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ID	Title	Author	Corrected Date of Publication (TCP Date of Publication)	STC	Words	Pages
A67187	An experimental treatise of surgerie in four parts : 1. The first part shewing the dangerous abuses committed among the modern surgeons, 2. Of cures of all sorts of wounds in mans body ..., 3. Of the symptomes of wounds ..., 4. Treating of all kinds of balmes, salves, plaisters, ointments, oyles, bloodstenchers, potions, tents, corrosives, &c. which are used for wounds ... / by that most famous and renowned surgeon, Felix Wurtz, citie surgeon at Basell ... ; exactly perused after the authors own manuscrip, by Rodolph Wurtz, surgeon at Strasburg ; faithfully the second time translated into Neather Dutch, out of the twenty eighth copy printed in the German tongue, and now also Englished and much corrected, by Abraham Lenertzon Fox, surgeon at Zaerdam ; whereunto is added a very necessary and useful piece, by the same author, called the Childrens book, treating of all things which are necessary to be known by all those, to whose trust and overlooking, little children are committed.; Practica der Wundartzney. English	Würtz, Felix, 1518-1575?; Fox, Abraham Lenertzon.; Wurtz, Rodolf.; Wurtz, Felix, 1517 or 18-1574 or 75. Childrens book of Felix Wurtz.	1656 (1656)	Wing W3733; ESTC R38771	274,491	374

Bloud which forsook their natural places as veins turneth to water and if there be no great quantity of such water-bloud it will be exiccated by natural applyed medicines and quite expelled But if you use much of greasie things and many wet Cataplasmes as some Surgeons usually do it will not onely be to no purpose but also cause perillous Symptomes for such applyed greasie wet Poultesses force the congealed bloud to turn unto corruption What wil that prove but a dangerous Imposthumation which after a long time in great pains breaks if it falls out so well sometimes it turns to a Fistula or other Ulcer yea sometimes such anger is caused that death ensueth upon Thus much of this one thing more I add a pulverise Potion may be used here also it will hasten the healing and ease the Patient the sooner CHAP. VIII Of Synptomes which are incident unto congealed Blood to be expelled by inward means THings spoken of in the precedent Chapter touching congealed Bloud are to be understood thus they concern such parties that find themselves well besides the trouble they are at of congealed bloud In our language I know not whether any sufficient information is extant touching this particular and I think it not amiss to give some hints of it If congealed Bloud in the body be left there so long till Congealed blood in the body it turn into matter then the aforesaid means will not help as being too weak Surgeons either out of carelesness or out of ignorance let their Symptomes run on If in the side back breast or a vein be broken be it about the milt liver or any other part and that sprained or broken vein bled very much but that bloud doth not run into the belly but sticks between flesh and skin and is nearer to the inside than to the skin and makes little shew at the outside and may be nearer the liver or milt however it is betwixt the flesh and the skin and there it putrifieth and comes to ulceration this will not be cured nor helped by purging c. Reader understand it thus if nature be opprest by abundance of bloud or neglected by Surgeons of these we intend not to speak For nature is able to expel it of her own strength The four outer parts of the body may be opprest with congealed bloud caused by a fall throw c. if neglected or by Surgeons dawbing brought to ulceration then the things spoken of in the precedent Chapter avail nothing therefore other medicaments must be had of which I will give you a hint Note one thing there is but one process be the hurt from what cause it will either from the superfluity of bloud or the Patients carelesness or the neglect of the Surgeon I will be orderly in my instruction and tell you the best way how to help congealed bloud in the body which is turned into corruption if the Imposthume be not absolutely within the body but more to the outside and that befals the four outer parts of the body either through the Patients or the Surgeons fault Then if that congealed bloud begins to putrifie it may be Signes of congealed blood known by signes the Patient wil feel it at his side whether it will come to any Imposthume he may know it also by the matter he brings up whether in clots and stinking if so then that congealed bloud begins to putrifie Such a party must not be delayed but speedily be taken into cure for delayes will make it run on to an Imposthume which must break at last If it comes to that then the party is neglected and the help will come too late for Nature having once begun to cast up that matter then she must be aided As I told you above so I say still when these foresaid signes are apparent then the named remedies will availe nothing because the Imposthumation is too sturdy for them and goes on in growing For putrified bloud goeth slowly out of mans body infecting other parts as the lungs liver milt c. Besides a dangerous cough will be incident which will breed mischief mischief therefore other means must be thought upon Tonching my medicine I tell you thus if congealed bloud be in the body and that within the hollow of it then use not Mercury spoken of afterward Diaphoreticks are to be used But if the Wound was not into the hollow body and none of the inward parts is hurt then these things may be used which I will speak of If the case be such as was told now then first make a gentle purging drink of sirup of Roses to give the Patient two stools the second day minister to him in ʒ ss of succus Rosarum 5 6 7 or 8 grains of the following prepared Mercury still regarding the Patients condition and let him lye still when it begins to work let the patient take some spoonfuls of broth and two hours after he may eat a broth into which two yolks of Eggs are beaten afterward let him take his rest and sweat upon This Mercury may safely be used if it fumeth up but once and that very gently according as he meets with an Mercuries operation object above in the body but it purgeth bravely by stool carrying away the congealed bloud and other filth though it had been an Imposthume it must go with a gentle stirring not so as usually precipitated Mercury doth If you are an Artist you wil prepare this Mercury in my way and you may prepare also somewhat of Antimony But Vitrum Antimonij is nought here by reason of its strong vomiting quality I tell you without Chymical preparations congealed bloud will not be eradicated out of the body if turn'd to an Imposthume The next day after the ministration of this purge phlebotomize the party provided Phlebotomie if the party cannot tell where his greatest pain lyeth then breath the Median of the right arm or open the Liver vein on the right arm if the party complaines of his left side then open the Spleen vein on the left arm This being Diaphoretick done and the patient is not wel yet as it fals out commonly then take the precious red Balsam of Sulphur whose preparation you find above in the Chapter of breast Wounds four or five drops of it and ℥ 1 of the Aquavitae described in Wound-diseases mingle these let the Patient drink it and sweat upon This Diaphoretick may be used twice or thrice once a day and so long till the party be eased of his pains Thus you will do much good Reader this is the remedie I opposed such malignant and mortal Symptoms with True I have seen other process with Pills Potions c. whereby congealed blood is expelled but these waies were to little purpose I neither reject nor condemn the means others do use Mercury is thus prepared ℞ ℥ 1 of Mercu●●●urged with salt and water taking away all his blackness ●●d impuritie put it into a

before there breaking in appear in some tokens which tokens a Surgeon ought to know if he intends to do good and get credit It deserveth more praise to prevent an enemies invasion and is sooner opposed then then when his armie is come into a land to be expel'd A Surgeon hath the more cause to be knowing in such Symptoms because there is such a variety of them which to rehearse is impossible If men in health are subject unto Symptoms what shall we say of wounded men there are some held for sound in whom many infirmities lie hid who being wounded fall into the wounds causing some fistula's cankers or the like which without a true process are hardly cured well and Surgeons may easily be deceived herein if not well expert in those wayes Situations of dwelling places either further or hinder such Symptoms foggy places are not so wholesome as those of a clear and pure aire And the same cause it is with the yeares seasons as also the weapons are of different natures whereby a wound is made some are poysonous others are not the former cause more dangerous Symptoms than the latter and one part of the body is more subject unto Symptoms than the other and so are men also according to their several complections Some patients cause Symptoms upon themselves with their disorderly course of life from thence several Symptoms within and without are caused which a good Surgeon ought to know else he will have but ill success in his curing of wounds These have been the stronger motive unto me to write of the Symptoms in wounds because that knowledge lyeth hid deeply whose names scarcely are known whose true knowledge is very necessary without which little good can be done of these I will speak in brief and plainly however fundamentally and really not having borrowed it from others but as I found them true experimentally my intention is to write of mine own and leave others to their opinion and it is fit every bird should wear his own feathers Setting other things aside I come to the things themselves CHAP. I. Of the Signes in general whereby Symptoms are duly discerned COurteous Reader before I come to speak in particular of Symptoms I will first rehearse some tokens in general whereby Simptoms may be known hoping you will be thereby enabled to conceive the better of them if you hear every Simptoms signe described in particular He that is wounded at the Dura pia Mater looketh horrible Signes of a wounded Brain when he beginneth to draw his mouth together then it is a figne that there is a cramp in the wound but if he stareth with his eyes it is a figne of an Apoplexie and of death if none of these signes are present and the patient is hot and his face is red it signifieth a Feaver or a disease of the wound is like to befall him But if all the said signes be at hand then nothing so sure as death But if the patient Wound-disease is besides these in a rage and furie then is he in a worse condition again if the patient looks pale in his face and is still and quiet then is he in the better condition If a patient still thinks that some body gapeth into his wound after he is A pulling wound drest it signifieth a Cramp unless the Surgeon have put too much of the resigne which runneth like Turpentine or any other Gum of that nature whereby he causeth that pulling or griping If a wound be in a flame when drest it signifieth that a A burning wound sharp humor is faln into it which eateth of the flesh already healed unless the Surgeon have put too many hot hearbs to his Salve or hath put to it too much of Mastick or gum Sarcocollae If a wound swelleth on the outer member and paineth the patient very much at the changing of the weather it signifieth A wound sensible of weathers a withering and consuming of the member delay no time to help it for if you should stay till the wound be healed afterward you will hardly bring that hurt to right A true Surgeon must understand and know aforehand and help before the hurt be done let him make use of exiccating medicaments If there be a swelling in an outward joint or member near the wound and is yet hard and doth not pain the party Swellings without pain and that wound healeth together from within then is it a sign that the medicaments are nought and will do no good though the wound be not unto lameness yet in this manner it will be made lame if the Surgeon goeth on in his applyed medicines if he perceiveth it then let him take better mecicine Viz. Of Storax Gum Opopanax c. This Symptome befals a joint-wound when stitched and afterward a poultesse applyed to it If a wound swelleth on an outward member and doth Signe of a Fstula not pain the party when touched and closeth and the more it closeth the more it swelleth it is a sign that a fistula groweth on if it pricketh much being felt and toucht it signifieth that a splinter of the bone would fain get out but if it doth not prick and seemeth to the patient as if he were toucht with an Iron it is a sign that a piece of an affthrusted bloud-vein would fain get out and the Surgeon ought to make vent but in case the swelling paineth the party sometimes and at other times it doth not at one time it is red at another it is pale it is a sign that a Cancer will come Signe of a Cancer into the wound if it doth gnaw a little and doth prick when it is not toucht and looks brown-red then is it a sign there is a Cancer in it already A wound that yeilded much matter at first and the party being well but afterward the wound begins to water I Water in a wound do not speak here of the joint water it is a sure sign that either a Cancer or a Fistula is coming but if the patient groweth dayly weaker it signifieth death If a wound inclineth to heal very fast and yet the party Hasty healings of wounds groweth daily weaker it is a sure sign of death such wounds are commonly purple-brown shrink commonly and it is an unnatural healing When wounded men are continually in a fright it is an ill sign if a tucking pulling be accompanied with it it is a Frights in patients sign that a wound-disease is coming and if any redness be joined with it it is a sign that the wound-disease is already Wound-disease Suddain pains at the door If suddain pains come into a wound and goeth away suddainly and the party can after it not stir the joint it signifieth that the Palsie is come into of that joint you may say that it will keep lame if no worse thing come unto which is to be feared If a Joint wound swelleth

that a wound is very dry yeilds no matter but onely a little water its lipps are hard and turned outward are thick and red round about disformed and indisposed and a slyme in it no great heat and pain the patient feeleth Further note if the wound be in an outer part for that about the bodies bulk is of another nature and the party feeleth panting and pulling pains in that joint or part it is a sign of the cold fire which usually hath its cause from the Prunella if it be not timely opposed Touching the cure of such wounds note If Prunella be Cure discerned and known in a wound by some of the said signs then the patient in the first place must be phlebotomized as you shall see occasion It would be well if it could conveniently be that a vein were opened under the tongue for if a party be troubled with Prunella it is soonest discerned by the throat and so it will soon shew it self in the wound also if it was in the mouth or throat at which some Surgeons are estranged and others do slight it but no sport for the poor patient After phlebotomizing take water of Salarmoniack mingle it with half as much of Rose Vinegar make it warm siringe the wound with it if it may be done conveniently afterward use this following Ointment to the wound or stab Take of well scummed Honey ℥ 4 Vinegar of Roses and of Juniper ana ℥ 1 phlegme of Vitriol ℥ ss mingle these make an Unguent of and use it and apply a defensive plaister without about the wound but on the wound you are to put a stiptick plaister But if the wound be very angry then the following Lavament is to be used Take of Rose vinegar lb 3 of Myrrh ℥ 2 mingle these and let it boil together for an hour then ad to it of Camphore ʒ 1 of Saltpeter ℥ ¼ these must be well beaten dip cloths in it wring them out lay them four doubled and warm to the wound let them be big and broad enough but the wound must be covered first with a good plaister before the cloths be applied if these grow cold then apply other warm ones and this must be iterated so long till the wound be well warmed then apply a stiptick plaister If a wound by these be brought to a good pass and Signs wherby is known a wound to return right sheweth a true and good sign then go no further on with these medicines then you are to take good wound Ointments and stiptick plaisters But how you shall know that a wound returns to a right tune it is thus The patient as well as the wound altereth and the best sign whereby to know it is when there is no more pain in the wound and looks ruddy and is soft and tender The patient must take heed of drinking of wine as much as of poison and to shun all meats seasoned with spisces arumatical Let him drink Barley water wherein must be dissolved prepared Saltpeter of which hath been spoken above to five pound of water you are to take half a dram of the said Saltpeter it will allay his heat as well that in the wound as that in his body About the dressing of his wound and the applying of the medicines you are to do it in that manner as you heard above about wounds which were exiccated by the Suns heat Out of these in my judgement may be enough discerned that it is of great concernment that a simptom in a wound be well known then it will fall the easier to cure such wounds It is most certain that these simytoms in wounds will by no means admit of any greasie medicines Now those that do not know it and go on in their old waies applying their wound ointments and plaisters these will do little good nay rather do mischief There ignorance is in fault why so many wounded parties loose their lives especially if the wound be in the head or any other perrilous part and when such Surgeons have done their best it is at the least God blesse patients to the losse of the wounded member For your better instruction I wi●l set down here how this water of Salarmonick is prepared Take of Salarmonick one part of white calcined Tartar one part mingle To prepare water of Salm●ack these together sublime them to a powder according to art Let this Salmoniack sublimed be dissolved to a water in a celler or other cool place In case you are to go into the Country with it then is it better to keep this sublimate in a powder and carry it not dissolved And coming to your patient you may dissolve it in Rose water and in case you cannot have neither Rose water nor Aqua Nenupharina then take fresh Well water which for a need may serve the turn especially in a Campe where Prunella usually is brief among Souldiers One rare thing more I must relate viz. the phlegme of Verdigriece is dangerous here Vitriol or Vitriol it self is very good for such wounds whereas Verdigriece is very hurtful to them though both are made of Copper The wounds and the medicines differ here in their conditions the one affecteth wounds the other dissafects them or the one is a friend and the other an enemy unto them c. Therefore I say this that Alchymie is worth to be praised whereby medicines are prepared in that manner as occasion doth require CHAP. XXII Of the Cramp Palsie Apoplexie c. how these Symptomes befalling Wounds must be cured CRamp is a dangerous simptome especially in Head wounds in the neck throat c. where wounds are in dangerous places there the Cramp is the most hurtfull Cold causeth the Cramp in a wound either by that cold Cause of wound Cramps which from the raw ayr is come into or else the patient was kept too cold It is most certain assoon as the arteries and white veins have felt but the least cold presently shrink upward and cause the Cramp Therefore the Surgeon ought to have a care that when he is about to dresse the party to let the wound not be open too long but dresse and bind it presently go not beyond the allowed time of dressing and the patient must be looked to that he commit no fault in fretting and vexing at one thing or other There are other causes of the Cramp which we now pass by Touching the cure of the Cramp note if you discern Cure in head wounds the Cramp in a Head wound then alwaies annoint the patients back and neck with proper oiles of which in the description of Head wounds I made so often mention of viz. you are alwaies to annoint his back and neck with the oyle of Cammomil of the oyl of Lumbrici terrestres c. And it were not amiss to annoint him well with Petroleum The best oyl for such is the oyl of Amber but is not fitting to be used per se or

are dressed And if there any bone be loose then take it out but in case it hangeth yet and sticketh inward then raise it outward again with an Instrument into his former place Let it stand so use convenient means and let Nature provide for the rest I know she will not be wanting unto her self CHAP. VIII Of the Head-ach after the Cure and how that is to be helped How to make the subtile Head ointment with remarkable examples of Head-wounds cured Head-ach after the cure of a Head-wound IT happeneth sometimes after that a Wound hath been fully cured that the Patient after two three or more dayes or after so many weeks feeleth pains in his head and the same pains do increase more and more and many die of it for all Surgeons do not understand the cause thereof and how the same were to be helped of the which I will inform you here First when a Head-wound is healed and riseth after the When a Wound doth swell after healing healing and swelleth and is very painful then lance the Wound presently for it signifieth that some splinter would fain be out and if you do not open it then the matter would make a mighty great hole and break out in another place which would cause many simptoms and troubles and the blow would come on a fresh therefore look you give vent to that matter and when such things are opened then the plaister will draw out the splinter together with the matter bloud and water and if you think it good you may let him use an expulsive vulnerary potion then the Wound will be cleansed and cured Secondly look well to these following signes if the Patient complaineth of great pains feels great prickings in the head and these smarting pains increase more and more and cannot endure to be toucht in that place where the Wound formerly was yet no swelling nor rising of the skin appeareth as you heard formerly then is it a sign that within the scull there is a splinter which hangeth inward and causeth these prickings in this case that place must be lanced instantly and the splinter must be taken out as hath been said Thirdly In case the Patient complaineth more and more after the Cure not onely of the place where he was cured but all his head is panting and broyling accompanied with extream pains This is a sign that congealed bloud is gathered under the scull and is turned to an Imposthume And if his eyes be swelled and some bloud and matter runs out of his nostrils then is it a more sign of it This infirmity may with Gods help be cured easily as hath been said already Viz. Cut off the hairs in the place where the pains are lance the skin cross way to the scull in the breadth of half a Crown and put back the four pieces that the scull be naked then cut with a Raisor or other Knife a Wound into the scull open it that you may look into it then the matter will start out against ye and the Patient will be eased and if there be any splinter at hand you may easily see it and take it out as you have heard before This is the onely way to help such a Patient Such Wounds now made are soon healed again onely govern the Patient well as is fitting and as I have informed you before You must lay nothing to his brains as I told you afore for the brains will expel the things of their own accord when they have a vent for it without any further help and suffer not any strange matter to stay or abide there Touching the cutting up of the scull note that there is Note the cutting up of the scull no difficulty in it and is done easily and quickly For the scull gapeth and openeth if there be any splinters or little bones there therefore with a little help those small bones may be taken out onely look narrowly to it whether there be any fracture at hand for you may easily discern whether a splinter within goeth down and inwards or whether there be any more of congealed bloud there But if you find after the opening of the skin neither fracture nor scissure a hundred to one but there is and however you are sure that the scull must be opened be it either by reason of the congealed bloud or by reason of an Imposthume take a well turn'd sharp borer and bore thorough the scull at the place where the pain is then the matter will startle out and when the place is almost thorough bored then work gently and look well to it that you cause no small bones with the boring to fall into the hollow of the head for if so then you will find somewhat to do and not without danger In this case some will have though I never had need Another way to open the scull of that when the matter at the first opening doth not appear then another hole a fingers bredth from the first is to be bored and then to cut both these holes into one and so to make a Wound into the scull into that made hole you may see with a lighted candle in a dark place and understand the cause if you find then either congealed bloud or a swelling then touch it onely a little with an Instrument as soon as it feeleth vent it will soon come forth at the Wound I should like this way well enough in case any splinter or loose bones be there But it is your duty to study in what manner it may be done most fitly and conveniently as the condition of the case requireth and to regulate your self accordingly For it is impossible to set all down in writing onely be mindful of the vulnerary potion as you shall hereafter hear of Before the close of this matter I will tell you how you shall prepare the Head-plaisters and the thin ointment so To make Head-plaisters often mentioned hitherto Make the Head plaister thus â„ž Of Wax â„¥ 8. of washed Turpentine Ê’ 4. of oyl of Roses â„¥ 2. of the juyce of Bettony â„¥ 6. put all these into a pan let it boil let all the joyce boil away when the other are melted then take it off the fire and put thereto pulverized Colophonium â„¥ ss Mastix Frankincense Myrrh of each half a drachm this must be continually stirred till it be so cold that you may touch it with your hands then work among it Oleum Storacis CalamitaeÊ’ ss make it up into rouls and keep it clean for use This plaister cleanseth Wounds leaves no unclean thing in them and is pleasant and proper for the brains and the whole head Therefore use it as it ought it will not deceive you and doth better than Oyls Aqua vitae Waters Salves as you heard above I will teach you another Head plaister which is yet better â„ž Wax lb 1 Turpentine â„¥ 6. melt these together being well heated pour it into Rose water let it

then there is no need of the Defensive Plaister because it doth not alwayes good Annoint then the Patient with warmed oyls of Cammomil of Rose oyl mixed with a little Saffron or annoint the Patient round with Gray s grease his Neck and Back bone and the Wound also and look carefully to the business Govern the party in his diet as you were told at the Head-wounds Keep him from cold and air and let him be quiet and not stir much and be temperate in eating and drinking You may apply also to his Wound a Sandel plaister which I call the red Sandel plaister with these things you proceed in the cure till you come to a perfect healing These wounds being very subject to simptoms and among Note the signs by reason of dangerous simptomes as Cramp joynt water the rest to the joynt-water which in the whole body is no where so dangerous as it is about the Neck and Throat especially when a Cramp fals into therefore you have cause to look the better to it and to prevent such accidents But how you must behave your self touching the joynt and sinew water and against the Cramp also with the brown Ointment you shall find direction for it in the third part of this Book or else in some other place Touching Throat-wounds these you must trouble as little Throat-wounds with Tents and with the Seeker as the other in the Neck Proceed thus If you have a Throat-wound in cure True proceeding where the bloud issueth forth mainly so that there is fear that a bloud vein hath been hurt or that the swallow and Throat be cut then note if the Wound or Stab be deep or shallow neer the Ear then you may stitch it but not slightly as commonly is done but must be drawn strongly together cross-way so that neither breath nor bloud can get out then apply to the Wound an Opodeldoch with a defensive plaister upon which is described also in its due place this do so long till the anger be past Having drawn the Wound together with that stitching then is it requisite that you have a good Medicine which penetrate with its vertue and that is the Magnetick plaister which is described in Books of Decoctions truly that will draw all matter you need not to use any other thing to the Wound but onely apply this plaister great and thick Let it not trouble you which way the matter in these wounds goeth for Throat-wounds afford not much corruption and the Opodeldoch is of that quality that it leaveth not much uncleanness behind If the Wound be great and wide so that you fear it may not be stitch'd that way then let it alone for common stitches will not hold in this case and keep in the bloud from issuing forth therefore make use of a Bloud-stencher and proceed further as you did with other perillous Wounds and if you use any plaisters hereto then spread it thick that the air may press the less thorough for the swallow is a substance which can endure no air at all But if the throat be hurt at the side then do not stitch it especially if the Wind-pipe or swallow be in pieces for if a swelling should be incident the patient will be choaked or perish in his food And if the Wound be not great or deep then do not stitch it and draw much flesh into it would cause an ugly upcast scarr For at the Throat usually happen gross scarrs and therefore take heed of many stitches there and of too much flesh and if-you can endeavour to heal it up to a scurfe for if you suffer the flesh to grow freely and high then the scarr will be as big as a great nut therefore be not neglective in the preventing the simptom betimes else it may be too late to undertake the opposing of it you ought not to put into the Wound any Salve oyl or Tent for it may as little endure any Tent as the Back bone by reason of the variety of sinews which are in the Throat It being a thing more usual in Throat-wounds that swellings Gargarism are incident whereby soon great sorrows and troubles are caused therefore is it requisite that there be used besides the defensive Plaister a Gargarism not onely the sooner to further the healing of the Wound but to asswage also the pains And if there be not heat at hand then take Wine else do you take Water lb 3. put one hand of Mallow seed boil a third part away which being done then strain it through a clean cloth put thereto of Honey ℥ 2. boyl it again after you scummed it put it in a pewter dish put to it of Storax Calamintha ℥ ¼ and so let it stand for your use Some add a little Cinnamon which cannot be amiss Let the Patient use this water several times a day it will not onely further the healing but ease him of his pain and keep off rheumes This Gargarism may safely be used also in Head-wounds and is effectual alwayes Touching the joynt-water when that commeth then carry If the joint-water com●● with pain your self as you shall be instructed in the Chapter about the joint-water And if accompanied with great pains then take notice of the causes and signs thereof that you may know whether the Prunella or inflammation be either at hand or coming on and if it doth signifie the Wound sickness or any other thing then proceed as you shall be informed All such that are troubled with such deep Neck and If a heat comes Throat-wounds and endure great pains then use smarting plaisters it will ease them One thing more in case the Patient feeleth great heat either in the Head or in the Face and by reason of it feareth the Prunella the Wound-sickness or other such like then phlebotomize the Patient chiefly under the Tongue if it may conveniently be for such phlebotomy cooleth much both Head and Throat taking away all the heat quencheth thirst opposeth many simptoms and maketh the Wound forward unto healing therefore neglect not Phlebotomy in these Wounds if need not else These veins you may safely open in Head-wounds where any heat is felt surely it will not be fruitless CHAP. XI Of Wounds at the Breast how a Surgeon ought to behave himself there TO speak of Breast-wounds I mean not small slight Wounds which require no singular great cure being Of Breast-wounds without danger By Breast-wounds I understand the first part of the Ribs If a party be wounded there and the Wound is not gone through the body then no great danger to be feared and upon that you ought to deal as usually is done to common Wounds For those Wounds which deeply run into the body are very dangerous It fals out in such wounds that the stab doth not go deep into the wound and yet one of the inner members is wounded Sometimes a party is run quite thorough and yet no internal part wounded Let the

I applied to the Wound an Opodeldoch and a Bean-plaister in this manner I dressed him but once a day to give no cause to the urine to pass onely at the Wound I used no tent neither did I sound the Wound with the instrument for fear I should touch any bloud vein and so cause a fresh bleeding I ministred to him w●rm Beer in which was steeped Clophium wood Purslane I let him drink no other and kept him in his diet as a Patient ought By these means I reduced the urine to its right place in three dayes and the Patient recovered in a short time How could any one tell what had been hurt here inwardly but onely by the urines coming to that way whither the fleshy part of the bladders neck was hurt or no troubled not me nor stayed me in the healing of him for my chiefest care was to reduce the urine to its natural course and not to run through the Wound and to cause a great deal of pains CHAP. XIV Of the Wounds of the four outer Joynts and of Joynts contused all comprehended in one Chapter where you may find several good manuals and examples quoted THe Wounds of the four outer Joynts I comprehend in one Chapter because their cure is all one onely in the handling of them there fals in some difference Here I speak not of slight Wounds as hath been often said but such which deserve the name which are subject unto simptoms For slight Wounds be they in the Head Neck Belly or any where which ought not to be too much slighted neither because from a little hurt great matter may come of it may easily be cured with pure Cloath or lint Wine Water Salt c. for the natural balsam in Man doth much and applied Medicines perform not the cure alone Wounds subject unto simptoms where the natural Balsam is disturbed must have other meanes ordained because every simptom requireth a particular expulsive Medicine I could divide these Wounds into several sorts as into Wounds of the legs flesh sinews and veins it happeneth sometimes that all these four parts are hurt at once and yet onely one of them wounded this is the reason why I put them together into one Note that you ought not to stitch any such Wound unless Joynt-wounds not to be stitched unless it have a flap there hang down a great flap of it and chiefly have a care you stitch none of them that went into the great Muscle or joynt as in the Shoulder Elbow Hands Knees Knockles or Ankles for if you stitch them with needle and threed as the fashion is you will cause onely great pains which would prove a fore-runner of many simptoms Rather stitch them To stitch with plaisters and bands with a twisted stitch or twisted Silk for these must be stitched strongly more strongly than other Wounds or else they break out again For if you should stitch a Wound on the Shoulder like one on the Belly that stitch would not hold a day and a night Therefore I advise you to use a very strong one especially one upon the Wound as strong as you can yet stitch not too deep for fear you hurt the sinews or veins for too much is nought be moderate prospective and cautious in stitching and not too hasty Then apply the stitching plaister on the stitches it will help to keep together pull them even and well together with the plaister and roulers holding them together as long as you can for it is good for the members and sinews and very good to further the healing Though the Wound for all that doth keep asunder let it not trouble you but go on and press the Wound together as it ought at the several dressings If you have in hand a flap-wound then do not cut off Flap-wounds the flap as many do for Nature may strangely recover that and close it in a short time therefore proceed thus Stitch on the flap but not over-stitch it for fear you kill all the life in it and after the stitching apply a Stitch-plaister to it trouble it not with any feeling in and sounding and trying whether the stitch hold and let the stitches not eat thorough these else will cause scarrs neither must you put any tent be it flat or round betwixt the flap and the body nor suffer any water to come betwixt but press the flesh side of the flap close to the body Bind the Wound not too hard but close and gently as the flap requireth and cause as little pains to the Patient as you can choak not the flap else inflammation is caused and make it thus that the stitches do not hold all but the band also must help as you heard If you take off the Plaister then pull it off not against To take off the plaister the flap which would cause great pains but take it off with the flap or by that side where it hung on a little and by no meanes against the flap and apply not any strong clinging plaister else at the taking it off you stir the flap and disturbe the cure the flap must be bound gently one manner of way and not to day so and to morrow another way else the flap is hindered in its closing with the other flesh If you have made two or three stitches let the Silk not hang down into the Wound else it causeth matter and slime in it and hinders the flap in closing Have a care also you do it not too hard nor pull against the flap and apply alwayes a bolster to the middle of the flap that it grow not hollow underneath that you may do it the better make vent with a tent thrusting it under the flap that the matter do not run upward but downward and the tent must not be so long as to reach from one end to the other else the flap will be raised and stirred Do not search a Wound in a joynt with tents or the iron Instrument for reasons above quoted do not put the Tent-ointment to a flat tent to apply it to the Wound and then to lay a plaister upon no but let the Ointment run into the Wound to the bottom and it must run every where in the Wound and fill up the Wound with it and the Brawn-ointment must sometimes be let run into it it preventeth the running of the joynt water cleanseth the Wound furthereth the healing and suffereth no simptoms to be incident if the flap be so great and broad that of its own accord it separateth Flap separateth then make vent for it with a little tent which must be very thin that it stop not the matter neither must it be too long as to reach to both ends which would increase the Wound and loosen the flap Let the Wound have vent that the Ointment may the better run to all the places of it let the vent be in two or three places it will close at the vent holes as

Knees to make use of a lenitife by reason of the swelling and the water which is in it which ought not to be used Use no mollifying things made of Althaea Mallows Honey Meal Lin seed Butter Grease and such like c. for I do not advise that any softning things should be applied to Knees but to let Nature have her course and if Nature be too weak to expel then aid her with a Lancet make a hole which is to be made wider with a Corrosive or burnt Allom which is enough I used no more Here I speak of hard and not of soft Knees for when they are soft then they soon ripen unto matter or water CHAP. XIX Of the little Vcler that groweth on the Knee IT fals out sometimes that one gets an Ulcer or Sore before on the Knee-pan and paineth much and appeareth with a swelling and heat and sometimes there is also a cold in it it gripeth the party extreamly it shooteth and rageth like a Plague bile and it groweth red and hot at first it looketh ghastly but the danger is not great let it have time unto maturity it will get a little Blister with a black head like unto a small Pox. At its breaking there comes forth a little water there standeth a green husk which cannot be prest out before it cometh to a ripeness and being grown ripe then it openeth like a sore and is healed again without any tent or mollifying is curable like any other sore and is called the good Pox it is full of pains and easily cured CHAP. XX. Of an Inflammation or St. Anthonies Fire on the Knee Erisipelas Those Knees that raise and swell and have many red pimpels here and there they raise but swell not and is called the Rose These ought not at all to be annointed much less must any greasiness or moisture come to it onely dry warm clothes must be applied unto which dry up all their damps Some do foment those and I used such means also and me thinks it doth very well This Rose or Anthonies Fire must be so dealt withal and that swelling or raising goeth away without any peril if onely kept warm with dry clothes These Knees must be tied pretty stiffely that the Knee-pan do not raise too much It is good to bind a Knee hard as much as the Patient is able to bear be it in any infirmity whatsoever except when there are gray blains or blisters at hand these ought not to be bound that the sooner and better they may come to their ripeness for they grow and swell till they be ripe In case you were to use any tents to the Knees by reason of the hollowness and bigness of the hurt or sore that in the inside it be too wide and too great then the Tents must not be of that bigness as to fill out the hole else the matter will be deeper undermining before you dress it again by reason of the abundance of it but at that hole where the tent is put in the matter and water must run out CHAP. XXI Of some humours of the Body which sink down into the Knees and Legs what these are and how they must be cured THe hurts and simptoms of the Knees are several among the rest there is a malignant humor running down from the Body making a passage through the Thigh to the hollow Knee by the sinews which humour stinketh and is like to matter and white like Whey there it stayeth and admits of no cure it is one of the worst humours and I never heard that any was cured of it either by fomenting woods lancing cooking or by other manuals nor by potions or corrosives but it kept its course which it hath from the Body downward and the passage it made is hardly found out Therefore I advise you not to attempt much upon it but onely keep these Knees clean that they may stink the less There are other sharp humours also of the nature of a salt rheum which fall down from the Body upon veins and sinews and these also have their revelets and passages These corrode and gnaw the bones into a black colour and cause more pains than the former and are very hardly cured yet through good counsel and good diet they may and must be held to the Wood cure and if they are cured it is done with inconvenience by cutting or taking out of bones if these rheums are taken off and their condition changed through a good diet then these sharp rheumes are consumed and gone and may the easier and better be healed than the other above named There are other rheums also in the Body which fall on the bones above like great Imposthumes and swellings where they putrifie and sink till they come to the Knee which proveth nought some of these rheums have their supply from the Body but these are neither stinking nor corroding as the other two sorts named above are and these run most round about the bones before they come to any maturity and fill the Legs with matter and are easily cured if come to a full ripeness and when they have mollified the flesh and skin then must they be opened and a cleanser put in and let the rheum run out let it not rest one quarter of an hour in its running and let the party have a constant dressing applying Tents and Plaisters let the hollowness be not much covered with flesh that the Muscles and the skin together with the panicles may close the better for these do willingly close for that reason they must not be filled up with flesh and must be tied stiffely then the hollowness healeth together therefore sit your Wicks so that the moisture may run out by it and gather not at the one place or sinew to the other for I held it not good when I pulled out a Tent that the matter followed close if the matter is run out before the Tent is pulled out then is it more wholesome when no matter followeth after the Tent. The Patient must not alwayes lie still but must turn himself this and that way that the matter settle not any where The Tent that is to be put in must be covered with Aegyptiacum or with a Wound-ointment as you see cause for it You may siringe him a little and that gently Use no Glisters they cause windiness which bringeth danger But siringing is good and the Balsam and Ointment cometh the better into and the simptom being inwardly well cleansed and the swelling allayed then dress the opened hole with the Ointment and Plaister then you will know whether any matter is settled it raises then like dough you need not to put the Patient to any pain nor to make any hole for it will run out freely when you dress him with the rouler and apply the red Plaister over that dough or softened place and if it thrusts against as the matter usually doth and you are sure of the matter then you may lance

Surgeons use Camphire to cool the Wounds mingling Camphire of no use here it with other things but they do not well because Camphire is not of a cold quality but of a penetrating heat And that Camphire bringeth out heat and expels it is not because it is of a cooling property but it comes from other cooling simples mingled with it In this case Camphire is not to be used for many reasons which to relate I forbear at this time and chiefly in Wounds made by shot it is to be avoided by reason of the affinity it hath with Saltpeters fire known to Artists that deal therein There are some Surgeons which use Gum Opium to their cooling Ointments but as far as I know it is to little purpose Gummi Opium is nought here Such Gum is not good to any Wound for outwardly it cooleth no Wound within the Wound it burneth unto which Experience beareth witness Therefore it cannot quench any burning caused by Gun-powder that thing quencheth such a burning which attracteth fire as Saltpeter and Sulphur doth Saltpeter and Sulphur keep their native quality still which is to attract that fire which they have lost and quench that they set into fire No more of this and let every one defend what they use I do not intend to gain-say that which others have found good in their trials for experimental knowledge is endless and every day new things are brought to light and they may be such which I do not know of CHAP. XXIV Of Bone-fractures and first of the naughty custom which is kept in dressing them To cure Bone-fractures is common and known almost to all it is of great consequence that it be rightly understood for many know much but have small experience and some want fundamental knowledge who doubtless make many naughty cures as Experience witnesseth and whereas I have spoken in the first Part of many abuses committed in general so I thought good to speak in particular of abuses that are committed at the dressing of Fractures and to give a warning to Novices in Surgery Touching the naughty use at the dressing of Wounds Abuses at the dressing of Bone-fractures whereby Patients are neglected which though it be common yet it shall not stop me in the disclosing of it for reasons quoted above Know therefore courteous Reader that under this common use there lieth hid a great abuse If a Fracture be set and placed right after the setting they dress and bind it with splinters made purposely for that use these are laid round about the Fracture and with fitting fillets and bands on which there are small eylid holes through which the tapes are put and so pulled together and closed up that it stir not Before they do so they usually make a pap called the drying band of Tile stones Bole Walwort and other such like as every one thinketh good or hath seen others do it this they apply about the Fracture hoping with this Drier to reduce the Fracture to a speedier healing This is their common way and hold it for a Master-piece As touching their Medicaments I do not intend to disanul them and to make them of no effect I should not dislike them so much if they had dealt well with the Bone-Fracture The quoted manner of dressing I do not like at all First by reason of the great pain caused thereby to the Patient because every Bone-fracture being set right striveth a little to a swelling but the Fracture being thus inclosed and bound up as you heard how can it come to a swelling which Nature would have Therefore she presseth and striveth the more is made angry and swelleth the more and still at the bands where it finds any vent there it forceth out the swelling which cannot be done without smarting pains to the party Yea by this anger and forced swelling a whole Joynt and Member is suffocated which can be proved by woful examples But this is little regarded of those who are ignorant of Nature and the true cause and though it doth not happen alwayes that a Fracture is choaked with such dressing because it getteth vent sometimes yet that pain is so great that all those parts about the Fracture be they sinews veins Muscles c. are so much angered that the Patient is bereaved of his natural rest for in his sleep he feels such pulling in the bone which awakeneth him with an amazement these smartings and amazements may easily cause other simptoms viz. Feavers Inflammations c. all which is caused by his untoward and rude dressing All this is not enough yet which ensueth upon such rude dressing there are other difficulties and inconveniences For they dressing a Fracture in the quoted manner they can neither see nor know well whether the broken ends are well set or no for they think if the splinters and boards lie well then the bones also stand well together They little think that the parts of the broken bones either at the left or right side are terrified and so the bone stands awry and crooked This maketh them leave the Fracture undressed for some dayes thinking as long as the splinters lie right the bones also are in a right posture which must not be taken ill at their hands because they not knowing how to dress a Fracture well it is no wonder why they are so loath to undress it but this is little ease to the Patient which many times gets crooked legs and joynts the one standing outward the other inward which such Surgeons little regard be it straight or crooked as long as they have made a cure This before named manner of dressing is old and hath been practised many years and so men must beleive that it is good because it is antient I will say nothing of that which is still in use viz. of the Screw-box which hath been a long time in practise not regarding the great danger and hurt which they cause thereby as daily experience witnesseth but poor Patients have small cause to rejoyce at this This box usually openeth with wings which some use for Fractures I partly commend it but never made use of it because my Band is easie and the band with the Leg may easily be lifted and thereby the whole Member I may easily lift which way I please and never feared to stir the Fracture because no splinter nor band is made loose And when I intended to open it then I placed the Leg even and plain as I thought it was fittest and then I laid it down and undid the splinters which I was to take off by reason of the Wound which was to be cleansed I will not speak here of those which think themselves wise and subtiler and make use of Wheel-chips or such boards that are used for sheaths such things indeed are of no great consequence neither doth it matter much whether the one use Walwort the other broken stones and a third use another thing and every ones cookery differs

long till the hurt breaketh out and counting it ignorantly to be a Belly-flux or humour in the upshut they call it a Sprain Of these I quote some examples that you may know what I do call a crackt Fracture and what the condition of it is 1. A Maid coming home ward loaden with bought Wares fell on a stone in the street after she rose she went on her way though with pain and coming home she annointed the place to disperse the bloud and this annointing she continued for half a year at last it broke out with great pain and stink it was held to be a humour of the body which they dawbed with Plaisters for a whole year but it would not come to any healing This Maid was brought to me perceiving the cause of it I desired her to let me open it there I found a Fracture with a cut and the bone began to be scaled and black I took it out cleansed the sore and cured it as a cracked bone and she was healed 2. A Maid gathering Apples under a tree taking up a load of them on her head going along she stept into a hole broke her shin in pieces she sate down staying for her Father to lead or carry her home her Father coming chid her bidding her to rise telling her that some vein or other she did sprain she went on that Fracture some hundred paces and made it thereby worse and worse at last she could not tread upon it I was sent for I told that her bone was broke I was laughed at they saying it were not possible a body should tread on it if the bone were broken much less to go so farre as she did after her fall Their beleif was brought to experience upon their own peril For the bones went asunder and the Fracture began to grow too big for her to endure and for me to heal 3. A Man servant carrying a bundle of grass perceived he cracked his Leg yet he went on and in pains he carried home the grass with much ado This fellows Fracture was of so great difficulty to be set and healed as ever I had any for when I lanced it it was found to be enough for one Fracture 4. A young man taking down from a Horse a sack of salt broke his bone for all that he went about for some dayes but at last the bones broken appeared in good earnest many Surgeons had him in cure before I came to him and it proved a real Fracture which at first it would not be taken to be one 5. A Barber riding along came among Horses which fought among themselves by their kicking his Leg was broken he felt it well enough that it was so but he knew not whether it was broken in two lighting from his Horse he went into his house and in his going it was not seen by the boot whether he was hurt or no the boot being pulled off he tried whether he could go but could not for the two bones of the Leg were beaten in pieces I had to do enough to cure them and were healed without limping 6. A Girl carrying a basket full of chips and stepping over a block heard her bone give a snap she flings in the chips at the door sits down on the next block but her Parents being hard to her made her go for all that this Fracture was lanced afterward and was long under the cure 7. A Servant had a Fracture which I judged to be a lame one I was laughed at because I called it a Fracture but it was past laughing when I took out the bone from the gartering place to the Ankle For those Surgeons which saw him thought it a thing impossible that he should be able to go when his bone was in pieces and many agreed with these Surgeons it was so But the Patient said my bone is broken I presently opened the place opened the flesh to the bone which was black because the marrow prest thorough the Fracture but he was healed could leap and jump without halting at all Many more examples I could quote but forbear it and rather tell the cause why any one can go for all his bone be broken viz. if a bone be broken so that the Fracture hath branches and splinters these hold the bones still together because it stands together yet and beareth up the Patient as when ones bone be not well healed he goeth but in pains and with much ado more than one whose bone is but broken lately A Servant broke the bone next to the hand complained much his Mistress applied to it Vinegar and Bran I coming to dress the old Womans Sore on her Leg I looked on the Lad knew what he ailed but would say nothing for fear they should give me the lie the Lad complained more and more at last I was bid to see what he ailed I told that the Medicine applied could do no good for the Lads Arm is broken and it was so as I said and the Lad had no rest and it was worse with him every day then my words were found true The Lads Hand being grown crooked then they gave leave that he should be drest I set his bone right drest him he felt ease and his Hands swelling was allayed How cracked Fractures may be learned or discerned in old and young Folks If you have a Patient whose Arm or Leg is red accompanied with a swelling and the redness doth not alwayes appear at first but after when it beginneth to swell and will break out if such a thing appeareth then ask the Patient how long that sign was there if he can tell then you may the better discern the hurt but if he cannot tell either by reason of his young age not able to speak being a Child then feel it hard and try whether you feel any unevenness or any thing broken ask again where he doth feel any pain if he be able to answer you But if a Child take notice where it shrinketh at if toucht whether there be a hollowness or a bump or any other crookedness and at the feeling of the place take notice whether it doth stir if you find it to do so and giveth a snap or you can feel the hollowness or it yeilds to bowing then is it surely a Fracture and if it should not yeild to bowing and yet the other signs are at hand which you felt with your Signs of a crack-fracture hands then is it surely a crack which holdeth stiffely yet and the party can stand upon it and go and can work and no body could think that he ailed any thing In case you are not yet sure by feeling bowing c. then take notice of ●●e Patients words whether he heard any thing crack or snap and what work he had done whether it came by a jump lift fall thrust blow or slipping into a pit or by striding over ditches or climbing up the Ladder or hurting himself against the bedsted For I

and the joint water runs strongly Joint water join'd with a swelling and the more the more it swelleth it is a sign that the Surgeons medicines are not proper for it therefore let him use better in case he intends not to spoil the joint quite and by too much running it cost the patients life let him learn to make better Salves than he hath in his Dispensatory If a party be wounded on a joint and complaineth of pains on the extream part of that joint as being wounded Pains in a wound in the arm and his pains are worse in the finger than in the wound it self then is it a sign that the member will dye and that the cold fire is coming into then is it high time to Cold fire prevent that evill and do not neglect the patient A wound made into the body and prickings are in the side signifieth death if so be the wound is in that place A wound made into the hollow of the body and is at a stand in healing signifieth death but if a wound be at such A wound at a stand a stand on an outward member and the wound waters a little it signifieth Cancer Prunella Inflamation Wound-disease or death if they be not prevented it may be that some imparity was in the wound Ointments and Balsoms which set the healing backward for such slovens are found which care not whether their medicines be made clean or no and that fault is committed in medicaments that are both for inward and outward use If a cough is incident which Cough a sign of congealed bloud is not cansed by the lungs it is a sign of congealed bloud in the body if he brings up any bloud with his cough then is it the surer sign of it but if that bloud brought up by coughing is red and fresh then is it a sign that a bloud vein is wounded which is still a bleeding If a wounded party begins to stammer in his tongue looks gastly turns his eyes is deaf it signifieth madness and death if he be snoaring at the noistrils knoweth no body hath a Stammering great droughth yet drinketh little his sleep is gone and still will be gone all these are ill signes and easily judged If a hard knot or callus groweth on a wound which is painful and increaseth yet the wound healeth it is a signe Collossities that the veins and sinewes which are there about are dying and rotting death ensueth upon of such heavy examples I know too many which have thus been neglected and such collossities grown there must be looked to These few signes I hold forth to you thereby to learn to discern other Symptoms it is not possible to rehearse all the defect hereof may be supplyed in those that follow for to discern such Symptoms CHAP. II. Of the Sleep of a wounded party what a Surgeon ought to judge of it REader marvel not that I keep no method in describing of Symptoms I took these Simptoms in hand to write of as they fell out in my practick Touching Sleep sound peoples sleep is not alike some snoar in their sleep others without a noise in these it matters not much but it is another matter with those that are wounded because Surgeons ought to take notice of such signes in their patients sleep If a patient puls in his sleep his wounded To judge the signs by the sleep member and is thereby awakned it is a sign that the Cramp or Wound disease is coming but if he is frightned in his sleep and awakneth of it if his vvound be in the head a Cramp or Palsie ensueth upon If a wounded party awakneth knoweth not where he is and talks idely it is a sign that he is in a great heat which soon will cause a disease in the wound A head wound which suffereth not the party to sleep accompanied with a heat it signifieth a mortal Symptome in such a case phlebotomy is very needfull if he cannot sleep after that then death ensueth A patient that sleepeth much and is idle withal in his sleep is hot in his body yet sweats not it is a sign that the wound disease is predominant for such there is no remedy and dyeth but if he sweateh all the body over then there is better hopes of him but if he sweateh onely on his brest it is a deadly sign If a patient le ts go his stool in his sleep it signifieth death A patient who at first is in a good posture unto healing but grows worse afterward and looseth his sleep it is a sign of a mortal Symptome If a patients sleep be thick and short but sweet it is a good sign and if he be in a good temper not too hot and his pulse beats orderly it is a good sig●●● but where no such signes are there is it dangerous Touching medicines to cause sleep withall when they are good and when not you will find them in the Receipt described of Anodin or Laudanum CHAP. III. Of pains in Wounds what doth cause them how judged and how remedied PAins in wounds are natural and in there cure they will Paines in wounds are usual be caused one way or other and pains will be felt as long as nature separateth the bad from the good and is done when the wound matters thereby cleansing it self pains caused in that way are of no consequent in case the patient be not otherwise disturbed and is kept in a good dyet but it is another case when the wound brings not out the matter in due time and the patient in his dyet or by the Surgeons carelesness is neglected out of such pains a Surgeon which is expert will look to the circumstances must be considered and for that reason I thought good to write one Chapter of it to know from what the pain is caused how it is to be judged and to fit the remedy against it Here I will not speak of ordinary and natural pains but of extraordinary ones which are caused either by the patient The patient causeth paines or by the Surgeon or by both A patient causeth pains to himself with disorderly eating and drinking pretending they must have a recruit for their bloud some spoil themselves by eating of Cabbages slimie Fish Pork c. by sour or strong Wine stinking and sour Beer c. some by being too much in the Sun shine or being too much in the Ayre or stirring too much in Leachery c. whereby pains are caused in wounds if not quite spoyled A Surgeon cannot exactly judge of the causes thereof nor to allay them unless the patient be better governed in such wayes The Surgeon ough●●● warn the patient of the danger which such disorders do breed if he will take no warning then let him take what falls Surgeons also may cause such unnatural pains as first with stitching with tents by forcing them into Wounds c. Surgeons in fault of which

stirred then the flesh in that joint is so prest together with painfulness whereby a lameness is caused and the party can make no use of that joint by reason of the great pains which the overmuch growth of the flesh doth cause And this commonly befals the joints in hands by reason of the plurality of the bones that are there This rude Surgeons bring to pass which hasten their cures away with annointing salving somenting c. ordinarily men may know that such things cannot be performed in such wayes if so be that the flesh shut up there is thus imprisoned therefore observe another process Viz. In case a party be lamed in the said manner by Surgeons silliness and you intend to help that party to right do thus launce the healed wound with a rasor pretty deep provided you hurt neither bone nor sinew and enlarge the wound dayly with gentle corosives but in the middle of the wound even on the hollowness of the joint where the party complaineth most and where you think the fault is to leave some flesh which you may soon discern that the corosive powder did not touch that part of flesh when the wound is open and the party bloweth the joint That flesh in the middle you must loosen round to the bone lye a four doubled threed about it draw it close together and then gently pul if it be not quite loose then make it loose with a launcet then give a stronger pull and see you get it out that flesh will ●●●full of ravelings and streaks Thereupon presently put into it the brown Ointment and so dresse the wound twice a day with the Opodeldoch so long till your cure be at an end Make use onely of the Plaister and forbear to use any greasie things as oyles poultesses c. in case you have not the brown Ointment then you may use other things Many may marvail at this strange process and cure let them observe that which hath been said viz. on that flesh which is to be pulled out hang many ravelings and roots are like the little roots which are scattered in the joint which in the bowing are stifned and made inflexible these cannot be cut out because they lye hid strangely in the depths and hollowneses of the joints these cannot be gotten out with any corosives they will sooner corrode away the sound flesh and bones before they could touch the scattered and deeply hid roots and streaks neither is there any difficulty in this way because these flesh roots hold not very fast slide easily off from their places and that very neatly and purely I do impart unto you also a fundamental instruction of curing of joints lamed with a blow or fall be it on the knees elbowes and hands where the joints stand still and are well set yet the patient cannot bow nor stretch them or turn them as he would such may in some sort be helped for I brought many such elbowes to right I took an easier way in hand I greased that joint with warmed Dialthaea and at night I laid good store upon it and drest the joint with binding below and above it in the mornings I annointed it stroaking it gently sometimes I continued it a whole hour and every day I measured the joint on his body to see how far he could bring it and two daies after I tryed further and tyed the joint into a splinter because it should not shrink and grow shorter and so after the pulling I proceeded For if a joint be stretched suddainly usually an exiccation befals that joint but if done gently and by degrees then is it advantageous to the joint if a joint be out-stretched forcibly yet it will not keep so it runs backward and if you leave off the splinter then the jo●●● swelleth or dryeth up Therefore I still set and bowed it gently and brought it at last to its due proportion though the out-stretching falls not out so just as it doth in the bowing Wounded joints which lame many several wayes are to be understood and taken the same way as the above named joints and used gently in the out-stretching and bowing as much as the joint may endure and to lenifie them with Oitnments Fomentations according as occasion will serve And to illustrate this cure with some examples I had one of Nurnberg that was cut in his hand and was cured lame which I cut and lanced again pul'd on the great sinew and drew it upwards and cured him so that his hand hung no more down as it did after the first cure Another receiving a wound in his knee was cured lame upon occasion he suddainly starting up to defend himself he was hurt again on that knee but was cured then without a lameness Another was cut lame at Nurnberg on his elbow he was cured without a lameness I alwaies observed whether it was possible or no to heal a wounded joint and regulating my self accordingly and still having a care to heal the thumb upward out of the hand and hold it better to heal a finger straight than crooked and too straight is dangerous and an upset hand is sooner bowed than a hand which hangeth down to be set upright and a knee and elbow is sooner bowed than stretched out to make it stand right as it should CHAP. XIII Of Wounds spoyled through external accidents as through the heat of the Sun and the raw ayre and are dryed up and how these ought to be remedied HOw can a Wound be spoyled by outward causes and in what condition such wounds are you shall hear some parties are wounded in a place and cannot get from that place where they were wounded must lye under the cope of heaven in the heat of the Sun whereby all his body is set in a flame and the wound also is made angry is grown brown red dryed up and the party commonly hath exceeding great thirst and if such a party were to continue to lye in the heat of the Sun death would befal him especially if the wound be in the scull But if such a party can be brought to a good Surgeon in any time then ready well prepared medicines will be aiding to Nature with Gods blessing upon the means Such a wounded party happily tarryeth long in the field Wounds soon are burnt or spoiled with cold is farre from home before he can be drest the wind gets into the Wound exiccateth the same and if that Wound taketh cold if in a winter season then that wound is spoyled by frost and many other inconveniences are incident thereunto Touching Wounds that are exiccated or have taken cold of these I will plainly deliver my mind and the rather because such things fall out frequently and chiefly Surgeons to an Armie in the field have need to be ready for such accidents for here they meet with all manner of inconveniences when parties are either skirmishing then they have no long time to bethink themselves what to do

then is it a sure sign that the Synonia or moisture from the sinews doth separate and beginneth to be in a furie In this case tarry not but instantly lance that part and How to proceed in this case give vent where you think it to be best till to the hollowness within and to squeeze out that water or matter it had been well if it had been lanced sooner experience must teach you how to deal herein for it is impossible to set all down in writing the work will put the manuals upon you Then thrust a propertent into the Wound well covered with the brown ointment and prepared Verdigriece then apply about the wound a defensive plaister But forbear to apply any hot Cataplasmes as usually they do because the strong heat of them causeth putrifactions and suffocations to the sinews But in case the matter diminisheth not still increaseth and the swelling retreateth further then is it a sure sign that the sinews and veins are all inflamed In this case above the swelling there must be made another incision and mix the brown Ointment with the Balsam of sweet Arsenick make tents of it as you heard above about the brown Ointment thrust these tents into the uppermost hole once a day then the anger of it will be allayed and the dying of the sinews shall creep no further then other convenient means may be used of good wound Ointments c. and so go on with the cure so long till the ill be separated Remember to continue the brown Ointment to the end of the cure for fear of a relapse The mischiefs which those do cause that undertake the curing of such things which they do not understand ought Abuses what hurts they cause not to be past over in silence being a thing of great concernment Those that understand not these hurts use this process they presently apply to such hurts warm Cataplasms though their swelling still goeth back yet they still continue their poultesses but to what purpose they give cause to putrifaction suffocating the sinews others make their experiments upon with annointing fomenting bathing c. but to little purpose because they know not what lyeth hid under it When all these will not help they made use of and the Abuse committed ignorantly pain encreaseth still and the swelling also incroacheth more and more upon the body and all turneth to nought then they conceive where the fault lyeth and lance that place and let run out what will But their judgment faileth them not knowing from whence that matter cometh and so they cannot hit the nail on the head but give leave to the matter as much as it will run forth not considering the tuffness and clamminess of the matt●● and sometimes ravelings of the sinews come out also which they not regarding goe on with their old raggs though that be an apparent sign that the sinews veins lig aments within do rot that is an Inflamation hath taken hold on the sinews If this misery be not remidied then the sinews will be burnt away to the body whereby great heat and feaver is caused And that joint also being bereaved of its food it had from the sinews then the cold fire will get into which bringeth death upon the party For though that member be dismembred yet all the other sinews are taken with the flame and draw on into the body which puts the party to death miserably For this fire is of another nature than the cold fire is occasioned by other causes Other Inflamations can be discerned in time and prevented from running further and by dismembring can be remedied but the foresaid inflamations do not appear so plainly to the eye and are not taken notice of but when they have all inflamed and cannot be remedied These I make mention of to inform how by carelesness great mischiefs are caused no other as when by a small fire a whole Town or House is set on fire and burnt down if not quenched CHAP. XV. Of swellings of Wounds after they were healed and what it meaneth and bow they must be handled THe causes of the several swellings in and about Wounds ought to be known to Surgeons Formerly I have spoken of some kinds of such swellings at this time I will give a hint of two kinds of them not as yet mentioned In the first place it is to be noted that all kind of swellings do not come into the number of dangerous Symptomes those are of the dangerous ones when sinews bones joints c. are grievously wounded 〈◊〉 ●re not onely the wound but all other parts thereabout are ●welled of that sort having a natural cause of its swellings I intend not to speak of because if the wound doth frame well to healing the rest in time will pass away The other sort of swelling coming after healing I intend to give a hint of Viz. An utter joints muscle being wounded and well healed was by the Surgeon kept too hot and with Cataplasmes suffocated after which such a wound begins to swell at the beginning being without pains when toucht nor altering the colour Such a swelling passeth away in tow or three weeks time but leaveth behind a pain which continueth with an increase and the swelling being quite gone it is found that on that joint a great deal is tender and that hapneth as it were in a sleep not payning the party For to prevent this swelling and to hinder that consuming A plaister to prenent the tenderness or up-drying and updrying of the joint much salving dawbing annointing c. they have used but I never saw any which hath done more good then the ensuing Receipt ℞ meal of Fig beanes ℥ 1 meal of common Beans ℥ 3 well beaten Orras ℥ 1 pulverised Marigold flowers ℥ ¼ gum Amoniack ℥ ¼ boil these to a spissitude with vinegar ad to it of distilled Annise seed oyle ℥ 3 of emplastrum Diaguilon ℥ 5 the emplastrum must first be melted and then with the said oyle be mingled and stirred with the Cataplasme spread a cloth with it answerable to the bigness of the swelling apply it warm in few dayes the svvelling will be assvvaged and no exiccation vvill ensue Because the vertue of the Plaister expels and outdravveth all humors before they shall come to any settlement in such places There are other means expelling vvinds and humors viz. Annise Fennel Carravvay seeds c. as also Diuratick means may de used Surgeons ought to order themselves herein as they see occasion There is yet another sort of svvelling viz Some receive a vvound vvhere no sinevv is vvounded yet that being healed the party cannot bow that joint in which some raising there is but is not a perfect swelling and the party feeleth no pains This is incident 〈◊〉 ●●ch that were wounded iether in the Hand or Foot where some humor or other is settled to that wounded joint and this befals those usually that are troubled with the stone

keep wounds oopen thereby make them of linnen cloth cover them with an Unguent mingled with burnt Allum c. then they will bite round about and make an open place My advise is that medicins should be conveyed to the bottom of the wound and not onely to dawb the Tents therewith and Tents used to spoiled wounds are such which of themselves melt within the wound These are thrust home to the bottom of it Melting tents and to the upper place of the wound there is laid another made of linnen to keep in the first Tent that it come not forth before it is melted of such Tents I have made mention afore hoping to speak more largely of it in another place when I shall publish my Cures about wound Fistula's and the like Sores Of Corrosives To use Cauteries to fresh wounds is needless and hurtful and spoils a fresh wound wholly and does no good Cauteries are not good to be used at all neither in Blood stenching or other occasions Corrosives have poisoned many wounds turning them to a Fistula Cancer Noli me tangeri Corrosives do wound bones and are the cause why such a wound cannot be healed and turns to a Fistula they inflame sinews and cause many other mischiefs Surgeons usually corrode with sublimed mercury which Sublimed Mercury is a great abuse and misunderstanding for Mercury doth not bite the salts do it which he received in the subliming these corrode the broad way causing smarting pains Mercury ought not to be used at all to fresh wounds Others use crude Arsenick and some do sublime it but it is as hurtful to fresh wounds as Mercury is some use the caput mort of Aquafort and otheres use the red calcined Vitriol all these are naught to wounds Nature desires quietness will not be disquieted by such evil medicines sweet and gentle things are to be used here and not to press Nature with sharp Corrosives I never used any stronger Corrosive to wounds but quenched Allum true I hold that Extinguisht Allum Arsenick is to be used to spoiled wounds but my way of preparing of it is that it deserves no more the name of a Corrosive or venome it separates the ill from good not Arsenicks operation causing any pain The Brown Unguent performs all what is to be done about wounds as you heard above in want Brown Unguent of this Unguent you may use Vnguentum Egyptiacum provided there be no Allum in it or a very little as some use it But this Egyptiack Unguent is not to be compared in any degree with the Brown Unguent How to prepare Arsenick that it may safely be used Arsenick ought not to be used crude being a meer venome Arsenick how prepared its operation is answerable to its preparation usually it is prepared thus Take of Christallin Arsenick â„¥ 2 of Saltpeter â„¥ 2 grind them well together put it in a melting pot make a circular fire about it let it melt and let the smoak and fume go away increase the fire that it be red hot let it stand thus two or three hours then cast into it of yellow Sulphur Ê’ 1 this being done cast it forth on a marble set it in the Cellar it dissolves in few dayes that liquor keep in a glass for use Thus I close this Fourth Part true I could have quoted many other things but I purposely avoided prolixity being Conclusion this Book is already grown bigger than I inrended it should Reader I hope these will be an occasion to you to regulate your self in other things intreating you to accept in good part this my labour which was to be servicible to others The bad things in it must be ascribed to Man for the good things in it God is to be thanked and praised FINIS Of the Fourth and Last Part of this Book of Surgerie The Childrens Book OF FELIX WVRTZ A famous and expert Surgeon This Book was never published till now Treating of infirmities and defects of new born Children and of the faults and abuses which wet or dry Nurses commit among and against little Children and of Medicins and Cures of such Children which receaved hurt in that way Written for young Surgeons wet and dry Nurses Maid Servants and other parties to whose trust and overlooking little Children are committed MY purpose is to communicate an usual little Treatise concerning the infirmities of new born Babes and sucking Children which are befallen them by the neglect of wet and dry Nurses or else brought them into the world from their mothers wombe In the first place I will speak something how Midwives wet and dry Nurses ought to be conditioned that they may the better deal with such little Children or Babes even as it becomes an understanding sober godly Woman Such Women to whose trust little Babes are committed Duties of such Women ought to be pious honest modest and civil in words works and manners she must be one that hath been a Mother of Children and is expert in those waies for experience is the Mistriss of things and there is more credit to be given to experienced Women than to such which know things by hearsay Therefore if a Midwife be a Woman of credit and fidelitie and hath endured in her own body anguish miseries and pains which others neither can nor will beleeve because they never endured any torments in their own bodyes neither may they hear nor have heard of the like those that had such things befallen them know what they are neither is there any need to tell unto such what miseries pains and torments mean and those that were never in such perrilous cases may hold their tongues and not speak of it jeeringly or contemptibly It falls out often that in such dangerous travails one three or two loose their lives besides the loss a good Husband hath in his Wife and poor Children in their Mother c. And in case such parties may escape with their lives in hard travails yet are they so pulled and torn that they are made unfit for any work which otherwise might have better been preserved if honestly and faithfully they had been dealt withal This I speak not as an invective against others let every one look to it what they are instrusted withal and make a conscience in their waies remembring also that they must be accountable unto God for it then they need not to be put in mind of it by my words I beseech every pious Matron not to take ill the things I speak of for what I intend here is for the good of little Children which cannot complain of their griefs but by crying For it is most certain that Children will not cry unless How Babes reveal their griefs they ail somewhat because it is more ease for them when quiet and they are not able to make their complaints any other way but by crying Hence we are to note that assoon as man is born into the