could that Fume excite such horrid Phoenomena's Answer Thus The Stalk being hollow within and perforated onely with a very small hole and also outwardly compressed on every side by the Boys hand the more volatile and less cohering Particles were forced from within outward but seeing all those could not at once pass out together the one urged the other and so were driven out far more swiftly No otherwise than as we see Water forced out of a Syringe though the Pistil be but gently or very slowly thrust forwards or as we discern by an easie compression of the sides of Bellows the Air through the Pipe or Nose thereof is driven out with very great force But some one may perhaps ask me of what nature those dusty Particles are To him I answer They are Accido-corrosive and sharply cutting That such Acid-Particles are in this Stalk is sufficiently evident by the frequent use thereof in stopping Bloud For when a small part of this Stalk is put into a sanguiferous Vessel wounded the Bloud is stayed partly by reason of the stringy Particles folded one within the other and closing the Orifice of the open Vessel and partly by reason of the Acid-Particles of that hollow Stalk which coagulate the Bloud as Milk is coagulated by an Acididity infused Therefore these Acid-Particles with great force driven through the aforesaid Stalk deeply penetrated into the Pores of the Eyes and interior-Superficies of the Eye-lids and so with their cutting sides excited the Nervous Fibres there dispersed to a motion more vehement by which Vehemency the Mind first perceived the sense of pain which was augmented by that Distention which took beginning thus The Pores being obstructed by the Particles of that Stalk the Vapours wanted their natural Exit and so were collected within the small Pipes of the Membranes in the form of Humour which in a very short time waxed sowre by reason of the Acid-particles of the said Stalk acting as a Ferment no otherwise than as we see any sowre Ferment taken in a small quantity to convert a great mass of Dough into its own Nature These Acid-Particles I say with the acuteness of their sides forcibly striking upon the Nervous-Fibres drew to those parts a more copious influx of Animal Spirits than usual whence arose certain slight Contractions which notwithstanding proved sufficient in some measure to impede the Circulation of the Bloud and Humours circulating through the small Veins of those circulating parts For they were in this case helped by the Vapours within the Veins of those parts converted into Water When the Bloud conteined in the Capillary Vessels and the Humours in the Veins were thus stagnized they likewise in the aforesaid manner waxed sowre and were coagulated and by that means rendred more unapt for Circulation Hence it is sufficiently manifest whence the Redness and Tumour of the Eyes and Eye-lids had their Original But whence proceeded that continual efflux of sharp Tears From the aforesaid the true cause thereof is easily gathered and it is thus Certain Acid-Particles forced from within that hollow Stalk had entred the Pores of the Glandules and Lachrymal Vessels and there by their irritation exciting certain Convulsions did continually force out Tears But whence were they imbibed with a more than usual sharpness There is no mortal Man who by the taste onely finds not Tears to be Saline wherefore these in their passage with the acid Particles there inherent were invaded with a certain sudden Effervescency These things being by me for some small time considered of I soon ceased to admire that that Fume should be the cause of so great Evils thence ensuing and also at that time discerned that the Cure would not be difficult For I knew that hot Milk coagulated by an Acidity if digested with some fit Salt would again be dissolved in the space of one hour Like wise I knew Vinegar was easily deprived of its sharpness by infusing Crabs-Eyes or Lithargyry therein Also I understood the reason of that Effervency which is excited by commixion of the Saline Oyl of Tartar with the Acid Oyl of Vitriol Hence I concluded that the Bloud coagulated by Acidity might again be made fluid and the sowreness temperated by Crabs-Eyes Lithargyry and many other Medicines containing much Salt such are White-Vitriol Gum Ammoniac Sagapenum Galbarum c. Therefore I being called the third day after the Boy was hurt instilled hot into his Eyes some Drops of a certain Collyrium compounded of White-Vitriol and other things mixt with convenient Waters and upon the Eye I applied a Plaister of Gum Ammoniac Galbanum Sagapenum Lithargyry c. spread upon a Linnen-cloth This I changed daily twice and commanded the Boy should be kept in a dark place by which means in the space of two Weeks he recovered his pristine Sanity OBSERVAT. II. Of the use of an Issue and its way of Operating A Young Maid Thirteen years of age had for several years been afflicted with dolour and redness of her Eyes and tumour of her Eye-lids which after sleep were closed together by a viscous Humour concreted into a Rosin-like matter This Ophthalmy for a long tract of time was attempted to be cured by two Surgeons but not overcome I being afterwards sent for judged the cause of the Disease to be the too great Acidity of the Bloud and a Ferment of the same nature produced from that Bloud and firmly inherent in the Pores of the Eyes and Eye-lids there causing the Bloud in the Capillary Vessels and the Humours in the small Veins to become too acid and be coagulated and stagnized For from these few signs it was not difficult to judge of the aforesaid apparent Symptoms Moreover I firmly perswaded my self that the Maid might soon be cured provided that Acidity could be temperated and expelled by the Pores of the Eyes and Eye-lids and that acid Bloud purged out of the Body wherefore I used a Collyrium consisting of Medicaments containing much Salt and besides that applied to the Eyes a Plaister made of like things But I did little good by this method for so soon as any part of that Ferment was rendred temperate and cast out shortly after a new Ferment arising from the Bloud succeeded in place of the former Seeing this I for several weeks purg'd the maid twice a week but in vain At length I found the Assertion of the famous Silvius which is written in the first Book of his Praxis Chap. 2. in the 26 Section to be most true viz. That there are scarcely any purging Remedies at least known to us which can purge out acid Humours from the Bloud Finding the matter thus I judged it high time to betake my self to the searching out of better Remedies and whilst I was occupied in consideration thereof the following Experiment came seasonably into my mind and it is this When you have a Compound of Water and Oyl mixt and would separate the one from the other proceed thus If you would
find out the Cause of the Varix nor its Effects much less the Remedy of the same For they deduced almost all Diseases from their Four Humours viz. Choler Phlegm Bloud and Melancholy though in the mean time they understood not what any one of them is or of what Particles it consisted Hence it came to pass that it was impossible for them to find out true Remedies They had much more prudently acted if they had in a special manner had respect to the various Particles of the Bloud which differ each from other in Figure Magnitude and Motion as also to the Acidity and Salt as well as they might have done whether of these holds dominion in the Bloud If it were Acidity then Purgations by the Belly could in no wise be thought convenient In like manner they too much confounded their Conceptions when they thought those Ulcers were first to be cleansed by certain peculiar Medicaments then by others incarnated lastly that again by others the Eschar must necessarily be induced Now that this too anxious distinction is very unprofitable will be plainly evident by this viz. That I with my one onely Placentula in a short time cured both Ulcers Likewise they in the Cure had respect to their own Axiom which saith Contraries must be cured by Contraries and discerning great heat in the Erysipelas surrounding the Ulcers they endeavoured to expel that by cold things which stopped the Bloud and Humours and by that means did in no small measure augment the burning hear of the Erysipelas But these men were abused by their own Axiom which had they endeavoured to make a right use of they should first have considered that burning Heat to be onely the Effect and owned for the Cause certain acid Particles by reason of Obstruction inherent about the Ulcer which with their cutting sides struck the Nervous Fibres with a more than usual trembling and then they had more rightly cured Contraries with Contraries viz. applying such things which they had by experience found fit to resist the corroding Acidity and remove the Viscosity obstructing OBSERVAT. VII Of a Wound of the Eye IN the year 1680 on the 21th day of November I was commanded to be sent for by a young Nobleman leading a Military life who three days before was wounded with a Leaden-Bullet in that part of the left Eye which is between the Iris and Pupil so that the Bullet had penetrated even into the Eye and soon after the Wound made no small quantity of aqueous Humour flowed out I found the Orifice of the Wound closed with a certain fibrous and white Matter The Iris with the Pupil wounded waxed very livid and the remaining part of the Eye thus hurt was intensly red and swoll'n attended with burning Heat and a proflux of sharp Tears The dolour was continual except that it was more remiss when the Patient held his head backward but as oft as he held his head down the pain augmented The Sight of the Eye hurt was wholly lost and the right Eye though it remained untouched was red and much pained A certain Chirurgeon to that matter closing the Wound had applied sharp things and to the remaining part of the Eye cold things This was done three days before I was called It will perhaps seem strange to some that all the aqueous Humour issued not out by the Wound but their wonder will soon cease after they have well weighed and considered the following Reasons First Let them consider that the Bullet in its inferiour part was more strongly forced into the Eye than in its superiour part and so it broke the inferiour part of the Membrane of the Eye the superiour part of that Membrane remaining entire By this means part of the Membrane broken turning inward formed a certain Aperture through which part of the aqueous Humour issued out and in its efflux again turned outward the before turning inward Membrane which then like a Valve turning from without to within not from within outward again closed the Aperture of the Wound and so impeded the out-flowing of the aqueous Humour from die Eye Secondly That fibrous and white shining Matter closing up the Orifice of the Wound falls under our consideration But whence had this Matter its Original Should I now with the Company of vulgarly-learned men fly to the accustomed Asylus of Ignorance I could readily subjoyn a Reply saying onely that Nature was so provident in this case that she in a short time filled up the hole with fit Matter not onely that all the aqueous Humour might not issue out but also that the most cold ambient Air might not penetrate to the parts and endamage them But such an Answer seems to me no less rediculous than if I should ask why in boyling hot Broath exposed to the Air a thin Skin is generated on the Superficies And another should answer The nature of the Broath is so provident that it presently forms a Pellicle on the Superficies of the hot Broath lest the cold Air having access to the internal Particles should hurt them and that the heat in the Broath might be longer preserved and the otherwise flying Vapours retained and constringed within the Broath by the superposited Membrane whereas he should rather have said that many of the more thin parts of the Broath apt for motion having figures fit for the same easily evaporated into the Air and in their flight carried with themselves up to the Superficies of the Broath certain Particles more gross stringy and less fit for motion which their motion being terminated by the ambient Air acquiesced in the Superficies of the Broath where with their small Fibres folded one within another they concreted into that Cuticle which covered the Broath But returning to our purpose we shall by a better right answer in this manner Some Particles passed out from the Pores of the Arteries and circulating in the small passages of the Membranes of the Eye were carried to the end of those passages interrupted by the Wound and so indeed the more thin parts evaporated but certain more stringy Particles prolapsed without the said passages their motion by the extream coldness of the Air at that season being taken away by their stringy Fibres infolded themselves one within the other and so concreted into a certain fibrous and white Matter not unlike to that which is often seen in that Water into which flows the Bloud from a Vein of the Foot or Hand That leaden Bullet could not enter into the Eye but very much contused it and broak certain small sanguiferous Vessels from which the Bloud flowing by reason of the cold was stagnized and infected the Iris and Pupil with a livid colour This Wound could not be made in the Eye but many small Fibres must needs be broken and being broke retire together into Curls and so obstruct many passages in which the circulating Humours accumulated did press the sanguiferous Vessels nigh so that the Bloud in the
Oleaginous Volatile Salt xxv drops Make a Mixture Using this Lavament for one day and finding little benefit by the use thereof I scarrified the parts affected and washed them with Unguentum Egyptiacum mixt with Spirit of Wine I did not at all fear any damage to accrew from the Vinegar which is put into this Unguent because in the boiling that is all evaporated Also I anointed the exteriour Circumferences of the affected parts with Oyl of Tyles called Oyl of Philosophers Lastly I applied a Cataplasm of Rue Wormwood Dittany of Crete Root of Galangal and Calamus Aromaticus Flower of Lupines Metheglin and other things temperating Acidity By use of these aforesaid Remedies good Pus began to be generated which by its gently cutting Particles brake in sunder the remaining intermediate Fibres which as yet had retained the dead and living flesh together and by this means the parts affected with the Gangrene were separated Seeing this I applied Common Turpentine mixt with Basilicon and the White of an Egg by which all the viscous Particles were removed which were otherwise wont to obstruct the Pores of the Arteries and cavities of the Veins By this means several Particles came forth from the Arteries and adhered to the Ulcers by reason of the similitude of their Superficies and soon after all the Ulcers were discerned to be filled with flesh then I applied dry Lint scraped and in a short time induced an Eschar by that onely For that imbibed all the Pus which otherwise would have corroded and wholly closed the Orifices of those tender Vessels Thus our Patient was compleatly restored to her pristine sanity Octob. 21. OBSERVAT. IV. Of a Sphacelus of the Foot A Man of Seventy years of age that had all his life-time devoted himself to Wine and Venery and by frequent intervals was afflicted with a Spasmus of his right Leg in the year 1681 February 22 was invaded with a small Fever not vehement On the 26th day of February his prostrated appetite seemed to return wherefore on that day he twice eat a great quantity of very sowre Butter-milk and the same day about nine at night he began to complain of a very great pain of his right Foot and soon after of a Stupor and great coldness of the same and the same Dolour Stupor and Algor in two hours space ascended above the Knee The 28th of February I was called and by Scarification found that the Sphacelus had ascended an hands breadth above the Knee for so far was present that extream Cold and Rottenness and in Scarification no sign of Dolour appeared nor did any Bloud issue out except a very little very black and coagulated breaking out in one part or other Very attentively considering all these things I concluded that the abuse of Wine and Venery had rendred the Bloud of this Man its more subtile and more volatile part being absumed too viscous and acid and when certain acid and viscous Particles of this Bloud were by Circulation come to the right Foot perhaps they there stagnized and afterward pertinaceously adhered and by their stay there acquired greater sharpness These Particles inferred no Dolour so long as they remained unmoved but when by intervals they were forced from their residence by the Humours circulating and by them excited to motion then they became the cause of the Spasmus of the right Leg irritating and cutting the small Fibres of those parts and so gave occasion to a greater afflux of the animal Spirits But the continued excess of Wine and Venery had left scarce any thing in the Bloud of this man except a Caput-mort as I may call it that is nothing besides Bloud very viscous and acid which could no longer duly exercise its proper effervescency in the Heart nor circulate through the parts yet this Bloud when it had by a small Fever received greater motion and was rarified more than usual did sufficiently open the Pores of the Arteries so that many acid and viscous Particles issued out and stayed without and this hapned rather in the right Foot than elsewhere because there resided the acid and viscous Ferment which caused the Acidity and Viscosity contained in the Bloud to draw nigh to it self in such a way as we explained in the Second Observation and perhaps a great cause was that abundance of acid Butter-milk eaten because this happened the 27th day of February rather than at any other time Those acid and viscous Particles that passed out from the Pores of the Arteries on the 27th of February setled in the Veins of the right Foot and conjoyned themselves with the acid Ferment therein contained and there by the acuteness of their sides impressed on the small Fibres a very vehement motion and so produced that Dolour but the small Fibres being not long able to sustain that violence were soon after wholly cut in sunder and by that means the sense of pain notwithstanding the Scarification then made was totally annihilated and the broken Fibres infolding themselves each within the other had so obstructed the veiny passages of the right Foot that the Bloud and Animal Spirits could not enter this was occasioned by the coagulation of Humours in the Foot produced by the aforesaid Acidity Hence I discerned the Original of the Sphacelus of his right Foot also that it must needs take beginning from Acidity is confirmed by that black and coagulated Bloud which in scarifying had its Exit For every man knows that the Bloud waxeth black and is coagulated by Acidity This Sphacelus had by this time transcended the Knee and soon after a little above the part affected the Patient felt an intolerable pain I considering with my self the fore-passed dessolute Life of the Sick-man his Age his Leg above the Knee infected with this Sphacelus and his whole Mass of Bloud grievously tainted and moreover calling to mind that I never knew any Old men infected with this Disease to escape did boldly predict the inevitable death of the Patient yet in the mean while I promised I would mitigate the dolour as much as I could and if possible prevent the further ascent of the evil In order hereunto I commanded the Patient should every two hours take two spoonfuls of a mixture tempering Acidity consisting of Borrage and Bugloss-water Treacle-water Sugar-perlate Crabs-Eyes Coral Mineral Bezcardic and other things infringing Acidity and attenuating Viscosity Also I caused a Decoction to be made consisting of Water Wine Roots of Calamus Aromaticus and Enula Campane with Rue Dittany of Crete Wormwood Flower of Lupines c. which I applied hot with a double Cloath by which Application some ease of pain was induced For the Acidity inducing dolour by its accuteness was thereby rendred more temperate Therefore when the Cloath was dry I again moistned it in the same Liquor and this reiterated Application I continued for several days Now when the 7th day of March was come I saw that Down or Mossy Lanugo which
of the Leg grating of the Bone dolour and imbecility of morion For one extremity of the Shin-bone by reason of the Fracture tended this way the other that way whence was the inequality of the Leg and when those two extremities hit upon each other the grating of the Bone was heard and when they with their sharpness pressed the Periosteum and adjoyning parts the first cause of dolour discovered it self but the second cause when the extremities of the broken Bone by their pressure compelled die Humours in the small passages of the bordering parts to stagnize wax acid and irritate the small Fibres But when the Fibrils were thus disturbed by the points of the Bones and acid Humours the Animal Spirits could not be determinated rather into this than into that Muscle but without distinction rushed into all disturbed parts and if though but in a small quantity they approached nigh to certain Muscles they could not enter and flow in by reason of the passages of those Muscles obstructed by the stagnizing Humours And although some Spirits had flowed into the same Muscles yet all their tendency was was to move one extremity of the cutting broken Bone to this party the other to another whence proceeded nothing but Vellication Pressure and Renovation of the dolour Hence the cause of the imbicility of motion is sufficiently manifest I being called presently set the Broken Bones and then my principal end was to restore the circulation of the Bloud and Humours for without doubt the Bloud was here and there stagnized Therefore to temperate the peccant Acidity I washed the affected part with Sprit of Wine in which a little Gum Ammoniac was dissolved and for the same end I applied a Plaister composed of Diapalma Bolus Spirit of Wine and Oyl of Camomil Then for retaining the Bones so lately set I used Ligatures and other things fit renewing these by certain intervals and so the Patient in six weeks time could again walk I am not willing in this place to say that a Fracture made transverse may more easily be retained than an oblique Fracture nor that it is for the most part accounted a good sign of restriction if the great Toe of the Foot directly respect the Knee seeing these things are well known Nor shall I endeavour to render a reason why the dolour is mitigated after the Bone is let because it is known that this is effected by removal of the first cause of the Dolour of which I so lately spake But before I conclude I purpose to shew how the Callus is induced which conglutinates the fractured Bones When the Circulation of the Bloud and Humours is again restored as well in the fractured Bone as elsewhere then certain Particles issuing from the Pores of the Arteries pass through the small passages of the Bone and when they come to the extremity thereof they can proceed no further by a right Line because the passages were interrupted by the Fracture therefore they turn to the sides where adhering to die Bone and each to other they constitute a Callus which again conjoyns the Bones This Callus in the aged and weak is difficultly generated by reason of the gross and viscous Bloud which cannot pass through the streight passages of the Bones Therefore in such a case the more gross Particles of the Bloud must be attenuated by Ê’j of the Stone Osteocolla daily taken Yea it will not be injurious if powder of the same stone be mixed with the Plaister that is externally applied But in our Patient the matter was far otherwise For the Callus extended it self to a very unseemly bulk wherefore I applied a Plaister of Frogs with Mercury to the end that this Plaister should so attenuate certain Particles of the Callus that they might fly away and also a good Ligature that it might so compress the Callus as no-nothing new might have access thereunto Thus I put an end to this Observation after I shall have told you that I commanded the Sick-man's Leg always to lie extended and took care that the Sole of the Foot might rest upon a small Pillow in the middle of which was an hole For otherwise as experience testifies a Gangrene might have invaded the bottom of the Foot because the Vessels and small passages of the parts are vehemently compressed by long lying There are some who in a Fracture of the Tibia as this was commend viscous things which I reject as noxious because in a body without exercise Obstructions do not a little augment which on the contrary should rather be diminished OBSERVAT. X. Of a Dislocation of the Shoulder A Man Thirty two years of Age falling from a Coach suffered a Dislocation in his left Shoulder so that the head of the Bone fallen into the inferiour part was the cause of a certain eminency there whilst on the contrary in the superiour part was discerned an unusual Cavity The Patient complained of very great pain and could not move his hand by the anteriour part to his Forehead nor by the posteriour to his Neck For the Bone fallen from its seat compressed the Periosteum and adjoyning parts whence arose pain which was augmented because in the small passages of the parts compressed and distorted the Humours stagnized waxed acid and shook the small Fibres He could not move his Arm as formerly because the head of the Bone thrust from its former Cavity no longer as before enjoyed an hollow and slippery place requisite for its motion also hence was the occasion that the Animal Spirits could not enter through the small passages obstructed by the stagnizing Humours and compressed by the dislocated Bone into the Muscles and excite them hence it happened that no motion could be because the head of the Bone did more and more compress the parts adjoyning whence arose a new excitation of dolour which also induced no small impediment to the due performance of motion I being called to the Sick reposited the dislocated Bone and then the motion presently returned there was indeed some dolour present because the acid Humours stagnizing did as yet in some measure irritate the Fibrils nevertheless the pain was very much diminished because the head of the Bone now contained in its proper Cavity did no longer press upon the sensible parts The Bone being set I endeavoured by things temperating Acidity to dissolve the stagnizing Humours and restore to them their due Circulation wherefore I washed the affected part with Spirit of Wine in which Gum Ammoniac was dissolved and applied a Plaister composed of Spirit of Wine Bolus Diapalma and Oyl of Camomil and then put Lint wrapt up like a Ball under the Arm-pit and by this means the Patient was healed in a short space of time Peter Pigraeus a French Author and Chyrurgeon worthy of praise commends Astringents to a Bone lately reposited but be it spoken with the leave of so famous a man in this he is egregiously deceived For Astringents augment Obstructions
which should rather be diminished Paulus Berbette wills that the influx of Humours in this case be prohibited but improperly because that influx being natural should not be stopped That man undoubtedly saw in 2 Dislocations the near adjoyning parts often elevated into a Tumour Also he observed by frequent experience that Frankincense Mastich Bolus and the like removed this Tumour But when he judged this Tumour to be produced from an influx more copious than usual and when according to this stated opinion he thought his Medicaments did therefore help because they prohibited that Influx then I say he erred For Obstructions were the cause that the Humours were coacervated and elevated into a Tumour and so waxed acid and the said Medicaments onely profit because they remove the Obstructions and temperate the Acidity Having now spoken of the Dislocation of the Shoulder suddenly happening there is yet another Dislocation slowly invading and more slowly sanable viz. when by External force the Ligaments of the Shoulder are contused so that the small passages are distorted whence the Humours circulating through the Ligaments do there subsist and in process of time insinuate themselves into the Pores of the Fibrils of which the Ligaments consists and extend those Pores not according to the breadth but according to the length of the Ligaments For the Ligaments when motion is are often extended in length even so the Ligaments which otherwise were wont to contain the head of the Bone in its Cavity are now so far prolonged that the Bone falls out of its proper seat This Dislocation is easily restored but the Bone reposited is very difficultly retained in its place External Medicaments helpful to retain a Bone reduced to its place are such as consist of much Volatile Salt because Volatile Salt can attenuate the Particles inherent in the Pores of the Ligaments and so force them out and restore the circulation of Humours But the cure will be rendred more easie and in less time accomplished if we contribute help to the external Medicaments by a Decoction to be inwardly taken consisting of Lign Guaiacum Root of Sarsaparilla China and other Medicaments abounding with much Volatile Salt The end of the first Decade of Chyrurgick Observations DECADE II. OBSERVAT. I. Of the Puncture of a Nerve A Young Man aged Twenty years exercised in Chyrurgery with the Puncture of a Lancet hurt the middle Finger of his left Hand about the middle Article whence arose pain at first not very great but by the next morning it was vastly augmented and besides redness invaded the whole Finger attended with burning heat and swelling and the Cutis in places nigh the Wound was separarated pallid and insensible After I had accurately considered the Phaenomena's I concluded the Nerve to be hurt by the Razor whence at first arose but small pain But by reason of the small passages bordering on the wounded Nerve Humours interrupted by that small Wound otherwise freely circulating were constrained to subsist about the Wound and there became acid and so by the Humours following them were driven to the wounded Nerve where permixt with the Animal Spirits hastning through the Nerve they excited a certain effervescency by reason of the Volatile Salt contained in those Animal Spirits and by this means the acid Particles constituted in motion great enough with the acuteness of their sides egregiously vellicated the Fibrils of the wounded Nerve and so excited that grievous dolour I even now spake of The acid Humours thus forced into an effervescency with the Animal Spirits not onely irritated and disturbed the Fibrils of the wounded Nerve but also the Fibrils of the adjacent parts yea of the whole Finger whence many small passages were so distorted that the Bloud and Humours setled in them and by a short delay there assumed the nature of Acidity whence the heat and tumour of the whole Finger or inflammation of 〈◊〉 same were readily induced The same acid Particles exercising their Effervescency had wholly cut in sunder those Fibrils which knit the Skin sited round about the Wound together with the subjected part and so the Cutis was separated pallid and insensible because those often-cited acid and cutting Particles had cut in sunder very many Fibrils constituting the same Cutis which Fibrils crisping on heaps produced so many and so pertinacious Obstructions that the circulation of the Bloud Humours and Spirits through the Cutis was totally impeded Things being thus I judged the Wound sufficiently dangerous and therefore the cure thereof to be diligently set about having long before seen a French Souldier whose Nerve about the Cubit of the Arm was but lightly prickt with a Sword who after a long series of time and many difficulties overcome was with very great care and pains at last restored to his pristine state of health Yea I also saw an Husbandman the Nerve of whose Thigh was wounded with a Leaden-bullet shot out of a Gun this man a Convulsion being excited died in a short time after the wound was inflicted I had often before mixed Oyl of Turpentine with the acid Oyl of Vitriol and saw an Effervescencâ—â—o arise thence yea with my hands I â—ave felt sufficient heat produced in the Glass containing those Liquors Hence I did without difficulty perceive how powerfully Oyl of Turpentine did resist Acidity and by consequence how excellently serviceable it would prove in this our case wherefore I poured Oyl of Turpentine before made sufficiently hot into the Wound that so the Parades thereof of put into greater motion might more easily and more profoundly penetrate and consequently act more powerfully in temperating the peccant Acidity Then I applied Paracelsus his Stiptick Plaister which also temperates Acidity Afterward on the Finger and indeed all over the Hand I laid a doubled Cloath moistned with a Lavament consisting of Spirit of Wine Water of Elder Camphire and Salt-prunella changing these twice a day and with an Instrument removing the Cutis already separated from the subjacent flesh Thus our Young man was cured in a short time In the mean while it is worthy observation that I saw a necessity of being industriously careful to prevent the access of the ambient Air because that contains in it self Acidity which is apparent thus viz. because it coagulates Milk yea Bloud it self when extravasate is in a short time coagulated by the Air whereas the same is found to persist in its wonted Fluidness for several days if it remain in the Vessels of any Carkass where it is free from the ambient Air. By the aforesaid it is sufficiently manifest why there is much less dolour in a Nerve wholly cut off than in that which is onely prickt or but lightly wounded for when a Nerve is totally cut in sunder one Extreamity is retracted to this part the other to another and is absconded by the flesh so that the acid Humour inherent in the Wound and the ambient Air cannot have access to the Nerve The famous Sylvius
deduceth extream dolour and other Phaenomena's occurring in a Wound of the Nerve from a far other cause than I do For he thinks some of the Fibrils in the Nerve being cut the other as yet intire suffer so much the more by a continued stretching produced by the Animal Spirits and that hence ariseth Dolour Convulsion and other Evils frequently observed in such cases But with the leave of so great a man this Cause pleaseth me not seeing from it I cannot conclude that the pallid and insensible Cutis is frequently separated from the adjacent part This Cause of his is repugnant to Experience which teacheth that the Puncture of a Nerve is more dangerous than if the Nerve were cut to the midst For in a Nerve cut to the midst many more Fibrils are cut than in a Nerve prickt in which often but a few Fibrils onely are hurt But it is certain that Sylvius did himself believe his own reason not sufficient seeing in the same Twenty third Chapter of his Second Book he saith that Phaenomenons exhibiting themselves in the Puncture of a Nerve seem to him more like a Dream than to any observation made by the Senses Therefore that I may put an end to this Observation I say that in the wound of a Nerve Acidity is peccant and that such Medicaments should be applied as infringe Acidity For this Cause is commended Oyl of Wax and Ear-wax but acid things are not fit here to be used which was well observed by Felix Plaiterus who in his Book of Observations page 468 saith Acidity is very inimical to the Nerves OBSERVAT. II. Of Dolour of the Head A Man Forty two years of Age was vexed with a most vehement dolour of his Head and indeed that only about the Temple of one side where it remained fixed which Affect if any one will for this cause insignize with the name of a Clavus let him for me I judged the cause of this Dolour to be an Acido-corrosive Humor there lying hid and stagnizing by reason of Obstruction very pertinaceous There was one studious of Medicine present who perswaded himself that the cure of this Affect would be best performed by Sudorificks which by reason of the pertinacy of the Obstruction in this Disease I judged equally as impossible as in the Panaritium which I never heard to have been healed by Sudorificks though the same Affect derives its original from an Acido-corrosive Humor for it is but a very small portion of the Sudorifick that can arrive to the pained part Therefore I rather applied to the affected part Powder of Cantharides with his own Spittle formed into a Vesicatory about the evening and left it on all night The famous Sylvius to Cantharides addeth Vinegar thinking there would thence arise a certain Fermentation and so the Vesicatory operate the better Yea the most Learned Willis also adjoyns acid things to many forms of Vesicatories which I my self have often imitated but as often observed that after the space of a whole day no Blisters have been raised by the Cantharides when I mixed them with Vinegar viz. for this reason because the Volatile Salt of die Cantharides was enervated by the Vinegar in which Salt the principal Virtue of them consists Coming the next day I beheld a large Blister raised by the Cantharides and understood that the sick-man was wholly eased of his pain But I could not perswade my self that this dolour was removed by the Blister raised and by reason of the Water flowing from the same when opened For the Water that issued out was neither sharp of taste nor could be such because had it been so it must needs have inferred some dolour on the subjected skin before apertion of the Blister which notwithstanding it did not although the Cutis the Epidermis being by this means removed be of it self sufficiently sensible as is apparent because it is often hurt and feels pain by the ambient Air. What was it then that removed that Dolour The Volatile Salt of the Cantharides which by the Vapours passing out through the skin stirred up to a sufficiently swift motion penetrated to the Acido-corrosive humor and temperated and cut the same and took away the obstruction But whence then did the Blister derive its original I say that in the mean time when the more volatile Particles of the Cantharides had penetrated far enough for correcting the peccant Humor other more grose and more acid Particles subsisted about the Cutis in which they brake certain Fibrils which crisping up together did so obstruct the small passages that the Humors in circulation were partly impeded and so gathered together in the Superficies of the Cutis and elevated the Cuticle into the form of a Blister which might easily happen because the Fibrils which joyn die Cutis with the Cuticle were now broken in sunder by the aforesaid more gross and more acid Particles of the Cantharides But some one may perhaps here say that that Water should not have been there congregated but rather have passed out by the Pores of the Cuticle by which we so often see Sweats to issue out To him I answer the most gross Parts of the Cantharides remained and adhered about the Cuticle and very much constringed the Pores thereof which should seem strange to no man who even but once in his life-time hath seen how easily by heat of fire Parchments may be crumpled up and that the common Fire which so crumples them doth also sometimes excite small Blisters wholly like those that are raised by Cantharides but because the Pores of the Cuticle were so closed therefore the Vapours otherwise freely exhaling were accumulated and augmented the abundance of Humor contained in the Blister If any man not as yet plainly convinced by our way of reasoning believes that the long lying on of the Cantharides by reason of the Blisters raised helps until his mind be altered by the Authority of some approved Writer I would have him go to Lazarus Riverius who in his Third Century Observation 4. declares that a Vesicatory left on but a quarter of an hour had in that time wholly removed the dolour of a Bees sting no Blisters being raised by reason of so short delay Francis Redi in a Treatise of Insects affirms that he had seen a white shining Humor undoubtedly Acido-corrosive flowing out from the Stings of Scorpions and it is very probable that such an humor in the Punctures of Bees doth in like manner flow from their Stings which is the cause of dolour Hence it is now manifest that the dolour of which Riverius speaks vanished because the acid Humor which flowed out from the Bees Sting and excited dolour was temperated by the Volatile Salt of the Cantharides But that the Stings of Bees are hollow no man will wonder who hath at any time seen the Glass-Pipes made by Art which are used for examining and beholding the Bloud and other Liquors through a Microscope seeing they though small
cause of the Evil we could not through the whole length of the Arm find either Fracture or Dislocation but a very great Contusion of the whole Arm so that much of the Extravasate Bloud and also of the Humors adhering in the small passages of the Arm distorted by the Contusion stagnized and in a short time waxed acid whence that Imbecility Tumor and Dolour may rationally be concluded to have derived their Original Some to render the motion of the Bloud more pleasing do here presently cut a Vein whereas I on the contrary omitted the opening of a Vein gave to the Patient an Anodine Tincture prepared of Opium and other things which much more securely and with greater Utility diminished the motion of the Bloud After some few hours I exhibited to the Sick a sudorifick Powder which would also temperate the Acidity of the Extravasate Bloud and stagnizing Humors this I repeated the two following nights with good success This Powder consisted of Diaphoretick Antimony Crabs-eyes prepared Salt-prunella Antimoniat and other things and hereby the dolour was in no small measure remitted and the Extravasate Bloud was driven out to the Cutis which then all over the Arm from the Shoulder to the Fingers was very livid yea waxed black The Chyrurgeons that were present with me did in the beginning of the Cure without my consent anoint the whole Arm with Oyl of Roses which hurts not so much by reason of the Roses as by reason of the Oyl-Olive For although this might do some good yet it could not profit unless it could have penetrated to that place where the Extravasate Bloud and stagnizing Humours lay but so far it could not penetrate unless in form of Vapour and the heat of our Bodies is too weak to convert Oyl-Olive into such Vapours seeing indeed a sufficiently strong Fire made of Wood and Coals is not of force sufficient to reduce the Particles of Oyl-Olive put into a Pot into the form of Vapours Therefore the Oyl-Olive was so far from doing good that as I judged it rather did hurt because by its stringy Particles it augmented the Obstructions and so caused the Bloud and Humors yet more to stagnize and besides by its closing the Pores of the Skin it hindered the access of other Medicaments to the place affected If common Roses be cold as many think I should reject them in this case but because from their bitterness and penetrating Odour the contrary may be judged by those who laying aside their prejudices will rather follow Verity than Antiquity Therefore I in this case condemn Oyl of Roses by reason of the Oyl-Olive but not by reason of some Particles of the Roses mixt therewith The same Chyrurgeons applied to the whole Arm anointed with Oyl of Roses that Defensive Plaister the description of which is found in the Ultrajectine Pharmacopoeia which indeed I do not here wholly reject because it containeth many Ingredients temperating Acidity as Bolus Terra Sigillata Lithargyry and other things but to what end should here be added Myrtle-Berries Oyl of Myrtles and Austere Red-Wine These indeed bind up the Pores of the Skin and so wholly impede the penetration of other fit Ingredients to the affected part Experience did in a short time confirm the truth of my Assertion when many Pustles dispersed through the whole Arm came in sight Wherefore I prescribed the following Lavament which I substituted instead of the Oyl and Plaister as being a Medicament that would powerfully resist Acidity and consequently well dissolve the coagulated Bloud and Humors â„ž Roots Of the Flower de Luce. Of Calamus Aromaticus Of Bryony of each â„¥ ss Herbs Rosemary Betony Sage of each M. ss Berries Of Juniper Of Bays of eachÊ’iij Boyl these in a close Vessel with French-Wine and to two pound of the Colature add Of Gum AmmoniacÊ’ij Of Salt of TartarÊ’j Make a Lavament By this means the Pustles vanished the Dolour was diminished the motion of the Arm gradually returned and the Livid colour was turned yellow Then the Chyrurgeons willing the Medicaments should be changed instead of the Defensive Plaister which they again proposed I prescribed a Fumigation temperating Acidity which consisted of Bay-Berries Juniper-Berries Frankincense Mastich Myrrh and other things For if these latter could help in the aforesaid Plaister where they lay bound up by the Suet and Wax they must needs be much more profitable when in the form of Fume they could fly up and surround the Arm its superiour part being covered and so being forcibly enough agitated could enter the Pores of the Arm by that time well opened by the heat After this I commanded Spirit of Wine to be burnt the Vapour of which ascending to the Arm and entring through the Pores infringed the Acidity which had in no small measure coagulated the Bloud and Humours and by that means the Patient was healed the dolour and yellowness removed and the motion of the Arm restored I most assuredly perswade my self that the Contusion would not have been so great if a Fracture of the Bone in the Patients Arm had also been concomitant For the Bone when broken recedes and contuseth no more but when the Bone remains entire and consequently by reason of its hardness makes strenuous resistance and when there is on the other part a solid Body contusing then the interstanding Flesh is no otherwise pressed on either part than as if it were put under a Press and so it is in a strange manner contused And this is no more than what our daily practice confirms in which I have often observed a Contusion where the Bone hath been broaken to be much less than where the Bone hath remained unhurt In this Cure my fear was that the Extravasate Bloud should be so much coagulated that it could not be afterwards dissolved and so might at length become so very acid and corrosive as to infect the adjacent parts with a Gangrene For it was not long before that I was called to a young Man who had for eight days neglected a Contusion of the Tibia after that I was called and seeing how it was compelled to open the contused part with a Lancet I perceived many sufficiently large Clots of Bloud firmly coagulated black and putrid which had in some sort infected the Cavity in which they were conteined with a Gangrene which notwithstanding I in a short time removed by washing it with Spirit of Wine and by inspersing the Pouders of Myrrh and Aloes OBSERVAT. VIII Of a Ganglion in the Hand A Youth aged Sixteen years complained of a Tumour hard and painful which sited in the upper part of his right Hand in magnitude equallized an Hazel-Nut and was of the same colour with the Cutis and there was now near three Months passed since the Patient by unaccustomed labour was affected with this Evil. The Tendon lay in the upper part of the Hand the small passages of which were by that unusual labour so distorted that the Humors
of Motions that are made in this Corporeal Universe and according to the rules of these Motions giving heed onely to the magnitude of Bodies to the figure and position of them not onely the Phaenomenons of this Disease but also many other far more wonderful than these may very accurately be explained If you be desirous to know how Plants proceed from a Grane or Seed it will behove you attently to peruse the Anatomy of Plants made by Mr. Grews Microscope published both in English and in French There in the greater Bean you may behold the Rudiment both of Root and Plant already formed there you may perceive how the Juice strained through the Membranes of the Bean committed to the earth is fermented in the Body of the Bean also how there through a small hole of the Bean admittance is given to the Air and an exit also permitted to the superfluous Vapours how the Juice thus fermented is constringed into the Rudiment of a Root and converts that Rudiment into a true Root which then receiving nutriment from the Earth repels the other Juice coming from the other part upwards to the Rudiment of the Plant that so at length it may present it self to the sight as a true Plant. If you desire to know the causes of the stupendious powers in the Magnet of the Ignis Fatuus Rainbow and other things consult Cartesius who will clearly explain them to you The same Philosopher in his Treatise of Meteors will also there teach you that Souldiers sometimes seen fighting in the Air touching which the ignorant Vulgar tells so many tales are no other than certain Clouds I know not indeed whence arose this so evily-founded Judgement of the people by which such cases as this of ours is are accounted Inchantments and Mawworms so frequently ejected from the Bodies of men by Vomit and Seidg esteemed meerly natural whereas the generation of Mawworms is far more wonderful than that of these Eggs in the Humane Body Vigelius professor of the Mathematicks is reported to have formed an Horse of Metal which in one day for several hours could by the help of Rotula's walk like a living Beast Rayselius is reported to have fabricated an Engine like a man in which a certain Liquor poured into the mouth was seen to circulate like our Bloud the more thin part of which Liquor was expelled by the Yard as Urine but the more gross part as Dregs or Dung of the Belly by the Fundament If Man can do such things what cannot GOD the supream Architect effect according to the ordinary rules of Motions Therefore how were these Eggs produced in this Woman I answer In the Thigh of this Woman from this or that cause many Pores of this or that Artery were distorted and enlarged so that many Humors flowed out and were collected in one place in which when they began to be fermented the Particles stringy and less apt for motion were thrust out to the sides where they were not compelled to so swift a motion and there cohering and twisting themselves one within the other were formed into that sufficiently gross Membrane which did include all the Eggs afterward generated But because the Pores of the above-mentioned Artery were diversly distorted therefore some of the Particles contained in this gross Membrane did in some measure differ from the other in figure and magnitude and perhaps the Particles like each other flowed into almost an hundred divers places and so every of those Particles besides the Congesture of their like still exercising a certain kind of Fermentation did again thrust out the more stringy Particles to the sides and so were formed the Membranes in which were included all the Eggs. Thus I suppose I have produced a sufficiently intelligible cause of this Phaenomenon which I beheld with my own Eyes OBSERVAT. V. Of a vast Tumor of the Neck A Young Maid aged Fifteen years being otherwise very well had now for six years sustained an hard round Tumor in her Neck of the same colour with the Skin and void of pain equalizing in magnitude a white Loaf that is wont to be sold at the price of half a Sesterce and miserably defacing the Patients Countenance I judged the humidity of this Tumor to be very viscous and divided almost after the same manner as we see the Juice in a Pome-Citron or Orange contained in many Cells By reason of the viscosity of the Humor this Tumor could not be discussed nor in the common way brought to suppuration therefore I applied a Corrosive and the Eschar being removed put in a Tent anointed with the Unguent Basilicon mixt with common Turpentine By this means some part of the viscous Pus issued out daily and so the Bulk of this horrid Tumor began to be diminished the viscous Humor nearest the hole was first evacuated and afterward that also which lay far remote from the Ulcer But when the small passages round about this hole made by Art were obstructed by the viscosity of the Humor as it often hapned then with the Unguent wherewith the Tent was anointed I mixed some Crocus Metallorum that so an Eschar might be induced which being separated the small passages were again opened and so this young Maid in the space of three Months was wholly freed from this Tumor and that great deformity attending it I shall not in this place speak of the way or manner of the Corrosives operating having already discoursed of that in the First Observation of this Third Decade nor will I at this time further explain by what means the Eschar is separated because this may sufficiently be understood by the Second Observation of this Decade where I teach how the rotten Fragments of Bones may be separated from the sound part Perhaps some one will wonder that I use Medicaments so few and so little compounded but to what purpose are so many Simples and so many composed Forms of Remedies which many Physicians use at this day for no other cause than to boast of their vain Learning before the Ignorant If Gun-powder made of Cole-dust Nitre and Sulphur onely produceth such stupendious effects in the Macrocosm that omitting all other it can blow up into the Air vast and heavy Ships and also if put under the Earth cause the same to tremble and cleave in sunder why may not a few Medicines seasonable taken be sufficient to heal very many Diseases in the Microcosm I do indeed assent to Bacon Verulam great Chancellor of England who is by some called the Day-star of Cartesius thus speaking Variety of Medicaments is the daughter of Ignorance OBSERVAT. VI. Of a wonderful Abscess A Man Fifty years of age was vexed with an Abscess arising below his Ear which was round painful waterish and soft with this he had been afflicted some days before he came to me I being certainly perswaded that ripe Pus was contained in this Abscess made an Aperture with my Lancet and so presently issued out no small
thrust out through the Skin the Affect is mortal of greater danger if restored than if not restored For if it be not restored an Inflammation Convulsion or sometimes Death follows Secondly Foulness of that Member will be present And Thirdly an uncurable Ulcer which if it happen to be covered with a Cicatrice that by reason of softness is easily broken If it be restored it infers very great danger of a Convulsion Gangrene and Death But some fear dangers of this kind onely in the great Articles viz. in the Wrist Shoulder Talus and Thigh which by reason of the strength of the Tendons and magnitude of the Ligaments and Vessels prohibit Restitution Then he adds If a Convulsion follows the Joynt must be presently again Dislocated My purpose is no otherwise to answer these words of Scultetus than by an exact and faithful Declaration of the Medicines we applied to this our Patient seeing thereby it will be sufficiently manifest how well or how ill the above-named Author hath written First We washed the Bone of the Tibia forced out of its seat with Spirit of Wine warm for removing the coagulated Bloud and Filths adhering then sufficient Extension being made we set the dislocated Bone in its place applying to the Wound a good Digestive with a fit Plaister superposited not omitting a Lavament temperating Acidity and a Common Ligature The Leg thus bound up was laid upon a soft Cushion and so the Patient was carried to his Bed over which hung a Rope by the help of which he could raise his Body as I said in the precendent Operation and at the Feet of this Sick-man we set up a Board that the Clothes with their Weight might infer no detriment to the wounded Leg. The Leg affected by reason of the abundance of Pus flowing out of the Wound was dressed twice a day But in the mean while most vehement dolour exercised its Tyranny on our sick Patient who was both feverish and had a Delirium passing whole night almost without sleep or if he was between whiles somewhat refreshed with sleep a little after that was excited the aforesaid Terrour of which we spake in the precedent Observation whence the Talus was often of some measure distorted again To remove the Dolour Fever Watchings and Delirium the Patient at time assumed some of the following Mixture ℞ Water of Betony ℥ iv Of Bawm ℥ j. Syrup of Card. Bened. ʒiij Antimony Diaphoretic ʒj Salt prunella antimoniate ʒss White Corals Crabs-Eyes of each ℈ j. Laudanum Opiat Gr. 4. Make a Mixture But the Talus as often as it was found distorted after sleep was reposited By this means the space of three Weeks being scarcely elapsed the Fever and Delirium ceased then also but more slowly the aforesaid Terrour vanished and at length the Dolour and Watchings likewise But here I call to mind one thing which I had almost forgot viz. that two Abscesses arose in the affected Leg one nigh the Wound the other in the External part of the Leg but both these Abscesses after Apertion were healed In process of time very many Fragments were separated from the Bone of the Tibia which we then gently and easily took out of the Wound and upon the fungous flesh which was seen in the Wound we strewed almost every day once the Powder of Burnt Allum and so at length a Cicatrice came in sight which from day to day increased more and more so that about the sixth Month the whole Wound was almost covered Wherefore the Patient began to walk with Crutches but by this motion the Wound was again inlarged so that it closed not in every part which should seem strange to no man For I at this day know two who after Dislocation of the Talus with a Wound had an Ulcer several years But what if after setting the Dislocated Talus the Patient had been afflicted with a Convulsion must we needs have followed the counsel of Scultetus and again have dislocated the Article so lately set in its place I think not seeing I see no cause that should incite us to such an Action In this place I render not a Reason of many Phaenomenons and indeed considerately least I should set before the Readers a Dish of Crambe twice cookt For I think I have here omitted no reason of any Phaenomenon which may not be found in one or other of the foregoing Observations OBSERVAT. VII Of a Nose hurt by Winters-Cold A Young Maiden Sixteen years of age in Mid-Winter in extream cold Weather complained of a Tumor Redness and Dolour in the Tip of her Nose and she had been often before afflicted with this Evil in the Winter-Seasons The coldness of the Air both within and without affecting the Nose the Bloud in its very small Vessels and the Humors in their small passages were in some measure stagnized and in process of time contracted a certain Acor whence the Tumor Redness and Dolour were easily excited But whence was it that this Evil had now several times returned in the Winter This Return proceeded from no other cause than because the small Vessels and Passages were the first time so distorted by the Bloud and Humors stagnizing and waxing acid that afterwards they could never so well return to their pristine state but they would in Winter-time much impede the Circulation of the Bloud and Humors This Affect in Dutch called de Roud is without danger as to life yet in the mean while it is not a little displeasant to young Maids accounting their own Form whatsoever it is as their chiefest good and therefore are often willing rather to lose their Life than their Beauty This Evil I wholly removed in a few days with a Linnen-Cloath onely anointed with Sperma Ceti I shall not now dispute what that is which is known by the Name of Sperma Ceti whether it be the Seed of that great Fish or a certain Substance which is found in the form of thick Oyl in certain small Cells in the Head of the Whale about the largeness of Goose-Eggs or lastly whether it be a certain artificial Composition of the Brain of some Fish dried made up with a Lixivium of Lime In this place I say I will not dispute of this matter it sufficeth me that much Oyly Volatile Salt is contained in the aforesaid Medicament which corrects the Acidity in the bloud and stagnizing Humors This Evil is wont to invade not only the Tip of the Nose but also the Fingers Toes and Soles of the Feet To attempt to render a Reason of this would be superfluous seeing it is manifest that the cold Air doth more affect the Extreamities of the Body than other parts and small Vessels are sooner obstructed than others more capacious To prevent this Evil Cupping-glasses with Scarification are wont to be applied but improperly because the Obstructions are not by this means removed but multiplied and the distorted Vessels are not reverted to their pristine state but more
the other way seems to be far more difficult For they judge that the Pus can in the form of Dew transpire through the Pores of the Diaphragma from within looking outward and so passing through the whole Abdomen at length enter the Cavity of the Bladder through the Pores of the same from without looking inward That such Pores from without looking inward may be found is evident by the following Experiment In an hot Room invert a Bladder and fill it with hot Water and then you will see the Water transpire like Dew When it happens that the Pus copiously contained upon the Diaphragma cannot be expelled by the wounds being too highly sited nor by the Mouth with coughing nor be evacuated by the Bladder with the Urine then is commended a Paracenthesis that is an Artificial Incision in a lower place of the Thorax This Incision is usually made between the fifth and sixth Rib if you number from the Inferiour not in the midst of the Breast but in the Side and this rather in the Anterior than in the Posterior part thereof and rather about the Superiour than the Inferiour part of the Rib and indeed with a Knife having for a good part of it a Cloath wrapped round about just at that moment of time in which the Patient breaths But in this Age wherein we now live and in these Regions this operation is very rarely exercised The Paracenthesis being made the Pus must not be let out all together and at once but at several times This all Chyrurgeons concede to but few of them know why they do so Some say the Spirits would be dissipated if the Pus should be let all out at one time others feign that provident Nature is then sensible of that Vacuum therefore presently sends much yea too much Bloud and Humors into that place But both these Reasons are so very frivolous that they deserve no refutation Therefore I shall briefly declare what I judge to be the reason of this It is certain that into that place from which the hot Pus hath receded the cold Air hath immediate access which doth not only molest the Fibrils before somewhat injured by the Pus but also produceth many Obstructions in the small passages so that in them the Humors stagnize are coacervated wax acid and by that means an Inflammation is excited much after the same manner as when we have been exposed to the cold Air and presently after are well warmed we are not seldom afflicted with Catarrhs as they are vulgarly called and when we are above measure hot and at that time drink cold Beer we are sometimes punished with a Pleurisie OBSERVAT. III. Of a penetrating Wound of the Abdomen A Young man aged Twenty years was wounded by an Adversary of his so that the Sword passed through the anterior part of the Abdomen and pierced through his Back The Patient soon after he was wounded took his Bed and the first days did somewhat complain of this or that Discommodity but afterwards from day to day he waxed better and better and both his Wounds in three weeks space were perfectly consolidated with the use of Tents put in which were first anointed with a good Digestive and a fit Plaister superposited It was not necessary in this case to search into the profoundity of the Wound it being sufficiently manifest that this Wound had penetrated into the Cavity of the Abdomen because the Swords point had passed through the Belly and came forth at the Back Otherwise the profundity of a Wound is wont to be searched out by an Iron or Leaden Probe but better is a Wax-candle which is in Dutch called een Waslichie because it can much more commodiously be bowed and accommodated to all occurrent Meanders Here in the mean while it is to be studiously observed that sometimes the Probe enters very deep passing through the Interstitiums of the Muscles and the Wound notwithstanding penetrates not so far as into the Cavity of the Belly And on the contrary the Wound sometimes penetrates into the Cavity of the Abdomen though the Probe when thrust in presently finds resistance viz. because the parts in the Body hurt were otherwise figured when the sick was wounded than afterward when the state of the Wound was searched into A Wound of the Abdomen though it penetrate not into the Cavity of the Belly yet is difficultly healed by reason of the motion of Respiration For Wounds to be consolidated require Rest But if a Wound of the Abdomen not penetrating be in the White-Line so called then it is much more difficultly healed and very painful In the Second Observation of this Decade I willed the enlargement of very small wounds of the Breast but this Operation deserves not place in wounds of the Abdomen For in such it is to be feared that the Omentum of Bowel through too large an hole of the Belly should slip out of the Cavity of the Abdomen Some dream that the Resurrection of the Dead shall take beginning from the small Bone contained in the 18th Vertebra but they dream indeed without any similitude of Truth Truly I know not what answer men of such an Opinion would give me if I should ask them whether that man should not rise in whom that small Bone had while he lived been broken to pieces by a Wound The Testicles hang without the Cavity of the Abdomen and therefore may be easily wounded yet their being wounded hazards not the life of the Patient For we by experience find that a man can supervive the cutting out of both his Testicles I my self familiarly knew a man studious of Medicine who had both his Stones by reason of a carnous Hernia happily cut off What then are the Testicles They are no other than a certain Congesture of very many most small Threds or Vessels confecting the Seed which Threds if separated each from other without breaking would in a man easily exceed the length of twenty Ells. For the Testicle of a Dormouse is extended to fifteen Ells. Many Chyrurgeons to Wounds do first of all apply repelling things that is things cold and astringent but in wounds of the Groin omit them If you ask their reason they will answer you Because the Emunctory of the Liver is in the Groin This Answer is both frivolous and rediculous and we have already in the Eighth Observation of the First Decade exploded and and sufficiently refuted the same What then is the reason that Chyrurgeons do any where else but in the Groins use cold and astringent things Attend a little and I will tell you Cold and astringent things hurt almost every where but more in the Groins than elsewhere which Experience the Mistress of Fools hath taught them The fact they know and confess but are wholly ignorant of the cause of such an Effect Therefore they seign to themselves such a Chymaera whereas in the mean while the true cause is that certain Glandules have their seat
in the Groins which Glandules are no other than a Congesture of very small Vessels much inflexied in the Meanders of which the Humors more easily subsist than elsewhere if Chyrurgeons by cold and astringent things unseasonably applied retard their Circulation All penetrating Wounds of the Abdomen are dangerous but far more perilous when they are large because the Omentum or Bowel at that time easily slips out and if it be not presently after its Egress forced into its proper place it dies and changeth its colour by reason of the ambient Air. But whence is it that the Omentum for some time remaining out of the Belly so suddenly dies The Omentum consists of very many small Bags into which the Grease is conveyed through several fatty Vessels as the most accurate Anatomists of this Age plainly witness Hence it is now easily manifest how readily the Grease in its small Bags and the Matter contained in the very small fatty Vessels may be coagulated by the cold Air. Now when the Omentum issuing out of the Cavity of the Abdomen by reason of some delay is in the aforesaid manner corrupted then must a Thred be tyed between the sound and the corrupted part and least the sound part also be infected what is corrupted must be cut off and if the Wound be found too large that must be sewed up but the aforesaid Thread hanging out of the Abdomen must be a left so until it falls off of it self in process of time Thus I knew one part of whose Omentum by its too long stay out of the Abdomen was corrupted recovered happily of his Wound who was after the same manner handled by my Father In a large wound of the Abdomen the Bowel sometimes issues which must be presently thrust in for otherwise it is so distended with Flatus's as it cannot be thrust into its pristine place But whence is it that the Bowel is so distended with Flatus's remaining out of the Belly for some short time I answer A certain Fermentation is excited not onely in the Chyle Pancreatick Juice and Choler but also in the Feces left of the Chyle and in the Ferment adhering to the sides of the Bowels Hence arise many Vapours not to mention those Vapours which from the Pores of the small Arteries continually enter into the Cavity of the Bowels which must needs be accumulated in the Cavity of that Bowel and distend it if in the Bowel abiding out of the Abdomen the Pores from within looking outwards be closed up by the ambient Air. Now what remains to be done when the Bowel out of the Abdomen is seen distended with Flatus's The closed Pores are to be opened and greater agitation contributed to the Vapours contained within which may well be effected if a Thred newly twisted but not purged by boyling having been first boyled in sweet Milk be applied hot Then the Bowel the Flatus's being absumed must be reposited and if need be the Wound in some part sewed up If the Bowels be also wounded the life of the Patient is in very great danger and indeed the more if the Wound be inflicted in a thin Bowel but not so if in a more gross Bowel because in this the Wound after it is sewed up is more easily conglutinated the Bowel being such as consists of a greater number of small passages through which the nourishing Humors are conveighed So the gross Bowels generally contain onely Feces but Bowels more slender the Chyle Whilst I here treat of the Bowels a certain Dispute which hath been for a long time contraverted among Physicians comes into my mind viz. whether nourishing Clysters injected do obtain the wished Effect or whether as some say they be wholly unprofitable for Nutrition because according to their opinion they come not so far as to the sanguineous Mass But they err who embrace the last opinion if credit may be given to credible men who taught by Experience witness that the same quantity of Spirit of Wine if injected into the Fundament by a Clyster will sooner inebriate than if taken in by the Mouth The Liver consists of certain glandulous Kernels into which the small sanguiferous Vessels conveying their own Humor are terminated and of the Branches of the Bilary-Pores which receive the Choler separated in those glandulous Kernels Moreover great sanguiferous Vessels are seen in the Liver whence it is easily understood how dangerous are those Wounds that are inflicted on the Liver For if the great Vessels be opened an Haemorrhagia yielding to no Remedies follows And though those great Vessels be not hurt yet a wound of the Liver though but small doth in the mean while disturb the separation of Choler which notwithstanding we know to be exceeding necessary in the Oeconomy of an Animal But notwithstanding these Paulus Aegineta speaks of a man that recovered of a Wound that had taken away a piece of his Liver It is wonderful indeed that one man should supervive the loss of a piece of his Liver and another die by the too-great increase of his Liver So some years ago to my Fathers care was committed a Sick-man afflicted with a vastly tumified Belly continuing so unto Death His Carkass being opened clearly presented the cause of this Evil to the sight for his Liver was incredibly augmented I remember the same hapned in an Hen which never laid Egg the Liver of which weighed an entire pound The Spleen is a congesture of small Membranes formed into small Cells and Concamerations in which Cells innumerable oval and white Glandules into which the Arteries Veins and Nerves are opened do in a wonderful manner adhere Here it is to be understood as an industrious Anatomist of this Age judgeth that the Humor is carried through the Arteries into the Glandules of the Spleen and by the Glandules being there separated and somewhat acid into the above-named small Cells and from those Cells imbibed with an acid Ferment into the Splenetic-Branch and so to the Liver where in the Bloud it in some sort precipitates the Choler to the end that may so much the more easily be separated in the glandulous Kernels of the Liver Hence it is now manifest what great misery a Wound of the Spleen infers on the sick The Reins consists of Glandules into which the small Arteries Veins and Branches of the Ureters are terminated Through the small Arteries the Humour is deferred into the Glandules of the Reins in which the Urine is separated and taken from the Branches of the Ureters is forced into the Bladder That the matter is thus you will more easily believe when you shall know the following Experiment which a certain Professor communicated to me and is this If you by a Syringe inject warm Milk into an emulgent Artery the more gross part will return by the emulgent Vein and the wheyish Portion be sequestred in the Reins and thence conveyed into the Ureter Hence it is apparent how perilous Wounds of the Reins