Johannes Prevotius principal Professor of Physick in the University of Padua maketh in that Letter of Advice and Counsel which he wrote unto the Illustrious and most generous Lord Nicolaus Sapieha chief Standard-bearer unto the great Dukedom of Lituania and Earl of Coden c. I shal anon give you the whol Letter at large where he thus writeth The Nature of this poyson saith he is altogether unknown so that as it seems to me it was truly spoken by that illustrious person who said in my hearing that the Boors inhabiting within his Territories had sound out more of the original of this Plica the progress and the Cure thereof than any of those Authors that had written concerning it of which there hath been never a one of them that as yet hath had the fortune to restore unto perfect health any one that hath been afflicted with the said Plica The Physick Professors of Padua have indeed made trial there of very many Remedies but al to no purpose The same aforesaid Noble person Count of Coden himself told me that a certain Padua Physitian induced thereunto as it were by the signature shape of the Disease for they that are affected with the true and perfect Plica seem in a manner to have Serpents hanging down from their heads and as it were the head of the Monster Gorgon prescribed him some Vipers to eat but without any success at al. And that another of them had provided him a Psilothrum Oyntment to use instead of the usual Ley perswading him to condescend unto the cutting off of his hair promising him an artificial covering for his head but that being advised to the contrary by a German a student in Physick unto whom this Disease was not altogether unknown and one who wel understood the danger that was like to follow upon the rooting out al his hair he therefore refused it But although I dare not arrogate unto my self a perfect knowledg of this Disease and albeit that in no case we cannot attain unto the perfect and exact knowledg of Diseases that depend upon an occult and secret Cause yet nevertheless what I know touching the Nature of this Disease by means of my converse with the Noble Earl before mentioned who was afflicted therewith and what I conceive touching the Cause thereof I wil here briefly acquaint you with that in so doing I may give a further occasion and encouragement unto such as live in those Regions where this Disease is commonly and familiarly known to publish what is come to their knowledg touching this Disease It seems not to me to be any new Disease For although it hath hitherto been unknown unto the people of Italy and most of the European Regions yet nevertheless I see no reason at al why it should not be common and frequent in Polonia many Ages past as wel as now since that the causes that produce the same at this day might then be present as wel as now only that there were then wanting Physitians that might inquire into and acquaint us with what they knew touching the Nature of this Disease Now as for the Nature of it we are first to take notice of this to wit that this Disease as for what concerns the name thereof is known indeed from the intricateness and intangling of the hairs yet notwithstanding that the said Plica is only somwhat that is Critical as it were arising from the expulsion of the vitious matter out of the body and that the said Plica bringeth no danger at al along with it unto the affected person who oftentimes bears it about with him al his whol life without any the least damage But that which most of al threateneth danger unto the diseased party is that vitious humor which yet sticking fast in the body exciteth those most grievous symptoms that have been before recounted in the History of this Disease which cease al of them afterward so soon as the matter is thrust forth unto the hair And moreover this is further to be added unto the History That in such as are thus affected especially if the Disease proceed unto the height not only the hairs are vitiated but the nails also and more especially in the feet but most of al in the great Toes thereof which become rough long and black like unto the horn of a Goat and this I observed in the afore mentioned noble Lord Nicolaus Sapieha and I have heard that the very same hath also befallen unto others But now this Vice is not without cause referred unto and reckoned among Diseases in regard that the hairs are not wholly to be excluded out of the number of the parts And it is to be referred unto the Diseases of Conformation seeing that the hairs neither retain that figure that they ought naturally to have neither do they every of them appear single and severed as they should but are variously complicated among themselves and entwisted one within the other so that of many hairs there is made one long thick intangled and frightful lock And yet notwithstanding that the Distemper of the hairs is likewise changed cannot be denied in regard that there floweth unto them a preternatural humor and such like hairs as these when they are cut pour forth blood As touching the Causes thereof in the first place these things that are commonly believed and by tradition pass from hand to hand touching the paines that is taken by the Incubi Infants not baptized and other Spirits besides in the weaving of the long ugly and frightful Locks there is none but may easily perceive that they are meerly fabulous and superstitious But that this vice of the hair as wel as many other Diseases may somtimes proceed from Witchcraft and Inchantment appeareth even by the Observation of Christophorus Rumbaumus Doctor and Professor of Physick and my fellow Citizen which Hercules Saxonia reporteth to be Extant in the Observations of Johannes Schenckius the Elder in the seventh Book in these very words of Rumbaumus In the yeer 1590. while I was a long time bestowing my pains though all in vain in the Cure of a Mans Wife who out of the Lees of Beer artificially destilled Brandy Wine at Uâ—atislavia being newly brought to bed and by reason of a great and sudden affrightment upon occasion of a lamentable sire burning the next adjoyning houses taken with an Inflammation of the Lungs upon the retention of her Courses Secundine and what should afterward have come from her and this Inflammation through her own carelessness terminating in an Impostume of the Lungs and the Consumption a certain Emperick an old Woman came unto her and offering her pains promised present help Which she would by no means admit of Whereupon the Emperical old Woman growing much enraged uttering many threatning words she causeth her to be shut out of doors and then presently as she was wont she fals a washing and Cleansing away the filth of her Head having first Combed plaited
with his own Eyes he beheld while they took out of an Impostume ful of filth and opened in the Calf of a Mands Leg a certain round substance or Globe such as is to be seen in Weavers Shops And Wierus in his Book of the Devils impostures Chap. 13. relates that in the incision of an Impostume on the left side of a certain Gâ—â— above the Spleen there was taken forth an Iron Knife and after it there issued out abundance of filth and corruption The like whereunto Langius also hath observed in his first Book and thirty eighth Epistle Now if any such strange thing chance to happen the Vulgar People are wont to ascribe it presently unto the Sorceries Spels and Charms of their Devilish Neighbors But there is no necessity why for all things that are evacuated out of Impostumes besides purulent matter we should by and by have recourse to such Causes as these or rank them among the supernatural Causes of humors seeing that many of these contingents may be generated out of the humors erewhile rehearsed For whenas Experience makes it manifest that in most parts of mans Body smal Stones Sand and Gravel Hairs or such like and also divers kinds of Worms may be produced out of the excrementitious humors and that likewise not only in the Body of man strange and wonderful kinds of Worms and other little Animals may be bred out of the Corruption of others it should not seem any great wonder that the matter in Tumors especially if it be naught and hath been long there shut up and deteined doth admit of those various and strange mutations happening by means of its rottenness and putrefaction But yet notwithstanding if such things be found in Impostumes that are come to a suppuration and likewise in Tumors which cannot be generated in mans Body by nature or at leastwise by Natures strength alone without the concurrence of Art such as are all things formed of Metals Bodkins Knives Iron Nayls and the like then indeed they cannot be referred unto natural causes but may upon more than probable Grounds be imputed unto the Impostures subtilty and power of the Devil But as for the manner how such things may be either generated in the Body or covertly conveyed into it is not my purpose here to determine I therefore proceed to dispatch what I have further to deliver touching the rest of the causes of Tumors that take their rise and original from the humors So then Tumors how caused by congestion or the heaping together of humors as for what concerns the causes remote be they what they will for their kind they may easily be known if we do but enquire into the manner how Tumors come to have their first being and withal take notice from whence and after what sort or by what means that humor which hath rightly gained to be stiled the containing Cause comes into the part affected Now therefore that humor which is the nighest and containing Cause of a Tumor is either insensibly and by degrees heaped up in the part or else altogether as in a heap which the Grecians express by the word Athroos flow into it The matter is gradually and by little and little gathered together in the part affected primarily and most especially by reason of somwhat amiss in the member to wit when either the concoctive power is grown weak and therefore cannot as it should digest the nutriment but generates more excrements than it ought to do or else when the expulsive faculty doth not cast out all the excrements as it ought to do and this may come to pass either through its own weakness or otherwise because the way by which those excrements should be ejected is not sufficiently open And again a humor is likewise then heaped together in the parts whenas the food it self is naught and unwholsom for hence it happens that either so great abundance of excrements are caused that the expulsive faculty cannot cast them al forth or else that they are so thick that Nature cannot easily expel them But upon what causes these causes do depend hath been already declared in its proper place nor is it requisite that we should at large repeat what hath been spoken Only in a few words take this That the weakness of the faculties wholly depends upon the intemperies or distemper of the parts and the decay of their native heat The passages are obstructed by overmuch and thick matter which happens to be condensed by the vehemency of cold Meats of an ill juyce produce store of excrements Now what these meats are Galen gives us to understand in his Book touching meats of a good and evil juyce A Humor then flows to some part this being in truth the more usual cause of Tumors when either it is drawn by that same part tumors how caused by an afflux How by attraction or transmitted unto it from some other place Attraction primarily proceeds from heat caused either by overmuch motion or from the heat of the Sun and Sun-beams from the fire or lastly from any sharp Medicine taken in For the parts so soon as they are heated by these causes draw unto themselves humors from the rest of the body although there be not therein any excessive store of humors and yet I deny not but that the more the body abounds with humors the greater is the store of them that is attracted Moreover Pain likewise frequently enough excites Tumors by attracting the humors unto the part aggrieved Yet we say not that pain of it self draws the humors but that this is done by some other means and commonly it is said to draw for these three causes First because Nature while she attempts to relieve the suffering part sends in an extraordinary supply of blood and spirits to the part in pain and this she doth with an endeavor more than usual so that by this means she over fills and hurts the parts she intended to succour Secondly the grieved part by this time grows hot from that abundance of blood and spirits transmitted thither by Nature and hereupon fals to drawing more than before by reason of this adventitious heat And lastly pain weakens the Members Now the Members once weakned if they attract not yet they readily receive and in the least resist not the matter flowing in upon them from several parts Secondly A Tumor is caused by a defluxion when as the humors are transmitted unto some part although they be not drawn by that part For whereas there is in every part a faculty not only of attracting al things familiar and agreeable unto it but also of expelling and casting out whatever is superfluous and burdensom hence it is that being stir'd up and provoked by the excess or offensive quality of the excrements and humors it expels and thrusts forth unto some other part whatever is useless or at least burdensom unto it Where if it be not digested or evacuated by transpiration it is thence
unless it make use of the blood for a vehicle or as we say a Conduit-pipe of conveyance and that the acrimonious humor it self excites a pain in that part into which it is thrust and shut up hereupon it is that there follows a conflux of blood unto that part and from it proceeds an Inflammation And much after this manner the Pleurisie the Peripneumonia or the Inflammation and Impostume of the Lungs the Quinsie the Phrensie the Inflammation of the Ears and Gums the hot Tumors or Swellings in the groins called Bubones Carbuncles and such like are generated and excited The Differences The principal Differences of an Inflammation are taken from the variety of the containing cause and from the great difference of the blood that stirs up and begets the Inflammation For a Phlegmone is said to be for distinctions sake either that which is a true and legitimate one or otherwise that that is not a true Phlegmone but rather a bastard and spurious one The true and legitimate Phlegmone is that which proceeds from good blood and such as is in a due natural temper or at leastwise such as whereof there is more than ordinary store and this is absolutely and simply termed a Phlegmone But the spurious and counterfeit Phlegmone is that which hath its rise and original from corrupt and vitiated blood and such as swerves from its natural temperament and this may be occasioned two manner of waies for if the blood doth neither lose its nature nor change its substance but only hath mingled together with it some other Humors then there are three bastard spurious sorts of an Inflammation that thence arise To wit if Choler be mingled with the blood producing an Inflammation it is then called Phlegmone erysipelatodes if Phlegm Phlegmone oâ—dematodes if Melancholy Phlegmone scirrhodes But if the blood change its substance it then excites not any kind of blood-Tumor for the blood as Galen writes upon this very subject in his 2d Book of the Differences of Feavers Chap. 9. if it be overmuch heated and as it may be so expressed boyled to an extream intense heighth then it s more subtile and fat part is converted into yellow Choler but the more thick part into black Choler or as we usually call it the Melancholy humor The Signs Diagnostick The Signs of Inflammation as may be gathered out of its definition are heat pain a swelling and stretching out of the part a renitency or Resistance a redness of color and a pulsation or beating 1. And in the first place in this kind of Tumor there is present so intense a heat that from it the Tumor hath its very name and denomination and many indeed are the causes wherefore this heat is necessarily raised and stirred up For first of all the blood that through its overgreat abundance excites the Phlegmone is hot which heat it also communicates to the part affected Moreover whenas by the plenty of blood and oftentimes likewise by a certain kind of thickness al the pores are so filled up and obstructed that the hot exhalations cannot sufficiently be sent forth and evaporated neither the heat eventilated or cooled as is ought to be the heat by retention of these exhalations and fuliginous vapors is much encreased Unto which also a third cause may be added to wit putrefaction for the blood contained in the inflamed part assumes at length a putredinous quality by which as is to be seen likewise in other things the heat is excited and communicated unto the part inflamed And this heat is somtimes greater somtimes less according to the greatness and growth of those causes The second sign is Pain for whereas there are two remarkable causes of pain an Intemperies or distemper and the solution of continuity they both of them take place in Inflammations For in truth this extraordinary heat by its distemper first of all excites pain and then the abundance of blood by filling ful and distending the part dissolveth continuity and thus doing is the cause of this pain Again the pain that is thus caused is various much different viz. distending or stretching out pulling or twinging pressing and burdening according to the variety of the parts affected but more especially there is present a beating pain which likewise for this very reason is peculiarly reckoned up amongst the proper signs of a Phlegmone and of which more hereafter In the third place a Distension For when the plentiful store of blood doth not only fill the Veins and Arteries but even the whol substance of the part all things are now distended and stretched out but chiefly the skin the which as it lieth round about al the other parts and hath a Membranous substance must necessarily partake of the distension and the extensive pain 4. Fourthly Renitency or resistance or as the Grecians cal it Antitupia in like manner follows upon this repletion and distension For albeit the inflamed part be not hard in its own nature yet it is so stuffed out and distended with store of blood that now it wil no longer answer the touch neither yield thereunto but resist and withstand it and withal it appears hard unto the touch 5. Fiftly the parts inflamed wax red the blood imparting this color unto them For there is nothing in mans body that assumes this redness of color besides the blood and flesh 6. And lastly In the sixth place there is perceived in the inflamed parts a Pulse and beating pain to wit when with grief and extream irksomness there is perceived a bearing of the Artery in the inflamed part which while the part was â—ound was not to be perceived From whence we are instructed as Galen writes in his sixt Book of the parts affected Chap. 7. that this beating pain doth not happen unto al the parts but only to such of them as have in them certain notable and remarkable Arteries The heating pain how it is caused and that have a part endued with an exquisite sense and when the Inflammation is raised up unto a magnitude worthy of observation Now this Pulsatory or beating pain chanceth from hence that when they are lifted up and distended the parts inflamed by reason of their store of blood do not allow nor afford a due free and sufficient room unto the Artery now distending it self but that themselves are rather stretched out by the Artery lifting it self up which said distension excites the pain And this pulsatory pain is then most of al perceived whenas the Inflammation tendeth toward a suppuration For then the blood boyls as it were and grows exceeding hot from whence it also comes to pass that it assumes and makes use of a larger space of room and so much the more distends the part by the which part the Artery is henceforth much pressed kept down in its motion which we cal Diastole and then afterward hereupon the Artery likewise compresseth and bears down the adjacent and neer neighboring parts that lie round
number three dried Figs and Raisins an equal proportion boyl them in strong white Wine to a softness and then bruise them adding thereto a dram of Salt and two Yelks of Eggs mingle and then make a Cataplasm of them But now if there be any that wil not endure Scarification or if otherwise the Carbuncle wil not yeild unto these Medicaments and it be so that the corruption the blackness and the signs seem alwaies to be augmented we must in this case have recourse unto Cauteries and that instanly and with all possible speed Cauteries for even the least delay may cast the sick Person into an extream peril yea into the greatest danger even of death it self But here Potential Cauteries may not so safely be administred in regard that the Crust which is drawn over them sals off more and so the exhalation of the corrupt and malignant humor it hardened The actual is therefore by most accounted the safer For why the Actual Cautery by the heat and driness of the Fire doth especially resist putrefaction and preserveth the sound parts lest that they also should be infected with putridness and it likewise attracteth from the depth and the very bottom all the malignant and corrupt Matter and for this cause it is hereby the most commended as the most effectual Remedy who conceive that here in this case this is not so grievous a Remedy seeing that the sick Person is hardly sensible of it in regard that the Flesh is dead and because that the use of it must be so long continued even until in all parts thereof there be a sense of pain Yet notwithstanding even the Actuall Cautery hath also in this discommodity that it induceth and causeth a Crust or Eschar which it self so hindreth that the malignant and poysonous matter cannot exhale If therefore any will use this Remedy he must be altogether careful that the Crust drawn over it hinder not the exhalation of the corrupt and malignant humor and therupon he must use his endeavor that the Crust may speedily even within the space of twenty four hours be removed in regard that there may be danger in the delaying thereof And indeed for this purpose they commonly use Butter the Suet or Fat of a Hog the Fat of a Goose and such like moistening and suppurating Remedies But the Truth is that Horatius Augenius and Gulielmus Fabricius do rightly inform us that in those affects in the which there is otherwise so extream a danger threatned from putridness these Remedies may not with any safety at all be administred forasmuch as by their humidity and Emplastick virtue they do in a wonderfull manner encrease the putridness cause that the rottenness and corruption of the part creep so much the further and moreover these do but very slowly take away the Crustiness And therfore these conceive that we ought rather to use those Remedies that do greatly cleanse and dry resist putrefaction and break assunder those smal slender fibres by which the Crust adhereth unto the part affected Galen in his second Book to Glauco Chap. 9. for the taking away of the Crust after burning in the case of a Gangrene useth the Juyce of a Leek with Salt Gulielmus Fabricius for the falling off of the Eschar and for the cleansing of the Ulcer commendeth this following Unguent Take the meal of Orobus or bitter Vetch the root of Aristolochy or Birthwort the Flower-de-luce of Florence and the lesser vernal Gentian of each half an ounce Treacle two drams with a sufficient quantity of Honey of Roses and so make Vnguent Horatius Augentius commendeth this Take Vitriol two drams the best Honey half an ounce Hogs grease two drams and mingle them And that the Ancients did not alwaies use moysteriers and those Remedies that forward the Pus or Purulent matter for the removal of the Crusts is sufficiently evident out of Galen his sixth Book of the Composition of Medicaments according to the place affected Chap. 6. and Paulus Aegineta his fourth Book and Chap. 19. in the which said place there are many more such like Medicaments to be seen And as for my own part I had rather for the taking away of the Crusts which for the most part the Carbuncle contracteth use such like Remedies then Cauteries whether Potential or Actual For here the Putridness is not simple as in a Gangrene and other corruption of the parts where that that is putrid is most commonly separated from the sound part so that we may safely enough burn away what is corrupt and putrid But in a Carbuncle there is present a malignant humor and that diffused throughout the whole part and therefore we are to make use of those Medicaments that extract that so by this means what is as yet sound may be preserved from purridness and Corruption Aetius writeth that wild Rue imposed in a Cataplasm with Honey and Raisius of the Sun doth likewise instantly separate the Crusts of Carbuncles and therefore even those medicaments also that resist malignity as Treacle and the like are for the most part very properly herewith mingled And therefore we conceive that the Unguent of Gulielmus Fabricius erewhile mentioned is exceeding profitable in a Carbuncle not only after the burning but likewise at all other times Others compound such a like medicament which as they affirm wil in two daies space separate the good and sound Flesh from the corrupt Take Rue one handful Leaven one ounce dry Figs three in number Pepper a dram Salt a dram and half make a Cataplasm which may be applied mornings and evenings In general in Pestilent Carbuncles to extract the Poyson we must prevent and hinder the creeping and further spreading of the putridness For the taking off the Scar this Emplaster is principally commended Take of the best Treacle and Mithridate of each half an ounce Leaven and Turpentine of each two ounces Honey of Roses one ounce and half fresh Butter two ounces common Salt one ounce Chimney Soot two ounces and half Saracen Soap three ounces Saffron three drams three Yelks of Eggs bake them altogether and make an Emplaster Or Take Scabious the greater Comfrey of each two ounces of ful and fat Figs dryed three an Onion roasted in Embers Squils half an ounce Raddish root cut into smal pieces two ounces two Yelks of Eggs Salt two ounces Leaven and Chimney Soot of each one ounce Honey Turpentine of each as much at wil suffice and so make a Cataplasm and having spread it upon a Linen Cloath lay it on hot and let it be shifted almost every hour If now we perceive the Crust to become round and a circular redness appearing it is then a sign token of ensuing health and recovery and a manifest testimony that Nature hath now separated the corrupt from the sound When the Crust is wholly taken away the Ulcer is then to be throughly cleansed with Honey of Roses and the Juyce of Smallage and such like After the
Physitians understand hereby al kind of Scabies whatsoever Now albeit the next cause of Scabies be a humor sharp and salt yet notwithstanding Avicen doth not altogether absurdly assert that blood is the matter of the Scabies For seeing that Scabies is an Univerversal Affect of the whol Body it cannot therefore easily proceed from any other humor unless that blood be likewise therewith mingled and yet notwithstanding the blood cannot properly be said to be simply the cause of Scabies to wit so long as it retaineth its benign and tempeperate Nature For whilest it continueth benign and good it can in no wise excite and cause the itching neither yet those Ulcerous Tumors or Swellings Wherefore before such time as the blood can possibly produce and breed the said Scabies it must of necessity be corrupted and other humors that are sharp and biting there with mingled And true it is indeed that yellow Choler is sharp and corroding but then it scarcely floweth in so great abundance or is of that thickness as to excite such like Tumors But black Choler and salt Flegm are Humors very fit and most apt to produce the said Scabies For these Humors being thick hot and dry and withal biting and corroding if they chance to be thrust forth unto the Skin there they stick fast in it and there they excite a hot and dry distemper an itching a swelling and an exulceration But now as for the primitive Causes and more especially for the generating and breeding of those salt biting and sharp humors the kind and ordinary course of Diet that is kept doth exceedingly advance and further the same Meats to wit of a bad juyce and that afford an unwholsom and corrupt aliment such as are salt sharp and that are easily corrupted And hence it is that the poorer sort of people who live upon these kind of unwholsom corrupt meats are most frequently infested with the Scabies or Scabbiness as likewise Children and yong people in general in regard that these are altogether careless and heedless in their Diet whereupon they contract great store of excrements that being retained in the outward part of the body are there corrupted and so they get an acrimonious quality But then from these bad and naughty meats those sharp and salt humors are the more easily bred if there be present a hot and dry distemper of the Liver And hitherunto likewise relateth the uncleanness and nastiness of the body to wit when there is altogether a neglect in the keeping it sweet and clean and if the foulness and impurities of the Skin be not duly washed off or the garments not shifted and changed often enough whereupon it is that filth and impurities sticking in the superficies of the body do not permit so free a passage forth unto the excrements and by this means the said excrements acquire a certain acrimony and so corrupt the other humors The Scabies ariseth likewise somtimes after a Crisis and after Diseases both acute and those also that are of a long continuance to wit when Nature expelleth forth unto the Skin those naughty and depraved humors which it is not able any other way to discuss and evacuate And lastly Congium is likewise accounted and reckoned up among the principal causes of Scabies which cause Galen also acknowledgeth in his first Book of the Differences of Feavers Chap. 2. and Book 4. of the Differences of Pulses Chap. 3. For in the Superficies of the Skin of those that are Scabby there is a certain viscous and clammy moisture gathered together which being either by the Apparel oâ— by some other means communicated to the body corrupteth the humors therein after the like manner and produceth the like Affection and that especially in these bodies that are now already disposed unto the Scabies And indeed the humid or moist Scabies is the more contagious in regard that in this there is generated more of the aforesaid viscid and clammy humidity The Differences Some there are that reckon up very many Differences of Scabies as that one is new another old and inveterate and that one seizeth upon the whol Body another upon the Hands only and the Thighs but the main and special Difference is that which is taken from the Difference of the Humors that one ariseth from a black and melancholy humor and this is called a dry Scabies in which although there be a concurrence of other humors yet notwithstanding the greatest part thereof is of this last mentioned humor from whence it is that out of the parts affected with this Scabies either there is nothing at all sent forth or if there be any thing issuing our it is thick dry and the Ulcers themselves as likewise the prints and footsteps as we may so term them of these Ulcers are wan and pale and somtimes black another is humid and moist in which there aboundeth a salt flegm out of which there plentifully floweth forth much moist filth and corruption that is thin and subtile sharp and now and then likewise it wil be thick Signs Diagnostick The Scabies or Scabbiness is an Affect very wel known and it may easily be discerned as may also its Differences and from those signs and tokens especially that we but even now mentioned And yet notwithstanding those signs do now and then vary and are somthing changed according as the aduition of the other humors is greater or less Prognosticks 1. Now although the Scabies be in this respect troublesom to wit in regard of the foulness and deformity that it causeth in the Skin rather than that it bringeth with it or threateneth any other danger nigh at hand and that in youth it oftentimes preserveth and likewise freeth from other Diseases yet notwithstanding it is not alwaies secure and safe For if it be of any long continuance it may and somtimes doth turn into the Lepra or Leprosie and in Ancient persons it is contumacious and stubborn and hard to be cured 2. And among the several species and kinds of them the dry is more difficult in curing than the moist And therefore whatever kind or sort it be of it is not at any hand to be neglected but by a due and fit Cure even for the very deformities sake if there were no other cause speedily to be taken away and removed Of the Scabies retiring inwardly That Scabies that hath its rise and original not from any contagion but from some internal default of the humors for the most part breaketh forth as it were critically and ariseth from some internal vice of some one or other of the Bowels in which so soon as any vitious humors are generated they are immediately by Nature thrust forth unto the outward part of the body the which motion if Nature be not able to perfect and accomplish it or in case she be by Medicaments administred unseasonably hindered in her operation divers Diseases are from hence excited Many Diseases proceeding
therefrom Touching the Quartan we have spoken before where we treated of Feavers There are oftentimes other Feavers long continued and sufficiently dangerous and likewise very often intermingling Feavers but for the most part they are inordinate Feavers that arise in this manner and by this means Of this I here cured in the yeer 1636. in the month of April a certain man of a melancholy Constitution An example of a continual Feaver from the Scabs retiring inwardly and who had withal likewise a continued Feaver together with a sore and very grievous Cough by means of which he cast forth and brought away much Spittle and somtimes also great store of blood he was likewise afflicted with a difficulty and shortness of breathing insomuch that there was now great cause to suspect and fear a Phthisis or Consumption Now having for eight daies made use of Medicaments to very little purpose I made a further and more strict enquiry into the Cause of the Disease and then the Patient gave me to understand which until now he had concealed from me that before he was taken with this Disease he had the Scabies or scabbiness as we cal it the which was no sooner vanished and gone but this Feaver and Cough followed thereupon The which I no sooner came to understand but that I used the utmost of my endeavor by Medicaments made of Fumitory and such like to cause the Scabs again to break forth Which I had no sooner effected and administred such other Medicaments as I thought fit but both the Feaver and the Cough ceased and the man is yet living and perfectly sound without any the least fear of a Consumption I have told you elsewhere of a certain Student Another example of blindness from the same cause this man affected with this Scabies after and immediately upon the striking in of the Scabs became instantly blind and for two daies could see nothing at al this his blindness was likewise accompanied with an extraordinary streightness of the Breast difficulty of breathing and black Urines This man upon the use of fit and convenient Medicaments that were administred to evacuate the adust humor as Fumitory and such like within four daies recovered his sight again The same party a quarter of a yeer after being again afflicted with the same Malady did not lose his sight as formerly And likewise of the Epilepsie but had one fit of the Falling-sickness But yet notwithstanding having had fit and proper Medicaments prescribed him he again recovered I have likewise seen many that from Scabbiness have been surprized and invaded with prickings and shootings in the Breast And many other discommodities and inconveniences arising from the same cause with the bastard Pleurisie and dangerous stitches and likewise with the Cachexy I knew also a youth aged fourteen yeers that upon the unseasonable use of inunctions against the Scabies to made his Urines black lost his sight and at length being seized upon by the Epilepsie and the fits thereof being become very frequent in the end he died thereof Wherefore we say that this Scabies is no way to be sleighted neither driven inwardly or up and down and if it arise from any internal vice of the humors and the Cacochymy then externall Medicaments are by no means to be administred before the use of Purgers and other internal necessary Medicaments But now what hath been said touching the Scabies or Scabbiness The same is likewise to be taken and understood touching the Achores in Infants the same is likewise to be asserted touching the Achores or running sores in the Head yielding a thin excrement in Infants Concerning these Hippocrates in his Book of the Epilepsie or Falling sickness which he calleth Morbus Sacer writeth thus Those Infants saith he that have Vlcers breaking forth upon their Heads and upon their Ears and upon the rest of their Body and such as spit often and abound with Snot these are they that in the progress of their age live most at ease For hither floweth and from hence is likewise purged forth that Flegm which ought to have been purged in the Mothers Womb and these Infants that are thus purged are never seized upon by the Falling sickness Whereas on the conâ—rary iâ—â—â—ther the Physitians or the Women-Doctors as they call them do without due caution and unseasonably administer astringent and Repelling Medicaments and therby heal up the said Achores the Infants must then unavoidably fal into Feavers the Epilepsie Convulsions the vitious humor retiring and running unto the internal parts and somtimes likewise they within a very short space even die hereupon The Cure Now therefore in the first place there is a due care and regard to be had in point of Diet and there must be a totall abstinence from those Meats that generate adust and salt humors Viz. all things that are salt sharp bitter Oyls themselves and whatsoever partaketh of an oyly Nature and on the contrary Meats of a good and wholsom Juyce are constantly to be fed upon And this may also be observed and taken for a general rule that it is more convenient that the food that is given unto Persons that are thus affected to wit with Scabbiness be rather boyled than either rost or fried For what is either roasted or fried doth especially generate a more sharp and dry humor After this the acrimony sharpness of the humors is to be qualified and tempered and the distemper of the Liver is especially to be reduced unto its pristine Natural state and the salt and sharp humors are likewise to be evacuated And therefore in the very beginning the first waies and passages as we term them are to be purged and emptied as for example Take Electuar Diatholic half an ounce Powder of prepared Sene half a dram and so with Sugar make a Bole. If there be present any extraordinary store of Blood that the humors are overhot it wil then be very requisite and proper to open a Vein in the Arm. For Nature is wont to expel the vitious humors out of those greater internal Veins unto the external branches and those that lie under the Skin which from thence a Vein being opened are together with the Blood evacuated Afterwards in a moist Scabies from salt Flegm Preparatives are to be administred of Cichory Agrimony the Hop and Maiden-hair and Purgers of Agarick Rheubarb and Sene Leaves In a dry Scabies Preparers of Fumitory Borrage Bugloss Violets and Purgers of Epithymum we commonly call it Mother of Tyme Polypody Sene black Hellebor from whence for this present purpose various forms and Receipts may be made and compounded As Take the Roots of Cichory one ounce Polypody sowr Sorrel the inward rind of the black Alder Tree of each half an ounce of Sassafras wood rasped Liquorish of each two drams Fumitory Sorrel Agrimony Scabious of each one handful Epithymum the Flowers of Borrage and Bugloss of each half a handful Raisins
Oyl of Yelks of Eggs two ounces Wax half an ounce Mingle them c. Or Take live Sulphur one ounce Frankincense and Myrrh of each two drams Camphyre one dram bruise them into a very smal and fine powder and add of Borax one scruple Rose Water a Quart and destil them Or Take the Flour of Cicers one ounce Alum half an ounce Honey as much as wil suffice make an Unguent Or Take the Raddish root make it hollow by taking forth as much of the pith as you please and then fill it up with Salt Mustard and Wine let them stand for the space of one whole night and then anoynt the Lichenes with the Liquor Or Take Chalk beaten to a powder and let it be mingled with the Juyce of Sengreen in the manner of a Liniment with which let the place affected be anoynted But if the Impetigo be fierce contumacious and of a long continuance then there wil be need of such Remedies as do cleanse more forcibly And here we must commend unto you as that which is very efficacious that liquor that is destilled out of the Oyl of Tartar per de liquium or by draining and Quick-silver as for example Take Oyl of Tartar by draining half a pound Quick-silver two ounces destil them by a Retort The Quick-silver wil first come forth and after it a Water that is excellent against all contumacious and stubborn Lichenes Or Take Turpentine washed in Rose Water one ounce Oyl of Roses half an ounce Swines Fat three drams live Sulphur two drams Nitre a dram and half Alum Sugar Salt of each one dram Seed of Stavesacre Litharge of each one scruple Yelks of two Eggs Wax as much as wil suffice and make an Unguent Or Take the Flour of Darnel one ounce Staves-acre seed two drams the Spume or froth of Silver six drams Ceruss two drams burnt Lead and Antimony of each a dram and half Swines Fat one ounce the Juyce of Scabious and of Lemmons of each six drams Quick-silver extinguisht or kil'd with Hogs Grease half an ounce Oyl of the Yelks of Eggs and Oyl of Tartar by draining or as it is usually prescribed per de liquium of each two ounces Mingle and make a Liniment Or Take the Leaves of Willows of Mallows of the Bur of the Ivy Leaves of each one handful boyl them in red Wine Let the place be washed with the Decoction and after the washing let the leaf of the Bur be laid thereon This following Unguent is likewise commended by Valescus and Guido Viz. Take the Seed of Juniper shaken wel together one ounce boyl them and to the straining add of Hogs Grease six ounces Turpentine one ounce dissolve all over the Fire When they are removed from the Fire and cooled let the watry part be poured off from them and then let the remainder be diligently stirred about in a Mortar adding thereto of live Sulphur one ounce and so make an Unguent But if so be that the Malady wil not yield â—or be removed by these Medicaments but that the part become Callous we must then make use of Excoriatives such as Pamphilus heretofore used at Rome touching which and other the like Remedies against the Impetigo we are to consult Galen in his fifth Book of the Composit of Medicaments according to the places Chap. 7. and Aetius Tetrab 2. Serm. 4. Chap. 16. Chap. 31. Of Gutta Rosacea A Tumor neerly allied to this Impetigo is that which the more modern stile Gutta Rosacea and others Gutta Rosea the Arabians Albedsamen or Alquasen and others likewise Albutizaga which is a spotted redness or rather a redness with Tubercles with which the Cheeks the Nose and the Face is defiled and polluted as if it were all to be sprinkled with Rosie drops And somtimes these Tubercles get a growth and increase in so much that the Face becometh unequal and frightful to look upon and the Nose augmented unto an extraordinary bigness and deformity There lived a yeer or two ago not far from Dresda a man affected with this Malady whole Nose grew to such a vast greatness that it hindred him in his reading which Malady brought him to that pass that in the yeer 1629. he was content to have some certain parts and small parcels of his Nose pared away and quite cut off Nicholaus Florentinus Serm. 7. Tetrab 6. Summ. 2. Chap. 15. maketh three Differences of this Malady For there is somtimes present saith he a preternatural redness without any Pustules Bladders or Vlcers and this we call absolutely a red Face and somtimes this redness is accompanied with Pustules or Bladders and then it is called a Pustulous or Bladdery redness and somtimes it hath attending it an Vlcer and then we call it an Vlcerous redness And this last Difference seemeth very little to differ from that Affect that we call Noli me tangere which they thus describe to wit that it ariseth in the Face and especially above the Chin neer about the Mouth and the Nose and they conceive that it is so called in regard that even by those Remedies that seem most fit and congruous it is rather irritated then any waies mitigated and notwithstanding all the means that are used it is more and more carried on by eating and consuming the sound parts And hereupon it is likewise that in one and the same Chapter they treat both of Gutta Rosacea and the Noli me tangere There is notwithstanding another Affect which they likewise vulgarly cal Noli me tangere touching which we have already spoken above in the 20. Chapter The Causes The Cause of this Affect is acknowledged to be a hot blood and the same is likewise thick and gross and generated through some default in the Liver that produceth such like blood the which being carried especially unto the face as otherwise we see even in blushing the blood is easily and soon carried thither and there diffused whenas by reason of its thickness it can neither retire back again nor yet be discussed and scattered it there sticketh fast in that place and first of al it causeth a red color of the Face and soon after likewise if the said Malady continue long it generateth red Pustules Now this distemper happeneth unto some through a default and somthing amiss in their Natural Constitution and these let them live never so soberly and temperately yet notwithstanding they are nevertheless subject and liable unto this Affect But however for the most part this evil is contracted and procured by such persons as are addicted to the pot and given over to drunkenness and swilling and they are not only those that are excessive drinkers of Wine but likewise such as exceed in drinking of Beer and I once knew a Student that was notoriously affected with this Malady and he had gotten a most foul and deformed Face This man travelling afterwards into Italy and France where there is not that plenty of Beer at his return home again was
Glandules are situated under the Vessels like as also in other Glandules already mentioned And somtimes likewise but this is very rare they are bred from the Flesh of the self same places which by a certain affinity is converted into the nature of Strumae and is augmented by the access of Matter For first of all the Glandules of the said parts in like manner as all other parts the Flegm being dried or the Melancholly humor or both of them together mingled become hard like as a Scirrhus doth But somtimes the very substance of the Glandulous flesh being dried waxeth hard which yet notwithstanding being afterward moistened by the melancholly or Flegmy humor increaseth and becometh preternaturally augmented Yet notwitstanding in regard that both those waies of generation are coincident and in a manner one and the same Galen thereupon seemeth for the most part to sleight this difference and in his Book of preternatural Tumors Chap. 11. he there saith that such as are affected with hardened Glandules may properly be said to be affected with Strumae But yet notwithstanding touching the Causes we have before in the place alleadged acquainted you that Platerus determineth that Flegm alone and the Melancholly humor are scarcely sufficient to generate Strumae seeing that if they were from those alone they would not then be of long continuance but they would rather be obnoxious unto putridness or turned into Pus like as are other Tumors but that these Strumae derive their original from a Juyce nourishing these parts For whereas Glandules are nourished with a thicker Juyce than other fleshly parts if this Juyce exceed in Quantity it then generateth divers kind of Tumors But although this be altogether to be granted yet notwithstanding this is not altogether impossible but that some melancholly and flegmy humor be mingled together with the aliment of the Glandules Now this matter of the Strumae is included in a peculiar Membrane which the formative faculty that is seated and planted in all the parts that have life in them produceth For whenas there is some Membrane distended or even broken by the superfluous humor that floweth thereto Nature extendeth and dilateth the same and attempteth the structure and forming as it were of a new Membrane The Differences These Strumae are by some distinguished into Malignant and Benign and they will have those to be benign that are without an Inflammation without pain and those they will have to be malignant that have with them both Inflammation and pain and that are the more exasperated by Medicaments But we must know that those Strumae that are termed malignant are not properly Strumae but a Tumor as it were mingled of Strumae and a Cancer so that this Tumor doth not alone proceed from a flegmy and Melancholly humor but it hath likewise mingled together with it a black Choler They are likewise distinguished in this manner that some Strumae are free others of them infiltrated Those of them are said to be free and simple that are not complicated with any Vessel or tied together with it but such of them as are knit together either with some notable Vein or some Nerve and are as it were wrapt and folded within them these we call Strumae infiltrated or haply as by a name more fit and congruous Strumae implicated Those things that should have been further declared touching these Strumae have already been propounded in the place alleadged viz. in the second Book of our Practise Part 1. Chap. 35. and there they may be seen Chap 34. Of Ganglium and Nodi GAnglion so called by the Greeks and by the Latines Ganglium is by some reckoned up among the Affects of the Head But by Paulus Aegineta in his fourth Book Chap. 16. and Book 6. Chap. 39. and by Aetius in Tetrab 4. Serm. 3. Chap. 9. it is attributed unto many parts and it is an Affect of the Nervous parts and by the Author of the Physical Definitions it is thus defined viz. that it is a preternatural rowling together or knot of a Nerve which groweth together into one Body The very same Tumor Guido in his second Tract Doct. 2. Chap. 4. seemeth to call it Lupia and Tagautius in his Chirurgicall Institutions Book 1. Chap. 13. writeth that it appeareth in Aetius out of the Cure Philagrius that Lupia of the modern Physitians the Glandula of Avicen and Ganglion of the Greeks is one and the same Affect But by what names these Tumors are called by the Germans is not very evident For if we wel weigh the Descriptions and Signs yea and the Cure likewise of Ganglion and Lupia of the Greeks and the latter Physitians as also of the Glandules of Avicen Ganglium is that Affect which by the Germans is called Vberbein uberbein so called not that it is indeed a Bone but because it is a Tumor upon a Bone to wit in that same place where the Bones are only covered with the Skin or because it resembleth the hardness of a Bone Notwithstanding Platerus doth not cal those Tumors that arise from the Nerves and which Authors every where describe under the name of Ganglium by the name of Vberbeine but a peculiar kind of Tumor when the Periostium being shaven or eaten through there springeth up and groweth unto the former as it were a new Bone But now that Tumor which he propoundeth under the name of Ganglium viz. which is bred about the joynts especially the Knees somtimes comprehending the whol Joynt and this one while in a more narrow and other while in a broader limit and somtimes also so stopping and hindering the motion thereof that the Member is altogether either motionless or else so that it cannot be wholly and entirely moved seemeth to be that Tumor which the Germans cal Glied-shevva Glied-shevva to wit because as it were a certain Mushrom it ariseth under the Skin neer about the Joynts and especially the Knee which is not alwaies round but often overspreadeth the whol Knee when yet notwithstanding Ganglion is alwaies a round Tumor as Ambrose Parrey writeth in his sixth Book and Chap. 20. But as I told you likewise before there is a great confusion in the names And therefore as Joh. Tagautius in the first Book of his Physical Institutions and Chap. 2. adviseth us the thing it self is to be heeded with al care and circumspection and as for the names we need not much to regard them since that oftentimes one and the same word hath in several Authors various and different appellations Ganglion ariseth indeed in al or the most parts of the body and yet more especially in those parts that are moved neer about the Joynts to wit In the Hands and Feet and in those very places where the Bones are only covered with Skin and where there is a concourse of the Tendons Ligaments and Nerves And yet notwithstanding Aetius addeth the Head and Forehead as likewise the Elbows and Arms but it
Palate that the sick party could hardly breathe neither could he speak distinctly and so as to be understood This Gulielmus Fabricius in his third Century and Observat 1. tels us yet likewise of another Fungus that he had seen growing out of the Ear and that he cured the same And in his fifth Century and Observat 62. he mentioneth yet another Fungus that sprung and was bred out of the very Center of the Navel This kind of Tumor Gulielmus Fabricius in his third Century Observat 36. conceiveth that it is to be referred unto those that we cal Nattae or Naptae But what these Naptae are we have before declared in the thirty sixth Chapter And although there be somthing of Fungus contained in the aforesaid Tumor Natta and albeit these Tumors may in the general be said to be Fungus yet notwithstanding that is covered over with the skin but Fungi properly so called and of which we are now â—reating hang forth al naked and bare without the skin and there they grow and encrease And therefore likewise they breed not in the whol and sound Membranes of the brain but they are bred in them when they are wounded bruised together and hurt The subject of these Tumors is a Membrane that is any waies hurt or wounded or bruised The Causes Johannes Philippus Ingrassias touching the Cause and the manner of generation of these Fungi writeth that this Fungus is wont to be bred in like manner as in Candles lighted or Lamps we see the Fungus in the Winter time especially that is wont to arise and appear in the top of the Wick of the one and the match of the other and which is with weak and simple Women a notable presage of Rain suddenly to follow even as Virgil in the first of his Georgicks and Pliny likewise in his eighteenth Book about the end thereof do both of them attest For when the Air begins to be moist the sparkles that were wont to pass forth with the smoke being now prohibited and hindred by reason of the thickness of the Air do there reside in the Lights and there they represent as it were certain resemblances and Images of Fungi And just so it is in the Membrane of the Brain when it is discovered and laid open at the first there is a certain substance that representeth the likeness of that soft and Cotton-like tender Hair that is found upon the heads of new born Infants But then afterwards the vapors being discussed by exhaling and the Fumes being made to assume a round form in that substance by the coldness of the Air they are by little and little burnt and extreamly dried by the more inward heat until at length there appear also a substance like unto the said Fungus signifying that the Membrane is altered by the Air. But in very truth it is indeed to be granted that these kind of Fungi are generated from a superfluous humor as it were sweating forth thorow the hurt Membranes but that this matter may be even deteined there by the coldness of the Air and that it may likewise be there exsiccated meerly and only by the heat is altogether false and therefore not to be granted For these Fungi cannot possibly be so suddenly generated after this manner and get such a growth But it is most agreeable unto truth that the humor destilling forth into the soft Flesh that is spungy like to the Mushrom in Trees is changed by the formative faculty of the part and that Nature which is never idle doth change and form into this substance the humors flowing thereunto which by reason of their abundance as likewise their unfiâ—ness for motion and the debility of the part it can by no means possibly convert into the aliment and substance of the said part Signs Diagnostick This kind of Tumor is very easily known For out of a Membrane hurt and bruised or wounded there shoots forth a soft Flesh spungy and pale and not covered with the Skin and suddenly it attaineth unto a great and exraordinary growth Prognostick This Malady is very dangerous and hard to be cured and if it be not handled aright it easily turneth into the Nature of a Cancer The Cure Universals having been first premised the which it is not our purpose here to mention the Fungus it self is to be taken away which is done either by Medicaments that exsiccate and corrode or else by excision and cutting it out Medicaments that exsiccate and dry are far more safe then those that corrode and eat through in regard that by Corrosives the matter is easily exasperated and so obtaineth the nature of a Cancer Now such are made of round Aristolochy the roots of it and of the Florentine Flower-de-luce Angelica the true and right Acoruss the Leaves of Savine of Card. Benedict of Rosemary of Plantane Horstail Storks-bil the Flowers of Red Roses Mastick Frankincense Myrrh prepared Tutty burnt Lead Sugar of Saturn Lapis Calaminaris the Ashes of Froggs and Sea-Crabs But they are to be cut out either by a Silken Thread tying it about therewith or else any other strong Thread otherwise it is done by an Iron So soon as the Fungus is taken away either by the aforesaid Ligature or Iron then there ought to be strewed and sprinkled thereupon Powders of the before mentioned Medicaments As touching these operations see further in Gulielm Fabricius in the place alleadged to wit Century 3. Observat 1. and Century 5. Observat 62. Chap. 40. Of Tumors Malignant and Poysonous and in special of Elephantiasis WE are at length come to treat of a certain kind of Tumors arising from the humors that have joyned with them a Malignity Among the which the first we meet withall are the smal Pox and Measils But because we have already handled them in the fourth Book of Feavers Chap. 12. we shal here add no more as touching them but rather refer the Reader thither for his further information And then the next we meet withall are those we call Bubones and pestilent Carbuncles touching which we shall likewise here in this place spare our pains in the further treating thereof in regard that we have also spoken of them in the place alleadged to wit the sixth Chapter There likewise belong hither in the third place those Tumors that we term Venereal of which we shall hereafter treat further in its proper place among the malignant Tumors And lastly there is this Elephantiasis touching which alone we intend here to discourse That Affect which the Arabians call Lepra we have told you above in Chap. 28. that it is by the Greeks called Elephantiasis Elephantiasis Now it is called Elephas Elephantiasis and Elephantia from the Elephant by reason of the likeness and resemblance that this Disease hath with that Creature the Elephant to wit as some conceive because such as are affected with this Disease become great as the Elephants but this is but a weak and simple conjecture
the Ambient Air especially that that is cold a contusion of bruise an Incision and tart or sharp Medicaments Signs Diagnostick If the Bone be in the open view the corruption thereof doth then easily appear because as Celsus writeth in his eighth Book and Chap. 2. that that is vitiated at the first appeareth almost as if it were fat and afterward either black or rotten But although the Bone lie hid and do not in the least appear yet nevertheless its Corruption discovereth it self by certain Signs And if a Fistula went before or that there were an Ulcer of a long continuance then the Bone is corrupted by the touch of the Pus and the Sanies touching which Hippocrates thus writeth in the sixth of his Aphotisms Aphorism 45. If the Vlcers saith he be Annual and such as return yeer after yeer or if likewise they be of a long continuance then there will necessarily follow an Impostumating and putrefying of the Bone and the making of hollow Cicatrices Moreover he saith that such like Ulcers are indeed sometimes brought unto a Cicatrice but that they are soon after again renewed the Cicatrice being broken For the humor and the Sanies that sweateth out of the corrupted Bone eateth through the Cicactrice and reneweth the Ulcer And therefore if there be any Ulcer ofen renewed it evermore giveth us great cause to suspect that there is one or more Bones corrupted as Galen tels us in his Comment upon the sixth Book of the Aphorism Aphor. 45. and Paulus Aegineta in his fourth Book and Chap. 10. And this is oftentimes to be seen in the rottenness of the Teeth out of which there stilleth forth a Sanies through the holes of the Cheek or Jaw-bone and there in the external part of the Jaw it exciteth and causeth an Ulcer which although it may be and oftentimes is healed yet notwithstanding after a very short time the Cicatrix is again broken If such an Ulcer therefore appear in the Cheek and be there often renewed the Teeth are then to be lookt into and if there be any one of them rotten it is forthwith to be brawn For the Ulcer cannot possibly be perfectly and wholly healed before the Tooth that supplieth the material cause unto the Ulcer be drawn forth Thirdly the flesh that lieth above upon the Ulcer is soft and flaggy for it is made thus soft by the Sanies that sweateth as it were out from the Bone and sometimes likewise it becometh wan and Leaden-coloured by reason of the vitious humor that floweth forth from the Bone in the seventh Book of the Aphorisms Aphor. 2. Fourthly the Sanies that floweth forth of the Ulcer is more abundant then what is usual considering the bigness of the Ulcer it is likewise thin stinking and of very ill consequence as Galen tels us in his third Book of Fractures Tit. 18. And if there be a dry Liniment put into the Ulcer so that it may teach even unto the very bone and the next day drawn forth again it wil stink loathsomly And lastly if the Probe or searching Instrument be conveyed into the Ulcer even unto the very bone then the said Ulcer is not found to be smooth and slippery and hard but unequal rough and soft But whether this rottenness be deep or only superficial Celsus in his eighth Book and Chap. 2. teacheth us how we may discover it in this manner If saith he a slender and smal Probe be thrust into the hole of the Vlcer it wil by its more or less entring thereinto give us sufficient notice whether the rottenness be in the top and superficies only or whether it hath descended deeper The blackness likewise of this Sanies and rottenness may rightly be gathered from the pain and from the Fever which if they be mild and moderate it is then an Argument that the said rottenness hath not descended very deep but when the aforesaid Symptoms are great then the rottenness hath gotten down very low and deep but it wil appear yet more manifestly by turning about the Wimble in it For there is then an end of what was amiss when there ceaseth to come forth any more of the black scursiness Thus Celsus Prognosticks 1. All rottenness in the bones hindereth the Cure of the Ulcer neither can any Ulcer be perfectly healed under which there lieth a bone that is corrupted 2. If by reason of the diseased and rotten bone the flesh be become blackish and of a Leaden colour it then betokeneth much evill 7. Sect. Aphor. 2. For as Galen Comments upon the aforesaid Aphorism it signifieth no mean and smal distemper of the bones but an extraordinary corruption of them 3. If the rottenness of the bones be neer unto the Nervous parts as in the Hands or Feet or else in the Joynts and heads of the greater bones or otherwise about the heads of the Muscles and the Nerves and the Tendons it is not in any of these cases easily cured in regard that we cannot with any safety make use of or appoint any Chirurgical operations 4. The Cure in like manner it altogether as difficult if the rottenness be about the great Arteries and the Veins The Cure Besides the Indications that the Ulcer affordeth us the rottenness of the bone sheweth us likewise that what is corrupted must be wholly taken away for neither can that that is dead be by any means corrected and amended For that which is in the flesh and soft parts we call it Sphacelus but if it be in the bone it is then rottenness But now that the corrupted bone may be taken away it is first of all to be cleansed and then made bare if it be covered with flesh the Ulcer being cut off But nevertheless as we told you erewhile there cannot oftentimes any Section or Cutting be administred by reason of the Nerves Muscles Tendons Arteries and the greater Veins The bone is therefore then as much as may be to be cleansed with a Gentian or Rape root tenderly conveyed into the Ulcer The flesh likewise that lieth at the top of the bone may be consumed by a Caustick Medicament or by any potential Cautery and so the bone may be bared in the same manner as Issues are wont to be excited The corrupted bone when it is made bare it is then to be taken away either by Chirurgery or by Medicaments We must of necessity make use of Chirurgery when the Corruption of the bone is more deep and not in the Superficies or when we desire a quick and speedy Cure as in the bones of the Thorax For Nature doth but very slowly separate the corrupted bones and scarcely now and then in the space of thirty five or fourty daies And therefore this separation of the corrupted bone from the sound may otherwise be assaied by Medicaments Now those Medicaments that separate the corrupt bone from the sound ought to be very drying that so they may consume the superfluous humidities in the corrupted bone
destruction of the innate and natural heat as on the contrary the life of the part dependeth upon the preservation and safety of the said Native heat we conclude that whatsoever destroyeth the Native heat of the part that same may likewise be accounted a cause of the Gangrene and Sphacelus Now the Native heat is destroyed when by its contrary it is either corrupted or suffocated or dissipated or altogether extinguished for want of Aliment It is destroyed by its contrary either acting by a manifest quality and cold or else by a secret and hidden quality as by poyson It is suffocated when the transpiration it hindered It is dissipated by a greater heat It is extinguished if necessary food and sustenance be denied so that there are as you see five causes of the Generation of a Gangrene and Sphacelus to wit overmuch cold a poysonous quality the hinderance of transpiration a vehement external heat and a defect of Aliment and the heat flowing in For first of al we see that oftentimes in the Winter those that take Journeys in the Snow and Ice have the extream parts of their feet and of their hands their Ears and their nostrils almost dead with cold by reason of the vehemency thereof and thus it happeneth somtimes also that by reason of Medicaments over cooling in a Phlegmone or an Erysipelas carelessly and incauteously administred the part is taken and surprised with a Gangrene or a Sphacelus although I had rather refer this case unto transpiration hindered There is also a very great power of destroying the innate heat in those things that are poysonous and such things as destroy our Bodies by a secret and hidden quality For somtimes the humors in our bodies do so degenerate and acquire so great a malignity that they bring a Necrosis or deadness unto those parts whither they are by Nature thrust as we see it done in a Carbuncle And so in like manner the biting and stingings of poysonful Creatures do corrupt and putrefie the parts And the same also is done by the Septick Medicaments which if they be not wisely and carefully administred have in them a power of corrupting the flesh especially in places that are hot and moist as in the Emunctories the privy parts and the other places that are like unto these Thirdly Transpiration hindered exciteth likewise a Gangrene For whereas our heat standeth in need of perpetual ventilation and cooling if this be denied it is suffocated by the abundance of Vapors And for this very cause in great Inflammations and especially in the moist parts there very frequently happeneth a Gangrene the Native heat being extinguished as otherwise likewise we see that a little flame is extinguished and put out by casting thereon good store of water and that the flame is stifled if it be put under a Cupping-glass that hath no hole or vent in it or any other Vessel whatsoever that is kept covered which is preserved in a Cupping-glass that is perforated or any other Vessel that is open And this chiefly happeneth if in Feavers especially if they be malignant the humor be with violence either thrust forth or that of their own accord they rush unto any one part And so I remember that here a certain Citizen that was taken with a malignant Feaver from the humors that were thrust down unto the Scrotum had the said Scrotum al of it so inflamed and mortified with a Sphacelus that there was a necessity of cutting off the whol Scrotum or Cods so that the stones hung down altogether naked and bare which yet notwithstanding the Gangrene being cured became afterwards covered again with flesh that grew out of the Groyns That Inflammation likewise which the Gangrene followeth is sometimes caused by Wounds and these not alwaies great but oftentimes also very smal and sleight Wounds that seem inconsiderable and of no moment So Henricus ab Heer relateth in the first Book of his rare Physical Observations Obser 12. That he was present and saw a man fifty nine yeers of Age who having pared the Nails of his Toes and cut them to the quick was presently surprized with a Gangrene and within a very short space died thereof And he telleth us likewise of two other eminent persons who being desirous to have the hard and callous brawniness of their feet pared away were both of them taken with a Gangrene that within a short time caused their deaths And this may likewise be done by Emplastick Medicaments in great Inflammations and especially if they be unseasonably applied in moist places which frequently produce there a suffocation of the Native heat Fourthly A preternatural heat likewise and such as is extraneous and from without produceth the Gangrene by wasting the Radical moisture and the Native heat and so many times a Gangrene followeth after great burnings And lastly A Gangrene ariseth from the defect of Aliment to wit the blood and the spirit flowing in that is altogether necessary and requisite for the cherishing of the Natural heat implanted within For whereas the innate heat standeth in need of continual Nutriment as the flame doth of Oyl if this be denied it languisheth and is extinguished like as is the flame when the Oyl in the Lamp faileth And in this manner a Gangrene happeneth unto the external parts of the body somtimes in an Atrophy Consumption and the like Chronical and long continued Diseases that extenuate the body And for this very cause it is that when the greater Joynts are put out of Joynt if they be not again wel and rightly set then the disjoynted bone presseth together the vessels that lie neer and hindereth the influx of the blood and of the Spirits into those parts that lie underneath from whence there followeth a leanness and consumption of the said parts and in process of time very frequently a Gangrene also And so it is found by experience that from a hard Tumor about the Vena Cava where parting several waies it descendeth into the Thighs pressing the same together and hindering the descent of the blood into the Thigh a Gangrene very often ariseth And in this manner a Gangrene likewise happeneth if any part be too hard and long bound about with Ligatures and bands or else if Medicaments that are over astringent shal be imposed upon any part Signs Diagnostick It is no hard matter to know the Gangrene For the color of the part beginneth to be changed and turned unto black the flesh to grow loose and flaggy the pulse and sense to be diminished and the heat to be abolished Which said Symptoms the more the Gangrene tendeth unto a perfect corruption and a Sphacelus by so much the more are they increased and made more evident For in a perfect and absolute corruption and Sphacelus the life and sense of the part are wholly abolished there is no pulse at al to be perceived the part whether you cut or burn it is insensible of pain the flesh appeareth to be
it self doth scarcely at al differ the difference lying only in the removal of the Causes But if the Malady become to that that the Member is now already altogether mortified and dead and that it be sphacelated from whatsoever cause it be that the Malady hath its original there is then one only way of curing it For seeing that what is altogether dead in the body cannot possibly recover life again and that it hath now altogether the nature of a thing that is preternatural there is this one only Indication to wit that it is to be taken and amputated from the body Which if by reason of the unfitness of the place it cannot conveniently be done then the case is wholly desperate For some parts are much more fitly scituated for amputation than others as for instance the fingers the feet the hands the genitals may be cut off with less danger But if the Malady be in the Thorax or Chest or in the Belly the parts cannot then be cut out and especially if there be many particles of the Member at Once infected For it somtimes so falleth out that the whol Member is not to be taken away but only some part thereof But oftentimes indeed the whol Member is wholly to be amputated and cut off to wit when the putridness hath seized Upon and corrupted al the parts thereof round about which in some may be speedily done and without any great danger as in the Scrotum or Cods but in other parts the amputation is ful of difficulty and peril as in the Feet Army and Hands But after what manner the said amputation and the taking away of that which is corrupted is to be performed we wil now acquaint you Now this may be done divers waies some there be that having first applied a Defensive upon the sound part they then with many straight and oblique Sections scarifie the dead flesh that lieth neer unto the sound and this they do very deep even unto the very bone And afterward upon the Wounds they strew the pouder of Arsenick and Sublimate that so the mortified part may be separated from the sound But in this way of extirpating the corrupt flesh Arsenick as we lately gave you notice is suspected and therefore in the stead thereof we are to administer other burning Medicaments of the ashes of Vine-sprigs and unslaked Lime The Crust that is al over the part affected is to be taken away with a Pen-knife neither must we expect til it be separated of its own accord Yet nevertheless that the dead part may be dried and be easily separated from the sound Fallopius applieth this Sparadrape Take Aloes Myrrh Acacia Gallia Moschata Alipta Moschata al the Saunders Lign Aloes Cumin Allum of each one dram make a Pouder Of which Take one ounce Ship-pitch Rosin of the Pine-tree Colophony of each two ounces Frankincense Mastick Styrax liquid of each one ounce and half Gum Arabick and Tragacanth of each half an ounce Let them be all melted put a Linen cloth into the Liquor until it be throughly soaked in the Medicament And afterwards let al other things be done as it useth to be in other Ulcers There are others that with an actual Cautery burn that that is corrupted even until there be a pain perceived in the part and al other things are afterward to be done according to art But now Fallopius doth advise us if much dead flesh be to be taken away not to make use of an actual Cautery alone in regard that from the said burning there wil be caused a most abominable loathsom stench Others there are that by Section and the Razor amputate that that is corrupted and afterwards to avoid the Hemorrhage and to dry up and consume the reliques they apply likewise an actual Cautery if need require But what hath hitherto been spoken touching this way and method of Curing is to be understood only of that Sphacelus wherein the whol Member is not corrupted and when there is no cause of taking away the Bone likewise For if the whol Member be corrupted The cutting off the corrupted Member when to be done and therefore to be amputated this cannot be effected either with an actual Cautery or a Potential neither yet with a Razor but there is a necessity of cutting off the whol entire Member the Foot the Hand c. But in what manner this amputation ought to be performed Authors differ much in their opinions concerning it Celsus in his seventh Book and Chap. 33. perswadeth us to make the Section between the sound flesh and the dead and rather to take away some of the sound than to leave any of the dead flesh remaining left the Malady that is left corrupt that that is sound Which way of curing most of our late Physitians disapprove of by reason of those dangers that follow the Section in the sound part to wit an immoderate profusion of the blood and an extraordinary great pain and the faintings and swoundings that depend upon these And therefore that these may be avoided they advise us to make the Section in the corrupted part alone Fallopius indeed with a Razor cutteth into the dead flesh even unto the bone a fingers breadth distant from the sound part and then after this he forthwith taketh away the bone with the saw and then again with Irons red hot he burneth the greater Vessels and the flesh even unto the causing of pain Hieronymus Fabricius also leaveth a portion of the sound flesh as much as one fingers breadth and appointeth the Section likewise to be made with a Razor in the dead flesh and he afterwards burneth the part with fire-hot Irons after the same manner to hinder and restrain the Hemorrhage and to waste and consume the reliques of the putrefaction But here in this place we are to advertise you that somtimes the putridness wil yet creep further and infect the neer neighboring parts but then again that somtimes the putridness ceaseth neither doth it creep any further unto the parts neer adjoyning which whensoever it happeneth then round about the corrupted part there appeareth a Circle that is exactly red and of an exquisite sense In the latter case indeed that way of curing seemeth not altogether improper and unfit in a part that is corrupted and dead For by this means those many dangers which accompany that Section that is made in that part that is alive are prevented to wit the profusion of blood pain and faintings since that through the corrupted part the blood cannot pass and because that the said part hath no sense at al. But if there be any of the dead flesh left remaining this when the putridness shal cease any longer to creep although there shal not be any Cauteries administred wil afterwards divide it self of its own accord and then it wil be separated by Nature upon the administring of fit and proper Medicaments But if as yet the putridness be creeping forward and that Nature hath not
arise thereupon the Trunk or Stump of the part that hath been cut assunder yea and the Neck likewise and all the Spinal Marrow is to be anoynted with those Medicaments that are otherwise also wont to be applied unto affects of a Nervous Nature made of Sage Rosemary Marjoram Rue Lavender Dil Camomile St. Johns wort Bayberries the Oyl of Earth-worms the Oyl of a Fox Turpentine and the like We must not here pass by in silence the Scoâ—butick Gangrene The Scorbutick Gangrene touching which we have already spoken something in the third Book of our Practise Part 5. Sect. 2. Chap. 4. Which most usually beginneth about the extream part of the Foot with black and purple spots and a little after this there appeareth from hence a crusty and Gangrenous Ulcer dry and yielding forth neither the thin Excrement Sanies nor yet the thicker which we term Pus and then one or other of the Toes beginneth to die and then there appear red lines and purple spots upon the juncture of the Foot according to the length of the Leg. I have my self seen some examples of this Disease But both this Gangrene and Sphacelus differ from that Gangrene and Sphacelus that are both of them wel and commonly known and that in many things For that Gangrene that is so wel and commonly known hath its original for the most part from Causes that are manifest and apparent and there alwaies floweth forth of the Member that is dead in such a like Sphacelus a stinking and waterish humor the Member becometh soft and putrid and it sendeth forth from it a grievous and noysom stench like unto that of a dead Carkass and it creepeth much in a very short time and most commonly it soon destroyes and kils the man that hath it But now the Scorbutick Gangrene almost ever appeareth and invadeth the person without any manifest cause creepeth forward but very gently and slowly and doth not destroy the person therewith affected until after a long time for I knew a Noble-man that lived above three months but a certain School-Master I saw that lived above six months notwithstanding this Malady The part affected with this Gangrene is altogether dry so that there floweth out of it nothing at al and when the corrupt part is taken away by the Iron although a red flesh offer it self unto the view yet nevertheless that same red color is withal somwhat dark and blackish and the day following it likewise is even found to be dead also and there is here no stink at al perceived that offendeth And moreover so soon as ever the Malady hath first of al seized upon one of the feet only then presently after without any manifest cause at al there begin to appear in the other Leg and Foot also certain spots and blemishes of a red or purple color and then likewise not long after this one or other of the Toes of that Foot becometh wan and leaden colored and in a very short time it is found to be quite dead and at length most commonly the party as it befel that Noble person before mentioned being taken either with the Apoplexy or with the Epilepsie upon the first approach thereof dieth And yet notwithstanding this Malady somtimes invadeth suddenly to wit when the peccant humors are by wrath terror or the like Cause first disturbed and then afterwards thrust down suddenly and as it were in a moment unto the Toes and first of al to some one of them only after the very same manner as the Erysipelas or Rosa is wont suddenly to arise and this humor in regard that it hath in it a very bad and destructive quality or else hath received it from some affect of the mind causeth that part that it seizeth upon instantly to die and hence it is that by some this kind of Gangrene and Sphacelus is in special called Syderatio whereas otherwise the Gangrene is wont in the general also to be termed Syderatio Now this said humor seizeth upon the Tendons most usually from whence there arise most terrible and intolerable pains that torment and grieve the sick person both day and night which said Tendons in regard that they do not so easily and soon putrefie as doth the flesh hence it is that this Gangrene likewise or repeth on so slowly that somtimes unto the external view it is a whol months space in overspreading one only joynt and ere it seize upon another albeit that within almost al the Tendous of the Foot are already infected and this Malady continueth somtimes a quarter of a year before it kil the person and it is seldom or never cured in regard that this depraved humor hath insinuated it self more deep than usually into the Tendons and therefore cannot be so easily taken away So a certain Noble person that had otherwise a Cacochymical and foul body and was subject unto the Erysipelas upon a fear and terror Nature then suddenly thrusting down the vitious humors unto the little Toe was surprised with a Gangrene which afterwards by little and little overspread likewise al the rest of the Toes and almosâ— the whol Foor with extream great pain upâ— which after the space of three months 〈◊〉 died Of this kind was that Gangrene also with which a certain Citizen here about thirty yeers of age was taken in the month of January 1633. He first of al complained of a pain in his left Arm neer unto the Elbow which he making light of the pain descended unto his Hand and it was presently taken with a cold Tumor or Swelling and at length became suddenly overspread with a purple color so that now there appeared manifest signs and tokens of mortification and a Gangrene Yet notwithstanding upon the administring of fit and proper Medicaments of which we shal speak more hereafter his Hand had its natural color again restored unto it and the swelling vanished away so that there was nothing further to be seen but only in the very tip of the little Finger the Scarf-skin appeared to be somwhat wrinkled upon the opening of which here flowed forth a little of an humor and the Skin underneath appeared pale and so the very tip of the finger was taken with a Gangrene which yet nevertheless without any diminution of the Joynt was cured In the curing whereof we found this one thing wel worth our observation that from the said finger most sharp and exquisite pains were extended into the whol Hand insomuch that the sick person was even afraid to betake himself unto his bed but that rest and sleep he took was in the night time as he sate When his finger likewise was handled by the Chirurgeons the pains that he felt were so great that he could not endure the least touch the feet moreover swelled much and his face was somthing more swoln than usually Neither indeed wil any man that is not a stranger unto what is done in the practice of Physick admire that some vitious
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
from the purpose that we purge the whol body since that these Worms arise from a vitious humor mingled together with the aliment of the hair Take of Broom one ounce Myrrh two drams Vinegar as much as will suffice boyl it a little and let the hair be Cleansed with the straining Or Take Nettle seed pulverized let it be macerated in Vinegar and the hairs wel wet with the same The Decoction likewise of Fenugreek and Scabious made with Ley is very useful in this Case and so are also Squils with the Leaves of Myrtle and Sage boyled in Oyl Or Take Garlick Centaury the less equal parts of both boyl them in Vinegar and add thereto the Gall of a Bull. Or Take the grearer Nettle boyl it in Ley and wash the Head therewith Or Take Southernwood Root of Avens and Wormwood boyl them in Vinegar and Spring Water as much of the one as the other and let the hair be washed with the Decoction thereof Chap. 6. Of the Cleaving of the Hair ANd somtimes likewise the hairs on the Head and in the Beard are cloven and divided so that those that before were single and but one now seem and appear to be cleft into two Which Vice of the Hair happeneth without doubt from some sharp humor cleaving the Hair in the ends of them But now since that this Vice breedeth tome kind of deformity it is therefore to be amended Which is done if that part which remaineth be anoynted about the ends of them with the Gall of a Bull and be afterwards again washed with the Decoction of the Capillary Herbs Southernwood the Reed and the like Chap. 7. Of hoariness in the Head and Beard FOr a Man in old age to become grey and hoary in his Head and Beard is a thing altogether Natural but yet sometimes nevertheless it so happeneth that immaturely and oversoon hoâ—riness appeareth in some before their old age yea indeed before they are come to be Men. And furthermore Hoariness cometh on and appeareth leisurely and by degrees But yet it is observed that some persons have suddenly and all on an Instant become white and hoary And to this purpose Scaliger in his Exercitation 312. relateth a History of something that happened under Franciscus Gonzaga This Gonzaga having committed and imprisoned a neer Kinsman of his in a strong Castle upon suspition of treachery in him thereby to reserve him until he were questioned and punished according to his demerits news was brought him next morning that his Kinsman was suddenly become all over white and hoary And the like we read in Lemnius in his second Book Chap. 2. of Complexions and in Hadrianus Junius in his Comment upon the Hair In Ludovicus Vives his Scipio's Dream and in Coelius Rhodiginus in the third Book of Ancient Reading Chap. 24. and in the thirteenth Book Chap. 17. And Cuspinian relateth many Histories of such as suddenly out of fear became gray and hoary and so doth Johannes Schenkius relate the like in the first Book of his Observat And of this kind of hoariness it is that cometh immaturely and before its due time that I am here in this place to treat For this Affect in regard that it both depriveth a man of his Natural beauty and likewise betokeneth that the health is not right and as it ought to be it is therfore not without good cause made the subject of the Physitians care and pains As for that grayness whiteness and hoariness that chanceth unto men and women in their old age and is a Natural ornament of their old age to endeavor to cover and hide this with fucusses and other artificial paintings is altogether whorish and an Argument of a light wanton and luxurious mind The Causes It is not to be doubted that natural hoariness doth proceed from the change and alteration of the temperament of the body and the blood that nourisheth the hair But here we are to enquire how it cometh to pass that there should be somtimes such a change as this in the blood and aliment in those that are yet in their youth and green yeers Aristotle in his fifth Book of the Generation of living Creatures Chap. 5. writeth That the Aliment that produceth these white and hoary hairs when it is not concocted doth rot and putrefie and so becometh a white hoariness because that the filthy snottiness of them being rotten is almost white And so he deduceth this hoariness from the defect of Native heat which when it cannot concoct the humors these humors being deserted by their natural heat are then the more attempted by an external and adventitious heat and so they become putrefied from which putridness they are made white Galen seemeth to follow the opinion of Aristotle when he tels us in his second Book of Temperaments Chap. 5. That the hairs are made white because that the aliment whereby they are nourished is as it were the shot of flegm which in space of time putrefieth And that which Aristotle calleth putridness he termeth Situs and we cal it filth snor or snivel this being such a kind of affection as happeneth unto Bread in the Dog daies which we therefore call finnowed or hoary Bread And for this cause likewise it is as he writeth that men are more apt to grow hoary in their Temples because that the fore part of the head is by reason of its driness more prone to baldness but the Temples by reason of their humidity and consequently upon the generating of snot and filth from the putrefying of the aforesaid humidity are more apt and prone unto hoariness The Opinion of Galen in this one thing only seemeth to differ from that of Aristotle to wit That Aristotle speaketh only in the general without making mention of any one particular humor whereas Galen writes that hoariness proceedeth from the putridness of flegm alone And here it is altogether more safe by flegm to understand any simple crude humor then flegm properly so called and that any crudity rather than that putridness only which is so called may be the cause of hoariness To wit that we may in a word or two propound our opinion touching this very thing in controversie of which others have so largely discoursed seeing that the hairs as we said before are not generated and nourished from vapors or excrements elevated in the form and likeness of vapors but rather from the blood as al other parts are it is without al dispute that the blood that is generated in old age is not so fresh flourishing and temperate as in youth but that as the body is now hastening toward death so the blood also that is therein bred is nothing so good as formerly which is cleerly shewn and manifested even by the change and decay of that fresh and lively color of the body and that witheredness that befalleth men and women in their old age And therefore we are not to wonder that seeing the blood that nourisheth the hair is
any other parts and why in tract of time it vanisheth of its own accord but yet wil not in the least yield unto those Remedies that cal it forth and such as we cal Alexipharmaca or Counterpoysons and lastly from whence it obtaineth that notable and altogether to be admired power of Conglutinating For neither can these be referred unto the manifest qualities of any one humor the first or second although true it is that according to the generating of these depraved humors more or less the evil may possibly creep more or less and be more or less confirmed This may wholly be said which is likewise usual in the explaining of al other poysons that those Waters and the exhalations thereof are infected with a poyson endued with this property that it is more annoying unto the head is fixed more pertinaciously unto the root of the hairs bindeth them together most strongly and wonderfully writheth them and most obstinately resisteth all kind of Remedies whatsoever by reason that the peculiar nature and generation of this poyson is altogether unknown insomuch that this Noble man seemed to have said but the very truth unto me that some Boors there were within his Territories that had discovered more of the original of Plica as also of the progress and Cure thereof than those Authors that had written concerning the same none of which have as yet been so successful as to restore unto perfect health any one that hath been afflicted with this Plica But for the Scurvy it is to be esteemed a far more grievous Malady in regard that it creepeth into the whol blood and the corruption thereof prevailing and getting strength may at length cause death unto the party therewith affected which the Plica if let alone without cure and not medled withal never yet did unto any So that this Noble person is not without good cause very much perplexed and troubled as touching this his Malady being in good earnest grieved that there is hardly any regard had unto this Affect in this City where there hath scarcely ever yet been seen at any time any one infected with the Scurvy And I for my own part although I have seen two Hollanders and one English man both at Venice and at Padua also al three of them affected with an exquisite Scurvy yet I neither expect nor desire that any Credit should be given unto what I say but yet notwithstanding from what I find written touching the Scurvy by Forestus Eugalenus and Sennertus most truly and according to what they had seen and found attested by many Histories I shal presume and that very confidently to affirm that this illustrious Lord is at present much afflicted with the Scurvy For excepting only the swelling of the Lips and the flagginess of the putrid Gums the Accidents of the Scurvy confirmed al other signs and tokens of the Scurvy are present to wit the much and long use in former time of salted and smoke-dried flesh unto which the Soldiery in the Septentrional parts are extreamly addicted add unto this the loosness of the Teeth with some kind of itching in the Gums the continual great lassitude and weariness of the parts and especially of the internal the extension of the left Hypochondrium and the Mesentery and the broad Efflorescencies one while wan and other whiles red budding forth continually here and there throughout the whol body without any Feaver which is conceived to be a Pathognomick Symptom of the Scurvy Unto this we may add that this illustrious person about some three yeers since was apparently affected with the Scurvy and that the Physitian who then had him in cure being most expert in the knowledg of the Scurvy told him plainly and freely at his departure that the reliques and remainders of the Scurvy were not in the least to be sleighted by him but upon al occasions opportunely to be prevented But perhaps the Italian Physitians do therefore sleight and but little account of the name of the Scurvy in regard that they are of opinion that al the aforesaid accidents may be al of them referred unto those causes that are evident and not called by unusual names and such as in former times were not so much as ever heard of For the redundance of the adust Melancholy which is much defiled with Ichores and thin Excrements which said redundance of Melancholy and other the said humors that they are at present to be found in this illustrious Lord is manifestly shewn by the boyling heat of his Liver the weakness of the Spleen the familiar flux of the Haemorrhoids and the frequent use of meats salt and earthy may possibly breed and produce a lassitude and litherness but more especially in the internal parts unto which the humor by its weight and heaviness naturally tendeth Unto al this it may be added that it much impaireth the strength and natural powers enervates and weakens the body and extenuateth the same by corrupting the Aliment it extendeth likewise the Natural Bowels by its great plenty and thickness and obstructeth the same by the admixture of the diffused Ichorous Excrements with the overhot blood Neither are we at al to wonder that various spots arise since that both by its own proper thinness that more hot part of the adust humor is easily carried forth unto the outside of the body and that the expulsive faculty of the internal Bowels being irritated it is no hard matter for it to be purged forth through the loose skin being porous and weak And therefore to me there seemeth to be no cause why we should abuse the new and unusual name of the Scurvy in the explaining of things so wel known But how many sick persons have been most miserably cast away through this kind of reasoning we may every where read in those Authors that have written touching the Scurvy who all of them with one consent affirm that never any yet being affected with the Scurvy and having had administred unto him only these remedies that have acted by a manifest quality and such as were proper to evacuate and temper Melancholy adust and to take away the obstructions of the Bowels although administred by the most able and expert Physitians was thereby perfectly cured in regard that the Melancholy blood in this Disease contracteth a corruption peculiar and such as cannon wel be expressed which ought to be removed and taken away by those Alexipharmaca that are fit and proper for it and that otherwise irritate and enrage adust Melancholy if we regard the manifest qualities For Spoonwort or Scurvy-grass Water Pimpernel and certain kinds of the Cresses and Water Parsley al of them being most sharp and unto which alone the Scurvy giveth place seeing that they attain unto the third degree of heat and greatly dry they would vehemently increase the vices of the adust Melancholy and al the causes thereof unless by their Alexipharmick quality they opposed the corruption of the Scorbutick blood And that the
that they contract these Clefts especially about the Joynts yet nevertheless this same happeneth somtimes likewise unto the Feet It may be Cured most speedily and most conveniently by this Unguent Take Litharge of Silver Myrrh and Ginger of ech alike parts bruise and pouder them very small and so with Virgins Wax Honey and common Oyl as much as wil suffice make an Vnguent unto which for the rendering it the more grateful to the smel Musk and Ambar may be added THE FIFTH BOOK THE FOURTH PART Of WOVNDS Chap. 1. Of the Nature Causes and Differences of a Wound AMong the external preternatural Affects of the Body and such as are obvious unto the senses there remain Wounds Fractures and disjoyntings of which we will now speak in order And First of all as touching a Wound that it is a solution of Unity in a part Bone and softer Cartilage is without al doubt and controversie But yet nevertheless it is sometimes taken largely and somtimes in a more strict sence Celsus taketh it in the largest sence of all whn in his fifth B. and sixth Chap. he thus writeth That Wound saith he is far worse and more dangerous which it caused only by a Bruise then that which is made by incisiom and dividing the part so that it is also far better to be wounded by a sharp and keen edged Weapon then by that that is blunt It is taken in a large acceptation when it is attributed unto all kind of solution of Unity made by any sharp instrument whether this solution be made by pricking or by cutting like as Galen in his Sixth B. of the Meth. of Physick the first and following Chap. calleth the pricking of the Nerves the wounding of them It is taken strictly when it is distinguished from a pricking that a wound is the solution of Unity in a soft part made by a Cut from any keen and cutting instrument but a pricking is that solution of unity that is caused in a soft part by a prick from an instrument that is cutting By which it appeareth that the solution of Continuity in a soft part is wider and broader then a Wound whether it be made by cutting or by pricking For Unity may also be dissolved in a soft part by a thing that is not sharp but only hard and heavy and this may be the Skin either appearing whole or even broken likewise which happeneth in those Wounds that are inflicted by Bullets from Guns Moreover also the Unity of the soft part may be dissolved by extension which in special in the similary parts is called Rupture but in the Compound Apospasma to wit when those fibrous Ligaments and Threads by which the parts are fastned together the one to the other being broken the parts themselves likewise become broken A Wound what it is By all which it appeareth that a Wound is the solution of Unity in a soft part caused by a cutting and sharp instrument But if as Guido in the Second B. of his Chirurgery and Fernelius in the seventh B of his Meth. of Physick Chap sixth rightly admonish us the Wound become sordid and foul and that some thing be by the Pus or filthy corroding matter eaten away from the substance of the wounded part then the Wound passeth into an Ulcer or certainly we may very well say that an Ulcer is conjoyned with the said Wound The truth indeed is that Rudius in his B. of Wounds and first Chap. doth impugn this Opinion but al to little purpose For neither is it absurd as he without Reason thinketh that one Disease should be changed into another or that one should be added and Joyned to another The Wound and Ulcer they are both of them the solution of Unity in the soft part buâ— the Wound is made by section of cutting alone whereas the Ulcer is caused within it by Erosion and therefore it is that in an Ulcer there is somwhat that is lost from the substance of the part If therefore in a Wound of any part somthing shall be Eaten away and consumed from the substance of the flesh it is then altogether to be granted that now there is likewise present even an Ulcer also Which nevertheless is not so to be taken as though so soon as ever on the fourth day the Pus or filthy corrupt matter doth begin to appear in the Wound that then likewise an Ulcer may be said to be present For that said Pus proceedeth from the blood that is shed forth without the Veins or some Aliment that sticketh in the Capillary Veins and spaces of the parts neither is there then any thing Eaten away from the substance of the part But if there be so great an abundance of the Pus gathered together whatsoever the Cause thereof be that somthing be Eaten away from the substance of the part then it cannot be denied but that there is an Ulcer likewise present seeing that there are then present all things that are required unto the Essence of an Ulcer and in this Case the Cure is no longer to be ordered as in a single and simple Wound but as in an Ulcer But since that a Wound is to be accounted in the number of Diseases there may be enquiry made and that upon good grounds what actions they are that are hurt thereby Unto which it may be rightly answered that all the Actions of the said part and the severall uses thereof unto which the part is destined are hurt by the Wound whether that part perform those actions either as a similary or as an instrumental part That the Organical Actions may oftentimes be hurt by a Wound to wit when the part destined for motion is Wounded cannot be denied â—t being a thing so manifest since that the wounded Member can no longer be moved in a due and right manner As likewise the Vein that is cut assunder can no longer convey the blood unto the part for the nourishment thereof neither a dissected Artery the vital blood and spirits or a Nerve the Animal Spirits But indeed the truth is that the temperament of the part is not next of all and immediatly hurt by the Wound but yet never the less it is mediatly hurt to wit when the Vessels being cut assunder and the blood poured forth the heat of the part is withal dissipated and the influx of the Blood spirits and heat flowing in this last being so necessary and requisite unto the temperament of the part is altogether hindred For all which Causes the attraction of the part the Concoction the Nutrition and the expulsion is hurt And from hence it happeneth that the temperament being changed there are more Excrements generated in that part then otherwise were wont to be And from thence also it proceedeth that the Pus is not presently generated in the very beginning of the Wound but afterward to wit about the fourth day when the heat of the part that was dissipated is again restored The Use is
needeth no at all any Medicaments to cleanse it away and that after in process of time it is confounded and becometh one with the Pus and so is by Nature expelled forth together with the same Secondly For this Cause likewise the frequent uncovering of the Wound is held necessary in regard that there is somtimes need of Manual operation since that in the Cavity of a Wound there may be collected many Excrements that cannot possibly be purged forth by any Medicaments but they are to be cleansed away by the operation of the Hand Answer But now Caesar Magatus in his 44. Chap. denieth this and there determineth that the Excrements that are bred in a Wound may partly be insensibly digested by exhalation and partly by Nature sensibly expelled by the Wound when there is present a fit afflux and this no waies hindered and detained in the Cavity of the Wound Thirdly Wounds are therefore according to the common opinion often to be uncovered that so according to the various State and conditions of them various and different Medicaments may be imposed first of al Suppurating or Digestive Medicaments then Abstersive after that such as generate flesh and somtimes likewise such as take away superfluous and proud flesh and lastly such as produce a Cicatrice Al which seeing that they cannot possibly be effected by one only Medicament therefore the Wound is often to be opened that so unto every state of the wound fit and convenient Medicaments may be administred Answer Unto which Argument Magatus in his 1. B. and 44. Chap. endeavoureth to give an Answer to wit that this is indeed necessary in the old way of curing but not in his new way as being such in which the care of the Excrements is for the most part committed unto Nature her self and in his 37. Chap. he writeth that he is wont to commit the whole work to Nature and that it is sufficient that the Medicament serve instead of a covering and discharge the Office thereof by cherishing and defending the Natural heat and that the same Medicament may in all Wounds undergo the Nature of a covering and serve instead thereof And he saith that he himself hath observed that Wounds have been suppurated throughly purged and filled up with flesh by the help only of the ordinary and common Digestive Now he thinketh that the Medicaments cannot perform this any other waies then by their corpulency and bulkiness whiles that they hinder and forbid the efflux of the heat and defend the part from all external injuries but that it maketh no great matter what quality shal be adjoyned unto this corpulency especially in regard that for the most part such Medicaments are made choice of that are of a temperate heat and most agreeable unto our Nature And at length Magatus concludeth that by any Medicament of a convenient corpulency provided that it be not poysonous and corruptive or so sharp and Corrosive that it excite and cause a fluxion all hollow Wounds that are curable may be cured and filled up with flesh Fourthly It is therefore also thought that Wounds ought often to be opened and uncovered that so it may be known what the effect is of the Medicament applied and whether or no it be sufficiently drying whether the Wound be moist or not that so the driers may answer in a due proportion unto the moisture since that the more moist Wounds are to be cured with the drier Medicaments as Galen tels us in the third B. of his Method and 3. Chap. Answer But unto this Caesar Magatus and Ludovicus Septalius give this Answer that for the cause aforesaid there is no need at all of this frequent uncovering of the wound seeing that in this new way of curing the care of the Excrements is not to be committed unto Medicaments but unto Nature and the natural heat and our study must be only how to cherish this Native heat Fifthly And for this cause also the more often uncovering of the wound seemeth to be necessary that the state of the wound may be known and that the Symptoms that are wont here to happen may the better be prevented and those things of which Hippocrates maketh mention 1. Praedict Text 18. 5 Aphor. 65 66 67. 6 Aphor. 4. may be sufficiently known Answer Unto which they Answer that al those things may be known some other way and by other means as namely from the itching the heat the smel that comes from it the beating pain the terrible Feaver heaviness in the part and the like and that evermore the Eyes of the minde are sharper sighted and see more cleerly then the Eyes of our Body Sixthly And for this cause likewise the wound seemeth to require frequent opening that so the Swaths and little Pillows and the Linen clothes laid thereon may be wiped and made clean which Hippocrates in his B. of the Office of the Physitian Sect. 2. and Galen in his Commentary do both of them strictly enjoyn in regard that the filth and impurities of the Wound may excite an Itching Pain and at length an Inflammation Answer Unto which Septalius answereth and granteth that the Swaths may indeed be changed provided that the Wound be not uncovered Seventhly For this cause likewise the Swaths and coverings of the Wound seem to require often changing that so the hurtful Exhalations that are bred in the Wound may pass forth in regard that being kept shut in they disaffect the wounded part and alter the temperament thereof Answer But unto this also Magatus answereth that there is no necessity that the wounded part should have so many and such Linen Clothes put upon it neither that it should be so close and strictly bound up but that the offensive vapors might exhale and not be supressed And that if the Pus hath a passage forth much more then may the Vaporous Excrements be scattered and find a passage forth and that should they be stil kept in yet they never bring so much hurt and damage as cometh by the uncovering of the wound But in very truth that I may briefly shew you my opinion touching this controversie I will not in the least detract from the Reputation of these men Caesar Magatus and Ludovicus Septalius men so Famous and Eminent that they are not to be so much as named without due honor and respect and yet nevertheless I shal take the liberty to say that here in this controversie they seem to me to seek as we say a knot in a Bul-Rush and that there is not any sufficient cause to move them to find fault with that Ancient way and Method of curing of Wounds The general examination and inquiry into the Opinion of Magatus and Septalius and so to extol this new way of their own For first of all they themselves cannot but confess that in the old way of curing for so many Ages past many and the most grievous Wounds have been happily Cured And then again neither can they deny
and thereupon produce new fluxions The Fourth is because that these Pensils and Tents may be filled with base corrupt Humors and so defiled therewith that they may acquire an ill quality by which they may hurt the wounded part and they do moreover hinder the Evacuation of the Pus and cause that the said Pus acquire and get it self a depraved and Malignant quality Fifthly They say that Hippocrates and Galen when they write of the curing of Wounds do never make any mention of these Tents as we may see in Galens 14. B. of the Meth. of Curing Chap. 4. and in Galen his B. of Fracturers Sect. 3. Comment The Reasons of those that make use of Tents in the Curing of Wounds But now on the contrary Those that make use of Tents give these Reasons for their so doing The First is this that in the wounds the use of Tents is therefore necessary that by the help of them the orifice of the Wound may be kept open and a passage may be made for the Pus 〈◊〉 flow forth The Second is this that for this cause Tâ—â—rs are to be made use of that so by meanâ— of them the Medicaments may every where touch the Wound and that they may peâ—â—trate even to the very bottom thereof Thirdly For this Cause likewise Tâ—â—â—s seem to be necessary because by them it maâ— be prevented that the upper part of tâ—e Wound be not closed up before the deeâ—â—â— parts thereof be filled up with flesh Unto these Reasons they Answer unto the First thus The Answer of Magaâ—us 〈◊〉 the said Reasons that there will not be more Excrements geâ—â—rated in the Wound if there be a due Course taken in the curing thereof then what may caâ—â—â—y be expelled forth by Nature And then that although Excrements should be generates that yet Tents do rather shut up the passâ—â—â— forth of the Pus then any waies keep it opâ—â— And unto the Second they Answer that there is no need of Tents since that the Medicaments if they be liquid they will of themselves penetrate unto the bottom of the Wound neither therefore is there any â—â—â—d of so often repeating and imposing of 〈◊〉 Medicaments Unto the Third they Answer that the continual efflux of the Excrements by the external wounded parts doth hâ—â—â—r the meeting together and uniting of the Lips before the Cavity be filled up wiâ—h flesh But that I may briefly shew you my opinion touching this Controversie Myâ—â—en Opiâ—â—â—a I do indeed willingly grant them that in such Wounds as are superficial straight and such as generate but little Pus Tents are not at all necessary neither is the curing of the Wound rashly to be retarded by the putting in of the Teâ—â—s But if the Wound be deep and oblique so that there be no right and straight passage for the slowing forth of the Pus and that there be much Pus generated in this Case Tents seem to be altogether necessary that so by them there may be made an open and free passage forth for the purulent mattier and that a way may be left by which the Medicaments may penetrate unto the more inward parts of the Wound and that by this means the orifice of the Wound may be kept from Conglutinating and closing togâ—â—her until such time as that which is in the bâ—â—tom of the wound shall be first Conglutinaâ—ed which if they be neglected and that the Pus and Excrements be still retained in the Wound they may easily prove the Causes of the extreamest pains and dangers as a little above in the 7. Chapter we gave you some instances and examples of this very thing out of Guilhelm Fabricius his Observations Answers unto the Reasons of Magatus Now as for what they Answer unto these Arguments and what they likewise object they are neither of them of any great moment For First of all whereas it is said that Tents are not necessary that by them the Wound may he kept open since that the orifice is of it self alwaies open this we altogether deny For oftentimes Wounds according to the various Scituation of the Patient that he then had when he was wounded are oblique and ful of turnings and windings so that although the sides and lips of the wound be not as yet closed up they yet nevertheless so touch and lie one upon the other yea and oftentimes so press one another that there is no open passage left for the Pus to flow forth Secondly For this very cause and when the Wounds are not straight the Medicaments cannot so easily penetrate unto the bottom And albeit that the wound be not writhing and oblique yet notwithstanding it wil not alwaies be Convenient to instil into the Wound Medicaments that are over fluid seeing that they may be easily washed away again by the Sanies or thin Excrement but there will be oftentimes occasion to make use of the thicker and more viscid sort of Medicaments which being conveyed into the Wound by the Tents will stick so much the longer and more firmly unto the wounded parts and thereupon they will the more rightly put forth their Virtue and efficacy Thirdly That the superior orifice of the Wound is never Conglutinated before such time as the inferior Cavity is closed up and that therefore the orifice of the Wound needeth not to be kept open with Tents this is false and experience very often teacheth us the Contrary and Guilhelm Fabricius in his 4. Cent. Observat 7. reciteth two Examples of Wounds whose orifices were very suddenly healed and yet the Wound within all this while not cured from whence it happened that there was abundance of Pus collected within and from thence many grievous and dangerous Maladies excited And wheras they say that the continual efflux of the Excrements wil cause that the orifice of the wound shal not be closed up herein they contradict their own former presupposals when as they asserted before that there would be altogether very smal store of Pus generated in the Wound Fourthly The Tents ought not neither to be over thick that so they may not press the part nor distend it nor by any means whatsoever cause unto it any trouble grief or pain and that they likewise shut not up the passage of the Pus or purulent mattier And if now and then any such thing should happen such as that that Ludovicus Septalius in his 8. B. of Animadversions Num. 10. alleadgeth out of Hippocrates in his History of a certain person at Massilium the Errors of the Artists are not to be imputed unto the Art it self when as haply they uncovered not the Wound so oft as was requisite And yet nevertheless we are here to give you to understand that albeit we are to use our utmost endeavour that Wounds may be Cured without all kind of trouble and pain or at least that they may be healed with as little as possibly may be yet notwithstanding it is not to be
some thought to be done by this Weapon-Salve the Conglutination of the Wound is to be ascribed unto Nature alone as the next and principal cause Which being so and the truth thereof being such that it cannot be denied now in the next place we are to enquire whether in the said Cure the healing of the Wound be to be ascribed unto Nature alone or else indeed whether or no there be not likewise some Concurrent efficacy of the Weapon-Salve Unto me the former seemeth the more probable therefore because that it is a truth most certain as but now we told you that Wounds are oftentimes Cured by Nature alone without the Concurrence of any Medicament the truth whereof is sufficiently attested likewise by internal Wounds unto which there cannot possibly be any Medicaments administred And hitherto tendeth the whole business in the curing of Wounds according to Caesar Magatus his way touching which we have spoken in the foregoing Chapter to wit that the whole work be committed to Nature that the heat and temper of the part it being the instrument be kept entire and that without urgent necessity it be not molested and disquieted by Medicaments And somtimes we see that such dangerous Wounds chiefly and especially by the benefit of Nature without the application of any Medicament or such as is of no great moment are cured so that it seems to be ascribed rather unto a Miracle then the Medicaments Of which very thing the Observations and Examples are every where sufficiently known Neither yet notwithstanding are the Patrons of this Unguent so bold as to extend the virtue thereof unto al Wounds for as a little before we told you Crollius and Goclenius do except the Wounds of the more principal Members as also of the Nerves and Arteries and there was never yet found any that durst make use of this Unguent in Wounds caused by Gun shot And who is there that dares deny that other lighter and sleighter Wounds may be cured by Nature alone And if any thing extraordinary and that which seemeth to exceed the power of Nature happen at any time in the said Cure by the Weapon-Salve we ought well to consider and look unto it whether it be not wrought by the assistance of the Devil thereunto engaged by a Compact and agreement either explicite or implicite And now therefore it being a known truth that Nature alone and as the next Cause may agglutinate Wounds and that Medicaments as above we shewed you do perform nothing else then the preservation of the native heat and the Natural Temperament of the part or the removal of those impediments that hinder Nature in her work we are now in the next place to see whether the Weapon-Salve can perform those things Where we instantly meet with this first difficulty to wit Whether the Weapon Salve can Act at a distance whether possibly the Medicament that is not anoynted upon the Wound it self but upon the Weapon or any thing else that is besmeared with Blood from the Wound can yield any benefit especially if the wounded person be absent and many miles distant from the anoynted Weapon And indeed to prove this they use two Reasons as we also told you formerly the first is this that there may be actions from occult and hidden qualities and at a distance which they cal Magnetick actions because that by the spirit of the world the virtue of the Unguent may be conveyed unto the Wound as we see it to be done by the Sympathy and Antipathy of many things But neither proveth the thing that it ought to prove For first of all albeit we grant that such Actions there are and that those things that mutually Act and are passive do not alwaies corporeally touch one the other yet nevertheless that this is so in the Weapon-Salve and whether or no any virtue can be derived from the Weapon anoynted unto the Wound at so great a distance and interval of places this is yet to be proved For it doth not follow there are such admirable actions of other things and therefore also the Weapon-Salve hath such a vertue And that this is not done he shal easily perceive that will but consider those other Actions of this Nature that are performed at a distance Since that the operation followeth the being of a thing it is therefore necessary that between the Agent and the Patient there should be a certain conjunction and mutual Contact But now in regard that the things between which the Action is do not all of them touch one the other with their Bodies there is a necessity that they should touch in some other manner And this is twofold Action at a distance twofold for either the thing that is said to act at a distance sendeth forth somthing from its own Body and substance which the Ancients called Effluvium or Aporrhoia and Physitians where they treat of Contagion cal it Miasmos touching which see further in the fourth B. of Feavers Chap. 4. and the 2. B. of our Institutions Part 2. Chap. 12. to wit when there flow forth of the Body the smallest imaginable parts and Atomes and by the Medium of the Air or some other body are transfered unto another body and affect it with that virtue which it hath in common with the whol entire body But now as for such small bodies as these they have no Regular motion at al but according to the motion of the Air they move inordinatly this way and that way and by every blast they are variously dispersed like as we may see in the smoak of Candles when they are extinguished and of other things when they are first lighted and kindled But other bodies there are that Acting at a distance do not indeed send forth from their own body any thing that may be transferred unto another body but only they send forth a species as we may call it and in this manner by means of these sensible species as light sound smel and the like even the distant bodies are affected And very probable it is that there are more of these like sensible species then what are perceived by our senses And this is commonly sayd so be done by a virtue or virtual contact And yet nevertheless virtue doth always presuppose a substance from which the said virtue floweth So the flame being extinguished the illumination or light that comes from it that also ceaseth And moreover secondly there is likewise a fit subject required thorow which it may be propagated which if there be not the Action ceaseth And so an opacous and thick body being interposed betwixt the light body and our sight the Illumination ceaseth Thirdly this virtue is likewise diffused orbicularly and at a certain distance Naturalists term it the sphere of Activity which in some things is greater and in others less The greatest of all is in light or lucid bodies but a less in those bodies that yield a sound But yet the greater the
lucid and lightsom body is the greater also is its sphere of Activity and hereupon it is that the starrs of all other bodies do scatter and disperse their light from them furthest in distance and widest in breadth We are now therefore to make enquiry in regard that it is of a certainty that the Weapon salve with which the Weapon is anoynted is in body absent and distant from the wounded party whether the weapon-salve touch the Wounded body either of these two waies for a third way there is none Neither can this be done by Accident some quality since that an Accident doth not pass from one subject to another neither diffuse it self at a distance and unto any other body Now I say that this is not done neither indeed can be either of these wayes The Weapon-salve doth not Act by sending forth any small bodies For first of all those Atomes or Effluvious bodies that flow forth having no certain motion of their own but moving inordinately hither and thither this way and that way how can these possibly directly and in a straight line tend unto the wounded person Neither is there any Cause that we should here fly unto and plead the likeness of Substance For although that those smallest bodies do at the length apply themselves unto others of their own kinds as we may plainly see in thunder and lightning yet notwithstanding when they at first exhale out of the body they wander up and down inordinately this way and that way And much less may we have recourse unto the spirit of the World by whose carrying and conveying whereof these smallest bodies may from the weapon anointed at length come unto the wounded person and the wound it self For those things are indeed spoken of the spirit of the world but they are not proved yea but rather they are opposed by reasons strong and weighty And furthermore since that this cure extends it self very far in length and as they wil have us beleeve at the distance of some miles if this were done by the effusion of those small bodies seeing there is so very little of the Unguent and yet much less of that natural Balsam that sticketh unto the Weapon that Unguent with the Balsam would easily fly abroad into the Air and there vanish and so the very foundation of the cure being taken away and gone the cure it self must needs cease The Weapon salve doth not Act by any species But if they wil say that his Action is performed by the species or Magnetick action they ought first of all to prove that there are such species in this Unguent for indeed Nature hath given unto some simples and things natural not compounded by art a virtue of sending forth such like species as these we speak of and then they must shew us what the nature of them is and what their sphere of Activity For it is no way credible that the virtue of this Unguent should extend it self for twelve miles round about and so orbicularly As for what concerns the Loadstone from which they are wont to term these magnetick actions the Load-stone doth indeed attract the Iron although it be at some distance from it but if very far removed and beyond the sphere of its Activity it doth not attract and the very same is likewise well known to be done in other such like occult and magnetick Actions For the Loadstone and other the like bodies do put forth their virtues in a straight and direct line which yet nevertheless are not extended in infinitum as we say and they are oftentimes likewise intercepted by the interposing of other things So the Sun-beams by the coming between of an opacous body are excluded Who then can believe that from so smal a pittance of the Unguent and so little of the blood there should break forth so many of these small bodies or species thorow the chest in which the anoynted weapon is shut up and that they should thence be carried so great a distance even twelve miles that they should penetrate thorow Mountains and Walls and tend directly unto the wounded person close shut up within his Chamber or in bed and that there they should pass throw those many double swathes wherein the wound is wrapped and so insinuate themselves at length into the wound it self The Loadstone is moved unto the Iron but this unguent is not anoynted upon the Wound but upon the Weapon And the Loadstone indeed being but only moved toward the Iron draweth it but now in the right using of this unguent what a company of Ceremonies and superstitious practises there are used we have shewn you before And in other respects also there appeareth a very vast difference between the Loadstone and this Weapon salve The Loadstone is a natural body and so hath its Natural Effect wh ch it evermore worketh in one and the same manner The Weapon salve is a Composition out of many things and by some it is made one way and by others after a different manner and of other things as before we have shewn you And the Unguent ought also to effect many things to wit perform all those things that are Necessary for the curing of the wound preserve the Wound free from pain and likewise bring pain upon it if it be not rightly preserved or if it chance to be defiled For if it ought to perform all that that is otherwise the work of Nature in the curing of Wounds there will be then altogether a necessity that it perform many things to wit that it concoct whatsoever is to be concocted that it expel the Pus and excrements and that it generate flesh Yea moreover it ought to perform the office both of the Physitian and also of the Medicaments which is indeed very various For neither are all those bodies that are Wounded a like disposed some of them being sound bodies others Plethorick and a third sort Cacochymical the parts likewise are various as flesh Nerves Membranes which require Medicaments of a different kind the virtues of all which this unguent ought to sustain And if a man shall at one and the same time as it very often happeneth receive dvers wounds in different parts of his body and from different weapons the question then wil be whether it be sufficient to anoynt one of the Weapons only and whether or no the virtue thereof wil be conveyed unto al these several wounds or whether or no all the weapons are to be anoynted and whether each particular unguent wil do its own office and this tend straight and directly unto that wound that was inflicted by this weapon and that unguent likewise unto another wound made by that other weapon A reason should likewise be rendered why the unguent should not perform the same while it is in the box which they say it performs when it is anoynted upon the weapon For they have no ground to say that by the benefit of that balsam
are performed and whether by a Natural Cause or by the assistance of the Evil Spirit But now unto any one that shal accurately and exactly and without any prejudice weigh and consider the whole business it wil very easily appear that these vertues and effects cannot proceed from any Natural Cause For two things there are in those Seals the matter it self and the Characters engraven upon it unto neither of which this virtue can be ascribed for the matter is from Nature and hath in it no such virtues and this they themselves see a necessity of confessing And here therefore for the proving of the efficacy of these Seals they betake themselves to Amulets and pretend the virtue of them But be it so indeed that all things whatsoever are written touching these Amulets are true as most certain it is that very many of them are yet what is all this unto these Seals in which if we consider the Metals Characters and the like it is without all doubt that those things have in them no such virtues And Paeony the Hoof of the Beast Alx and the like do shew and put forth those virtues that they have albeit there be no Characters at all engraven upon them and the like also Galen in the place before alleadged tels us that he himself had by experience found to be true of the Jasper-stone And then as these Seals have not their virtue from the matter so neither from the Characters that are from the Artificer and cannot have any such virtues either from the Artificer or from themselves For why these Characters are from an Idea in the minde of the Artificer which doth not work any effect upon things external And of themselves they are nothing else but Figures But now there is no power nor efficacy at all in Figures for the working any effect in regard that they are nothing else but only qualities of a quantity For all virtue and power of acting is principally from substance which by its qualities is efficacious and operative Action is between Contraries of the same kinde and such are not Natural and Artificial among which are these Characters Neither do things Artificial work upon things Natutal nor alter or affect them as they are such but they Act and work upon them as they have a Natural matter And so on the contrary things Natural do not Act upon Artificial things by altering or affecting them as such but as they consist of a Natural matter And therefore Images or Names engraven upon matter can of themselves perform nothing and the matter if it be at all affected by the Heavens is equally and as much affected if it hath not any Image or Figure at all engraven upon it and as for Characters Figures and Words engraven upon the mater they have in them no peculiar virtue of receiving the Influences of the Caelestial Bodies neither can they give any such virtue unto the Matter The truth is that Rodolphus Goclenius the younger doth indeed endeavour to give an Answer unto this objection whilest in his Magnetick Synarthrosis page 101. he thus writeth It is not the Statue saith he as a Statue neither yet the Seal nor the Image and figure as such that can affect any other Statue or quality For the very truth is that these Artificial Seals do acquire no virtue at al from Art but the virtue is instilled and infused into them from Heaven and the Stars I say again that this same Celestial Ray and Astral spirit that is sent down hither and here hath its influence in this sublunary world doth not only Accomodate it self unto the Metalls Stones and those plants aforesaid but doth likewise secretly and imperciptibly insinuate it self into their very substance with the which even from the very first Creation it hath obtained a Mutual and sympathetick familiarity connexion and continuation But now this spirit hath its influence without any adjuration Consecration and invocation of Devills but altogether in a Natural way But all that he answereth is nothing worth For this is that very thing according as it is in the Question which he ought to prove to wit that upon Metals and papers ignorantly engraven and Lettered there can any such like virtue as is attributed unto these Seals be derived from heaven and the Stars For although we do not deny that the Stars have their secret influences upon these inferiour bodies and therefore he hath taken much pains to very little purpose in proving of it to wit that the Stars do act upon these inferior bodies not only by their motion and light but also by their occult influence yet nevertheless two things there are especially of which there is great question to be made The first is this whether the Stars have in them any such virtue of producing fortuitous Events and meer casualties and such effects as are not Natural but wholly depend upon the will and good pleasure of Men. And the other is this to wit why they do not communicate those their influential virtues unto Metalls as they are of themselves but only unto such of them as are engraven with Characters For what have those Characters to do with the Stars And what hath Mars in the Heavens to do with the image of an Armed man Or what hath Saturn to do with an old man holding the plough And so of all other the Planets And the very same is likewise to be sayd the case standing al one touching the signs of the Zodiack and the rest of the Asterisms unto which Names have been given by Men according to their wills and pleasure for the teaching and instructing of others in the grounds of Astronomy who could if they had so pleased have given some other names unto those Asterisms which we now from them call Pisces or Sagitarius Like as the Hollanders even in our Age have most freely and according as they thought good imposed names upon all those Meridional signs that they observed in their Navigations to the Southerly parts And so the signs and figures likewise denoting those Asterisms have been imposed according to the wills and fancies of Men and therefore we conclude that there is no Necessity at all why the virtue of any Star should insinuate it self into any such Character as is imposed meerly by the wil and fancie of Men although it be engraven and inscribed at such a certain time the Star being then in such or such a position And therefore the whole controversy at length returns to this that from a Naturall Cause there can no such virtue be ascribed unto Seals and such like Characters and if there be any for of this very thing there is great doubt to be made and many things without question are much talked of and boasted which indeed were never yet experimentally found to be true as Paracelsus Arnoldus de villa Nova Thurneiserus and other of our more Modern Authors produce many things to this purpose I say if any such
the Shoulder be broken a Linen ball is then to be bound under the Wing thereof and the binding is not to be loosened before the seventh day unless there happen somthing else Let the sick person lie on the opposite side and let him all he can keep the part in quietness Chap. 16 Of the Fracture of the Sternum or Breast-bone THe Sternum or Breast-bone it self is somtimes broken either by a fal or by a blow Signs Diagnostick Which is known from the pain and especially from the inequality which is discovered by the touch and at the compression of the Fingers the broken bone retireth inwardly and there is a certain sound or noise heard and there where the bone is broken there may be notice taken of a Cavity And there is also difficulty of breathing the Cough and spitting of Blood that for the most part follow thereupon Prognosticks 1. The Fracture of the Stern is very dangerous in regard that by reason of the Pleura Membrane which is easily hurt together with the Stern and the noble parts that lie under it it is wont to attract sad and grievous Evils 2. But yet it is consolidated in twenty or twenty four daies in regard that it is spungy and thin The Cure Now that this bone when it is broken and depressed may be restored again unto its own seat the sick person being laid flat upon his Back a Pillow is to be put under the Spina or Back bone over against the Fracture and by some Servant of the Chirurgeon the Shoulder is on both sides to be pressed down but let the Chirurgeon himself with his Hand press together the Ribbs on both sides and so let him bring back the broken bones into their places And after this those Medicaments that are wont to be administred in other Fractures and which prevent Inflammation and serve for the Conglutination of the Fracture are to be imposed and the binding is to be instituted with fit Swathes above the Shoulders in the Cross Figure of the letter X and this binding must not be over hard lest it hinder the breathing Chap 17 Of the Fracture of the Ribbs ANd sometimes also the Ribbs are broken from violent causes as a fall a blow or the like But now the Ribbs are sometimes so cleft as Celsus writeth in his 8 B. and Chapt. 9. that indeed not the top of the bone but the inward part thereof which is thin may be hurt and sometimes so that this fal hath wholly broken them And indeed the broken bones do sometimes decline inwardly and sometimes they stick forth outwardly and sometimes notwithstanding that they are wholly broken yet they are not moved out of their proper places and sometimes likewise the flesh about the Ribbs is battered and bruised Signs Diagnostick If the Whole Ribb be not broken then neither is there any blood spit forth neither any fever following thereupon nor any thing suppurated or but very rarely neither is there present any great pain and yet nevertheless this place is lâ—ghtly pained even upon the very touch But if the Ribb be wholly broken and yet the broken extremityes thereof not moved out of their places by being either driven inwardly or forced into the Exterior part there are but very few that are hereupon taken with a fever And many there are also that do not at all spit blood neither is there any Pus contracted in the Chests of some and those indeed not a few But if the Ribb be both wholly broken and the extremityes thereof moved out of their places there is then a certain inequallity or unevenness and Cavity that may be both discovered by the sight as also by the touch and there is likewise a certain ratling noyse heard unto which also there are divers other symptoms Joyned There is present a very great and grievous pain and especially if the internal part of the Ribb be broken and this pain much resembleth the pain of such as have the Pleurisy the breathing is very difficult the Cough extremely troublesom and now and then likewise spitting of blood followeth thereupon the Lungs soaking in the blood flowing forth of the broken vessells and a feaver is also herewithall joyned and accompanyeth the same But more especially two evills there are that usually attend the Fracture of the Ribbs The first whereof is the puffing up of the flesh lying upon the Ribb which is discovered both by the touch and sight and if the place be pressed together with the hand there is heard a certain noyse and sound of the Air going forth thereof Unto which unless timely Remedies be administred in the second place an Inflammation and a fever and an Impostume are wont to succeed The cause of which thing is the separation of the flesh from the bone and a weakness brought upon the part with the blow which cannot therefore sufficiently concoct the Aliment that by reason of the pain is more abundantly attracted and flowerh thereunto which remayneth thereupon partly crude and is partly resolved into vapours and flatulencies or windiness And somtimes the Corruption of the Ribbs is wont likewise to follow this Malady For when the flesh is separated from the bone the Air getteth in in the place thereof by the contact and impression whereof the bone is offended and corrupted Prognosticks 1. If the Fracture be single without any Contusion or bruising of the parts lying neer thereunto there is then little or no danger at all and the Ribbs will grow together again within twenty days 2. But if the flesh about the Ribbs be battered and bruised then the evil is very dangerous by reason of those symptoms that as we have before told you do happen herupon somtimes deadly Touching which Hippocrates in his 3. B. of the Joynts Text. 65. if the Contusion sayth he or the bruising that is caused about the Ribbs be neglected although upon this a worse Mischief doth not follow yet notwithstanding it hath the flesh more soft and spungy in the bruised place then it was before and where such flesh is so left and not by curing thereof restored unto a good habit the thing is so much the worse if filth and snottiness be left about the bone itself in regard that the flesh wil now no more fasten unto the bone in like manner as formerly and in regard that the bone it self is rendered more apt and ready for diseases and for this very cause many have their bones vitiated because that the evil is a long while protracted ere it can be Cured 3. And thirdly likewise the Fracture is ful of danger if the Ribb be driven inward and there prick or wound the Pleura Membrane and then almost al those symptoms that are wont to infest those that have a pleurisy do follow upon the sayd fracture and the Cure is scarcely ever perfectly accomplished in less then fourty days The Cure If the whole Ribb be not broken or if wholly broken yet not removed out of
Crashing Noise and sound that is observed in the handling thereof and in its motion Prognostick 1. The Whirle-bone indeed as all other thin bones easily groweth together again if it be but rightly Joyned together and so preserved 2 And if the fracture be made in the length thereof the bones may very easily be joyned together and being so Joyned they may without any great difficulty be so kept in their own places by the use of pillows and Swathes For whereas about the whirl-bone the extremityes of the Seventh Eighth and Ninth ' Muscles that move the ankle and leg run along together and end in that most strong Tendon that is implanted in the Whirl-bone and that the Muscles are wont of their own accord to be moved and drawn toward the place of their originall therefore even without any great industry and paines the fracture that is made long wayes may be reduced into its own place again the bones most closely conjoyned as before and so no great cause to fear the bunching forth of any callus a lameness following upon this fracture Paraeus indeed in his 14 Book and 22 Chapt. writeth that he never saw any who having this bone broken was not lame so that he halted al his life after it and this even therefore because that the Concretion of the Callus being produced the Consolidation doth hinder the free bending of the knee But although this may easily be granted as touching the transverse fracture yet notwithstanding Guilhelmus Fabricius in his fifth Cent. and 88 Observat hath rightly determined that this is not alwayes necessary especially in the fracture that is made in the length of the bone in regard that there is no necessity that there should evermore be bred a Caslus so sticking forth that it should cause an impediment of the motion in the knee and so consequently a lameness and halting and we may see that in the fractures of other bones Nature doth usually so generate the Callus and with that Neatness and skil that oftentimes there scarcely remaineth any the least sign or token of any fracture appearing and this especially happeneth when the Periostium is whole unbroken which reteineth the matter of the Callus that it may not grow forth overmuch nor bunch out too far 3 But if the fracture be made either transversly or obliquely all the industry that we can use will hardly so cure it as that no lamenesâ— nor halting shall follow thereupon For seeing that the Seventh Eighth Ninth Muscles moving the Ankle draw it upward toward the hip but the Tendon that under the knee is inserted into the shinbone draws the whirlbone downward the bones of the broken whirlbone are so di joyned that they can hardly by any art be joyned together again or being joyned can be so kept together whereupon the Callus buncheth forth the Muscles moving the Leg and Ankle are hurt and so a Lameness and halting followeth The Cure The Leg is first of al to be extended And then after that by the Chirurgeon the Whirlbone whether it be broken into two or more parts is to be Joyned together again and an Emplaster or Cataplasm be fitting the Fracture that may keep together the bones when they are set is to be layd on and the Member is conveniently to be bound up and by imposing of râ—wls of Straw as is wont to be done in the Fracture of the Leg the Member is to be kept immoveable and great Care must be taken that the Leg be not at al bended for if this should be the broken Fragments that were set together would be again removed out of their places If some sharp fragment of the bones be separated from the rest of the bone and prick the Sk n some there are as I told you before touching other Fractures who advise us to cut into the Skin and so take forth the bone If grievous Symptoms shall happen to follow we must timely oppose them with such Remedies as in other Fractures Chap. 22. Of the Fracture of the Bones of the Foot ANd Lastly The bones of the Foot are likewise somtimes broken of which how many bones there are As for that we refer you unto the Anatomists But Hippocrates in his 2 Book of the Joynts writeth that the bones of the Foot as likewise of the Hand are not at al broken unless the fleshy parts be wounded by something that is very sharp or heavy For these bones being harder then ordinary these things that are sharp and very heavy if they break these Bones they leave not the Skin lying upon them whole and sound but much bruised And Paulus Aeginet in his 6 B Chap. 106. writeth that the Ankle can by no means be broken not only by reason of its hardness but in regard that it is fenced and guarded round about Signs Diagnostick If the bones of the Foot be broken it is easily found by the sight and touch in regard that these parts are void of flesh and therefore if they shall stick forth upon their breach this is easily discovered by the sight and touch Prognosticks 1. The Fracture of these Bones is not of it self very dangerous yet because they are greatly broken by reason of the forcible and violent Cause the parts incumbent and that lie neer being Fleshy and Nervous are withall bruised and wounded whereupon most grievous pains Inflammations and other Evils do arise 2. And yet notwithstanding for the most part they grow together again in twenty daies unless such as are nigh unto the Leg for these being greater require the longer time for Consolidation The Cure The Cure is almost one and the same with that of the broken bones of the Hand To wit there ought in the first place to be a fit extension and the Bones whether they stick forth unto the Superiour or the Inferior part are to be forced back into their Natural seats which may most fitly be done if the sick person stand with the broken Foot upon a plain table covered over with a woollen cloth And then Secondly fitting Medicaments such as the Fractures require are to be administred And Thirdly The Foot is to be wrapt about with Swathes And since that Splinters cannot conveniently be imposed upon the Foot by reason of the unevenness of the place the Splenia Coverings are to be made use of and the place to be bound with Swathes that so the bones being set in their places may be there kept And yet nevertheless the Scituation and placing ought to be ordered otherwise then in the Hands For our Hands being given us to lay hold upon the Fingers as we told you before in the 19. Chapt. are to be placed in a Crooked Figure but our feet being given us to stand upon and to walk withal are to be Scituated in a straight Figure and not crooked lest that their Action be depraved and hindered And thus much we thought good also briefly to speak touching Fractures For in
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
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