it which will be good thereby the matter will take its course and let the first little Wound be healed up as fast as you can and bind it strongly And the neathermost hole must have vent and be kept open till to the last of the healing Let the Knee not lie still and rest but stretch and bow it as much as you can that it grow not lame For if you stay till all be healed then will it be too late for the Knee to be stirred Therefore do it betimes what you ought to do that the Knee be not healed stiffe For if you stay too long and neither bow nor out-stretch the Knee then you will hardly help it afterward and it will be a great difficulty to bring it to right For if you deal rightly and heal it well in the joyning of it then the party will be of a sound and strong body for all the dangerous humidity which was in all the body was expelled through this strong humour I have seen that all those which were cured of such humours grew strong and sound men There are other humours which fall into the Knee even A humor like the Rose but worse as the Rose or Anthonies Fire useth to fall and with such a cold as the Plague doth and looks like unto this Rose or Anthonies Fire but is somewhat worse having blew spots as the Rose hath red ones but the blew ones are not so big but are of that bigness as the black blisters are and this redness is altogether nought for it is a flour of the cold Fire But if that Member hath great help from the body then it doth not so much hurt for there fall little holes into those blisters and when their skins are pulled off their matter looks black and fals out and these are easily healed but are worse than the Anthonies Fire is and ought not to be made wet neither must they be annointed but kept onely warm and dry as long as the redness and the black blisters hold then plaisters are applied unto them as other little holes usually are healed There are also Dogs blisters very like unto the above named Dogs blisters but not so dangerous and they make the Knees swell these also ought not to be made wet There are also on the Knees laming humours which are of a difficult healing make deep impressions cause a great deal Laming Humours of trouble and are not easily turned or diverted and do not shew from whence their original is the pain they cause is just in the middle of the Knee with a little swelling and stand on the Knee-pan there seemeth to be store of filth in it but is not onely the pain is apparent there is a sinew and lame water which can neither be softened nor ripened even like the water which is in a Joynt as we heard above much pain usually creepleth and maketh the Knee crooked or shrinks it especially toward the day My constant practise was to dress and bind them dry strongly and warm to keep the Pores open No greasie things no Ointments no wet things I used thereunto after I had well learned the simptom but my red Plaister I still applied and warm clothes And as I shewed at the great Bands to keep things there in a sweat so these lame biles also will steal away for if Patients sweat well under the Plaister they will doubtlese be healed and tie the places hard though it makes the foot swell it matters not for that soon allayeth and goeth away if kept warm with clothes even as other humours are expelled by keeping open the Pores CHAP. XXII Of Wounds made by Gun-shot of the abuses committed with the thorough pullings and Ointments what a Surgeon ought to note here ANy shot that went thorough Mans body is held mortal Wounds made with shot because the internal parts are spoiled and hurt by that heat such Wounds are not easily cured of these I intend not to treat nor of such where the shot hath carried all away which things can neither be filled nor set on We will speak here how to quench such burnings and how such inflammations are to be prevented so that that burning cause no further mischief than the shot hath made and then how Surgeons in such particulars are to regulate themselves The condition of one that is shot is this some bullets Bullets stay or penetrate the Body stay in the Wound or else go quite through if gone quite through then the cure is this that the burning be quenched because if that prevaileth it causeth more hurt than the shot hath done But if the bullet staid in the Wound then it must be taken When a bullet stayes out but how that is done is not well possible to set down every particular for shots are made several wayes the one is not like the other a whole book could be written of it Experience must shew the way how they are to be dealt withal and so here you must go to school and learn The Antients indeed have used hereunto many strange Screws and Instruments and were very careful herein But these are either of no use or of very little For if the bullet cannot be laid hold on by the Instrument how shall it be gotten out The bullet will strive to get out at the Wound if the Patient be laid downward with the Wound or else by its sinking it will come to a place where it may be cut out if none of these can be Experience must shew you another way Touching Wounds where the bullet went through here I must shew the dangerous abuses which Surgeons commit if they have a Patient that is shot through a Member they take hempen threed or some twisted hair which rotteth less and draw it through the Wound let it hang out on both ends they put their cooling Ointments to it before they draw it thorough and when they come to dress the Patient again then they pull the threeds forth and besmear it afresh with their cooling Ointment and then they draw it through again that part of the threed which staid in the Wound they make very clean from that it gathered in the Wound then they apply their Plaisters to the Wound as they think they are fitting With these thorough-drawings as they call it they Thorough-drawings do more hurt than good suppose to have done great good Nay some are of opinion that this is the onely way to dress and heal Wounds made with shots But it is otherwise For they do not effect so much with these thorough drwaings as they think for the hurt weighed with the good that is done thereby it will be apparent that more hurt is done than good and ought to be omitted altogether For such a cord or line drawn through the Wound must Hurts done with the thorough-drawings needs cause great pains and that not onely at the first but at the several dressings This way
Surgeons use Camphire to cool the Wounds mingling Camphire of no use here it with other things but they do not well because Camphire is not of a cold quality but of a penetrating heat And that Camphire bringeth out heat and expels it is not because it is of a cooling property but it comes from other cooling simples mingled with it In this case Camphire is not to be used for many reasons which to relate I forbear at this time and chiefly in Wounds made by shot it is to be avoided by reason of the affinity it hath with Saltpeters fire known to Artists that deal therein There are some Surgeons which use Gum Opium to their cooling Ointments but as far as I know it is to little purpose Gummi Opium is nought here Such Gum is not good to any Wound for outwardly it cooleth no Wound within the Wound it burneth unto which Experience beareth witness Therefore it cannot quench any burning caused by Gun-powder that thing quencheth such a burning which attracteth fire as Saltpeter and Sulphur doth Saltpeter and Sulphur keep their native quality still which is to attract that fire which they have lost and quench that they set into fire No more of this and let every one defend what they use I do not intend to gain-say that which others have found good in their trials for experimental knowledge is endless and every day new things are brought to light and they may be such which I do not know of CHAP. XXIV Of Bone-fractures and first of the naughty custom which is kept in dressing them To cure Bone-fractures is common and known almost to all it is of great consequence that it be rightly understood for many know much but have small experience and some want fundamental knowledge who doubtless make many naughty cures as Experience witnesseth and whereas I have spoken in the first Part of many abuses committed in general so I thought good to speak in particular of abuses that are committed at the dressing of Fractures and to give a warning to Novices in Surgery Touching the naughty use at the dressing of Wounds Abuses at the dressing of Bone-fractures whereby Patients are neglected which though it be common yet it shall not stop me in the disclosing of it for reasons quoted above Know therefore courteous Reader that under this common use there lieth hid a great abuse If a Fracture be set and placed right after the setting they dress and bind it with splinters made purposely for that use these are laid round about the Fracture and with fitting fillets and bands on which there are small eylid holes through which the tapes are put and so pulled together and closed up that it stir not Before they do so they usually make a pap called the drying band of Tile stones Bole Walwort and other such like as every one thinketh good or hath seen others do it this they apply about the Fracture hoping with this Drier to reduce the Fracture to a speedier healing This is their common way and hold it for a Master-piece As touching their Medicaments I do not intend to disanul them and to make them of no effect I should not dislike them so much if they had dealt well with the Bone-Fracture The quoted manner of dressing I do not like at all First by reason of the great pain caused thereby to the Patient because every Bone-fracture being set right striveth a little to a swelling but the Fracture being thus inclosed and bound up as you heard how can it come to a swelling which Nature would have Therefore she presseth and striveth the more is made angry and swelleth the more and still at the bands where it finds any vent there it forceth out the swelling which cannot be done without smarting pains to the party Yea by this anger and forced swelling a whole Joynt and Member is suffocated which can be proved by woful examples But this is little regarded of those who are ignorant of Nature and the true cause and though it doth not happen alwayes that a Fracture is choaked with such dressing because it getteth vent sometimes yet that pain is so great that all those parts about the Fracture be they sinews veins Muscles c. are so much angered that the Patient is bereaved of his natural rest for in his sleep he feels such pulling in the bone which awakeneth him with an amazement these smartings and amazements may easily cause other simptoms viz. Feavers Inflammations c. all which is caused by his untoward and rude dressing All this is not enough yet which ensueth upon such rude dressing there are other difficulties and inconveniences For they dressing a Fracture in the quoted manner they can neither see nor know well whether the broken ends are well set or no for they think if the splinters and boards lie well then the bones also stand well together They little think that the parts of the broken bones either at the left or right side are terrified and so the bone stands awry and crooked This maketh them leave the Fracture undressed for some dayes thinking as long as the splinters lie right the bones also are in a right posture which must not be taken ill at their hands because they not knowing how to dress a Fracture well it is no wonder why they are so loath to undress it but this is little ease to the Patient which many times gets crooked legs and joynts the one standing outward the other inward which such Surgeons little regard be it straight or crooked as long as they have made a cure This before named manner of dressing is old and hath been practised many years and so men must beleive that it is good because it is antient I will say nothing of that which is still in use viz. of the Screw-box which hath been a long time in practise not regarding the great danger and hurt which they cause thereby as daily experience witnesseth but poor Patients have small cause to rejoyce at this This box usually openeth with wings which some use for Fractures I partly commend it but never made use of it because my Band is easie and the band with the Leg may easily be lifted and thereby the whole Member I may easily lift which way I please and never feared to stir the Fracture because no splinter nor band is made loose And when I intended to open it then I placed the Leg even and plain as I thought it was fittest and then I laid it down and undid the splinters which I was to take off by reason of the Wound which was to be cleansed I will not speak here of those which think themselves wise and subtiler and make use of Wheel-chips or such boards that are used for sheaths such things indeed are of no great consequence neither doth it matter much whether the one use Walwort the other broken stones and a third use another thing and every ones cookery differs
long till the hurt breaketh out and counting it ignorantly to be a Belly-flux or humour in the upshut they call it a Sprain Of these I quote some examples that you may know what I do call a crackt Fracture and what the condition of it is 1. A Maid coming home ward loaden with bought Wares fell on a stone in the street after she rose she went on her way though with pain and coming home she annointed the place to disperse the bloud and this annointing she continued for half a year at last it broke out with great pain and stink it was held to be a humour of the body which they dawbed with Plaisters for a whole year but it would not come to any healing This Maid was brought to me perceiving the cause of it I desired her to let me open it there I found a Fracture with a cut and the bone began to be scaled and black I took it out cleansed the sore and cured it as a cracked bone and she was healed 2. A Maid gathering Apples under a tree taking up a load of them on her head going along she stept into a hole broke her shin in pieces she sate down staying for her Father to lead or carry her home her Father coming chid her bidding her to rise telling her that some vein or other she did sprain she went on that Fracture some hundred paces and made it thereby worse and worse at last she could not tread upon it I was sent for I told that her bone was broke I was laughed at they saying it were not possible a body should tread on it if the bone were broken much less to go so farre as she did after her fall Their beleif was brought to experience upon their own peril For the bones went asunder and the Fracture began to grow too big for her to endure and for me to heal 3. A Man servant carrying a bundle of grass perceived he cracked his Leg yet he went on and in pains he carried home the grass with much ado This fellows Fracture was of so great difficulty to be set and healed as ever I had any for when I lanced it it was found to be enough for one Fracture 4. A young man taking down from a Horse a sack of salt broke his bone for all that he went about for some dayes but at last the bones broken appeared in good earnest many Surgeons had him in cure before I came to him and it proved a real Fracture which at first it would not be taken to be one 5. A Barber riding along came among Horses which fought among themselves by their kicking his Leg was broken he felt it well enough that it was so but he knew not whether it was broken in two lighting from his Horse he went into his house and in his going it was not seen by the boot whether he was hurt or no the boot being pulled off he tried whether he could go but could not for the two bones of the Leg were beaten in pieces I had to do enough to cure them and were healed without limping 6. A Girl carrying a basket full of chips and stepping over a block heard her bone give a snap she flings in the chips at the door sits down on the next block but her Parents being hard to her made her go for all that this Fracture was lanced afterward and was long under the cure 7. A Servant had a Fracture which I judged to be a lame one I was laughed at because I called it a Fracture but it was past laughing when I took out the bone from the gartering place to the Ankle For those Surgeons which saw him thought it a thing impossible that he should be able to go when his bone was in pieces and many agreed with these Surgeons it was so But the Patient said my bone is broken I presently opened the place opened the flesh to the bone which was black because the marrow prest thorough the Fracture but he was healed could leap and jump without halting at all Many more examples I could quote but forbear it and rather tell the cause why any one can go for all his bone be broken viz. if a bone be broken so that the Fracture hath branches and splinters these hold the bones still together because it stands together yet and beareth up the Patient as when ones bone be not well healed he goeth but in pains and with much ado more than one whose bone is but broken lately A Servant broke the bone next to the hand complained much his Mistress applied to it Vinegar and Bran I coming to dress the old Womans Sore on her Leg I looked on the Lad knew what he ailed but would say nothing for fear they should give me the lie the Lad complained more and more at last I was bid to see what he ailed I told that the Medicine applied could do no good for the Lads Arm is broken and it was so as I said and the Lad had no rest and it was worse with him every day then my words were found true The Lads Hand being grown crooked then they gave leave that he should be drest I set his bone right drest him he felt ease and his Hands swelling was allayed How cracked Fractures may be learned or discerned in old and young Folks If you have a Patient whose Arm or Leg is red accompanied with a swelling and the redness doth not alwayes appear at first but after when it beginneth to swell and will break out if such a thing appeareth then ask the Patient how long that sign was there if he can tell then you may the better discern the hurt but if he cannot tell either by reason of his young age not able to speak being a Child then feel it hard and try whether you feel any unevenness or any thing broken ask again where he doth feel any pain if he be able to answer you But if a Child take notice where it shrinketh at if toucht whether there be a hollowness or a bump or any other crookedness and at the feeling of the place take notice whether it doth stir if you find it to do so and giveth a snap or you can feel the hollowness or it yeilds to bowing then is it surely a Fracture and if it should not yeild to bowing and yet the other signs are at hand which you felt with your Signs of a crack-fracture hands then is it surely a crack which holdeth stiffely yet and the party can stand upon it and go and can work and no body could think that he ailed any thing In case you are not yet sure by feeling bowing c. then take notice of â—â—e Patients words whether he heard any thing crack or snap and what work he had done whether it came by a jump lift fall thrust blow or slipping into a pit or by striding over ditches or climbing up the Ladder or hurting himself against the bedsted For I
by it self but should be mixed with oyl of Olives or oyl of Majoram it allayeth the Cramp keeps off the Palsie caused by the Cramp usually But if the Cramp be in a wound of an outer joint or part Cure of the outer parts where you suspect some sinewes be hurt then mix your wound ointment with some of the red oyl of Turpentine and apply upon a thin stiptick plaister Annoint round about the wound with Tile oyl or with distilled oyl of Bayes and bind him warm And in case the Cramp will not yeild to these means and is on an outer part as hand or foot then foment the wound with warm Lye made of Beech or Oak ashes wherein are boiled Cammomil flowers or Saint Johns-wort Being thus bathed or fomented for half an hour and is well warmed then presently dresse it doubtless the Cramp will cease But take heed you do not cause the Cramp to return and let the patient also be warned of it hereby In such cases I have seen Piony root to be often used for the Palsie wherewith indeed some good may be done if Pionie is good if digged seasonably seasonably digged if not then I found that these roots did no good It must be digged in Aprill when Soll is in Aries and at a plenilunium before the rising of the Sun It must be dryed in the Ayr not in the Sun shine then they are right and proper to be â—â—â—nged about the party you may make of this green root either a sirup or a conserve it will be the more effectual Touching Palsie Apoplexie c my intent is not to write much of it being it concerneth Physitians more than Surgeons But whereas the Cramp is commonly a cause and forerunner of the Gout Palsie and such like simptoms there seems a necessity to lye upon a Surgeon to have some judgement of it that the better he may oppose and cure it therefore I could not chuse but to give an hint of it I know nothing better to allay this simptom than a well Cure rectified spirit of Vitriol I must confess there are several pretious waters powders c. good against the Palsie I I reject none of these but this I hold to be none of the least Spirit of Vitriol is made thus Take crude Vitriol which is pure and green put it in a coated glass body set it in an To make Spirit of Vitriol Oven into the open fire apply a Receiver and lute it well let your first fire be gentle encrease the fire by degrees get over all the phlegme when the retort hath been red hot a good while and no more water comes over then let the fire go out and let it be cold That phlegme which is come into the Receiver containeth that body in which is the spirit of Vitriol for he is not in the Colcotar as some suppose because in that there is no more spirit but a meer oyl for if you take that spirit of Vitriol which is made of the said Colcotar and you abstract all its spirits in a glass body then on the bottom you will find nothing but a corrosive oyl of Vitriol whereby we see that no small fault is committed herein for the one is not comparable to the other in its vertue That spirit of Vitriol is pure and clear like rock water is acide and not heavy and it is made thus Take that phlegme you have received in the Receiver let it evaporate in Balneo Mariae on the bottom you will find the spirit of Vitriol abstract it in sand a second and third time in an Alembick the oftner the better if any phlegme stayed with it the same you may separate at any time And if you will have it yet better then put to it half as much of spirit of Wine put it into a doubled glass body lute it well set it in Sand for a moneth into digestion This is the true Spirit of Vitriol which hath no corroding quality and may safely be used and specially it is a soveraigne thing for the Head when an Apoplexie Palsie c. is feared and if this Spirit be mingled with Magistene of Pearles and Corals then nothing comparable unto it for the said diseases That Spirit thus mingled may be given to those that are The use of this Spirit troubled with a wound disease or with a Prunella It refresheth and corobrateth the inward parts principally the head and heart It serveth also for a pretious vulnerary Potion The use of it is to be taken fasting four five or six drops in one ounce of distilled water of Stellaria but the soveraignest is that grass green oyl of Vitriol which being it cannot be had every where I forbear to speak any more of it CHAP. XXIII Of consumed withered or updryed Wounds and Members how Surgeons ought to deal with them A Withering is a Symptom which is incident to joints wounded commonly to armes or leggs as much as my experimental knowledge will afford I shall faithfully communicate it This withering or consuming is easily discerned because From whence this withering comes the skin on the outer member looks blacker than that on the found member the causes thereof are several either when muscles sinews joints are wounded by a fall blow thurst c. there may be an external cause of it though not any wound hapned to that part as a cold humor falling into or other diseases be it in the shoulder hip knee c. An Ariditie comes thus also a parry being wounded and by the Surgeons neglect the joint water did run too Exiccation Adridum Membrum long this expert Surgeons call Membrum aridum or an exiccation For the joint water is a food whereby all joints and members are susteined Now if that joint water did run too long then thereby that part was bereaved of its natural humor without which it cannot subsist it being so how can it chuse but to decrease and consume The condition of this joint water is like a tree which is Comparison opend at the prack in the spring whose sap runneth out where it is cut and so the tree withereth and dryeth up and cannot be recovered So if the joint water be run thus long whereby that member is dryed up and grown hard stiff and inflexible then Surgeons bestow their pains in vain about such cures can do no more to it but to allay the pains that are still in it But if it be not gone too farre then be not affraid to fall on the cure and be helpful unto nature There are several causes of this witheredness all of them Cause of this Ariditie I shall not relate one in general I will name touching the occasion of the up-drying That updrying for the most part comes from an oppilation of that member be that caused from what it will either from pains diseases or woundings For where there are great pains in a member which have held a
is would have them sleep and others rock them when they cry others there are which will not use their Children to it at all as one a Clergy Mans Wife did who set her Child every night into a Cellar because nothing should disquiet him in his sleep not thinking on any other things the Child might befall but no honest Woman I hope will imitate that fashion In my judgement I hold it to be best that if a Child be laid down in Gods Name c. to rock it gently and not too hard then let it rest But if a Child sleepeth unquietty being as it were frighted as it can be perceaved when it snorteth snuffeth or when frightned or cryeth then rock it gently again then the melancholly blood which opprest the Child and frightned it is by rocking brought to right again out of its fear and anguish and are dispersed or expelled It falls out sometimes that a Mother meaneth to quiet her Child with rocking whereby the Child is the more unquieter and with crying inflames his head so vehemently that in many daies he cannot be brought to right again sometimes such a Child aileth that which a Mother doth not think of supposing to be the Childs frowardness which is not so but it feeleth something to be amiss in the bed which doth hurt it or its hand lyeth hard or a prick straw or hard feather doth prick it or a pin which eareless Nurses left in the linnen or a flea or louse tormenteth the Child therefore my advice is that if a Child will not be quieted to take it up and see what doth ail it Little Children are tormented also sometimes with the Cramp when they are taken up then their blood runs To help Children of the Cramp up and down and by that means are they quieted few people take notice of the cause of it and is remedied when the bloud getteth its course again and come to that place which was bereaved of it it warmeth that part again which warmth driveth the Cramp away and the pains which are caused thereby A Cramp will hold a Child strongly if once it takes possession in a Child causeth great pains below and above as these pains are to the Children continue in their crying and commonly the Gout doth accompany it Therefore these things must be taken good notice of when the Child cryeth much either half sleeping or awakened then take it up and wrap it in warm clothes This misery is caused by the following things viz. when Children are kept cold in the Nurses or Mothers lap or in the bed bath or lye in wet clouts bepissed by Children or such Children sit naked on the flower or stone I have seen that the sitting so naked on cold places hath proved so dangerous unto Children that in short time they were creepled with whom I had great toyle before I could recover them to their former health for if once they take cold in that way they are hardly recovered again This befalls old people also some whereof I have seen dye of in great anguish and misery and lay long by it before they dyed Therefore tender Children must by all means be kept warm not to shake stir and dally them too much If a new skin in old people be tender what is it you think in a new born Babe Doth a small thing pain you so much on a finger how painfull is it then to a Child which is tormented all the body over which hath but a tender new grown flesh if such a perfect Child is tormented so soon what shall we think of a Child which stayed not in the wombe its full time surely it is twice worse with him Touching Baths of Children it is known that they are Childs Bath bathed sometimes so hot that the heat thereof is scarcely sufferable to an old bodies hand whose skin is strong we must not here that if a water bath be made for any one which seemeth to him to be not very hot at that time when he was scabby and went in the first time so the skin of a Child is so thin and tender as his who is full of scabbs A hand which is usually naked can endure more cold heat air c. than that strong sound body which usually is not naked c. This every one doth or may conceive easily if he taketh notice of some Women are so careless that they take no notice nor observe what pains they do or may cause unto others and make Baths for Children so hot as if Children were able to brook with not considering that Children are weak in their little bodies and not so strong as aged people are in theirs The bodies of such little Children may be compared to a young and tender root or twigg of a Tree which in the fouch is not so grosse as an old root or branch of a Tree take heed you cause no paines unto little Children that they may not be filled with pains in their joints whereby they are made unfit ever to follow closely or well any mechanick calling And it is a most certain thing that those which are bathed too hot get a more tany skin than those which are not bathed so hot neither must they be bathed too cold else there will be caused to them pains in the Pains in the belly and the Cramp how caused belly and the cramp and is then most of all caused when Children are naked in the water are not covered in their body or else when the bath is made too thin or when such a bath is made but once and no more used a long time after and no order is observed herein or when the Child is taken out of the bath and they care not how long they keep it in the lap Some use to lye the Children bathed behind the hot oven whereby the Child may soon be Children are hurt if after bathing are laid behind a hot Oven stiffled or choaked not regarding whether that heat doth not cause a pain in the body or head supposing onely if the Child be but laid behind the oven then is it well cared for Some have that custome when they have bathed their children then they rub them with Wine and the whites of Eggs saying now I think I washed my Child neatly and rub it so strongly as if they had an old bodyes skin in hand which is grown hard thereby to soften it they do not consider that if an old bodyes skin after bath should be so rubbed and the party were scabbed how he would be affected with it or if a sound bodyes skin should be thus stretched or reacht what pain would it cause to it little do they consider what great wrongs are done thereby unto little Children All honest Mothers and Nurses will be cautious and carefull Children must not be kept loug naked or wet that their Children be not uncovered too long be it either at their taking up or their carrying
no effect Have a care that the stitches break not else they will cause scarrs but supply them with stitching-plaisters CHAP. IV. Of abuses committed in blood-stenching with Corrosives nealed Irons and the like and the dangers or hurts which ensue upon it illustrated with some examples BLood-stenching in Surgery is a very necessary point insomuch Stenching of blood is necessary that without it little is effected For Patients loose their lives if they bleed too much neither are the medicaments effectual if by a continual running of blood they be hindered in their operation and where there is a necessity of blood-stenching there it ought to be used and applyed according to Art And God be thanked Surgeons are found which have reasonable judgement in it and know how to stench blood and use it without any prejudice but rather to the great benefit of their Patients But the ruder sort goes to work basely whose number alwayes overtops the better sort and refuse better instructions Blood-stenching abused keeping and sticking to their old wayes obstinately observing their abuses even as when they intended nothing else but the ruine of their Patients I speak of such onely which use Corrosives supposing the stenching of blood must be effected onely with nealed Irons and other burning meanes among others they use sublimed Mercury crude or sublimed Arsenick calcined Vitriol Alumen Plumosum Caput mort of Aqua fort Euphorbium and such like things whereby they suppose to stench the blood Some there are found which to mend the matter take one or two of the mentioned things put them together and mingle other medicaments among it as Bole Armoniack Terra sigillata Millers dust Crocus Martis and such like This they hold for a rare Secret and Master-piece calling it a sharp Blood-stenching not without a cause for it is sharp enough nay too sharp It is a great pitty that these and such like things must be Abuses condemned cried up for rarities and master-pieces whereas they are nothing else but heavy and dangerous abuses and errors whereby infinite wrongs are done For all those above mentioned things one or more of them being used to a fresh wound for to stench the blood withall effect or do little or no good at all which were tollerable yet but they cause thereby infinite wrongs and do no lesse therewith as if they had strayed the wounds full of venom Tell me I pray if a wound bleedeth vehemently and you will stench it with one of the above named materials or corrosives when you stray that pouder into doth the wound cease to bleed presently Whoever affirms it I deny it For these materials in and outside I know very well and understand whither they have any efficacy in them to stench blood presently yea or no Must not the Wound being straid full be bound up with cotton Wool plaisters and the like that the blood may not issue forth Now vvhen you have thus bound up the wound and stench'd the blood so that it can run out no more could you not procure also that the in-strayed pouder should not work in the wound and that the corrosive which pulleth the running veins together cannot effect that because the running blood driveth it back and washeth it away For if a wound be carefully bound so that no blood can run out then of necessity the blood is stench'd and congealeth in the Wound This being done then the corrosive incorporates with it and begins then to work that is to say to rage to eat and to burn I would fain know here of what use Corrosives are in Corrosives are hurtful extreamly blood stenching as long as the blood congealeth without such fretting things and may be stayed onely by a careful binding of the Wound Perhaps you think the Patient is not sufficiently tormented unless you put more affliction and plagues upon him you immagine the Patient is not weak enough and so with your sharp Corrosives you must make him a Martyr Ah how many veins ah how many sinews which are not hurt at all by the blow nor toucht are eaten through by your sharp corrosiive blood-stenchers and are forcibly torn in pieces or at least benummed or mortified which would not have been so if you had not medled with them Are not lamenesses caused thereby and much wrong and evill inflicted upon Patients whose Wounds might have been easily cured if they had been dealt honestly withall I knew one who professed Surgery he was to stench a Example of one whose blood was stenched bleeding wound He took his pouder of the which he boasted much thrust the pouder into the Wound with some cotten wooll bound it up supposing he had done enough at it a little while after the Patient cried out extreamly complaining of his paines by reason of the raging and burning he felt in the Wound I asked the said Surgeon what he had put into the Patients Wound He was loath to reveal it because he held it for a great Secret and Master-piece however upon my importuning he said it was calcined Vitriol and Gummi Euphorbium sublimed Mercury mingled with Bole and Terra sigillata and a little quantity of Vinegar among it which he called quenching This was his great Skill and Secret wherewith he usually bound up Wounds But what happened He did more hurt then a wound twice as big would have done For though this mans Wound was not such where a lameness might be feared yet was he made a Cripple because this corrosive pouder hath corroded and eaten off his sinnews which were not hurt at all I pray what simpathy have these said simples one with the other especially Terra sigillata Gummi Euphorbium In like manner many Receipts are screwed together with a company of simples which do fit as much as a piece of new cloth a Beggar-patch'd coat of severall sorts of old rags all this is no sport or pastime to the poor Patient whose skin must reach for it These abuses hitherto shewed about blood stenching are great and grosse ones whereby incurable hurts are caused Abuse of hot Irons in blood-stenching which cause great hurt A horrible Skill and yet are they not comparable unto those which are committed with hot Irons whereby the Patients wounded veins sinews and other parts are drawn and shrunk together and haled as if pulled by a horse And this is held a great Skill amongst many but it is in my opinion such a terrible Skill which meerly belongeth to murthers and I am easily perswaded that Hangmen have taught this way at first Others that will outstrip their fellows in their Skill take cotten wool thrust it lighted into the Wound whereby they suppose to have done well for the good of the Patient But as I have said in general that I reject nor condemn blood stenching but rather hold it necessary and allowable as occasion serveth neither do I wholly condemn hot Irons to stench bloud withal and hold it to
then there is no need of the Defensive Plaister because it doth not alwayes good Annoint then the Patient with warmed oyls of Cammomil of Rose oyl mixed with a little Saffron or annoint the Patient round with Gray s grease his Neck and Back bone and the Wound also and look carefully to the business Govern the party in his diet as you were told at the Head-wounds Keep him from cold and air and let him be quiet and not stir much and be temperate in eating and drinking You may apply also to his Wound a Sandel plaister which I call the red Sandel plaister with these things you proceed in the cure till you come to a perfect healing These wounds being very subject to simptoms and among Note the signs by reason of dangerous simptomes as Cramp joynt water the rest to the joynt-water which in the whole body is no where so dangerous as it is about the Neck and Throat especially when a Cramp fals into therefore you have cause to look the better to it and to prevent such accidents But how you must behave your self touching the joynt and sinew water and against the Cramp also with the brown Ointment you shall find direction for it in the third part of this Book or else in some other place Touching Throat-wounds these you must trouble as little Throat-wounds with Tents and with the Seeker as the other in the Neck Proceed thus If you have a Throat-wound in cure True proceeding where the bloud issueth forth mainly so that there is fear that a bloud vein hath been hurt or that the swallow and Throat be cut then note if the Wound or Stab be deep or shallow neer the Ear then you may stitch it but not slightly as commonly is done but must be drawn strongly together cross-way so that neither breath nor bloud can get out then apply to the Wound an Opodeldoch with a defensive plaister upon which is described also in its due place this do so long till the anger be past Having drawn the Wound together with that stitching then is it requisite that you have a good Medicine which penetrate with its vertue and that is the Magnetick plaister which is described in Books of Decoctions truly that will draw all matter you need not to use any other thing to the Wound but onely apply this plaister great and thick Let it not trouble you which way the matter in these wounds goeth for Throat-wounds afford not much corruption and the Opodeldoch is of that quality that it leaveth not much uncleanness behind If the Wound be great and wide so that you fear it may not be stitch'd that way then let it alone for common stitches will not hold in this case and keep in the bloud from issuing forth therefore make use of a Bloud-stencher and proceed further as you did with other perillous Wounds and if you use any plaisters hereto then spread it thick that the air may press the less thorough for the swallow is a substance which can endure no air at all But if the throat be hurt at the side then do not stitch it especially if the Wind-pipe or swallow be in pieces for if a swelling should be incident the patient will be choaked or perish in his food And if the Wound be not great or deep then do not stitch it and draw much flesh into it would cause an ugly upcast scarr For at the Throat usually happen gross scarrs and therefore take heed of many stitches there and of too much flesh and if-you can endeavour to heal it up to a scurfe for if you suffer the flesh to grow freely and high then the scarr will be as big as a great nut therefore be not neglective in the preventing the simptom betimes else it may be too late to undertake the opposing of it you ought not to put into the Wound any Salve oyl or Tent for it may as little endure any Tent as the Back bone by reason of the variety of sinews which are in the Throat It being a thing more usual in Throat-wounds that swellings Gargarism are incident whereby soon great sorrows and troubles are caused therefore is it requisite that there be used besides the defensive Plaister a Gargarism not onely the sooner to further the healing of the Wound but to asswage also the pains And if there be not heat at hand then take Wine else do you take Water lb 3. put one hand of Mallow seed boil a third part away which being done then strain it through a clean cloth put thereto of Honey â„¥ 2. boyl it again after you scummed it put it in a pewter dish put to it of Storax Calamintha â„¥ ¼ and so let it stand for your use Some add a little Cinnamon which cannot be amiss Let the Patient use this water several times a day it will not onely further the healing but ease him of his pain and keep off rheumes This Gargarism may safely be used also in Head-wounds and is effectual alwayes Touching the joynt-water when that commeth then carry If the joint-water comâ—â— with pain your self as you shall be instructed in the Chapter about the joint-water And if accompanied with great pains then take notice of the causes and signs thereof that you may know whether the Prunella or inflammation be either at hand or coming on and if it doth signifie the Wound sickness or any other thing then proceed as you shall be informed All such that are troubled with such deep Neck and If a heat comes Throat-wounds and endure great pains then use smarting plaisters it will ease them One thing more in case the Patient feeleth great heat either in the Head or in the Face and by reason of it feareth the Prunella the Wound-sickness or other such like then phlebotomize the Patient chiefly under the Tongue if it may conveniently be for such phlebotomy cooleth much both Head and Throat taking away all the heat quencheth thirst opposeth many simptoms and maketh the Wound forward unto healing therefore neglect not Phlebotomy in these Wounds if need not else These veins you may safely open in Head-wounds where any heat is felt surely it will not be fruitless CHAP. XI Of Wounds at the Breast how a Surgeon ought to behave himself there TO speak of Breast-wounds I mean not small slight Wounds which require no singular great cure being Of Breast-wounds without danger By Breast-wounds I understand the first part of the Ribs If a party be wounded there and the Wound is not gone through the body then no great danger to be feared and upon that you ought to deal as usually is done to common Wounds For those Wounds which deeply run into the body are very dangerous It fals out in such wounds that the stab doth not go deep into the wound and yet one of the inner members is wounded Sometimes a party is run quite thorough and yet no internal part wounded Let the
condition of the Wound be what it will you must note first a party being wounded at the Breast commonly there cometh a wind out of the Wound which is like unto mans breathing here you must have a care for that is from thence observed viz. In case an internal part is wounded then there is a remarkable sign accompanied withit For if the Lungs or the Signs of internal parts wounded Midriffe which distinguisheth the Lungs from the Breast is wounded then is the Patient troubled with a continual cough and there appeareth a scum in the Wound and the Patient is full of pains and can hardly fetch breath if the heart be wounded then no remedy expected of which I say nothing more for the party dieth presently for no Art nor care will avail here however be not wanting on your side dress his Wound as Wounds of Lungs usually are drest Of the same conditions are other internal wounded parts And in case the party be quite run thorough without hurt to the internal parts yet that Wound is to be judged and undertaken as perillous and mortal For though none of Back-wounds are a cause of lame members the inward parts be hurt yet it may be that that thrust hath hit some of the white veins or sinews on the back which is dangerous by reason of the affinity they have with the Heart It happeneth many times that when a party is wounded in the Back that he fals lame either in his hand arme or elsewhere where no defect at all was which is caused onely by those white veins that are hurt Touching the cure of such Breast-wounds I intend not Breast-wounds â—â—red to give any other doctrinals herein but what hath been made known at the dressing of Throat-wounds Onely concerning the defensive Plaister that may here be omitted unless the Back bone be run thorough also and great pains are felt caused by the hurt sinews Therefore as I have informed you in Wounds of the Throat what you should do touching stitching so you must Stitching is permitted note here also that Breast-wounds are to be stitched and the stitches drawn strongly together cross-way yea you may use twisted stitches because they go easily asunder by reason of the breathing which constantly is against it whereby they are forced asunder And whereas breathing hinders the vapours and the air the healing therefore the Wound must be stitched as close as possible may be After that use no more but the green Salve which enforceth the healing then lay the Magnetick plaister upon and bind it quickly care not what course the matter taketh or which way the bloud runneth for it ought not to have any vent and may get perhaps more vent than the Surgeon shall well like of Bind it well with warm clothes but not too hot else it would incline to a fistulo neither use any Tents and above all search not with the Iron in the Wound which is a cursed custom In case the Wound be so great and so wide that it cannot be drawn together and stitched but it will keep some vent Stltching when disproved of then omit stitching altogether because such stitches would break out and burst asunder by reason of the breath which if it hath but a little passage it presseth more vehemently against the stitches as when the Wound were more narrowly closed In such Wounds use neither flat nor round tents but onely put in your Tent-ointment and then lay your plaister upon Take heed of flat and round tents on for the wounded parties breath being drawn would strongly draw also the Tent into the body and the Patient would bring great misery upon himself and cause his own utter ruine because that indrawn Tent must lie on the Midriffe or Diaphragma and rot there and indeed no wick or tent is fit to be used in these Wounds Note also that cold and warm dressing is dangerous and Cold and hot dressings are dangerous hot dressing is more dangerous because it causeth infallibly a putrefaction as experience sheweth For many suppose that hot dressings and hot Medicaments were best but the contrary ensued upon as hath been known Therefore a medium is best in all things let it be neither too hot nor too cold If you undertake to cure a Wound which cannot be stitched then use a strong Bloud-stencher unto as you heard How to dress breast wounds that cannot be stitched above and more of it followeth after and at the taking off the Bloud-stencher and at the dressing again all necessary things you ought to have in readiness as I told you above that the Wound be drest nimbly that the parties breath may not pass much thorough which would be very hurtful All this must be done in a dark place and sharp rough air be kept off Have a great burning Candle by the hand you shall Air hurtful to the Wound see that the breath that cometh forth out of the Wound will blow out the Candle Hence you may gather that such Wounds are endangered if not quickly dressed and a care must be had that the Lungs draw not into the body the rough air for if you suffer this to be done the Patient will never be recovered Breath if it gets but a little passage and is warm it causeth moist vapours whereby are caused internal Fistuloes and hot feavers Internal sistuloes hot feavers with the loss of understanding and sense and so all natural means lost Therefore use such Plaisters which stick and cling easily and suffer not air to come by and use such stiptick Plaisters in manner of an Opodeldoch or use an Opodeldoch which is very useful in such cases By these things may easily be gathered that Cataplasmes Cataplasms of no use which in such cases are too much used are useless altogether for they are too weak and have no power to oppose the air and breath and besides they are too moist and so they further putrefactions I know that there are many which will not like my manner of dressing no more than I like other mens dressing for some may object saying if a Wound in the said manneâ— be stitched and closed whither runs the bloud Doth it not run into the hollow of the body where it may doubtless cause great troubles and miseries Answer For the taking off of this doubt note Dayly experience witnesseth that Breast-wounds which can be thus stitched have no where such danger as those which cannot be stitched and it is known that that which is inwardly hurt sooner healeth because no air troubleth it than that where the air cometh to it For the air in the hollow of the body is judged mortall and deadly Touching the bloud which you say runs into the body troubleth me little For Nature which alwayes endeavoureth to help her self turneth that bloud into water which if good and fit means are used may be expelled by sweat and urine It may further be objected Whether runs
some Knees came to my cure full of lameness biles and joynt-sponges such I cured in the following manner When the Knee was hard and ugly then I bound it strongly all the Joynt over and mollified it and was careful to see where the joyntwater would appear and having found it in a ripeness being gathered under the band and there also where it appeared first and there also where it never was then I took care where it might be best to open it and took hold on the matter where I was sure it was which I let run out as clear as water not mingled with matter or bloud and that water looked as clear as Well water In case I could not come so nigh as to get the water out at one cut lying yet under the knee-pan then I cut onely through the skin making a little hole putting in a Wick rould in Allom or other Corrosive and still eat a deeper and broader Wound with Corrosives till I came to the water For it is sure enough if you hit and meet with the water it gusheth forth as the bloud doth out of a breathed vein It often happened to me that I was fain to set the bason farther off when it gushed forth in this manner one time it gushed into my Mans face scarce able to hold the bason so fiercely came it running Having let out this water then I drest him with a Tent and Ointment every day thrice like an open Fracture Once I lanced a young Mans Knee the water gushed out so vehemently that none of it run down his Legs till at the end when they were empty I know not one but he was healed if any water was found therein and I had good success also upon those which I drest with bands and roulers and when I was about the lancing of any Knee I did it so that the Patient was no where endangered thereby I never opened any with a Knife or other instruments but onely with that Lancet I used to phlebotomize withal making no great incision onely of such a bigness that I might get in a Tent. Further I did so I dropped one drop of Ointment on the place where I meant to cut and was sure that in that hollowness the water did lie and having thus marked it with a drop then I took a long rouler and bound the place beneath it and then I struck upward above the marked place then I laid another band tied it strongly so that the skin rose on high and made it insensible with the stiffe and hard binding and raised it so high that I knew I could not hurt him and to come onely to the hollowness with the iron and it hurt the Patient not so much as it would if the place had not been tied neither could it slide away under the Lancet it must stand to it and it could not but be hit and surely found Now is it time here to consider what sores I mean to be opened on the Knees and Elbows Note I mean not such Knees or other Members which are full of matter or other swellings filled up with scirrosities but onely such that are full of water and are soft and by that water are brought to a lameness of such I had a great many neither are they marked with any weakness or defect onely they complain of it when they go or stand still and at mornings near the breaking of the day they are most pained neither do they feel any great pain when touched onely there they are pained where the water lieth and is swelled a little no other sign to be seen It is hardly beleived how it gusheth out at the cutting but if tied it spinneth out as when a vein is breathed but no bloud cometh with it Many such Knees would not yeild to any softness under the Plaister though they were much annointed and troubled with Cataplasms of Althea Malva Grease c. hot Wines Oyls Sweatings Fomentations Coolings and chiefly Water-baths all which were hurtful and rather caused the growing of a Joynt-sponge When they were so hard and shapless and unmoveable for the abovesaid Medicines make them stiffe tough hanging and clingling then I was forced to do what I was loath to do and seeing that the thing must be opened namely the top and the highest part of the bile and put some Corrosive into the Wound and made it angry every day more and more till the hardness was consumed and then I drest him as any other Wound of the Knee ought to be dressed after it was somewhat healed I applied the red Plaister also and so exiccated the rest as I usually did to Knees not lanced I often bowed out-stretched and moved them fitting them for motion for the flesh sticketh so close to the healing that it will hardly admit any stirring therefore by force they must be stretched bowed and bound as hereafter shall be spoken of at crooked joynts Note also that a Mercurial Ointment is good for lameness and pocky biles if his foot be annointed with it or it is better if laid into it for the Pox and lame blains come sometimes onely into the Knee though no where else but men are loath to hear that these are caused by that Morbus There are other strange hurts on the Knees more than to the whole Body may come and differ so much that no body can tell what they are and I beleive there is no man who knoweth them all There are also some humours of the Body which stink and fall down upon the Knees of which many perish and die and I say not that these may be cured for besides the misery pains stink putrefaction of the bones and sinews there grow Worms therein which fall from thence and to speak truly these ought to be cut off and the Patient be ready for death And my counsel is to you Novices in Surgery not to undertake alone to cure Knees unless you know first what accident there is in it whether it come by a hurt or whether it accrue to it for an accrued hurt is worse than one that is made and an accrued simptom hath a root which if it be stirred and roused a dangerours excrescence may be caused and the root not known But things proceeding from the Pox which are running are bad enough to be cured especially when they break forth of their own accord for then they are worse than when they are opened for when corruptions seek to come forth they search then many places betwixt the veins and sinews and stay there and have many passages and wayes and when a Surgeon thinks he is almost at his journeys end then is he onely at the beginning and can hardly come near it and fals out many times that the true ground can never be had and then bodily humours come also which come from ill Lungs and fall down from the Diaphragme Moreover take care and understand me right that you will have perhaps cause in sore
Knees to make use of a lenitife by reason of the swelling and the water which is in it which ought not to be used Use no mollifying things made of Althaea Mallows Honey Meal Lin seed Butter Grease and such like c. for I do not advise that any softning things should be applied to Knees but to let Nature have her course and if Nature be too weak to expel then aid her with a Lancet make a hole which is to be made wider with a Corrosive or burnt Allom which is enough I used no more Here I speak of hard and not of soft Knees for when they are soft then they soon ripen unto matter or water CHAP. XIX Of the little Vcler that groweth on the Knee IT fals out sometimes that one gets an Ulcer or Sore before on the Knee-pan and paineth much and appeareth with a swelling and heat and sometimes there is also a cold in it it gripeth the party extreamly it shooteth and rageth like a Plague bile and it groweth red and hot at first it looketh ghastly but the danger is not great let it have time unto maturity it will get a little Blister with a black head like unto a small Pox. At its breaking there comes forth a little water there standeth a green husk which cannot be prest out before it cometh to a ripeness and being grown ripe then it openeth like a sore and is healed again without any tent or mollifying is curable like any other sore and is called the good Pox it is full of pains and easily cured CHAP. XX. Of an Inflammation or St. Anthonies Fire on the Knee Erisipelas Those Knees that raise and swell and have many red pimpels here and there they raise but swell not and is called the Rose These ought not at all to be annointed much less must any greasiness or moisture come to it onely dry warm clothes must be applied unto which dry up all their damps Some do foment those and I used such means also and me thinks it doth very well This Rose or Anthonies Fire must be so dealt withal and that swelling or raising goeth away without any peril if onely kept warm with dry clothes These Knees must be tied pretty stiffely that the Knee-pan do not raise too much It is good to bind a Knee hard as much as the Patient is able to bear be it in any infirmity whatsoever except when there are gray blains or blisters at hand these ought not to be bound that the sooner and better they may come to their ripeness for they grow and swell till they be ripe In case you were to use any tents to the Knees by reason of the hollowness and bigness of the hurt or sore that in the inside it be too wide and too great then the Tents must not be of that bigness as to fill out the hole else the matter will be deeper undermining before you dress it again by reason of the abundance of it but at that hole where the tent is put in the matter and water must run out CHAP. XXI Of some humours of the Body which sink down into the Knees and Legs what these are and how they must be cured THe hurts and simptoms of the Knees are several among the rest there is a malignant humor running down from the Body making a passage through the Thigh to the hollow Knee by the sinews which humour stinketh and is like to matter and white like Whey there it stayeth and admits of no cure it is one of the worst humours and I never heard that any was cured of it either by fomenting woods lancing cooking or by other manuals nor by potions or corrosives but it kept its course which it hath from the Body downward and the passage it made is hardly found out Therefore I advise you not to attempt much upon it but onely keep these Knees clean that they may stink the less There are other sharp humours also of the nature of a salt rheum which fall down from the Body upon veins and sinews and these also have their revelets and passages These corrode and gnaw the bones into a black colour and cause more pains than the former and are very hardly cured yet through good counsel and good diet they may and must be held to the Wood cure and if they are cured it is done with inconvenience by cutting or taking out of bones if these rheums are taken off and their condition changed through a good diet then these sharp rheumes are consumed and gone and may the easier and better be healed than the other above named There are other rheums also in the Body which fall on the bones above like great Imposthumes and swellings where they putrifie and sink till they come to the Knee which proveth nought some of these rheums have their supply from the Body but these are neither stinking nor corroding as the other two sorts named above are and these run most round about the bones before they come to any maturity and fill the Legs with matter and are easily cured if come to a full ripeness and when they have mollified the flesh and skin then must they be opened and a cleanser put in and let the rheum run out let it not rest one quarter of an hour in its running and let the party have a constant dressing applying Tents and Plaisters let the hollowness be not much covered with flesh that the Muscles and the skin together with the panicles may close the better for these do willingly close for that reason they must not be filled up with flesh and must be tied stiffely then the hollowness healeth together therefore sit your Wicks so that the moisture may run out by it and gather not at the one place or sinew to the other for I held it not good when I pulled out a Tent that the matter followed close if the matter is run out before the Tent is pulled out then is it more wholesome when no matter followeth after the Tent. The Patient must not alwayes lie still but must turn himself this and that way that the matter settle not any where The Tent that is to be put in must be covered with Aegyptiacum or with a Wound-ointment as you see cause for it You may siringe him a little and that gently Use no Glisters they cause windiness which bringeth danger But siringing is good and the Balsam and Ointment cometh the better into and the simptom being inwardly well cleansed and the swelling allayed then dress the opened hole with the Ointment and Plaister then you will know whether any matter is settled it raises then like dough you need not to put the Patient to any pain nor to make any hole for it will run out freely when you dress him with the rouler and apply the red Plaister over that dough or softened place and if it thrusts against as the matter usually doth and you are sure of the matter then you may lance
at the first it is needless This is the best and plainest way of dressing of Fractures The conveniency of the dressing and you may look every day to the band several times onely the plaister must not be taken off and the Patient as he pleaseth may add to or take from these three bands and may do it safely without any peril and such a Patient may with more convenience be carried into the Country being drest in this manner then if he were drest after the common way for this band is light and plain and doth not burthen the Fracture at all and in case the bones Fracture would be in a swelling it may do it conveniently without causing any anger and that swelling being upon settling then the plaister bone and skin settleth also drawing and clinging much unto it and thereby the bones are kept and forced to stand stiffely together Other ordinary bands which are applied round about the The inconveniency of the other bands broken Member cannot effect the same For as soon as there any swelling appeareth then are the bands stirred and raised and Nature not enduring to be tied up there is soon an anger caused thereby which surely will afford enough of smarting pains For it is often seen that such forced swellings press forth betwixt the bands and the splinters whereby that Joint or Member is suffocated and in case these mischeives appear not yet is this incommodity subsequent that the bands which lie about the Fracture and have quite encompassed the Member are so strongly extended that when the swellings are upon settling and the Joynt or Member begins to lessen that the band groweth loose and slack about the Member and the foresaid swelling and anger having brought some humour into the Member causeth the Fracture to yeild to the side and the healing of it proveth uneven Hence is it why so many halting and crooked Joynts about men are seen The cause of short and bowed Members I have never annointed any Fracture because I was perswaded that thereby the Fractures would be healed soft therefore I still applied the plaister to it and never used any Why Fractures ought not to be annointed Ointment and drest the Patient but seldom for I was afraid that at the dressings I might stir the Fracture Therefore if the Patient at the first time be well drest let him keep that band for a time but in case the Patient complaineth that his Foot and Toe is swelled and is painful unto him then look where the fault lieth and let him not lie long in that misery You may easily know where the fault lieth if you undo the bands and the Fracture hath vent if then the pain ceaseth To know the errors committed in the dressing then the splinters were in fault which pinched the Patient or else he was pained in another place In case after this opening the Patient feels still some pains then is it a sure sign that something is stirred in the Fracture be it as much as it will the place where the fault is committed you may learn of the pains for when you touch the Fracture on that place where the pain is on that side the neathermost part of the bone is stirred and turned either up or downwards or to the side if you find it thus delay no time undo the Fracture and bring to right the disordered part and then dress it in the former manner and is done quickly Some Fractures may not be ordered in many dayes This was alwayes to me a sure Sign whereby I knew whether it stood well or no with the Fracture and whether it was bound too hard or too slack Short and true Rules of Fractures whereby you may know is what posture the Fracture is Rake nor stretch not any Fracture neither strike nor set it with your Hands unless you be sure that it stands right and even and that you cannot feel no hole no bile nor raised place be it never so little let it not pass so but endeavour to set it plain and even Measure and fit the splinters well for Legs and Arms that they be of a fit length and shortness well cut as they ought and that they pinch not the Patient any where Presume not to dress any Fracture before you be provided with all necessaries as you heard above let there be no want of splinters roulers linnen clothes plaisters and be sure you want none of such like things be not to seek such that hold the Patient or that help to lift him for men at the beginning may be lusty and strong but in time these growing weary looking for fresh ones one danger or other will be caused and in case you be not provided sufficiently with plaisters and splinters what time can you have to spread and to split more of them for when once you begin to press and to set the Fracture how can you get off or hold up the Fracture without hurt and pains to the Patient The Fracture where it is broken must be supplied thick with plaisters especially that place where the bone came forth and apply small pieces of plaisters close and thick and keep in the Fracture by force that it may not come forth again for it easily comes out by that first place and the splinters also must be bound hard to it Splinters must not be cut too short which would pinch the Patient neither must you apply any splinter to the naked skin else they are burning and pinching the Patient too much Bind the Patient not too hard which would mortifie the Member which I found true many times neither bind him too slack which would easily remove and stir the Fracture keep a medium according to these Rimes The whole sum be spoken briefly And this warning is given really Bind the Patient not too strong Else he 's choak'd and his bloud gone Thereby is caused the cold Fire It shames the Surgeon to the sick it draws Smarting swellings and hearts misery Give way for the Pulse and do not tarry This advice I give you in good troth In following my counsel be not sloth In the binding be very cautious Not too hard nor yet too loose The Band must hold the Fracture stiffely Yet the pulse must have its way throughly Signes bring to the Surgeons head That there is no pain when swelling is laid Let the Knees and Toes be laid upright let them not fall to either side and let not his Heel be without a stay and rest Set the Patient not too soon upright as if all were well with him unless you know that he hath recovered strength enough CHAP. XXVI Of Flap-fractures and of their orderly dressing and healing HAving sufficiently and largely spoken of ordinary Fractures and Contusions now it follows that I speak some remarkable things about Flap-fractures and will declare it faithfully as much as I have seen in my practise and as much as Novices in Surgery ought to know I
and stroaked the inside of the Leg and going to annoint it I applied a band where the Fracture was or else I had one that held that place strongly then I annointed the Leg very well above and below the Fracture alwayes warming my hands I never toucht the Leg with cold hands warming also the bands and plaisters and let the Leg hang down when I annointed it I did not gripe the Leg hard but the skin I stroaked freely More of this shall be said in the Chapter which handleth of exiccated Members I intend now to speak of swelled Fractures which are healed Of swelled Members and Joynts yet are still thick and gross and that one Joynt and Member is as heavy as two in the going or standing which thickness I took away without causing any pain I had several such swelled Members which amaze the beholder yet the Lord gave a blessing to their healing but some signs were left behind The reason why I speak now of swelled Members is because formerly I have written of exiccated Members these being contraries that Surgeons may take notice how to help these simptoms for that which is good for the one is nought for the other and a wet Bath is nought for both but in other things contraries are used viz. if you have in hand a withered and up-dried Member you must stroak it downwards and a swelled Member you must stroak upward at the dressing If in an Arm or Leg a humour remained and is not a swelling caused by some ulceration of a wounded and lamed part be it of a fall or a blow be the cause what it will either itch small pox imbroidered clothes hard and long labour or a long down-hanging of the Member or an ulcerated Fracture or a great scabbedness redness dropsie c. of all these I do not speak but of a humour of the body where there is neither redness anger nor water Here you may judge if you be judicious of what humour I do speak Such means must not be used spoken of formerly for swelled Members whereby the Patients Member would easily be mortified and death ensues upon Look well and consider what swellings are spoken of here all sorts of swellings are not yet related as among the rest the swellings of lamed Members which have neither spots nor biles or holes such may be drest in the manner spoken of and bound not so hard as the first Such simptoms are incident to Knees Elbows Shoulders Ankles but seldom to other places Lastly If a Flap-fracture be so great that whole pieces of the Leg come out you must not therefore cut off that Member When the bones are gone out as many would do but set the bones right again one upon another and let Nature provide for the rest These bones will grow together again but the Member groweth shorter I could quote many examples serving to that purpose where the two bones of the Leg were taken out some fingers breadth which were set again from below upward and were healed successfully but the Leg fell as much shorter as those pieces were long that came out CHAP. XXVII Of Arm-fractures above and below the Elbow how these ought to be drest and healed IF a Patient hath a broken Arm above or below the Elbow set him on a strong stool tie his sound Arm to the stool or let him be held strongly by that Arm that he may not interrupt you in your work and do it well at first that you may have no disgrace afterward and the Patient be put to further misery for if his Arm be not well set at first afterward you will hardly do it and the Joynt will be pained a long time which at first was not well set therefore presently stretch the dislocated Arm and set it well one upon another and having well set it then have good help about ye especially when you have in hand any great Fracture in Arms or Legs For the greater the Fracture is the stronger help you must have and one body alone is not sufficient unless your Patient be hearty and willing to endure when you are about to dress him let him lay his Arm on a cushion in his lap in the mean while be you ready with your plaisters splinters bolsters roulers needle and threed and stitch-plaisters as you heard above To an in-bowed Member you need but two splinters the one to lie to the bowing to keep in that raising or callusity and the other must lie opposite to it to be helpful to that which lieth on the bowing for one alone will not keep it down sufficiently But if the Fracture be great and on a strong Joynt and Member then you must use four splinters which will be the safest way for splinters will hardly be so broad as to keep the roulers off from in-printing and when four splinters are laid then the bands or roulers cannot come so nigh to it on that splinter which lieth on the raised place or bulk lay another smaller splinter it will hold the stronger and spread a little of the Fracture salve to it that it may not slide away for if you lay two splinters one upon another the one must be broader than the other to keep that raised part the better in and will slide off the less Have a care you do not bind it too hard nor too slack the hard binding is dangerous and destructive to the Member causing an inflammation and dying and a slack binding is hurtful also but not so much as the other causing a crookedness in the healing when the band yeildeth and the Fracture begins to raise or to slide though that raising may be helped but not so well as when it had been done well at first the Patient must lie very quiet neither stirring or turning much be the Fracture in the Arm or Leg. Though I speak here of in-bowed Members think not that I mean onely such for hereby you have further information for all other Fractures be they broken in what manner they will for an in-bowed Joynt or bone requireth as much toil as if it were quite broken there is a very small difference between a Fracture and an in-bowed bone a Fracture requireth care that it stir not and go asunder but an in-bowed bone if once pressed or turned right will keep so but so doth not a Fracture especially that above the Elbow and that on the Thigh that striveth alwayes to get out again for these bones commonly are somewhat crooked naturally that is the reason why it doth not keep its standing and that bone is in some straighter than in others Now if you can set right an in-bowed bone much more may you do it in a Fracture an in-bowed bone well set keeps the place but a plain Fracture hath more wayes to get out again I have seen also that in the looking to it I was put to more trouble then I had at the first setting it right it is not so with
before there breaking in appear in some tokens which tokens a Surgeon ought to know if he intends to do good and get credit It deserveth more praise to prevent an enemies invasion and is sooner opposed then then when his armie is come into a land to be expel'd A Surgeon hath the more cause to be knowing in such Symptoms because there is such a variety of them which to rehearse is impossible If men in health are subject unto Symptoms what shall we say of wounded men there are some held for sound in whom many infirmities lie hid who being wounded fall into the wounds causing some fistula's cankers or the like which without a true process are hardly cured well and Surgeons may easily be deceived herein if not well expert in those wayes Situations of dwelling places either further or hinder such Symptoms foggy places are not so wholesome as those of a clear and pure aire And the same cause it is with the yeares seasons as also the weapons are of different natures whereby a wound is made some are poysonous others are not the former cause more dangerous Symptoms than the latter and one part of the body is more subject unto Symptoms than the other and so are men also according to their several complections Some patients cause Symptoms upon themselves with their disorderly course of life from thence several Symptoms within and without are caused which a good Surgeon ought to know else he will have but ill success in his curing of wounds These have been the stronger motive unto me to write of the Symptoms in wounds because that knowledge lyeth hid deeply whose names scarcely are known whose true knowledge is very necessary without which little good can be done of these I will speak in brief and plainly however fundamentally and really not having borrowed it from others but as I found them true experimentally my intention is to write of mine own and leave others to their opinion and it is fit every bird should wear his own feathers Setting other things aside I come to the things themselves CHAP. I. Of the Signes in general whereby Symptoms are duly discerned COurteous Reader before I come to speak in particular of Symptoms I will first rehearse some tokens in general whereby Simptoms may be known hoping you will be thereby enabled to conceive the better of them if you hear every Simptoms signe described in particular He that is wounded at the Dura pia Mater looketh horrible Signes of a wounded Brain when he beginneth to draw his mouth together then it is a figne that there is a cramp in the wound but if he stareth with his eyes it is a figne of an Apoplexie and of death if none of these signes are present and the patient is hot and his face is red it signifieth a Feaver or a disease of the wound is like to befall him But if all the said signes be at hand then nothing so sure as death But if the patient Wound-disease is besides these in a rage and furie then is he in a worse condition again if the patient looks pale in his face and is still and quiet then is he in the better condition If a patient still thinks that some body gapeth into his wound after he is A pulling wound drest it signifieth a Cramp unless the Surgeon have put too much of the resigne which runneth like Turpentine or any other Gum of that nature whereby he causeth that pulling or griping If a wound be in a flame when drest it signifieth that a A burning wound sharp humor is faln into it which eateth of the flesh already healed unless the Surgeon have put too many hot hearbs to his Salve or hath put to it too much of Mastick or gum Sarcocollae If a wound swelleth on the outer member and paineth the patient very much at the changing of the weather it signifieth A wound sensible of weathers a withering and consuming of the member delay no time to help it for if you should stay till the wound be healed afterward you will hardly bring that hurt to right A true Surgeon must understand and know aforehand and help before the hurt be done let him make use of exiccating medicaments If there be a swelling in an outward joint or member near the wound and is yet hard and doth not pain the party Swellings without pain and that wound healeth together from within then is it a sign that the medicaments are nought and will do no good though the wound be not unto lameness yet in this manner it will be made lame if the Surgeon goeth on in his applyed medicines if he perceiveth it then let him take better mecicine Viz. Of Storax Gum Opopanax c. This Symptome befals a joint-wound when stitched and afterward a poultesse applyed to it If a wound swelleth on an outward member and doth Signe of a Fstula not pain the party when touched and closeth and the more it closeth the more it swelleth it is a sign that a fistula groweth on if it pricketh much being felt and toucht it signifieth that a splinter of the bone would fain get out but if it doth not prick and seemeth to the patient as if he were toucht with an Iron it is a sign that a piece of an affthrusted bloud-vein would fain get out and the Surgeon ought to make vent but in case the swelling paineth the party sometimes and at other times it doth not at one time it is red at another it is pale it is a sign that a Cancer will come Signe of a Cancer into the wound if it doth gnaw a little and doth prick when it is not toucht and looks brown-red then is it a sign there is a Cancer in it already A wound that yeilded much matter at first and the party being well but afterward the wound begins to water I Water in a wound do not speak here of the joint water it is a sure sign that either a Cancer or a Fistula is coming but if the patient groweth dayly weaker it signifieth death If a wound inclineth to heal very fast and yet the party Hasty healings of wounds groweth daily weaker it is a sure sign of death such wounds are commonly purple-brown shrink commonly and it is an unnatural healing When wounded men are continually in a fright it is an ill sign if a tucking pulling be accompanied with it it is a Frights in patients sign that a wound-disease is coming and if any redness be joined with it it is a sign that the wound-disease is already Wound-disease Suddain pains at the door If suddain pains come into a wound and goeth away suddainly and the party can after it not stir the joint it signifieth that the Palsie is come into of that joint you may say that it will keep lame if no worse thing come unto which is to be feared If a Joint wound swelleth
spirit corroding the sinewes bringing them into putrifaction whereby great holes and pains are caused I have met with such a party who was hurt in his finger his Surgeon could not allay the joint water because the sinewes were corroded and eaten whereby holes got into the hand and from thence even to the elbow pieces of putrified sinews were taken out This joint water his Surgeon could not stay it run up into the arm further and came into the shoulder the party dyed miserably of it Here let Sugeons take notice not to set so slieght by the joint water and to stay it in time how that may be done you shall hear An expert Surgeon must not be terrified by the joint water because it is the excrement of sinews and white veins let him endeavour to stay it with proper medicines which if right and good they will stay it within five dayes and the running of it is chiefly caused by improper medicines applyed and by the patients disorderly life Note the joint water cannot be reduced to a corruption which among ignorant Surgeons hath begotten that fowle abuse which they commit in the staying of it and is still in practise for they suppose that it can be stayed with exiccating things therefore they used Terra sigillata Bolus calcined Shells bones of Pickrels Egg shells of new hatched Chickens vinegar of Sloes c. some being taught by the Hangman burnt Cotton wool and thurst it thus burning into the wound some use Cantharides whereby they make it known that they never knew what joint water meaneth else they would never go so dreamingly about so weighty a matter I must confess that the manuall is of as great consequence as any Receipt may be I reject none of the means which they have learned because the vehement course of the joint water requireth sometimes such hasty stenching But if such wounds be drest in the way I told you of the joint vvater needs not to be feared To stay the joint water you may best conceive by these examples in what manner it is done Examples A Carpenter hurt himself against a piece of Timber I know not in what manner he was drest at first the joint water run out abundantly at the wound and about the wound many holes fell in which the Barbar Surgeon drest alwaies with tents and in his thinking he had done well But the extraodinary pains grew so much on the patient that he was fain to change his Surgeon because he saw that things grew worse with him and he sent for me whom with good success upon Gods blessing I drest and cured thus I warm'd my brown ointment let it run into all the places of the wound filled them up therewith afterward I drest him vvith stiptick Plaister after the manner of an Opodeldoch that nothing may run out of the vvound this I iterated three times a day I kept the vvound vvarm also and applyed a defensive plaister This continuing a vvhile the joint vvater vvas stayed after that I vvent to healing and proceeded succesfully in the cure Note this Master piece accompanied vvith much advantage the brown Ointment a true Master-plece if you think the depth of the vvound be such that the bottom of it cannot be fill'd out every where vvith the ointment then take my brown ointment boyle it to such a spissitude that you may make tents of it â—hurst it to the bottom of the vvound cover it vvell that nothing of it get out again apply a stiptick Plaister to it the inthrust tent vvill melt in the vvound joyne vvith the joint vvater repelling it back and vvill stay it more than any other ointment made of greasie things for the joint water being humid receiveth not easily any greasie thing but expels it vvithout any operation done But that brovvn ointment made of Vitriol is not greasie and easily uniteh with the joint vvater and being sharp consumeth the tuffness in the humidity and vvorketh more effectually This is the mean and plain way whereby I stay the joint water making use of no other means in case no other Symptomes came into This is the reason why I mentioned so often this brown Ointment to be used against the joint water and other Symptomes You shall hear more of it hereafter when I come to describe how this brown Ointment is to be prepared CHAP. VI. Of the false Joint water that is when another humor is joined with the joint water whereby many Surgeons are deceived THere is no disease of the body which if a party be wounded will make shew of in the wound this maxime Wound-disease will not sink into many mens brains let experience cry never so loud By diseases the joint water or radical humor is falsified when other humors are mingled with it and are driven forth at the wound This deceiveth unexperienced Surgeons maketh theâ— misse in their cures I have seen Surgeons though they had good judgement in joint water yet such incident humors put them to great perplexity The joint water comes from white veins or sinewes and hath its colour as it is known if other sharp humors are Colour of joint-water what it signifieth joined with it then it looseth its own colour inclining to a whay-colour and is tuff like the white of an Egg sometimes it is of a â—uddy or flesh coluor sometimes it looks like oyle tinging the ravelings of linnen about the tents It is known by experience that the white colour of it brings the greatest danger commonly causing a Palsie to that member and the other humor joined with it hath its cause from the head The red matter which holdeth longest here intimateth a humor falling from the liver milt and reins The yellow water which causeth the greatest pains comes from the yellow Jaundice or from the gall If a Surgeon is about the staying of such a joint water and another humor be joined with it it is hardly repelled or stayed as long as these humors are joining with it Therefore Surgeons must endeavour to prepare their medicines Note the cure of the joint water accordingly that those humors coincident with the other may be taken away suppose the humor come from the head then the medicine must be Cephalical and so with the rest must be proceeded The manner of this cure is thus If a humor accompanieth white the joint water which came from the head then this subsequent remedy I found to be best for the party Viz. The fume of Storax Calamintha mingled with some Amber which the party took down at his mouth going to bed in a funible or pipe This may be used two or three dayes then look whether it do stay that white water if not then use it once more to cleanse the head the better of that white humor for that fume is very proper for the head item other specifica proper for the head may be used In the intrim let the wound be dressed as it
long time then it comes to an updrying because that sick member cannot digest that food which Nature afforded and causeth an oppilation in that member no marvail then if it withereth It falls out also when a member is wounded very deeply there may be incident there such an Ariditie because the natural balsam hath not its true course and it is impossible for Nature to skip over the wound and that which runs amisse doth not go well There may also fall a humor to a member which though it be not wounded yet it may be obstructed and so causeth an exiccation More causes could be quoted of such updryings but it is needless to do it because their cures differ very little for Acidities caused either by a fall blow thrust or by any other occasion all these are comprehended under one cure Those cold witherings by a shot fall c. whereby great pains and consequently a consumption of that member is caused that hath a peculiar cure differing but a little from the other it may be said of the rest also Touching such cures we will first of all speak of that which Surgeons call Aridum membrum caused by the running out of the joint water you must conceave that I do Cure of Arudum membrum not speak here of an aridity which is come unto an extreamity for that which one neither knoweth nor is able to cure why should he write of it I will speak here only of a consumed member which is not gone too far where there is yet great hope of its recovery Do it thus Take head feet lungs and liver of a Goat or of a sheep or Calfes gather cleanse the head and feet well from hairs wool c. put these together into a great pot put alike quantity to it of water and white wine let it boil that all the bones fall off from the flesh throw away the bones the rest cut small put it into that liquor it was boiled in boil it again to a mash with this liquor the patient must be fomented as hot as he can endure it But in case the withered member could not conveniently be bathed then spread that mash on a thick cloth apply it like a Cataplasm as hot as the patient can endure it assoon as that groweth cold then apply another of the same as warm as he can endure it That which was used must still be put into the pot that you may not want materials for Cataplasmes This must be continued so long till the patient confesseth that it hath warmed his member very well this warmth may hold half an hour or more which being done then take the following Ointment annoint the withered member at a coal fire do it downward still warming one hand after the other so long till the said member be warmed wel throughly then lay on it a plain plaister made of Wax and Hoggs grease that member and the patient must be kept warm forbear to use any Oxycroceum or other hot plaisters Go on with the former so long till you see and perceave that the member is at a mending hand and getteth strength When you perceave that all the pain is gone and that member beginneth to prove again then use other Ointments against shrinkings and updryings which are found at the Receipt for ordinary Consumptions and witherings all the skill lyeth herein to stay the consuming and to get to the member its natural nourishment which being brought to pass then you may easily go on with the rest The Ointmunt above named against withered members is thus Take Cranes grease Foxes grease ana â„¥ 2 grease of a young Hogg â„¥ 1 ss mingle these together make an Ointment and use it as you have heard Reader out of these you may gather what the fundamentals are of my cure about exiccated members which exiccation though it be a withering yet it differs from other exiccations in the cure For the medicines used here are not of hot qualities as those are which they use to other withered members Now this difference not being understood of those which undertake such cures how can it be otherwise but that many patients are spoiled and utterly und one I have much read seen and heard of withered members and made use also of such medicines that were usual then but afteward finding better I left the other some used to whip the dryed member with Juniper twigs or Horse tayles or with Nettles others rubbed the place with Sackcloth c. others annointed the party at a good fire others used Cupping glasses others used Fomentations c. all these wayes I do not condemn because my self made use of some of them I will inpart unto you my way with the reason thereof I hold the flesh of every sound body hath its growth from abundance of blood and natural humidity my chiefest endeavour was to imitate Nature herein and to restore flesh to a withered member and to convey blood and food to it by rarifying the same by stirring and monving it now by the lifting up the hand then by hanging it down in which way the blood is made to come forward and backward and by stroaking it may be lead further To which end I took in hand such a withered member and stroaked it downward not upward annointing each part thereof with Wound Ointment all downward and stroaked the blood and humidity down to the member in the manner of milking afterward rubbing the member so long till the very marrow in the bone was warmed thereby at which work my hands also were heated This stroaking downward to the hand or feet I continued for an hour bringing the blood into the fingers or toes and forced the blood to the extream parts as much as I could insomuch that the toes or fingers began to swell from the abundance of blood After this stroaking I applyed a warmed Oxycroceum well and thick spread laid it on gently only to keep to the part and let it have ayr and room enough for the blood and natural humidity to come unto That member I bid the patient alwaies to hang it down not upward that the blood may the easier get into I annointed the party twice a day which saveth toyling to the party when the member begins to grow again then the party felt no pain when annointed That witheredness caused by a fall and not by a fracture I have annointed twice a day if a member did consume away by reason of a cold or other simptom then I annointed it four times more than if it had been caused by a fracture If a hand or foot was swelled but the part above was not swelled I liked it well then I knew my labour would not be ill bestowed when that member felt a tickling or tingling it was a sign of healing and when that member at the undressings grew warm and the veins looked blew then I proceeded in the cure It fell out often that a great pain was come into
following drink be prepared for him Take of Cardnus Benedictus â„¥ 1 of Calmus â„¥ ¼ Flowers of Centorie â„¥ 1 ss Wormwood â„¥ ¼ Cinnamon â„¥ ¼ pour upon these six quarts of Wine let him drink of it and no other or a very little of Barley Water in case the party be very dry Thus the Sciatica will soon pass away make no doubt of it though the hip were out of joint it will soon turn inward again to its right place without any further purging fomenting wood cures and such like which are otherwise made use of in that case though to little purpose Thus I close this third part of Symptoms let no man imagine that I have written of all Symptoms because there are many which have not been touched at all neither was it my intent to do it But these are the chiefest and of greatest concernment he that knoweth these aright and can handle them well he may easily deal with the rest if so be he have judgement in Surgery Finis of the Third Part of Symptomes in Wounds The Fourth Part. Treating of all kinds of Balmes Slaves Plaisters Ointments Oyles Blood-stenchers Potions Tents Corrosives c. which are used for Wounds have been mentioned hitherto in the former parts of the Book How they are to be Artificially prepared and used well This Fourth Part is called the Book of Cookery COurteous Reader it is well known and found it so perhaps by your own experience that a bad Cook may spoile good Meats over or under seasoning them though in themselves they be good and wholesome yet by his bad cooking may be very unwholesome and on the other side Meats that in themselves are unpleasant and unwholesome may be dressed so that they may safely be eaten Even so is it with Medicaments and those that prepare them For Medicines which in themselves are good and usefull are by those which are to prepare them made pestiferous and unsafe to be used on the other side there are some Druggs which in themselves are naught and poisonous may in their preparation be so rectified that they prove wholesome and effectual Medicaments Therefore those that profess such an Art as to prepare Medicaments must do it so that their compounded Medidâ—caments may be proper and safely used to Wounds Sores Ulcers Fistulaes Cancers and that their Medicaments may agree with Wounds c. In consideration hereof I would not could not intermit to annexe to my practick of Surgery this fourth Part which for some reasons I call the Book of Cookery And that Novices in Surgery may know how to deal in Salves Plaisters Vulnerary Potions Ointments c. the which to do I am the more moved thereunto because in the precedent parts I named some Ingredients but did not set down the composition of them nor how they were to be prepared and directed the Reader to this fourth Part. Courteous Reader do not think that I will write of such things here which are known all the world over as how Oyl of Roses Oyl of Cammomil and such like are to be made which would not only raise the Book to a great Volum but would be needless also and superfluous therefore if I give only hints of Plaisters made of raw Druggs is the reason because their compositions are common and very well known Other things which do not lye so open as yet and their preparations are not known to every one these I will reveale and impart faithfully And then will I speak of things also which want corrections which though they be good yet have some bad things also for which cause they ought not to be ministred unto patients unless their good and pure things be first separated from their impure parts and that is commonly called correcting when a harmless thing is put to that which is dangerous which is a great fault to do so and be warned that you beware of it CHAP. I. Of Wound Balsams Ointments Plaisters Oyles c. and among the rest of that pretious Brown Ointment which was so often mentioned hitherto I Never made use of any distilled Wound-Balsams neither Distilled wound balsams do I greatly esteem them because usually they are too hot and are not only dangerous in Head wounds and useless in other wounds but also by reason of their too violent penetrating quality are poisonous to Head wounds But if sinews are cut in a member there I praise the red Oyl of Turpentine and hold it to be very good Use of redd oyle of terpentine Some Surgeons are accustomed to use Wound Balsams to all Wounds which I do not approve of advise them rather to forbear though many pretious Ingredients come to their composition yet they are made too hot in the destilling I like and approve better of Wound Oyles and of Wound Ointments than of Wound Balsams I know no Wound-oyles wound ointments other difference between them but onely that the Ointments are somewhat thicker and may more conveniently be carryed into other places for that reason I rather used Ointments for easier carriage sake and when I had use for them I dissolved and applyed them warm by letting them run into the wound Note also this difference about Wound Ointments some Clear terpentine Wounds are better pleased with this Ointment and others are dissafected unto it which may be seen by that when an Ointment causeth pains in a Wound for that reason I approve not so well of clear Turpentine to be used thus crude into the Wounds especially to Head wounds because it paineth them The dry Turpentine or the Gum of Larix is better for this purpose if it be well washed Of Wound Ointments in particular Note about Wound Ointments there are so many things used hereunto that they hardly can be named because Gumms of trees Surgeons hold this or that and as many heads so they varie herein Several sorts of Hearbs Roots Flowers Seeds Fruits are used hereunto also all sorts of Gums of Apple trees Cherry trees Juniper trees Mastick Frankincense c. Balsam of Apples c. Who is able to relate all What matter it is how many things are used to Wound Ointments as long as the Ingredients are good It is not so great a skill to heal wounds because one Salve or Ointment if good may heal many wounds though one wound is not healed so soon as the other yet it will be done in due time The chiefest thing is that a Surgeon have judgment in these things and be able to discern when any simptom is coming that it may timely be opposed or prevented Many Surgeons use these Gums Bdellium Opopanax Bedellium Opopanax Serapium Serapium and such like for to dresse wounds withal of which I do not approve because they are of too strong an atractive quality which ought not to be used to wound Ointments being more dangerous with their too much drawing Other Surgeons make use of Unguentum Apostolicum which is an absurd thing