haue learned both of excellent Phisitions and chyrurgions partly when I trauelled in sundry dominions of Europe and partly by the familiar companie which I had with most skilfull Phisitions abroad in the campes And first I will set downe my opinion concerning the essence and nature of such woundes the which question by the consent of all that haue written thereof is the mincipallest Batallus Iubertus and Paraeus haue deliuered to vs that the hurts by gunshot are accompained with two inconueniences that is they consist of solution of continuitie and brusing with rending oftentimes of the muscles vessels and flesh to the which manie accidentes dâ—o come the which beâ—ng diuers must needs haue diuers intentions of curation These are the two sortes of inconueniences of the which by disputation they haue agreed on woundes by gunshot to consist and therefore they haue set downe two kindes of remedies one wherewith the partes so torne and wanne are holpen that is the flesh sinewes lygamentes tendons ioyntes and bones and that by meanes of the bruse the which may come to passe without anie manifest wound at all and of the Erccians is called Ecchymoosis yet not without daunger but oftentimes subiect to great accidentes and manie times hath great effusion of bloud betweene the muscles which when it is shed out of the vaines presently putrifieth also great aches which are accompanied with great fiuxe of humours diuers swellinges inflamations and at the last Gangrena and mortification of the part affected The other sort which comes with a manifest wound is more daily seene and the deeper and greater it is so much it is thought the more dangerous because the shot whether of lead or brasse the more vehementer it goeth in so much the more it bruseth the parts in which it entreth by the which cause the bloud is congealed which falleth in the hollownes of the wounde and filleth the orofice of the veines and hollownes of the other partes then being destitute of his natur all heate the which being quenched and mortified by the resolution of the spirits by reasoÌ„ of the paine tearing of so many parts it goeth againe to the spring heade that is to the heart by reason of the feare which is takeÌ„ with the deadly hurt it becomes of a wannish leady colour like to that which the common sort calleth Asure the which is easily rotted and easily doth rot the parts adioyning and especially the Spermatical the which according to the opinion of our auncesters is easily turned to quitture and that the easier and speedier this fleshe being brused and dead may be separated from the quicke and liuely flesh the Chyrurgions doe commonly vse remedia suppuâ—aâ—tia mollientia the vse of which althâ—ugh it bee 〈◊〉 vsed in common bruses yet in these hurts it may not be followed without graue waightie considerations and especially without consideration had of the body time and part for in so much as these woundes doe easily admit great store of putrifaction so that manie times wormes are ingendred with intollerable putrifaction it is not to be doubted but that by the vse of suche medicines which by nature moue putrifaction the griefe is increased and augmented through euil vapors wherewith the principall partes that is to say the heart the braine and liuer are molested whereof come crampes and phrensies with continuall feuers and so commonly death followeth But this happeneth for the moste parte in bodies filled with euill iuice whose flesh when it is agreeued through putrifaction of the bloud it is no maruell if the wound be verie dangerous and verie hard or not at all to be cured In this case the disposition of the aire and heauens is to bee considered and also the qualitie and state of the member hurted Who also doubteth but that through the entraÌ„ce of the South winde into the hollownesse of these wounds whereby naturall heate is weakened there is great occasion to increase the putrifaction and generation of wormes which is seen by dayly experience that I may ouerpasse the authoritie of Hipocrates lib. Apho. 3. and in his booke de Epid. which also he signifieth in another place where he teacheth that drith is more healthier then moisture and so all corruption to come of ouermuch moysture as it were of his proper matter And to this purpose also it shall greatly auaile vs to haue a perfect knowledge of the temperamentes of partes for wounds in the head bottome of the stomacke and other moyst partes and therefore more apt to putrifaction although they be bruised doe require of vs the vse of suppurantia but yet not without great iudgement and heede taking for because in this case great hurt doth often come through the vnskilfulnesse and rashnesse of the Phisition neyther at anie time shall the Phisition be excused although he see the wound verie muche stinking which is alwaies an euill signe or berayed with stincking matter and wormes which may come to passe in one day by reasons afore alledged yet I say he may not vse medicines called commonly Digestiues although he reason that it is a brused wound therefore must come to suppuration because these incommodities drawing on we must presently haue recourse to such medicines as resist putrifaction that the moste dangerous accidentes may be preuented which are threatned by that which is said before that is to say Gangrena Sphacelus and mortification of the whole members Such medicines are the salts both mettaline and meane minerall drawne out especially of copper iron mercurie vitriol sulphur arsnick and orpiment as we shall declare in such place where we shall intreate of curation for these saltes hauing the office of an exterior Baulme doo by their heate and subtlenesse cut and make thinne thicke humours which doo choake naturall heate and doo by their saltnesse and sharpnesse withstand putrifaction they doe defend the wound from Gangrena and mortification and doo prepare the way being mixed with meet medicines as hereafter shall be declared to an easie and short curing and that without paine Farre better medicines surely then simple precipitate commonly prepared or Egiptiacum that specially which hath arsnicke and sublymate in it or such like whose common and dayly vse I can scarslie allowe by reason of the great paine which they bring to the patient of whome we ought to haue a great and speciall regard the which incommodities may easily be auoyded by a true and apt spagiricall preparation which will be a great solace and comforte to the sound patient Hitherto concerning the first remedies which are appointed to the first intention that is to the restoring of members brused torne in which â—ase it â—ehoueth to be a wise warie phisition in altering the medicines and applie them as occasion do serue to sundrie affections and sodaine mutations that so it be foreseene in all the whole sickenesse as Galen also hath taught The second kinde of medicines which serue to a more
extraordinarie aches and also with inflamation and pricking and shooting paines especially about the wound with vnlustinesse and heauinesse of all the whole bodie and many times burning feuers with sounding and alienation of the minde all these doo testifie that there is some venemous qualitie ioyned with the wound especially when there can no manifest cause be found out by y e Phisition whereof all these euill accidents should proceede which sometimes I haue seene to happen in simple wounds yea without the tearing of any sinewes But more certainer signes of this matter may be if any tokens appeare outwardly which may bee learned at the mouth of the patient and by relation of his familiar friendes and companions considering also the manner the place and the person being wounded But the surest signe of all is learned by the bullet if it may be found for if you cut him in two parts you shall see him darke and mixed with a purple and violet colour vnlike to the colour of other shot being cut which is wont to haue a yealow colour Then maist thou surely affirme that the shot was poisoned whereby the very substance thereof was altered as plaincly is seene by his inward colour which is greatly altered wanne and darke as we said before Proofe thereof also may be made in the fire which was said not rashly to haue great force in purging of all poison Because such things which are strong poison in deede doe consist of a spirituall and ayriall substance and therefore by force of fire doe easily vanish into the aire yet not with a smal heate such as is felt in going out of y e shot as Ambrosius Pareus thought which rather in processe of time woulde fixe it and make it not volatle and so consequently vnhurtfull But by a most strong heate of fire such as they vse in subliming for in that force of fire y e mercurie is eleuated and vanished away so likewise is the Arsnicke orpigment and such other spirits and for that cause they cannot be purged except they be pressed in the cold necke of the subliming vessels and so the suspected bullet being melted and kept in great heate a sufficient time then a darke and stinking smoke ariseth couering the mettall of which smoke or fume you must heware which after the melting is found not onely vnpurged but also appeareth blacke wanne and darke which commeth through the venemous fume spreding it selfe about the mettall and this is an infallible signe that the shott was poysoned whereby the wound may be venomed as I said before and that according to the time as it remaineth in the wound These be the signes whereby a poysoned wound is knowne which are the more dangerous to be iudged the more they doe weaken the strength of the patient Likewise blistering bladdering pricking paine drinesse contraction and hardnesse of the skinne doth manifestly shewe that the wound is also burnt with powder the which may be learned more surely by relation of the wounded person which can commonly declare whether he ware wounded nigh or farre off which also may be gathered by the burning of the vesture and it behoueth the Phisition to take heede diligently of all these thinges because they are of great waight and may bring great hurt to the wound and hinder greatly the curation thereof and through aboundance of fiures and other grieuous accidents which commonly insue vnlesse timely with wholesome medicines they be preuented as Galen commandeth in 4. Met. cap. 5. where he teacheth the maner of curing of an vlcer ioyned or coupled with another griefe not as the curation of a simple vlcer but first that affection must be remoued and then the vlcer to be cured Of the iudgement Furthermore a sounder iudgement in this case may be giuen by a heedie consideration of the saying of Galen written in his method where he teacheth that diseases may be dangerous for three causes first by reason of the worthinesse of the part affected secondarily through the vehemencie and strength of the griefe lastly by the malignitie and euill qualitie of the disease Therefore if the spirituall parts or if the braine and especially the substance thereof be wounded it is deadly Likewise the lunges the midriffe the stomacke the splene and kidnie being wounded doth cōmonly bring death for they also by reason of their offices are reckoned among the principall partes of no lesse ieopardie are the wounds of the guts especially in the smaller where there is no fleshe also in the bladder which cannot be aglutinated because they are vnbloudie parts and likewise woundes wherein the head or stomacke is pearced through are counted verie dangerous and the more greater and deeper y e wounds be with tearing of the sinewes and brusing of the bones so much the more dangerous they are and especiallie those which happen in the head with fracture of Cranion and also suche as be nigh the ioyntes through great and vehement accidentes insuing hereon but woundes ioyned with venome although in shew they be but small yet are they moste dangerous because by the contrarie substance excessiue qualitie thereof not onely the naturall disposition but also the verie substance of the bodie is altered and changed and especially when the wound is with breaking of the skinne which by thicknesse thereof doth defend the flesh which otherwise it woulde so that the poyson be not subtill that the contagiousnesse thereof doth not infect the bloud spirites and humors and consequently the principall partes whereby death commonly insueth Moreouer all these woundes are to be counted the more dangerous in case they be accompanied with euill accidentes and great passions and also the passion filled with euill humours and so much the more if at that time anie common sicknesse doth raigne in the campe caused by the aire whose qualitie although it be simple and not subiect to putrifaction yet oftentimes it bringeth great alteration to the qualities being infected with noysome and stincking fumes which oftentimes comes to passe in great hostes and chiefly in that part which is molested with composts and dead carcases of beastes and men from whence arise the noysome stincking fumes whereby the souldiers are afflicted also vnstablenesse of the weather comming with tempestes doth greatly hurt these woundes and oftentimes put the partie in great hazard and chiefly when a drie winter goeth before with northen blastes and a wet spring insueth with southerly windes through which many grosse humours are ingendred which with that vnstablenesse of weather are stirred and corrupted and the euilenesse of the aire ioyning therewith bringeth forth pestilent and burning feuers with inflamacions Gangrena and mortification yea and at the last death it selfe as Hipoc witnesseth in the third Aphorisme in lib. Epid. Neyther may we ouerpasse the loose and vnorderly kinde of dyet vsed not onely among the common souldiers but also with the Captaines rulers legates and protectors Which oftentimes are inforced to take such
generall intention pertaine to consolidate togither partes disioyned the which is chiefely performed by the diligence of the radicall and naturall Baulme which is present in euerie part as the principall doer and chiefest workemaster being maintained with fit and conuenient nourishment which balme hath great power and strength in vniting and knitting togither of partes disioyned and this Baulme as the cause principall and efficient must be defended by the Phisition who must fore-see that the strength and efficacie therof by no meanes be hindred must keepe from it al outward causes which are noysome and hurtfull thereunto and also all such as haue power to hinder the consolidation thereof which he may do both by orderly kinde of dyet by applications of meete medicines These reasons as I may conclude in few words do signifie to vs two sorts of griefes which wounds by gunshot are accompanied with that is to say solution of continuitie with brusing and rending of the soft meane and sound parts of mans bodie and indeede it oftentimes so falleth out And these two intentions curatiue as I may say were sufficient for vs were it not that I can easily prooue as well by reason as experience and also by the fauour of most brauemen which haue written before me that these wounds are commonly accompanied with venome and blasting the which two being adioyned doâ— require of vs other intentions curatiue Notwithstanding we haue not spoken this to the intent to defend those which haue thought this venome to come of the powder partly through his essence and partly by the transmutation thereof of which opinion was Iohn de Vigo otherwise an excellent and learned Chirurgion and nowe lately renewed by one Alphonsus Ferrius an Italian PhisitioÌ„ whose disputation is learnedly confuted by Botallus Phisition to the king and also in Chirurgerie most excellent For the composition of the pouder especially declares that the nature thereof can bee by no meanes venemous in that it consisteth of brimstone salt-peter coale all which simples are without venome and also so holsome that they haue great vertue in expelling of strong diseases and amongst these brimstone vpon which Alphonsus especially groundeth his disputation is most excelleÌ„t for diseases of the Lungs so be it it be right and orderly prepared as we haue taught in our booke of the Spagirical preparation of medicines and that same may be learned out of the writinges of Galen Theophrast Plinie Dioscorides and also by the dayly vse and experience of our France and other nations For the Phisitions dispairing the curing of any notable disease doo send their patients to the whot Bathes which are in Bearnia Germany Subaudia and Italy the which waters running through the mettaline vaines of the earth they do retaine some of the spirit of Sulphur some of Alome some of Nyter some of Vitrioll and such like yet notwithstanding they are not wont to be deadly but holsome and especially those which tast of Sulphur and Nyter the which are very profitable against the palsie Sciatica stone long griefes of the stomake and such other Tartarous diseases whose cause is resolued and purged by vrine by the diureticall and percing power which proceedeth of the spirits of these mettals which dayly experience doth teach by the incredible curation of most desperate diseases And thus much of brimstone which by no meanes is to be thought ve emâ—â—s no more then is saâ—t Peter which notwithstanding I doe not thinke that it is all one with the Niter of Dâ—oscorides other ancients as Botâ—llus supposeth for that must be had out of Macedonie Egypt where in old time great flore was to be found In Macedonie by reason of y â— nature of the ground and Nitrous lake named Clitis and in Egypt through the water of Nylus which flowing â—uer his banâ—es did rest in vn-euen places and in space of time it is imbibed with the saltnesse of the ground and by little and little through the heate of the sunne was so hardened that being not preuented it would consume to the hardnesse of stones And such was the Nyter of Alexandria which was the basest of all and farthest dissenting from the markes of the best because the chiefest is wont to be porous or hollow for so it is described by Plinie and Dioscorides and so that we may returne to our salt-peter which is vnlike to Niter except paraduenture it hath a certaine agreance of qualities therewith as all saltes haue a certaine agreeance among themselues notwithstanding we may truely and aduisedly â—ffâ—rme that gun-powder hath no poyson or venome in it by reason of the salt-peter because the salt-peter is made either of aâ—ertame fatnesse falling from the old wals or cellers caues and denâ—es whereof it seemeth to take this name sal-petrae or else it is made of the fat and rotten flores stables and old Churchyards that it is no more venomous then is the salt which we dayly and commonly vse is easily prooued in that many men do vse to eate it in-steede of ouâ— common salt and so because we â—â—dge there is no man that will withstand the authoritâ—e of most excellent Phisitions we may conclude that gun-pouder through his composition is not venomous for coaâ—e either of Willow or other drie wood which is the third ingredience thereof is without al veâ—â—me as is proued dayly by the gyrrles which are pale faced and are sicke with the disease called Pica much lesse then are the lyquors veâ—amous with which it is imbived which is wine and Aquavitae Thus much of the nature of powder which if we weigh his composition is not venemous because none of his simples or ingrediences are venemous neither can it bee venomous by any meanes by chaunging it into a firie qualitie For reason it selfe teacheth that fire both Actu and Potentia doth resist venome And this is the venis error in which Alphonsus Fer. is fallen when hee sought for venome in thâ—s powder in which is none at all as by the particilar examination of the parts and sunples we haue declared and of this matter may also the Germaine souldiers be a good â—nsample for they so soone as cuer they perceiue themselues wounded by shot by and by they put no small portion of the powder in a cuppe of wâ—ne and as a holsome medicine drinke it vp Now some man wil say I pray you from whence then do you thinke this venome in the wouâ—d doth proceed it seemeth then that the cause is in the bullet when it striketh woundeth the person and that also being commonly of leade cannot be venomous in so much as lead doth greatly agree with our nature and is verie holsome thereunto for it greatly auaâ—leth to the consolidation and drying of sores whether it be applâ—ed in his metaâ—itue forme and shape as wheÌ„ places of leade are applied to depresse the swelling lippes of sores or else the ashes thereof mortified and dissolued are mixed with emplaisters
of purpose as some would haue it but by often dipping and quenching them in mercuriall waters and deadly iuices through y e which their substance may be altered spoiled and so they doo venime and infect the wound with their euill disposition although they stay not in the wounde but presently passe through of such force is the subtiltie of them as by experience often made in beasts hath ben often prooued the which we meane to confirme with probable reasons in that booke de Antidotis of which we spake off a little before But yet we graunt that the shot passing so swiftly through the body cannot so sodenly infect with his poison yet often it commeth to passe that the bullet lieth long in the wound vnknowne to the Chyrurgion and so I thinke there is no man that doubteth but that in such space it hath time enough to infect with his venime the hurted part for the more subtiller and spirituall the poison is as we haue declared before so much swifter quicker are the effects thereof by spreading abroade his maligne vapours through the vaines arteries and sinewes whereby it doth infect the spirits naturall vitall and animall choaking them with a certaine disagreeance and contrarietie ioyning themselues with them whereby the life of man is extinguished the which doth consist of a liuely and meete action of the saide three spirits And these poisons the more subtiler and finer they be so much the more daungerous they are the which is plainly to be seene by the biting of Vipers and other venâ—mous wastes But if any man will frowardly contend as I see some will that the strength of the fire will take away all the poison of the bullet I will answere them with the same argument which they themselues are wont to vse for say they these wounds are not any thing burnt at all in that the shot by reason of his hardnesse is neuer so hot but that it may be handled with bare hands and likewise I say that then the fire cannot haue such power that it is able to abolish the poison which is spred through the substance of the bullet specially when the venime is so mixed with all parts of the shot that it hath infected with his venime all the substance thereof Neither am I mooued in that Aristotle lib. de Coelo cap. 7. writeth that by the impulsion of the aire the dartes or arrowes waxe so hot that the leade thereof melteth the which by the thing it selfe and dayly experience is knowne to be false and especially in gun bullets which are sent out by fire and are carried away farre more swifter then any arrowe but if this might be graunted to Aristotle yet the witnesse of auncient writers of whom mention before is made doth plainly proue that the poison therby cannot by any means be extinguished much lesse theÌ„ can it be ouercome with a far lesser heate Nay I say that not onely that the venime cannot be taken away with so smal heate but also I affirme that if the bullet it self should be molten yet very hardly thereby the poison would be purified for so greatly deeply is it spred mingled w t the whole substaÌ„ce therof that for the most part there is not one part left vnaltered Likewise the spirite of Arsnicke Calaminae or Tuthiae being mingled with gray or yellowish Copper dooth not at the first melting vanish away yet we count not those like to them which wee spake off before such as be deadly being only outwardly farre from the principall parts applied through their hid and secret qualitie as the effectes thereof doth most plainly declace By this we trust it is manifestly prooued that shot may be poysoned which verie quickly will worke hys effectes especially if it stay in the wound as oftentimes we haue seene that poyson being heated with a small fire and scarsly made warme would very hardly be quenched or taken away By which reasons it may be concluded y t shot may be venemous but not thorow the pouder which we haue proued to be quite voyd of venom but by dipping and seasoning the shot in poyson which oftentimes we haue seene wherefore it behoueth a wise and expert phisitâ—an not to be selfe minded for as this thing happeneth not dayly yet manie times it commeth to passe and yet not oftentimes when a sudden battell is fought when eyther through ignorance or want of poyson it is not practised but it is rather wrought in defence of Cities being besieged or of set purpose when anie is minded villanousâ—ie to murther another to which most wicked deuise in these our vnhappie dayes Princes and noble men are more in danger then common souldiers in this place we will ouerpasse the signes and tokens whereby it may be knowen whether the shot be vâ—nomous or no hauing a more fitter place therefore in the chapter of the true and orderly curation thereof This place requireth that we reason of the varietie which is found in such woundes that is of the burning which sometimes is and sometimes is not and to say my minde therein I cannot allow their opinion moued thereunto by the authoritie of diuers learned men which write that the cause of the burning and blasting comes through the shot which they thâ—nke by reason of his swift mouing and motion of the ayre through which it swiftly passeth waxeth so hote that it hath the strength of a cauterise which they labour to proue by the effect following that is by the escharre great inflamation and blacknesse and other such accidentes which are woont to accompanie burning Of this I will not with manie wordes contend insomuch that the nature of the shot being wisely waied which is commonly of lead and therefore can hardly abide such force of heate without melting their error with small adoâ— is conuinced and so muche the easier beeing alreadie confuted by manie learned reasons of Laurentius Loubertus a most excellent phisition and famous in our countrey whose wise and learned iudgement I doubt not wil also verifie with me that this blasting of the wound is not through the heate of the shot which comes farre of out of an Iron peece But it may be when one is wounded by shot standing hard by asdayly we see doe happen that they stand so nigh the peece that with the wound their garmentes verie beard are also scorched which happeneth onely through the burning of the powder which firie and burning with the shot flieth out of the mouth of the gunne which if anie man saith it cannot flee farre I will answere hym by the contrarie that it may verie well flie so farre that if anie man touch his bodie he may plainely feele it before it be quite extinguished And againe if anie more captious will demaund whether that the harnesse and apparell be not sufficient to defend the fleshe from burning by the powder I doubt not but the harnesse hath much more force in defending thereof
then hath a doublet made of a beastes skinne or such other kinde of apparell the which with the verie shirt oftentimes wee haue seene by shot burned neyther then is it to be doubted but that the aire beeing on fire following and driuing the pellet into the wounded person but thereby the flesh may also be burned But what will they say then when the gunne is discharged euen close at the partâ—es bodie and the wound happeneth in an vncloathed and naked place doth euerie souldier weare gauntlets and helmets yea oftentimes it happeneth the gunne to be discharged at the verie face necke handes and open mouth as they which are dayly conuersant in the warres can beare me witnesse farre better then those which dispute of the matter in their closets and according to the prouerb without hazard of gunshot Surely I denie not but when one is wounded so nigh the Ordinance but that the wound may be burned and blasted in which case they are greatly deceaued which thinke that such woundes are alwaies without blasting and doe iudge the heate to come onely of the pellet and therby do make rules so general that they may haue many exceptions which easily may be gathered by that which we before haue spoken intreating of the venome and blasting happening to these woundes Thus much haue I thought it good to declare vnto you concerning the nature essence of wounds by shot and of the sundrie accidentes which may happen thereunto the which for the most part are woont to be solution of continuitie with brusing and rending of the partes which requireth two intentions curatiue that is consolidation and restoring of the brused and torne partes but if it be accompanied with burning as it may be then must we repaire to the third intention that is to the extinguishing of the fire and drawing out of the heate yea and last of all to the fourth that is to some wholesome remedie named of the Greekes Alexipharmacon as often as we shall thinke that there is some venom in the wound hauing speciall regard to the moste dangerous discommodities and to finde out so manie curatiue and conseruatiue and preseruatiue intentions as sundrie woundes ioyned with sundrie accidentes shall require CHAP. II. Of the differences tokens and sundrie signes of woundes by Gunshot THose which more heedily consider those partes which by shot are wounded and doe wisely weye their office necessarie substance situation sence and figure and likewise the essence or maner of the hurt and the proper differences thereof may presently see and iudge as well by reason as experience what and howe manie intentions are necessarie to the curation therof and so may prouide indications much able to sundrie accidentes and present griefes and thereby to preuent things which are as yet to come as Galen teacheth lib. Met. 4. 7. To which purpose it greatly auayleth a perfect knowledge of proper differences and a consideration of the greatnesse or smalenesse deepenesse or hollownesse of the wound the which differences are taken as of the cause efficient of the manifold figures substances shapes and kinde of mettall of the shot for some of them are long some plaine some great some litle some verie slender which causeth that the wound is of sundrie sortes some strike awaie the member other pearce through tearing and rending the sinewy parts and bursting the bones or sometime by onely brusing and not pearcing the flesh according to the sundrie â—nd vnlike kinde of shot or to the nighnesse or farre distance thereof or according to the state of the bodie being hurted that is eyther naked or couered yea sometimes so safe it is defended with so sure a corslet and as we may say so teÌ„pered that it cannot be pearred neyther the bodie by anie meanes be wounded And if it bee wounded it is verie little and without danger in that the violence of the shot is weakened by the hardnesse and strongnesse of the armour and especiallie being the shot of no great ordinance but of some small peece and all these differences without doubt may be referred to one kinde that is to the solution of continuitie which sometime is seene and somtimes is hidden that is manifest which is perceiued by handling and sight and when a plaine wound appeareth with wannesse of the fleshe as it were an Escare ioyned with great dolor and specially when the sinewes are hurt which doth plainly shew vnto vs beside the signes of a wound which doth not a litle auaile to this purpose that the same is made by gunshot A hidden or secret wound is without anie manifest breaking of the skinne which the Grecians call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and is knowen by shedding of the bloud betweene the flesh and the skinne and doe stayne the hurted part with a violet and wannie colour These are the common signes of such woundes wherein a consideration is had of onely brusing and solution of continuitie but insomuch as we haue taught in the former chapter that such woundes may sometimes be accompanied with venom and blastinâ— contrarie to the opinion of some it behoueth the Chirurgion to imploy all his studie and labour in this case to iudge and discerne euerie affection by the tokens and signes proper thereunto because such affections as we said before be often ioyned to such woundes and let him seeke out a proper remedie for ech of them and diligently consider which of them is most dangerous for that as Galen teacheth is not onely first but also chiefest to be cured that insomuch as sometimes wee are compelled by reason thereof not onely to let passe the other accidentes but also to make new that thereby we may remedie that which is most dangerous And this is the very cause why the knowledge of these wounds poisoned by shot are so necessarie as in the Chapter before we haue taught least that the sodaine death which many times comes thereby be imputed to the corruption of the aire and other first qualities when commonly the fault lieth in the wilfulnesse and vnskilfulnesse of the Phisition perswading themselues that these wounds by no meanes may be venemous therby they refuse the true kinde of healing And some no doubt will attribute it to the aboundance of blood and to the euill iuice of the bodies called by y e Greeks Cachochimia the which two verily I doe acknowledge with Galen confesse haue great force in hindering of al wounds and the chiefest causes of euill accidences notw estanding if the signes which signifieth venom hath in theÌ„ any thing coÌ„mon with these y t happen to gunshot where only coÌ„tusion is ioyned yet may they easily be discerned whether they be great or litle or waightie fearefull accidents and extraordinarie which oftentimes come to passe Therefore if the flesh be more wanner then it is wont to be in common wounds by shotte and as it were deade with an euill colour of all the whole member with intolorable and
beginning of the sicknes so straite a dyet is not to be kept but by litâ—e and litle it must be deminished vntil the end of the state of y e disease but so as y e strength of the patient may suffer it which thing must be warely obserued And so these things rightly considered we must come to the administration of the things not naturall and so satisfie our intent After this it behooueth to choose a drie and temperate aire for such is required of all wounds because by exiccation they are conglutinated but and if any man obiect that it lieth not in our power to bring a drie aire to the sicke when as there is not any thing to bee founde more moister as Aristotle teacheth in the seconde chapter of his Meteors in so much it exceedeth the water in moisture which in sight seemeth moister in that it moistneth things dipped therem which the aire cannot doo by reason of the subtilnesse therof This may easily be answered that such aire may be chosen and by art corrected and so made meeter to our purpose intent for it is not vnknowne but that some places and houses are whotter dryer moister and colder then others be for those which be nigher the North are colde and such as are Sowtherly are whot euen as the sunne is nearer or farther from them Also the situation of the country is to be considered for some are hilly some marrish others adioyning nigh to lakes standing pooles and riuers by the varietie whereof the qualitie of the aire is changed and altered Who is ignorant but that the nature of the men of Asia is farre differing from those of Europe the which Hipoc lib. De aere Locis etaquis doth attribute to the change varietie of times which causeth the nature of countries to be more rougher and harder and that is the cause that countrie and sea-coastes men be of an vnlike nature and disposition to those which are bredde in cities and vallies farre from the sea-coasts What shal we say now of the situation of the cittie of Ferraria or Florence of the which in the first all wounds in the head are deadly in the other al the hurts of the legges are vncurable for which cause Hippocrates treating of this matter saith that the nature of the south wind is altered by reason of the countries by which it is carried which are some hotter some colder then some for hee writeth that first it comes from cold and Isie countries whereof winds are ingendred as Aristot in the second of his Meteors sheweth and that they are of the same nature at the first as the Northwinds are which are frostie and colde as those which inhabite these countries doo feele And after being carried by the South and beames of the sunne waxeth so hot that through the heate thereof it looseth his coldnesse and burneth the herbes and makes the inhabiters thereof to be dry and so passing ouer the seas and imbibbing the moisture thereof it looseth the great drynesse it had receiued and becomes moiste as is seene and perceiued in all Italy and also in that part of Fraunce which is named Occitania And this is the reason why wee iudge the South-winde to bee hurtfull to woundes because that this moisture is ioyned with heate which is the mother of putrifaction as wee haue before prooued The like may bee saide of the North-winde which in sundrie regions is verie wholsome and withstandeth putrifaction and againe in some very unwholsome insomuch that the pestilence or anie other disease raigning is thereby increased the cause whereof as we sayd before is to be attributed to the varietie of countries and situation of Cities being in low and marrish places wherebyth e proper nature of the windes may be altered and so the bodies of men are corrupted and filled with all humours These thinges waied and the season of the yeare considered which are diuers and vnlike by reasons before alleadged and sundrie mutations which dayly happen and alter the qualitie of the aire as Hippocrates hath taught libro de â—ere locis aquis we must choose fit and profitable aire where the wounded person may remayne But insomuch that that is hard and vnpossible to be done because the wounded by bitternesse of the griefe can neyther ride nor goe but commonly are compelled 〈◊〉 to stay in the place where they are wounded or at the least â—â— the â—itie next adioyning thereunto yet specially that place where the campe hath long stayed is aboue all to be shunned because the ayre thereby is infected and also moyst and marrish places are to be auoyded for thence doe noysome and thicke vapors ascend And contrariwise such aire is to be chosen that is farre distant from moist and wet groundes for such is pute cleare wholesome And let the windows next the north be open rather then those next the South but and if that shall seeme colde it may be amended by heate of fire made in the chamber and also sometime corrected with odiferous thinges as Masticke Roses Jumper Berries such like And in the sommer you shal vse lauing of the house with Oxicrato and strew the chamber with rushes and greene herbes and leaues of the wythie or vine tree and after this order may the aire be applied and corrected to the health of the patient as the part hurted shall require For woundes and hurtes of the head or coÌ„missures thereof cannot suffer so cold an ayre by reason of the nipping thereof as woundes in other places may And as concerning his diet it is no doubt but it must be ordered according to the maner of the hurt as Hippocrates hath taught and as the nature of the patient is able to abide auoyding sodaine changes for such as we said before are verie dangerous let his meate be such as breedeth good iuice and the quantitie thereof the lesse especially vntill the state of the disease be past in which time a more slenderer dyet must be kept then afterward and let the bread be well leauened and throughly baked And let him vse the fleshe of small birdes as thrushes or such like eating therewith the iuice of an Oringe or Lemon or Greenesauce made of Sorrell to get him a stomacke Also bread-broath which is made of bread and a chicken first boyled with buglose sorrel lettice such kind of hearbs and this broath he may vse in y e morning to mollifie his belly raisons of the sun and prunes in this case be very wholsome so are likewise Damascenes Grapes condit Barly picked and sodden Almond milke and Oten milke all these are very wholsome and chiefely in the beginning for then the wounded commonly refuse all meates sauing broathes and such as are liquide But after the state of the wounde hee may vse Partriges Chickens young Capons and Mutten minced with his owne iuice and the iuice of an Oringe and all other meates are wholsome which are sweete delicate of
Egshels Ê’ i. the sirope of drie Roses and of mirtils of ech â„¥ i. and with the water of the flowers of red popie make thereof a potion and minister it three houres before meate the which may be barly broth boyled with Rosewater and popie seede if it â—e toward bed Aboue all there cannot be found a worthier remedie both to stop bloud and case all paines and suppresse fluxes of humours then Laudanum Opiaticum if you minister a pill thereof as bigge as a Pepper come the vse wherof especially in these kind of wounds cannot to highly be commended that I haue more plenteously intreated of in my answer to y â— treatise of Aubertus vindonis do ortu causis Metal After these thinges being first done then apply medicins which quickly may suppurate and being come to maturation let it be mundified with exiccation that naturall fleshe may growe that is it be neither ouer hard or soft or proud and the scales of the bones if there be anie may come out from the sound bone Moreouer we hasten the suppuration of these wounds least the venome closed within and filthy saines doe some greater hurt for being throughly ripened feuers paines and almost al other passions will decay For this intention the common sorte are woont to vse at the second dressing digestiues as they tearme them made of the yeolke of an egge oyle of Roses and Turpentine which as I may say the trueth I cannot allow in that they soone putrifie and cause the wound to smell whiche thing is alwaies ill Others vse hydreleon warmed with butter and other thinges which haue nature to suppurate and some boyle the flower of wheate with a litle safron some againe there be which greatly commend Tetrapharmacon made of pitche rosin waxe and suit and Cor. Celsus esteemeth this aboue all others Also Macedonioum is made with the forenamed simples and frankencense and much commended of some Other greatly allowe Basilicon for it is a great suppuratiue and also readie at the Pothicaries and some commend Dialthea which they call Resumtiuum Others Emplas dia Chilo simplex and de mucilaginibus which they temper with oyle of lylies And with all these and other like medicines they out of hand doe suppur at the bruised flesh following the preceptes of Hâ—ppoc For he writeth that it is expedient that the brused flesh be supurated and by such meanes is the wound lesse subiect to impostumation and anguish and this is the iudgement of Hippoerates and all other antient Phisitions and I my selfe cannot but highly commend the vse of the supuratiues for they doe defend the nature and strength of naturall heate and do temperate the rage of rotten humours and verie quickly doe bring the corrupted bloud to matter and thereby doe bring the wound in a farre better estate But yet this one thing must be taken heede to that the vnorderly vse of them cause not the wound to rot which is remedied by putting to euerie ounce of the suppuratiue one dram of precipitate prepared after our order yea and more to if the wound shall smell and so shall the medicine pearce farther and worke his effeâ—t without danger and by this onely meanes you shall haue white matter and the affected member shalbe safâ— from Gaâ—grena and putrifaction whereunto in theâ—e kinde of woundes they are much subiect and this haue I oftentimes proued by sure experience Neyther haue I thought it amisse in the behalfe of the vnpractised chyrurgions to set downe some ensamples for this intention I would therefore that the tents Plegetes and whatsoeuer is put in the hollownesse of the wound be dipped in this oyntment following which is easie to be made Take vnguents Basilici maioris discrip Mesnae â„¥ ii fresh butter â„¥ i. Precipitate prepared after our manner â„¥ ii ss mingle them and annoint therewith the tents and plegets Another Take new Waxe Rosme ship Pitch of ech â„¥ iiii Goates sueâ— marrow of calues leggs of ech â„¥ ii aesypi humidae â„¥ i. oile of Oliue or of Linseed or of Visci pomorum one pound melt them straine them and make thereof an ointment An addition Take of that ointment â„¥ ii of our Precipitate Ê’ ii mixe them and so shalt thou haue a most excellent remedie which being vsed in emplasters without Precipitate is to bee annointed and put into the wound Or else thus Take venice turpentine and white hony of ech halfe a pounde the yelkes of twelue eggs and mixe them very well and boile them to the thicknesse of a pultise This ointment which the Paracelsians call Galcinatum magnum you may safely vse in sreede of a digestiue for being so prepared it resisteth putrifaction and is very good to bring such wounds to suppuration But in so much as it is the office of naturall heate to maturate and not of medicines we must therefore by all meanes possible increase such heate as is likest thereunto which is to be increased and nourished by wraping the member in bombase lana succida and linnen clothes or else with some Cataplasme by all which meanes as Celsus writeth daungerous wounds are cured and such things must be dipped in Hydraelion made of oyle of Rosâ—s and Rose-water wherunto you may put a little vineger but not too much in that it hindereth suppuration or else vse this fomentation following which I my selfe do often vse A fomentation to mollifie and ease paine Take of the leaues of Visci pomoruÌ„ smal shred with the berries m. iii. the rootes and leaues of Holihock Mallowes Violet leaues ana m ii of Fenigreke Linseed ana â„¥ ii the flowers of Camomell and melliâ—ote ana p ii seeth them in milke This medicine neuer failed me for it driueth away inflamation greatly easeth paine and strenthning the substance of the member it very quickly moueth good matter and of the foresaide substance pounded and driuen through a seeue is made a cataplasme by putting thereunto the meale of Lineseed Fenugreke ana â„¥ ii Oesepâ— humidae and marrow of calâ—â—es â—eete ana â„¥ i. ss the yelkes of foure eggs of saffroÌ„ sixe graines oile of Viscipomorum and rosarum as much as sufficeth let it be applied to the wound and parts nigh vnto it but round about it somewhat farther off let this ointment following be vsed to withstand the flux of humors An excellent defensiue Take the powder of red Roses and of Myrtils of ech Ê’ i. bole Armeny terrasigillata of ech Ê’ vi the iuice of Plantine and Dwaâ— of ech â„¥ i. vinegar of Roses â„¥ ii oile of Roses Omphacine and of Myrtils ana â„¥ ii ss Waxe â„¥ ii make thereof a defensatiue And such medicines so long you must vse as we saide before dressing it twise a day vntill the wound come to good matter and then must you vse clensing medicines wherwith you may always mix our Precipitate in greater dose which brauely clenseth wouÌ„ds from matter and also resisteth corruption An excellent mundificatiue easie to
and therefore it is to be done by and by which is as it were to set that present before his eyes which is not yet and is also vncertaine whether it will bee or no. Moreouer it is better first to die that kinde of curation which is of credite and profite then to attempt a taking heed of other hanious griefes not yet come neither may we thinke that nature is so weake but she is able to performe that which seemeth impossible being holpen in time dâ—oth oftentimes deceiue our expectation and iudgement as in the ensample before we haue declared But in case the member must needs be taken away it is better to be done by a generall consent of the learned then by the rash iudgement of the vnskilfull which oftentimes will boldly enterprise the same The cause why intreating of these woundes which happen without breaking and brusing of the bones I take my beginning of these which happen to the head as the most waightiest and dangerous by reason of the worthinesse of the braine inclosed therein And also because there can no bands rowlers whâ—ch they say to be very necessary in all fractures bee applied thereunto which bands were inuented to repell to aswage impostumation to auoide quitture and to take away all hurtfull things sticking in the wound without which meanes Galâ—n thinketh Meth. vi cap. vi no bone broken may bee vnited whereby it comes to passe that Cranion being fractured it is necessarie to open the scull which commonly we call trapaning that thereby we may clense and make a passage for the matter which otherwise might corrupt the paniâ—les and so the braine it selfe And that we may intreate orderly hereof and our meaning the better vnderstood let vs imagine to be set before vs some one wounded in the heade by shot and the first thing to bee considered shalbe this whether the wound bee manifest or secret shewing it selfe onely by brusing which may come to passe if so be the helmet be so strong that the shot is not able to pearce him but onely bendeth it and so bruseth Cranion and breaketh it without opening of the skinne This happening the wound must be launced crossewise and to the incision let some assringent medicine be applied with lint or towe made of sang drac mastic and bole Armeny mixed with the white of an egge and so in the day following the wound will be greater and so may yee iudge better of the fracture which doth happen after sundry sorces for some whiles one part and otherwhiles both partes of the table are perished sometimes the fissure is to be seene and then with the Grecians it is named 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 otherwhiles it is verie narrowe and not to be seene which the Latines call Pilosa the Gretians 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the which againe doe pearse both partes of the table or one which is not so dangerous Therefore the fracture being manifest the wound being sufficientie delated eyther by shot or incisiion so soone as may let it be taken in hand first of all let all things bee taken out which are contused and torne and whatsoeuer oppresseth the panicles but if there bee any great fragment which oftentimes chanceth you may not too hâ—stily pursue it as Galen wrâ—teth in his sixt Meth. med ca. 6. It shalbe sufficient if the bone bee so much opened that the matter may auoid thereby These are to be considered when the incision or fracture is manifest but as concerning such woundes as haue onely a simple fissure such require a skilfull and expert Chyrurgion to discerne them for oftentimes it is not to be perceiued by sight nor handling The ancient in this case that is when the fracture is pilosa or Capillaris did vse a certaine blacke medicine which leauing behinde it a blacke scarre in the bone did shewe the fracture to bee there To this purpose may bee vsed inke wherewith wee write tempered with masticke or else coles with mell Rosate or else which is better tartar calcinid till it be blacke which also of his owne accorde easily resolueth but the later writers doo iudge of the fracture by applying of astringent medicines for in what place and where it is soonest dryed which comes of hot vapours percing through the fracture there it is shewed to be which being found out we must presently search by proper signes and tokens whether the fissure dooth passe both the tables or else but one for if it be but in the vppermost table only it sufficeth to scarifie the bone where the fracture is with a razore which the greekes call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 or any other fit instrument as farre as the fracture extendeth that the bone be made equall and after proceede to the residue of the curation applying medicines meete for wounds contused of which we haue already intreated in the first booke Moreouer you must take great heede in all wounds of the head that they take no moisture as Hipoc witnesseth de vuln cap. But contrariwise let such things as dry and comfort the head be applied either drie or in powder or mixed with mell rosate Such as comfort the head are these the roots of both Aristolochies frankeÌ„sence myrrh ireos panax farina orobi and other such like also mercurie precipitate is very good mixed with mel rosat ruineth the superfluitie of bones but if the rising perce through then must it bee trapined before the third day or by some other meanes an issue made as Hippocrates saith which must be so ample that inflamation be staide and a passage for the matter made so that throughly it may be taken away and clensed which must be done circumspectly and with fit and meete instruments which are liuely set out by Ambrosius Pareus in the Chapter of woundes of the heade And this handie worke being ended wee must diligently marke when the broken bone doth waxe lose for then it is to be taken out so be it sticketh not fast to the panicle which if it doth it must not bee medled with least thereby you hurt the panicle or hinder it by letting in of the aire but you must stay till such time as the bone fall away of his owne accord but if the bone be quite separated from the skinne which oftentimes happeneth in such wounds through the great force of the shotte and there is also inflamations and other davngerous accidents which commonly accompany these wounds Then it must presently be opened yea before it doe rot if so the Chyrurgion be come in time which ought to bee both diligent and skilfull and hath a perfite knowledge of all such places as may be trapaned in that y e seams of Crainon are not to be medled with but if the wound chance to happen there then it must be trapaned on both sides not touching the seames and it must be done in that part which shall seeme most conuenient to auoide the corruption Moreouer you must