Suppuratives Marsh-Mallow Roots Mallows Camomile-Flowers Figs Galbanum Bdellium Sagapenum Ammoniacum Fat of Hogs Geese Ducks Hens Oyl of White-Lillies Ointment of Marsh-Mallows both
is to be powred upon it and mixt with it but first it ought to he seven times rectified You must make this Conjunction in a Matrace a Glass-Vessel so called by reason of its roundness in the bottom and long neck and in a warm Balneum till the Calx hath imbibed its Spirit then in a Glass-Alembick you shall separate by Balneum whatsoever of waterish Humidity can be separated and there will remain in the bottom the Buttery Calx of Arsenick of great virtue which must be kept in a Glass-Vessel well stopt Take some of this Powder mix it with Basilicon or a Digestive and thus mixt apply to the ulcerated Cancer CHAP. XIV Of a Gangrene and Sphacelus A Gangrene is a beginning Mortification of the the soft Parts of the Body most commonly following a great Inflammation or ill cured Sphacelus Necrosis Syderatio is a perfect Mortification not only of the soft but of the hard parts also Differences In a Sphacelus the parts are altogether dead but in a Gangrene they begin but to die and the sense is not perfectly abolished there the Skin is first pallid suddenly livid then black here in a manner red greater stink in that than in this The Causes of both are six 1. The External Cold of the Air or Repelling Medicines 2. External Heat from burning or use of Corrosive Medicines 3. A Defect of Nutriment as in an Atrophia either by the compression or obstruction of the Vessels by reason of which straightness the Blood cannot pass to the Part. 4. The stopping of the Pores or Perspiration hindred from whence comes a Suffocation of the Natural Heat 5. Malign Humor either begotten in the Body or contractee from venomous Beasts or Medicines 6. The Scurvy which by a peculiar property causeth the Parts sometimes to mortifie Signs A Sphacelus is easily to be known the Part looks black Spungy Flesh Sense Heat and Pulsation abolish'd But the Signs of a Gangrene vary according to the variety of the Causes If contracted from Cold a great pricking Pain is felt in the affected Part First 't is red then pale at length black The Natural heat by degrees is extinguished and there happens a shaking not unlike that in a Quartane Ague If caused from an External Heat or stopping of the Pores the Redness is changed into White then into Black Pulsation and Pain cease the Senses lessened and at last there appear some Pustules from whence issue a gleety Humor If from defect of Aliment there is neither Pain Inflammation or Tumor the Body waxeth cold and for the most part seizeth upon the Joynts If from a venomous Creature or Humor great Pain and Fever always accompany it frequent Faintings and oftentimes Deliriums Here ariseth a Pustule under which appears a black Spot which spreads it self over the whole part If from the Scurvy it for the most part begins at the Toes it shews it self outwardly with blackish spots and lines which degenerates into a dry Crust upon which follows a Numness of the Part and at length a Mortification it self without any Stink Sometimes without pain other times very great especially in them that are given to Passion or Sadness Prognosticks Except a Gangrene be suddenly stopt it degenerates into a Sphacelus easilier cured in young than old People The Humors continually flowing to the part affected bring danger with them and that very great if they are Malignant In the Cavities of the Body to wit in the Mouth Privy Parts and Fundament c. a Gangrene is always difficult of Cure as also that which happens among the Nerves and Tendons in Hydropicks always mortal That which happens from the Scurvy may be spun out from many Months but seldom cured A Sphacelus is not cured but by the Knife and Fire Cure Diet must be good the Air Meat and Drink generally cooling and drying But seeing the Causes are various we leave it to the Physitian to prescribe what is convenient who also must well distinguish concerning Bleeding and Purging when to be used with advantage or disadvantage Sudorisicks and Cordials are of great use here and because that in this and other Diseases they are often used I thought it convenient to set them down in this Place Diaphoreticks or Sudorisicks Roots of Angelica Scorzonera Lovage Contrayerva Herbs Holy-Thistle Fumitory Scordium Harts Horn Unicorns-Horn Bezoar the Stone of an Indian Hog called Pedro Porco Waters of Threacle Alexipharmick Diascordium Threacle Mithridate Species Liberantis Antimony Diaphoretick Salts of Wormwood Prunella Holy-Thistle Rob. Sambuct Take Diascordium Farcastorii one dram Alexipharmick-Water two drams Holy-Thistle water as much as is sufficient Syrup of Limons half an ounce Make a Potion Cordials Waters of Roses Borage Bugloss Conserves of Rosemary-flowers of Roses Violets Borage Bezoar Harts horn Unicorns horn Confections of Alchermes Hiacynthus Rob. of Red Currans of Barberries of Scorzonera Roots Candied Citron and Orange-peels Candied Saccharum Perlatum Salt of Coral Take Water of Borage Bugloss of each two ounces and an half Alexipharmick-water three Drams Cinnamon-water two Drams Saccharum Perlatum half an ounce Confection of Hiacinth half a Dram prepared Crabs eyes two Scruples Spirit of Salt four Drops Mix them Let the Patient now and then take one or two Spoonfuls Externally Cupping glasses and Leeches but chiefly Scarification must be used although there are some of our Chirurgeons which altogether reject Scarification nevertheless happily curing their Patients by the following Medicines which resist Putrefaction External Medicaments against a Gangrene Roots of Angelica round Birthwort Herbs of Wormwood Holy-Thistle Tobacco Rue Colewort Germander Flowers of Elder St. John's Wort Mellilot Camomil Lye Brine Ink Urine Spirit of Wine Treacle Ung. Aegyptiacum Fuscum of Felix Wortz Horse-dung Some mix Hemlock in Plaisters or Poultices and use it with success Or Take the Tops of Wormwood Camomil and Elder flowers of each half a handful Leaves of Germander a handful and half Rue half a handful Crums of brown Bread seven ounces Horse-dung three ounces Boyl them in Brine in the end adding to them Ink two ounces Spirit of Wine three ounces Make it into a Cataplasm The sound part ought also to be preserved partly by keeping the Humors from flowing and partly by keeping the Gangrene from spreading For this purpose the Red defensive Plaister or the Cerot of Virgo is good as also this following Cataplasm Take Bolearmonick half an ounce Powder of Galls Cypress-nuts Pomegranate-rinds of each three Drams Barley-meal six Ounces Oxymel simplex as much as is sufficient to make it into a Cataplasm Or Take Seal'd Earth Bolearmenick of each half an ounce prepared Harts-horn a dram Camphire a Scruple Rose-vinegar an Ounce Oyl of Mirtles three ounces white of an Egg Make it into a Linament Cure of a Gangrene caused from Cold. The part gangren'd if not grown black but as yet appears very red with pain the Patient is to be placed at the Fire but not too near but at a distance
it remains for some time in the same condition 3. When it relaxeth so that it is restored into its former seat and quiet by its Antagonist The Glandulous flesh is white thick and spungy formed of seed from whence it cannot properly be call'd flesh to this purpose ordained 1. To prop up the Vessels 2. To receive the superfluous Humidities whence they are called the Emuâ—ctories of the noble Parts Some Anatomists make strange diversities of them but it will appear to any one that diligently enquires into all the Glandules that they differ not so much in substance as in their Use and Humor The Viscerous flesh or the Parenchemick is red hard convenient to prop the Vessels and to serve for many particular and various operations this is the flesh of the Lungs Heart Liver Spleen which shall be treated of in their places Chirurgical Considerations The Muscles are subject to many Diseases very many of which are of so little consequence that they shall not be numbred here some we have declared in another place the following require consideration oftentimes wonderfully exercising the patience and diligence of the Chirurgeon 1. An Atrophy of the whole Body oftentimes comes from an Internal Cause But if of the Finger Hand Arm Foot for the most part from an External Cause Thus a Fracture Luxation Contusion Tumor too hard Ligature and the like so vehemently compressing the Veins and Arteries that it hinders the free passage of the Blood to the Parts upon which happens an Emacitation for where the Vessels are wholly divided or stopt so that the least quantity of Blood cannot be carried to the Parts there follows not a Wasting of the Part but a Mortification in this Case the External Causes must be removed And care is to be taken that the Blood may again be carried to the Part Here chafing the Part and the use of Nettles as many will is good the Chymists commend much Alumen Plumosum all hot Oyls likewise are here good and this Oyntment is of excellent vertue Take fresh tops of Savin Juniper Lovage of each two handfuls Camomile Flowers Juniper-berries of each two handfuls Oyl of Bayes White-Lillies of each twelve ounces Hogs-grease three ounces Dogs-grease an ounce and half Aqua vitae two ounces Boil them to the consumption of the moisture then add to the express'd Liquor Oyl of Spike three drams Juniper a dram Mustard-seed in Powder half a an ounce Roots of Pellitory of Spain Long-Pepper powdred of each two draws Yellow wax as much as is sufficient to make it into an Ointment Or Take Pulvis Amianti three drams Roots of Pellitory of Spain a dram and half Castor Euphorbium Oyl of Earth of each two drams Gum Ammoniacum an ounce and half Laudanum and Wax as much as sufficeth to make it into a Plaister 2. The true reason of the generation of Wens in my opinion is this the mouths of the Arteries appointed to carry nourishment to the Muscles sometimes are more opened than they ought to be whether it be by Fall or Blow or from an internal Cause especially in Plethorick People and in Parts disorderly moved the native heat converts the extravasated Blood into Flesh But seeing the Member requires not so great a quantity of nourishment it increaseth into a preternatural Swelling and if this Blood be impure Choler produceth Pain Phlegm Viscousness Melancholy a Cartilaginous hardness and 't is to be attributed to these Humors that this preternatural flesh is more yellow white or livid 'T is seldom included in a proper Tunicle except where Phlegm is its greatest Cause and then those Tumors are generally in the Neck The Veins grow big according to the increase of the Tumor so that under the Skin they appear as thick as ones Thumb 'T is not in it self malignant yet by ill applications may be easily made so Air is very hurtful if the Tumor be exposed to it For the most part the best Remedies are here used to little purpose on the contrary the Tumor more and more increasing You cannot promise any Cure except you take it away by a Thred Knife or both In the beginning the Medicines that are to be applied ought to be very astringent and repelling the Part is gently to be rouled having applied to it either a Plate of Lead or a Diachalcitheos Plaister or of Frogs with Mercury or the following Take Pomegranate-rinds Bistort-roots of each one dram Scales of Iron Quick-silver Burnt-Lead of each two drams Bole-armenick Lapis Haematitis of each a dram and half Turpentine Wax as much as is sufficient to make it into a Plaister according to Art In the mean time Purging Bleeding Scarification and the Application of Leeches are not to be neglected Sweating also Watchings and Abstinence profit very much But if the Tumor yields not to these Remedies but daily increaseth Suppuratives are to be applied but if these within few days effect nothing and the Tumor continuing in the same state an actual Cautery may be used which let not the contrary Opinions either of Chirurgeons or standers-by hinder for by its use the increase of the Tumor will be stayed for a long time yea sometimes the Disease will be wholly eradicated But if the Flesh begins to repullulate again beyond expectation the Surgeon ought not to defer to endeavour either by a Thred or Knife its extirpation the Thred being small and strong must be twice wound about the neck of the Tumor and tied with a double knot which must be straightned the same day and so every day until the Tumor be deprived of its colour sense and life which is within seven or eight days then 't is to be taken off with a crooked Knife which is very easie to perform seeing neither any great pain or flux of Blood is to be feared If the Thred be wet in Mercurial or Arsenick-water it hastens the mortification of this Tumor But in this Operation a Phlegmatick Body is required for in other Bodies pain and inflamation do so much afflict the Patient that 't is seldom that the Thred in a short time should take them off yet the Chirurgeon may to lessen the Symptoms and to cool anoint with a Feather the part which the Thred toucheth with white camphorated Ointment of Roses or the like continually putting the Patients in mind how that others bear it more quietly But if you design to use a Knife only the whole Tumor must be endeavoured to be taken away except you will consume the remaining by Medicines which is very rarely effected besides the Chirurgeon must have a Care that he divides not the greater Vessels lest there follows a Flux of Blood not to be stopped 3. The Viscerous Flesh belongs rather to the Physicians care than the Chirurgeons 4. Of the Glandulous Flesh we have treated particularly in several places In general 't is to be noted 1. That the Glandules are of a cold temperament therefore require hot Medicines but very ill suffers cold 2.
10. Of Nerves 233 11. Of the Flesh 237 12. Of the Skin 243 13. Of the Fat Nails and Hair 247 14. Of the generation of the Blood and its Circulation 250 15. The division of the Parts of the Body 266 The second Book of the Head 1. OF the outward parts of the Head 268 2. Of the inward parts of the Head 292 3. Of the Neck 296 The Third Book Of the Breast 1. OF the External parts of the Breast 300 2. Of the Internal parts of the Breast 305 The Fourth Book Of the lower Belly 1. OF the outward parts of this Belly 311 2. Of the Internal parts of the Abdomen 314 The Fifth Book Of the Joynts 1. OF the Hands 332 2. Of the Feet 337 An Index to the Treatise of the Plague A Description of the Plague Page 1 It 's Cause 3 It 's Diagnostick 5 Prognostick 6 It 's Cure 9 Whether Bleeding and Purging is convenient 9 10 The use of Sudorificks 11 Medicaments against the Plague 12 Symptoms of the Plague are 18 Feaver Ibid. Drowsiness 20 Continual watchings 21 Great pain of the Head Ibid. Vomiting and the Hicough 22 A Loosness 23 Spots 25 Bubo Ibid. Preservatives against the Plague 32 Practical Observation 36 BARBETTY'S CHIRURGERY The First Part. CHAP. I. Of Manual Operations in general ALthough the word Chirurgery signifies all Manual Operations in general yet by reason of its pre-eminence above all the rest it is now only given to that Art which endeavours to remove the Diseases of the Body by the assistance of the Hands 'T is true that External Accidents require not only the help of the Hands but also Internal Means therefore it is no wonder for a Part of Physick to require the whole Chirurgery being a Part which depends upon the Body of Physick But these internal Medicines we impart to you not as Chirurgeons but as Physicians The General Operations of this Art to which all the particular ones may be reduced are of four sorts 1. Synthesis which teacheth how to unite parts disjointed 2. Diaeresis To separate parts unnaturally joyned 3. Exaeresis To remove what is superfluous 4. Anaplerosis To supply those that are wanting CHAP. II. Of Synthesis or Vnition UNition is of two sorts one regards the Hard and Boney the other the Soft and Fleshy parts of the Body The Unition of Bones is again twofold the one setting Bones broken the other reducing Bones wrenched or disjointed We will begin with Fractures CHAP. III. Of the Nature Difference Signs Prognosticks and Cure of Fractures in general A Fracture is a Solution of Continuity in the hard parts of the Body caused by an hard Instrument externally forced upon the part The Differences are taken 1. From the Manner there being some transverse which are properly called Fractures others that are made according to the length of the Bone called Fissures and others are Comminutions when the Bone is broken into many small parts 2. From the Part it being some times in the Head sometimes in the Shoulders Ribs Arms Legs c. 3. From the Accidents there being sometimes a Wound accompanying it at other times a Dislocation Inflamation Gangrene c. Cause is Whatever is able to break bruise or cut Sometimes also a Bone corrupted by the Pox Gout or otherwise hath been broken without any external force Signs A Bone being transversly or obliquely broke by handling it you perceive an inequality the Patient is scarce able to move the Part affected and sometimes that Part is shorter than the other the Thigh Leg or Foot being broken the Patient cannot stand at all but he may somewhat though with pain in a Dislocation And this is the surest difference between a Fracture and a Dislocation A Fissure is discerned by the thickness pain and unevenness of the Part and requireth the judgment of a skilful Chirurgion A Comminution is easie to be perceived the Bone being very unequal and here and there yielding to the Fingers Prognosticks A Transverse Fracture is more easie to cure than an Oblique or when accompanied with apparent Inequalities that where but one Bone is broken than where two are or where the Bones are much shattered that which â—s made in the midst of the Bone than what happens to be near the Head and a single one than a compound If the Patient remain undressed beyond the seventh day the Member is in danger of mortifying especially if that the Part be too â—ard bound The Cure A broken Bone requires these four Operations Extention Conjoining Ligature Well-placing and withal the application of outward and inward Remedies Extention can hardly be performed without pain which yet will be much less if the Member be so extended that the Muscles do not labour that is to say The Part must be so laid that when in health they could hold out longest without tiring Sometimes the extension must be greater sometimes lesser which will be performed aright if regard be had to the time of the Fracture to the Age of the Patient and to the greatness of the Bone A recent Fracture a tender Patient a small Bone require a gentler Extention on the contrary an old Fracture a strong Patient and a big Bone a greater The manner of extending I describe not because it is better learnt by the frequent view of Practice than by Reading After Extention you are to join the Bones together in the doing of which the Muscles must not be wrested but retain their natural position and figure Then the Part must be bound with a double Rowler the first is to be rowled thrice about the Fracture and then upwards The second which must be twice as long is to be once wound about the Fracture proceeding downwards and then upwards again a little higher than the first Rowler to which you will give more firmness if you bind some convenient Splints of Wood or rather of Past-board round about the Member The Ligature ought not to be too strait lest it cause pain and rob the Part of its nourishment nor too loose lest the Bones slip out of their place And unless great pain or other symptoms require it must not be opened before the third day and at the second dressing it must be bound somewhat closer and afterwards changed but once every four five or six dayes Lastly The Part ought to be well placed that is softly evenly and a little raised If you lay it too low the Bone will bend outwards if too high it will bend inwards Wherefore you must observe a mean Now whether these four Operations have been duly performed may be known by the ensuing Signs The Extention is well done if the part be strait and as long as its fellow if it appear to outward view every where even and a little hollow about the Fracture The joining together is duly made if the Bone be any thing firm and all about the Fracture be found equal The Ligature is as it ought to be if the Patient as soon
Belly-ach that the membranes of the Pudenda were so far stretcht out that the unskilful have taken it for the Matrix it self and do so still For though many Authors have dared to write that the Womb may be cut out without danger of life seems altogether impossible to a skilful Anatomist To cure this Disease lay the Patient on her back with her Knees on high and Legs asunder then take a Wax-Candle of a competent thickness mix therewith some Castoreum or Assa Foetida and with it gently press the Womb inward and having sastened the Candle with a Bandage apply outwardly to the Belly the Emplastrum Barbarum or the following Take the Roots of Cyprus Bistort of each a dram Galls Acacia of each half a dram Cypress-Nuts Date-stones Myrtle-Berries of each one dram Pitch and Colophony as much as sufficeth to make it into a Plaister Then presently enjoyn the Patient to lie still with the Legs cross and to beware of speaking aloud of scolding and of whatever may occasion coughing or sneezing Here great care is to be had that your Wax-Candle be not too thick to the end that by its continual friction it may not cause Fluorem Album whereby the strength of the Body would certainly come to decay Yet because ev'n by the greatest care and circumspection this inconvenience will hardly be altogether or always prevented therefore those do very well and discreetly that long-ways perforat the Candle and thereby give a convenient passage for the humors flowing that way CHAP. IX Of the falling down of the Fundament IF the Gut be sunk down anoint it with Oyl of Rose and Myrtle mixing a little Powder of Galls amongst it and with your Fingers and a small Linnen-Rag put it in If an Inflamation hinder the reducing it then bathe the Anus with these Medicines Take Flowers of Elder Camomile and St. John's-wort of each a handful Red Roses rwo Pugils the tops of Wormwood and Melilot of each half a handful Boil therein Milk and Red Wine and bathe the part Here especially care is to be had that no external cold may come to the fallen-out Anus for then you may sooner than you are aware of be surprized with a Gangreen Wherefore do your utmost to put it in again with speed and in the mean time endeavor with the above prescrib'd Bathing and warm Linnen Rags to preserve its natural heat There is yet another though in appearance ridiculous yet in reality a good way of reducing the Gut With a strong hand strike five or six times the Patient's Buttocks and thereby the Muscles called Ani levatores will presently draw the Anus into its right place again But before the Patient be thus chastized take care that the Gut may first be anointed with Oyl of Roses or of Myrtle CHAP X. Of the second Operation called Diaeresis or the seperation of what was united together HItherto we have joined together again what had been disjoined now it follows that we separate what is united and treat of the second Manual Operation called Diaeresis which teacheth us the manner of Cutting and Burning and that both in the hard and soft parts of the Body In the soft the Cutting is called Incision In the hard it is performed four manner of ways By Terebration or Perforation by Rasion or Scraping by Limation or Filing by Serration or Sawing Burning is done either by an Iron which is the Actual Cautery or by Medicaments called the Potential Cautery as shall be declared particularly hereafter CHAP. XI Of opening a Vein BLeeding one of the greatest Remedies in the Art of Physick is sometimes highly necessary but sometimes so dangerous that it ought not to be used without very urgent Causes Here therefore I think it will be better somewhat to digress for fuller information than to leave the unskilful in their error The Blood is the darling of Nature by whose assistance she performeth all her Operations and which can hardly be drawn from her without dammage yet does Art require that those who meddle with it being neither venturous nor timorous but discreet and couragious and making out of necessity a virtue do sometimes proceed to the opening a Vein yet for no other than these four following causes 1. In a Plethora or super-abundance of blood that by this means Nature may be eased of her too heavy burden and the innate heat preserved from suffocation 2. For Revulsion-sake when the blood and the therein mingled humors by flowing too plentifully to this or that part hinder the Cure Here you are always to chuse a Vein of the opposite side and that sometimes the farthest distant sometimes the nearest 3. For the Derivation or conveyance of the Blood which is already got into the part but is not yet altogether setled there nor extravasated into another place in which case a Vein is to be opened the nearest to the Part. 4. For Refrigeration when the heat of the Blood is so excessive that it cannot be allayed by cooling Medicines or not time enough These limits are too narrow for some who will needs take into those a fifth cause which they make the Corruption of the Blood held by them to be as great an inducement for bleeding as any of the four by us recited to the end say they that Nature being rid of part of what is corrupt may be the better able to correct what remains But I much wish 1. That they could make this discharge without the loss of that strength which is so highly necessary 2. That they would be present when their Patient is to bleed and precisely tell to what degree of corruption his blood is come that so the Chirurgeon may know how much of it he is to take and how often forasmuch as they will not allow that Bleeding is good in all sorts of the Blood 's corruption but in that only which is not gone considerably far 3. That they would declare why they will have cur'd the greater corruption by Purging and the lesser by Bleeding since that they give to the one as well as to the other and that duly the name of Cacho-Chimia Let them shew that things differing only secundum Majus Minus do differ in specie and so require specifically different Remedies Others proceed yet further and shed innocent Blood in all sorts of Fevers without any consideration of spots of the Plague or of Poison it self thus freeing themselves from a great deal of labor and trouble otherwise caus'd to the Physitian from the variety of Fevers But because the nature of all Poyson and Malignant Humors is continually to assault the Heart and suddenly to prostrate the strength of the strongest Persons and since Bleeding doth likewise both not only diminishing strength but also drawing the malignity toward the Heart and driving in again for the oppression of Nature what she had thrown out for her relief I do intreat and warn all the Practisers of our Art That as they love the
less danger than the next foregoing and people oftner recover upon it yea Learned Writers assure us that by this Operation and the use of Injection they have cured many of Ulcers of the Lungs Concerning the Place of Opening Authors are not agreed in it the reason whereof is obvious For the Diaphragma runs higher in some persons than in others whence it comes to pass that the collected Humors in some Patients lie higher than in others Secondly the Chest is raised in some flat in others which here much alters the case Besides the Lungs do often grow so fast to the Pleura that the sanious matter cannot easily be carried into the Cavity of the Breast In which case it would be ill done to chose the place of Opening lowest in respect of the Diaphragma And in regard that in this as in other swellings the most eminent place is esteemed the most convenient for opening it cannot be otherwise but that one Chirurgeon hath made choice of this place and another useth that place as the best Upon which account Hyppocrates Guido Amatus Lusitanus c. do make the apertion between the third and fourth Rib counting from beneath upwards Fienus Riverius and many others between the fourth and fifth Paulus Aegineta Vidus Vidius Fabritius ab Aquapendente Sennertus c. between the fifth and sixth which place in my opinion is the safest for if higher the Pericardium if lower the Diaphragma may be wounded of which there have been many sad Examples But in this difference of dissenting Writers what hath been said will direct you to pass into the safest Haven All things therefore well considered chuse the place where to make your Apertion not the forepart for before the Sternum or Breast-bone will hinder your operation here nor in the back-part for the Ribs are so close to one another that without hurting some Vessels you cannot make any Apertion there but on the side four or five inches from the Sternum Neither ought the Incision to be so near to the upper Ribs as to the lower because the intercostal Vessels viz. the Vein Artery and Nerve lie in the lower part of each Rib where Nature hath assigned them a place branching themselves into the middle of the intercostal Muscles which dissemination nevertheless hinders not but that the Incision may be made in the middle between the two Ribs After you have marked the place with Ink charge the Patient to breath forth as long as possibly he can without taking it in and in the mean time make an oblique but small Orifice and put into it a Silver or Leaden Pipe and take forth four or five ounces of Matter to run out in a day In case the Matter does not come forth well place your Patient on the wounded side and make him to cough if by reason of its toughness it will not yet come forth then inject into the cavity some abstersive exsiccating and healing Medicines As Take Goats whey eighteen ounces Honey of Roses four ounces the Juice of Celandine and Smallage of each six drams Mingle it Or Take the Roots of Comfrey the greater an ounce of Sanicle half an ounce the Leaves of Betony Agrimony Periwincle Burnet of each half a handful the Cordial Flowers two pugils the Seed of St. John'swort Holy-Thistle Roman-Nettle of each half a dram Boil them in Water and Honey to a pint and half strain it and keep it for your use Of this Injection the Patient may also drink a little twice or thrice a day It is yet further to be observed that the collected Matter is often contained in a Membrane of its own and by its rising manifests it self from without and then the Latines call it Vomica Pulmonis In which case you must not stay till the Membrane breaks of its self for by delay the Matter flowing up and down is more difficulty to be got out of the Breast but open it presently taking no other place but the most raised part of the swelling Now since an Empyema for the most part follows upon a Pleurisie and 't is dayly found that ignorant Chirurgeons take all kind of pain in the Sides Belly and Breast although caused from Winds only for a Pleurisie thereupon immediately opening a Vein I thought therefore necessary to write in this place of the Pleurisie as much as is necessary for a Chirurgeon to know for the preventing such mistakes The Pleurisie then is an inflammation of the Pleura and commonly of the Lungs themselves caused from afflux of Blood accompanied with Pain Cough spitting of Blood shortness of Breath continual Feaver strong and quick Pulse The Cause is the Blood sometimes alone when a true Pleurisie sometimes mixt with other Humors then it occasions a Bastard one The Signs as may be seen in the Description are so evident that those who know not how to distinguish it from a Cholick are not worthy of any excuse The Prognosticks The sooner the matter is concocted and the whiter and easier 't is ejected the quicker and safer is the Issue If the Cough and difficulty of breathing lessen not by a copious Expectoration 't is an ill sign If the Patient come not to spit the third or fourth day then will he scarce see the seventh If upon Bleeding and other fit means the pain cease not the Patient must either die or the Pleurisie will turn to a Consumption or an Empyema The Cure In this case Bleeding is one of the most necessary and safest means of Cure and if used in time the Patient in the very Operation and before the Vein be closed will find relief and sometimes be altogether freed of the pain Nor do I know any Disease in which there may to the Patient's benefit be so much Blood taken away at once as in this There are different Opinions concerning what side the Patient is to bleed on But those have had little Experience of this sickness who have not found that Patients at least in these Countreys are relieved much more and sooner when they are bled in the Arm of the same side where the Pain is than when it is done in the opposite side The Pain not ceasing in four and twenty hours we are necessitated to bleed twice or thrice most commonly in the same Arm but here you must well observe the Patient's strength After letting Blood sometimes Purging Swearing and Expectorating Remedies are very necessary One only Medicine I cannot conceal from you because of its Excellency The Industrious Physitian Dr. Hadden in his Cure of the Pleurisie hath much commended it and I have after once Bleeding always in the beginning used it with great success viz. Take the Juice of Dandelion an ounce and half the Water of Plantane two ounces of Holy-Thistle and Scabious Syrup of Poppies Erratick of each an ounce Crabs-Eyes a scruple and half Mix it Let the Patient every half hour take down a spoonful or two of it until the Flux be stopped After which you
and Species of Diacarthamum Cream of Tartar Take Syrup of Roses solutive with Senna Diacarthamum of each an ounce Jalap eight grains Cream of Tartar two scruples Parsley-water as much as is sufficient to make it into a Potion A Purging Wine which cures the Dropsie it self Take Roots of Orrise Gentian Succhory Fennel Masterwort of each an Ounce the middle Bark of Elder an Ounce and half Leaves of Ground-pine a handful Rosemary two Pugils Flowers of Centaury the less one Pugil Seeds of Smallage Coriander Carraway Roman-Nettle Fennel of each a Dram Senna two ounces Agarick three Drams Jalap half an ounce Turbith a Dram and half Let them be cut and infused in six Pints of Rhenish-wine Dose four ounces Medicines consuming Water outwardly used Roots of Orrise Bryony Birthwort Flowers of Elder Camomil leaves of Celandine Centaury Calamint Rue Dill wild Majoram Sulphur vivum Salt Allum Bay-berries Ammoniacum Bdellium Take Cows-dung half an ounce Pidgeons dung two drams Sulphur vivum half an ounce Nitre two drams Honey Vinegar of each an ounce and half Bean meal two ounces Bay-berries Cummin-seeds of each half an ounce Oyl of Dill Nard of each an ounce White-wine as much as is sufficient to make it into a Poultice Or Take Frankincense Mastick Myrrhe of each half an ounce Camphire half a Dram Goats-dung an ounce and half Brimstone Salt Cummin-seeds of each three drams Turpentine and Wax as much as sufficeth According to Art make it into a Plaister Hydrocephalus is always of difficult Cure Water contained in the Ventricles of the Brain or between the Brain and Meninges is very dangerous but less dangerous when collected between the Dura and Pia Mater or between the Dura Mater and the Skull For the Dura Mater may be divided into a Lancet if you can come at it but least danger of all when detained without the Skull Purging Sudorificks and Diureticks seldom do any good here but Cauteries Blisters Issues Setons are more profitable but sometimes we are forc'd to come to Incision or Ustion which Remedies although dangerous have cured several Some Chyrurgeons use with an actual Cautery to burn the Skin of the Head in five six or more places but not together and at once but at several times lest the Patients strength should be too much spent continually choosing that place which the watry Humor makes to appear most convenient Some with a Lancet open the Skin near to the Sagital Suture Which of these Remedies are best cannot absolutely be declared I must esteem an Actual Cautery when the Water is between the Skin and the Skull but if under the Skull between the Meninges I do not see how this operation can be performed without a Lancet But which of them soever you chuse have a care of discharging all the Water at once for in the very Operation it self the Patient dies or at least is very much debilitated for till the end of the Cure all the Water is not to be taken away lest the debilitated Parts be deprived of that heat which the Water possest do corrupt but rather what remains must be consumed by Internal and External Discussives and this is to be observed in all Watry Tumors that are Cured by a Paracenthesis In the same manner the Watry Tumor in the Navel and Cod ought to be handled after other Medicines have been applied in vain Dropsie of the Breast belongs not to Chirurgery except where a Paracenthesis is convenient concerning which Read the 15 th Chapter of the first Part. CHAP. VII Of the Flatuous or Windy Tumor THe Flatuous Tumor is a Disease produced of Wind not yielding without resistance to the Fingers Difference Some are without pain others with it in the one the wind is in motion in the other quiet Causes of Wind are Phlegm especially when mingled with Choler which as Ferment doth froth so it proceedeth wind it always happens upon a debility of the Parts by reason of which although endeavoring to concoct the Humors yet are notable Signs are Inflation with a resistance yielding to the Fingers a rumbling noise especially if shaken Prognosticks It seldom comes is fleshy parts in other parts it brings many inconveniencies in weak and Cacochymick bodies it 's of difficult and tedious Cure Cure The same Diet in here to be observed as in an Oedema Pease Beans Turnips Chestnuts and all Crude Fruit do extreamly hurt On the contrary Wine and other things moderately warming profit as also Spices and those things which disperse Wind as Nutmegs Mace Anise Carraways Lovage The Stomach and the whole Body require purging and corroborating Medicines always mixing with them those that disperse Wind and sometimes also where Corroboratives are used Anodines Laudanum Opiatum cautiously used that is half a grain or a grain for a Dose is here excellent For besides that it ceaseth pain it also by its Diaphoretick quality removes the Cause of the Disease To cause Sweat is as necessary as Bleeding is unnecessary Outward Medicines discussing Wind. Roots of Galangale Lovage Herbs Dill Mint Marjoram Peniroyal Rosemary Rue Chervil Flowers of Elder Mellilot Camomil Seeds Anise Carraways Cummin Fennel Nutmegs Cardamum Castor Oyl of Rue Nard Spike Dill Carraway distill'd Mace Nucista exprest and distill'd Mellilot-plaister Take Oyl of Wormwood Rue of each two Drams Oyl of Nucistae exprest one Dram of Mace distilled half a Dram Castor dissolved in Aqua vitae two Scruples Make it into a Linament Or Take the Leaves of Rue Calamint of each half an handful Bean-meal two Ounces Seeds of Cummin and Anise of each half an Ounce Bay-berries Salt of each three Drams Nitre Brimstone of each a Dram Goats dung six Ounces White-wine as much as is sufficient Mix them and boyl them into the Consistence of a Cataplasm Or Take the Roots of Pelitory of Spain half a Dram Venice-Sope three Drams Castor dissolved in Aqua vitae one dram Seeds of Cummin Carraways of each two drams Ashes of Earth-worms half a dram Oil of Spike half an ounce Mastick three drams Wax and Turpentine as much as sufficeth Make it into a Plaister according to Art CHAP. VIII De Herpete HErpes is a Tumor besides Nature sprung from yellow Choler disfiguring the Skin with corroding and spreading Pustules Difference Where Choler solely predominates it produceth Herpes exedens but where Phlegm is mixt with Choler a Herpes Miliaris Cause is sometimes Choler alone sometimes mixt with Phlegm and I see not why the serum of the Blood may not often be here taken as a Cause For the Lymphaeducts being out of order do produce Mutations in mans body heretofore unknown Signs Are little Pustules like to Millet-seed a heat itching and after rubbing a moistness and little Ulcers Prognosticks Herpes is of difficult Cure but of little danger unless so rendred by the immoderate use of Repellents Cure The same Diet is here required as in an Erysipelas Moreover Purging is here very necessary Bleeding not to be allowed of the use
again but if great not so easily yielding to the touch not so strong a Pulsation but there is a noise observed as of boiling Water yet in the Head and Jaw I have found after death an Aneurism which while the man was alive there could be no Pulse perceived In the hard parts is greater Circumspection to be used than in the soft and fleshy Prognosticks It is difficultly cured if great not at all except with the taking off the Member for the most part it is a long Disease although I have seen it kill without any other accidental Cause within two years If Incision be made Death suddenly follows Cure In the beginning there may be some Hopes Astringents and Repellents and convenient Ligatures by which we do not seldom administer something of Remedy to the Patient as also the applying a piece of Lead straightly bound on have sometimes cured little Aneurisms But where the Tumor is encreased there are some would have the Skin divided and the Artery tied both above and below and cut out the middle with the Tumor and loosen not the Ligatures till the Wound is perfectly cured and there is no fear of an Hemorrage but this Operation is dangerous painful and troublesome and oft-times of little Benefit But to preserve Life I would take off the Member CHAP. XVII Of Opthalmia OPthalmia is an Inflammation of the Membranes of the Eye from Blood with Redness Pain and shedding of Tears Difference A light Inflammation and which depends from external Causes is called a Bastard Opthalmia Taraxis or Epiphora but a great Inflammation accompanied with pain and tears a true Opthalmia And if it be so great that the Eye-lids are so inflamed and as it were turned inward 't is called Chemosis Causes are two 1. Internal as Blood oft-times mixt with Serum or Choler seldom with Phlegm or Melancholy 2. External as Smoak Dust c. Signs vary according to the variety of Causes If it proceed from too great a quantity of Blood the Face looks red and the Vessels of the Eyes are extended If either from more of Serum or Choler the Redness of the Face is less but the Tears are more sharp and the pain greater if from more of Phlegm the reddish pain Heat and Acrimony of Tears are more remiss and the Eye-lids at night are as it were glewed together If from any thing of Melancholy there are but few Tears and the Eye-lids are not closed together the Inflammation is not great but stubborn Prognosticks An Opthalmia is flower cured in Children than in old people Continual pain menaceth Blindness by how much greater the Inflammation is so much the more dangerous it is Cure The Diet must be the same as in a Phlegmon all sharp things are carefully to be avoided as Garlick Radishes Mustard c. little or no Suppers profit Purging the use of Glisters Bleeding ought to be oft-times re-iterated as also Cupping-Glasses Leeches Blisters sometimes also Seatons Issues and Artereotomy it self which is not to be done by any but an expert Chirurgeon Sneezing is hurtful Provoking of Sweat is sometimes necessary sometimes not which the Physician must distinguish Dieureticks are of great use provided they are not too hot External Remedies vary according to the variety of Causes if from Smoke or Fire let them be extinguished If from Dust or any thing got into the Eyes 't is to be taken forth which is often performed by blowing or by the spurting in of Rose-water If from the inversion of the Eye-lids the Hairs are to be cut off or wholly to be pull'd out If the Eye-lids are glew'd together they are to be separated with Butter Beer or Cream the Rheum is gently to be wiped and let the Patient have a Care lest by the rubbing of his Eyes he increaseth his Disease Fat things are here hurtful Repellent Medicines except in the very beginning are not to be used or in a very slight Opthalmia Medicines good for the Eyes Roots of Valerian Solomons-Seal Orrise Vervain Herbs Betony Celandine the great Eyebright Fennel Fumitory Plantain Flowers of Roses Violets Anni-seeds Quince-seeds Linseeds Pippins boil'd or rotten Camphire Mussilage of Lin-seeds Tragacanth Fresh Veal Whites of Eggs all sorts of Milk especially Womans Tutty white and green Vitriol Saccharum Saturni Glass of Antimony White Troches of Rhasis fresh Cheese not salted Ung. Saturni A Water for the Eyes Take Waters of Eyebright and Celandine the greater of each an ounce and half White-wine six drams Glass of Antimony eight grains prepared Tutty fifteen grains White-Vitriol two grains Sugar-Candy two drams Camphire four grains Make it into a Collirium Another excellent one Take Wheat three handfuls Bruised Ginger three drams Common Salt a handful and half White-wine Water of Roses of Fennel Plantain of each ten ounces Infuse them in a Copper Vessel the space of forty days strain them and reserve the Liquor for your use Another very much esteemed Take a whole Egg boil it hard then the shell and Yolk being taking away put into the Cavity Sugar of Saturn six grains Camphire two grains White-Vitriol three Grains Honey of Roses half an ounce then press it very hard and let the prest out Liquor be dropt into the Eyes twice or thrice a day Another second to none Take Waters of Fennel and Eyebright of each a pint Common Salt six drams prepared Tutty white Vitriol of each half an ounce Let them boil a little and reserve for use Let not the great quantity of Vitriol afright any it causeth only a slight pain which suddenly vanisheth but 't is of so great virtue that it cannot sufficiently be extoll'd but its use will prove it true A Powder for the Eyes Take Dulcified Vitriol half a dram prepar'd Tutty fifteen grains Sugar-candy a scruple Make it into a fine Powder Unctious Medicines seldom are applied to the Eyes or else this Ointment is much commended Take Verdigrease twelve grains Camphire Lapis Calaminaris of each half an ounce prepared Tutty half a dram fresh-Butter washed in Rose-water two ounces Make it into an Ointment An Anodine Cataplasm Take Camomile and Melilot Flowers of each a pugil rotten Apples two ounces Fenugreek-seed an ounce Crums of Brown Bread three ounces two yolks of Eggs Saffron half a dram Boil them in Cows-milk to the consistence of a Poultice An Anodine Collirium Take the Juice of Housleek two drams Whites of Eggs half an ounce Womens-Milk two ounces Rose-water an ounce white Troches of Rhasis one scruple Opium three grains Mix them Another which I have often found excellent in the greatest pain Take Gum Tragacanth two drams Mussilage of the seeds of Fleawort three drams Rose-water and Plantain-water of each as much as sufficeth Make it into a Collyrium of an indifferent Consistence and let it be instilled by drops into the Eyes and Linnen-Cloaths wet in it outwardly applied CHAP. XVIII Of a Quinsie A Quinsie is a Tumor of the Jaws from Blood hindring Deglutition and
a Wound penetrating into the Cavity it self all the Tunicles being divided the Wound of the Abdomen ought to be united by a Stitch a little Orifice being left through which a Tent is to be put which must not enter the Wound of the Stomach but only outwardly touch it let it be armed with this or the like Take Oyl of Mastick of Fir-tree of each an ounce Manna of Frankincense two drams Powder of the Roots of Tormentil of the greater Comfrey of each a dram Saffron a Scruple Earth-worms half a dram White-Wine two ounces boil them to the Consumption of the Wine and make a Liniment Take Turpentine half an ounce Yolk of an Egg Oyl of St. John's-wort an ounce Mix it and make a Liniment Wounds of the Small-Guts sometimes though seldom may be cured this I can prove by a notable Example Those of the Great-Guts are more easie Where the Small-Guts are hurt the Chyle and sometimes the Meat Drink comes forth through the Wound there is great pain with a Fever and Nauseousness Where the Great-Guts the Excrements come out at the Wound or at least the scent the Body is bound the Wound is forthwith to be stitcht together and the Gut to be restored into its natural place well cleansed with warm Water and this following Powder sprinkl'd upon it Take Aloes Mastick Frankincense Mummy Dragons-blood of each a dram Make it into a Powder Wounds of the Liver and Spleen require bleeding and if the Belly be bound Clisters are daily to be injected to the Wound it self are to be applied Astringent and Drying Medicines Wounds of the Kidneys are difficultly and slowly cured If made into the Cavity it self the Blood that comes forth is Serous otherwise more pure This Liniment is of great esteem to be used outwardly Take Rosin of the Pine six ounces Oyl of Bays and Turpentine of each an ounce Gum Elemny four ounces and an half Mingle them Inwardly are to be given the Troches of Alkakingi Gordonius de Carabe or Sealed-Earth Bole Turpentine and Wound-Drinks Wounds of the Bladder are generally cured after the same manner but it is very seldom that they leave not behind them a Fistula The following Pills are of great use in Wounds and Ulcers in the Kidneys and Bladder Take Mans Bones calcin'd three drams Chalk Burnt Talk of each a dram Troches of Winter Cherries three drams Venice-Turpentine a little boil'd as much as is sufficient Make them into Pills about the bigness of little Pease rowling them in the Liquoras-powder let the Patient take morning and evening six of these The End of the Second Part of the Second Book BARBETTY'S CHIRURGERY The Third Book of the Second Part Of CHIRURGERY Of Vlcers CHAP. I. Of the Nature Differences Causes and Signs of Vlcers AN Ulcer is a Solution of continuity with Diminution of Magnitude in the soft Parts from a Corroding Matter Differences are taken .1 From the Form of the Ulcer so 't is great little long short broad narrow right transverse equal unequal deep superficial 2. From the Part affected which sometimes is the Skin and Flesh only sometimes the Tendons Nerves and Vessels that carry the Blood 3. From the Causes which shall be presently spoken of 4. From the Symptoms so 't is painful itching obstinate verminous carious Cause is a sharp and corrosive Humor and that is twofold 1. Internal as Choler Melancholy Serum Salt Phlegm and other Malignant Humors 2. External as Burning and Corrosive Medicines the Sweat of Man infected with the Itch Leprosie or Pox. Signs of Ulcers in general are manifest enough the particulars you shall have in their places Prognostick By how much deeper the Ulcer is so much the longer 't is in Curing Ulcers in Parts that are subject to much Humidity are difficultly cured If an Ulcer cannot be cured in a long time or when Cicatriz'd breaks out again the Cause is the Bone being foul under it Ulcers near to the Nerves Veins or Tendons are dangerous In Cacochimick Bodies their Cure is tedious If the Matter which comes from them be good it gives hope of an easie Cure Good Matter is of a middle consistence between thin and thick white light equal and not at all stinking That which is ill is thin and fluid pale livid and of ill smell Old and inveterate Ulcers are not cured without danger except the Body be well purged and a good order of Diet observed otherwise some Diseases will ensue CHAP. II. Of the Cure of Vlcers PUrging and Bleeding are here often necessary but a good ordered Diet always Hot Meats and Drinks hurt as also all Sweet and Salt things Outwardly the Humor ought to be concocted and turned into Matter the lost flesh ought to be repaired and then to be skinn'd Remedies necessary to perform these are Digestives Sarcoticks and Epuloticks which are set down in the seventh Chapter of the second Book of the second Part. We will add some Compounds A Defensive Take Guaiacum-Wood long Birthwort-Roots of each an ounce Centaury the less Wormwood Agrimony of each a handful Boil them in white Wine and to two ounces and an half of the strained Liquor add of the Meal of Orobus half an ounce Myrrhe powdered two drams of honey of Roses two ounces Spirit of Wine an ounce Venice-Turpentine as much as is sufficient to make it into a Liniment A Sarcotick Take the Brown Ointment of Foelix Wurtz three drams Basilicon half an ounce Gum Elemni two drams Turpentine six drams Colophony Mirrhe Aloes Mastick of each half an ounce Litharge of Gold three drams Oyl of Roses as much as sufficeth to make it into an Ointment An Epulotick Take Sacchar Saturn Litharge of each two drams Lapis Calaminaris one dram Roots of Tormentil Bistort round Birthwort Dragons-Blood burnt Egg-shels of each half an ounce Make them into a Powder Let it be sprinkled upon the Ulcer or mingled Gall half an ounce Honey as much as sufficeth to make it into a Linament CHAP. III. Of an Vlcer with foul Bones IT falls out sometimes that the Bone which lies underneath the Ulcer to be foul Bones are corrupted and contract a rottenness either from the long Flux of Humors or from the Acrimony and Malignity of them or from an Occult quality or from a Contusion in some manner injuring the bone it self or from sharp Medicines Signs of Corruptions are many Where the Bone lies open to the sight at first it appears of the colour of fat then yellow afterwards black and unequal but where it cannot be seen Chirurgeons may judge that there it is a Corruption 1. If a Fistula preceded or the Ulcer hath been of long continuance 2. If the Ulcer being skinn'd break out again 3. If the flesh above it becomes loose spungy pale or livid 4. If with the Probe you find no resistance but an Inequality 5. If the Matter be much thin and stinking Prognostick If the Caries be near the Nervous parts or in the Joynts or about
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
of some Humor which renders the Cure very difficult For this I commend the often praised Restorative Powder 3. A great Tendon is inserted in the Calcaneus or Bone of the Heel which being wounded or much contused brings Convulsions and death it self About this place comes Kibes whose cause is intense cold or heat with driness Here first are observed Fissures in the Skin then follows an Ulceration All fat things and Plaisters profit here especially the following Take Powder of Galls of round Birthwort of each half a dram red Lead a dram Mercury sublimate six grains Litharge Mirrhe of each a dram and half Camphire a scruple Franckincense two drams green Wax as much as sufficeth to make it into a Plaister In the room of green Wax you may take the Fat of Deer or of Rams 4. The Fingers or Toes being frozen must be rubb'd with Snow or with a bruised frozen Turnep then this following Plaister is much commended Take Hogs-grease fresh Oyl of Olives of each an ounce white Wax two ounces boil them a little and make a Plaister 5. Issues are often made in the Joynts we have formerly declared the place In the Arms between the Muscle Deltois and Biceps in the Thigh two fingers breadth above the Knee in the inside in the Leg the uppermost two fingers breadth below the Knee the lowermost two fingers or three above the Ankle That you may make these Issues without pain instead of a Conclusion take this Caustick which works without pain which is also very much to be commended in sordid and cancerous Ulcers and in Excrescencies Take Crude Brimstone white Arsnick Crude Antimony of each two ounces the Brimstone being melted by a gentle fire and stirred about with a Spatula add the Arsnick and Antimony powdred and mix them whilst they are incorporated with the Brimstone and look red Afterwards Take of this Mixture an ounce Caput mortuum of Vitriol half an ounce Mix them and make a Powder let it be washt six times in Spirit of wine and dried for your use A TREATISE OF THE PLAGUE THE Plague is a Disease whose nature is not to be comprehended by us the Cause thereof seems to proceed from a Spirituous and Infectious Vapour which is powerful enough to make a sudden dissolution of the consistence of the Blood by which means the Heart is deprived both of strength and life I do assert that the Nature of it is not to be comprehended by us as well because it is a Punishment inflicted on us by the immediate hand of Almighty God who vouchsafes not that his Incomprehensible Wisdom and Essence which is sometimes faintly described to us should be narrowly pryed into by his creatures as also that it is in it self so mutable that if we should seriously recollect our selves and recount the several Pestilences wherewith all former Ages have been visited we shall not thereby be able to instance in two of that whole number which have agreed with each other in all circumstances From whence we may easily infer that in the Cure of this Disease an Experienced Physician may much more safely follow the Dictates of his own Reason than adhire strictly to the Method Prescriptions of others For although it doth sometimes by the more remarkable symptoms sufficiently evidence it self yet we cannot likely discover its Nature and Essence although we should the most industriously attempt it But that we may cautiously enquire into it we must know that it is sometimes not accompanied by any Fever And it is necessary that what Physician soever is ignorant of this should either by perusing good Authors or his own Experience acquaint himself throughly with it I have been sent for to several Patients my self who although they appeared otherwise in good health not refusing their meat nor disturb'd in their sleep have nevertheless had Buboes arising in their Groin on their Neck under their Arm-pits or behind their Ears which have apparently discovered a greater Malignity than could be discerned in those Buboes which in other persons have been attended by a violent Fever And many hereupon who have been incredulous and lightly regarded the cautions which I have given them upon this account have with great danger to themselves experimented that as soon as those Buboes have sunk down the Pestilential Symptoms which have appear'd have been very dreadful and much more dangerous than in those that have carefully used the means prescribed to them who have been also much more easily and speedily cured than the other Sometimes the Plague is accompanied with a Fever and again there are some Pestilent Fevers without the Plague To distinguish this Fever from the Plague I used to observe that they that are seized with it complain of pain in their Head and Stomach which sometimes is dispersed over the whole Body sometimes it confines it self to the Arm-pits the Neck the Parts behind the Ears or to the Groin To outward appearance there is not the least swelling If the Patient by such means as is requisite be provoked to sweat at the beginning of the Disease the pain utterly ceaseth and in a few dayes he will be perfectly restored to his health the Disease not having at all discovered it self by any outward Symptoms Why such a Fever should be accounted a Species of the Plague I see no reason But there is no one but will confess it to have seized on that Body on which Buboes Carbuncles and Spots do outwardly appear The cause of the Plague is either Internal or External but unto which soever we impute it it is necessary to conclude that there is in it a power of dissolving the natural Consistence of the Blood and depriving the whole Body of its strength As to the Inward Cause which is Meat and Drink it is evident to all that it cannot produce in any Body whatsoever so great sudden a change but it is most certain that by a long continued course of bad Diet the Blood may by degrees be after such a manner dissolved weakned and corrupted that some part of it assuming to it self a malignant quality a man may be surprized by a sudden Disease sometimes be deprived of life it self which hath been observed in sick persons at several times when there hath been no contagion in the place nor any suspected who have been troubled with perfect Buboes and other Symptoms of the Plague much more intolerable than others have been at any time when the Air hath been infected As to the outward Causes every one confesseth that there are such but their Nature is known but to few The Chymists who are able by the force of Fire distinctly to separate the Parts of simple Drugs endeavour to find the Original of the Contagion in a Volatile Salt which suddenly dissolves the fixed Salt of the Blood which hath indeed some appearance of truth though it will not be relished by all men If you enquire into the Cause hereof from others their
CHIRURGERY According to the Moderne Practice Written by PAULE BARBETTE DOCTOR of Physick Practitioner at AMSTERDAM Printed for Henry Rhodes THESAVRVS CHIRVRGIAE THE CHIRURGICAL and ANATOMICAL WORKS OF PAVL BARBETTE M. D. Practitioner at Amsterdam Composed according to the Doctrine of the Circulation of the Blood and other new Inventions of the Moderns Together with a Treatise of the PLAGUE Illustrated with Observations Translated out of Low-Dutch into English THE FOURTH EDITION To which is added the Surgeon's Chest Furnished both with Instruments and Medicines all useful Illustrated with several Copper-Plates And to make it more compleat is adioyned a Treatise of Diseases that for the most part attend Camps and Fleets Written in High-Dutch by Raymundus Minderius LONDON Printed for Henry Rhodes next door to the Swan-Tavern near Bride-Lane in Fleet-Street 1687. THE AUTHOR'S PREFACE TO THE JUDICIOUS READER WHat should be the scope of putting forth this my not sufficient Polished Treatise after so many Excellent and Learned Writings of Physicians the Title before will declare unto thee viz. That my Design was both out of the Ancient and Modern to extract the very Marrow and plainly to shew the best way of Curing Diseases belonging to Chirurgery Therefore I have purposed not to obtrude upon thee this or that Man's Fancy or Conceit for Modern Practice For who ever was so mad as to Embrace the Opinion of any one Region City or Man Who ever though most ingenious and judicious equally excelled in all the Parts of his Profession Seeing it hath not pleased the Giver of all Arts to grant this perfectness to Men But I resolve to set down that Practice which Reason and Experience after a diligent Reading of the best Authors and an exact observation of several Operations have Taught me to be the safest convenientest and easiest for prolixity I have purposely avoided and used not more words than only to express the thing it self Nevertheless I have studied to conprehend the Foundation of the Art in few Chapters Read over all diligently and let not what I purposely omitted trouble thee Great Volumns easily affright the Reader as those that are too little betrays him I have carefully endeavoured what is hardly found a mean and therefore I have rather in few words inserted my Observations in the very descriptions of the Diseases then to waste thy time with a prolix discourse To this end that I might not repeat in particular Diseases what I had once set down in generals Tumors Wounds and Vlcers which neither in Cause nor Cure differ I have reduced under one Head contrary to what most Writers use to do who only from the difference of the Part and Member affected difference the Diseases which aftewards giving them new names they without any benefit multiply and so they render that Art which is difficult enough of it self much more difficult The most diligent of Students can scarce distinguish them who unprofitably spend much labour and time in the Controversies of the Ancients concerning the Name whose Opinions they suppose they ought to follow to a Tittle if they will arrive at the degree of Doctor We are the Ministers of Nature not the Slaves of those Men that describe it We account neither them Prophets nor their Writings sacred neither unlawful to add or diminish to them without the name Heretick I have set down both few and many Medicaments for those that I have produced although few in number yet of great vertue which by vast pains and no less charges I have found out and which dayly Practice hath confirmed to me as the safest of all Other Medicines seek for amongst others Farewel kind Reader and whil'st I am imployed about other and better if I can possible Writings receive these with a grateful mind and as I study to be profitable to thee so also do thou endeavour always by these to help others The Index of Chapters to Barbetty's Chirurgery The First Part. Chap. 1. OF Manual Operations in general Pag. 1. 2. Of Unition or Conjunction 2 3. Of the Nature Difference Signs Prognosticks and Cure of Fractures in general Ibid. 4. Of particular Fractures of Bones 10 5. Of the Nature Differences Signs Causes Prognosticks and Cure of Dislocations in general 17 6. Of particular Dislocations 20 7. Of Ruptures 26 8. Of the Falling down of the Matrix 34 9. Of the Falling down of the Anus 35 10. Of the second Operation called Diaeresis or the seperation of what was united together 36 11. Of opening a Vein 37 12. Of the opening of Abscesses or Imposthumes 42 13. Of the separation of parts unnaturally joyned 46 14. Of the Paracentesis 48 15. Of the opening of the Breast 54 16. Of removing a Cataract of the Eye 60 17. Of Leeches 63 18. Of cuting in the hard parts 65 19. Of Ustion or Burning 69 20. Of Issues 70 21. Of the Seton 71 22. Of the drawing forth of Bullets 73 23. Of the Extraction of a dead Child and the Secundine 74 24. Of the extirpating of a mortified part 78 25. Of the fleshy Rupture 80 26. Of the Extraction of the Stone out of the Bladder 82 27. Of a Hare Lip 87 An Index to the Second Part. Chap. 1. OF Tumors in general 88 2. Of Inflammation 90 3. Erysipelas 95 4. Of Oedema 98 5. Of Scirrhus 101 6. De Tumore Aquoso or Watry Tumor 103 7. Of the Flatuous or Windy Tumor 107 8. De Herpete 109 9. De Atheroma Steatoma and Meliceris 111 10. Of Scrophula Struma or Kings-Evil 113 11. Of a Bubo 116 12. Of the Carbuncle 121 13. Of a Cancer 122 14. Of a Gangrene and Sphacelus 126 15. Of Paronychia 133 16. Of an Aneurism 135 17. Of Opthalmia 136 18. Of a Quinsie 141 The Index of Chapters to the the second Book Of the second Part. Chap. 1. OF the Nature Difference Causes and Signs of Wounds pag. 147 2. Of the Cure of Wounds in general 152 3. Of the preservation of the strength and native heat in the wounded parts Ibid 4. Of the Symptoms of Wounds 153 5. Of the drawing forth of extraneous Bodies out of Wounds 157 6. Of the manner of joining the Lips of Wounds together 159 7. Of Medicines necessary for the curing of Wounds 161 8. Of Wounds of the Nerves 166 9. Of Wounds by Gun-shot 168 10. Of poisoned Wounds 170 11. Of particular Wounds 172 The Index of Chapters to the third Book of the second Part. Chap. 1. OF the Nature Differences Causes and Signs of Ulcers 177 2. Of the Cure of Ulcers 178 3. Of an Ulcer with foul Bones 182 4. De Ulcere depascente 184 5. Of Fistula's 186 6. Of Burns 190 7. Of particular Ulcers 193 The Index of the third Part of Chirurgery Chap. 1. OF the Practical Anatomy 201 2. Of the parts in general 205 3. Of Bones 207 4. Of Cartilages 215 5. Of Ligaments 217 6. Of Membranes 219 7. Of Fibres 220 8. Of Veins 221 9. Of Arteries 228
it well observing here that the Arm during the whole time of Cure must remain in that posture in which it was extended otherwise the Fracture will upon the least change of its posture slip out again Where yet 't is to be understood that the Chirurgeon after the second or third dressing as often as after that he dresseth the Patient must stretch out his Arm strait to the end that the Tendons which run from the Arm and are inserted below the Elbow shrinking by the long lying still may not cause a troublesome stiffness However this shrinking of Tendons which are by pretenders to Chirurgery ridiculously call'd Nerves may yet conveniently be cured in two or three months if you make the Patient to carry every day some weight and endeavor to relax and mollifie the Tendons with Fomentations and Embrocations abstaining from the use of any Brandy or any other corroborating and astringent Medicines I have always found successful the following Unguent Take Man's and Duck's Grease of each one ounce Oyntment of Marsh-mallows half an ounce Oyl of Earth-worms white Lilly and Camomile of each two drams Make an Oyntment This broken Bone is cured in forty days The restoring of the broken Thigh-bone hath nothing different from this 12. The Elbow hath two Bones of which the greater is called Radius the lesser Ulna both Fociles The small Focile being broken 't is easie to restore it The Cure is harder when the great one is broken and yet harder when both are broken In which case the extention is to be made the stronger When they be well set and bound up then must the hand be placed a little higher upon the Chest than the Elbow and afterwards every second or third day without pain or violence the Arm is gently to be stretch'd out to the end that the Humors flowing thither and there staying too long may not cause a concretion in the Bones and a stiffness in the Arm as not extensible any more It is cured in thirty days 13. The Leg hath also two Bones the greater called Tibia and the lesser Fibula Their Cure had nothing different from the next foregoing 14. If the Patella or Knee-pan break cross-ways the Patient commonly remains lame If it break long-ways then by the Muscles that draw upwards without any great help of the hands it is almost of it self restored and cured in twenty days CHAP. V. Of the Nature Difference Signs Causes Prognosticks and Cure of Dislocations in general A Dislocation is a forcing of the Bone out of its cavity and natural place into another hindering voluntary motion The Differences are taken 1. From the manner for sometimes the Bone is altogether forced out of its place and that is properly called Luxation or Dislocation Sometimes it is got out but a little or half which is called Sub-laxation or Elongation 2. From the Cause for sometimes it is from an external accident as by wrestlings Falls or Blows c. Sometimes from internal Causes by the afflux of Humors The Causes are of two sorts 1. External Such as are Falling Beating Running Wrestling and vehement extention as it often happens to Women in Labour through the unskilfulness of Midwives yea by a violent stroke or fall even the Bones of the Infant in the Womb may be dislocated 2. Internal By the afflux of Humors which falling into the Joints relax and resolve the Ligaments and so causeth the Bones to slip out of their places The Signs especially in a lean Body are manifest enough The Bone causeth in the place to which it is forced a tumor or rising and in that whence it is forced a cavity If there be a perfect Dislocation the Member will be drawn up and shorter unless the luxation happen by the laxity of the Ligaments than it becomes longer the part is painful chiefly upon motion In a Subluxation these Accidents are lesser and seldom all together Prognosticks In Children and other tender Bodies the Bones may be reduced more easily but are kept in with more difficulty the contrary happens in strong and full grown persons The Dislocation of the Head is mortal that of the Vertebra's dangerous and that which is inveterate is hard to be cured That which proceeds from an inward Cause is of a slower Cure and does easily return Cure The Bone forced out must be reduced to its place either by the Hands Ligatures or Instruments but by which of these three it shall be performed the Nature of the affected part will declare 'T is certain that these four Manual Operations Extention Setting Binding and Well-placing must here be used as well as in Fractures of Bones Extention must be made so great that there may be a cavity between the Bone that remains well and that which hath been forced away to the end that in the setting the one may not rub against the other whence afterwards are wont to rise very grievious and sometimes incurable Accidents In the Setting care must be had not to wrest the Bones nor the Muscles but to keep their natural figure Before you proceed to binding up the Member endeavour to preserve the part from inflammation and flux of Humors and strengthen it with the following Medicines A strengthening Plaster Take Frankincense Mastick Bole-armonick Dragons-Blood of each half an ounce fine-Flower an ounce Roots of great Comfrey two drams Weather-Sewet three ounces white-Wax as much as sufficeth to make a Plaister Another Take Litharge Wax Rosin of each three ounces being melted over the fire add to them of great Comfrey Bean-Meal Bole-armonick steeped in Vinegar and dried of each three ounces Tragacanth two ounces Make it into a Plaister If the pain or other symptoms do not necessarily require it you ought not to loosen the Bandage before the fifth sixth or seventh day and then do it with as little motion as is possible Lastly lay the Part even and in such a posture in which when found it can longest remain without trouble If you find the Dislocation accompanied by an Inflammation beware of extending the part or doing ought to it before that be removed which you are to do first with emollient and afterwards with discutient Medicines An Emollient Unguent Take the compound Ointment of Marsh-mallows two drams Hogs-grease half an ounce Oyl of white-Lillies Roses and Mirtles as much as is sufficient to make it into a Linament A Discutient Plaister Take Colophony Frankincense Mastick Pitch of each an Ounce Cummin-seeds Fennel-seeds of each six drams Wax and Oyl of Dill as much as sufficeth Mix them and make it into a Plaister CHAP. VI. Of particular Dislocations 1. THe Jaw-bone except it be in young Children can hardly be dislocated otherwise than forwards Sometimes it is only dislocated in one side and is easily restored sometimes in both in which case it is difficult to set and very dangerous and often mortal It is very seldom luxated from a debility of the Muscles sometimes from the laxity of the Ligaments for
Simple and Compound Basilicon the Plaisters of Diachylon of Mussilages and Melilot Take Onions roasted in Embers three ounces Figs No. x. beat them together adding of Ointment of Basilicon six drams Ducks-Grease an ounce Virgins-Honey and the Meal of Linseed of each as much as is sufficient to make it into a Cataplasm Or Take the Roots of White-Lillies Marsh-Mallows of each an ounce ane half Leaves of Mallows Cows-Parsnips of each an handful Figs No. viij Raisins six drams Meal of Marsh-Mallow-Roots or of Wheat two ounces Venice-Sope three drams being boil'd and strain'd add to them of Hogs-grease on ounce Oyl of Camomil two ounces Mix them according to Art and make a Cataplasm 4. Indication respects the Symptoms which if not removed hinder the Cure the chief of which are 1. A Fever The chief of which concerns a Physician except it be removed by Bleeding 2. Hardness whose Cure look for in the Chapter of Schirrhus 3. A Gangrene Which is treated of in a particular Chapter 4. Pain Which we do remove by the following Medicines Anodines Marsh-Mallows Dill Mallows Camomil Henbane Tobacco Lin-seed Seed of Poppy Fenugreek Sperma Ceti Cream White of Eggs Oil of White-Lillies Linseed Ointment of Populeon fat of Hogs Hens and Mans Opium The great Vertues of the following Poultice I have not seldom experimented Take Flowers of Dill Camomil of each a handful Elder a handful and half Linseed-Meal four ounces Oil of Dill White-Lillies of each half an ounce Boil them in Milk to the consistence of a Poultice CHAP. III. Erysipelas ERysipelas is a Tumor besides Nature from Choler thrown forth for the most part only into the Skin it self sometimes on the subjacent Muscles causing Pain Heat and other Symptoms Difference 'T is perfect when sprung from Choler alone as it is imperfect when Blood Phlegm or Melancholy is mixt with it from whose Appellation it likewise takes its name and is called Erysipelas Phlegmonodes Oedematodes Scirrhodes sometimes an Ulcer is joined with it which sometimes consumes only the Skin other times the Flesh it self Cause is Choler seldom alone sometimes mixt with Phlegm and Melancholy but oftentimes with Blood or Serum whence those Medicines that are proper for a Phlegmon oftentimes do good in an Erysipelas Signs Great heat sharp pain Redness mixt with Yellowness easily giving way to the touch but as suddenly returning the Swelling and Extention of the part little and the Pulsation lesser which last gave occasion to Authors of questioning whether an Erysipelas ought to be reckoned amongst Tumors It is accompanied always with a Fever except from an External Cause Prognosticks An Erysipelas is seldom dangerous except the Matter be repell'd from the External parts to the Internal yet more dangerous when it seizeth on the Noble Parts and Jaws and when a Wound Fracture Dislocation or Putrefaction are join'd with it Cure What concerns Diet here is first and chiefly to be considered Air Meat and Drink must be cooling all sharp hot fat and sweet things hurt as likewise do too great Motion of the Body Watchings Costiveness Venery and Anger Purging is very necessary therefore those Medicines described in the third Chapter of the first Part are here convenient A perfect Erysipelas admits not of Bleeding for the fatness of the Blood bridles the sharpness of the Choler But if the Fever be vehement the Flux great and any Blood which for the most part happens be mingled with the Choler 't is convenient to bleed especially in Plethorick Bodies In delicate and weak Bodies Cupping-Glasses with Scarification or Leeches if things should require will serve These being thus done to provoke Sweat is the best of all other Remedies Outwardly to the affected part ought not to be applied 1. Oyl or any fat thing as those things which yield matter to the Choler easily increase Putrefaction But if yet it is your pleasure to use them they must be tempered by mixing them with other Medicines 2. Repellents except the Erysipelas be very little the Part affected remote from the Noble Part and the Humors be yet flowing and then they ought not to be used without Resolvents mixt with them The Cataplasms described in the foregoing Chapter may for the most part be applied here with success The Plaister of Diapalma dissolved in Vinegar is in dayly use the leaves of Tobacco Colewort and Henbane applied to the part affected strongly draw forth the heat There are those which use Sheeps dung boiled in Wine-Vinegar as also the Flowers of Camomil Mellilot and Elders boyl'd in new Milk Chalk powdred put upon the Part laying Cap-paper over it quickly and safely Cures The following Fomentations I have experienced to be of great Virtue Take Red Myrrhe powdred two drams Saccarum Saturni one dram Camphire a Scruple Opium 25 grains White-Wine six ounces Let Linnen Clothes be dipt in it and applyed warm to the Part often renewing them when dryed or cold Another Take the white Troches of Rhasis one dram Camphire one Scruple Spirit of Wine an ounce Elder-water six ounces Mingle and apply it as before Fumes of Mastick and Frankincense may likewise be used five or six times a day especially if the Erysipelas be in the Face When an Ulcer accompanies it Take the white Troches of Rhasis two drams Red Mirrhe Litharge of Gold of each a dram Flower of Brimstone half a dram Sarcocol two Scruples whites of Eggs as much as is sufficient to make it into a Linament CHAP. IV. Of Oedema OEdema is a Tumor beside Nature arising from Pituitous Matter white soft without pain oftner caused by Congestion than by Fluxion Difference It is perfect when it proceeds only from Phlegm Imperfect when mixt with other Humors Thus Oedema Phegmonodes Erysipelatodes Schirrhodes Cause is Phlegm sometimes alone sometimes confused with other Humors for the most part it is produced from the ill disposition of the Limphaeducts Signs are Whiteness Softness yielding to the Fingers little Pain and less Pulsation Prognosticks If an Oedema degenerate into a Scirrhus or Abscess it is hard of Cure It is dangerous if a Consumption or Dropsie accompany it it oftner happens in old People Phlegmatick bodies in the Winter time and in all those who with immoderate eating and drinking continually debilitate the natural heat Cure This as the precedent Tumors requires a good Diet Meat and Drink as also the Air must be moderately hot and dry Rosted Meat is better than Boiled Fruit Cheese and Fish hurt as also too great a quantity of Meat and Drink Wine either of it self or altered with hot Herbs is good moderate Exercises of the body before Meals is as profitable as much Sleep especially diurnal is prejudicial Costiveness Rest and Sadness are Noxious Bleeding is altogether here unprofitable and very seldom used but Sweating and Purging very necessary sometimes Vomiting Always regard must be had to the Stomach To the Tumor it self In the beginning we apply Repelling Medicines mixt with Discussives but so that the
that the heat by degrees may be again restored to the part and to that purpose strongly rubbing it with Snow or cold Water giving also to the Patient Treacle or Mithridate in warm Wine If the pain and cold remit let the part be embrocated very warm with Oyl of Dill Camomil bitter Almonds or Earth-worms c. A Decoction of congeal'd Turnips is good to foment withal then are required both stronger and hotter Medicines viz. Oyl of Earth of Tiles Turpentine Castor Treacle-water Mithridate Or use the following Fomentation Take Herbs of Scordium a handful and half Swallow-wort a handful Rue half a handful Seeds of Roman Nettle Cresses of each three Drams boyl them in White-wine let them be strained and to a Pint of the Liquor add Spirit of Wine two ounces Mingle it When the part hath begun to Mortifie Scarifie continue the use of the above prescribed Medicines Cure of a Gangrene from external Heat or hindred by Perspiration Let the cause of the Disease be removed if possible which if it happens from external Ligature Hot or two Astringent Medicines let them be forthwith removed from the part affected and let it be washed being first Scarified with the following Decoction Take the Water of Endive Night-shade of each six Ounces of Sorrel-water eight Ounces Vinegar half a pint Salt an Ounce and half Scordium a handful Lupines half an Ounce Mix them and boyl them to the Consumption of the third part Then let the Chirurgeon use Ung. Aegyptiacum or any other of the above prescribed Medicines Cure of a Gangrene from the Defect of Nutriment Let the Patient use nourishing Aliments all strong External or Internal Dryers hurt Friction of the part with moderately hot Medicines as with Oyl of Sweet Almonds Olives Earth-worms Scorpions Vipers Man's Fat Bears or Hens is good Scarifie if necessity require Discussives here are very injurious Cure of a Gangrene from a venemous Humor If the malignant Humor be in the Body it self Sudorifick cooling and Cordial Medicines are best For Purging and Bleeding I have seen them oftner to do hurt than good Outwardly Defensives are useless but Cupping-glasses Leeches and attractive Medicines are necessary But if the Malignant Humor come from an external Cause the surest remedy is an actual Cautery lest the Malignity spread it self which is to be used the very first time and also to put a further stop apply a Defensive to the sound part two fingers breadth distance from the wounded part so also it will put a stop to the Flux of Humors or else all the hope consists in Leeches Cupping-glasses Attractive Medicines and others set down above Cure of a Gangrene sprung from the Scurvy Internal Remedies we commit to the Physitian Externally these are commended Take Seeds of Broom Roman-Nettle Rue of each a Dram Tops of Wormwood two Drams Gum Galbanum Ammoniacum dissolv'd in Vinegar of each six drams Oyl of Juniper three drams Wax as much as is sufficient to make it into a Plaister Or Take Oyl of Earth-worms Bayes Rue of each two Drams Castor a Dram Spirit of Wine three Drams Make it into a Linament Or Take the Raspings of Guaiacum Sassafras of each an ounce Root of Angelica Celandines the greater Tamarisk-bark of each six Drams Leaves of Scurvy-grass Water-cresses of each a handful Fennel-seeds an ounce Spirit of Wine a pint and half Infuse them a Night then distil them in Balneo Mariae Foment the part affected with this and scarifie if there be occasion and let the Chirurgeon proceed according to Art Where a Gangrene hath degenerated into a Sphacelus especially in the Joynts let the Part be amputated concerning which look in the First Part. CHAP. XV. Of a Paronychia PAnaritium or Paronychia is a Tumor very painful in the end of the Finger from a sharp Malignant Humor corroding the Tendons Nerves Periostium and Bone it self Cause is a sharp humor proceeding from Choler or Serum Signs are an intollerable pain about the Nail tormenting the Patient day and night an Inflammation oftentimes extending over the whole Arm A Fever for the most part and sometimes Delirium Prognostick By how much the Humor is the more malignant the greater Symptoms it raiseth corrupting sometimes the Bone the Finger the whole Hand and sometimes from extream pain it occasions the death of the Patient Cure Foment the Finger a while in this Decoction Take Flowers of Camomile Mellilot Elder of each half a handful Linseed and Fenugreek each two drams Boil them in Milk Or let this Cataplasm be applied Take Flowers of Dill Elder Leaves of Hen-Bane of each a handful Poppy-seeds and Linseed of each three drams Marsh-mallow-powder an ounce and half Boil them in Milk to the consistence of a Cataplasm Then make Incision upon the Part affected according to the length of the Finger and for the most part there appears one or more red spots containing a sharp Matter but little in quantity which is the cause of the Disease After the Apertion of the Tumor at the first dressing apply to the Finger Treacle dissolv'd in Spirit of Wine and a Defensive to the whole Hand so in a day or two the Cure will be perfected But if this Part should be gangren'd or Sphacelated either by the neglect of Patient or Chirurgeon let it be taken off Except you will commit the business to Nature which oftentimes separates and throws out this Bone A great Inflammation sometimes here produceth a Fleshy Excrescency occult and sensless this is removed by Knife or exeding Medicines Then cure according to Art But if being too late call'd you find a great collection of Humors let Discussives or Suppuratives be applied then the Tumor being either broke or opened take great care lest the Tendons which do very easily putrifie or incline to putrefaction Separation is here necessary whether it be by Medicines or a cutting Instrument Repellents in this case greatly hurtful CHAP. XVI Of an Aneurism ANeurisma is a Tumor besides Nature from a Rupture of an Artery continually beating easily yielding to the Fingers and as suddenly returning Cause All Arteries except those that are dispersed through the Brain and upper parts consist of a double Tunicle the inmost of which being either corroded or broke the External may be extended so much without a Rupture of it whatsoever others say as to cause an Aneurism Nevertheless where the Tumor is of the bigness of ones Fist it cannot be but that the External also must be either corroded or broke Anatomy doth confirm this Opinion which the Studious in the Art of Chirurgery may enquire into This Tumor also may be caused where an Artery be divided so that the External Tunicle united to the Muscles the Internal by reason of the continual pulsation remains open Signs A Swelling increasing by degrees of the same colour as the skin a continual Pulsation If the Tumor be little it easily yields to the Fingers so that it altogether disappears but suddenly returns
Respiration Difference 'T is divided into three species the first is called Cynanthe when the Muscles of the Larinx are inflamed the Symptoms here are very dangerous although neither internally nor externally appear any Tumor the Patient puts forth his Tongue like a tired Dog to fetch his breath Second is Synanche when the Tumor shews it self within the Jaws the Symptoms are likewise here great but much less than in Cynanthe Third is Parasynanche when the Tumor appears more Externally than Internally and in this the Symptomes are least of all Cause is Blood for the most part mixt with Serum or Choler seldom with Phlegm or Melancholy Signs of an approaching Quinsie are a stiffness of the Neck swallowing and breathing somewhat hindred an unusual heat and pain in the Jaws especially when Quinsies are Epidemick Signs of a present are a suffocating Asthma swallowing hindred which often increaseth to so great a heighth that Drink taken in at the Mouth comes forth again through the Nostrils Pain Redness Tumor for the most part also a continual Fever the Tongue likewise swell'd and the Voice altered Prognostick A perfect Quinsie never wants danger but sometimes suffocates the Patient the first day generally before the fourth If the Matter be not suddenly concocted and thrown forth it is desperate if the Vertebraes be laxated death is near at hand foaming at mouth is a sign of present death if the Patient be taken with a pain of the Head a Delirium raving and death it self suddenly follows Cure Bleeding in this case effects much both by taking away of the Inflammation and by hindering its increase which is to be performed at first sight therefore let the Median or Cephalick Vein of the side most affected be opened though in Women with Child then the Vein under the Tongue Cupping Glasses with Scarification may also be applied to the Neck about the second Verrebra Shoulders and Breast Leeches Cauteries and Blisters do much good especially in them that are Subject to Quinsie In the mean time if the Patient can swallow let some purging Medicines be given him if not let a Clister be cast in with Bleeding which must be often reiterated as occasion requires Gargarisms then and other External Medicines are to be used which in the beginning are to be more Repelling afterwards more Discussing for Experience and best Authors have taught 1. Repellents never are to be used alone except in the beginning and in a light Quinsie 2. That Repellents ought always to be mixt with Resolvents for Repellents destroy the heat of the Part Resolvents cause Fluxion Medicines in a Quinsie Roots of Marsh-mallows Liquoras Herbs Comfrey Myrtle Prunella Dandelion Scabious Plantain Housleek the greater Sage Alehoof Violets Flowers of Balaustians Red Roses Saffron the four cold Seeds Poppy the Rinds and Juice of Pomegranates Figs Album Graecum Burnt-Swallows Burnt-Allom Swallows Nests Syrups of Maidenhair Violets Purslane Jujubies Scabious Lungwort Honey of Roses Rob. Diamori A Repellent Gargarism Take Flowers of Red-Roses Balaustians of each two pugils Pomegranate-Rinds half an ounce Oak-leaves a handful Burnt-Allom half a dram Boil them in Smith's Water and add to a pint of the Liquor two ounces of Rob. Diamori Mix them Another very convenient in the beginning of the Disease Take leaves of Dandelion two handfuls Alehoof Violets of each half an handful boil them in Barley-water and to a point of the strained Liquor add of common Honey of Roses and strained of each an ounce and half Spirit of Vitriol 15 drops Mix them A Repellent and somewhat Discussive Gargarism Take Liquoras Pomegranate-Rinds of each two drams Balaustia Flowers a pugil Jujubies No. xij Figs No. iij. Raisins six drams boil them in Barley-water To a pint of the Decoction add of common and strained Honey of Roses Syrup of Maiden-hair of each an ounce Mix them A Gargarism greatly Repelling but strongly Discussing Take the Roots of Dwarf Elder Orrise of each two drams Flowers of Camomil a pugil Red-Roses Hysop of each two pugils Dates No. iij. Figs No. vj. Fenugreek-seeds two drams Album Graecum one dram Boil them in Turnep-Broth Add to it Syrup of Maiden-hair and Jujubies of each an ounce Mix them If the pain be very great boil them in new Milk chiefly in Goats External Medecines for a Quinsie Oyl of Nuts White-Lillies Almonds Camomile Dill Capons-grease Hoggs-grease Ointment of Marsh-mallows Plaister of Musilages Dogs and Pigeons-Dung Swallows-Nests Take Roots of Marsh-Mallows White-Lillies of each an ounce one Swallows Nest Figs Dates of each No. iij. Album Graecum half an ounce Boil'd Onions half an ounce Boil them in Barley-water and to a point of the strained Liquor add of Wheat-meal and the Powder of Lin-seed of each an ounce Fenugreek and Marsh-mallows powdered of each two ounces and a half Yolks of two Eggs Eastern Saffron two drams Oyl of Camomile two ounces and a half Make it into a Cataplasm Take Juice of Onions two ounces Oyl of white-Lillies Orise of each an ounce and half boil them a little adding to them of Swallows-Nest a dram Pitch and Wax as much as sufficeth to make it into a Plaister But if the Tumor tends to Suppuration 't is to be forwarded and then to be opened either by Medicines or Launcet A Suppurating Cataplasm Take Roots of Briony white-Lillies Orrise of each three drams Leaves of Pellitory of the Wall a handful Camomile-Flowers half a handful Onions an ounce Figs No. xij Boil them and bruise them adding of the Powder of Fenugreek-seed and Lin-seed of each two ounces Hens grease an ounce Oyl of Camomile two ounces Mix them A Suppurating Gargarism Take Roots of white-Lillies and Liquoras of each three drams Onions half an ounce Raisins stoned an ounce Figs No. vj. Lin-seed and Fenugreek of each two drams Leaves of Mallows and Coleworts of each half a handful boil them in Barley-water and to a pint of the strained Liquor add of Syrup of Maiden-hair two ounces Mix them And to make the Abscess break add to this Gargarism Take Mustard-seed two drams Roots of Pollitory of Spain powdered one dram Saffron a scruple Oximel simple an ounce Mix them But if it doth not forthwith break by these Medicines 't is to be opened by a Launcet or some other Instrument afterwards using Emollient Gargarismes and somewhat abstersive The end of the first Book of the second Part. BARBETTY'S CHIRURGERY The Second Book of the Second Part Of CHIRURGERY Of Wounds CHAP. I. Of the Nature Differences Causes and Signs of Wounds A Wound is a Solution of continuity in the soft parts of the Body from a hard Instrument causing an Abolition or Immination of Action Differences are taken 1. From the Form some are long others oblique some are little others great some are deep others superficial 2. From the wounded Part as the Head Lungs Heart Stomach Liver Spleen Guts Nerve Tendon Vein or Muscle sometimes the Skin is only penetrated then 't is a simple Wound sometimes a Part
of the Flesh is taken away and then 't is call'd a compound or hollow Wound 3. From the Causes which shall presently be set down sometimes a wound happens to be poisoned and to have many Symptoms joined with it Causes are five-fold viz. 1. All things that cut as a Knife Sword Glass 2. Al things that prick as Needles Arrows Teeth 3. Which perforate as hot Iron Bullets 4. Which break as a Fall Stroke or the carrying or lifting of any great Burdens 5. All things which contuse as a Stone Stick c. Signs External Wounds are of themselves manifest enough but those of the Internal parts are not always so easily judged of these therefore are to be known by Anatomy 1. What is the situation of each part 2. What the use 3. The Symptoms are to be considered 4. The Quality of those things are to be noted that Nature ejected through the Wound The other Signs you shall have in their proper places Prognosticks To know the Events of Wounds especially to predict which are Mortal which not is a thing absolutely necessary for a Surgeon For from this judgment oft-times depends the Life of unfortunate Man A mortal Wound is that which in the space of few hours or days of necessity causes Death and cannot by any Art be cured For those that in themselves are curable yet by reason of ill Symptoms or through the neglect either of the Patient or Chirurgeon do occasion Death ought not to be accounted mortal Wounds Incurable Wounds themselves are not to be call'd Mortal if they are not the cause of Death suddenly to the Patient but that he not only lives many weeks but oftentimes many years after 1. Among the Wounds that are Mortal are to be accounted the Wounds of the Brain but not all of them for Experience hath taught us that part of the Brain hath been taken forth and the Life preserved though the Understanding lost Therefore those Wounds of the Brain that be absolutely mortal are 1. When besides the Brains a Nerve is also wounded 2. When Blood or some other Humor obstructs the beginning of the Nerves 3. When after a few days the concrete and putrified Blood produceth a Fever Delirium and Death it self By concreted Blood I understand not that which lies between the Dura-Mater and the Skull for that is to be taken forth by the Trepan and the Patient this way may be preserved but that which is included between the Dura and Pia-Mater or between the Pia and the Brain Although sometimes that which is detained between both Membranes by the dividing of the Dura may be taken forth and so the Patient preserved 2. The Wounds of the Spinal Marrow are also mortal which happens in the Neck or nearer to the Head but those which happen lower as about the Os Sacrum are of lesser danger 3. The Wounds of the Lungs are mortal if great and deep where the great Vessels or the Branches of the Aspera Arteria are hurt Where the Vessels are divided there follows a great effusion of Blood where the Branches of the Aspera Arteria the Breath comes forth more through the Wound than the Mouth 4. Wounds of the heart are always mortal for though one or two wounded in the heart have lived two three or four days it was never found yet that ever any escaped 5. The Wound of the Wind-pipe may be cured if the Membranes only behind to which the Cartilaginous Rings are join'd be hurt but if the Rings themselves are wounded there 's no cure to be expected yet sometimes those wounds being a lingering Death so that I have seen on so wounded live Eighteen weeks before he died 6. Wounds of the Diaphragma those that are inflicted in the fleshy Part of it are curable but those that are in the Nervous Part though these always occasion not sudden Death yet 't is impossible ever to cure them 7. Wounds of the Stomach are sometimes cured those chiefly being mortal that happen in the upper Orifice or in Nerves that are distributed over the Stomach 8. The Wounds of the Small Guts are seldom cured but the Wounds of the Great Guts much oftner especially if they are not great 9. Wounds of the Liver and Spleen are mortal where the Vessels themselves are wounded where not they may be cured 10. Wounds of the Kidneys are not mortal if the Wound penetrate into the Cavity it self for the most part an Ulcer follows which consumes the whole Kidney yet the Patient may continue many years If the Parachyma only be wounded sometimes through difficulty it may be cured 11. Wounds of the Bladder are seldom so perfectly cured but that for the most part there remains a Fistula but those that are made at the neck of the bladder are daily cured 12. Wounds of the great Veins and Arteries are often mortal but every Surgeon understands not rightly to bind up such Wounds therefore the cause of death is not always to be cast upon the guilty 13. Wounds of the great Nerves are for the most part incurable and sometimes mortal 14. Wounds from poisoned Instruments or Creatures generally are mortal Wounds of Nerves Veins Tendons and Membranes are more difficultly and longer of Cure than those of the fleshy parts A Wound from a pricking Instrument is of less danger than from a bruising A Nerve Vein or Artery if wholly divided are less dangerous than if they were but in part A great Inflamation coming upon a great Wound is of no great danger except it continue too long but a great Inflamation falling upon a little Wound is an ill sign The Inflamation for the most part vanisheth by the fifth day therefore if the Wound then appear white livid or black 't is not void of danger A Fever Vomiting and Convulsion are dangerous but a Fever and Vomiting of less danger than a Convulsion CHAP. II. Of the Cure of Wounds in general HEre are required four Intentions 1. To preserve the strength and native heat of the wounded Part. 2. To remove the Symptoms 3. To endeavour that nothing remains or be left behind in the Wound 4. That the gaping Lips of the Wound be joined together and being so joined be kept CHAP. III. Of the preservation of the strength and Native heat in the wounded Part. CHirurgery removes the impediments of Cure but Nature her self cures the Disease which it will scarce effect where the Native heat is weak or the Blood vitiated or where it flows in too great or too little quantity to the Wound in flowing in too great quantity it produceth an Inflammation Pain Putrefaction and many other Symptoms where in too little quantity the Wound is robbed of its Natural Balsam necessary to consolidate it The natural strength and native heat is preserved by a convenient Diet fitted to the temperament of Mans body in general and in particular to the Part affected Of the Diet of the Sanguine Cholerick Phlegmatick and Melancholick we have treated of before
the Tendons Arteries or Veins 't is not easily cured but for the most part the Tendon and Nerve are corrupted with it No Ulcer can be cured whilst the Bone remains foul Cure The corrupted Bone ought to be corrected either with Medicines or with Chirurgery or by both Therefore the flesh must be divided as soon as may be that the Carious Bone may be laid open left some considerable Nerve Tendon or Artery be hurt according to the length of the Part and the Ductus of the Fibres not transverse then let those Medicines be applied that may separate the Corrupted Bone from the Sound and that may preserve the Sound from Corruption Medicines against Corruption of the Bone Roots of round Birthwort Briony Orrise Dragons Hores-strong Guaiacum Bark of the Pine Aloes Euphorbium Mirrhe Alom Chalcanthum Lime Chrysocalla burnt Pumice the Scales of Brass Aqua-fortis Spirit of Brimstone of Vitriol Salt Tartar Oyl of Vitriol Brimstone Antimony Take Mummy Sarcocols of each half a dram Euphorbium a dram Mix them and make a Powder Take Roots of Round Birthwort Orrise Hore-strong of each half an ounce Mirhe Aloes of each a dram and half Bark of the Pine Scales of Brass of each a dram Earth-worms two drams Honey as much as sufficeth to make it into an Ointment Take Juice of Celandine the greater two ounces Spirit of Wine an ounce Mirrhe Aloes of each two drams White-Vitriol a scruple Mingle them for an Injection If the corruption of the Bone be so great that it cannot be removed by Medicaments then we must come to Chirurgery and either scrape the foul Bone if the corruption be small or Perforate it if great or rather use an actual Cautery for without these you will scarce be able perfectly to cure it CHAP. VI. De Vlcere Depascente c AN Ulcer further and deeper spreading is call'd Depascens and if it be with putrefaction is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 if without it Phagaedaena if only in the Skin Herpes if ill-natured Cacothe Cause is the salt Serum of the Blood salt Phlegm burnt Choler or some other Malignant Humor These Ulcers can scarce be cured unless the Cause be first removed and the whole Blood purified therefore here must be observed a good Diet often Purging and sometimes Bleeding External Medicines for Depascent Ulcers Plantain Night-shade Flowers of Red-Roses Balaustians Cypress-Nuts Pomegranate rinds Frankincense Mastick Tutty Ceruse Litharge Red-Lead Burnt-Lead Brimstone Pepper Ginger Mercury Ung. Aegyptiacum Fuscum Diapompholigos Emplast de plumbo de minio Gryseum de ranis cum Mercurio Take flowers of Red Roses Balaustians of each a handful Leaves of Plantain half a handful Cypress-nuts Mirtle-berries Pomegranate rinds of each half an ounce Boil them in Red Wine Wash the Ulcer with it then use over it this following Take prepared Tutty half an ounce Burnt-Lead washed Ceruse of each an ounce Bole-Armenick half an ounce Ung. Aegyptiacum as much as is sufficient to make it into an Ointment Or Take Long-Pepper half a dram Ginger a scruple Flower of Brimstone Litharge of Gold each two drams Gunpowder a dram Ung. Fusci of Felix Wurtz three drams Ung. Album Camphoratum as much as sufficeth Make it into an Ointment Take Mastick Frankincense Mirrhe of each three drams Litharge of Gold Burnt-Lead of each half an ounce Quicksilver extinct in Turpentine two drams Brimstone half an ounce Pitch and Wax as much as is sufficient to make it into a Plaister Concerning the Cure of these Ulcers 't is to be noted 1. External Medicaments ought to be changed three or four days for Nature rejects the best longer applied 2. They ought not to be drest above once or twice a day except the Matter be very sharp that the Medicine may not be disturbed in its Operation 3. Repellent and Mercurial Medicines are not to be used except with continual Purging you drain the Body of its Impurities 4. These Ulcers are seldom cured without the use of purging or drying Decoctions made of China Guaiacum Sarsa c. CHAP. V. Fistula's A Fistula is a long narrow hollowness or a sinewous Ulcer narrow and callous not easily receiving Cure for the most part taking its beginning from an Abscess Difference are straight oblique simple manifold that is having many hollownesses some going to the Bone some to the Veins Tendons or Nerves Signs The edges of this Ulcer are white hard without pain or but little sometimes moist but commonly dry Outwardly the Cavity may be perceived in one place or other by pressing the Part in which also sometimes there is a noise perceived and the Matter now in lesser quantity otherwhiles in greater is prest out through the Orifice of the Fistula By a Probe we can search the Cavity of a straight Fistula but in an oblique we use a Wax-Candle instead of a Probe That is more convenient when the Fistula penetrates to the Bone this when it is in the fleshy and sensible parts If the Fistula remains only in the fleshy parts that which is touched by the Probe is soft and the Matter that comes out is white equal and in great quantity If it extend to the Nerve there is great pain in searching it to the bottom of the hollowness and the Matter is fat and oyly but is less in quantity and the action of that Member which the Nerve goes to is rendred very uneasie If it passeth to the Bone that which is touched by the Probe is hard not yielding and painful where the Periostium is not consumed The Bone is foul is rough and seems unequal to the touch the Matter is black stinking and very thin If the Cavity joins to a Vein the Matter is like dregs but reder and thicker where the Vein is eroded If it penetrates the Arteries that which comes forth is thin and shining and comes forth with a leaping Prognostick All Fistulas are of hard Cure some incurable others that ought not to be cured to wit those by which the superfluous Humors have for long time been vented A recent Fistula and not deep in a young body and otherwise sound is easily cured but an old deep Fistula having many Sinew's in an ancient emaciated cachochimick Body is very difficult Those are also difficultly cured yea for the most part incurable which touch the Tendons Nerves Veins Arteries Bones and those that are in the joints Vertebra's Cavity of the Breast and lower Belly the Womb Bladder or Guts Fistulas are wont to come in those places where Nature is accustomed to discharge her self of vitiated Humors to wit in the Abdomen Groins Buttocks Fundament Cod and Perinaeum Where the edges are not very hard but somewhat soft and mattery they do promise speedier Cure Cure of Fistulas are twosold one Real and the other Palliative by this the Fistula is dried within and skinned without the hollowness nevertheless remaining commonly continuing some little while closed but easily breaks forth again except by a good Diet often Purging
be purified and in some manner concocted in which its operation that the Blood may be rendred more perfect 't is carried to the Heart especially when by reason of its continual and necessary Pulsation the Blood cannot remain long in the Heart and for this reason I judge the whole Blood must needs be moved about with a circular motion The Blood made in the Liver as is declared but now in the eighth Chapter enters the Vena Cava and from thence into the Heart And thus the Royal Liver at the same time when Kings are taken away may yet use a limited power and may remain with honour in its own Kingdom But what shall we do with the Melancholick Spleen which makes many laugh It hath many accusers and not fewer excusers 1. It was never accounted by Hippocrates the Learned Greek a receptacle of the Excrements or is it any where to be found in him that he call'd the Spleen another Liver 2. The great number of Veins and Arteries and so by consequence the abundance of Vital Spirits do not permit the Excrements to be collected here 3. It hath not any convenient Cavity wherein the Melancholy Faeculent Juice can be received 4. And if you imagine that there is no necessity here of a Cavity its Parenchyma is too thick and not porous enough therefore unfit for the reception of so thick a Humor which also is never naturally found in it 5. It is too great a Bowel to perform so vile an Office 6. In dead men where Melancholiness hath been the cause of their death upon the examination of the Internal parts there none of them less recede from its natural state than the Spleen the Heart only excepted whom the Vital Spirits do so greatly defend that it is less affected than other parts which seldom happen to the Intestines Kidneys Gall and Bladder What is therefore its Use It elaborates the Acid Humor which is very necessary but not Excrementitious and mingles it as a Ferment with the Blood by which it becomes more perfect and fitter for Circulation In my judgment the Salt of the Blood affords matter to this Humor which it greatly requires that it may not be corrupted but this Salt which proceeds from the Meat and drink is never so pure but that it hath need to be brought to a more perfect state in our Body But this is my Opinion The Supremest of the Kings is the Heart to this are two others subject the Liver and Spleen I beseech you give me leave to make use of this Similitude in favour of the Ancients the Heart makes the Blood the Liver repeats the Concoction and separates the Choler the Spleen from its own Salt by an innate vigor produceth an Acid Humor which as a Ferment by the Venal Splenic Branch it mixeth with the Blood to render it the perfecter and the more fit for Circulation if any Excrementitious part should be there separated it is all by the Caeliack Artery and the Haemorrhodal Vessels sent to the Guts If it appears to any one to be a contradictory that by Salt a Humor should be made Acid we advise that person to taste some Spirit of Salt About sixteen years since the great Anatomist Franciscus Sylvius put forth some particular things concerning the use of the Spleen he was of opinion that the Blood was not made in the Ventricles of the Heart neither that it was carried from the Heart by the Arteries to all the parts of the Body for nourishment-sake alone but that it likewise underwent some other Mutation in the rest of the Viscera's particularly that the Spleen further concocts the Arterial Blood and brings it to a higher degree yea that it more then perfects it so that the Blood in a manner in this place assumes the nature of Ferment by whose means in a short time a great quantity of Mass may become acid in the same manner he affirms that the Blood more and more concocted in the Spleen there receives strength by which it restores the returned and weakned Blood and preparing together with it the Chile that it may the sooner be turned into Blood The Reasons which he produceth for it are these 1. The Spleen receives a much greater quantity of Blood from the Heart than is necessary for its nourishment 2. That it can be returned back again to the Heart by no other way than by the Branches of the Vena Cava and Porta for what hath hitherto been delivered of the short Vessel are to be accounted but ridiculous Fictions as may most evidently be made appear in dissected Bodies 3. Seeing this Blood is continually mix'd with the returned Blood and Chile in its passage to the Heart it ought not to be an Excrement for so the Noble Parts and the whole Body would not be purged but the more injured 4. Chymistry hath long since taught us that such mutations happen daily in Nature The Remaining Part of the Blood unuseful to the Body therefore Excrementious is thrown out through the Guts Ureters and Parts of the Skin c. concerning which it is not necessary to add more here but now we are forced to describe those new watry passages which the studious in Anatomy have long and diligently inquired into The watery passages the Lymphatick Vessels have their rise both from the Liver and from the Joints and receive the liquid Juice from the Arteries with which they correspond Those which come from the Liver embrace the Vena Porta and so pass to the Misaraick Glandules of the Chile as do those also that ascend from the Feet thence they discharge their Water into the great Lacteal Vein which as we have already declared carries the Chile to the Heart Those which proceed from the Arm both lie above and under the Veins until they come to the Subclavial Vein which they enter about the same place where the great Lacteal Vein doth being furnished with a particular Valve just at their entrance and so altogether they carry the Water to the Heart This Water is Sweet not being as Urine is Salt These Vessels consist of a very thin Tunicle whence they are soon broke Use of them in my opinion is to take the superfluous Water from the Arteries and carry it to the Glandules of the Chile and Lacteal Vein by which the Chile being made more Liquid may the more conveniently be conveyed through the narrower passages thence to return the same to the Arterial Blood making it fitting to serve to the nutrition of the moist parts and to the cooling and moistening of the hot But that it may the more clearly appear in what manner I conceive how what hath already been said is perform'd in our Body observe that the Meat is converted in the Stomach into Chile to which part of the Drink is mingled this mixture is carried through the Glandules of the Chile and the great Lacteal Vein into the Heart where it is changed into Blood which is by means of
operation is injured 3. A just magnitude one Foot greater than the other causeth a troublesome walking 4. A Natural Figure Softness Thickness yea colour it self 5. A convenient Connection and sight 6. The presence of the Vital Spirits which are brought to the Part by the Arteries 7. The presence of the Animal Spirits which are carried by the Nerves 8. Outwardly the Skin that covers the whole Body Inwardly the Dura Mater the covering of the Brain Palate Tongue Jaws Breast and lower Belly requires also a particular Consideration 9. It is likewise necessary that the Nutriment be well concocted naturally carried and receiv'd that there may no defect be observed in the Parts The End of the First Book of the Third Part. The SECOND BOOK OF THE HEAD CHAP. I. Of the Outward Parts of the Head THE Head as Supream Lord both of its own and of a thousand other Bodies not only governs it self but others well when formed with a healthy Constitution and instructed with the knowledge of its own Office but they live a miserable life whose Head is not justly and with Art composed and who neither enquire into or know its Substance or Figure It s Figure is Oval the upper part is call'd Vertex the fore-part Frons the hinder-part Occipút the sides Temples the rest is call'd the Face and consists of the following parts First appears the Skin in several places endowed with Hair but in all with a Scarf-skin Under this lies the Membrana Carnosa and Pericranium which takes its rise from the Dura Mater and passing through the Sutures of the Skull first invests the Skull then all the other Bones Anatomists that are very curious make the Pericranium to be double the outward retains the old name of Pericranium the inward is called Periostium The Bones which lie under these Membranes first we divide into the Skull and Jaws then into many other Bones The Skull is composed of eight Bones joyned together by proper and common Sutures The proper Sutures are true or spurious The true are three 1. The Coronal 2. The Sagittal 3. The Lambdoidal The Spurious are the two squamous Sutures of the temporal Bones The common are three likewise 1. The Frontal 2. The Sphoenoidal 3. The Ethmoideal The Bones themselves which have many perforations and cavities for the passage of the Air of the Veins Arteries and Nerves are eight 1. The Bones of the Fore-head always in Children sometimes in old people is divided just to the root of the Nose by the sagittal Suture 2 3. The Bones of the fore part of the Head or Bregma 4 4. Temporal Bones or Petrosa 6. The Lambdoidal or Bone of the hinder-part of the Head 7. The Sphoenoidal or Wedge like Bone 8. The Ethmoideal Bone or Cribrosum The Muscles of the Forehead are the two Attollentes Muscles of the hinder part of the Head are the two Deprimentes The Jaws consist of several Bones conjoined so by Harmony that in old people they appear but as one the one is called the upper the other the lower Jaw The upper Jaw is composed of eleven Bones of each side five the odd eleventh is placed in the middle 1 2. Os Zygomaticum or yoke-bone makes the lower part of the Orbite of the Eye constituting with its Apophisis the Os Jugale or Zygoma 3 4. Os Lachrymale makes the internal corner of the Eye having a large Orifice descending to the Nose 5 6. Os Maxillare or Jaw-bone particularly so called which is the greatest of all the Bones which constitutes the Jaws 7 8. Os Nasi or Bone of the Nose which in its end hath five united Cartilages 9 10. Os Palati or Bone of the Palate 11. Vomer A peculiar Bone above the Palate which supporting the interstice of the Nose and joined to it by Harmony The upper Jaw moves not but when the whole Head moves therefore needs not proper Muscles The lower Jaw which generally remains divided in the fore-part till the eighth year and afterwards is so closly joined together as it appears to be but one Bone hath two Processes and in them a Cavity big enough to allow a convenient situation to the Veins Arteries and Nerves from whence the Teeth receive their Nutriment and Sense The Branches of the Nerves about the Chin pass out again through a little Orifice are distributed into the Muscles of the Lips It is moved by six pair of Muscles which are 1. Pterygoâ—… Internus Attollentes 2. Digastricus Attollentes 3. Latus Deprimens 4. Pterygoideus Externus bringing them forward 5. Masseter 6. Musculus Temporalis This Muscle hath this peculiar to it self that it is covered by the Pericranium by which the subjacent temporal Bones are altogether destitute of it which is not observ'd in any other part of the Body But no man hitherto as I know of hath yet given the Reason of it for whatsoever hath been delivered by others concerning this hath been so slight that they give little satisfaction to the lovers of Truth But of late Job Mekeren an Experienced Chirurgion of this City hath in an Epistle communicated something particular relating to this matter the substance whereof I here give you until he put forth his Observations some of which I have seen TO Dr. PAUL BARBETTE Physician at Amsterdam SIR I Will truly declare to you my Opinion concerning the Question I informed you I had moved in the company of some Physicians which was Why the Bones which lie under the temporal Muscles are not covered and invested by the Pericranium as are the other Bones On the 6th of Janaury 1654 being commanded by the Honourable Senate of this City to open the Head of PETER JACOBS Brick layer then was my Opinion which I had been hitherto big withal sufficiently confirmed for as soon as I had observed a great depression in the upper part of the Skull I also found a great quantity of coagulated Blood which had part of it past through the Ears and part of it remained yet in the Cavity of the Ear then being very desirous to know the way by which this Blood had descended into the Cavity of the Ear which when I had diligently enquired into I also discovered the reason and cause wherefore the Pericranium covers in this place the temporal Muscles and not the Bone under them First The Opinion and the Answer which the Honourable and Experienced Dr. TULPH Burgomaster of Amsterdam had given to the propounded Question to wit from whence this Blood should come which very often in Wounds of the Head flows out of the Ears I found to be true and reasonable for I perceived as the Noble Consul had affirmed to me that the Blood from the upper part of the Head did descend between the Skull and Pericranium and so did enter the space that is between the Os Parietale and Petrosum and from thence to be as it was strained through a Sieve into the Cavity of the Ear afterwards in searching further I found
together In great Noses there are likewise two other Muscles which we call'd Aperientes which open the Nostrils The Mouth the Gate of Air Speech and Nourishment hath two Lips the parts of each side call'd Cheeks as that below is call'd the Chin. The Lips have two Muscles common to the Jaw 1. Quadratus or drawing backward In some this motion is performed by the Zygomative 2. Buccinator The upper Lip hath two Muscles proper to it self 1. Sursum Trahens or drawing it upwards 2. Deorsum Movens or moving it downwards The under Lip hath but one Deorsum trahens or drawing it downward Common to both the Lips are 1. Obliquè sorsum trahens or drawing them obliquely upwards 2. Obliquè deorsum trahens or drawing them obliquely downwards 3. Sphincter Oris Constrictor or Orbicularis which purseth the Mouth together The inward parts of the Mouth are the Teeth the Gums the Palat Uvula Tongue and Os hyodis Of the Teeth we have treated The Gums offer nothing worthy a particular consideration The Palat consists of a sensible Membrane common to the Stomach which hath its rise from the Dura Mater The Uvula is a long little Body it hath two Ligaments as many Muscles but very little The Tongue as a Sword-cutting out Honour either well or ill as it is moved by pure or impure Spirits behind is fastned to the Larinx Os Hyodis to the Jaws and to the Tonsils before to a certain Membranous and strong Body whose extremity makes the String of the Tongue Of both sides the string lies a Glandule call'd Ranina from the neighboring Vessels It hath two Veins call'd Raninae from the Jugulars two Arteries from the temporal two great Nerves from the seventh pare as also many little ones from the fourth and fifth It is destitute of Fat. Its Muscles are 1. Genioglossus which brings the Tongue forward 2. Styloglossus which draws it upwards 3. Myloglossus which draws it obliquely upward 4. Basiglossus which draws it directly inward 5. Ceratoglossus pulling it downwards Os Hyodis by the assistance of Muscles and Ligaments is tied to the sharp process of the temperal Bones and to the Buckler-like Cartilage of the Larinx it is composed of five united Bones the middlemost of these which is the greatest call'd the Basis of the Tongue hath two Cartilaginous Productions which often degenerate into Bones It hath four Muscles on each side 1. Geniohyodes raising it directly upwards 2. Sternohyodes moving it directly downwards 3. Styloceratohyodes obliquely bringing it upwards 4. Coracohyodes obliquely drawing it downwards All these are the outward parts of the Head which is either solely moved by its own proper Muscles or together with them likewise with the Muscles of the Neck these shall be treated of hereafter The proper Muscles are 1. Flectens or the nodding Muscle 2. Splenius or the Muscle that shakes the Head 3. Complexus the associate of the Splenius 4 5. Obliqui drawing the Head obliquely backwards 6 7. Recti drawing the Head straight backwards Chirurgical Considerations Very many as well Internal as External Diseases take their rise from the Head which is is not improperly compared to a House-roof that receives the vapours of the whole House which afterwards being changed into a Catharre distils upon the inferiour parts creating a Pain and Palsie in the Joynts an inflamation in the Eyes and Jawes c. a shortness of breathing in the Breast and in the Stomach a depraved Chylification in the Guts a looseness c. some of the External Diseases shall here be considered by us the Internal belong to the consideration of the Physician 1. There is often in the Head Porago Achor or Favâ—…s which is a crusted Scab happening as well in old as young people these Scurffs are oftentimes very thick sometimes accompanied with moisture which causeth great itching and a very ill smell The Cause is salt Phlegm it is for the most part a stubborn Disease and very easily returning again The Cure In this case are generally used strong Purging Bleeding Sweating Salivation Unctions pulling out of the Hairs But without using any of these Remedies I have often cured this Disease only with this Decoction Take Ashes which are call'd by the Dutch Weidasch in English Pot-ashes with White-Wine make a Lixivium of a moderate Acrimony in a quart of which boil the Leaves of Marjorum Southern-wood of each two handfuls of Maiden-hair a handful and half Rose leaves three pugils Make a Fomentation With this let the head be washed twice or thrice a week warm then dry it well with hot Linnen Clothes and in a few weeks space the Patient with thus doing will be cured You may likewise sometimes use gentle Purging Medicines 2. In a Hydrocephalus and great Cathars an Issue with great success may be made in the Nape of the Neck because the Cavities of the Dura Mater are thereabouts joyned to the Jugular Veins especially in Children in whom very often the Sutures do too much gape 3. Fat things hurt the Head because it is not covered with many Muscles 4. In the Skull sometimes a rough matter is collected in several places which if not remov'd by those Medicines that purge Phlegm and outward discussives in process of time acquire a very great hardness which still increasing grow into a perfect Horn not to be cured but by Chirurgery 5. Upon the Skull likewise comes other Abscesses which although they may belong to a Steatoma Atheroma or Melicerides yet in the Head especially they are call'd Testudo Talpa Natta These give little hope of Cure where the Bone is much corrupted otherwise they may be taken away by a Thred or what is better by a Knife when they reject other Remedies The manner of taking them away by a Knife is this the Skin being divided in form of a Cross the Bladder is to be taken out then the Pericranium being separated the Cranium is to be scraped with a Raspatory till you come to the sound part then sprinkle upon it some Astringent powder and let the Skin forthwith be consolidated again which if it be too loose a little part of it may be taken away which is very seldom necessary to be done when it may be closed enough in the time of the Cure 6. If the Sutures of the Skull are too open they bring a weakness upon the Brain if they are too straightly united they cause the pain of the Head Experienc'd Chirurgions affirm that it is as safe to use the Trepan in the very Sutures themselves as any other part of the Head 7. The Muscles of the Head occasioning nothing differing from other Muscles except upon a Wound or Contusion of the temperal Muscle a Convulsion easily follows neither ought it to be transversly divided lest there happen a distortion of the Mouth 8. The Teeth seeing they neither are furnished with Membranes nor Nerves are altogether insensible but they which attribute the pain to those Membranes which cover the Alveolus
found four Cavities sometimes seven in which many of the branches of the Carotide-Arteries are inserted afterwards joining with the Jugular Veins These Cavities have the use and substance of Veins so that they may not unproperly be reckoned among the Veins The Pia Mater is more sensible hath more Arteries than the Dura which doth not only invest the whole Brains but also enters the winding every where which for this cause may more easily be separated We do divide the Brain into three Parts which are 1. The Brain it self 2. The Spinal Marrow 3. The Cerebellum or little Brain The Brain is of an Ashy colour and of a softer substance than Marrow which is both whiter and solider whence also it was wont to be call'd Rind it receives several Branches from the Carotide-Artery and is destitute both of Nerves and Sense It hath divers turnings and windings which fold in deeply especially those in the fore-part of the Head where the great Fissure divides the Brain outwardly even to the Marrow The Marrow is the Mother of all Nerves within the Skull 't is call'd the Marrow of the Brain but without it is termed the Spinal Marrow The Cerebellum or little Brain is more of an Ash-colour than White receives Arteries from the Cervicalis and Carotide yet there are fewer branches here than in the Brain as being much less It hath no windings but is made up as it were of several thin plates lying one upon another These being thus considered the Anatomist takes off some part of the Brain with a Knife forthwith the Corpus Callosum and the Fornix joyning to it come in view Under these laterally lie two great Ventricles in figure resembling a Horse-hoof which the Septum Lucidum distinguisheth into the right and left or into the first and second In them is contained the Rete-Mirabile or Plexus Choroides consisting of many little Glandules composed from the branches of the temporal Artery twisted together in form of a Net In the fore-part these Ventricles are united and make a third In this third Ventricle are two Cavities the first of them runs to the Infundibulum and to the Glandula Pituitaria the other to the fourth Ventricle contained in the Cerebellum above this Ventricle are observed four round Bodies which are call'd Testes and Nates to which joyns the Glandula Pinealis which is falsly call'd by some the seat of the Soul Of late the famous Sylvius hath demonstrated it not to reside in the Ventricles but without them by whom also it is esteem'd but a Glandule and that with more reason because that both he and I have found in it not seldom two or three Stones but sometimes four which we yet keep by us The Bodies being removed eight pair of Nerves appear which we have already treated of on the fore-part of whom joyns the Rete Mirabile of Galen which is a complication of the Cervical and Carotide-Arteries After these the Cerebellum comes in view like a double Globe in the midst of which is the Processus vermiformis and Pons Varolii under it lies the fourth Ventricle Last of all the Spinal Marrow shews it self divided in its beginning into two Parts not unlike a Writing-Pen which descending down the Back imparts its branches over the whole Body Chirurgical Considerations 1. In Wounds of the Dura Mater two Symptoms render their Cure very troublesome to wit a Flux of Blood and extream Pain if the Skill be not sufficiently open without any delay the Trepan is to be applied on the Part affected and forthwith the extravasated and grumous Blood being discharged let this Ointment be applied Take Manna of Frankincense two drams Aloes one dram Mirrhe a dram and half the softest Hares hair half a scruple white of an Egg as much as sufficieth to make it into a Liniment The Powder is also very useful that is described in the Chapter of particular Wounds in the second Part of this Chirurgery To mitigate the pain Oyl of Roses Violets and Myrtles used warm as also the warm Blood of a Hen or Pigeon c. is very much commended The Flux of Blood and the Pain being ceased the following Medicines are to be used which are not to be left off unless the Matter begins to flow too plentifully Take Oyl of Turpentine two ounces Spirit of Wine Syrup of Wormwood of each an ounce Mix them But if a Gangrene or Putrefaction should happen the following Liniment is of great use Take Sarcocols Mirrhe Aloes of each a dram Syrup of Wormwood Honey of Roses of each two drams Ung. Aegyptiacum two drams and an half Aq. vitae an ounce and half White-Wine an ounce Let them boil gently then strain them Neither do I apprehend any danger is to be feared in the taking off part of this Membrane when putrifi'd so that you can come at it with a pair of Scissers and that the Sinus or Pia Mater be not hurt 2. When the Pia Mater is likewise affected the Chirurgion must abstain from all Oyls although they be drying lest a Corruption of the soft Brain be caus'd Drying Cephalick powders are very convenient to be used here But seeing that these Wounds for the most part are Mortal I shall say no more of them CHAP. III. Of the Neck THe Neck under the Scarf-skin Skin and fleshy Membrane and the common and proper Membrane of the Muscles hath of each side four Muscles Of these the Longus and Scalenus bend it Transversalis and Spinatus draw it back of each side It hath five Veins Cervicalis Muscula Superior and Inferior Carotis Interna and Externa And as many Arteries Cervicalis Muscula Superior Inferior Carotis Interna Externa It hath Nerves from the Par Vagum and the Spinal Marrow In the fore-part of it are many Glandules which are greater in Women than in Men. Under these the Larinx the Organ of the sound lies composed of five Cartilages which are 1. Thyroides or Buckler-like 2. Crycoides or Annular 3. Arytenoides 4. Glottis 5. Epiglottis It is moved by six pair of Muscles which are 1. Hyothyrodaei the pair that lift up the Larinx 2. Bronchii the pair that pull it down 3. Cricothiroidaei antici the pair that dilate 4. Cricothiroidaei laterales pursing it together 5. Thyro-arythenoidaei that open it 6. Arythenoidaei Sphincters that close it After these the Almonds or Paristhima by some call'd Tonsils offer themselves then the Pharynx to which appertain seven Muscles by whose assistance the Meat and Drink are swallowed 1 2 Sphenopharyngaei which raise up the Pharinx 3 4. Cephalopharyngaei moving it inward 5 6. Stylopharyngaei dilating it 7. Constrinctor or sphynctor which closeth the Gullet The back-part of the Neck hath seven Vertebra's the processes of some of which are perforated to give passage to the Vessels that carry the Blood into the Brain Chirurgical Considerations 1. We have already sufficiently treated of the Cure of Scrophulas or the Kings Evil I will only give you here
30 hours or more been troubled with the Spots at length after exceeding great pain accompanied with a Delirium he voided first Blood and after that a purulent matter through his Yard by which means he was restored to his health I conjectured that there was a Carbuncle in the case which seized not on the Membranous part of the Bladder but on the Neck thereof As to the Cure Blood-letting is very prejudicial to those that already have the Plague and dangerous to such that would prevent it The Poison oftentimes lies hid within the Bâ—dy for some dayes weeks or months before â—â— discovers it self by seizing on the conveyances of the Blood Wherefore I would advise you seriously to consider if by opening a Vein you invite it immediately to the Heart whether the diminution of Blood Spirits and Strength which is effected by this means be not the Cause why the Heart is suffocated and deprived of that vigour which it should make use of to repulse the Enemy I confess some Experienced Physitians of good credit have reported that in hot Countries there is no better means for restoring a Patient visited with the Plague unto his health than that of opening a Vein provided it be done cautiously and at the beginning of the Disease but whosoever have attempted it in colder Climates have quickly learnt by experience that it ought to be forborn Purging which is oftentimes very necessary in other gentle Diseases is excluded by the Malignity of this But every one is not quick-sighted enough to discern when it is requisite to be done and when to be forborn Moreover it is evident that in a Malignant Disease the Physick which is administred to a Patient ought to be more mild and gentle than at other times for besides that the Body cannot then bear strong purgations a Dysentery is oftentimes the consequence of them I have when I have been fully perswaded that there was no Malignity in the Disease oftentimes used this or some such like Potion with good success viz. Take Rhubarb a dram and half Senna two drams Cream of Tartar a dram Scorzonera-Roots half an ounce Aniseeds half a dram Boil them in Holy-Thistle-Water and to three ounces of the strained Liquor and Syrup of Succory with Rhubarb six drams Spirit of Salt a little Confection of Alkermes a scrupel Make it into a Potion I never adventured to prescribe any thing Purgative to such as have been taken with the Plague before the fourteenth day at which time the Fever and the other Symptoms of the Disease would be abated There are some who have attempted it while the Carbuncles remain purulent and before the Bubo is perfectly cured But I dare not advise any one to follow that Method whatsoever Remedies they administer at the same time which may be intended specifically against the Plague But if it happen that the Patient for several days be very costive and troubled with a pain at his heart and hopes to be relieved by Purgation It is to be considered that the Venom of the Disease and not the Costiveness is the cause of the pain at the Heart it is therefore most requisite to make use of Sudorificks to corroborate the Heart and not to concern your self for the costiveness of the Body but if you desire to open it a little it is better to make use of a Suppository than a Glyster which is not altogether so safe but hath been prejudicial to many on this occasion and to others it hath done but little good and not at all opposed the Malignity of the Disease But to such as will not take this advise which hath been very confirmed by experience and several good Reasons and will still persist to make use of Glysters it is fit however that they forbear to prescribe Scammony as an Ingredient especially to Women in the time of their Flowers Juleps are in this case very necessary but all persons may not make use of them nor any at all times I am never wont to prescribe them without joyning with them some Sudorificks which will appear hereafter and this I take to be the safest course for if the sick person should make use of such things only as refrigerate while he sweats freely the Sweat would oftentimes strike inward and the Venom would be conveyed to the Heart from whence would follow sudden Death There is no means more requisite than that of Diaphoreticks and Cordials especially those that are acid which produce such effects as are certain and therefore the more laudable for they rectifie the Mass of Blood and free it from the venom which infects it They dissolve the pituitous Matter which is lodged in the Stomach and the Entrails and correct the Choler which in this Disease is the cause of much mischief Nevertheless the several disguises of this Disease and the vanity of the Symptoms which attend it do require that they should be often changed since when the Disease is more gentle those things are not to be used which would do good service in an accute one Medicaments against the Plague Roots of Zedoary Butter-Bur Angelica Ditamny Galangal Vipers-grass Gentian Master-wort Lovage Burnet Orrise Florentine and ours China Sarsaparilla Leaves of Rue Scordium Sage Holy-Thistle Swallow-wort Wormwood Southern-wood Centuary the lesser Valerian Sorrel Fluellin Balm Marjoram Rosemary Thyme Mint Flowers of Borage Bugloss Violets Roses Marrigolds St. John worts Rosemary Indian-Spikenard Jesamy Seeds of Citrons Oranges Rue St. Johns wort Anise Coriander Lovage Fruits Citrons Oranges Walnuts Figs sharp Cherries Pippins Ribes sowre Pomegranates Barberries Spices Musk Ambergreece Civet Benjamin Storax Calamita Cinamon Mace Nutmegs Cardamums Camphire Animals or their parts Flesh of Vipers Mummy Serpents Quails Thrushes Harts-horn Unicorns-horn Bezoar Stone of an Indian Hog Ivory Castor Precious Stones and Earths the Jacinth Granate Emerald Ruby Carbuncle Pearls Coral Bolearmenick Earth of Lemnos and Seal'd Gold Silver Salts Common brought lately from the River Nile which moveth Sweat most powerfully of Scordium of Wormwood Rue Self-heal Holy-Thistle Vitriolated Tartar Bezoarticum Minerale Threacle of Andromacus's Diatesseron Mithridate of Damocratis Diascordium of Fracastorius Confection of Alkermes of Hyacinth Species Liberantis Electuaries of the Egg Rob. of Currans of Barberies Conserves of Balm Mint Rosemary-Flowers Borage Bugloss Marigold-Flowers Troches of the Juice of Barberries of Citrons Out of all which you may make choice of such as you judge most fit for the purpose The Writings of Authors who have treated of this Disease will give you an account of other Compounds out of which you may chuse such as please you best I shall here propound such only as I have found to be most efficacious and which I shall constantly make use of till by experience I shall discover some others whose nature is more excellent and that the use of them may the more plainly appear I shall premise some Medicaments that some years since were prescribed by my self and those Learned Men Dr. Francis Sylvius
and Sign pag. 116 Bubonocele pag. 33 Bullets their Extraction 73. Medicines for that purpose pag. 159 Burnings and their Cure pag. 190 C. CAncer its Difference Cause and Cure 122 of the Bone pag. 212 Carbuncle its Difference Cause pag. 121 Carpus pag. 210 Cartilage what 215. Swordlike 210. of the Breast-bent pag. 216 Cataract of the Eye the cause and removing it pag. 60 Catharticks pag. 112 Cautery Actual and Potential 37. Conveniency and Inconveniency pag. 44 69 Child dead the signs 75. It s Extraction pag. 74 The Glandules of the Chyle 253. It s motion by the Intestines pag. 254 Cholerick people how known pag. 203 Chilification its History pag. 153 154 Chirurgery what it signifies and the operations thereof pag. 1 Cicatrice or skars taken away pag. 244 Circocele pag. 33 Closing the Womb pag. 46 Comminution what pag. 2 Contra-Fissure what pag. 10 11 Contraction of the Member its cause pag. 236 Convulsion the Remedies pag. 256 Corrosives pag. 112 Cubit its Bones pag. 210 D. DIairesis what 2. Its parts Diaphoreticks pag. 36 Diaphragm and its parts pag. 308 Diarthrosis what pag. 208 Dislocation pag. 17 Dortos pag. 320 Dropsie Cause and Sign pag. 103 Dura Mater E. EAr Membrane thin and strong pain soreness 46 Its Bones pag. 209 Emphyma its Signs Cure pag. 54 Enarthrosis what pag. 208 Enterocele pag. 26 33 Epedymis pag. 320 Epigastrium pag. 311 Epiglottis indurated pag. 215 Epiploica pag. 226 Epulis pag. 292 Erysipelas its Cause Cure pag. 95 Excresis what pag. 2 Extention pag. 4 Extirpation of a dead part pag. 78 Extraneous Bodies how drawn out of a Wound pag. 157 Eye its parts Lids their Substance and Vse Iris pag. 274 F. FAce what pag. 268 Falx of the Dura Mater pag. 293 Fat whether part of the Body pag. 247 Fibre its Difference and Vse pag. 220 Fibula fractur'd pag. 16 Fissure what pag. 3 Fistula its Cause Signs and Cure 186. of the Breast 302. Lachrymalis pag. 285 Flesh what 237. Fleshy Rupture its Cure pag. 80 Focil its Dislocation pag. 23 Fracture what 2. It s Cause and Cure 3. Of the Skull 10. Of the shoulder of the Hip of the Jaw-bone of the Nose 13. of the Ribs of the Breast-bone of the Back-bone 14. of the Elbow of the Fibula of the Knee-pan 16. great and little pag. 334 Froenum or Bridle pag. 321 Frons pag. 268 G. GAngrene its Difference Causes pag. 126 Ganglion pag. 336 Gibbosity its Cause and Cure c. pag. 304 Ginglymus what pag. 208 Glandes pag. 333 Glandules of the Eye 274. Of the Chyle of the Loins 253. of the Neck pag. 263 Glotis straight wrong pag. 216 Gums pag. 278 H. HAir its shedding 249. Whether parts of the Body 247. Hare-Lip its Cure pag. 87 Hand pag. 266 Head what its Figure Parts c. 268. Wounds their Cure 172. Sores pag. 194 Heart its History 306. its Wounds pag. 174 Haemmorrage of the Nose how cured pag. 231 Herps its difference cause cure pag. 109 Hip-Bones Fractur'd pag. 14 Humors of the Eyes pag. 274 Hydrocele pag. 33 Hydrocephalus its Cure pag. 281 Hypocondria pag. 311 Hypogastrium Ibid. I. JAws their Bones pag. 270 Jejunum pag. 315 Iliack Passion pag. 324 Inflammation its cause and cure pag. 90 Infundibulum pag. 294 Internal Means pag. 1 Intestines 315. Intestines or Small Guts their Wounds pag. 157 Joynts what pag. 266 Iris of the Eye pag. 274 Issues when where and how made pag. 70 K. KIdneyes and their History 313 218 their Wounds pag. 176 Kings-Evil its Cause Sign Cure pag. 113 L. LAbour Natural and Preternatural its Cause pag. 74 Larinx cannot be inflamed pag. 216 Leeches their choice and use pag. 63 Leg pag. 210 Ligaments what and how many their Wounds and Wrenches pag. 217 Ligature pag. 5 Linea Alba pag. 312 Lips and their parts pag. 278 Liver its History its Vse 255 317 its Situation 312. its Ligaments 324. its Inflammations Vlcers Gangrene 325. its Wounds pag. 175 Loosness pag. 280 Lungs and its parts 306. their Wounds Signs Cure pag. 173 Lymphatick Vessels pag. 261 M. MAnual Operations pag. 1 Marrow of the Brain Spinal 293. of the Bones pag. 207 Matrix fallen down pag. 34 Mediastinum 305. its Cavity pag. 309 Medicines discussing Wind 108. against too great encrease of flesh corroding 257. Drawing or attractive 118. for a Cancer 124. provoking Sweat Cordials 128. Against a Gangrene 129. for the Eyes 138. against a Quinsie 143. stopping a flux of Blood 154. against Convulsions 156. against proud flesh 157. to draw forth Thornes Bones Bullets c. 159. Digestives 161 179. Sarcoticks 162 179. Vulneraries 162 Epulottick 164 179. against Wounds of the Nerves 166. Defensives 179. against Worms 181. against Corruption of the Bones 183. against spreading Vlcers 184. against Fistula's 188 against Burnings 191. Purging Choler 7. Purging Phlegm 8. purging Melancholy 9. Repelling 92. Resolving or Discussing 92. Suppuratives 93. Anodins 94. Emollients 102. Purging water 104. Cosmetick water of Minsickt 243. taking away Skars pag. 244 Meliceris its Cause Sign and Cure pag. 111 Membranes what and how many pag. 219 Mesentery and its History its Tumors Corruption Vlcer pag. 316 Metacarpus pag. 336 Metatarsus pag. 338 Mouth its Inflammation Vlcer Gangrene pag. 291 Muscle what c. pag. 237 N. NAils whether parts of the Body pag. 247 Nates of the Brain pag. 294 Nerves their Difference 233. their Coutusion its Cause and Cure pag. 234 Nodes pag. 214 Nose and its parts 277. Haemorhage how cured pag. 231 Nostrils broken pag. 13 Nymphae pag. 323 O. OCciput pag. 268 Oedema or Phlegmatick humor its Cause Sign Cure pag. 98 Omphalocele Navel-Rupture pag. 33 Opthalmia its Difference Cause Signs c. pag. 284 P. PAlate pag. 278 Palsie pag. 280 Paracentesis when in what place and how performed pag. 48 Paronychia its Cause Sign Cure pag. 133 Part of the Body what it is and its division 205 parts of the Body divided pag. 266 Patella or Knee-pan its Fracture pag. 16 Pericardium its parts and Liquor pag. 306 Pericranium what from whence pag. 268 Peritonaeum pag. 314 Pia and Dura Mater 292. their Wounds and Cure 295. its History pag. 292 Phlegmatick people how known pag. 203 Pixis pag. 312 Pexus Choroides pag. 294 Pleura its divers pains pag. 308 Physick and Physicians pag. 1 Pleurisie its cause and cure pag. 58 Polipus its cause and cure pag. 289 Poâ—rigo its cause pag. 280 Porus Biliarius pag. 318 Processus vermiformis of the Brain pag. 295 Prostataes pag. 320 Pudenda Virginam if clos'd how to be opened pag. 46 Pylorus pag. 315 Q. QVinsey its Cause Difference Sign pag. 141 Quintessence of Arsenick pag. 124 R. RAdius pag. 210 Ranula its Cause pag. 291 Rete Mirabile pag. 294 Ribs and their difference 210 302. Fractur'd 14 Dislocated pag. 23 Rostra pag. 210 Ruptures their Causes 26. Cure pag. 29 S. SAnguine persons how known pag. 202 Scarf-skin and Skin pag. 243 Scirrhus its Cause Sign
been several times quenched Hawes also boiled and made into a thick Electuary and strained is beneficial if taken in the morning fasting and an hour or so before supper the quantity of a Walnut Besides take new Milk with its Cream on it quench therein divers times red-hot Pebble-stones so that the Milk may grow hot of it then mix with it two or three well-beaten Yolks of Eggs two ounces of Sugar melting in it an ounce and an half of the Suet of a Deer or Stagg and about half an ounce of Album-graecum using it for a Clyster which cleanseth and healeth the Guts and allays the sharpness of the Blood and other corrosive humors that annoy the Bowels But take heed of not stopping too suddenly the Bloody Flux or any other Laske for if you do the annoyance will remain in the Body and cause Impostumes Difficulty of breathing and other dangerous Distempers Wherefore consult with thy strength and if that be considerable make not too much hast yet keep a bridle upon it so as to be able to stop it when there is need Mean time if it be without a Fever or heat you may do much with new Milk drinking it also mornings and evenings warm some red-hot Stones having been quenched therein and some Sugar mixed with it to prevent curdling in your Stomach This Medicine was known to the famous Grecian Physicians Aetius Alexander Trallianus and Galenus himself l. 10. de Simpl. Med. facult If you add a little Album-graecum to it 't will be the better I have my self done much good with thus prepared Milk but then there must be no Fever which if there be you 'l easily perceive it by a great thirst quick pulse hot hands and little sleep c. For bloody Fluxes are not wont to be accompanied with shaking Fevers but only with hot fits which spend more of the Patients strength in an hour than shaking Agues in several days which is to be well heeded Eggs boiled hard in Vinegar and given to the Patient that is troubled either with the Bloody or any other Flux it will be stopped The Roots of Tormentil or of Snake-weed pulverised and this powder drunk in a convenient vehicle the weight of a drachm is one of the most approved remedies against these Fluxes Tormentil-roots being very powerful not only to stop them but also to take away their catching malignity The Moss that grows on wild Rose-shrubs reduced to powder and taken in Wine wherein have been boiled the husks of Acrons is an approved remedy in this case Scrape red Lead or Rudle such as Carpenters mark their lines with put it into Wine or Broath wherein hath been boil'd the broader kind of Plantain and Tormentil-roots or take it in an Egg. Hares-blood dried and taken inwardly is also a tried Medicine in this Distemper Item open a new-laid Egg take out the white and fill it up with Nutmeg or the pulverised root of Tormentil or of Snake-weed and give it the Patient to eat or put into it some pulverised Blood-stone and it will do good I have used with good success the Seed of the broader Plantain grosly beaten and rosted in an Egg against the Flux and I know it also to have been beneficially used against the Bloody Flux Take of Mummy a little Mastick Bol-Armeniack Sanguis Draconâ— mix them together and make a powder of them and take of it in a convenient Liquor the weight of a dram once or twice a day Take Rye-biscuit and boil it in Water with Coriander and the roots of Tormentil or of Cranes-bill quench some Steel in it once or twice and give of it to the Patient to drink Make a Decoction of Shepherds-purse and Meadow-sweet in Water and Wine and now and then drink of it Burn live Crafishes in an earthen Pipkin well-closed until they be so burnt as to be reduced to powder of which give to the Patient mornings and evenings a Thimble-full or two in a convenient Liquor A dried Liver of a sucking Lamb or of any other such Animal is very good in this case provided such a Liver before 't is dried be boiled in Vinegar Let the Patient take a drachm of it twice a day Also the Blood of a Lamb or of a Hind both dried will have here a good effect Take a Pigeon Wood-cock or Patridge and having drawn any of them fill them with Mastick and a little Nutmeg and so rost them on a Spit and whilst they are rosting baste them with red Wine and so let them rost till they grow so hard as will make them pulverable then reduce them or any of them to powder and take a spoonful of it at a time in warm Broath The highest Experiment in this case is Crocus Martis taken in the Juyce of the broader kind of Plantain or in a Pulse of red Beans or Rice-broath the dose is half a dram But when the pain is very great you may then add to it some opiat Medicine as of the Trochisques de Garabe or one only grain of Laudanum Opiatum And give the Patient now and then a little new-made Treacle or mix with it a few grains of the Confection of Archigenes for of such Medicaments a Field-Apotheque is not wont to be destitute For the Patients ordinary drink boil water and in it Coriander dried Sloes dried slices of Quinces burnt Harts-horn Mastick Nutmeg or any one of these putting to it some of the roots of Snake-weed Tormentil or such like adstringent roots Of this water the Patient may drink according as his necessity shall require The red Juyce of Quinces boiled up without Sugar is also much to be commended in this case for strengthening the bowels two or three spoonfuls of it being taken at a time and that twice a day In many places a drink is made of Sloes Pilosella or Mouse-ear and Juniper-berries infusing them all in common water and letting them ferment together This yields a pleasant acid drink allaying the violence of the Flux and quenching thirst withal The Rich may make Granat or Quince-wine But I have here undertaken to deliver such things as are parable and cheap for the poor common Souldier I am sorry that in the Field there is no conveniency of administring Clysters For though I prescribe none without great necessity yet Clysters being of great benefit in Diseases of the bowels they being to them like Plaisters I cannot but recommend in this Distemper Clysters of Milk wherein Pebble-stones have been several times quenched mixing a little of the melted Suet of a Stag or Hind without any Oyl or other fat I remember I had once a Patient of quality that had about an hundred stools within twenty four hours who by the use of such Clysters once or twice applied was fully restored The cause whereof is that the Milk washes the bowels and clears them of the sharp humors that annoy them moreover it is healing and repairing by reason of the Pebbles quenched therein The Sugar
is abstersive and helps to clean the injured places The Fat sticks to the parts annoyed to defend them from being further hurt by the subsequent humors which running down over it can find no stay there and consequently cause no more hurt to those parts Yet must you not put in any greasie Fat or any Oyl of Olives because they hinder healing and all Oyl except that of Linseed Poppies Hemp and Almonds is very sharp and you will find that if any drop of Oyl of Olives should chance to fall into your Eye no Juyce of Oranges or Limons is so strong as to exceed the acrimony of that Oyl But of this Oyl more will be said in the next Chapter to which I therefore refer you If you would have your Clyster yet milder and more sanative you may beat a yolk or two of new-laid Eggs and mix them with it though I have contented my self with the Ingredients before mention'd and found great benefit thereby Else you may in this case use for a Clyster the Cremor hordei mixt with yolks of Eggs beaten in it which is also very good to wash out the bowels Here is no conveniency of making much use of Apothecary-shops else many things might be prescribed to lay upon the belly and the navil as also divers fermentations and stomachical Unguents You may therefore content your self with those plain and easily parable means already deliver'd and be thankful to God for them But then you are also to think upon means to obviate Symptoms of this Distemper and particularly Drought which is wont very much to torment people in this Disease 'T is true Acid things do quench thirst but they cannot be used boldly and therefore you must use them with great discretion and wariness And as for sweet things they usually increase thirst and do easily corrupt and turn into gall Wherefore give to the Patient preserved Currans or if fresh ones be in season mix a quantity of them with Honey or Sugar and give him of it to eat upon white-Bread and Butter Or plump dried Black-cherries or dried Damascene-prunes in half Wine and half Water and let him hold squeeze them in his mouth Or if you can mingle some Almond-milk with Chalybeat-water and let him drink thereof and this is both meat and drink Or let him drink water wherein Coriander and roots of Tormentil have been boiled Or boil in water dried slices of Quinces roots of Bistorta or Snake-weed and burnt Harts-horn put into it a tosted crust of Rye-bread rubb'd with Nutmeg but let it not lye in it above a quarter of an hour lest the water should thicken and become viscous Marmelat also of Quinces Black-cherries and Sloes is proper in this case giving the Patient a slice of it to hold upon his tongue and so to swallow it down Further you must learn how to remedy a Tenasmus which is more irksome to the Patient and occasions more trouble to the Physitian than the Bloody-flux it self since it night and day painfully provokes the poor Patient to go to stool and yet to no purpose For this I have used many remedies but found almost nothing more beneficial than Fomentations of this nature following Take Potentilla wild Tansie Silver-weed Knot-grass Mullein and Oak-leaves of each as much as you please put them into two linnen bags and let them boil in Smiths-water wherein much Iron hath been quenched Squeeze out these bags between two boards and let them be held alternately to the anus as hot as can be endured Black Pitch such as is found on Larch and Fir-trees put upon a heated fire-shovel and the fundament held over it is also a good remedy so is Turpentine used after the same manner Again take a black well-burnt Brick out of the hearth heat it thoroughly and wet it with sharp Vinegar and wrap it about with a linnen cloth and let the Patient sit on it as hot as he can endure it This was the Experiment and Remedy of old Aetius but he reduced the Brick to powder and by boiling it in Vinegar reduced it to a pulse and so put it into a linnen rag and applied it to the fundament You may chuse which you please of the two Milk-Clysters such as above prescribed would also be good but that 't is not safe with Clyster-pipes to vex the anus which is already sore enough Yet you may give a Suppository of Deers-suet mixt with some Oyl of Mullein And the grey Diapompholox or the white Camphire-unguent or the like mixt with it would not be improper in this case If there be a Falling down of the fundament then let it often take in the fumes of the above-mention'd Herbs adding to them the beaten stalks of Sloe-shrubs and those of red Roses as also Mouse-ear and Mug-wort The outer bark of Elder and of Shepherds-purse doth also well with it But above all things keep the Patient warm and let by no means any of the abovesaid steams grow cold on the sore part Make also a Decoction of Garlick and pour it hot into your close-stool let the Patient sit upon it to receive the hot steams Besides put some burnt Harts-horn in a linnen cloth and so strew it upon the fundament by little and little to drew it up Or heat an Oaken-board very well and cover it over with Stags-suet and let the Patient sit upon it whilst 't is hot Put Colophonium or the Rosin of Pinetree upon a heated Iron and let the Patient by holding his fundament over it take in the steams thereof Anoint also the part with Butter in which Onions have been boiled and strew upon it Album-graecum very finely pulverised You may also make a Salve of Ceruse Bol-Armeniack Dragons-blood Stags-suet Blood-stone Oyl of Myrrh or Butter in which first hath been boiled broad Plantain Mullein or wild Tansie Silver-weed and with this anoint the fundament As for the Marisca's which do torment Men especially they may be cured with Oyl of Eggs Salve of red Hounds-tongue as also with the Vnguentum Populeum or with Butter stirr'd up and down in a Leaden Mortar till it turn grey or blackish Let the Patient drink also of Scrophularia or Fig-wort infused in his drink this being a specifick for that evil Also the Oyl of Mullein Elder-blossoms Water-lilly and White-lillies is an excellent remedy for it a rag dipped therein being laid upon the part affected To use scarifying on the lower part of the back-bone is also very good though it be very painful If the Hoemorrhoid-vein bleed in a convenient time and do not overbleed it is an exceeding good thing and preserves from many Diseases as the Inflammation of the Lungs Stitches of the sides the Leprosie Melancholly Quartans and the like If the same vein should bleed in one that is mad or disturbed in his mind or in one that is troubled with the Inflammation of the Kindneys these Distempers would thereby be allayed But if it should bleed too often