take care that by appointing a due meet course of Diet there may be generated sufficient store of good blood But for the drawing of this unto the place affected frictions are more especially to be made use of Yea indeed almost before the use of any Topicks the frictions or rubbing of the head are to be administred as Galen teacheth us in his first Book of the Composition of Medicaments according to the places Chap. 2. For Friction doth both attract the Aliment unto the head and also strengthen and thicken the skin If this falling of the hair proceed from the pravity of the humors then universal purgations if need require being first premised the head is often to be rubbed and discussives are to be administred but yet let the Discussers be moderate especially if there be a concurrence of an abundant aliment left that by the excessive and overmuch use of them the aliment be likewise dissipated and the skin rendered over thin and therefore Ladanum is very fitly mingled together with the Unguents If the Defluvium depend wholly upon the thinness of the skin then we ought to apply those things that condense and thicken the skin Galen commendeth especially Ladanum the Oyl of Mastick and the Oyl of Myrtle mingled together Or else let Ladanum be dissolved in Wine and so made use of And Ladanum is also very fitly administred in almost every falling off of the hair But in regard that it is of too thick consistence in it self to be anointed with it is therefore to be dissolved in somthing that is liquid Wine or Oyl and indeed such an Oyl is to be made choyce of that may satisfie and answer the cause But seeing that Unguents and Oyls are troublesom unto many who wil not endure that their heads should be anointed with Oyntments or Oyls therefore for these we must provide Lotions for the head that please them better which are to be made or Southernwood Maidenhair Golden Maidenhair Mastick Roses Rosemary Ladanum And we must here again repeat what we gave you notice of about the end of the foregoing Chapter to wit That there are some who appoint and not without good reason such kind of Medicaments to be made for the recovery of the hair that do not only by a manifest quality take away the cause of the shedding of the hair but such as also by an occult and peculiar faculty do conduce unto the breeding of hair and such as these are only known by experience And these are al the Capillary Herbs Southernwood Reed root sharp-dock root the root of the greater Bur Asarabacca Ladanum Honey and Water destilled from it Bees beaten together with the Honey-combs or the pouder and ashes of them aâ— also of Wasps Flyes Moles Mice the Land Urchin Bears fat and Serpents fat Of which there are made many Compositions As for instance Take the Rind of the Reed root burnt Bees ashes of each two drams Southernwood burnt one dram Ladanum two drains Honey half an ounce Oyl of sweet Almonds and Bears fat of each as much as wil suffice and make a Liniment For the shedding of the hair after sicknesses this following is found to be good Take Maidenhair Southernwood Golden Maidenhair of each half a handful the Leaves of Myrtle of Roses and of Wormwood of each two pugils boyl them in a sufficient quantity of common Oyl and red Wine until the Wine be wasted then strain and squeeze them hard Take of the aforesaid Oyl four ounces Ladanum one ounce Mastick half an ounce and mingle them according to art Or Take Root of the Bur-dock six ounces Maidenhair three handfuls Southernwood one handful Pour thereunto as much white Wine as wil suffice and let them be destilled in a bladder Vnto what is thus destilled if you please you may add the Water of Honey Or else let the Roots of the Bur-dock be boyled in Ley and the head washed therewith Chap. 4. Of Alopecia and Ophiasis Alopecia THat which is called Alopecia and Ophiasis is a peculiar kind of the falling of the Hair Alopecia is so termed from Foxes because that this kind of shedding of the Hair is familiar unto them But Ophiasis is so called from its figure Ophiasis because that the bald and smooth parts destitute of their Hair and writhed seem like unto Serpents It is common unto both these Affects that in them the Hairs fall off areatim as they term it and hence it is likewise that this Malady is in the general called Area And Celsus in one and the same Chapter treateth of Area Area Alopecia and Ophiasis Now the name of Area is imposed upon this Affect from Country Garden-plats For as there the Beds or quarters are distinct and in certain places only and as these Beds when they are void of Plants are Naked and bare so it is likewise in these Areae for here in certain places the Skin appeareth smooth bare and slippery These Affects differ only in their figure For Alopecia hath no certain figure but as Celsus saith is dilated under any kind of figure But the Ophiasis creepeth up and down writhingly like unto a Serpent and one while being extended from the hinder part of the Head it creepeth along on both sides the Head even unto the Ears the breadth almost of two fingers and as soon again being carried beyond the Ears it creepeth forward Serpent-like even unto the very Forehead it self And moreover there is in the Ophiasis far more hurt and danger in the Cause thereof so that not only the roots of the Hair but even the Skin it self also is eaten and gnawn thorow to wit as far as the roots of the Hair reach The definition of Alopecia and Ophiasis And so Alopecia and Ophiasis may be thus defined that they are a falling off of the Hair after the aforesaid manner areatim having its Original from a corrupt and depraved humor gnawing assunder the roots of the Hair The Author of the Book of Medicaments soon provided referreth the Alopecia and Ophiasis unto those Affections that vitiate and marr the Colour of the Hair But we are to know that this is not proper unto the said Areal falling off of the Hair but that this change of Color in the Hair doth either precede the Alopecia and Ophiasis to wit when from a vitious Nutriment the Hair first becometh white but afterwards they fall off or else the colors of the Hair are changed after the Alopecia and Ophiasis For when after the Areae Hairs are again bred they are then either white or yellow like as it is in Horses after that the hair is fallen off by reason of some Ulcer caused by attrition or gauling there is wont in the place thereof to appear and grow again white hairs which happeneth from a vitious Nutriment and the weakness of the Skin And of this Celsus gives us notice in his sixth Book Chapter 1. to wit that the Ophiasis is extended unto the Hair
is that these Medicaments that even now we named and those that we shal hereafter further mention do not al of them generate hairs only by their manifest qualities and by taking away the Causes of the falling off of the hair but that they likewise produce hair by some occult quality that is in them such like Medicaments are therefore especially to take place in the production of a Beard not where there hath been a shedding or falling off of the hairs of the Beard but where they never as yet grew It is also wel known that it much conduceth unto the speedy growing of the Beard if the first soft hairy down upon the Chin be often shaved off by which means the Aliment is the more abundantly allured and drawn unto the Roots of the hair For the furthering and hastening of the Beard these following Medicaments are likewise commended Take Oyl of Dill Oyl of Spike of each five ounces the tender Sprigs of Southernwood two handfuls Squils three drams the best Wine three ounces let them boyl until the Wine be consumed and then use it Or Take Oyl of Garden Pinks and sweet smelling Spike of each three ounces Oyl of Roses four ounces of Cloves one dram of Ladanum two drams sweet smelling Wine two ounces Let them boyl al of them unto the consumption of the Wine Add of Musk one scruple and mingle them Chap. 3. Of the shedding of the Hair ALthough as we have already said al shedding of the Hair may be termed a Defluvium or falling off yet nevertheless use and custom have so far prevailed that the shedding of the Hair here and there in the Head in al or most parts thereof is in special termed a Defluvium or falling of the Hair so that they fal not only in one place but either they al fal off throughout the whol head or at least they most of them fal away in most parts of the Head The Causes There is not one Cause alone of this Defluvium of the Hair but the Causes are many to wit Either the want of Aliment or the pravity of the humors corroding the roots of the hair or the thinness of the skin not admitting the aliment of the hair The two former Causes have their place in those that are Phthifical in whom if the hair fal off this cometh to pass as Galen tels us in his Comment Aphotism 10. Sect. 5. because there is here both the greatest defect of Aliment and somtimes also the corruption of the humors The same happeneth for the most part in malignant Feavers such especially of them in which the Brain being withal affected the sick persons are seized on by a Delirye or Dotage For even in these Feavers also the sick parties are greatly extenuated and there is wanting unto the body a necessary aliment and the depraved humors likewise lie gnawing at the roots of the hair and eat them asunder The hair also falleth off in those that have the French Disease by reason of the pravity of the humors which somtimes happeneth likewise unto those that have drunk poyson and it is reported for a truth That whosoever toucheth the Salamander his hairs wil shed and fal away Bun somtimes also the hair fals off by reason of the thinness of the skin and this happeneth unto Women and especially in the Summer time And hence it is that those who travel out of Germany into Italy or other hot Regions find now and then this shedding of their hair for by the heat of the Ambient Air the Skin is made thin and it chanceth also that the matter out of which the hair ought to be generated doth withal transpire Signs Diagnostick The Defluvium or falling of the hair that is in special so called is easily known by the continual shedding of the hair But it is distinguished from baldness the Alopecia and Ophiasis because that in Baldness the hair fals off in the fore part of the head only but in Alopecia and Ophiasis the hair fals from al parts of the head and the head alone but then in this Defluvium the Affect we now speak of the hairs fal off in al parts of the body equally one while more and another while fewer of them But from what cause it is that they fal off may be known from the causes that went before For if there went before any sickness that was in it self apt to consume the aliment of the Body it is then credible that the shedding of the hair proceedeth from the scarcity of the Aliment But if vitious malignant and depraved humors excite and cause any disease it is then an argument that the falling of the hair proceedeth likewise from the pravity of the humors If lastly there went before causes rarefying the skin it is then probable that the said Defluvium of the hair proceedeth from the thinness of the Skin Prognosticks 1. Among al other the species of the shedding of the hair this Defluvium in special so called is most easily cured unless the cause be such as is not to be removed For the skin hath not as yet contracted any preternatural disposition that is difficultly cured And therefore it is that the Defluvium or falling of the hair that happeneth after acure and malignant Feavers is easily cured when the Feaver being healed there is an Aliment again supplied unto the body and the hair that is already fallen off is for the most part restored without the use of any Medicaments 2. But in the Consumption such a defect of the Aliment and such a vice of the humors cannot by any means be amended And therefore in this case there is not only no cure to be had for this shedding of the hair but the sick persons die also And therefore in such as are in Consumptions the falling of the hair is a sure and certain sign of Death approaching as in the fiftth of the Aphorisms Aphor. 11. 3. If the hair fal off by reason of the skins thinness it may then by the use of thickness be restored without any great difficulty The Cure The shedding of the hair is cured by taking away the cause upon which if dependeth If therefore the hairs fal away from the scarcity and want of Aliment it sheweth us that we must use our endeavor that there may be sufficient aliment bred in the body and that that which is bred may be drawn unto the skin of the head If this Defluvium be from the depraved humors and these be supplied from al parts of the body they are then to be evacuated but if they lie only at the roots of the hair they are then to be discussed If these humors be of a poysonous Nature as in the French Disease we ought then to meet with and oppose that poyson If the Affect proceed from the thinness of the skin the skin is then to be thickened If therefore this Defluvium or falling of the hair arise from the want of Aliment we ought then especially to
cal Pityriasis Scurf and Dandrif and which is by the Latines called likewise Porrigo is an Affect wherein when there is any scratching there falleth down out of the Skin of the Head something very like unto Bran and indeed most usually from the Skin that is under the very hairs themselves and sometimes also from the Beard and the Eyebrows The Causes The Cause of this Affect are humors that are serous or wheyish and also Ichores or thin Excrements not only such as are flegmatick but such as are Cholerick also elevated unto the Head together with that humor that yieldeth and supplieth matter unto the hairs and hence it is that this furfuration or scurfiness doth appear only in those places of the head that have hair upon them for this matter seeking a passage forth through the Pores of the Skin the thinner parts of them are discussed but the more thick and Clammy parts stick in the Skin about the hairs and there they pass into a matter that is like unto Bran or Scales The antecedent Causes are all those that may any way generate thâ—â—â— serous humors in the Head But now the mater 〈◊〉 attracted and drawn unto the Head in those especially that have a hot Brain Signs Diagnostick The Affect it self sufficiently manifesteth and discovereth it self when the Head is Scratcht Rub'd or Comb'd for then there fal down certain smal scales resembling Bran. The Prognostick This Affect hath no danger at all Joyned with it yea by some it is accounted for a very good Sign of a sound Brain expelling and driving forth the excrements from it self and yet nevertheless it causeth some kind of deformity and much trouble The Cure The vitious humors if they abound in the body are to be evacuated and care taken that they may no more be generated But unto the Head it self Discussive Medicaments are to be administred There are some likewise that therewith mingle some certain Astringents that the part affected may be strengthened lest that it easily receive the humor that floweth thereunto But then it is to be feared lest that the transpiration in the Head be hindred and the excrements therein contained excite far worse and more grievous Maladies And therefore as Galen in his first Book of the Composit of Medicaments according to the places Chap. 5. teacheth us the Head is to be washed with the Decoction of Fenugreek the Juyce of Beets and Nitre Or else it is to be Cleansed with the Decoction of Melon Seed the meal of Cicers Lupines and Beans Or else let it be washed with the Decoction of Cicers and Melons adding thereto a little Vinegar When the Head is washing in stead of Soap bitter Almonds bruised may be made use of If the Malady be confirmed and wil not yield let the Head be first washed with the Medicaments but just now mentioned and after this let it be rub'd with a course Cloth and then anoynted with this following Unguent Take Green Hyssop Ducks fat of each half an ounce the pulp of Coloquintida Oleum Cherrinum or the Oyl of Wall-flowers of each one ounce Thapsia two drams Ladanum two ounces and make an Vnguent Or else let the Head be washed with the Decoction of Beets and the lesser Centaury adding thereto Vinegar and Honey Or Take Marshmallow roots the Leaves of Beets of each one handful Pulp of Coloquintida half an ounce Nitre two drams boyl all in a sufficient quantity of Water to the Consumption of the fourth part and in the end add of Wine one pint After the Washing let the Head be anoynted with the following Unguent Take Copperas and the Gall of a Bull of each one dram and half Nitre and Sulphur of each two drams Oyl of Roses two ounces Mingle them over a gentle fire and adding thereto a sufficient quantity of Wax make a soft Vnguent You may see more of these Medicaments in the place before alleadged out of Galen and likewise in Paulus Aegineta and Alexander Trallianus Chap. 9. Of Plica Polonica ANd lastly among the Vices of the hair we must not in silence pass over that which although indeed not known in all places yet nevertheless may very wel be accounted the chief of them all It is called Plica to wit because that in it the hairs are wholly entangled one within another and by the Polonians Gvvodzicc that is a Club and by the Roxolani it is termed Koltun which signifieth a little Stake or small Post whereupon it is also by some called Helotis Others call it the Disease of the Locks the Germans Wichtelzopffe because they superstitiously conceived that such like Locks of hair were entwisted by Infants dying unbaptized for these by the Ancients were called Wichteln as likewise Mareuflecht Marenwirckung Marenlocht Schrottlinszopffe Indlezoppffe because they were thought to be knit and twisted by some Incubus in the likeness of a Jew This Disease is very familiar and as it were Epidemical especially unto the Polonians insomuch that Necessity enforceth them to ask the advice and to implore the assistance of the Physitians of Padua I had rather therefore give you the History hereof in the very words of these Physitians then in mine own Now therefore thus writeth D. Laurentius Starnigelius Rector of the University of Zamoscium and Professor of Rhetorick unto the Physitians Profesors of the University of Padua the last day of October in the yeer 1599. Excellent and Worthy Sirs our most dear and greatly to be respected Friends IN regard of that neer and Intimate acquaintance that we gained during our Converse and abode in the lowest Sarmatia with you most Excellent and Noble Doctors by reason of that common bond and tie which the best of Arts had knit between us and your Excellencies I the Rector of the lately erected Vniversity at Zamoscium held my self bound to write unto you my Noble and ever honored Friends famous indeed and renowned not only by the antiquity and eminency of the most Noble Vniversity of Padua but also far more enabled and dignified by your Learning and Practise The Cause of this my writing unto you was given me by the Novelty of a Disease among us and the extream difficulty of Curing thereof My request is that you the most Eminent Professors of the Vniversity of Padua would both please to read this my Epistle according to your wonted Candor and Courtesie and likewise when you have read the same that you would vouchsafe friendly to write back unto me your Advice and Judgment of what nature and quality you conceive the Disease to be what Precepts you think fit to be given touching the same what kind of Medicaments you Judg most expedient for the removing of the same The Case stands thus Betwixt Hungaria and Pocutium a Province of the Kindom of Polonia which are distinguished the one from the other by Mountains out of which there break forth divers Rivers it so happened that very many both Men and Women had one or
beyond Natures intention and hath its production from somwhat that is preternatural and comes to be adjoyned to some one or other part Nor is it of any validity what Rudius here objects That in Tumors which have their original from the humors and those likewise which have for their causes the strutting forth and falling down of parts and such like that there the difference is to be taken from the efficient next and containing cause and that from this cause we may gain excellent artificial and profitable Indications but not so from the consideration of magnitude augmented For albeit they differ in the containing special cause that this is now and then an humor somtimes above and somtimes also an Intestine or Gut fallen down yet in the general cause they agree which is some one thing or other preternatural added unto the part and swelling it up into a Tumor And in every Tumor as it is likewise in al other diseases depending upon the cause containing no profitable Indicacion can be gained or may be expected from this cause no not in those Tumors which have their dependance upon the influx of humors For the general Indication though it be altogether useless is this that the humor which lifteth up the part into a tumor is to be removed but how and by what means this may be effected is wholly left unto the skil of the knowing Artist In the mean time I wil not deny but that those tumors which have their original from the humors may fitly enough be ranked among the diseases that are compounded of augmented magnitude distemper arising from the afflux of matter and a vitiated figure yet however this is not to be granted in al Tumors And hence it is without doubt that Galen hath placed the Tumors one while amidst the Affects of the similary parts as in the twelfth Chapter of the difference of Diseases and assoon again among those Diseases we call organical and this he doth in the thirteenth of his Method and first Chapter Neither is it to be denied That now and then Authors whilst they make mention of preternatural Tumors do not intend al Tumors in general such as are also those that are produced by the falling down of the bowels or by some boney substance sticking out but those in special which are caused by the afflux of humors and these are evermore diseases that may properly be said to be compounded of magnitude augmented intemperies an unmeet figure and most usually also the solution of Unity The Cause The containing Cause of a Tumor as we take it in the general is somthing beyond Natures intent added unto a parâ— which elevates distends and swels it up to a more than ordinary greatness The Difference Now the matter which we say is added being threefold to wit a Humor a Wind and a solid Substance the primary Difference then of Tumors ought to be taken from that which we commonly term the Containing Cause Tumors then are somtimes thus differenced that some are great others not so some external some internal some new others that are of longer standing But these differences are meerly accidental denoting a certain mutation or change and an alteration of the condition but the species oâ— kinds they vary not in the least But the differences specifical and which constitute the several kinds are taken from the matter and the containing Cause which is threefold as hath been said First of al therefore Tumors derive their very being from the humors but these as yet have not obtained any peculiar appellations to be called by but at leastwise are al of them comprehended under the general name of a Swelling yea as some say they are only called Tumors Secondly Winds it shut up in any part distend the same and lift it up into a Swelling or Tumor and this sort of Tumors the Grecians cal Emphysemata the Latines Inflationes by reason of their windy original In the third place now and then somwhat resembling flesh or skin or that is hard and solid as a bone and other such like matter is super-added unto some one part and there causeth a Tumor or Swelling But in regard that these very substances have their original from the humors we will thereupon adjoyn this sort of Tumors unto the first kind And lastly even the very solid parts of the body themselves cause Tumors whenas they change their place together with their scituation and slip down upon some other part which they both distend and elevate neither have these any peculiar names to be known by There are yet some other differences behind From the quality of the concomitant matter some are said to be hot others cold some moist others dry some soft and loose others hard From their magnitude the greater of them are by a general name simply called Tumors the less Tubercula From their scituation that some are internal others external and these again either more deep and profound or else superficial From their figure some of them are said to be broad others again sharp-pointed But now to comprehend al those differences of Tumors under names and to give you the number of them is not very easie to do Galen in the close of his Book of Tumors writes That there was not any one kind of these preternatural Tumors which there he had omitted but that he had spoken of them all and had not left any one unmentioned And out of that Book Johannes Philippus Ingrassias in his Book of tumors first Tract first Chapter and second Commentary pag. 77 hath collected Sixty one Tumors which he reckons up in this order 1. Corpulentia 2. Phlegmone Tumors their number and names according to Galen 3. Abscessus calidus 4. Sinus 5. Fistula 6. Abscessus ex solidis humidisve corporibus that is to say an impostumated matter issuing from solid and moist bodies 7. Atheroma 8. Steatoma 9. Meliceris 10. Anthrax 11. Cancer 12. Gangraena 13. Sphacelus 14 Erysipelas 15. Herpes similiter 16. Herpes Esthiamenos 17. Herpes miliaris 18. Scirrhus 19 Ecchymosis 20. Aneurisma 21. Oedema 22. Phagedaena 23. Vlcus Chironium seu Telepium 24. Scabies 25. Lepra 26. Elephantiasis 27. Exostosis 28. Satyriasmus seu Priapismus 29. Achor 30. Cerion 31. Myrmecia 32. Acrochordon 33. Psydracion 34. Epinyctis 35. Dothien 36. Phyma 37. Bubon 38. Phygethlon 39. Struma 40 Sarcocele 41. Hydrocele 42. Epiplocele 43. Enterocle 44. Entero epiplocele 45. Cirsocele 46. Varices 47 Bubonocele 48. Exomphalos 49. Ascites 50 Tympanites 51. Anasarca 52. Epulis 53. Parulis 54. Thymus 55. Vva 56. Paristmia 57. Antiades 58 Polypus 59. Encanthis 60. Vnguis 61. Staphyloma But Ingrassias himself not content with this number Tumors their number and names according to Ingrassias Tumors of the Head are twenty seven adds unto these one hundred sixty five more to wit of such properly belonging unto the head twenty seven the which in page 301. he enumerates after this manner 1.
man who weighed more than four hundred pound yet notwithstanding this man appeared in publick and to tel you the whol truth in this Person Nature began to assay some certain kind of evacuation of the serous or wheyie humor by the Navel And the very same hath been found to happen unto others also in whom the Body hath attained unto so immense a bigness that they could neither move nor yet so much as breathe freely But now in such like Persons as these there is not an equal augmentation of all the parts of the Body as it is in them who grow and are naturally enlarged but only of their Flesh and of their Fat there is an excessive and over-great encrease The Causes The conjunct Cause therefore of this Tumor of the whole Body is the Flesh and the Fat. And here truly one while the Flesh and otherwhile the Fat is augmented and sometimes they are both alike encreased But the Antecedent Cause is the over-great abundance of Fat and good Blood And for this cause it is that this Tumor is referred unto Tumors proceeding from the Blood And yet notwithstanding the Reason of these is far differing from that of other Tumors arising from the Blood For the conteining Cause of bloody Tumors is the Blood but the conteining Cause of this Tumor is the Fat and Flesh and the antecedent Cause is the Blood The rest of the bloody Tumors that are properly so called spring from the Blood issuing out of the Veins or Vessels into some other places which never hapeneth in this extream and extraordinary corpulency in the which Blood is never known to fall or issue forth into other places but it is evermore put unto the Body But now what the Causes may be that much Flesh and Fat should be generated will easily and soon be discovered if we wel consider the Causes of breeding Flesh and Fat Now then Flesh is abundantly bred in those whom we call Eusarcoi that is Persons of a pure untainted and sound Flesh yet alwaies provided that the material cause of Flesh to wit nourishing Food be not wanting and likewise that the native virtue generating Flesh be as it ought to be vigorous and active That which administers matter towards the breeding of flesh is great abundance of good blood the which to produce and generate meats of a good and plentiful juyce and also a due and right temper of the Liver to wit hot and moist are evermore requisite But now again that much Flesh may be bred from much Blood it is required that there be a sound and healthful habit of Body and a good temperament of the musculous parts in the Body which said temperament is likewise hot and moist Hereunto also as we are to understand very much conduceth an easie or idle kind of life in the which there is not much Blood wasâ—ed as also the suppression of their accustomed bleedings and evacuations of Blood especially in Women As touching the original and increment of Fat many and various are the Opinions and controversies among the Physitians at this very day the which for me in this place to examin were altogether impertinent And therefore in a word we say that Fat is generated from the Oyly and fattish part of the Blood falling from out of the Veins and Arteries into the membranous parts and there digested by the innate virtue and temperate heat of the Membranes That great store of Fat should be bred in the first place the Liver is a principal cause thereof For if by reason of its excellent and perfect temperament it doth not generate either much earthy and cold nor much cholerick and hot juyce but produce a sweet fat and oyly Blood and fil the Veins and Arteries therewith and if this Blood be not consumed or wasted in the habit of the Body but that it stil continue to be more cool and moist then this Blood is there converted into Fat Ease likewise and the intermission of Exercise the retention of accustomed evacuations aliment temperately hot and moist and generally all things which either outwardly or inwardly any waies conduce to the making up of a plentifull and temperate mass of Blood or that have in them an efficacy in qualifying and allaying the over-intense heat of the Blood of the Entrails and of the habit of the Body Hence it is that Galen hath left it upon record that all Bodies tending towards a cold and moist temperament become Fat. And with this of Galen agreeth what Prosper Alpinus in his Book of the Egyptian Physitians Chap. 9. hath written his words are these The Bodies of the Egyptians saith he are hot and dry in regard that they live under the hottest and withall dry position of the Heavens but because they moderate and lessen this heat and driness by their dayly drinking of water by their continual use of meats that have in them a cooling virtue and likewise by their frequent use of Baths which they make for themselves with sweet Water their bodies hereupon become extraordinarily fat to fat that he never beheld in any part of the world in so great a number and generally such extream fat and gross Persons as he saw at Grand Cayre in Egypt For he reports that very many of them are so exceeding gross and corpulent and generally so fat in their Breasts that they have Paps of a far larger size and thicker than the greatest that ever he had observed in any Woman Other things there are which demonstrate unto us the truth of this assertion to wit that a hot temperament of the Liver makes very much for the breeding and augmenting of fat For I my self knew a Person of Honor who after he had been sick and was recovered of a malignant Feaver grew to be so extreamly fat and gross that he could very hardly move or stir himself in any place where he fat and as for the bulk of his body he came never a whit behind him whom we have formerly mentioned Signs Diagnostick As concerning Corpulency therefore it is sufficiently obvious to every mans Eye But then whether or no it only produce some kind of deformity and be no more then a Symptom or else whether it be not to be accounted a Disease or preternatural affect the hurt and offended actions wil evidence unto us of which we wil now speak Prognosticks 1. What the inconveniencies and discommodities are that this over-great fleshiness or as we term it extream Corpulency carries along with it I shal give you an account thereof in the words of Avicen that expert Arabian Physitian For thus he in his fourth Book Part 7. Tract 4. Chap. 5. Superfluous fat saith he is that which hinders the body from and in its motion walking and operation and streightning the Veins with an undue and dangerous constriction whereupon it oppilates and stops up the passages of the Spirit so that hereby it is many times extinguished and for the same reason likewise it is
parts are as I may so say embrued with blood yet notwithstanding there is a certain order observed to wit that some of the parts should sooner receive the fluxion and others of them not til afterward until that at length all of them come to be replenished and distended by the humor Now this kind of order wholly depends upon the natural distribution of the greater Vessels conteining the blood For whereas the Veins and Arteries when they first of all make their entrance into the aforesaid Vessels are evermore the larger and by how much the deeper they are distributed thereinto so much the less they are all this while there ariseth no Inflammation unless it so chance that the blood be emptied forth into those smallest Veins and again happen to fall out of them And this that hath been said manifestly appears unto those that by an exact and accurate inspection take a right view of those very little and almost imperceptible Veins that are branched forth and extended unto that Tunicle of the Eye which Oculists usually call Adnate or Conjunctive For these indeed do evermore convey blood unto the Eye for its nourishment and yet notwithstanding whilest that the Eye is free from distemper they are so exceeding smal that they can hardly be discern'd by the sharpest sighted Eye But then so soon as the Eye is inflamed those slender Veins are preternaturally replenished with blood then they shew themselves and become very conspicuous And it is most agreeable to truth that thus it should be also in al other Inflammations whatsoever they be But as yet there is no Inflammation present albeit the lesser Veins are even filled up with blood until that at length by and thorow them the blood be derived into the remaining substance of the parts which may be done two waies For in the first place the blood is emptied forth by those very smal and most inconsiderable orifices of the Veins by which the Veins do as it were gape open themselves into the surrounding substance of the part that so thereby the blood may through them the more easily drop forth for nutrition or nourishment Moreover likewise it strains and sweats through by the Tunicles of the Veins for even the Tunicles of the Veins are in like manner so framed by nature that they are not without their pores through which if not the blood it self yet certainly the ferosity or wheyiness thereof and its thinner part is exâ—udated or sweated forth by a kind of percolation From what hath been hitherunto spoken the distinction of the conjunct cause from the cause meerly antecedent in an Inflammation is sufficiently apparent For the blood which we have asserted to be the cause of a Phlegmone doth in a double respect take upon it self the virtue and Nature of a cause For either it is the next conteining and conjunct cause of which we have hitherto discoursed to wit as it hath already flown into the part and is irremovably impacted therein so far forth that it actually elevates that same part into a Tumor or else it is the antecedent foregoing cause to wit The antecedent cause of an Inflammation as by reason of its abounding in the body it hath a power of slowing into and by its influx of lifting up the part into a Tumor or Swelling The which antecedent Cause in an Inflammation like as also in other Tumors fals again under a twofold consideration to wit either in regard of the Affect simply considered as it is to follow upon this cause which it hath a power to excite although as yet it hath no being in the body And so a Plethory which is an extream and overgreat fulness of good and laudable blood is very frequently present in the body albeit an Inflammation doth not instantly ensue thereupon Or else secondly it is considerable as preceding and foregoing the affect that already hath a being and is already actually existent in the Body to wit when as the Blood now floweth to the exciting and augmenting of the Tumor Which to speak truth is more rightly stiled the antecedent cause then was the former since that this latter hath respect unto an effect already present but the former relates only unto an affect which hapneth in the future time But this antecedent cause that it may flow together unto the place affected it is thereunto moved and stirred up by other means whilst that it is either transmitted from some where else or else attracted by the part it self for those very causes we have hitherto been treating of and explaining But now for those Causes which we commonly term Procatartick The remote Causes more remote and primitive they are such as either conduce to the breeding of a copious and a plentiful blood as do al meats of good and much juyce an easie and idle kind of life and other such like requisites Or else they are such as render the blood more acrimonious and sharp as do all things that cause heat al acid and tart aliments wrath watchings stirrings and exercises in the extreme or else such as excite and stir up the blood to move unto the part affected as doth the overgreat heat of the part pain proceeding from a wound from a fall from contusion or beating from a fracture from disjoyntures and the like causes or else the weakness and imbecillity of the part affected receiving compared and considered in reference to the vigour and strength of those other parts which transmit the abundant store of hot blood unto the aggrieved part Notwithstanding an Inflammation never happeneth to be generated by a leisurely and gradual storing up of blood but it is evermore bred by a sudden and thronging affluence and influx of the said blood For although it may so chance that some kind of Humor may sensibly and by degrees be collected in some one part which being heaped up as aforesaid may afterward begin to excite a certain kind of pain in the part yet notwithstanding al this an Inflammation is never produced until such time as the pain gives cause sufficient that a more plenteous store of blood should forthwith and very easily make its approach Notwithstanding we are to take notice That although the Blood be the containing and antecedent Cause of an Inflammation yet notwithstanding we say that a Cacochymy or a depraved ill digestion and more especially sharp and cholerick humors are the prime and principal cause that the blood be moved unto the part affected in those Inflammations which are excited without any apparent cause as Wounds Contusions and such like For so it is That when Nature is twinged and pulled by such like Humors and yet notwithstanding is unable altogether to expel them out of the body to the end that she may free the principal parts from the danger impending by reason of them she assays to thrust them forth unto the external and less principal parts the which when it is not able to accomplish
Butter or with the fat of an Hog or with some other fit Digestive But if the hole be not wide and large enough it may very easily be dilated to wit if either a little piece of Spunge or Gentian root or Rape root dry be put thereinto For these things aforesaid when they are filled full with humidity they are then dilated and so consequently widen and enlarge the hole The Spunge is thus to be prepared the Spunge is to be wel soaked in the white of an Egg twice or thrice throughly shaken together then afterwards let it be close squeezed together on all sides and then let it be leisurely dried in the shade a smal portion of this when it is dried is to be taken and put upon the Ulcer But in regard that the crustiness thereof wil not fall off in a few daies time and that all this while the Pus or filthy corruption unless it stick immediately under the Skin is detained and imprisoned in the Impostume for this very cause if there were no other it is by far the safer way to open the Impostume with an Iron The Impostume being now opened whatever the way of opening it hath been the Pus or matter is to be evacuated but yet this needs not evermore to be wholly all at once or altogether For if the Impostume be great and contain much Pus within it neer unto the Arteries and Veins the whole matter and filth ought by no means to be evacuated all at once lest that together therewith much of the Spirits be likewise evacuated and dissipated and so by this means the sick Person should be caused to faint and swoon or be debilitated and weakned but rather the corruption is to be emptied forth by some and some especially if the Patient be weak or a Woman with Child or in case the Patient be a Child or lastly if the sick party be very aged When the Pus is evacuated if either pain manifest it self or else any reliques of the matter not suppurated appear in the circumference and it be so that the Pus it self be not wel and perfectly ripened then the pain is to be mitigated and more especially the remainder of the matter is speedily to be converted into the said Pus by some concocting Medicament which they commonly call a Digestive And such is that which is made of the Oyl of Roses and the Yelks of Eggs for it greatly mitigates the pain and helps forward the generating and breeding of the Pus so often mentioned Or Take Turpentine one ounce one Yelk of an Egg the Pouder or Dust of Frankincense one dram Oyl of Roses three drams mingle them wel together Likewise the Emplaster Diachylon simplex is very profitable in this case When this is once accomplished even while the concoction doth yet appear we must come to those things that throughly cleanse and purge it for neither can there flesh be bred nor any conglutination by drawing together the Lips of the Impostumated part be made unless the part be first cleansed Which to effect Take Clear Turpentine one ounce Honey of Roses six drams the Yelk of one Egg let them boyl together a little and afterward add of Saffron one scruple and a little quantity of Barley meal If there be need of a greater cleansing you may then add the juyce of Smallage As Take of crude Honey Barley meal of each alike one ounce of the Juyce of Smallage half an ounce Saffron half a scruple and mingle them If yet there be occasion for a more forcible cleanser there may be added of the Vngueut Egyptiack as much as wil suffice Centaury the less and round Birthwort is here likewise very useful As Take the juyce of the lesser Centaury two ounces Smallage one ounce Honey three ounces let them boyl together and after add of Barley meal and the Vetch Orobus of each six drams when they are taken from the fire add of Turpentine one ounce of the Pouder of the Flower-de-luce root one dram mingle them The Impostume being throughly cleansed such Medicaments as breed cause flesh are to be administred Now of what sort these are Galen in his third Book of the Method of Physick the second third and fourth Chapters teacheth us at larhe and we have likewise declared them in our Book of Institutions As for example Take Frankincense Mastick of each half an ounce Colophony two ounces Oyl of Roses and Honey of each as much as is sufficient let them be mingled Or Take The greater Comfrey one handful Betony Saint Johns-wort Hors-tail Grass of each half a handful boyl them in Wine and bruise them wel out of the mash of them squeez forth a Juyce and add of Frankincense and Mastick of each one ounce half Dragons blood an ounce Honey and Turpentine of each a sufficient quantity boyl them until the juyce be consumed and make an Vnguent Or Take Myrrh Aloes Sarcocol of each an ounce Honey six drams White Wine as much as wil suffice boyl them to an indifferent thickness When the Ulcer is filled up with Flesh then those Medicaments which we cal Epuloticks that is such as bring to a Scar are to be administred of which we have in like manner spoken in our Institutions such as are the Emplaster Diapalma or Diachalciteos de minio of Vigo and others which are every where known Chap. 6. Of the Sinus in the Tumor BUt it oftentimes so happeneth that although the said Pus or snotty filth be emptied forth of the Impostume yet notwithstanding it becomes again replenished from whence it comes to pass that the adjacent Skin doth not close fasten and grow together with the Flesh that is underneath it but there is a certain cavity or hollowness left to remain and at length there ariseth a certain difficulty if not impossibility of cementing and conjoyning the skin with the Bodies lying underneath which affect the Greeks cal Colpos and the Latines term it Sinus to wit when the enterance into the Impostume and Ulcer appears narrow enough but the deeper and more profound part thereof diffuseth it self into a breadth The Causes Now for the most part the Causes of this Sinus are Impostumes or Suppurated Tumors over-slowly opened or not wel cleansed For the corruption if it be longer deteined in the deep place than it ought to be acquireth a certain kind of sharp corroding quality and there causeth divers winding passages and turnings such like as we find in Coney-borrows and so unto the part in this manner affected there flow together from the neighboring parts yea from all the whole body such excrements and such humors as superabound from whence afterwards it chanceth that this kind of Sinus or windings to and fro can very hardly be conglutinated and filled up with Flesh The Differences But now of these Sinus there is an exceeding great diversity for they differ not only in the dimension of quantity that one should be less and shorter and another
end of the disease after other evacuations without any remission or abatement of the symptoms and together with a great debility of the Natural powers and strength of the body these are very dangerous and pernitious 4. As for those of them that break forth and shew themselves symptomatically and have their original from crude and extreamly opposite and as I may so say rebellious matter these evermore prove to be pertinacious i. e. resisting all good means that shal be used and they alwaies make much work and business both for Nature and the experienced Physitian and withal they cast the Patient into an extream hazard and the greatest dangers that may be For why they are in a place very nigh unto the Brain from the which both humors and vapors may easily be communicated unto the Brain and to its Membranes from whence an Inflammation of those parts and dotage or madness may be excited 5. Those Parotides which being bred at the very instant of the Crisis shal not be suppurated but before ever they are suppurated shal vanish they wil return get growth and so become to be judged of according to the manner and upon the account of their return even as are the returns of Feavers into the like circuit But there may notwithstanding be some kind of hope left that some Impostumes may arise in ihe very Joynts themselves Thus Hippocrates in the sixth of his Epidem Comment 4. text 1. The Cure In the Cure of the Parotides we ought in the first place wel to consider whether they be critical or symptomatical and what kind of Humor it is that they are bred of and from which they proceed If the Parotis break forth critically and so the disease from thenceforth be quite taken away or at least diminished then the whol work is to be committed to Nature according to the Precept of Hippocrates in his first Book and the twentieth Aphorism and nothing else is then to be done but only that those things that mitigate pain as they have been already propounded in the Chapter of an Inflammation be laid thereupon the which may likewise at one and the same instant together help forward the suppuration But then it must not be forgotten that in the Parotides whether they be critical or symptomatical whether the matter be much or little and whether it be benign or malignant that however it be yet Repellers or drivers back have no place at al as Galen teacheth us in his third Book of the Composition of Medicaments according to the place affected and second Chapter lest that the matter be driven back from the more ignoble part unto that which is more noble and especially the Brain that lieth so neer thereunto Yea moreover if the Tumor break not forth sufficiently and the humor that by reason of the disease fals and settles it self in the affected part be not by the vigor of Nature in a sufficient abundance thrust forth then in this case the gentler sort of Attractives such as are the Oyl of Camomile of Flower-de-luce of Dill and of Melilote are to be made use of But then the stronger sort of them are not to be administred but with an especial care and caution lest that the pain should be encreased and the Natural powers and strength dejected After this we are to take notice whether or no Nature attempt any resolution and discussion for which purpose she is to be assisted and furthered by discussive Medicaments or else whether which indeed is alwaies far more commodious it tends toward a suppuration and in this case likewise Nature her self is to be aided and holpen forward by those Medicaments that promote concoction and digestion of the crude matter Now the Medicaments of either sort are before propounded in Chap. 5. where we treated of an Inflammation and in the eighth Chapter where we discoursed concerning Bubo The suppuration being made and past the Impostume is then to be opened and as we have already in its proper place declared so to be cured In the Parotides that are Symptomatical Natures endeavor where it fals short is to be furthered and promoted and the overgreat abundance of the antecedent cause if any such thing be present is to be lessened and abated For if that there be present either an abundant store of blood or else of vitious and naughty humors we are not to fear that hereby Nature may be averted from and hindred in her work of expulsion but rather to expect that being eated of some part of her burden she will afterwards the more easily expel that which remains and ought to be emptied forth If yet notwithstanding an evacuation of the antecedent cause preceding she be not as yet able as she ought sufficiently to expel then the expulsion is to be forwarded and holpen on by the application of Cupping-glasses and other attractives And hence it is that either a discussion of the matter or which indeed we usually practise as most requisite the conversion thereof into Pus or matter is to be procured by those or such like Medicaments as are propounded in the eighth Chapter where we treated of the Bubo Tumor And yet notwithstanding here in this case the condition of the matter is to be heedfully regarded so that if it be more than ordinarily cold and thick the Discussers that we use are to be proportionably hotter and stronger and if there be any cause to fear that the matter may be hardened Emollients are likewise to be made use of After the softening of the matter as aforesaid albeit otherwise the matter tend likewise thereunto a suppuration is by all means to be promoted and furthered the Impostume to be opened and as we have already often declared in this manner the Cure is to be effected Neither is it to be expected that this Tumor should be broken of its own accord nor are we to wait til then forasmuch as the Pus being long reteined is oftentimes wont to produce many sad and dangerous symptoms And Gulielmus Fabâ—cius in his second Century Observ 39. relateth that he had observed that in a certain yong Maiden while she was afflicted with the Parotis we are now speaking of and yet notwithstanding was not so far amiss and ill as to take her bed being all the while free from any Feaver much about the fourteenth day of the Disease an Impostume likewise to the bigness of ones fist appeared â—orth the which said Impostume being not timely opened the Girl thereupon was suddenly surprized with a Feaver Swooning fits Vomitings and Qualms together with the loss of rest and sleep and miserably afflicted with a pain in her Back and Reins and albeit the Impostume was afterward of its own accord broken yet notwithstanding in regard that very little or no Pus at all flowed forth but rather sought its way and passage downward it was not long ere it cost her her life Chap. 13. Of a Carbuncle A Carbuncle hath very neer alliance
provoked and stirred up both for the repairing of the clour and the pouring in of blood And to tel you the truth in what place soever there is such an effusion of Blood it may in general be called Ecchymosis yet notwithstanding Paulus Aegineta in his fourth Book Chap. 30 according to the diversity of the parts affected reckoneth up three kinds or species all which may be called by their several distinct and peculiar names The first is those which we call Hypopia and by Hippocrates named Hypophthalmia that is Subocularia to wit palenesses or wannesses under the Eyes Now it is termed Hypopion from Ops that is the Eye because it appeareth under the Eyes and it is an Affect differing from that we call Hypopyon the difference lying in this that the former is written by ω and ι the latter by ο and Ï… from Pus which the Greeks call Pyon because it is a collection of Pus or purulent matter under the Cornea Tunicle The second Species is Hyposphagma which some in special term Suggillatio to wit an effusion of blood into the Adnata or Cornea both of them Tunicles of the Eye touching which we have already spoken in the first Book of our Practice Part 1. Sect. 2. Chap. 32. The third Species is that which is caused by the Contusion or bruising of the Nails this Species Hippocrates calleth Hyponychos and the Latine Authors term it Subungulus in regard that it is an Affect under the Nails Contusion Somtimes with Ecchymosis there is likewise conjoyned a Contusion yea and somtimes also there is so great an abundance of Blood poured forth that it being collected under the Skin and the Muscles it there causeth a certain hollowness and lifteth up the part into a Tumor or Swelling There is also somtimes according to the Nature of the part conjoyned therewith a pain from whence it happeneth that more blood floweth thereto and by this means an Inflammation yea and sometimes likewise at the length a Gangrene is excited There is to bâ—â—â— a notable History of this in Johannes Philippus Ingrassias in his Jatropologia When in the yeer 1537. in an Hippomachie or Tilting as we call it the Marquess of Terra Nova ran with the Baron of Volaterran it so chanced that the armed Knee of the Marquess by reason of the Fury and extraordinary fierceness of their Horses gave so great a blow upon the bare and unarmed Leg of the Baron that the Contusion or bruise that followed thereupon was so great and grievous that the Baron died thereof four daies after By reason of this his so sudden and unexpected death the Physitians were question'd and called to an account for that they had not rightly and as was fitting managed the Cure In whose behalf and defence Johannes Philippus Ingrassias wrote those two Books of Apology under the name and Title of Jatropologia There is likewise extant in Gulielmus Fabricius Cent. 2. Observat 83. another History which you may there see shewing how dangerous Contusions may be The Signs Suffusions and these Suggillations are easily known For the very colour it self and the Swelling if at least there be any fal under the sense and are apparently to be seen The Causes are known by those things that went before and such as are likewise present For if any external Cause went before as a Blow a Fall and the like the Physitian may understand it from the relation of the Patient But if none of these shall happen we are then to consider the Blood in the Body and well to weigh by what means it becometh thus peccant and offensive Prognosticks 1. Although in truth these Ecchymomata are for the most part void of all danger and the blood that is yet thin may easily be dispersed yet if this be not done and that the blood be deteined any thing long in the part affected out of its own Vessels it then may prove to be of dangerous Consequence in regard that by this means there may be excited both a Corruption of that very part that is affected and likewise a damage and detriment unto the whol Body For the Blood being clotted together unless it be forthwith insensibly discussed or turned into Pus which is necessarily done where the Flesh is withall greatly bruised so that hence the part yet continueth soft it putrefieth and corrupteth and breedeth a Gangrene and very frequently bringeth Death and Destruction upon the sick Person 2. But there is great danger threatned and nigh at hand when the part affected continueth not any longer green or wan but inflamed and becometh very red hard and distended Of which we related that former notable History out of Ingrassias The Cure As for what therefore concerneth the Cure we wil first of all treat of the Cure of that Ecchymoma that followeth upon a Contusion For even this also very often happeneth and whoever he be that knoweth the Cure of this he shal have a sufficient store of Medicaments with which he may cure the rest since that the discussing Medicaments that are here to be drunk have their place likewise in the other First of al therefore if the contusion be great we must use the best of our â—kil and care to prevent and hinder the afflux of blood unto the place lest that thereby an Inflammation should be excited This is to be done by Venesection for which cause Galen commands That in a fal from on high and in beatings and bruisings a vein be opened and that although the blood doth not greatly abound yet that by opening a Vein it be drawn forth lest that an Inflammation should be excited from whence not only evil symptoms but oftentimes also even death it self hath its original And the truth is this Venesection is forthwith to be ordained and put in practise withal at the same time Defensives and Repellers are likewise to be placed neer about the part that may impede and prevent the influx of blood into the part affected such as are made up of Bole-armenick Terra sigillata or Sealed Earth of Lemnos Dragons blood Roses Myrtles the Nuts of the Cypress Tree Galls Pomegranate flowers Roots of the lesser Consound and the like As for instance Take Bole armenick Terra sigillat of each an ounce and half Chalk half an ounce let them boyl in Vinegar after they be boyled Take Pouder of red Roses the pure sine flour of the Root Consolida or Consound of each half an ounce and with the Oyl of Myrtles make a Cataplasm Or only which is likewise in common use the white of an Egg shaken together with Rose water and with burds or the courser part of flax applied unto the place affected Or Take the white of four Eggs the Oyl of Myrtle and Roses of each one ounce Bole armenick Dragons blood of each half an ounce Cypress Nut two drams a little Vinegar Mingle them c. And this is also here to be taken notice of that there be not many
moist and clammy Medicaments administred for by reason of such humid things applied the blood fallen forth out of the Veins is easily putrefied whereupon divers il and dangerous Symptoms are afterward wont to arise But in very truth when from a fal from some high place beating and bruising and the like Causes the blood is not only gotten together under the Skin and the external parts but oftentimes also is poured forth into the more inward parts after the same manner as it is in the Circumference of the Body when the Vessels are opened or broken which said blood is there clotted and corrupted and is wont to cause Inflammations and the worst sort of Feavers dangerous Symptoms and very frequently death it self we must therefore use the best of our endeavor that the clotting and growing together of the aforesaid blood may be hindered that it may be dissolved and that it may be evacuated by stool urine or sweats and that with al due and possible speed For when once the blood hath gotten a putridness the Malady is not so easily cured nor indeed at al without the most exquisite and singular extraordinary Remedies Wherefore so soon as there is any the least suspition that the blood is fallen forth without the Veins into the more inward parts and that it cannot be dissipated by external Remedies we must then use these things following to wit Rheubarb Rhapontick Terra sigillat Sperma Ceti in the Shops termed Patmasitty the Eyes of Crabs Mummy red Corals Harts-born Madder such as the Dyers use in coloring with the Waters of Cherefoyl Carduus Marjoram St. Johns wort Fumitory Alkekengy Card. benedict Scabious the Syrup of Sorrel Syrup de Acetositat Citri Vinegar and the like which what they are will appear further from the following Receipts and Prescripts Take Rheubarb Terra sigilat Bole armenick Mummy of each one dram make of these a Pouder of which give one dram at once with the Water of Cherefoyl or Shepherds-Pouch Or Take Terra sigillat Crabs Eyes of each one scruple Sperma Ceti Goats blood prepared Angelica and Gentian Roots choyce Rheubarb of each half a scruple seeds of Carduus Bened. seven grains Cloves three grains Make of these a Ponder for two Doles to be taken at twice and drunk with the following Waters Take the Water of the Infusion of Lavender one ounce the Waters of Cherefoyl St. Johns wort Strawberries of each one ounce and half Wine Vinegar half an ounce for twice Or Take Terra sigillat Madder Mummy great Comfrey Rheubarb of each a scruple mingle them and make a Pouder Or Take Rheubarb the Root of Madder Mummy Crabs Eyes the seed of Carduus Mariae or Mary Thistle the Root of round Aristolochia or Birthwort of each one dram mingle and make a Pouder give hereof a dram at once with the Syrup of Sorrel Some there be likewise that commend the Water of Nuts They commonly administer one dram of Sperma Ceti dissolved in Vinegar or some fit and convenient Water There are likewise some that make use of Unguents and that with good success also which are likewise taken into the Body and are therefore stiled Potable as for instance the Potable red Unguent of the Ausburg Practitioners Or Take Green Sanicle four ounces the Leaves of Betony Fennel seed Juniper Berries unripe of each three ounces the Root of Elecampane of the greater Comsrey Rue Ground Ivy Rosemary Rhapontick root of each two ounces all these being shred very smal let them be stirred about and incorporated with three pound of fresh Butter Set them then in the Sun for eight daies afterward put thereinto one Cyath or little Cup ful about two ounces of Sanide Water then boyl it til the water and juyces be quite consumed and then let the Butter thus incorporated and moistened with the Juyces be pressed forth and kept for use The Dose is half an ounce twice a day to be taken with warm Beer the place affected may likewise be outwardly anointed with the same yet not at the first beginning and appearance of the distemper but some while after Or Take these Herbs Wormwood Southernwood of each two handfuls the Herb Ladies Mantle Motherwort or Mugwort the lesser Comfrey the lesser Sage Germander the lesser Centaury Crosswort Fennel Strawberries Fenugreek Ground Ivy or Aleboof Hyssop Lavender Milfoyl Marjoram Balm Bugle Penyroyal Pyrole or Winter green Pimpernel Rosemary Sage Sanicle Savory Spicknard Betony Vervain of each one handful the roots of Marsh-mallows Clove-gilliflowers the greater Consound Angelica Pimpernel and Tormentil of each of these one ounce These Herbs and Roots gathered green in the month of May or June boyl in six pound of May Butter adding thereto as much Wine as you judg sufficient let them boyl together until they be boyled enough stil taking heed that they burn not to and in the end adding of the Oyl of Bayes fresh and new four ounces Sperma Ceti half a pound Make herewith an Unguent of a green color the Dose is one ounce in Vinegar or Beer and this may likewise be outwardly applied unto Wounds Or Take the Roots of Tormentil Dittany Sanicle the greater Consound Consound Sarracen of each two ounces Castoreum one ounce that sort of it that is offensive by reason of its unpleasing tast may be omitted Madder three ounces May Butter three pound red Wine as much as will suffice mingle and boyl them till the Wine be consumed herewith make an Vnguent adding thereto of Sperma Ceti one ounce As for the Topicks at the first beginning some Astringents are to be mingled with the discussive Medicaments For when the Tunicles of the Veins out of which the blood is poured forth are somwhat bruised they ought then to be a little strained together bound fast and condensed lest that the new matter drawn thither by pain be poured forth since that if in the beginning only Digestives be administred they wil not only discuss the blood poured forth of the Veins but attract and draw unto the part that blood that is in the bruised smal Veins Afterward that the little contused or bruised Veins may return unto their Natural state Digestives alone are to be made use of For this end and purpose some there be now this indeed is the best kind of Remedy especially for those that are beaten that wrap about the sick person the Skin of a Ram new flaid off and whilst it is yet hot besprinkled with Salt Myrtle Berries and the Pouder of Water-Cresses or if such a skin may not conveniently be gotten they anoint the Patient with the Oyl of Roses of Myrtles and of Earthworms with which they mingle the Pouder of red Roses or Myrtle Berries and the day following such a like Liniment may be administred Take Vnguent Dialthaea three ounces Oyl of Earthworms Camomil and Dill of each one ounce Turpentine two ounces the meal of Fenugreek the pouder of red Roses and Myrtles of each half an ounce Saffron one scruple make
and Chap. 8. maketh a twofold sort of this Tumor differing according to the Nature and quality of their Causes The one he deriveth from cholerick blood the other from a salt and nitrous Flegm but this more rare Others there are that assert that this kind of Tumor doth arise from an exhalation or vapour of hot fervent Blood or else the admixture of the Cholerick and Salt humors The Causes Whosoever knoweth and understandeth the Nature of serous wheyish humors wil not deny that such like Tubercles may possibly be excited from serous or wheyish humors being such as are sharp and easily moved and likewise such as without much ado vanish and are discussed Which appeareth and may be confirmed even from hence that this Malady may be and is removed especially by Venesection or blood-letting which said Venesection doth chiefly and principally qualifie and allay that extream and fervent heat of the serous and wheyish part of the blood Yet notwithstanding the itch that is somtimes greater and somtimes less likewise teacheth us that there is not one alone difference of this wheyish humor but that somtimes this said whey is more mild and moderate and somtimes again more sharp and hot somtimes thinner and somtimes thicker as likewise thus much which I my self have very often observed that these Tubercles while the the Patients are in a hot place they then break forth and appear and that when they expose themselves unto a cold Air the Essere then vanish and as soon again on the contrary to bud forth in the cold Air and to vanish in a hot place the former whereof seemeth from hence to happen to wit because the humor is very thin and moveable and therefore is instantly driven in again by the cold ambient Air but the latter because the Humor is not altogether so movable and thin but somwhat more thick which for that very cause cannot transpire in a cold Air but in a hotter Air it wil transpire or breathe through But this wheyish and thin Humor is for the most part generated from the fault of the Liver which from some preternatural cause is disposed to generate and breed this humor Now that said Humor waxeth extreamly hot from the Causes Procatartick as they cal them that stir and move the blood And this happeneth likewise in the Winter time and in cold Regions rather than in hot Signs Diagnostick It is easily known by those notes and marks that are above mentioned to wit there somtimes goeth before an Ulcerous Lassitude and then there break forth in the whol body itchy Pustules as if the party had been pricked by Bees or stung with Nettles The Prognosticks 1. These Tubercles vanish of their own accord within a very short space although there be no course taken for the curing of them and they are not suppurated neither doth there issue forth of them any humidity at al. And if this should somtimes so happen yet this chanceth rather by reason of the scratching of them and also from the vehemency of the Itch which is extream troublesom to the sick persons than by means of the Tumor 2. Somtimes these Essere go before Cholerick Feavers and therefore such as are very frequently molested and grieved with these Tubercles ought not in any case to neglect the Cure lest that they fal into Feavers and some more grievous Disease The Cure For the most part there is no need at al to administer Topicks but if the fervent heat of the Blood and Humors be by Venesection and the administring of Medicaments that alter qualified and kept under the Tubercles wil then soon vanish and the smoothness and Natural color will forthwith return unto the Skin To wit in the first place a Vein is to be opened and so much of the blood drawn forth as the state and condition of the body requireth And afterwards if there be any need at al thereof the Cholerick and wheyish Humor is to be drawn forth by Tamarinds Myrobalans Rheubarb afterward let there be administred the Juyce and Syrup of Pomegranates Ribes Syrup de Agresta or Varjuyce Whey with the Emulsion of the four cold seeds and the like Milk tart and sowr c. It is likewise very requisite to put the sick person into a Bath of warm Water Let his Diet likewise be cooling and moistening Chap. 27. Of Scabies or Scabbiness SCabies or Scabbiness ariseth likewise from adust matter as doth also the Itch that is as it were a certain Praeludium and forerunner of Scabbiness and the like Affects Now Scabies by the Greeks and Latines is called Psora an Affect sufficiently known in the which there is not only present some kind of foulness and deformity of the body but a distemper also even of the very Skin together with a swelling and exulceration from whence it is that the actions of the Skin are likewise hurt But more especially in the Scabies or Scabbiness the top and utmost part of the Skin is affected insomuch that out of it as Galen tels us in his fourth upon the Aphorisms and the 17. Aphor. there is some such like thing cast forth that beareth a likeness and resemblance with the casting of Serpents From whence it likewise differeth from the Itch for in the Itch there is only a roughness of the Skin in which there is nothing that fals off notwithstanding the scratching whereas in the Scabies there is not only a roughness of the Skin but likewise a distemper with a swelling from which by scratching the bran-like bodies are easily and readily separated and together with them divers Ichores likewise and filthy purulent Excrements The Causes But what the Cause of the Scabies is in this Authors seem not so wel to agree Galen in his Book of Tumors Chap. 1. 3. tels us that Sabies also and Lepra are Melancholick Affects and likewise in the seventh Sect. Aphor. 40. that Cancers Elephantiases Lepra's and Psora's are al of them Melancholy Affects and the same he also tels us in other places But Avicen in the seventh Book of his fourth Tome Tract 3. Chap. 6. writeth that the matter of Scabies is the blood with the which Choler is mingled and that converted into Melancholy or salt flegm and with him the other Arabian Physitians agree But the very truth is that although in the Scabies the humor be not alwaies one and the same yet in every Scabies there is some kind of mixture of the adust and melancholy hot and dry humor And furthermore there is one sort of Scabies that is moist another that is dry The moist in the which there sloweth forth a certain matter that is moist and withal rotten filthy and purulent but the dry is that in which there is but little or none of the aforesaid matter cast forth And concerning this latter it is that Galen seems to speak as being such wherein that melancholy humor doth more superabound But Avicen and the rest of the Arabian
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â— In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
hinder that Section that is made with the Saw that flesh is likewise to be cut off with a Knife that is fit for the purpose And then instantly and with as much speed as possibly may be the Bone is to be amputated with the Saw unless the Section be in the Joynt for then the Member may be amputated with the Razor alone The amputation of the Member being finished the next thing to be done is the stopping of the flux of blood after that it hath flown forth sufficiently Most Practitioners burn the Vessels with a Cantery But Paraeus much disliketh this course for he conceiveth it indeed to be very cruel and barbarous in regard that it causeth an extraordinary great pain if the Section be made as it ought to be in the quick and live flesh and very bad and dangerous Symptoms happen unto the Nervous parts unto which we may add that by the said burning very much of the sound flesh is consumed whereupon the bones are left bare and the flesh together with the Cicatrice either it is not at all brought over the naked part or if it be it is not without much difficulty And therefore he Practiseth another way of stanching the Hemorrhage to wit with a Crows-bil he laieth hold upon the Vessels and draweth them altogether then bindeth them as close as may be The Vessels being thus straitly tied together with a Ligature or if you judg this more fit shut up close with a Cautery the bonds are then to be loosened and the courser part of Flax or Hemp we cal it Hurds after it hath been throughly soaked in the White of an Egg and sufficiently besprinkled with a Pouder that hath in it a virtue and faculty of stanching the blood is to be laid upon the Member And yet nevertheleless for the most part without any such Ligature or Cautery the blood may likewise be stopped and stanched after this manner As Take the finest Flour three ounces Dragons blood Frankincense Aloes of each two drams Bole armenick Terra Sigillata Parget or Plaister of each one dram Water Frogs prepared though there be some that for this use and purpose do rather commend those of them that live among Trees one ounce the Flix of a Hare cut very small a thin Spunge torrefied by the Fire of each two drams and make a Pouder Upon the Vessels likewise that pour forth blood there may very fitly be applied and laid on that Mushrom so much used by Câ—iturgeons to stanch blood which they cal Crepitus Lupi Others there are that make up Emplasters of Dragons blood Bolearmenick Terra Sigilata and the finest Volatile flout and the like with Pitch Afterwards the Trunk of the amputated Member is to be safe guarded with those Defensives or such like as we have above mentioned the like unto which is this also that followeth which is to be applied with Hurds and Swathe-bands having been first wel and throughly soaked in Oxycrate Take Bolearmenick Terra Sigillata Dragons blood Mastick Parget Oyl of Roses and Oyl of Myrtle of each one ounce Whites of three Eggs Vinegar as much as wil suffice and make an Vnguent And this is the first dressing or the first binding up which is not to be loosened in the Summer time before the second or third day but in the Winter not before the fourth day at the soonest unless in case of urgent necessity And in the mean time the Member is to be placed in a direct middle posture or figure in Pillows stuffed with the hairs of Harts or Wheaten meal The first binding being loosened and the first Provision taken away again with the White of an Egg as before the Pouder stanching the blood is to be applied and the excremities of the bones to be covered with a piece of the dry Liniment and in the end the Wound to be bound up with some kind of Digestive And this Cure is so long to be continued until there be now no cause of further fear that any mischief may follow upon the Hemorrhage and that the Wound be now become Purulent For then these Medicaments being laid aside we are to make use of Cleansers Gulielmus Fabricius commendeth tins Unguent following of the Juyce of Smallage not only for the Gangrene but likewise for other sordid foul and Malignant Ulcers Take the Juyce of Smallage of Water-Germander of Waybred or Plantane and of Rue of each two ounces Honey of Roses strained one pound boyl them to the Consistence of a Syrup and afterwards mingle therewith the meal of Lupines the Pouder of round Aristolochy root of Angelica root of Swallow-wort and of Treacle of each half an ounce Aqua vitae one ounce make an Vnguent In the mean time we must do our endeavor that the Lips of the Wound may be drawn together and afterwards that flesh may cover the bones and nay be unto them in stead of the Pillows Paraeus and others saw together the lips of the wound in the form of the letter X but a Suture which they cal the dry Suture seemeth to be far more convenient or else by a Glew which is done after this manner A Linen Cloth of a convenient figure and bigness moistened throughly in a Glew of Astringent Emplastick and viscous Medicaments such as are Bolearmenick Dragons blood Gum Tragacanth Sarcocol Mastick the White of an Egg and the like is to be laid upon the place As Take Mastick Dragons blood Bolearmenick Sarcocol and the finest Volatile flour of each half an ounce Rosin of the Pine Tree two drams mingle them with the White of an Egg. Of this Linen Cloth let there be made Emplasters which are to be applied unto the extremity of the Wound on both sides So soon as the Emplasters are become dry so that they begin to stick too fast unto the Skin then we use to annex unto them little handles to hold by of Thread twice or thrice doubled and with them we contract the lips and this may likewise be done in a suture that is more thin sewed And then at length we must do to the utmost of our endeavor that the excremities of the bones which were hurt by the touch of the Iron and the Air may fal off For which end some there be that burn the utmost parts of them with a red hot Iron yet stil taking great heed lest that the flesh and other of the sensible parts be hurt thereby Others make use of the Emplaster of Becony and other Catagmatick or Fracture Medicaments And so within thirty or fourty daies whatsoever there is of the bone corrupted wil fall off If the flesh be luxuriant or proud as we sometimes term it it is then to be repressed and kept under by the Pouder of Alum and the like and at length the Cicatrice is to be brought over it But whereas pains do in the mean time much infest and disquiet the sick Person and that there is cause to fear lest that Convulsions
of the Head alone but that Alopecia may be extended even unto the very Beard also The Causes The Cause of both these Maladies is a depraved and sharp humor of eating assunder the roots the Hair of whatsoever kind it he But for the most part notwithstanding this Malady iâ— caused by a salt flegm adust or putrified Whereupon Galen in his Book of the differences of Symptoms and Chap. 4. writeth that these Vices follow a depraved Nutrition of the Skin of the Head But that one while the Alopecia another while the Ophiasis is excited and that the Hairs do sometimes constitute a strait and direct Area and sometimes that that is winding and writhed the Cause of this is the great abundance and the quality of the matter For if there be an extraordinary great store thereof and it be likewise thin then it equally and alike eateth through the Hair in the more and greater places but if the Matter be less and mingled with a thick humor then there followeth an unequal and writhed Defluvium or shedding of the Hair because that the humors being unequal and mingled do not flow right forward but creeping along obliquely they gnaw assunder the hair The more remote Causes are the heat of the Liver and Head and especially the fault of the first and second Concoction by reason whereof salt and sharp humors are generated which although it may happen in every age yet nevertheless it happeneth more especially in Childhood and Youth and it followeth the Affects Tinea Achores and Favi by reason of the Causes that we mentioned in the Diseases of Children And somtimes likewise External and Malignant Causes make very much for the generating of this Disease among which Galen in his first Book of the Composit of Medicam according to the places Chap. 2. reckoneth up Mushroms because that they make very much for the generating of vitious and corrupt humors And hither likewise belongeth the poyson of the French Disease in regard that this also eateth through the roots of the hair which other poysons may likewise do Signs Diagnostick We have already before told you in what respects this falling of the Hair differeth from baldness and that shedding of the Hair that we call Defluvium But Alopecia differeth and is known from Ophiasis by the very figure of the Area and because that in the Alopecia the hair only falleth off without any hurt as all of the Skin But in the Ophiasis there is not only a falling off of the hair but likewise an excoriation of the Skin And the very color of the skin is also changed and in some it appeareth more whitish in some more pale and in others more black and if it be pricked there floweth forth a serous whitish blood Touching the difference between Alopecia and Ophiasis Celsus in his sixth Book and Chap. 4. hath these words That Area saith he that is termed Alopecia is dilated under all kind of Figures and it happeneth in the hair of the Head and in the Beard But that which from the likeness of a Serpent is called Ophiasis beginneth from the binder part of the Head and is not extended above two fingers in length it Creepeth on both sides the Head even unto the Ears and in some unto their Foreheads also the former of these in all Ages but this latter only in Infants But Alopecia and Ophiasis differ from Tinea in this because that in Ophiasis the Excoriation of the Skin is superficial and when it is cured the hair groweth again But in Tinea the excoriation and Ulceration is more deep and the skin is oftentimes so corrupted that the hair never groweth again As for what concerneth the signs of the Causes the Skin it self sheweth what kind of humor it is that offendeth which that it may be the more exactly known the hair that remaineth behind is to be shaven away and the Skin to be gently rubbed there are other signs also that wil instruct and teach us what kind of humor it is that aboundeth in the body The hairs likewise that grow anew by the various colour that they have according to the Nature of the peccant humor wil shew us what humor is the Cause of this Malady Prognosticks 1. Alopecia and Ophiasis although they bring not much danger along with them yet nevertheless they cause a great deformity and among the Romans those Slaves that were disfigured by the said Area and especially by the Alopecia were sold at a far lower rate then other Slaves And in our daies also these Areae in regard that they cause a suspition of the French Pox are therfore accounted very disgraceful unto him that is affected therewith 2. But whether the Ophiasis or the Alopecia may be soonest and most easily cured it is a great question among Authors and they herein much differ Celsus and Avenzoar are of Opinion that Ophiasis is more easily cured then Alopecia And on the Contrary Alexander in his first Book Chap. 2. and Serapio in his first Book Chap. 1. teach us that the Alopecia is more easily cured then Ophiasis But Celsus seemeth to speak only of the Alopecia of Infants which in the course of yeers and change of age is of it self oftentimes cured But if Alopecia and Ophiasis be such as are grown to maturity or likewise in one and the same age be compared the one with the other then the Ophiasis seemeth to be altogether the more difficult to be cured in regard that it hath its original from a matter more thick and far worse then the former and such as doth not only eat assunder the roots of the hairs but likewise even the very Skin it self which is never done in the Alopecia 3. Yet notwithstanding by how much the longer either of these Maladies hath been and continued by so much the more difficult is the Cure thereof and by how much the less while they have continued by so much the more easily are they cured 4. If by Rubbing the place become red there is then hope of Cure the sooner it is thus the more easie the Cure but if it wax not red at all then there remaineth no hope at all of any Cure 5. That kind of Areae is also the worst that hath made the Skin thick and somwhat fat and slick or slippery in all the parts affected 6. Alopecia and Ophiasis that proceed from the Leprosie are altogether incurable and that that hath its original from the French Disease is not to be Cured untill the Disease it self be Cured 7. There then shines forth some hope of a Cure to follow when the excremities of the Areae that are neerest unto the remaining hairs do again begin to send forth other hair For then those parts that are nigh unto the sound have the less receded from their Naturall State and so consequently will the sooner again return unto their Natural State and begin to produce hair The Cure If a Vitious humor abound in the whole body
and the Leprosie If the Cleft be from a Wound the Wound is then to be healed yet nevertheless the cloven Nails can no way be united but while they grow a whol and sound Nail is wont to succeed the cloven but care must hereby taken lest that the Nail in that part where it is cloven should grow together with the skin lying under it For if this should happen the Nail wil never be whol as it ought to be but wil evermore grow forth cloven and in two parts If this Fissure or Cleaving arise from any other Disease and vicious humors then that Disease is to be cured and such like Topicks are to be administred unto the Nail as are wont to be applied in the roughness of them The Falling of the Nayls And at length also the Nails are wont to fal off leaving the extream part of the Finger quite naked which Vice may not unfitly be referred unto Diseases in the number since that without cause the Nails are excluded from the Number of the parts notwithstanding that they have their Natural conformity and use and are nourished like as other parts are and cohere as al other parts likewise do unto the whole But why the Nails fal away this first of all and principally proceedeth from the fault of the Aliment which when it declineth into another Nature and so indeed that the Aliment is not only become simply vitious the same that happeneth likewise in the ruggedness and roughness of the Nails but that it is also sharp withal and corrodeth the roots of the Nails in the very same manner as the roots of the hairs are wont to be gnawn asunder in the Alopecia Ophiasis and shedding of the hair the Nails then fall off And so very often after Ulcers and Wounds about the roots of the Nails the Nails are wont to fal off Pus or filthy matter gnawing asunder the roots of them And when the roots of the Nails are eaten asunder by the said purulent matter although the Nails do not then fal off of their own accord yet by the Nail new growing they are thrust off And so it is found that after pestilent and Malignant Fevers not only the hairs have shed but the Nails likewise have fallen off and this hath likewise been observed to happen after the drinking of Poyson and in the French Disease And moreover the very same may likewise happen from the want of Aliment like as we have seen and found by experience that such as have travelled in the Snow and that have held their hands long in cold water have had their Nails fal off either from a Constipation of the Pores of the hands that carry the Aliment unto the Nails or else from the extinguishing of their Native heat Now this Vice which is obvious unto the sight doth not only cause a deformity but likewise hurteth the laying hold on any thing for which the Nails serve and moreover in regard that the Nails do as it were defend the Fingers ends against external injuries by this means the Fingers are rendered as it were defenceless and easily obnoxious unto al kind of external injuries And therefore this Malady doth deservedly require a Cure And yet nevertheless all the Nails that fal off cannot be restored For if from a depraved humor the whole root of the Nail be eaten asunder and the Malady hath now long continued or if by reason of the want of Aliment the Nails be fallen off they can very hardly be restored But if the root be not wholly eaten asunder and the Malady be but new begun there then remaineth some hope of a Cure and therefore in this case we are to cover the Nails with a Cap made of Ladanum Ammoniacum Bdellium and Wax The looseness of the Skin about the roots of the Nails And then at length Reduvia or the looseness of the skin about the roots of the Nails there is likewise a Vice not of the Nails themselves but of the Skin that is next unto the Nails which the Latines call Reduvia and the Greeks Paronychia because that it is neer unto the Nails But this Paronychia of the Greeks is a Vice far different from the Disease that is described before in the first Part of this fifth Book and Chap. 14. and is there reckoned up among the Inflammations and by the Arabians is also called Paronychia For that Paronychia as we there told you is a most grievous and dangerous Disease But the Paronychia of the Greeks of which we are now speaking or Reduvia as the Latines call it is the least and lightest of all Affects and bringeth along with it no danger at al and scarcely deserveth the Care and pains of a Physitian as appeareth out of Galen who in his Comment 2. touching the Nature of Man about the end thereof disputing whether or no that Book were written by Hippocrates saith that Sabinus and the rest that reject that Book do indeed take notice of a few smal faults that are therein but they neglect and pass over without any notice taken of the faults that are far greater and worth Consideration after the fashion of those ill Physitians who while they consider and take notice of the Paronychia of sick Persons they then through Ignorance neglect the greater and more difficult Evils Neither indeed is there any reason for us to think that the Paronychia of the Greeks and that of the Arabians is one and the same Affect and that Reduvia is a small and beginning Paronychia such as the Greeks describe either in the Swelling or Inflammation or any notable pain which is in a Species of the Rhagades and is described by the Greeks But if it be already become such it will then turn into an Inflammation and a dangerous Impostumation such as is described by the Arabians and is by them named Panaritium For these things do no way answer to Experience For neither doth the Panaritium of the Arabians begin from such like Clefts neither is the Reduvia and Paronychia of the Greeks ever turned into the Panaritium Paronychia therefore or Reduvia Reduvia what it is is a certain sleight Cleft of the Skarf-skin at the Roots of the Nails It proceedeth from a salt humor eating through the Skin in that place The Vice appeareth sufficiently of it self neither hath it any danger at all to attend it but only that it is somewhat troublesom by reason of some light and smal pain that followeth it whenas the Skarf-skin being cleft and divided the tru Skin is left quite naked Now it is Cured by Purslane the Roots and Seed of Mallows Oyl of Violets and Oyl of Roses Clefts in the Hands In the last place we think it not amiss to mention also the Clefts that are oftentimes found in the Hands which happeneth more especially about the beginning of Winter when the Hands being tender are exposed unto the Cold whereunto they have not as yet been accustomed whereupon it is
most grievous Epileptick Convulsion which in the space of â—our or five hours ended his life And I my self also remember a certain Student stout hearted enough otherwise Who being by a Chirurgeon to be let blood in my presence and at my command as the Surgeon was about according to the custom to bind his Arm and began but to move his Instrument toward the vein he fainted away and fell from the seat wherein he was sitting before ever the Lancet was put neer unto his Arm whenas Nevertheless he had neither fever nor any other Disease that might any waies cause and occasion this swounding of his Eightly and Lastly an Inflammation following upon a Wound may render that Wound Mortal if it be internal For indeed an Inflammation doth not necessarily accompany Wounds yet notwithstanding because that in internal Wounds those Medicaments cannot possibly be administred that were wont to be applied in external if any internal part especially if it be more Nervous and of an exquisite sense shall chance to be wounded then a pain is excited and thereupon an afflux of Humors and from thence an Inflammation a feaver a Gangrene and other Evils do arise that destroy the Wounded person within a very few daies And from hence it is that the Vulgar do likewise in Wounds observe the seventh and the nineth day because that within these daies those Symptoms are wont to supervene and in these daies to bring the greatest danger unto the sick Party Some there are that add yet another Cause to wit the influence of the Stars And so Franciscus Vallesius in his Comment upon the 95. Text. B. 4. of Hippocr his Epidem saith that the Malignant Aspect of the Stars and Constellations is the Cause why light and very sleight Wounds are oftentimes likewise rendered Mortal And the very same Quercetan also tels us in his Third Chap. Touching Wounds made by Guns and that for this very Cause the Wounds of the Head are for the most part wont to be Mortal at Ferraria and Florence But this Cause is not to be admitted of neither can there any Reason be easily rendered why at Ferraria the wounds of the Head should be mortal and not so in the neer neighbouring Rhodigium or Bononia And from these Fundamentals no doubt it is that Civilians likewise take upon them to pronounce what Wounds are of themselves and in their own Nature Mortal and what not Nicolaus Boerius in the place alleadged N. 18. propoundeth six Conjectures from which it may be Collected that the Wound was not Mortal of it self but that it was made such by Reason of some accident happening thereupon The first is if the Wounded person died not until a longer time after then wounded persons are wont precisely to prolong their Lives The Second is this if there were present no dangerous Symptoms in the beginning of the Wound or if there were any present and remained for a while the sick person notwithstanding was not much the worse for them but that he was able to perform all kind of Actions in such a manner as they are not able to do that are mortally wounded For if he shall appear to be in a fair way of Recovery and then afterward die it is to be beleeved that he died upon some other Cause and not from his Wound All which notwithstanding are to be understood only of a Wound that is not of it self Mortal The third Conjecture is if the sick person in the Course of his life were not so ordered as wounded persons ought to be but that he exposed himself unto the cold Air addicted himself unto excessive drinking were often distempered with passions of the mind immoderate Anger frequent affrightments and overmuch addicted to Venery The fourth if the Physitians were of opinion and that they adjudged the Wound not mortal who as men experienced in their Art ought to be beleeved The fifth is if the wounded person had no Physitian with him or if any were sent for unto him he was one altogether ignorant and unskilful which is al one as if he had had none at all Which yet nevertheless as hath been said is only to be understood of a Wound not simply mortal in it self For if a Wound be in it self mortal albeit there were no Physitian sent for yet nevertheless we are not thence to collect that the wounded person might have been cured The sixth and last Conjecture is if the wounded person be of a strong Nature For in this Case if due care be taken in the preserving of the said Natural strength and vigour the sick person very seldom miscarrieth But if the Wound being not mortal the wounded person die and that in a short time we ought to collect that he died not of his wound but that he died from some other Cause as we said before And this is the Judgment of all Physitians in general touching Wounds both mortal and not mortal But yet there ariseth another Question among the civil Lawyers to wit whether the person that inflicteth the Wound may be found guilty and condemned of Homicide For these do not only as Physitians weigh and consider the quality and Nature of the wound but the minde and intention also of the party wounding and other Circumstances likewise touching which we may see more in the Books of these Civilians The Rest of the Prognosticks Now although that out of what hath hitherto been said may easily appear what is to be foreknown and foretold touching the event of wounds yet nevertheless we think it not amiss here to add somwhat more as touching the premises For although that other Wounds besides those we have already spoken of do not indeed suddenly destroy and kil the person yet nevertheless some of them are far more dangerous then other and even of these some are more easie some more difficult to Cure And this in the first place is to be learnt from the very substance of the part For the fleshy parts of all other are most easily brought together and sodered again the rest as the Veins Arteries Nerves Tendons and Membranes with more difficulty They may be united and made to grow together again but it will be more slowly Galen in his 1. B. of the Seed and 13. Chap. tels us than himself saw the Veins in the Head and those both many of them and great ones also grow again and in his 5. B. of the Moth. of Physick Chap. 7. that he saw an Artery also united Secondly from the Action and Use of the part For the more Noble the part is in regard of its more necessary Use and the Action that it performeth for the good of the whole Body so much the more dangerous are the Wounds of that part And those parts likewise that are in continual motion will not be brought to grow together again but with much difficulty And the more exquisite likewise the sense of the part wounded is the more easily upon its being Wounded
a top is to be taken off with a speon and whatsoever sinke to the bottom throw it away Then afterwards Take of Earth worms washed in Wine or Water two sextaries let them be put for a while into the Bakers oven in an Earthen pot covered where as they must be baked so you must have a great care that they be not burnt and after this beat them into a pouder Take Of this Pouder the dryed brains of a Brawner Red Saunders that smells sweet Mummie and the Haematites or Blood stone as he calls it of each one ounce After this Take Vsnea or Moss from the skul of one that died a violent death let this Moss be cut off from the skul in the increase of the Moon and she being then in a good house as that of venus if it be possible but not of Mars or Saturn the weight of two filberds or thereabout And all of them being bruised together and well mingled with the fat let there be an unguent made according to art and then in a Glass vessel stopt or if you think good in a Box let it be carefully kept for use If after long time the unguent happen to be over dry it may be a new moystened and softened with the aforesaid fat or virgin hony Let the Vnguent be made the Sun being in the sign Libra The Vse of this Ungruent Now as touching the Efficacy and use of it he thus writeth This cure is performed by the Magnetick attractive virtue of this Medicament caused by the constellations which thorow the medium of the Air is brought unto the wound and Joyned therewith that so the spiritual operation may be drawn forth into effect It s wrought I say by means of the Astral and Elementary conjunction There are therefore three things that by this unguent cause so admirable an Effect 1. The Sympathy of Nature 2. The influence of the heavenly Bodies perfecting their operations by the Elements 3. The Balsam which being endued with a virtue of healing is naturally applyed unto any man without any difference With this unguent are cured all Wounds by what weapon soever they be inflicted and whatsoever the sâ—x he and yet so notwithstanding that neither the Nerves Arteries nor yet any one of the three more principal members be hurt so that the Weapon may but possibly be had although the patient be many miles distant from us And in regard that it is of a Couglutinating Suppurating and renewing Nature it doth not permit if it be rightly applyed any hurtful symptom to follow upon it The manner of applying the Unguent or Weapon salve First Let the Weapon wherewith the man is Wounded be anoynted every day once if necessity require it and the wound be great but otherwise it will be sufficient if the Weapon be anoynted every other or third day and then let it be kept in a Clean Linen Cloth and in a place a little warm but not over hot lest that any damage should thereby be brought upon the Patient We must likewise be very careful that the Weapon fall not down from on high neither that the wind blow upon it in a cold place for if this should happen the Patient wil run mad Secondly Before you anoynt the Weapon Consider whether the Wound were made with the point by pricking and if it were let the Weapon be first anoynted upwards and not below and so descending toward the point thereof for otherwise much hurt may be brought upon the Patient Thirdly But if thou canst not certainly know how deep or in what manner the Weapon entered into the flesh thou mayst then anoynt it all over but otherwise it will be sufficient to anoynt that part of the Weapon wherewith any one is hurt Fourthly There is no Necessity of sewing the wound together after the manner of Barber Surgeons but every day only to bind it up with a clean linen Cloth first wet in the Patients Vrine Fifthly That day that any one anoynts the Weapon let him abstain from Venery Sixthly Before the anoynting of the Weapon let the Wounded persons blood be with al speed stanched Seventhly In fractures and ruptures of bones you may add unto the unguent some of the powder of the greater comfry or the roots of black Hellebor Having the weapon wherewith the Patient was hurt if thou be desirous to know whether the Patient be likely to live or to die of his Wound thou art to make the trial in this manner Take the weapon and make it hot over the coals so hot that thou can hardly endure thy hand upon it and then sprinkle upon it some powder of Red Sanders and the blood stone and if the Weapon then sweat drops of blood the patient will die but if not he wil escape it But if we would know whether the Patient order himself aright in his drink and other Requisites this may thus be known if there be in the weapon spots of blood he is disordered but if no such spots then the Patient ordereth himself aright We are moreover to take notice first that if we have not the Weapon or instrument whatsoever it were yet nevertheless that any violent opening of the Skin and hurting of the flesh by which any Blood goeth forth may be Cured with this unguent so that a little piece of Sallow Wood be moystened in the bloody opening and after that the Blood sticking thereto be dryed not by the heat of the Sun or the fire but of it self and own accord it be then put into the above mentioned Vnguent kept close covered in the Box and there left Secondly If the Wound should be great and deep it may then be cleansed every morning and bound up with a new Linen Cloth without any other use of Extraneous Oyls Vnguents and the like and then this wound how ever it were inflicted will heal of it self and it sufficeth that the little piece of Wood once only moystened in the opening of the Bloody wound be then put into the Box of Vnguent as aforesaid and there left to remain until the Wound be perfectly Cured Thirdly But yet notwithstanding as oft as any new Wound is to be healed there is alwaies required a new piece of Wood. Fourthly But if it be so that the Wound wil not bleed it is then with the Wood so long to be scarified until the blood flow forth and so likewise in the curing of the Tooth-ach the pained Tooth is so long to be scraped with a Pen-knife until it bleed and then the Pen-knife after the blood is dryed up it to be anoynted with this Vnguent and so the pain is presently asswaged If a Horse be prickt with a Nail in his Foot let the Nail be first of all drawn forth and anoynted with this Vugment and the Horses Foot shall immediately be cured without any suppuration at all And so in this same manner all living Creatures having flesh and Bones may be Cured The description
unto that Woman out of whom they flowed Although they do not likewise here sufficiently and cleerly explain themselves For Crollius writeth that this Cure is performed by the Magnetick attractive virtue of the said Medicament caused by the Constellations which virtue say they by the Medium of the Air may be brought unto the Wound and conjoyned therewith and then immediatly he addeth that there are three things that by this Medicament Cause so admirable an effect 1. The Sympathy of Nature 2. The influence of the Celestial Bodies performing its operations by the Elements 3. The Balsam that being endued with a healing virtue is Naturally put upon any one whatsoever without any distinction of either Person or Sex Reasons against the defenders of the Weapon-salve But in very truth that we may briefly open unto you and shew you our Opinion touching this Unguent that which in the first place rendereth it very suspicious is this that they give us not one only way for the composition of this Unguent but very many and in some of them those things are omitted and wholly left out from which others derive al the virture of this Medicament as is apparent from the many descriptions above mentioned And so Wittichius leaveth out of the Composition the Vsnea or moss the Fat and Blood of man which yet nevertheless others make the very Basis and Foundation of all the virtue of this Medicament and it is with them the principal part thereof And yet nevertheless they will all of them promise you the very same effect and every of them extolleth his own as sit and proper for al Wounds whatsoever the Weapon be wherewith they are inflicted and whether they be by pricking or by Cutting or by any thing cast at the party or by a fal albeit that Goclenius indeed and Crollius do except those Wounds that are in the Nerves Arteries or any of the more principal Members as the Heart Brain c. What others object against the Composition of this Medicament to wit that the Authors of this Unguent require the Vsnea or Moss that is cut off from the Skul of a Man hanged as also joyning therewith Mummy Mans Blood a little warm and Mans fat and that in the Mans Blood and fat they think the marrow and pith of the whole business that is to say the whole virtue of this Unguent to consist whâ—ch these Judg to be superstitious this Objection I no waies own neither will I defend it it being so well known that Mans fat and Skul Mummy and Vsnea are made use of by other Physitians without any superstition in the Curing of Diseases And yet notwithstanding of this I must here admonish you that seeing that Magitians and Wizards as will appear out of Apuleius upon the 2. and 3. B. of Ovids Metamorphosis and Nicolaus Remigius in his 1. B. of Daemonolatry and â—6 Chap. and 2. B. Ch. 1. and others also that have written of witches and Sorcerers seeing I say that these are wont in their sorcery to use mans Blood and Flesh and other parts of Mans Body every one ought to be careful who will make use of such Medicaments that he do not superstitiously use the said Medicament for the procuring of a Natural effect and so thereby gratifie the Devil who is the enemy of Mans both Soul and Body and so unawares do him Service which may be done if he use such Medicaments for those effects that are not in the Natural power of those things and therfore if those effects shal follow they are to be imputed and ascribed unto the Devil by such like superstitious practises laying snares for mankinde rather then unto the thing it self As touching the effect of this Medicament that it doth not evermore answer the desire and expectation we are shewn by Guilbel Gabricius in his third Cent. and 25. Observation And be it so that as many great and eminent persons have testified divers who have made use hereof have recovered yet nevertheless these can attest no more but this that the person was wounded that unto him there was administred this kind of Cure by the Weapon-Salve and that this person recovered but that he recovered by the virtue of this Medicament this they cannot testifie For there may be oftentimes many things conjoyned with some effect that are not the Cause thereof And therefore as it doth not follow that such a person walking it Lightened therefore his walking was the cause of the Lightening so no more will it follow this wounded person was healed and he applied the Weapon-Salve therefore the Weapon-Salve was the cause of the cure unless it be demonstrated that from the said Unguent this effect necessarily followed And in nothing indeed is the fallacy of the cause more frequent then in Physick where oftentimes the healing of some Disease is attributed unto this or that Medicament whereas the truth is it proceeded not from the said Medicament but either from Nature her self or else from such other Medicaments as were administred before together with or after the said Medicament whereunto the Cure is ascribed And a very great difference there is between Physick and other Arts. For in other Arts the effect being upon somthing that is solid dependeth wholly upon the Artificer and if there be any thing well or ill done by him all this is to be imputed and ascribed unto the Artist unless it so fal out as happily it may and often doth that by reason of the unfitness of the subject matter for as we use to say a Mercury or Statue is not made of every piece of Wood or else by reason of some fault in the Instrument somwhat may happen to be done amiss since that as we told you before in the first B. of our Institutions and 1. Chap. the subjects of other Arts do nothing at all but only obey the will of the workman whereas in Physick the subject matter thereof hath a certain innate power by which being assisted by the Physitian for the most part of its own accord it tendeth unto health from whence it is that by Hippocrates 6. Epid. Comm. 5. Text 1. they are said to be the Curers of the Diseases of Nature So that the whol business in short comes to this that the State of the Controversie here is not whether in a person wounded and recovered again the Cure were done by the Weapon-Salve but this whether or no the Weapon-Salve were the Cause of the healing of the Wound touching which we are now to make a little further enquiry Now it being so that Nature as we shewed you above is the Cause of the Wounds Conglutination but without the virtue of any Medicament under what Notion or Consideration soever and that oftentimes likewise even by Lard or some other thing of no great moment laid on many Wounds without the help of any other Medicaments or any assistance from the Physitian have been Cured therefore in the Cure likewise that is by
that is in the blood the virtue of the Medicament is carried and conveyed unto the wound For if all that whol blood were resolved into Atomes it would not be sufficient to fil up all that so great a space Neither have they as yet proved that the blood can send forth out of it self any such species And if by the benefit of the blood the virtue of the Medicament may be carried unto the wound why should it not then likewise carry to the wound the virtues of other things into the which out of wounded persons the blood is oftentimes abundantly poured out which yet we see that it doth not But now as for those things that they alleadg in special touching the Secundines and the first menstruous blood of Virgins and as for their asserting that if this blood be not rightly handled there is much hurt and damage brought unto those maydens these things are to be imputed unto the superstition of these young Women And if in woman kind the Secundines being cast forth into some unclean places bring damage unto these women from whom they came why is not the like done in bruit Creatures whose Secundines or after births being cast forth and buried in dung do oftentimes putrefy And in what place soever you dig and bury these secundines they yet notwithstanding rot and putrefy And why also do not the Molae or false conceptions which women use to burn bring any hurt and damage unto the Woman from whom it proceeded And why should the first menstruous blood if it be burnt bring damage unto the virgin and none of the rest These things being as we have said and the case thus standing there is no need of any further tedious dispute touching those virtues that this unguent is said to have in curing the Wound seeing that it is hitherto sufficiently proved that there cometh no virtue at all from this Unguent unto the Wound And if this Unguent had indeed any virtue at all in it either of preserving and cherishing the temperament or the innate heat of the part they commonly cal it the Balsam or of drying up the Excrements it would better and more commodiously exercise and put forth this virtue being anoynted upon the wounded part it self then upon the Weapon And besides all this if as some will have it the virtue and strength of this Medicament consist in the Blood and fat of Man why then do some of them likewise apply it unto the Wounds of other living Creatures to wit of Horses c. For how great is the Difference between a Man and a Horse But that Crollius and some others that I may not here altogether omit the mentioning of this also derive the vertue of this Medicament from the Heaven and therefore command the preparing of it in such a certain position of the Heavens Neither will that at al patronize this Cause For they have not as yet proved that there is in the Heavens or any of the Stars any virtue at all to heal Wounds or that if there were any such virtue in these that it doth so mingle it self with this Unguent that as if it were in a manner bound and shut up it may be carried up and down about with us and drawn forth into use and Act when we please And so likewise as touching the manner of using this Medicament this also hath no Foundation to uphold it neither doth it want for superstition For first of al seeing that they place the whole Cause of the Cure in this that the virtue of the Medicament is derived unto the Wound by the benefit of the natural Balsam that is in the Blood why then do they anoynt only the Weapon with the which the man was wounded or some other Weapon or a piece of Wood bloodied with the Blood of the Wound and why do they not as well anoynt his shirt or the other Garments of the wounded party or a Stone or any thing else what ever it be upon which the Blood hath been spilt or poured out and if not there is then some implicite underhand compact with the Devil to be suspected And moreover why if the wound be made with the pricking of a Sword do they anoynt the Sword in the point therof towards the hilt but if the wound be made by the Cut of a Sword then they anoynt it from the edge towards the back and if it appear how far and deep the Sword penetrated into the wound so far they anoynt it and no farther but if it doth not appear how far it pierced they then anoynt the Sword all over all which are no better then Superstitious Ceremonies and of which no Reason can be rendered For if the power and faculty of the Medicament be Natural what doth this or that manner of using it in the anoynting make to the thing it self and whether or no doth it add any new virtue and quality thereto If the vertues be Natural there is no need of any such Ceremonies as it plainly appeareth in all Natural things whatsoever The Load-stone draweth the Iron and the Iron being touched with the Load-stone is moved unto the North-pole without any of the aforesaid Ceremonies And furthermore some there are that anoynt the Weapon once every day others every Second or Third day and some content themselves with once only anoynting And some there are who that so they may not Erre in the anoynting wholly dip and plunge the Weapon or Sallow Wood that now and then serves in stead thereof into the Unguent kept in along Box or little Chest until the Wound be perfectly healed but they altogether neglect the Weapon it self that dip the Arms or that they make use of in their stead all over in the Unguent But others there are that keep the anoynted Weapon in any temperate place what ever it be and others likewise shut it up in a little Chest But al of them generally are exceeding Cautious in this that the Weapon be never kept in any place that is over hot or over cold and that it be not polluted with filth and impurities for if this should happen the Cure will by this means be hindered and a most grievous pain in the Wound procured unto the sick person All which are meerly frivolous and superstitious For seeing that as it is before sufficiently proved there cannot possibly be any action of the Weapon-Salve upon the wound at a far distance and interval of place from the Wound so likewise we say that it cannot possibly excite any pain And therefore we conclude that if this at any time happen it is then caused and procured by the help and assistance of some evil spirit And most certain it is that the Blood of wounded persons is not alwaies poured forth into clean places but oftentimes into places very noysom and unclean and that in the Winter time it is frozen and that the Bloody Linen Clothes are washed with warm Water and the wood be sprinkled
now separated are soon discovered and likewise in the place of the fracture there is found a Cavity or hollowness that is not Natural And moreover the body and especially the broken Member cannot be moved after the due and wonted manner And there ariseth likewise before the bones be set and brought together again into their places an extreme and most intollerable pain whiles that the extremities of the broken bone prick and grate upon the parts nigh unto them being very quick of sense and feeling Which that it may be the more rightly known the member that is sound is to be compared as Arm with Arm Leg with Leg with that that is broken And very often also it so falls out that by reason of a broken bone the Member is made shorter then it should be whilest the Muscles draw up the inferior part of the bone And for the most part likewise fractures are generally and commonly well known some violent causes having power enough to break the bones usually preceding But then those fractures that are made longwayes in the bone are not to be known but with more difficulty and yet notwithstanding they may be discovered from the preternatural thickness of the Member as also from the inequality and pain thereof The bones oftentimes likewise impostumate and drop forth to wit when all their small parts and little pieces could not be brought back and set in their proper places and thereupon are left destitute and naked of flesh and this is known by the blackness of the bone if at least it lie open unto the view or else by the stirring and moving up and down of the bone if it be found not to adhere and stick close unto the other bones Prognosticks 1. The fracture of the bones made according to the length of them is more easily cured then that fracture that is made either in an oblique or in a transverse manner For there is no such need of any laborious replacing of the bones but it is sufficient if the bones gaping as it were be again Joyned close together 2. Among the Transverse and oblique fractures that is most easily Cured and hath least of danger in it that is single or simple and equal and in which the broken bones are not at al moved out of their places 3. Those fractures in which the heads of the broken bones are retuse and blunt have but little of danger in them but when they are sharp-pointed those fractures are the worst and most dangerous of any inregard that they are not easily to be set close together as having nothing of any blunt bone to rest upon and because they also hurt and wound the flesh and somtimes likewise a Nerve or Muscle as Celsus tells us in his fifth Book and Chap. 7. 4. The fracture is then very difficult to be cured when the bone is divided into many fragments and the more the smal pieces are still the more difficult is the Cure like to prove and so also when there are sharp pointed stickings out which prick and wound the parts that lye neer unto them 5. By how much the greater the fracture is and by how much the greater also the broken bones are with so much the more difficulty and slowness is the fracture Cured 6. When two bones Joyned together as in the Arm the Radius and the Vlna in the Leg the Ankle and the Fibula are both of them broken the Cure will be more difficult then if only one of these be broken For if one of these bones remain whole and unbroken the Muscles cannot then so easily be contracted as being kept stretched out by the unbroken bone And so likewise when the broken bone is set again in its former place if the other be whole that serveth instead of a prop unto that which is broken and a greater help and benefit it is unto it then are either the swathes or the splinters or both of them together But on the Contrary if they be both broken al things that are performed in the keeping in its place the bone after it is set must be done with far greater Care curiosity and pains-taking 7. The Fracture that is made in the middle of the bone is to be accounted lighter and less dangerous then that which is nigher unto the head of the bone whether it be the superior or the inferior head For whereas nigh unto the lower head there are many Tendons and neer unto the upper head very many Nerves the greater are the pains that are excited and the Cure is rendered so much the more difficult But if the fracture be nigh unto the Joynt it is then the most dangerous of any in regard that there are in that place both Tendons and Nerves and Ligaaments and because that the broken part cannot there be so conveniently bound up and because also in this bloodless and cold place the heat is but very weak And albeit that the fracture may in that place be consolidated yet nevertheless it leaveth behind it a great impediment in the motion of that Member by reason of the Callus which bindeth as it were the Tendons or Muscles 8. A new fracture is very apt and ready to be consolidated But if there be any time delayed the Cure is thereby altogether rendered the more difficult not only because that upon the happening of the inflammation that extension of the part which is required cannot be performed without much danger but likewise because that the extremities of the bones become hardned so that they can never after this be brought to Joyn and grow together again and this more especially happeneth in aged persons And there fore we must endeavour all we can that as speedily as may be the Extremities of the bones may be fitted and Joyned together the one to the other for so by this means they wil afterward the more easily grow together again for be it how it will if so be that pain and an Inflammation happen upon the fracture they render the Cure the more difficult 9. If in a fracture of some one of the more eminent bones the fit and Convenient Cure thereof be protracted and put off beyond the seventh day there wil then be danger lest that something of the bones be be nummed impostumated as Galen tells us in his third Book of Fractures Text. 37. 10. And so likewise if there be a Contusion of the flesh and a wound Joyned together with the Fracture the Fracture is then very dangerous and so much the more dangerous by how much the wound is the greater and especially if any of the greater Muscles as of the thigh and shoulder shal be Wounded For then Inflammations do very easily happen and at length the Gangrene and Sphacelus And that likewise which here maketh the Cure to be the more difficult is this to wit that the splinters and the other like things that are necessarily requred for the keeping of the bones in after they are
turned into Pus abundance of the said Pus must necessarily be bred which if it be reteined as needs it must if the Wound be wholly bound up soon becometh sharp and so exciteth an iâ—ching and pain and divers other mischiefs although that Nature be strong and vigorous yet nevertheless the generating of abundance of the said Pus cannot be avoided since that all whatsoever is bruised must of necessity be converted into Pus And although that Magatus doth cut and make little slits in all the Linen that he putteth upon the Wound that so there may be a free and ready passage for the Pus yet notwithstanding all the inconveniences that proceed from the retention of the Pus cannot by this means be prevented For if those Swathes and Linen Clothes shal not be shifted before the fifteenth and somtimes even the thirtieth day they must certainly be very much desiled and polluted by the Pus and Sanies whereupon in the wounded part an itching pain and exulceration may follow But then on the other side if the Swathes be still kept whole and not at all cut and thereupon to be loosned every third day it is then to be feared lest that the Pus reteined may in the mean time excite some mischief or other and also lest that in so many loosenings and new bindings up again the bones may be removed out of their places and having been wel set and joyned together they should again be depraved and disordered which may easily be avoided if the binding be but seldom loosened and the Wound kept open And yet notwithstanding as often as the Wound is dressed it may be covered over with a new Swathe which may contain both Medicaments and those Coverings they cal Splenia and may defend the Wound from the external Air and it may be loosened as often as there is any need thereof but then indeed it must be without any agitation shaking or violent moving of the broken Member And there must also no Splinters be applied lest that they too much compress the Wound and beget a pain and Inflammation And if any will needs apply them yet notwithstanding they are not to be put upon the very Wound but neer unto the same Yet the truth is the number of the Swathes may very well supply the use of these Ferulae or Splinters And these things are thus simply to be performed if there be neither any bone naked and bare and that we fear not the impostumating and falling cut of any broken piece and fragment of the bone Chap. 3. Of a Fracture with a Wound in which there is no bone made bare and yet nevertheless a Cause to fear the falling forth of some fragments of the broken bone IT happeneth oftentimes notwithstanding in Fractures with Wounds that there is no bone at all left naked and bare and yet nevertheless we may have great cause to fear that some broken bone may impostumate and drop forth and this is done when the bones are made dry and withered so that they cannot be agglutinated unto the sound bone or in a Fracture when they are so separated from the rest of the bone that they can no more be joyned therewith For then Nature endeavoureth to thrust forth whatsoever is troublesom and burdensom unto her and what cannot be united unto the rest of the bones neither is she at rest until whatsoever offendeth be wholly expelled out of the Body and this oftentimes she doth at length perform although it be a long time first Now this happeneth when the bones are either corrupted by the Sanies or else when they are altered by the external Air or else likewise when they are so separated in a Fracture from the rest of the bones that they cannot possibly be any more conjoyned with them Signs Diagnostick Now what the Signs are of a bone like to be impostumated and to drop forth we are told by Hippocrates in his 3. B. of Fractures Text 18. The First Sign is this that there floweth forth a greater abundance of the Sanies or thin Excrement then could rationally be expected from the greatness and Constitution of the Wound Secondly That the Lips of the wound do not meet together or if they do at any time meet together yet they soon seem as it were to be broken and to be stirred up and provoked to excretion and they become as it were loose and spungy and there is perceived in the wounded part a certain silent motion For Nature doth not entirely heal a Wound when there is somthing remaining within that cannot possibly be agglutinated with the rest Thirdly If the bone be left bare of Flesh it is then altogether a Sign of its separation and dropping forth in regard that then it may be altered and corrupted by the external Air and that the Veins and Arteries which convey the Aliment can no longer run forth unto it And Fourthly It is then likewise a Sign that the bones will fal out if they be broken and shattered into many smal pieces and fragments for then they cannot all of them be easily Conglutinated Prognosticks 1. It is a Sign of an Abscession instantly to follow if there be good Flesh bred in the sides of the sound bone 2. But the time in which the bones are wont to recede and fal forth is various and not at all times alike For in those of a tender Age and in the Summer and if the bone be not very great it is twenty thirty or perhaps fourty daies ere the bone will be separated and fall forth But if the bone be any thing great in one of a ful and ripe Age and in the Winter time it is usually threescore daies yea and somtimes longer ere it impostumate and drop forth The Cure If the bone that is like to fal forth be moved out of its place and that it stick in the very Wound it is immediatly as we told you before to be drawn forth with the Volsella or Pincers if it may indeed be so drawn forth without any pain and violence but otherwise the whole business is to be committed unto Nature which by degrees wil at the length separate that which cannot be agglutinated And yet nevertheless she is to be assisted and holpen by the Physitian and therefore the binding ought to be instituted in a loole manner and often unbound that so the Pus and filth may not be deteined but that it may freely and easily flow forth And likewise there are no Splinters to be imposed upon that place by which the bone is like to fal forth lest that by compression they cause pain And so also there are Medicaments to be laid upon the Wound that have in them a power of drawing forth of the Wound the bones and whatsoever is extraneous and no way belonging unto the part affected and such Medicaments we have above mentioned in the place alleadged But if there be some great and extraordinary portion of the bone like to
regard we have extant the most learned Books of Hippocrat upon this very subject touching Fractures and the Joynts and the most accurate Comment of Galen upon them I held it altogether needless and not worth while to treat more largely of them as I see that others have done before me but think it fitter for me to refer the Reader unto them if he desire to see more hereof THE FIFTH BOOK THE SIXTH PART Of Luxations Chap. 1. Of Luxations in general THere are very many Bones in the Body of Man which are composed and joyned together after divers sorts But they are chiefly composed by a Symphysis and Articulation A Symphysis is a union of the Bones without motion but the Conjunction by Articulation is composed for motion the differences of it are chiefly two a Diarthrosis and Synarthrosis Diarthrosis is with a manifest motion Synarthrosis with an obscure one of which consult with the Books of Anatomists When therefore the Bones which are joyned by Articulation do fal out of their place What Luxation is the Disease is called by the Greeks Exarthrema by the Latines a Luxation which is the falling down of the Joynt out of its place which is called the Acetabulum or hollow into another place by which voluntary motion is hindered where by a Joynt is understood What a Joynt is as Galen and Hippocrates also do teach Artic. 1. Text. 1. not that aggregate of the two ends of the Bones joyned together but only the head of the joynt The Causes Internal Causes But the Causes of a Luxation are either Internal or External The Internal are humors which falling down upon the joynts either do relax the Ligaments that they suffer the Bones to fal out of their seats or by filling them up do shorten and contract them that they draw the heads of the bones out of their seats To which haereditary defects must be referred whenas Experience doth teach us That oftentimes those that have bunches in their backs do generate the like and lame folks beget lame But the external violent Causes are External blows fals violent extension and the like which can expel or draw forth the Bones from their seat and that sometimes is done even in the Birth and the Arms or Thighs may be luxated while the Infants are drawn forth with violence by ignorant Midwives nay in the Mothers Womb Infants may have a luxation of their bones by a blow fall compression as Hippocrates seems to intimate 3. de Art 88. and 94. and 4. de Artic. Text. 2. and 3. but al causes of what kind soever do cause luxations either by violent distension or impulsion most commonly a luxation is caused by violent impulsion when from causes happening from without as fals jumping blows and the like the bones are violently expelled out of their seats Al other causes are to be referred to distension to wit when the Cavities receiving the heads of the bones which the Greeks cal Cotylae are rendered either narrower or larger and relaxt this Cavity is made narrower when a humor or some matter doth possess the bosom of the joynt and drives the bone out of its seat which happens somtimes in pains of the joynts but the Articulation is made larger or looser when the brows including the bosom are broken for so the bones may more freely wander and sal forth and the Articulation is made looser also when some humor doth too much mollefie and relax the Ligaments and renders the whol Articulation more loose The same happens when the Ligaments are too much distended or broken But the Bones are more and easier luxated in Children and young folks whose Ligaments are softer and weaker than in those of riper age whose Ligaments are firmer and stronger It happens also in them whose bodies are wasted and have weaker Ligaments but those who are fleshy and wel habited have not their joynts easily fal forth when as the joynt is on every side straightly girt in with strong Muscles also those joynts are easier luxated which are composed for many sorts of motions but those which have fewer different motions do not so easily fal forth of their seats those joynts also which are contained with one Ligament are more easily luxated than those with two the greater bones also are more difficultly luxated and not unless by a violent cause the lesser bones more easily last of al some bones do more easily some more hardly fal out of their places according to the nature of the Articulation as afterward shal appear in particular This must be observed in general That the joynts which are in a plainer bosom are more easily luxated but those which are hid in a deeper bosom more difficultly The Differences The proper Differences are taken either from the Subject or the Form The Differences from the subject or the Efficient Cause From the Subject because the bones which are luxated are joyned either by a Synarthrosis and with an obscure motion as when the broad bone of the shoulders departs from the shoulder bone or the Channel Bone from the top of the broad bone of the shoulders or the radius from the Elbow which kind of Luxation the Arabian Interpreters cal a disjunction when the bones gape as it were or by a Diarthrosis with manifest motion which Luxation is most properly so called There is also a peculiar kind of Luxation but improperly so called when the Epiphyses of the bones are pulled from the bone on which they were placed which happens chiefly to young folks From the Form because the Joynt somtimes wholly fals out of its seat From the Form which Luxation is called by the general name Exarthrema or Luxation but somtimes it fals forth only in part and to the brink of the bosom or hollow which the Greeks cal Pararthrema the Latines a Subluxation to which kind of Luxation also belongs that elongation when the Ligaments being luxated and made longer the joynt indeed according to the longitude doth somtimes depart from its seat yet fals not wholly out of it But from the variety of the Scituation to which the joynt fals forth there are fetcht three differences chiefly From the variety of the scituation The first is if the bone which is naturally placed in the upper part fal out to the lower or on the contrary The second is if that become on the right side which ought to be placed on the left or on the contrary it fal from the left to the right which others cal outwardly or inwardly The third is if that which was placed in the fore part fal to the hinder and on the contrary that which was placed behind fal out to the fore part and the joynts of some parts may be luxated into al these differences some only into certain differences not al so the elbow hand thigh fal forth into four differences viz. To the inward outward forward backward but cannot upward the knee fals
out into three scituations viz. The inward outward and hinder part towards the ham but the opposition of the patel bone hinders its falling out to the fore part of which shal be spoke hereafter in the Luxations of the particular parts The Difference is taken from the Efficient Cause From the Efficient Cause because the Luxation is somtimes from external Causes as fals blows jumpings running and from a violent distorsion extension and impulsion of the part but somtimes from internal causes as while a humor sliding into the cavity of the joynt drives it out of its place There are also certain improper Differences Improper Differences or rather complications of other preternatural Affects with Luxations as that an Inflammation fracture wound or somwhat else is joyned with the Luxation Signs Diagnostick A Joynt being fallen forth into another place is easily known by the sight and touch for there appears a Tumor in the part into which the joynt is fallen but a hollowness in the place from whence the joynt is fallen and that appears so much the easier if the body be not very thick and fat or the place be void of flesh Again if the Luxation be perfect that Member is made shorter whenas the joynt no longer included in its Cavity but falling out of it is drawn upwards yet somtimes the Member becomes longer as is afterwards said in particular When then the Member luxated is alwaies unlike to the sound one in scituation figure and longitude we must alwaies compare the Member affected with the like sound part of the same name Arm with Arm Thigh with Thigh in the same man where yet we must observe that the Member with which we compare it be found and have no fault Thirdly because Articulations are made for motion if a joynt fal out of its natural seat it must needs be that the motion of the joynt is hurt therefore where there is a suspition of a Luxation yet the motion is not hurt we must conclude that there is yet no luxation made Lastly because a joynt falling forth of its seat doth compress the sensible parts into which it is fallen as the Tendons Nerves Muscles from thence there is raised a pain And these are the signs of a perfect Luxation but if there be only a Subluxation the Signs propounded wil either be more gentle or some of them wil be wanting If there be a Luxation of a joynt joyned by a Synarthrosis in which the Bones do gape it is known by the thickness of the Member greater than usual and by a greater bunching out than the heads of the bones do consist of As concerning the Causes The signs of the Causes the external and violent are apparent by the relation of the Patient and the Luxation proceeding from thence happen suddenly but if the Luxation he by reason of the loosness of the Ligaments it happens by degrees and the luxated Member is moved and totters up and down with inordinate motions and whiles the joynt is forced into its seat the Member indeed acquires its natural longitude which being let alone again presently it becomes longer Also if the head of the Bone luxated be thrust with the fingers to the contrary part it easily recoil back every where about the joynt there is a Cavity begotten that if the finger be thrust into the joynt it easily goes in no body resisting as if al were empty When some Epiphysis is pulled off from its being it is known by the impotency of motion and by the crackling when they are handled and moved Prognosticks 1. In the Bodies of Children and yong folks and those that are softer the bones luxated are easily restored yet being restored are not so faithfully retained the contrary happens in riper and harder bodies 2. The Joynts which are dedicated to fewer differences of motions are more difficultly replaced but better contained 3. By how much the further the joynt is fallen from its bosom by so much the more difficultly 't is restored by how much the neerer by so much the sooner 4. The Luxations in which the brows of the bones are broken are worst of al for though the joynts be restored to their places yet they continue not long but fal out again upon the sleightest cause 5. The joynts which are fallen forth by reason of the Laxness of the Ligaments though they be replaced yet do easily fal forth again 6. Those Luxations which have a great pain inflammation or wound happen on them are hard to be cured and want not their danger and cannot be restored without danger of Convulsions nay of death Wherefore if the bone being reduced the Nerves be distended it must presently be forced out again as Celsus doth counsel 7. Old Luxations and which are grown hard with a Callus and which have a clammy humor filling up the Cavities of the Bones are never or very hardly cured therefore every Luxation must presently be replaced 8. They who in their Childhood have had their joynts fal forth and are not replaced they grow less than others 9. What Member also soever hath been troubled with a long continued Luxation by how much 't is the less able to be moved by a natural motion by so much the more 't is extenuated and wasted both because by intermission of motion the Native heat of the part is dulled and because the Vessels are comprest by the luxated joynt and the necessary influence of blood and spirits is hindered 10. A Luxation of the head brings death by reason of the compression of the Spinal Marrow presently at its first rise and the prohibition of the influx of animal Spirits We shal afterwards speak in particular of the Prognosticks of the rest of the joynts The Cure The Bone luxated and which is fallen out of its natural seat shews a reposition to its natural place and this Indication is satisfied and Luxations are cured by straining and forcing them to the part opposite to that from whence the change is made which replacing of the joynts fallen forth of their seats is called ton arthron embole and arthrembole But the replacing of luxated Bones is compleated three waies either by the hands of the Chirurgeon and his Servants which is the most simple and is called Palestrical because 't was used in the wrestling places if at any time the Fencers Limbs were luxated and 't is convenient in soft bodies and where the evil is fresh or by some vulgar instruments the joynts are forced into their seats as by the help of reins swathes ropes ladders seats two leav'd doors which is called the Methodical way and is convenient for children women and the stronger males and for old luxacions or 't is performed by instruments and certain singular engines and 't is called organical and 't is applied to stronger bodies and old Luxations and altogether to those which cannot be restored the two former waies But concerning such Engines see Hippocrates de artic et
Jaw it is easily apparent that that only can suffer a Luxation The which notwithstanding is not easily luxated by reason of the most straight coarticulation of it with the bones of the head and the exceeding strength of the Muscles that draw it upwards but into what part the Mandible may be luxated its structure and insertion do plainly teach us For as concerning its structure it hath two processes in its hinder part on each side the former of which drawn forward being broad and thin ends as it were in a point but the latter is carried backwards and makes a long and transverse head that is inserted into the Os Jugale but this is fitted to the second bosom ingraven in the Temple bone The Differences From which it doth manifestly appear that the lower Mandible cannot be luxated to the hinder part because the Teat-like processes of the Temple bone do hinder it not to the right especially in those of ripe age because the left head of the Jaw hinders not to the left because the head of the Jaw in the right side hinders that In those of ripe age I said for 't is wel known by Anatomy that the lower Mandible in Infants is cleft and in the midst of the Chin is joyned with a great deal of Cartilage which Cartilage if it be relaxt by a flux of humors or the Chin be struck that the bone be separated from the Cartilage perhaps the Jaw may be luxated to the right or left side the which yet seldom happens and therefore is not considered But in the riper aged because that Cartilage hath so degenerated into a bony nature that it can by no means be separated no not by boyling nay not the least footstep almost remains of a line or any seam but it appears one continued bone Physitians do rightly affirm that the luxation can be made only to the fore part But this Luxation happens if the former and sharp process like to a Beak which by the Greeks is called Corone do slide forth below the Os jugale that it becomes so much lower then it that it can no more return upwards again into its place for otherwise though this process be let lower then the Os jugale yet there is not presently a Luxation made but the mouth being shut it returns into its place again but this Luxation is made either in one side only when only its right or left part slips forth or in both sides together when the whol bone of the lower jaw on both sides is fallen out of its seat The Causes But the most common Cause of this Luxation nay almost the only Cause is the too much opening and gaping of the mouth whether it be by yawning or by taking some heavy burden in the Teeth and lifting it on high so that the forenamed process becomes lower than the Os Jugale as was said and withal be turned aside for its return into its seat is not prohibited unless it be turned aside Yet this very thing happens seldom and hardly and the Jaw is seldom luxated by reason of the strength of the Muscles by which 't is tied to the upward parts For from both processes of the lower jaw arise Nervous and most strong Tendons with which the Muscles are inwrapped which are called Crotaphitae and Masseteres Signs Diagnostick That the jaw is fallen out of its seat may be known in general because the lower jaw hangs forth to the fore part and the process of the bone like to a beak stands out by the jaw For if the process resembling a beak fal out of the Os Jugale it must needs be that there also it hang forth which in a man not very fat is easily known both by sight and touch The mouth remains open whence the speech is hindred and the spittle flows forth involuntarily If the jaw be luxated on one part that with the chin is inclined to the contrary part which is not luxated the mouth is distorted whence the Teeth cannot be joyned neither do they answer to their equals but the dog-teeth are under the Cutters In the luxated part there is perceived only a certain bunching out and the temporal Muscle appears stiff But if the jaw be luxated on both sides al of it with the chin hangs forth and that straight out towards the fore part or to the Breast the lower Teeth go further out than the upper yet they answer one to another the Cutters to Cutters the Dog-teeth to Dog-teeth neer the Cheeks on both sides there appears a certain eminency which the acute beak-like process doth make the temporal Muscles whose Tendons this process doth receive yea is wholly compassed by them appear stretcht stiff and hard Prognosticks 1. The Luxation of the Mandible is a dangerous evil and a jaw luxated as Hippocrates teacheth 2. de Art and Galen in his Comment must speedily be replaced since that the temporal muscles and the Nerves inserted in them and consequently the brain it self are easily drawn into consent For the temporal Muscles have the greatest consent with the brain and do receive nerves from the brain of the third conjugation from whence do arise not only pains inflammations continual feavers dul sleeps but also death it self is often hastened about the tenth day 2. Those whose Mandible is not reduced are wont to void by stool filthy and thin Choler and if they vomit the vomit is pure 3. Yet there is greater danger instant and the replacing is harder if the jaws be luxated on both sides then if only on one side whenas al the Muscles with which the jaw is contained are then distended The Cure The Mandible luxated shews that it must be reduced into its seat again which how it ought to be done Hippocrates teacheth 2. de Artic. t. 15. and 16. in these words One ought to hold the head of him that is luxated another the lower jaw the man gaping as much as he can conveniently and taking it about the chin with his fingers both within and without first a little while to stir it up and down and then with his hand to move it aside and to command the Patient that holding the luxated jaw he further it and be very obedient to him moving it Then endeavor must be used that at once of a sudden we strike it off of its three figurations for the lower jaw must at once be promoted from its distorsion to its natural position and it must be driven backwards and the Patient obeying these ought to shut his mouth not to gape any longer and this indeed is the reducing of it which cannot be done by other figurations but afterwards a little Physick wil suffice a bolster laid on with a Cerote we apply a loose binding up yet we perform this office more safely if the man be bended backward and his head supported with a leather Cushion wel stuffed put under it that it may yield as little as may be If the jaw
Afterwards by degrees strew in two ounces of white Vitriol poudrered then add two ounces of Litharge and at length when they are almost boyled to a just thickness add one ounce and half of Tacamahacca stir them again and boyl them to the consistence of a Plaister Gulielmus Fabricius Centur. 5. Observ 67. propounds such a one Take of the Plaister Slotanum half an ounce new Wax two ounces Osteocolla one ounce Pouder of the roots of the greater Comfrey Terra Sigillata of each three ounces Pouder of Pomegranate flowers Cypress Nuts red Roses of each one ounce Oyl of Roses or Mastick as much aâ— wil suffice mix them But before such Plaisters and Places be laid on it wil be good for some time before to foment the part with the following Decoction and to anoynt it to mollefie it if any thing be hard that it may be rendered more fit to be replaced As Take of Sage Marsh-mallows Flowers of Camomile Melilote St. Johns-wort of each one handful let them be boyled for a Fomentation Take of Oyl of Worms of Orrace of white Lilies of each one ounce Oyntment of Agrippa half an ounce Dialtheaea one ounce mix them Secondly A Luxation of the Vertebrae inwards if the Vertebrae be luxited inwards the restitution of them is altogether more difficult yet in tender bodies if the Evil be new some Plaister firmly sticking to the Skin may be applied to the place affected and the luxated Vertebrae may be drawn forth thither In those of riper age Guil. Fabricius Cent. 5. Observ 69. thinks an extream Remedy is rather to be attempted then to reliâ—quish the Patient who otherwise must lead the miserable life of the Disease or die To wit as Fabricius teacheth Incision must be made with a Knife even to the descending appendix of the Vertebra then through the same Wound putting in the Knife again two Incisions more must be made one to the right the other to the left side of the Appendix then the Appendix being laid hold on by Instruments fit for this purpose it must be drawn upwards and the Vertebra replaced in its natural seat but in the interim whiles these things are done it must needs be that the Back bone be extended for the Vertebra wil the easier start into its natural position The Wound must be smal or great according to the greatness of the dislocation for if only one Vertebra be prest in a smal Wound wil suffice but if two or more it must needs be great that both the luxated Vertebrae may be laid hold on If a Flux of blood do hinder so that the operation cannot be done presently after Incision is made it must be stopt with Hurds closely wreathed up and wet with the White of an Egg and strewed with a pouder to stop blood where this must be observed that the whole Wound especially on each side of the Appendix be most carefully filled up with those Hurd but that this may be done commodiously many little pillows must be made of Hurds wreathed up into this fashion and so one after another must be thrust into the Wound til it be filled afterwards let some Plaister that wil stick fast be applied and let it be bound with a Rowler after some hours when the blood is stopt the Hurds must be taken out gently that the blood break not forth again afterwards the Instrument must be applied as was said but the Instrument must be strong and toothed as we use in drawing forth a Stone if two Vertebrae be luxated both must be laid hold on and that with two Instruments There must therefore be two Chirurgeons who must equally and with one consent draw upwards moreover let the Chirurgeon have a care that the Incisions be not made too deep at the sides of the Appendix by reason of the Nerves which proceed from the spinal marrow to the sides of the Vertebrae moreover it is necessary that this operation be done at the beginning of the Disease while the strength is firm and before the part affected is possest with an Inflammation and Tumor neither makes it any matter whether the Patient be without Speech or Understanding which somtimes happens But if the Chirurgeon be not called at the beginning the second third or fourth day at least before the operation the place must be fomented with the Decoction of Beâ—ony Primrose Sage Camomile Melilote Roses and Juniper berries to which he may add some things mollefying as Mallows Marshmallows and then try to reduce them after the operation the Back must be anoynted with Oyl of Roses and Worms and the Wound also must be handled after the manner of other contused Wounds I have writ in the place alleadged that this operation seems to me not safe enough and to which few wil submit â— although Guil. Fabricius with Celsus l. 3. c. 33. affirms that it makes no matter whether the Remedy be safe or not which is the only one and he thinks this operation is not so dangerous since that in the middle of the Back there are no great Vessels of Veins and Arteries besides the Nerves in the Appendixes are smal Of the Luxation of the Ribs hath been spoken l. 2. p. 2. c. 25. Chap. 6. Of a Luxation of the Shoulder THe Shoulder bone with its round head covered every where with a Cartilage is joyned to the bosom of the neck of the Shoulder-blade by a most perfect manner of Articulation and most commodious for the undergoing and performing of all motions and when as this bosom is not deep enough engraved to receive the head of the Shoulder lest this Joynt should be subject to often Luxations provident Nature hath provided by strong Ligaments and a peculiar process and moreover besides the Cartilage with which she hath pargetted over this bosom she hath joyned another about it which indeed grows not to the bosom yet being tied with Ligaments begins thicker and by degrees is extenuated towards the Center yet if a violent cause come this Joynt fals out oftener and easier then the rest The Differences But this Joynt falls out downwards for the most part or under the Arm-pit hole for whereas as as Galen renders the Causes of this business 1. de artic tex 2. there are six places about every dearticulation Above and Below Before and Behind Without and Within the inner part of this Joynt by which it tends plainly upwards hath a fleshy part of a Muscle cast over it which by some is called Deltoides from its likeness to the Greek letter Δ but by that part it declines towards the Neck it hath the back of the Shoulder-blade where by the conjunction with the Neck-bone the top of the Shoulder is made which is called the Acromion where it looks inward that process meets with the Shoulder-blade which for its fashion some cal the Anchor-like some the Cornicular process which wholly forbids that the Joynt fal forth into that part But that it may fal into the hinder part
whenas there it leans on the Shoulder-blade Who is there amongst us that can so much as conceive it There are four parts then remaining which want a Guard into which it is likely the Joynt may fall Hippocrates in the alleadged place admits of no other Species of Luxation of the Shoulder but under the Arm-pitâ— nay he plainly denies that it can fal forth to the fore part yet Galen hath seen it five times once in Asia and four times at Rome and no wonder whenas in the Cities where Hippocrat lived there were scarce so many Men as in one Street at Rome and therefore there were more Examples of Diseases especially the wrastling place coming into use by which their Limbs were diversly distorted and perverted Parry l. 15. c. 21. 29. and 30. adds two differences more viz. upwards and outwards but those are very rare and you may see the places alleadged concerning them But 't is doubted whether the shoulder can suffer only a perfect Luxation or also a Subluxation Hippoc. 1. de artic tex 22. denies it and not without cause and reason for whenas the head of this joynt is round and inserted into Cavities which have their brims round it cannot stay in them and this is altogether true if the Luxation happen from an external violent cause but if the thick humors flow into the bosom of the shoulder-blade and there by their long stay do stick concreted and hardened they may by degrees thrust the head of the shoulder out of its seat and cause an imperfect Luxation yet this happens seldom in the shoulder more often in the Hip. The Causes From which it appears now that the Cause of a perfect Luxation of the shoulder is a violent cause a fal a blow vehement extension or distorsion of the Arm but the cause of a Subluxation is a thick humor fallen into the bosom of the shoulder-blade Signs Diagnostick That the shoulder is fallen under the Arm-pit is easily known and it is most certainly shewn by its proper and inseparable sign viz. somwhat round and hard under the Arm-pit is sensibly obvious to the touch to which notwithstanding other signs also are added not proper but common for there appears an unusual Cavity at the top of the shoulder but that is a common sign both of the shoulder fallen forth and of the broad bone of the shoulder blade In which things that Physitians are often deceived Galen teacheth at large both by his own and others example 1. de artic tex 61. the same falling forth of the shoulder is shewed by its unlikeness compared with the sound one by a sharp bunching out as it were of the upper process of the shoulder-blade by a departing of the Elbow from the Ribs more than usual and the difficult and painful bringing of it to them and the exceeding length and inequality of the same compared with the sound one unless the shoulder fallen downwards be nevertheless drawn up by the Muscles and the impotency of the Arm to any motion which sign also is not inseparable whenas the Muscles about the shoulders what way soever hurt whether by a Luxation or by any other Cause are unfit for motion If the shoulder be fallen forth to the fore part there is seen an unusual Cavity in the hinder part and too great a bunching out in the fore part the head of the shoulder is distorted towards the Breast the Elbow tends to the hinder parts and is with difficultly stretcht out to the fore parts and the signs are wanting of a shoulder luxated into the Arm-pit Prognosticks 1. The head of the shoulder fallen to the fore part is easier reduced than if it be fallen into the Arm-pit 2. An old Luxation of the shoulder is very hardly reduced and being replaced it fals forth again 3. They who have their shoulder reduced which is true also of other joynts the parts adjoyning being affected with no Inflammation may presently use their shoulder without any pain and these think they have no need of any further care or providence but 't is the Physitians part to correct their opinion whenas these have their shoulder more easily fal forth again then those whose neighboring parts are possessed with an Inflammation for these cannot use their joynts 4. They whose head of the shoulder could not be reduced if they grow stil that shoulder is not equally augmented as the sound one and though it be augmented somwhat yet it is rendered shorter than the other which happens by reason of the compression of the Muscles and Veins and because the whol joynt is immovable but in those who at ripe age have the head of the shoulder break forth and'tis not restored the part which is above the joynt is extenuated and becomes more slender habited The Cure That the joynt of the shoulder fallen forth to the Arm-pit may be restored into its seat from which it fel three things must be done as Galen teacheth 1. de artic text 5. First the head of the shoulder is to be forced to the fore part then to the upper part at last to the hinder part to wit that a contrary way to the Luxation may be undertaken for the head of the shoulder departing from its proper bosom is first forced to the fore part secondly by its weight 't is carried downwards thirdly 't is drawn backward to the Arm-pit hole by the Muscles But if the shoulder be fallen forth to the fore part it must be forced a contrary way to the hinder part yet that it may be freed from the Muscles with which it is detained there must first be some extension of the shoulder made yet but little But the waies of reducing it as we may see in Hippocrates 1. de artic and other Authors are various of which we wil reckon up the chief and most usual and those which require least preparation and are most safe The first way of reducing a luxated shoulder The first way is by bringing about the head of the shoulder about the neck of the shoulder-blade to wit when the Chirurgeon puts his hand most straightly under the Arm-pit and wheels about the shoulder with the other hand that the middle joynts of the fingers force it into its Cavity which way indeed wants not its danger for by the circumvolution not only the nervous and membranous bodies but also the brows of the bosom may be razed nay the Cartilage compassing the bosom cannot easily be pulled or hurt without great dammage yet it hath its place in children and other softer bodies so that the Chirurgeon do exercise it warily The second way is by the heel after this manner The second way The Patient must be laid with his back on the ground and between the hollow of the Arm-pit the head of the shoulder and the ribs a bal of a middle size made of Leather or some other matter not very soft must be fitted to it but the Chirurgeon sitting right against the
in its upper part hath a point which is sent into the bosom of the Spatha A. hollowed in the lower part next of al in place of that Spatha or Ambi there is a piece of wood which reacheth from the Shoulder even to the Bench on which the Patient sits Thirdly because that Spatha which is put under the Shoulder hath not a round head but a cross piece of wood prefixt which is sent under the Arm-pit Fourthly because the Arm is not bound to the Ambi or Spatha but only lies upon it but the swathe which is cast upon the luxated Arm on both sides of the Arm is made fast beneath to that drawing Engine For brevity sake we omit many more waies of reducing which present themselves every where in Authors and of these we have now reckoned up and others we may somtimes use this somtimes that as they are ready and at hand for it is not safe to defer the reducing long til more laborious Instruments are acquired If the Shoulder be luxated to the fore part The shoulder luxated to the fore part 't is restored almost the same waies as when ' t is fallen into the Arm-pit to wit by extending the Shoulder and drawing its head up and down and forcing it into its Cavity It differs only in this That in this kind of Luxation the shoulder being drawn downwards must be driven to the hinder part but the Chirurgeon must have a diligent care lest the head of the shoulder in the action do fal down into the Arm-pit which may be done if the Arm-pit be filled up with a bal or some round thing of a just bigness and this operation may be facilitated by a servant standing at the back of the Patient and with a rope or strong and broad swathe drawing upwards the shoulder-blade lest that follow upon the extension of the shoulder made by the Chirurgeon The shoulder being reduced Medicines that do hinder Inflammation and strengthen the relaxt and soft Ligaments must be applied of which we made mention in the precedent part concerning Fractures and above Chap. 1. of Luxations in general the most convenient way of swathing is if a bal made up of Linen or course flax and dipt in convenient Medicines be put under the Arm-pit that the head of the shoulder return not thither let the first swathe be here afterwards let it be rowled once or twice about the joynt hence let it be brought to the shoulder-blade and again descend to the joynt at last that it may draw the Arm the more upwards and keep it so let it tend to the neck on the other side and there be bound neither let it be loosened before the third or fourth day unless an Inflammation command otherwise But the swathe being taken off or laid on some Cerote must be applied viz. Diapalma if it be Summer or if it be Winter Barbarum or Oxycroceum Last of al we must not pass by here the Luxation of the top of the broad bone of the shoulder-blade The loosening of the tops of the broad bone of the shoulder blades of which Hippocrates 2. de artic tex 62. hath these words But in those in whom the top of the shoulder is pulled off the bone which is pulled off is seen to stick out But the bone is that which joynâ— together the throat and shoulder-blade whenas in this part the Nature of man is different from other Creatures Physitians therefore are wont to be most of al deceived in this wound for when the bone pulled off sticks forth the upper part of the shoulder appears low and hollow that they use the means as if the shoulder were fallen out truly I have known many Physitians in other things good enough who whiles they endeavor to reduce such shoulders thinking they were fallen out have caused much hurt by troubling them and have not given over til they have changed their opinion or thinking they had reduced the joynt they knew not what they should do more the Cure of these is this as to others of the like sort a Cerote Bolsters Linen Clothes and Swathing made after this manner the bone sticking out must be forced downwards and on that part many Bolsters must be laid and they must be prest down very wel and the Arm must be fastened to the Ribs towards the upper part and kept so for by no means whatsoever can it be done that the bone pul'd off can come close and grow together yet we must wel know and foretel also that these things are safe if you would have it otherwise because neither smal nor great hurt happens to the Shoulder by this Wound only the place becomes more deformed For whenas neither this bone can be restored to its ancient seat after the same manner as it was by Nature but it must needs be that it be comes little or much strutting out at the upper part neither doth any thing else return wholly into the same state which communicating and cohering with another hath been pul'd off from its ancient coherence In a few daies the pain at the top of the Shoulder is asswaged if it be bound down rightly Thus much Hippocrates see Galen also in his Comment Chap 7. Of a Luxation of the Elbow and Radius THe Elbow and Radius are joyned with the lower head of the Shoulder Tthe Elbow by a Gynglymus that is by that kind of Articulation in which the bones joyned together do mutually receive and are received by one another for the Shoulder hath in its lower part two bosoms the former or lesser of which receives the outer process of the Elbow but the hindermost or greater is devoted to the hinder process of the same but for receiving of the Radius the Shoulder hath also a peculiar head called the outer head The Differences From which we may easily collect that the Elbow may not only be wholly and perfectly luxated but also may suffer a subluxation next of all that it may be luxated into al the four Differences of place forwards backwards outwards inwards but the Radius as sometimes it follows the Elbow luxated into any part but sometimes states in its place so sometimes it alone fals from the Elbow without any luxation of it The Causes As the Luxation of other parts proceeds from violent Causes so this also and indeed the Luxation of the Elbow to the fore part for the most part is from a violent and sudden extension of the Arm to the hinder part from a violent bending of the Arm and outwardly or inwardly from a perversion of the Arm the Causes of a subluxiation are humors flowing to the Joynt which by degrees do fil up the Cavities engraved both in the lower part of the Shoulder-bone and also in the Elbow and Radius and do thrust forth the Elbow or Radius out of their seat The Signs Diagnostick It is easily discovered by the Sight and Touch into what part the Elbow is luxated
for if it be fallen to the fore part the Arm is extended and cannot be bent in the fore part there is seen an unusual Tumor but in the hinder part an unusual Cavity things contrary to these do happen if it be luxated in the hinder part to wit the Arm is crooked and can by no means be extended the Tumor appears in the hinder part but the Cavity in the fore part A Luxation to the outward part makes also a bunching out in the outer part but a bosom in the inner part but on the contrary if the Elbow be fallen to the inward part there is an eminency less then should be in the inward part and a Cavity in the outer part If the Radius follow the Elbow 't is known by the same Signs but if it only depart from the Elbow without a Luxation a gaping and disjoyning shews it the place is hollow and 't is easie to find a bosom with the Finger Prognosticks 1. The Elbow as it doth not easily fal forth by reason of its firm and fast coarticulation with the Shoulder and its plenty and strength of Ligaments so being fallen forth it is hardly restored 2. The Elbow luxated unless it be most speedily reduced doth not only bring divers and dangerous Symptoms to wit a most exceeding pain Inflammation Fever Convulsion but sometimes also Death 3. Of all Luxations which happen in the Gibbous part of the Elbow the most dangerous and painful is that which is to the hinder part Paulus Aegineta de re medic l. 6. c. 115. 4. When the Bone of the Elbow is divided from the other Bone it is not easily restored for neither do two bones which are joyned together when they once gape easily return to their ancient place but it must needs be that the Bones being so divided the part becomes swelled and the bones are quickly compast with a Callus The Cure The Elbow being imperfectly luxated or subluxated to the fore part is most easily restored by moderate extension and only bending of the Arm but a perfect Luxation is harder to be reduced and requires greater provision for first there must be extension made and that obliquely lest the high brow of the Elbow hurt the head of the Shoulder by two Servants one of which must draw the top of the Shoulder upwards but the other the Elbow downwards either with their Hands only or if need be with Reins then some round body must be placed by the brawny part over which afterwards the Chirurgeon bending his Arm and suddenly forcing the Elbow to the hinder parts may restore it into its place Hippocrates 3. de fractu affirms that he hath somtimes cured the Elbow luxated to the hinder part only by a sudden and continued extension of the Arm which if it suffice not convenient extension being made the Elbow must be driven inwards The Elbow fallen forth to the outer or inner part is most easily reduced if extension being made it be forced from that part into which it is fallen into the contrary The same manner of reducing is to be observed in replacing the Radius if it hath followed the Luxation of the Elbow but if it be only departted from it it must be prest with the prominent parts of the Hands and the Arm must be reduced to the natural figure it being reduced convenient Medicines must be applied and it must be bound up fitly as was said in general before c. 7. Chap. 8. Of a Luxation of the Hand and its Fingers HEre by the name of Hand we understand the Wrist and After-wrist but the Wrist is joyned with the Elbow bone and Radius by a Diarthrosis whenas there is a manifest motion but with the After-wrist whenas there is no manifest motion by a Synarthrosis or doubtful articulation the Metacarpium or After-wrist is joyned again with the bones of the Fingers by a Diarthrosis because the round heads of the four bones of the After-wrist do conspicuously enter the superficies of the first bones of the Fingers lightly hollowed and after this manner also the bones of the Fingers themselves are joyned one to another The Differences Whence we may easily collect that the Wrist may be luxated into all four parts to wit the fore the hinder and to the sides all the bones of the After-wrist indeed are luxated inwards and outwards but the falling of the two middle bones to the sides is hindred by the two extream bones that have respect to the little and Fore-finger the which two only may fall forth to that side which is free from bordering bones The bones of the Fingers again are luxated four waies to wit inwardly outwardly and to the sides The Causes The Cause of the Luxation of the Wrist After-wrist and Fingers as of other luxations is some violent Motion Blow Fall Perversion and Contorsion Signs Diagnostick The Signs of all parts of the Hands luxated are almost common for whether the bones of the Wrist After-wrist or Fingers be luxated to the fore part a Tumor appears as that place in the fore part and the Fingers cannot be bent If they be fallen to the hinder part a Tumor also is perceived in the hinder part and the Fingers by reason of the compression of the Tendous and Nerves going to them cannot be extended But if a Luxation be made to the sides a Tumor appears in that part into which the fall is made and a depression into that from which the Joynt is fallen The Prognostick The Luxation of these parts is not dangerous whenas they may easily be restored into their place The Cure The bones of the Wrist into what part soever they be luxated may be without any extension at all reduced into their place after this manner let the Hand of the Patient be placed upon a Board or Table and that with the palm downward if the luxation be to the hinder parts but with the back downwards if it be to the fore parts afterwards let the Chirurgeon most strongly force the luxated Joynt to the contrary part either with the palm of his Hand in more tender bodies or with his Heel in bodies that are stronger The same rule is observed in replacing the bones of the After-wrist and Fingers except that some servant holding with one Hand the Fingers with the other Hand the Arm doth make a light extension the bones being reduced Medicines that hinder an Inflammation and strengthen the Joynts must be applied and the part must be conveniently bound up and placed Chap. 9. Of a Luxation of the Thigh THe Thigh-bone the longest and greatest in the Body of Man at its upper part with its head sufficiently great thick and exactly half Globous is not only most exactly half joyned by an Enarthrosis to the bosom of the Hip sufficiently large and deep to receive this head but also is most strongly united to it by a most firm Ligament arising from the bosom of the Hip and implanted into the narrow
bosom of the head of the Thigh to the end that the Thigh might by so much the easier and more readily be bowed extended moved to the sides and turned about and not easily slip forth The Causes The Causes of a perfect Luxation of the Thigh are the same as of the Luxation of the Shoulder to wit external and violent a fal a blow or some other violent and indecent extension and distorsion of the Thigh but the causes of an imperfect Luxation are the humors flowing to this joynt and by degrees thrusting it out of its seat The Differences But this joynt fals forth to four parts the former hinder but seldom whenas the brow of the Cavity in this part is higher to the outer and inward part most often whenas at that place the brow is lower and somtimes the Thigh admits of a Subluxation from an internal cause whence when Paulus Aegineta lib. 6. de remed c. 118. writes that the Articulation of the Hip doth only suffer a Luxation and not a Subluxation that is to be understood of that only which is from an external and violent cause for we see oftentimes that by a flux of humors some have the Ligaments in the Thigh relaxt and mollefied that they cannot retain the head of the Thigh-bone firmly in its Cavity whence follows a certain Subluxation Signs Diagnostick the Diagnostick signs of a thigh luxated to the fore part If the Thigh be luxated to the fore part a Tumor appears about the Groins whenas the head of the Thigh leans to the Pubes the Buttocks on the contrary by reason of the Muscles contracted with the Thigh to the Pubes seem wrinkled the Urine is supprest by reason of the compression of the bladder by the head of the Thigh the external Thigh can neither be bent nor brought to the Groin whenas the head of the Thigh is in the very bending place the man is also in pain if he be forced to bend his Knee by reason of the former Muscle which ariseth from the bone which belongeth to the Loyns for that is comprest and being retcht is lift up by the head of the Thigh and whenas it can be no further extended it resists otherwise it equals in length the whol sound Thigh to the Heel for the Thigh going forth of its Cavity comes to the fore part and a little lower by which it comes to pass that the Thigh hurt equals the length of the sound one which especially fals out so at the Heel the Toes of the Foot cannot easily be extended nor turned to the ground whence in walking the Patient is compelled to tread only on the Heel But in them who at strong age have this joynt fallen forth into this part and not restored they when the pain ceaseth and the joynt is accustomed to be contained in that place into which it is fallen can forthwith go upright without a staff and wholly upright for by reason of the inflexibility of the Groyn they use the whol Thigh more straight in going than when it was sound somtimes also they draw their foot upon the ground whenas they cannot easily bend the upper iunctures which are at the Groyn and Knee although they walk upon the whol foot but in those at whose render age this joynt fallen forth is not restored their Thigh-bone is more diminished than that of the Leg or Foot but the Thigh is little diminished only the flesh every where is abated especially at the hinder part to the hinder part If the Thigh-bone be luxated to the hinder part there are contrary signs to those mentioned to wit The Head of the Thigh being fallen to the Buttocks is discovered by a Tumor about those parts both by the sight and touch the Groyns on the contrary appear more loose the affected Thigh by reason of the compression and distension of the Muscles compassing the head of the Thigh cannot be extended and 't is rendered shorter than the sound one the heel doth not touch the ground whence the Patients can neither stand nor go but fal headlong backwards because the body slides to that part and the head of the Thigh being out of its proper place is not directly opposed to under-prop the body yet the man may bend his Thigh if he be not hindered by pain for whenas the head of the Thighs is by force with its whol neck expelled into the great Muscle of the Buttocks which extends this Articulation this Muscle admitting the head of the Thigh fallen forth is most of al tormented whenas 't is distended and prest under it and of necessity must be seized on by an Inflammation but in process of time when this Muscle is freed from an Inflammation and contracts a certain glutinous humor that part of it which toucheth the joynt grows to a Callus and the Knee is bent without any pain moreover the head of the Thigh being luxated to the hinder part the Thigh and Foot appear moderately straight and do not incline much one way nor other But when in ripe age the Thigh-bone fallen forth is not restored when the pain is ceased and the joynt accustomed to be turned in the flesh the man indeed may walk yet he is forced to bow very much towards the Groyn when he walks and that for two reasons Because the Thigh is rendered much shorter and the heel is far off from touching the ground for if he try never so much to stand on that foot leaning upon no other thing he wil every where fal backwards but if in tender age this joynt luxated after this manner be not reduced the Thigh-bone is made short and the whol Thigh is spoiled and is less increased and made slenderer being for no use To the outer If the Thigh be luxated to the outer part it is known by these signs Between the Anus and Cod there is seen a Cavity and leanness on the contrary in the buttocks a certain Tumor the Thigh by how much the head of it is fallen forth to a higher place is rendered shorter the Knee with the Leg looks inwards the Heel toucheth not the ground whence when the Patient would walk he goes only a tiptoes And if in those of ripe age this Joynt be not restored but the flesh into which the Joynt is fallen grows callous and the pain therefore ceaseth they may go without a Staff and therefore when they use their Thigh in these the flesh is less offended but they to whom in tender age this misfortune happens require a diligent care for if they be neglected the whole Thigh becomes unprofitable and is little increased the flesh also of the whole Thigh is more abated then in the sound one Lastly a Luxation of the Thigh to the inner part is known this way to the inner the Thigh is longer if it be compared with the other and that for two reasons for the head of the Thigh sticks to the bone which proceeds from the Hip upwards
bent and moved Prognosticks Whenas this Articulation is more loose the Patel Bone may easily be restored to its seat The Cure That the Patel bone may be reduced into its seat let the Patient stand firmly upright upon a place but let the Chirurgeon with his hands force the Patel Bone from that part into which it is fallen to that from whence it is fallen when the Bone is restored to its place fit Medicines must be laid upon it and the hollow of the Knee must be filled up with Bolsters that the Thigh cannot be bent then a hollow piece of the figure of the Patel Bone must be placed about it especially on the side to which it fel that the Patient may not bend his Knee When there is no more danger lest the Parel Bone fal out again let the Patient by degrees accustom to bend his Knee again Chap. 11. Of the Knee Luxated THe Knee may not only be Subluxated but it may suffer a perfect Luxation and truly oftentimes fals to the inward and outward part seldom to the hinder part but seldomest of al to the fore part and not unless from a most violent cause in regard that the opposition of the Patel Bone doth hinder it The Causes This Luxation also happens from blows fals jumping vehement running and an uncomely extension or contraction and distorsion of the Legg Signs Diagnostick To what part the Knee is Luxated is easily known for in the side to which the joynt is broke forth a bunching out but a Cavity in the side from which it is departed is discoverable both by the sight and touch its figure is depraved the Thigh is extended and cannot be bent whence the motion is necessarily depraved or wholly lost Prognosticks 1. The Knee if it be compared with the Elbow the joynt in the Knee by reason of its manner of juncture oftener fals out and is easier reduced For the structure of the Bones with which both joynts are contained is more straight in the Elbow more loose in the Knee besides many processes and many bosoms joyned to one another do every where bind up the joynting of the Elbow but in the Knee the bunchings forth of the Thigh are cast into the smal Bosoms of the Leg. 2. For the same cause a Luxation of the knee is less dangerous nor doth an Inflammation easily happen for whenas an Inflammation ariseth from the force with which the bones are expelled and reduced again and the pain arising from hence because in the Knee the joynt may fal forth and be reduced without any great force there is no fear of an Inflammation The Cure The Knee luxated to the inward and outward part is not hard to be restored by moderate extension made either with the hands in a new Luxation and childs body or with reins in a Luxation not so late and stronger bodies and with forcing the bones with the hand into the contrary part from which they sel But a Luxation made backwards is commodiously restored if the Patient be placed with his Face on a Bench and some servant put a Linen Globe into the hollow of the Ham at what part the Bone sticks forth and strongly force the bone fallen forth towards the fore parts but let the Chirurgeon take hold of the lame Leg with both hands and of a sudden so bend and bow it that his Heel touch his Buttocks A Knee Subluxated by none or very little extension made and forcing it to the contrary part is reduced into its place When the Bone is reduced which is known by the free exten sion of the Leg and comparing it with the other Knee convenient Medicines must be laid upon it and binding up must be ordered and the Patient must forbear going til there be no more fear of a new Luxation Chap. 12 Of the Distraction of the Bracer THe Bracer adheres to the greater Bone of the Leg and as it was said in the former Chapter above to the Knee below the Ankle but 't is drawn from the great Bone three waies to wit To the fore part and both sides The Causes But this Divulsion comes from those Causes from which we said the Knee was luxated especially when walking in a slippery place the foot is not firm but dubiously is wrinched inwardly or outwardly the same may be by a fal from on high or by a blow Signs Diagnostick A Tumor appears in the part to which the Bracer is distracted and is discovered by the sight and touch and motion is hurt The Prognostick The reducing of the Bracer is easie The Cure For by the hands of the Chirurgeon it may easily be compelled and brought back into its seat by forcing it into that part contrary to its fal afterwards convenient binding up must be ordered putting bolsters to that part to which the Bracer is fallen and rest for some weeks must be commanded the Patient til the Ligaments are confirmed again Chap. 13 Of a Luxation of the Foot and its Bones and of the Toes BY the word Foot we understand al that part of Mans Body reaching out from the lower part of the Leg to the very ends of the Toes which contains divers Bones after divers manners joynted together and united by Membranous Ligaments to wit The Ankle the Heel the Ship-like Bone the Tarsus Metatarsus and Bones of the Toes of the Luxations of al which we should now speak but because the Bones of the Tarsus Metatarsus and Toes are here united almost after the same manner as the Bones of the Wrist after-Wrist and Fingers are to one another they are subject also to the same Luxations have the same causes are known by the same signs and are reduced the same way but the ship-like bone may suffer the same things as the Bones of the Tarsus it is not worth our labor to add much of these but those things which are said of the bones of the Hand may also be applied to these Luxation of the Ankle and Heel Some things only we shal add of the Luxation of the Ankle and Heel whenas no Bones in the Hand do answer unto these The Differences The Ankle joyned with the greater and lesser focil by a Ginglymus may be luxated perfectly and imperfectly to every part to wit The outward inward fore and back part But the Heel lying under the Ankle is often moved indeed more forward and backward but seldom to the sides The Causes The Luxation of these parts is from a violent fal a blow or some other inconvenient distorsion of the Foor But in particular the Heel is luxated and pulled from the Ankle if one leaping from on high do fal and stick heavily upon the Heel or in dancing doth insist much upon the Heel The Signs Diagnostick The Ankle if it be fallen to the outward part the lower part of the Foot is turned inwardly if to the inward part there are contrary signs if it be luxated to the fore part the broad Tendon