or no being Cured and his Wound healed he be likely to undergoe and suffer the hurt Action of some one or other of his Members For so oftentimes it happeneth that some Tendon being cut asunder the motion of some part is wholly lost and that the Brain being wounded the Memory or Rational faculty is thereby hurt and Moreover whether the wound be likely to be Cured in a short or whether it wil take up a longer time But on the other side if the wound be altogether incurable whether it be Mortal and such as is likely to hasten Death or else whether it be not more probable that it will degenerate into some long continuing Ulcer And Lastly it must be foretold likewise whether the Changes and Alterations of the Wound will be for the better or for the worse and when these Changes wil be Now in the first place it must be diligently explained What Wounds are Deadly and what Wounds are not so For indeed this Question is of very great Moment and therefore most diligently and exactly to be weighed and known by the Physitian For whereas oftentimes the lives of some men are much hazarded and endangered when they are brought before the Magistrates in the publike Courts of Justice by Reason of Wounds they gave unto others and that oftentimes the Judges desire the Physitians Opinion touching the same great Care and a diligent Endeavour ought to be used that the Physitian give so true a Relation and so distinctly deliver his Opinion touching the quality of the said Wounds that the innocent may not be condemned nor the Guilty acquited But in the first place we are to know that not every Wound which hath Death following it is to be called a Mortal wound but that alone which in its own Nature bringeth Death Now such like wounds are twofold For Mortal or Deadly as Galen in the 5. B. of the Aphor. Aphor. 2. and Aph. 18. teacheth us is somtimes taken and understood of those wounds that are of necessity deadly and somtimes again of such Wounds as are so for the most part as Hippocrates speaketh and such as by Reason of which as the same Hippocrat maketh the limitation in the 18. Aphorism 6. Sect in Coacis or his tract of Playsters those that are wounded almost or for the most part die like as Galen in his 5. B. Aphor. 2. writeth that Deadly is to be taken for that that is dangerous and is oftentimes terminated in Death But the Question is here especially of the former kind for that wound that hath been at any time Cured in others cannot be taken for a wound simply Mortal and Deadly But we shall afterward tel you when it is to be taken and accounted for Mortal or not Mortal And therefore Secondly Wounds cannot be accounted simply Mortal whereupon the supervening of most grievous Symptoms which said Symptoms notwithstanding do not alwaies and necessarily follow upon the reception of these like wounds the wounded person dieth as when in the Wounds of the Joynts and the Nervous parts an inflammation Deliry and other Symptoms happen or that by Reason of a Cacochymy lying secretly in the Body a feaver is kindled upon occasion of the Wound And it is altogether most true that many things often fal out that render Wounds incurable which in their own nature were curable Like as neither are those to be accounted for Wounds simply Mortal the Curing of which is long protracted by Reason of which it at length happeneth that the Wounded person perisheth by a slow and lingring Death the same that happeneth when the Lungs being Wounded an Ulcer and the Consumption follow thereupon or the Thorax or Stomack being wounded which oftentimes after a long space of time become the Causes of Death unto the wounded person For whenas it hath been observed and known that these like Wounds have been healed in others they cannot then be accounted for Wounds simply Mortal But those Wounds are only to be reputed simply Mortal which in the space of a few hours or daies do necessarily bring Death unto the sick person and cannot be cured by any Art And therefore we are to distinguish between Wounds Mortal and Wounds incurable For all Mortal Wounds are incurable but all Wounds that are incurable cannot be said to be Mortal For Wounds incurable as we have told you are al those that though they cannot indeed be cured yet notwithstanding they are not suddenly the Cause of Death unto the wounded person since that although they cannot be healed yet nevertheless the sick person may after this live not only many Weeks but even yeers also And such a like Wound was that which Mathias Cornax in his Epistle Responsory unto Dr. Aegidius Hertogh and Julius Alexandrinus in his Annotations upon the sixth Book of Galen his Meth. of Physick Chap. 4. have described unto us For when as a certain Bohemian Boor as he was hunting received a Wound in his Stomack with a broad hunting spear it could not possibly be consolidated but yet in tract of time the lips of the wound became hardn'd by a certain Callousness growing over them so that the wounded person survived for many yeers after and by applying of an instrument he could at his pleasure evacuate his stomack And now in the next place let us see what Wounds they are that we may account to be simply Mortal or Deadly And now whereas Death happeneth upon the defect extinction of the Native heat and that the Native heat may in a twofold manner be extinguished either sensibly and by degrees as it is in a Natural Death and long continued Diseases as the Consumption and the like or else suddenly and violently the latter way it is that Wounds are said simply and necessarily to bring Death unto the wounded person to wit a violent one Now the innate heat is extinguished either because the vital spirits are dissipated or because they are suffocated And therefore all Wounds that are Mortal and of necessity cause a sudden and violent Death either they suddenly suffocate the vital spirits or else they dissipate and corrupt them But in regard that the Heart is the Store-house of the vital spirits and the Native heat first of all therefore the Wounds of the Heart of all others do especially and most speedily bring upon the Wounded Person a violent Death And the very truth is as Galen writeth in his 5. B. of the places affected and 3. Chapter if the Wound penetrateth unto the ventricle of the Heart especially the left the wounded person of necessity dieth suddenly but if the Wound penetrate not so far as unto the ventricle of the Heart but that it consist in the substance thereof the man may then indeed live for a while but yet nevertheless he must necessarily die this violent Death Secondly It is of necessity that the man die if some Vessel be wounded in that part of the Lungs that are next unto the Heart and
most grievous Epileptick Convulsion which in the space of âour or five hours ended his life And I my self also remember a certain Student stout hearted enough otherwise Who being by a Chirurgeon to be let blood in my presence and at my command as the Surgeon was about according to the custom to bind his Arm and began but to move his Instrument toward the vein he fainted away and fell from the seat wherein he was sitting before ever the Lancet was put neer unto his Arm whenas Nevertheless he had neither fever nor any other Disease that might any waies cause and occasion this swounding of his Eightly and Lastly an Inflammation following upon a Wound may render that Wound Mortal if it be internal For indeed an Inflammation doth not necessarily accompany Wounds yet notwithstanding because that in internal Wounds those Medicaments cannot possibly be administred that were wont to be applied in external if any internal part especially if it be more Nervous and of an exquisite sense shall chance to be wounded then a pain is excited and thereupon an afflux of Humors and from thence an Inflammation a feaver a Gangrene and other Evils do arise that destroy the Wounded person within a very few daies And from hence it is that the Vulgar do likewise in Wounds observe the seventh and the nineth day because that within these daies those Symptoms are wont to supervene and in these daies to bring the greatest danger unto the sick Party Some there are that add yet another Cause to wit the influence of the Stars And so Franciscus Vallesius in his Comment upon the 95. Text. B. 4. of Hippocr his Epidem saith that the Malignant Aspect of the Stars and Constellations is the Cause why light and very sleight Wounds are oftentimes likewise rendered Mortal And the very same Quercetan also tels us in his Third Chap. Touching Wounds made by Guns and that for this very Cause the Wounds of the Head are for the most part wont to be Mortal at Ferraria and Florence But this Cause is not to be admitted of neither can there any Reason be easily rendered why at Ferraria the wounds of the Head should be mortal and not so in the neer neighbouring Rhodigium or Bononia And from these Fundamentals no doubt it is that Civilians likewise take upon them to pronounce what Wounds are of themselves and in their own Nature Mortal and what not Nicolaus Boerius in the place alleadged N. 18. propoundeth six Conjectures from which it may be Collected that the Wound was not Mortal of it self but that it was made such by Reason of some accident happening thereupon The first is if the Wounded person died not until a longer time after then wounded persons are wont precisely to prolong their Lives The Second is this if there were present no dangerous Symptoms in the beginning of the Wound or if there were any present and remained for a while the sick person notwithstanding was not much the worse for them but that he was able to perform all kind of Actions in such a manner as they are not able to do that are mortally wounded For if he shall appear to be in a fair way of Recovery and then afterward die it is to be beleeved that he died upon some other Cause and not from his Wound All which notwithstanding are to be understood only of a Wound that is not of it self Mortal The third Conjecture is if the sick person in the Course of his life were not so ordered as wounded persons ought to be but that he exposed himself unto the cold Air addicted himself unto excessive drinking were often distempered with passions of the mind immoderate Anger frequent affrightments and overmuch addicted to Venery The fourth if the Physitians were of opinion and that they adjudged the Wound not mortal who as men experienced in their Art ought to be beleeved The fifth is if the wounded person had no Physitian with him or if any were sent for unto him he was one altogether ignorant and unskilful which is al one as if he had had none at all Which yet nevertheless as hath been said is only to be understood of a Wound not simply mortal in it self For if a Wound be in it self mortal albeit there were no Physitian sent for yet nevertheless we are not thence to collect that the wounded person might have been cured The sixth and last Conjecture is if the wounded person be of a strong Nature For in this Case if due care be taken in the preserving of the said Natural strength and vigour the sick person very seldom miscarrieth But if the Wound being not mortal the wounded person die and that in a short time we ought to collect that he died not of his wound but that he died from some other Cause as we said before And this is the Judgment of all Physitians in general touching Wounds both mortal and not mortal But yet there ariseth another Question among the civil Lawyers to wit whether the person that inflicteth the Wound may be found guilty and condemned of Homicide For these do not only as Physitians weigh and consider the quality and Nature of the wound but the minde and intention also of the party wounding and other Circumstances likewise touching which we may see more in the Books of these Civilians The Rest of the Prognosticks Now although that out of what hath hitherto been said may easily appear what is to be foreknown and foretold touching the event of wounds yet nevertheless we think it not amiss here to add somwhat more as touching the premises For although that other Wounds besides those we have already spoken of do not indeed suddenly destroy and kil the person yet nevertheless some of them are far more dangerous then other and even of these some are more easie some more difficult to Cure And this in the first place is to be learnt from the very substance of the part For the fleshy parts of all other are most easily brought together and sodered again the rest as the Veins Arteries Nerves Tendons and Membranes with more difficulty They may be united and made to grow together again but it will be more slowly Galen in his 1. B. of the Seed and 13. Chap. tels us than himself saw the Veins in the Head and those both many of them and great ones also grow again and in his 5. B. of the Moth. of Physick Chap. 7. that he saw an Artery also united Secondly from the Action and Use of the part For the more Noble the part is in regard of its more necessary Use and the Action that it performeth for the good of the whole Body so much the more dangerous are the Wounds of that part And those parts likewise that are in continual motion will not be brought to grow together again but with much difficulty And the more exquisite likewise the sense of the part wounded is the more easily upon its being Wounded
any further enquiry thereinto we wil therefore make the more accurate search after thereby to find out the Cause of an Inflammation in this manner following There would be no Tumor at any time generated in any part of the Body were it not that either its substance as it were boyling over with heat is poured out or that from without some new substance makes its approach For there are but two only causes to be assigned of the augmentation of the bulk and quantity in any thing whatsoever For either the radical moisture through an internal or external heat is resolved into an aery substance which as it is wel known requires a far greater space room for dilatation then formerly it had or else as we said before some new substance is extrinsecally from some other place superadded thereunto Now therefore of necessity it is that one of these two causes must be present when as in that hot and burning Tumor which we commonly call a Phlegmone the part is lifted up into a greater bulk than is ordinary or agreeable to the intention of Nature But now that the fervency and boyling up of the natural moisture or the effusion thereof is not the Cause appears by this because that every thing that is poured forth and converted as it were into spirits when it is cooled it assumes again its pristine quantity and as we may so express it puts off and laies aside the Tumor as by common experience it is most apparent But as for the parts inflamed let them be never so vehemently cooled yet wil they never return into the former state and condition nor ever cast off the Tumor or Swelling Furthermore if by reason of the effusion of the part and its conversion into spirits a Tumor should be caused in the part inflamed then necessarily upon the incision of the part the spirit should appear which yet as we see is nothing so but that rather there follows an effusion of Blood and the whole place by its colour and the looks thereof seems altogether full of Blood It remains therefore that the accession of some new substance is the cause of a Phlegmone But now that this new substance is the Blood appears from hence to wit that the Phlegmone is exceeding red both within and without Now this red colour is only proper unto and inseparable from the Blood Blood the nighest cause of an Inflammation for there is nothing that waxeth red in the Body beside the Blood and the Flesh which later notwithstanding viz. the Flesh cannot by any means be the cause of a Phlegmone For if the increment of the flesh were the cause of an Inflammation there would be indeed a Tumor or Swelling in the part yet so as notwithstanding the internal heat should remain sound and in an healthful plight without the least distemper and that also it should not in the least vary its pristine nature when as in no one thing that is augmented according to its substance the heat may properly be said to be heightned and encreased so far forth that the increment of the substance and quantity should any way differ from the change or alteration of the qualities But now the case is otherwise in a Phlegmone wherein the colour is changed and the heat grown to be more intense the said colour evidently demonstrating not only the quantity but likewise the quality of the substance Moreover that the Blood is cause of a Phlegmone may be manifestly evidenced by this that the place in the greatest Inflammations especially which now and then happen in Ulcers appears and seems all bloody round about which certainly would never be if blood were not the cause of the Inflammation Furthermore that Blood is Cause of the Inflammation that generating of the Inflammation which happeneth in Wounds doth evidently demonstrate For in new and fresh Wounds the Blood its true at the first flows forth but then afterward being compressed and kept in either by the hand or else with Ligatures or Medicaments that stop the issuing forth of blood or else lastly being suppressed and staid of its own accord it is then reteined either in the Orifice or Cavities of the dissected Vessels and there it is compacted and so wrought that it grows together like as clotted blood useth to do and there by a continued heaping up of the blood abundantly flowing thereunto it lifts up the part into a Tumor or Swelling and causeth an Inflammation An Inflammation what it is Since therefore the Conjunct Cause of an Inflammation is proved to be the Blood preternaturally flowing thereunto it is no hard matter thence to collect that an Inflammation is a preternatural Tumor of the fleshy parts as Galen in the place alleadged takes and understands the name of Flesh arising from the preternatural afflux of the blood and that therupon it must necessarily be hot red extended and accompanied with a kind of renitency or resisting property pain and pulsation or beating The manner how an Inflammation is bred But now that there may not be left to remain any the least obscurity about the nature of an Inflammation we will here add the manner also how a Phlegmone is generated and this we wil do out of Galen who in his Book touching the unequal Intemperies Chap. 3. hath in these words described it it is saith he a hot fluxion or flowing the which when it hath seized upon and seated it self in some muscelly part at first the greater Veins and Arteries are fil'd up and distended and next after them the lesser and so it is carried on untill that at length it arrives even at the least of them In these when the matter of the fluxion is forcibly impacted and cannot therein be any longer conteined it is then transmitted unto the outward parts partly through their own Orifices and partly by a percolation as it were and straining or sweating out of it through the Tunicles and then the void spaces which are betwixt the most principal parts are filled full with the fluxion And so all those parts or places are on all sides very much heated and overspread Those parts or Bodies are the Nerves Ligaments Membranes the Flesh it self and before al these the Veins and Arteries For whereas the Veins and Arteries run along unto each particular part by the which is received both nourishment and vital Spirit so long as the blood flows in a due measure and just proportion and is conteined within those its receptacles the part is not wont to suffer any Inflammation at all but then only when at the length the blood is overcopiously and all on a huddle emptied and poured forth into the substance of the part by the Veins and Arteries By which very thing also a Phlegmone is distinguished from other fluxions in which the matter is diffused without the Veins into the whole substance of the part and there doth distend and dilate it For in a Phlegmone although all the
parts are as I may so say embrued with blood yet notwithstanding there is a certain order observed to wit that some of the parts should sooner receive the fluxion and others of them not til afterward until that at length all of them come to be replenished and distended by the humor Now this kind of order wholly depends upon the natural distribution of the greater Vessels conteining the blood For whereas the Veins and Arteries when they first of all make their entrance into the aforesaid Vessels are evermore the larger and by how much the deeper they are distributed thereinto so much the less they are all this while there ariseth no Inflammation unless it so chance that the blood be emptied forth into those smallest Veins and again happen to fall out of them And this that hath been said manifestly appears unto those that by an exact and accurate inspection take a right view of those very little and almost imperceptible Veins that are branched forth and extended unto that Tunicle of the Eye which Oculists usually call Adnate or Conjunctive For these indeed do evermore convey blood unto the Eye for its nourishment and yet notwithstanding whilest that the Eye is free from distemper they are so exceeding smal that they can hardly be discern'd by the sharpest sighted Eye But then so soon as the Eye is inflamed those slender Veins are preternaturally replenished with blood then they shew themselves and become very conspicuous And it is most agreeable to truth that thus it should be also in al other Inflammations whatsoever they be But as yet there is no Inflammation present albeit the lesser Veins are even filled up with blood until that at length by and thorow them the blood be derived into the remaining substance of the parts which may be done two waies For in the first place the blood is emptied forth by those very smal and most inconsiderable orifices of the Veins by which the Veins do as it were gape open themselves into the surrounding substance of the part that so thereby the blood may through them the more easily drop forth for nutrition or nourishment Moreover likewise it strains and sweats through by the Tunicles of the Veins for even the Tunicles of the Veins are in like manner so framed by nature that they are not without their pores through which if not the blood it self yet certainly the ferosity or wheyiness thereof and its thinner part is exâudated or sweated forth by a kind of percolation From what hath been hitherunto spoken the distinction of the conjunct cause from the cause meerly antecedent in an Inflammation is sufficiently apparent For the blood which we have asserted to be the cause of a Phlegmone doth in a double respect take upon it self the virtue and Nature of a cause For either it is the next conteining and conjunct cause of which we have hitherto discoursed to wit as it hath already flown into the part and is irremovably impacted therein so far forth that it actually elevates that same part into a Tumor or else it is the antecedent foregoing cause to wit The antecedent cause of an Inflammation as by reason of its abounding in the body it hath a power of slowing into and by its influx of lifting up the part into a Tumor or Swelling The which antecedent Cause in an Inflammation like as also in other Tumors fals again under a twofold consideration to wit either in regard of the Affect simply considered as it is to follow upon this cause which it hath a power to excite although as yet it hath no being in the body And so a Plethory which is an extream and overgreat fulness of good and laudable blood is very frequently present in the body albeit an Inflammation doth not instantly ensue thereupon Or else secondly it is considerable as preceding and foregoing the affect that already hath a being and is already actually existent in the Body to wit when as the Blood now floweth to the exciting and augmenting of the Tumor Which to speak truth is more rightly stiled the antecedent cause then was the former since that this latter hath respect unto an effect already present but the former relates only unto an affect which hapneth in the future time But this antecedent cause that it may flow together unto the place affected it is thereunto moved and stirred up by other means whilst that it is either transmitted from some where else or else attracted by the part it self for those very causes we have hitherto been treating of and explaining But now for those Causes which we commonly term Procatartick The remote Causes more remote and primitive they are such as either conduce to the breeding of a copious and a plentiful blood as do al meats of good and much juyce an easie and idle kind of life and other such like requisites Or else they are such as render the blood more acrimonious and sharp as do all things that cause heat al acid and tart aliments wrath watchings stirrings and exercises in the extreme or else such as excite and stir up the blood to move unto the part affected as doth the overgreat heat of the part pain proceeding from a wound from a fall from contusion or beating from a fracture from disjoyntures and the like causes or else the weakness and imbecillity of the part affected receiving compared and considered in reference to the vigour and strength of those other parts which transmit the abundant store of hot blood unto the aggrieved part Notwithstanding an Inflammation never happeneth to be generated by a leisurely and gradual storing up of blood but it is evermore bred by a sudden and thronging affluence and influx of the said blood For although it may so chance that some kind of Humor may sensibly and by degrees be collected in some one part which being heaped up as aforesaid may afterward begin to excite a certain kind of pain in the part yet notwithstanding al this an Inflammation is never produced until such time as the pain gives cause sufficient that a more plenteous store of blood should forthwith and very easily make its approach Notwithstanding we are to take notice That although the Blood be the containing and antecedent Cause of an Inflammation yet notwithstanding we say that a Cacochymy or a depraved ill digestion and more especially sharp and cholerick humors are the prime and principal cause that the blood be moved unto the part affected in those Inflammations which are excited without any apparent cause as Wounds Contusions and such like For so it is That when Nature is twinged and pulled by such like Humors and yet notwithstanding is unable altogether to expel them out of the body to the end that she may free the principal parts from the danger impending by reason of them she assays to thrust them forth unto the external and less principal parts the which when it is not able to accomplish
and the very natural flesh it self wanting and that Ulcer is no simple and single Disease but a Compound one such as is conjoyned with magnitude augmented There may likewise together with an Ulcer be conjoyned divers other Diseases a Distemper an Inflammation an Erysipelas an Excrescent Flesh and other Diseases which yet notwithstanding belong not unto the Essence of an Ulcer but may be taken away the Ulcer stil remaining the essence whereof doth consist only in the solution of Continuity together with some kind of diminution of the part affected The Subject of an Ulcer is a part soft or fleshy The Subject the word Flesh being here taken in a large acceptation viz. not only for the Musculous flesh but for that likewise that comprehendeth the flesh of which the Intestines the Bladder and other of the Bowels consist and herein lieth the difference between it and the rottenness that is in the Bones The Causes The neerest Cause is any matter whatsoever it be that hath in it any corroding quality which comprehendeth under it not only the sharp humors that are bred in the body but likewise all those external Causes that have in them a corroding power such as are corroding Medicadicaments and poysons for it is false that which some assert that the very same Ulcers arise only from internal Causes since that experience teacheth us that the very same Ulcers may be excited also from external Causes And so Galen himself being witness in his fourth Book of the Method of Physick and Chap. 9. it is most apparently known even by experience it self that by the Fire scalding hot water Oyl and other the like fervent juyces in burnings and scaldings they are not Wounds that are excited but Ulcers like as also Medicaments and Poysons that cause putrefaction and burning excite Ulcers And so poysonous and contagious vapors breed Ulcers like as Scabbiness by contagion and infection breedeth Scabbiness to wit whilest the Contagion that is imparted and communicated unto the Skin corrodeth it And in the very same manner the vapors that are drawn in by breathing from the Lungs of Phthisical Persons do exulcerate the Lungs and by contagion do breed a Phthisis or Consumption And in the like manner upon the very same ground Venome and Venereal Poyson being rub'd and chaf'd into any body or by any means communicated thereunto infecteth and exulcerateth the same Neither is it of any weight or moment that Eustachius Rudius endeavoreth to reduce such like Ulcers as these rather unto Wounds then unto Ulcers For by this means he confoundeth altogether the Difference that is betwixt Ulcers and Wounds in regard that Ulcers Wounds do not differ only in this that Ulcers are evermore with a loss of some of the substance whereas Wounds may be without any such loss but likewise in that Wounds arise from some Cause that either cutteth into the part or pricketh it or breaketh or bruiseth it but these to wit the Ulcers proceed from a Corroding Cause whether it be external oâ whether it be internal And this is also manifest in Medicaments that putrefie for who can deny that to be an Ulcer that is excited from the Juyce of Spurge from the which said Medicaments that Contagion that is in Scabies the French Pox and the Phthisis or Consumption differeth but very little For although as Rudius there Objecteth we do not deny that such like Poysons have likewise in them a power of infecting the humors which being corrupted may afterward also promote these Ulcers yet notwithstanding we say that all power whatsoever of corroding is not to be denied unto this very Contagion it self although afterward when the corruption of the humors happeneth in the body the increase of the Ulcer be thereby much promoted and furthered The Differences The Differences of Ulcers some of them are Essential others of them only Accidental The Essential are those that are taken from the very form of the Ulcer from the Subject and from the efficient Cause thereof Those that are taken from the form of the Ulcer are drawn from its figure its magnitude and the like For some Ulcers are great others but smal some of them long others short some of them broad others but narrow some straight others again oblique wreathed in and fistulous some of them equal in which the flesh in all the parts of the place affected is equally wasted others unequal in which there is a greater part of the flesh consumed in this place and a less portion in another place of the same Ulcer From the part affected some Ulcers are said to be External others Internal some sleight and superficial others of them profound and deep and they may be in this or in that part The Differences arising from the Causes shall he shewn in the next following Chapter wherein our purpose is to treat of the Causes of Ulcers But now the Accidental Differences of Ulcers are those that are taken from such things as are without the Nature Constitution of the Ulcer and they are such as are taken from the scituation of the Ulcer or else from their time viz. that some of them are Recent and new others of them old and inveterate And hither likewise there may not unfitly be referred those Differences that are taken from Causes accidental and such as are not common unto all Ulcers to wit that some Ulcers are joyned together with a fluxion but that others of them want the said afflux that some of them are pure others of them sordid and soul corroding eating up and Creeping along For these Differences depend upon the Causes And hitherto likewise belong those Differences that are taken from the Accidents and Symptoms of the Ulcers to wit that some of them are altogether void of pain others of them accompanied with a pain an itching pricking and burning some of them easie to be cured others difficult and rebellious by the Greeks called Dysepulota some of them benign and favorable others such as have contracted a most pestilent and malignant quality And hither likewise are to be referred those Ulcers that they commonly call Chironia and Telephia And yet nevertheless besides these Differences that may be properly called such there may yet some others be given that are improperly so called and such as may rather be termed the Complications of Ulcers with other Diseases then Differences and such like Differences are these to wit that some Ulcers are conjoyned with Pain a Distemper a Phlegmone a Callous or Brawny Flesh a Gangrene a Cancer Worms and the Rottenness or Corruption of the Bones And the truth is the Differences and Distinctions of Ulcers are drawn from the Springs aforesaid But it being a truth likewise that some of the sorts of Ulcers are taken and drawn from divers and several Fountains that so we may not treat of Ulcers without any Method I conceive that our Discourse touching these Ulcers will be most Methodical if we handle them in the
unto my remembrance a certain Drink no doubt at the first brought thither out of Polonia that was much in use in my Country in the City Vratislavia and it is made of Bears-breech the vulgar cal it by the common Polonian name Barsiez or as the Germans pronounce it Barkech which those that are Feaverish and especially the great Drinkers after their excessive Cups the day before use in their broths and in their ordinary Drink to asswage their chirst Now it is made in this manner The Leaves of Bears-breech dried are boyled in a sufficient quantity of Water that the Decoction may get only a yellow and not a purple color Unto the Decoction there is added a little Leaven or Breâd twice baked made of the Pounder of Bears-ââch with the sour Leaven of fine white Bread ââd then for some certain daies set in a warm place where it gets a boyling heat and fermentation until such time as it hath contracted a caste somwhat tart and sour But now whether or no this kind of Drink hath a power of doing any thing toward the expulsion of the matter in this Disease we are to consult with Experience And it is their part who live in those places to make publick those Medicaments that use hath taught them to be fit and profitable that so al their Experiences being conferr'd together there may at the length be composed a Method of Curing this Disease But in regard that the Plica hath some symptoms common with the Scurvy such as are the pains of the Limbs Cramps and the like and that the aforesaid illustrious Count Nicolaus Sapieha was affected with both those Diseases I think it not amiss therefore here to place the History of his Disease which wil add some light unto what we but even now spake touching the Plica and to what we have likewise before in the third Book of our Practice written concerning the Scurvy The History of the Disease of that Generous and Illustrious Lord Count Nicolaus Sapieha Earl of Coden Chief Standard-bearer of the great Dukedom of Lituania c. This Illustrious Count without doubt contracted this his Disease of the Plica in his own Country from the same common cause from whence the vulgar have it but as for the Scurvy he got it from the many Errors by him committed in his Dyet during his various troublesom Journeys throughout almost al Europe and from the Quartan Feaver that followed upon the same For when in the heat of Summer as himself related the story unto me he had travelled over the Pyrenean Mountains out of France into Spain and in this his Journey had drunk good store of Wine out of bladders that was corrupt and ful of Vermin the Autumn following in Spain he fel into a Quartan Ague The long continuance whereof having made him impatient and being quite tired out with the tediousness of a Methodical Cure he committed himself unto a certain Soldier for Cure who took some certain Cups of the strongest Spanish Wine and into the same he puâs the pouder of al sorts of sweet Spices and this Wine he gave him to drink not only to satiety but even to Ebriety until he had made him almost drunk by which be kindleth within him a continual Feaver which indeed lasted not long and quite took away the Quartan but yet nevertheless imprinted such a Dyscrasie in his Bowels and humors that shortly after the Scurvy followed thereupon With which being grievously afflicted at home in his own Country and yet notwithstanding so that he could not wel tel what the disease was he made a Journey unto Padua and there he committed himself for Cure unto the most Eminen Physitians of that University But yet he recovered not that health and strength that he had expected and hoped for and thereupon he is sent back again home into his own Countrey with this following Consilium which we may term a Direction Advice or Counsel The Advice of that most Famous and Eminent Doctor Johannes Prevotius Chief Professor of Physick in the University of Padua TOuching the manifold Diseases that this Noble person lieth under it is neither my purpose at large to treat of them since that I am not ignorant that they have already been discoursed of by some of the most Eminent Physitians in their long and learned Disputes neither indeed wil either the state and condition of mine own health not yet sufficiently confirmed permit the same nor likewise the health and safety so much desired by this illustrious person for whom I conceive that help and assistance is far more requisite than word ând tedious Discourses I shal therefore with al brevity state and determine the whol case and ingeâââly declare unto you my Opinion touching the same not that I may interpose my Judgment in opposition unto the Opinion of these grave and learned men but that I may in some measure gratifie the request of this eminent person and if I may any waies possibly be serviceable unto him in procuring his health that I may not in the least be wanting in the discharge of the Duty and Office of a Christian It seemeth therefore unto me that this illustrious Lord is disaffected with a twofold kind of Diseases the one of them most manifest depending upon Causes that are commonly known and confessed the other occult and secret the Causes whereof are as yet obscure neither seem they hitherto to be sufficiently expressed by any There is manifestly appearing a Catarrh of matter that is thick tenacious white oftentimes insipid and tastless and very rarely sharp and biting flowing and falling down unto the parts of the mouth and somtimes also unto the stomack There is moreover an exetraordinary pain of the lower belly returning afresh after long intervals and Cassations with an astriction and costiveness of the belly and a certain grievous and painful sense of extension and stretching about the Region of the Navel of the Hypochondria especially the left and somtimes also of the Loyns which indeed is wont in great part to cease upon the plentiful Evacuation of the Wind and a snotty kind of Excrement that comes from him To these we may add the Nephritick distemper and want of rest and sleep this latter being indeed very familiar and frequent with him for he usually passeth many whol nights together without sleep and the former to wit the distemper of the Kidneys hath now of a long time sorely troubled him with a redness and heat of his Urine and excretion of sand and gravel with his water The causes of al which Maladies it is most manifest that they are derived from the evil constitution of the internal Bowels and the excrements of several sorts from thence arising For the Brain being overmoist not without much weakness of the innate hear contracted by reason of a great wound he received in it at Paris engendereth much flegm there being added unto al this in a special manner the consent of
that they contract these Clefts especially about the Joynts yet nevertheless this same happeneth somtimes likewise unto the Feet It may be Cured most speedily and most conveniently by this Unguent Take Litharge of Silver Myrrh and Ginger of ech alike parts bruise and pouder them very small and so with Virgins Wax Honey and common Oyl as much as wil suffice make an Vnguent unto which for the rendering it the more grateful to the smel Musk and Ambar may be added THE FIFTH BOOK THE FOURTH PART Of WOVNDS Chap. 1. Of the Nature Causes and Differences of a Wound AMong the external preternatural Affects of the Body and such as are obvious unto the senses there remain Wounds Fractures and disjoyntings of which we will now speak in order And First of all as touching a Wound that it is a solution of Unity in a part Bone and softer Cartilage is without al doubt and controversie But yet nevertheless it is sometimes taken largely and somtimes in a more strict sence Celsus taketh it in the largest sence of all whn in his fifth B. and sixth Chap. he thus writeth That Wound saith he is far worse and more dangerous which it caused only by a Bruise then that which is made by incisiom and dividing the part so that it is also far better to be wounded by a sharp and keen edged Weapon then by that that is blunt It is taken in a large acceptation when it is attributed unto all kind of solution of Unity made by any sharp instrument whether this solution be made by pricking or by cutting like as Galen in his Sixth B. of the Meth. of Physick the first and following Chap. calleth the pricking of the Nerves the wounding of them It is taken strictly when it is distinguished from a pricking that a wound is the solution of Unity in a soft part made by a Cut from any keen and cutting instrument but a pricking is that solution of unity that is caused in a soft part by a prick from an instrument that is cutting By which it appeareth that the solution of Continuity in a soft part is wider and broader then a Wound whether it be made by cutting or by pricking For Unity may also be dissolved in a soft part by a thing that is not sharp but only hard and heavy and this may be the Skin either appearing whole or even broken likewise which happeneth in those Wounds that are inflicted by Bullets from Guns Moreover also the Unity of the soft part may be dissolved by extension which in special in the similary parts is called Rupture but in the Compound Apospasma to wit when those fibrous Ligaments and Threads by which the parts are fastned together the one to the other being broken the parts themselves likewise become broken A Wound what it is By all which it appeareth that a Wound is the solution of Unity in a soft part caused by a cutting and sharp instrument But if as Guido in the Second B. of his Chirurgery and Fernelius in the seventh B of his Meth. of Physick Chap sixth rightly admonish us the Wound become sordid and foul and that some thing be by the Pus or filthy corroding matter eaten away from the substance of the wounded part then the Wound passeth into an Ulcer or certainly we may very well say that an Ulcer is conjoyned with the said Wound The truth indeed is that Rudius in his B. of Wounds and first Chap. doth impugn this Opinion but al to little purpose For neither is it absurd as he without Reason thinketh that one Disease should be changed into another or that one should be added and Joyned to another The Wound and Ulcer they are both of them the solution of Unity in the soft part buâ the Wound is made by section of cutting alone whereas the Ulcer is caused within it by Erosion and therefore it is that in an Ulcer there is somwhat that is lost from the substance of the part If therefore in a Wound of any part somthing shall be Eaten away and consumed from the substance of the flesh it is then altogether to be granted that now there is likewise present even an Ulcer also Which nevertheless is not so to be taken as though so soon as ever on the fourth day the Pus or filthy corrupt matter doth begin to appear in the Wound that then likewise an Ulcer may be said to be present For that said Pus proceedeth from the blood that is shed forth without the Veins or some Aliment that sticketh in the Capillary Veins and spaces of the parts neither is there then any thing Eaten away from the substance of the part But if there be so great an abundance of the Pus gathered together whatsoever the Cause thereof be that somthing be Eaten away from the substance of the part then it cannot be denied but that there is an Ulcer likewise present seeing that there are then present all things that are required unto the Essence of an Ulcer and in this Case the Cure is no longer to be ordered as in a single and simple Wound but as in an Ulcer But since that a Wound is to be accounted in the number of Diseases there may be enquiry made and that upon good grounds what actions they are that are hurt thereby Unto which it may be rightly answered that all the Actions of the said part and the severall uses thereof unto which the part is destined are hurt by the Wound whether that part perform those actions either as a similary or as an instrumental part That the Organical Actions may oftentimes be hurt by a Wound to wit when the part destined for motion is Wounded cannot be denied ât being a thing so manifest since that the wounded Member can no longer be moved in a due and right manner As likewise the Vein that is cut assunder can no longer convey the blood unto the part for the nourishment thereof neither a dissected Artery the vital blood and spirits or a Nerve the Animal Spirits But indeed the truth is that the temperament of the part is not next of all and immediatly hurt by the Wound but yet never the less it is mediatly hurt to wit when the Vessels being cut assunder and the blood poured forth the heat of the part is withal dissipated and the influx of the Blood spirits and heat flowing in this last being so necessary and requisite unto the temperament of the part is altogether hindred For all which Causes the attraction of the part the Concoction the Nutrition and the expulsion is hurt And from hence it happeneth that the temperament being changed there are more Excrements generated in that part then otherwise were wont to be And from thence also it proceedeth that the Pus is not presently generated in the very beginning of the Wound but afterward to wit about the fourth day when the heat of the part that was dissipated is again restored The Use is
that out of it store of Blood be poured forth unto the Heart overwhelming it and suffocating the heat thereof Thirdly Al the internal wounds of the greater Vessels that cannot by any art be closed upon regard they cause the Blood being plentifully poured forth either out of the Veins or the Arteries that the spirits be suddenly dissipated therefore of necessity they speedily suffocate the wounded person Fourthly All those Wounds are said to be Mortal that suddenly take away the Respiration and hinder the ventilation of the Heart so that the Native heat of the Heart is suffocated and so cause that the Man die even almost in the very same manner as Apoplectical persons are wont to die And such like wounds are especially the Wounds of the Brain but yet not all of them since that there are many Wounds of the Brain that are not Mortal as afterwards we shall shew you and as we have already told you in the first B. of our Practice first part and 23. Chapter But those great Wounds and such as are the Cause that the Animal spirits be suddenly dissipated or that the blood being poured forth of the Vessels the Orifice of the Nerves be quite stopped and so by this means the influx of the Animal Spirits be hindered or that from the same an inflammation of the Brain or a feaver be excited And this is not only done by the Wounds of the very Brain it self but likewise by the strokes and vehement Confusions of the Head by which the Vessels of the Brain and those neer about it are broken and the Blood poured forth of them unto the beginning of the Nerves and there subsisting hinder the influx of the Animal Spirits And this may also happen if the Sinus or hollow places of the Brain chance to be hurt so that out of them blood be poured forth unto the Basis of the Brain and so it is likewise in the Wounds of the Eyes if they penetrate so deep that they open either the Vessels of the Brain or those that are in the Basis thereof or those that are neer about the said Basis of the Brain and so that the Blood poured forth unto the Basis of the Brain hinder the influx of the Animal spirits by compressing the beginning of the Neryes For although that the Blood if it be poured forth above upon the Brain may possibly be emptied forth by perforating and opening of the Cranium or Skul yet nevertheless if it be poured forth unto the Basis of the Brain it is impossible that it should ever be evacuated There seemeth yet nevertheless to be another way whereby the Blood poured forth into the Brain or about the Brain bringeth Death within a vâry few daies if it cannot be evacuated For when as it is without the Vessels it beginneth to putrefie usually about the fifth day from whence feavers deliries and Convulsions are excited so that the man dieth in the same manner almost as one in a Phrensie That which is done by the Wounds of the brain the very same happeneth likewise from the spinal Marrow if it be indeed wholly cut assunder in the superior part thereof for then the motion of all the inferior parts and so of the Thorax likewise is abolished and the wounded persons are suffocated And unto one of these four waies I conceive that al kinds of Mortal Wounds may be referred And therefore if a Wound penetrate into any interior part of the Body so that thereupon the wounded person die within a short space of time we are then to Judg that that Wound was Mortal and if diligent inquiry be made I am of Opinion that it may be referred unto some one kind or other of these Mortal Wounds whether that Wound hurt the vital faculty it self immediatly or else hurt it by the intervening of some other Disease or Symptom For as Nicolaus Boetius writeth out of Felinus in his 323. Decision Numb 10. it is all one whether a Wounded man die of his Wound or of some infirmity caused by the same Which yet nevertheless is so to be understood if the Wound necessarily attract that Disease or that Symptom which is the Cause of Death But as for all the other Wounds whatsoever that cannot be referred unto some one of these manners I conceive that they cannot simply nor necessarily be accounted Mortal The which that it may be made the more plainly to appear we have it now in our purpose in special to weigh and discover unto you the Wounds of all parts that are to be accounted Mortal Now Hippocrates Judgeth the wounds of seven parts to be Mortal What Wounds accounted Mortal by Hippocrates whilest in his sixth Sect. Aphor. 18. he thus writeth Whosoever hath his Bladder out through or his Brain or his Heart or his Midriff or any of his smal Guts or his Stomack or his Liver that Wound is Mortal Which Aphorism notwithstanding in his Coaca or his Tract of Playsters Aphor. 509. he both Limiteth and Amplifieth when he thus saith From a Wound even Death it self may almost happen if any one be wounded in his Brain or in his spinal Marow or in his Liver or in his Midriff or in his Heart or in his Bladder or in any one of the greater Veins Death likewise soon followeth if any extraordinary great Blows be inflicted upon an Artery and upon the Lungs so that the Lungs being wounded the Breath that passeth out at the Mouth is less then that which issueth forth at the Wound But they suddenly perish whosoever they are that have received a Wound in the interior Nerves whether smal or g eat if the Blow or Wound be both Transverse and great but if the Wound be but smal and straight there are some that escape the danger But there is neither Death nor any great dangâr impending from those Wounds that are inflicted on those parts of the Body in the which there are none of these or which are as far distant at may be from these Indeed he limits the Aphorism whilest that he doth not simply write that such like wounds are altogether Mortal but almost and for the most part He amplifyeth it whilest that he addeth the spinal Marrow the greater and thicker Veins the rough Artery and the Lungs and the interior Nerves And therfore we wil in order consider the wounds of these parts For it is without doubt that the Wounds of the rest of the Parts are not at all of theâselves Morâal and this Hippocrates himself teacheth us in the above mentioned Aphorism 509. in Coacis Celsus in his 5. B. and 26. Chap. thus rendereth the foresaid Opinion of Hippocrates He cannot possibly be preserved that hath the Basis of his Brain his Heart his Stomack the parts of his Liver the Marrow in his Back-bone wounded or that person that hath either the middle of his Lungs or the Jejunum i. e. the hungry Gout or any of the smaller Guts or the Stomack or the Reins be
needeth no at all any Medicaments to cleanse it away and that after in process of time it is confounded and becometh one with the Pus and so is by Nature expelled forth together with the same Secondly For this Cause likewise the frequent uncovering of the Wound is held necessary in regard that there is somtimes need of Manual operation since that in the Cavity of a Wound there may be collected many Excrements that cannot possibly be purged forth by any Medicaments but they are to be cleansed away by the operation of the Hand Answer But now Caesar Magatus in his 44. Chap. denieth this and there determineth that the Excrements that are bred in a Wound may partly be insensibly digested by exhalation and partly by Nature sensibly expelled by the Wound when there is present a fit afflux and this no waies hindered and detained in the Cavity of the Wound Thirdly Wounds are therefore according to the common opinion often to be uncovered that so according to the various State and conditions of them various and different Medicaments may be imposed first of al Suppurating or Digestive Medicaments then Abstersive after that such as generate flesh and somtimes likewise such as take away superfluous and proud flesh and lastly such as produce a Cicatrice Al which seeing that they cannot possibly be effected by one only Medicament therefore the Wound is often to be opened that so unto every state of the wound fit and convenient Medicaments may be administred Answer Unto which Argument Magatus in his 1. B. and 44. Chap. endeavoureth to give an Answer to wit that this is indeed necessary in the old way of curing but not in his new way as being such in which the care of the Excrements is for the most part committed unto Nature her self and in his 37. Chap. he writeth that he is wont to commit the whole work to Nature and that it is sufficient that the Medicament serve instead of a covering and discharge the Office thereof by cherishing and defending the Natural heat and that the same Medicament may in all Wounds undergo the Nature of a covering and serve instead thereof And he saith that he himself hath observed that Wounds have been suppurated throughly purged and filled up with flesh by the help only of the ordinary and common Digestive Now he thinketh that the Medicaments cannot perform this any other waies then by their corpulency and bulkiness whiles that they hinder and forbid the efflux of the heat and defend the part from all external injuries but that it maketh no great matter what quality shal be adjoyned unto this corpulency especially in regard that for the most part such Medicaments are made choice of that are of a temperate heat and most agreeable unto our Nature And at length Magatus concludeth that by any Medicament of a convenient corpulency provided that it be not poysonous and corruptive or so sharp and Corrosive that it excite and cause a fluxion all hollow Wounds that are curable may be cured and filled up with flesh Fourthly It is therefore also thought that Wounds ought often to be opened and uncovered that so it may be known what the effect is of the Medicament applied and whether or no it be sufficiently drying whether the Wound be moist or not that so the driers may answer in a due proportion unto the moisture since that the more moist Wounds are to be cured with the drier Medicaments as Galen tels us in the third B. of his Method and 3. Chap. Answer But unto this Caesar Magatus and Ludovicus Septalius give this Answer that for the cause aforesaid there is no need at all of this frequent uncovering of the wound seeing that in this new way of curing the care of the Excrements is not to be committed unto Medicaments but unto Nature and the natural heat and our study must be only how to cherish this Native heat Fifthly And for this cause also the more often uncovering of the wound seemeth to be necessary that the state of the wound may be known and that the Symptoms that are wont here to happen may the better be prevented and those things of which Hippocrates maketh mention 1. Praedict Text 18. 5 Aphor. 65 66 67. 6 Aphor. 4. may be sufficiently known Answer Unto which they Answer that al those things may be known some other way and by other means as namely from the itching the heat the smel that comes from it the beating pain the terrible Feaver heaviness in the part and the like and that evermore the Eyes of the minde are sharper sighted and see more cleerly then the Eyes of our Body Sixthly And for this cause likewise the wound seemeth to require frequent opening that so the Swaths and little Pillows and the Linen clothes laid thereon may be wiped and made clean which Hippocrates in his B. of the Office of the Physitian Sect. 2. and Galen in his Commentary do both of them strictly enjoyn in regard that the filth and impurities of the Wound may excite an Itching Pain and at length an Inflammation Answer Unto which Septalius answereth and granteth that the Swaths may indeed be changed provided that the Wound be not uncovered Seventhly For this cause likewise the Swaths and coverings of the Wound seem to require often changing that so the hurtful Exhalations that are bred in the Wound may pass forth in regard that being kept shut in they disaffect the wounded part and alter the temperament thereof Answer But unto this also Magatus answereth that there is no necessity that the wounded part should have so many and such Linen Clothes put upon it neither that it should be so close and strictly bound up but that the offensive vapors might exhale and not be supressed And that if the Pus hath a passage forth much more then may the Vaporous Excrements be scattered and find a passage forth and that should they be stil kept in yet they never bring so much hurt and damage as cometh by the uncovering of the wound But in very truth that I may briefly shew you my opinion touching this controversie I will not in the least detract from the Reputation of these men Caesar Magatus and Ludovicus Septalius men so Famous and Eminent that they are not to be so much as named without due honor and respect and yet nevertheless I shal take the liberty to say that here in this controversie they seem to me to seek as we say a knot in a Bul-Rush and that there is not any sufficient cause to move them to find fault with that Ancient way and Method of curing of Wounds The general examination and inquiry into the Opinion of Magatus and Septalius and so to extol this new way of their own For first of all they themselves cannot but confess that in the old way of curing for so many Ages past many and the most grievous Wounds have been happily Cured And then again neither can they deny
Method had been practised For he himself oftentimes very rightly inculcates and writeth very cleerly that it is Nature that cureth the Wound and not the Physitian or Medicaments For if the Pus ought to be moved this is performed by Nature or if that flesh be to be generated and the broken bones to be strengthened by a Callus these are the work and business of Nature If the Wound be to be Agglutinated it is she that must do it and if the Excrements ought to be expelled this is likewise her Office And through the strength of Nature there happen Miracles oftentimes in Wounds Yea as he proveth in his 37. Chap. a strong Nature wil likewise bear out and overcome the Errors of the Chirurgeon committed in the Cure And so no doubt may those Chirurgeons that stil use the old way and Method of curing produce the like examples on their part That Student that was run through the Thorax his Lungs being withal wounded of whom we made mention in the 2. B. of our Practise 2 Part. Chap. 11. and a little above in the 3. Chap. of the Wounds of the Lungs was cured within the space of one Month the care of which Wound in regard that it was inward was chiefly to be committed to Nature and the cure thereof to be ascribed unto her and not either unto the old or the new way of Curing And Glandorpius relateth that a Wound of the Oesophagus was in twenty four daies drawn all over with a Cicatrice as you may find the relation in his Speculum Chirurgic Observat 30. And indeed I will in the next place most readily grant him that those frequent terebrations which seem somtimes to be instituted rather for the exercising of the Chirurgeons Body then for any need the Patient hath of them are not alwaies safe and that they somtimes bring more damage then benefit unto the sick person But yet that the Wounds of the Head are not to be uncovered before the fifth or the seventh day this I shall not so easily grant him seeing that such Wounds pass through divers parts and heap up divers sorts of Excrements and for the most part there is Blood collected between the Skul and the Membranes of the Brain which is therefore with al possible speed to be evacuated For which cause the Terebration also and the perforation of the Skul is somtimes necessary lest that this Blood if it be kept in putrifie and so cause grievous Symptoms Yea and as oftentimes it doth bring Death it self upon the wounded person which may likewise very easily happen if those Wounds should seldom be opened and cleansed Secondly The Reasons alleadged by Caesar Magatus and out of him by Ludovicus Septalius are of no great moment at least they carry not that weight in them that may perswade the rejecting of the old and usual way of curing Wounds First they mainly urge this and indeed herein chiefly consisteth the very strength and pith of this Opinion that the heat of the wounded part is to be preserved and they accuse Galen for that he hath omitted an indication of the greatest moment and that he hath troubled himself more then he needed in other things of far less moment and about the generating of Excrements in the Wound whereas if the innate heat be preserved there will be but very few Excrements bred and those that are will be such as can no waies hinder the glutination of the Wound Where we willingly grant and do confess that Nature as she is the Curer of other Diseases so she is the healer of Wounds likewise and that it is she alone and not the Medicaments that by the benefit of the Natural heat doth perform this glutination of Wounds and therefore that the innate heat and the natural temperament of the part is carefully to be preserved and cherished And this albeit that Galen hath passed it by in that place where he professedly treateth of the Cure of Wounds but whether he hath therein done well or ill I here dispute not yet notwithstanding in other places he often inculcates that there cannot possibly be any curing of the Wound unless the part obtain its own Natural temper and those very Medicaments which are called Sarcotick are provided for that very purpose the Conservation of the heat of the part as we said before in the precedent Chap. But here two Questions arise the first this whether the natural heat be preserved bettter in this new way or in that other old and wonted Method of curing and whether or no there be any necessity that more excrements should be generated in the old way then in this new manner of curing The Second Question is this whether the alone preservation of the Native heat be sufficient for the curing of the Wounds We deny both As for the First it shall be shewn in the following Arguments that the more rare and seldom opening and uncovering of Wounds is oftentimes more hurtful and prejudicial unto the Native heat then useful and serviceable thereto but on the contrary the more frequent uncovering of the Wound and as oft as there is need thereof is no way offensive unto the Native heat and that therfore it is not by reason of the uncovering of the Wound but by reason of the debility of the heat or the constitution of the part or the Body that those Excrements are generated For when there is blood poured forth in the Wound from hence it is that the heat and spirit is dissipated and the part rendered the weaker from whence it is likewise that in the Concoction that is made in the part there are very many Excrements generated And that somtimes fewer and somtimes more Excrements are generated in the Wound this is not therefore because that the Wound is more seldom or more frequently opened and uncovered but because the whol Body and the wounded part are more or less disposed unto the generation of the said Excrements But as for the Second to wit that the innate heat alone is not alwaies sufficient for the curing of the wound this is apparent since that there oftentimes so many impediments and obstacles cast in Natures way that unless they be by the Physitian removed and that indeed very frequently even every day Nature can by no means attain unto her end and drift The Pus first of all and the Excrements that are collected in the wound are to be evacuated and somtimes a passage forth likewise made for them as oft as need requireth by Tents and those Medicaments that cherish the heat dry up the Excrements and hinder the generating of them and help forward the Glutination of the wound are often to be laid on since that when they are once laid on they are soon defiled with the Pus and Sanies that is to say the thick and thinner Excrements of the wounds and thereby weakned and the virtue of them is likewise otherwise dissipated by the heat of the part And albeit
altered and at length the overgreat abundance of the blood is to be lessened and the vitious humors to be evacuated and this may fitly be done either by vene-section or else by purgation And therefore if blood abound in the body Venesection or blood letting so that therebe cause to fear the afflux there of unto the wound it is in this case unless it hath already before much flown forth very fit to open a vein and let forth a due quantity thereof Touching which Celsus in his fifth Book and 16. Chap. saith thus The Physitian ought to take forth some of the blood thereby to cause a dryness And presently he adds let the blood therefore flow forth more abundantly that so there may be the more abundant dryness but if it flow not forth sufficiently let the vein be opened as much as may be if it be so that the patient hath strength enough to bear this loss of blood And this is chiefly to be done in great wounds in which there is cause to fear an Afflux of the blood by reason of the pain of the Wounded part and here in this case blood is likewise to be drawn forth albeit that it doth not over-greatly abound in the body whereupon Hippocrates in his Book of the Joynts in the bruising and wounding of a Rib prescribeth the taking forth of blood out of the Arm where Galen in his Comment upon the place addeth Although saith he there be no extraordinary store of blood abounding in the body yet in those kind of blows and bruises we must have recourse unto vene section and letting out a due quantity of blood And in his second Book or the composition of Medicaments according to the places he commendeth in the first and chiefest place venesection for all pains of the head proceeding from a blow But now that this venesection may perform the whol work and that it may cause not only evacuation but likewise revulsion the vein is therefore to be opened a good distance from the part affected and on the contrary side as else where we have told you touching revulsion Now this is to be done with al speed possibly even the very first day of the wound and indeed before there be any medicament administred that so the afflux of the blood unto the wounded part may be prevented As for the quantity of the blood to be let forth it ought to be according to the store that is in the body and according likewise to the strength of the Patient and his ability to bear it And therefore if there flowed forth much blood before then venesection is to be omitted But if there flowed forth little or no blood before then you may now let forth a due proportion thereof but alwaies according to the strength of the Patient and no otherwise which you may best of al know by the Age of the wounded person the habit of his body the time of the yeer and other Circumstances touching which we have already spoken in its proper place But now if vitious humors abound in the body then there wil be need of purging Purging For it being so that the Wound is so much the more succesfully and more speedily cured by how much the more sound the part is and of a good constitution and that the ill constitution of the wounded part doth much hinder the cure we are therefore by all means possible to do our indeavor that so the vitious humors may not flow unto the part affected And thereupon seeing that by occasion of the Wound it may very easily come to pass that they may flow unto the part affected if they be found in the body they are forthwith to be evacuated And this is to be done in great wounds and where we have cause to fear lest that by reason of pain the depraved humors should rush unto the wounded part as also in those wounds where there is any kind of cutting or dilating to be used and where any bones is to be made bare of its flesh and in a word in al wounds whatsoever wherein the pain is more vehement then ordinary But smal Wounds and such likewise as are free from pain may be cured even without any purging but yet notwithstanding if the belly be bound it is then to be opened and loosened with a Clyster There are some indeed that are utterly against purgations in any wound whatsoever Whether those that are wounded may be purged as fearing lest that the humors being much stirred and disturbed by the sayd purgations should flow so much the more unto the wounded part But Hippocrates admitteth of them as we may see in his fourth Book of affections touching Fractures Text 48. Comment 3. and Galen in the fourth Book of his Method of curing Chapt. 4. and 6. And indeed reason it self perswadeth hereunto For if hot thin and cholerick humors abound in the body they render the blood very apt for motion and then by means of pain and want of rest they easily become hot and are inflamed and so afford an occasion for a feaver But now albeit that all the vitious humors abounding in the body are to be evacuated yet notwithstanding as we have sayd more especially the hot Cholerick and wheyish humors are to be evacuated which are more apt for motion and flowing and such as make much for the generating of inflammations and Erysipelases and such as do very easily excite feavers Even at the very first beginning a purgation is to be appointed to wit before ever there be any afflux excited and that any feaver shall happen But if there hath already happened any feaver purgation cannot then so conveniently and safly but indeed with some kind of danger be instituted and appointed And therefore to purge in Wounds there are most fitly and safely to be administred Manna Syrup of Roses Solutive Rheubarb the Leaves of Sene and of compositions Tryphera Persica Elect. de Psyllio Elect. of Roses of Mesues But we must abstain from the hottest purging medicaments lest that there should thereby be excited an afflux of humors that might dispose the wounded part unto an imflammation But in what manner the purgation is rightly to be ordered we have elsewhere already shewn you Chap. 14. Of the Wounds of the Veins and Arteries and of the stopping the Haemorrhage in Wounds AS touching the wounded parts themselves oftentimes by reason of them there is something that is peculiar to be done in the Curing of wounds How and after what manner the Cure of the wounds of private parts is to be rightly ordered we have already told you in those places which we shall afterward alleadg In the general the wounds of the Veins Arteries Nerves and Nervous parts do require a peculiar and proper kind of Cure The Haemorrage in Wounds And First of all indeed the Wounds of the Veins and the greater Arteries have this peculiar unto themselves to wit that there is alwaies some
Nerves ANd moreover the Wounds likewise of the Nerves Tendons and Ligaments are for the most part of such a Nature that somthing in the Curing of them may fal out that is peculiar and proper to them alone And first of all as for what concerns the Nerves as also the Tendons for what we shall speak touching the Nerves may likewise be applied unto the Tendons they are of another Nature then the flesh and therefore also as we shall afterward shew you they require other Medicaments then the wounded flesh doth and furthermore they have a very quick and exquisite sense as the Tendons likewise have and thereupon if they be hurt they bring great Pains and Convulsions Now the Wounds of the Nerves are twofold to wit Pricking and Incision according as the wounding Instrument inflicteth the Wound either by a Prick or a downright Cut. Signs Diagnostick Now the Wound of the Nerve is known first of all from the Consideration of the wounded place and from Anatomy which acquaints us with the Nerves that are in every Member and how they enter and are Scituate in them For which cause it is likewise to be considered whether the wound be in the Heads of the Muscles or in the ends of them and whether the wound be above upon the Joynts or else in the very Joynts themselves for if it be in the Heads of the Muscles it betokeneth that a Nerve is wounded but if it be in the ends and neer the Joynts it is a sign then that a Tendon is wounded And moreover from the vehement pain that immediatly after the receiving of the wound infesteth the wounded person unless the whole Nerve be cut assunder transverswise or over thwart For the Nerves have a very quick and exquisite sense and therefore when these are prickt there instantly ariseth in the wounded part a vehement pain and upon this an inflammation and so the Brain being drawn into a Consent oftentimes Convulsions and Deliries are excited But now the Tendons although they are not endued with a sense altogether so quick and exquisite yet nevertheless even these they being not wholly void of sense and feeling when they are pricked there are also pains and from thence Convulsions excited Prognosticks 1. All Wounds in the Nerves are dangerous by reason of that exquisite sense they have and their Consent with the Brain And yet notwithstanding a Wound by pricking is more dangerous then that that is made by cutting as afterwards we shall shew you 2. The Wounds of the Tendons are less dangerous then those of the Nerves 3. That Convulsion that happeneth upon a Wound is Mortal as we find it in the 5. Sect. Aphor. 2. Which is to be understood of the Wounds of the Nervous parts And yet notwithstanding the Greek word Thanasimon and the Latine Lethale as Galen explaineth it in his Comment do not here signifie that which of necessity and evermore bringeth Death but only that which is very dangerous and oftentimes causeth death 4. Those that with their Wounds as suppose those of the Nerves have conspicuous Tumors those are not greatly tâoubled with Convulsions neither with madness but those in whom the said Tumors suddenly vanish if this be done in the hinder part unto such Convulsions and the Tetanus do usually happen but if it be on the forepart that these Tumors vanish then there wil befal them madness a sharp pain in the side an Empyema and Dysentery if the Tumors be of a Reddish coâour Sect. 5. Aph. 65. 5. Yea what we find in the 5. Sect. Aphor. 66. and Which we have above alleadged touching wounds in general hath place here more especially to wit if the Wounds being great and dangerous there shall no Tumor be seen to appear it is then a very ill sign For in no kind of wounds are Inflammations more easily excited then in the wounds of the Nerves And therefore if there be present any Cause and occasion of a fluxion and yet nevertheless a Tumor shall not happen thereupon it is then a sign that either the matter is driven to some other place by repelling Medicaments and so deteined in the more inward and deep places and parts of the Body or else that they are by Nature her self thrust unto some other place 6. And yet notwithstanding there oftentimes appear no Tumors at all in such kind of Wounds to wit if the Physitian take away all the Causes of fluxion or if that Nature her self shall allay and asswage the violence of the Humor And there is alwaies ground of good Hopes if even unto the seventh day there shall follow no evil thereupon for it is a sign that Nature hath appeased the motion and the impetuous violence of the Humors touching which Galen in his third B. of the Composit of Medicam according to their several kinds and 2. Chap. thus writeth If unto the fifth or even unto the seventh day of the Disease there be neither Phlegmone so much as appearing and that there be altogether a freedom from pain and that the sick person feel no extension and stretching in the part affected he shall after this time be safe and secure 7. The wounded Nerves do very easily likewise conceive a putridness since that they have in them but a weak heat and are of a very dry Nature and so may be easily hurt by those things that are moist whereupon it is that Water and Oyl are enemies unto the Nerves Neither is that putridness and Corruption conteined in the wounded part alone but it is likewise communicated unto the neer neighbouring parts yea and oftentimes also unto those parts that are more remote Whereupon it is that the hand being wounded or but the Finger only the pains are wont to appear in the Arm and Shoulder and that the Leg being hurt there are wont to be in the Thigh not only pains but also Impostumations and that the Malady is imparted not unto one of the sides alone but even unto that also that is opposite Yea and in the whole Body likewise the Humors are corrupted whereupon feavers pains in the sides and Dysenteries are wont to be excited And that which we are here to give you notice of and not to pass it over in silence there are not evermore present signs that betoken an Inflammation or putridness yea and oftentimes there are likewise present no vehement pains but that very often secretly and suddenly the Convulsion invadeth the wounded persons For the vitious matter being thin and depraved is hiddenly carried by the Nerves unto the Brain as we see that this is done in the Epilepsie or Falling-sickness a poysonous Air ascending unto the brain from the extream parts without any notable pain in those parts by and through which it passeth Of which thing we meet with many examples and how that the wounded persons without any pain and Inflammation have been suddenly surprised with a Convulsion and have instantly died thereupon And therefore in the Wounds of
to be cured in that manner we told you of in its own proper place Touching the Inflammation Now very often there happeneth unto Wounds an Inflammation and somtimes likewise an Erysipelas And indeed an Inflammation doth most commonly if not evermore follow upon the inflicting of a Wound and more especially in the Nervous parts in regard that the afflux of Blood unto the part affected stirreth up and causeth a pain therein and moreover because that the Blood when it cannot sufficiently flow forth from thence it putrifieth and very easily exciteth an Inflammation which is prevented by a due and sufficient efflux of the Blood touching which Hippocrates thus writeth in his B. of Vlcers If there flow forth of the Wound Blood more or less according to the strength of the wounded person then both the Wound it self and those parts that are neer about it are the less troubled and affected with any Inflammation that shall follow upon the Wound And therefore if there be any cause to fear an Inflammation and if the blood hath not sufficiently flown forth then forthwith a Vein is to be opened in the opposite place and the Blood is to be evacuated according to the strength of the sick person and as he is well able to bear it Yea and moreover if there be already present an Inflammation and that the Patients strength will bear it and necessity so require Venesection and Purgation are both of them to be administred according as there shall be need If the Inflammation be excited from pain then we are to endeavour that the said pain be taken away and withal that the afflux of Humors be repressed Avicen for this use highly commendeth the Cataplasm that is made of the Pomegranate boyled in astringent Wine then bruised in a Mortar and so made up into the form of a Cataplasm There may likewise a Cataplasm be made of the meal of Barley of Sea-lentiles Mouse Ear and Oyl of Roses But if the Inflammation be not removed by these the rest of the Cure is then to be performed as we shewed you before in the first Part Chap. 5. Touching an Inflammation Of the Erysipelas If an Erysipelas follow upon the Wound this will soon appear from those Signs that we gave you in the first Part and 7. Chapter touching an Erysipelas And in what manner it is to be cured is manifestly declared by those things that are there spoken of And the truth is Hippocrates in his B. of Ulcers teacheth us that whensoever an Erysipelas shall follow upon an Ulcer that then the Body is to be purged And indeed if it be so that Choler abound lest that there should be an afflux thereof unto the Wound it will be very expedient wholly to evacuate the same And yet notwithstanding because that the Erysipelas which we cal Rosa hath its original rather from the thinnest of the Blood and that part of it that is peculiarly corrupted Sudorificks are therefore most especially useful as there we told you Hippocrates was wont to impose upon the part affected the Leaves of Woad or the Juyce thereof with Clay We may likewise apply unto the place affected Cataplasms of Barley meal and Eldern Water and other the like such as we have there mentioned to wit in the place before alleadged Of the Super-excrescent Flesh And sometimes likewise it so happeneth that the Flesh becometh Luxuriant and proud as we term it and groweth forth beyond all reason and measure which hidereth the production of the Cicatrice and its covering over of the Wound or at least it causeth the same to be unfightly and deformed But this happeneth through the unskilfulness or want of care in the Physitian who administred Medicaments that were not sufficiently drying And therefore what Flesh we finde to be superfluous we must take it away that so the Wound may be shut up with a Cicatrice But now this is the work of the Physitian who is to consume the superfluous Flesh with Medicaments that are sufficiently strong in their drying cleansing and if need so require somwhat Corroding likewise But now what those Medicaments are with which this may be done we have told you before in the 2. Part and 7. Chapt. whither we refer you Of all which Medicaments there mentioned the most useful and principal is the Green Water there spoken of which both consumeth the superfluous flesh and likewise bringeth the Cicatrice over the Wound when it is cured Of the Haemorrhage There happen also many Symptoms unto Wounds which partly deject the strength of the Patient and partly render the Curing of the Wound more difficult then otherwise it would have been And first of all there oftentimes happeneth indeed an extraordinary great Haemorrhage and profusion of the Blood which doth not only deject the strength and Spirits depriving the Patient oftentimes of his Life but it likewise very much hindereth the Cure For so long as the Flux of Blood lasteth there can nothing at all be done in the Cure Now that said Haemorrhage happeneth upon the wounding of the greater Veins as also the Arteries not only the greater of them but the mean and middle sort of these Arteries But touching this Symptom we have already spoken above in the 14. Chapter where you may see further Of pain with the VVound And oftentimes likewise there is an extraordinary vehement pain following and accompanying the Wound For although there be indeed hardly any Wound without pain yet nevertheless very usually this pain is tollerable and such as the Patient can wel bear But somtimes it is vehement and altogether intollerable which happeneth more especially when the Nerves and the Nervous parts are hurt and Wounded and an extream vehement pain arising immediatly upon the inflicting of the Wound is a sure and certain Sign and token that either a Nerve or a Nervous part is wounded The Cause Now this pain is excited in Wounds somtimes by reason of Errors committed by the Patient in the Course of his Dyet whiles he eateth all manner of bad and corrupt food as Cabbage and Cole-worts salt Fish Swines flesh or the like whiles he exposeth the wounded part unto the cold Air and moveth it overmuch by exercise And somtimes also this pain happeneth by the Carelesness of the Chirurgeon who administreth Medicaments that are overhot and too sharp hindeth the part too hard and streight placeth â not aright thrusteth into the Wound Tents over long or thick leaveth the Pus over long in the Wound and suffereth some piece of bone to prick and molest the part that lieth next unto it And somtimes also without any of these Causes a pain may be excited by an internal afflux of the Humors and this pain oftentimes invadeth the wounded person suddenly and with a certain unwonted coldness and Chilness and this is oftentimes a very shrewd sign of some great Inflammation instantly to follow or even of a Gangrene very nigh at hand and this especially if together with the pricking
from Christs Priestly Office 8. Satans Power to tempt and Christs Love to and Care of his People under Temptation 9. Thankfulness required in every Condition 10 The Spiritual Actings of Faith through Natural Impossibilities 11 Evangelical Repentance 12 The Spiritual Life and In being of Christ in all Beleevers c. Four New Books of Mr. Sydrach Sympson 1. Of Unbelief 2. Of not going to Christ 3. Of Faith 4. Of Coveteousness Mr. Hookers New Books in three Volumes One in Octavo and two in Quarto Mr. Rogers on Naaman A Godly and fruitful Exposition on the first Epistle of Peter By Mr. John Rogers Minister of the word of God at Dedham in Essex The wonders of the Load-stone By Samuel Ward of Ipswich An Exposition on the Gospel of the Evangelist St. Matthew By Mr. Ward THE CONTENTS OF THE Art of Chirurgery Explained in SIX PARTS PART I. Of Tumors CHAP. 1. Of the Nature Causes and Differences of Tumors Page 2401 Chap. 2. Of Tumors arising from Humors in general Page 2407 Chap. 3. Of Impostumes Page 2411 Chap. 4. Of extream Corpulency or overmuch fleshinss Page 2416 Chap. 5. Of an Inflammation Page 2420 Chap. 6. Of the Sinus in the Tumor Page 2441 Chap. 7. Of the Tumor Erysipelas or Rosa Page 2445 Chap. 8. Of a Bubo Page 2446 Chap. 9. Of the Tumor Furunculus Page 2448 Chap. 10. Of the Tumor Phyma Page 2449 Chap. 11. Of the Tumor Phygethlon Page 2450 Chap. 12. Of the Tumor Parotis ibid. Chap. 13. Of a Carbuncle Page 2453 Chap. 14. Of the Tumor Paronychia Page 2459 Chap. 15. Of Perniones or Kibes Page 2460 Chap. 16. Of the Tumor Ecchymoma Page 2462 Chap. 17. Of the Tumor Herpes Page 2467 Chap. 18. Of the Tumor Oedema Page 2470 Chap. 19. Of a Scirrhus Page 2473 Chap. 20. Of a Cancer Page 2476 Chap. 21. Of a Watry Tumor Page 2481 Chap. 22. Of Exanchemata Ecchymata Papulae Pustulae Phlyctenae and Eczesmata Page 2482 Chap. 23. Of Vari or Pimples Page 2484 Chap. 24. Of Sudamina and Sirones Page 2485 Chap. 25. Of Epinyctides and Terminthi Page 2486 Chap. 26. Of Essere Page 2487 Chap. 27. Of Scabies or Scabiness Page 2488 Chap. 28. Of Lepra of the Greeks Page 2495 Chap. 29. Of Vitilligo or Leuce and Alphus Page 2497 Chap. 30. Of the Tumors Impetigo and Lichen Page 2500 Chap. 31. Of Gutta Rosacea Page 2502 Chap. 32. Of Crusta Lactea Achores Favi Tinea Ficus Helcydrium Psydracia and Phthiriasis Page 2504 Chap. 33. Of Strumae and Scrofulae Page 2506 Chap. 34. Of Ganglium and Nodi Page 2507 Chap. 35. Of Meliceris Atheroma and Steatoma Page 2510 Chap. 36. Of Testudo Talpa or Topinaria and Natta Page 2513 Chap. 37. Of Verrucae or Warts Page 2514 Chap. 38. Of Cornua Page 2517 Chap. 39. Of Fungi Page 2518 Chap. 40. Of Tumors Malignant and Poysonous and in special of Elephantiasis Page 2520 Chap. 41. Of a flatulent or windy Tumor Page 2527 Chap. 42. Of Tumors proceeding from the solid parts falling down into or resting upon some other parts in general Page 2528 Chap. 43. Of Aneurysma Page 2529 Chap. 44. Of the swoln Veins called Varices Page 2533 Chap. 45. Of the Elephantiasis of the Arabians Page 2537 Chap. 46. Of Particular Tumors Page 2538 PART II. Of Vlcers Chap. 1. Of the Nature and Differences of an Vlcer Page 2544 Chap. 2. Of a simple or single Vlcer Page 2546 Chap. 3. Of an Vlcer with a Distemper Page 2553 Chap 4. Of an Vlcer with the afflux of Humors Page 2556 Chap. 5. Of the Sordid Putrid and Corroding Vlcer Page 2557 Chap. 6. Of an Vlcer with Tumors Page 2559 Chap. 7. Of proud flesh growing forth in Vlcers Page 2560 Chap. 8. Of an Vlcer that is wan and Callus ibid. Chap. 9. Of Vlcers that are hallowed and furrowed Page 2561 Chap. 10. Of Fistula's Page 2563 Chap. 11. Of an Vlcer with Vermine or Worms breeding therein Page 2568 Chap. 12. Of a Varicose Vlcer ibid. Chap. 13. Of an Vlcer with the rottenness of a Bone Page 2569 Chap. 14. Of Vlcers hard to be cured commonly called Cacoethe Telephium and Chironium Page 2572 Chap. 15 Of the Vlcer Phagedaena Page 2574 Chap. 16 Of an Vlcer with pain Page 2576 Chap. 17 Of the Vlcers of the Legs and other particular Vlcers ibid. Chap. 18 Of Burnings Page 2577 Chap. 19 Of a Gangrene and Sphacelus Page 2584 PART III. Of the Vices of the Skin Hair and Nails SECT I. Of the Vices of the Skin Chap. 1. Of the color of the Skin changed in general and in special touching that blackness that is contracted from the Sun Page 2598 Chap. 2 Of the Ephelides in Women with Child Page 2600 Chap. 3 Of Lentigines Pimples or specks in the Face ibid. Chap. 4 Of Cosmetical or Beautifying Medicaments Page 2601 Chap. 5 Of those they cal Mother Spots or Blemishes Page 2604 Chap. 6 Of the Volatick or flitting spots of Infants Page 2605 Chap. 7 Of the spots and blemishes that the Germans cal Hepatick or Liver-spots ibid. Chap. 8 Of the Itch Page 2606 Chap. 9. Of the ill and offensive Smel Page 2608 PART III. SECT II. Of things amiss in the Hair and Nails Chap. 1. Of the Nature of the Hairs Page 2611 Chap. 2 Of things amiss in the Hair and first of Baldness and want of a Beard Page 2613 Chap. 3 Of the shedding of the Hair Page 2616 Chap. 4 Of Alopecia and Ophiasis Page 2618 Chap. 5 Of Tinea or Worms eating off the roots of the Hair Page 2621 Chap. 6 Of the Cleaving of the Hair Page 2622 Chap. 7 Of hoariness in the Head and Beard ibid Chap. 8 Of the Scurfiness and Dandrif of the Head Page 2626 Chap. 9. Of Plica Polonica Page 2627 Chap. 10 Of the Vices of the Nails Page 2643 PART IV. Of Wounds Chap. 1 Of the Nature Causes and Differences of a Wound Page 2593 Chap. 2 Of the Diagnostick Signs Page 2595 Chap. 3 Of the Prognosticks and the foretelling of the Event of Wounds ibid. Chap. 4 Of the Cure of Wounds and first of all touching the Indications Page 2614 Chap. 5 Of things extraneous and from without that are to be taken forth of a Wound Page 2616 Chap. 6 Of the Provision that is necessarily to be made for the binding up of Wounds Page 2619 Chap. 8 Of the Swathing of wounded parts Page 2622 Chap. 8 Of those Medicaments that are necessary for the Curing of Wounds Page 2628 Chap. 9 My Judgment touching the Method of Caesar Magatus and Ludovicus Septalius in their Curing of Wounds Page 2639 Chap. 10 Of the Weapon Salve Page 2654 Chap. 11 Of altering Medicaments and Vulnerary Potions Page 2663 Chap. 12 Of the Diet of Wounded Persons Page 2667 Chap. 13 Of keeping the flux of humors from the Wounded part Page 2669 Chap. 14 Of the Wounds of the Veins and Arteries and of the stopping the Haemorrhage in Wounds Page 2671 Chap. 15 Of the Wounds of
beyond Natures intention and hath its production from somwhat that is preternatural and comes to be adjoyned to some one or other part Nor is it of any validity what Rudius here objects That in Tumors which have their original from the humors and those likewise which have for their causes the strutting forth and falling down of parts and such like that there the difference is to be taken from the efficient next and containing cause and that from this cause we may gain excellent artificial and profitable Indications but not so from the consideration of magnitude augmented For albeit they differ in the containing special cause that this is now and then an humor somtimes above and somtimes also an Intestine or Gut fallen down yet in the general cause they agree which is some one thing or other preternatural added unto the part and swelling it up into a Tumor And in every Tumor as it is likewise in al other diseases depending upon the cause containing no profitable Indicacion can be gained or may be expected from this cause no not in those Tumors which have their dependance upon the influx of humors For the general Indication though it be altogether useless is this that the humor which lifteth up the part into a tumor is to be removed but how and by what means this may be effected is wholly left unto the skil of the knowing Artist In the mean time I wil not deny but that those tumors which have their original from the humors may fitly enough be ranked among the diseases that are compounded of augmented magnitude distemper arising from the afflux of matter and a vitiated figure yet however this is not to be granted in al Tumors And hence it is without doubt that Galen hath placed the Tumors one while amidst the Affects of the similary parts as in the twelfth Chapter of the difference of Diseases and assoon again among those Diseases we call organical and this he doth in the thirteenth of his Method and first Chapter Neither is it to be denied That now and then Authors whilst they make mention of preternatural Tumors do not intend al Tumors in general such as are also those that are produced by the falling down of the bowels or by some boney substance sticking out but those in special which are caused by the afflux of humors and these are evermore diseases that may properly be said to be compounded of magnitude augmented intemperies an unmeet figure and most usually also the solution of Unity The Cause The containing Cause of a Tumor as we take it in the general is somthing beyond Natures intent added unto a parâ which elevates distends and swels it up to a more than ordinary greatness The Difference Now the matter which we say is added being threefold to wit a Humor a Wind and a solid Substance the primary Difference then of Tumors ought to be taken from that which we commonly term the Containing Cause Tumors then are somtimes thus differenced that some are great others not so some external some internal some new others that are of longer standing But these differences are meerly accidental denoting a certain mutation or change and an alteration of the condition but the species oâ kinds they vary not in the least But the differences specifical and which constitute the several kinds are taken from the matter and the containing Cause which is threefold as hath been said First of al therefore Tumors derive their very being from the humors but these as yet have not obtained any peculiar appellations to be called by but at leastwise are al of them comprehended under the general name of a Swelling yea as some say they are only called Tumors Secondly Winds it shut up in any part distend the same and lift it up into a Swelling or Tumor and this sort of Tumors the Grecians cal Emphysemata the Latines Inflationes by reason of their windy original In the third place now and then somwhat resembling flesh or skin or that is hard and solid as a bone and other such like matter is super-added unto some one part and there causeth a Tumor or Swelling But in regard that these very substances have their original from the humors we will thereupon adjoyn this sort of Tumors unto the first kind And lastly even the very solid parts of the body themselves cause Tumors whenas they change their place together with their scituation and slip down upon some other part which they both distend and elevate neither have these any peculiar names to be known by There are yet some other differences behind From the quality of the concomitant matter some are said to be hot others cold some moist others dry some soft and loose others hard From their magnitude the greater of them are by a general name simply called Tumors the less Tubercula From their scituation that some are internal others external and these again either more deep and profound or else superficial From their figure some of them are said to be broad others again sharp-pointed But now to comprehend al those differences of Tumors under names and to give you the number of them is not very easie to do Galen in the close of his Book of Tumors writes That there was not any one kind of these preternatural Tumors which there he had omitted but that he had spoken of them all and had not left any one unmentioned And out of that Book Johannes Philippus Ingrassias in his Book of tumors first Tract first Chapter and second Commentary pag. 77 hath collected Sixty one Tumors which he reckons up in this order 1. Corpulentia 2. Phlegmone Tumors their number and names according to Galen 3. Abscessus calidus 4. Sinus 5. Fistula 6. Abscessus ex solidis humidisve corporibus that is to say an impostumated matter issuing from solid and moist bodies 7. Atheroma 8. Steatoma 9. Meliceris 10. Anthrax 11. Cancer 12. Gangraena 13. Sphacelus 14 Erysipelas 15. Herpes similiter 16. Herpes Esthiamenos 17. Herpes miliaris 18. Scirrhus 19 Ecchymosis 20. Aneurisma 21. Oedema 22. Phagedaena 23. Vlcus Chironium seu Telepium 24. Scabies 25. Lepra 26. Elephantiasis 27. Exostosis 28. Satyriasmus seu Priapismus 29. Achor 30. Cerion 31. Myrmecia 32. Acrochordon 33. Psydracion 34. Epinyctis 35. Dothien 36. Phyma 37. Bubon 38. Phygethlon 39. Struma 40 Sarcocele 41. Hydrocele 42. Epiplocele 43. Enterocle 44. Entero epiplocele 45. Cirsocele 46. Varices 47 Bubonocele 48. Exomphalos 49. Ascites 50 Tympanites 51. Anasarca 52. Epulis 53. Parulis 54. Thymus 55. Vva 56. Paristmia 57. Antiades 58 Polypus 59. Encanthis 60. Vnguis 61. Staphyloma But Ingrassias himself not content with this number Tumors their number and names according to Ingrassias Tumors of the Head are twenty seven adds unto these one hundred sixty five more to wit of such properly belonging unto the head twenty seven the which in page 301. he enumerates after this manner 1.
Eczesma 2. Elcydrion sive Papilla 3. Sycon that is a Fig or pushes in the head resembling it 4. Exanthema that is an Ulcerous blowing out like a flower 5. Ganglion 6. Hydrocephalus 7. Syriasis 8. Phrenitis 9. Lethargus 10. Typhomania seu agrypnon coma 11. Catochus Pauli 12. Catalepsis seu Catoche 13. Carus 14. Apoplexia 15. Rhia alsabian 16. Sibare 17 Fatera 18. Sekakilos 19. Testudo 20. Talpa 21. Topinaria 22. Lactumen 23. Cornu 24. Alopecia 25. Ophiasis 26. Pityriasis 27. Phthiriasis Those properly belonging to the Eyes and the parts thereof Tumors of the Eyes and their parts 63. sixty three which in page 351. he reckons up in this order following 28. Proptosis Galeni sive ecpiesmos Pauli 29. Taraxis 30. Ophthalmia 31. Epiphora introductorii 32. Chemosis 33. Xerophthalmia 34. Sclerophthalmia 35. Scirrhophthalmia 36. Phlyctaena 37. Bothrion 38. Coeloma 39. Argemon 40. Epicauma 41. Encauma 42. Myocephalos 43. Melon 44. Clavus Pauli et Aetii 45. Clavus introductorii Celsi 46. Hypopyon 47. Onyx that is Vnguis a Nail 48. Hyposphagma 49. Achlys Aetii 50. Nephielion Aetii 51. Vla or Nephelion 52. Leucoma 53. Sebel 54. Bothor Avicennae 55. Hymene panastasis 56. Nyctalopia 57. Anthracâsis 58. Carcinoma 59. Synchysis 60. Mydriasis 61. Proptosis Pauli 62. Ptylosis 63. Madarosis or Milphosis 64. Pladarotes 65. Emphyspma 66 Symphysis or Ancylosis 67. Eutropion 68. Laâ ophthalmos 69. Trachoma 70. Sycosis 71. Tylosis 72. Dasyma 73. Pachytes 74. Barytes 75. Hydatis 76 Psocophthaâmia 77 Truhe 78. Thalazion 79. Porosis 80. Litâiasis 81. Alanâisac 82. Sude Avicennae 83. âarcosis 84. Lupia 85. Mydesis 86. Pustula Abenzoaâis 87. Scleriasis 88. Anchilops 89. Aegylops 90. Epinyctis Plinii And ãâã these he mentions many more in other parts Tumors in all other parts of the Body 97. to the number of ninety seven and in this following order he sets them down 91. Auritus 92. Parotis 93. Pherea 94. Ozaena 95. Sarcoma 96. Theluâ Albuc 97. Alharbian Avicennae 98. Chaisum Arabum 99. Haemorrhoides Arabum 100 Batrachos 101. Glossomegethos 102. Ancyloglosson 103. Aphtha 104. Cynanche 105. Paracynanche 106. Synanche 107 Parasynanche 108. Gongrona 109 Folium 110 Bronchocele 111 Alhadal 112 Dionysisci 113. Hypopion 114 Jonthi or Vari 115 Montagra 116 Ephelis 117 Ignis sylvaticus 118 Noli me tangere 119 Buttizaga 120 Gutta rosacea 121 Sparganesis 122. Chondriosis 123 Trichiasis 124 Gynaecomaston 125 Pleuritis 126 Peripneumonia 127 Phtoe 128 Althahalop 129 Napta 130 Cyphosis or Cyrtosis hybosis 131 Lordosis 132 Scoliasis 133 Coeliacus 134 Aurys Rasis 135 Colica 136 Hâos 137 Condylomata 138 Haemorrhoides 139 Marisca 140 Hepaticus 141 Cachexia 142 Altherel Bellunensis 143 Thelegi 144 Altherbel Bellunensis 145 Splenicus Aureliani 146 Nephritis 147 Lithiasis 148 Satyriasmus Pauli 149 Cercosis 150 Mola 151 Nymphomegethos 152 Kion Hippocratis 153 Seliroma Pauli 154 Arthritis 155 Podagra 156 Cheiragra 157 Ischias 158 Lupia Guidonis 159 Tophi 160 Cornua Avicen 161 Ancylosis or Ancyla 162 Paâonychia 163 Pterigion Celsi 164 Condya 165 Perniones 166 Gemursa Plinii 167 Dentes muris Bellunensis 168 Alliathan 169 Lupus 170 Dactilia Haliab 171 Malum moriuum 172 Terminthos 173 Emphysema 174. Phlyctaena 175 Turmusios Avicen 176 Impeâgo 177 Essere 178 Palmos 179 Clavus 180 Calli. 181 Aegritudo bovina Abenz Albuc 181 Dracontium 183 Syrenes or Pedicelli Guâdon Argelatae 184 Variolae 185 Morbilli 186 Rubeola 187 Crystalli 188 Exanthemata 189 Ecthymata Fernel 190 Hidroa or Sudamina 191 Epinyctis Romanorum 192 Bothon lenes 193 Ganglia 194 Seps Hippocr 195 Spina ventosa 196 Bubasticon Vlcus 197 Hypersarcon 198 Cacoethes 199 Sepedon 200 Nome 201 Therioma 202 Herpes Esthiamenos Celsi 203 Herpes ecthiomenos Avicen 204 Thymion Celsi 205 Ignis sacer Celsi 206 Cerion Pauli 207 Paratrimmata 208 Aposirmata 209 Zerma 210 Rancula 211. Spina 212 Morsus Diaboli 213 Patursa that is Morbus Gallicus 214 Scopuli 215 Tincosati 216 Pinitae 217 Spili 218 Tusius Aviceââ 219 Eparma Hippoc. 220 Rosboth 221 Cunus Rasis 222 Albothir Albucasis 223 Nakir Albuc 224 Alchalan Abenz 225. Arcella Abenz 226 Rosulae sataritiae So that the number of all the Tumors recited by Johannes Philippus Ingrassias amounts unto two hundred twenty six But that Entities should be multiplied in this manner without any cause is altogether unfitting For as al the affects which are here reckoned up under the name of Tumors are not properly to be accounted Tumors besides that one and the same Tumor is somtimes repeated under different names So again Ingrassias having not at this time compleated the remaining Sections of his Works concerning Tumors it is not sufficiently apparent what Tumors he would have us to understand under some of these names Now for the truth of this that I may give you an instance or two of what hath been said he reckons up among Tumors Sinus and Fistula Vlcus Chironium and divers other Ulcers But before or since Ingrassias who hath there ever been that hath taken the liberty or made so bold to enumerate among the Tumors that are properly so called such as are these following viz. Lethargus Typhomania Catochus Catalepsis Carus Apoplexia Lordosis Coeliaca affectio Colica Affectus hepaticus Splenicus and other such like Affects which relate either to Symptoms or the kinds of other Diseases rather than unto Tumors And in very truth many of the Tumors wherewith this Catalogue is stuft are not peculiar kinds of Tumors but only differences of their species according to the parts affected Tumors their Differences Now therefore we conceive that there are two main Differences especially to be heeded in Tumors one whereof ariseth from the variety of Causes and the other is by reason of the parts affected We have said before that the conteining cause of a tumor is threefold a Humor a Wind and a solid Substance Again the humors are various much different to wit Blood Phlegm Melancholy a black humor a waterish and wheyish humor and divers other thin excrements as also mixt humors and matter into which other humors degenerate and likewise malignant humors From the Blood there is caused an extraordinary Corpulency which the Greeks call Polysarcia and an Inflammation Their Cause containing There are likewise that refer a Gangrene a Sphacelus unto an Inflammation in regard that an Inflammation somtimes degenerates into them But because that a Gangrene and Sphacelus do very often proceed from other causes without an Inflammation and have not alwaies a Tumor to accompany them and are of neerer alliance unto Ulcers very usually degenerating into them we wil therefore treat further of them anon when we come to speak of Ulcers But with more right it is that unto an Inflammation we refer an Erysipelas or Rosa as it is commonly termed Bubo Furunculus Phyma Phygethlon Parotis Carbunculus Paronychia Perniânes Ecchymosis as afterward from the special Explication of these Affects wil
further appear From Choler is produced Herpes and its differences From the Pituitous or Phlegmy humor proceeds Oedema From the Melancholly humor Scirrhus From black Choler Cancer From the watry humor Hydrocephalus Hernia aquosa But of the wheyie humor and the thin excrementitious matter called Ichores from which various less swellings by the Latines called Tubercula do arise there is a very vast difference and oftentimes these ferous and wheyie humors as likewise the salt and cholerick humors are mingled with other and from hence originally proceed divers Wheals or Pushes in the âkin as to instance Psydrasia Vari Sudamina Spinyctides and Terminthi Essere Arabum Elcydria Scabies Lepra Graecorum Vitiligo Impetigo and Lichen Crusta Lactea Achores Favi Tinea with many other of the like Nature Moreover from the humors there is derived also a certain peculiar kind of tumors yet nevertheless differing from those we have hitherto made mention of in a twofold respect The former difference lies in this that it proceeds not from one single humor but from more to wit Phlegm I mean such as hath other humors Melancholly or Choler mixt therewith yet notwithstanding so that the cause conjunct may not any longer be said to be an humor but some other matter generated from out of those humors The later difference consists in this that the aforesaid matter is included in some one peculiar Membrane Tumors of this sort are Strumae and Scrofulae Bronchocele Ganglia Nodi Melicerides Atheromata Steatomata Testudo Talpa and Natta Out of the humors likewise where you are to understand such humors that degenerate into another matter take their rise and original those tumors which the intelligent Artist cals Polypus Pamela sub lingua bernia carnosa Verrucae Fungi and others the like There are moreover tumors that have their very being from malignant humors and these are Variolae Morbili Lepra as the Arabians or Elephantiasis as the Greeks name it Tumors Venereal of different kinds Bubones and pestilential Carbuncles From flatulency or windiness are derived Emphysemata as the Grecian Authors or Inflationes as the Latines call them and all other flatulent tumors whatsoever From the solid parts lying out of their proper places arise Hernia in the Cods and Navel when the Intestines fal down thither Epiplocele And hitherto also is to be reduced Aneurisma a tumor that hath its original from an Arterie dilated as in like manner Varix being a tumor from a dilated Vein From the Bones proceeds that which we term Exostosis and from the Vertebrae or turning Joynts of the Back when they stick out is caused Gibbositas like as in other parts also tumors arise when disjoynted or broken Bones slipping out of their own place happen to fal down thither But now those tumors receive various appellations by reason of the part affected of which enough hath been written already in its due place And moreover as concerning divers of these Tumors this is to be taken notice of that very many and that in most Countries have indeed been not a little infested by them and that they have been likewise as ordinarily cured of them but yet notwithstanding what the German Italian French Spanish and other names of several Nations are and unto what names of the Grecians Latines and Arabians they may fitly answer is not alwaies manifest which very thing hath exceedingly perplexed and puzled the studious Physitian in his perusual of Authors And of this also Johannes Philippus Ingrassias who took a worlâ of pains in comparing together and explaining the Greek Latine and Arabian names extreamly complains as wil appear by what he writes in his Book of tumors Tract 1. Chap. 1. page 220 after this manner I cannot but exceedingly admire and withall greatly lament the so great unhappiness of our Age in the which we are evermore infested with divers and almost innumerable kinds of Diseases and day after day are sadly afflicted especially more with this kind of Tumor he here speaks of Dothien or Furuâââlus by reason of an unwholsome and corrupt kinâ of Dyet insomuch that questionless the Affect âs most perfectly known but as for name it hâth none other than what is as obscure and as ambiguous unto most men as that of Epinyctis and Psydâacion so that hence we find it a business of the highest difficulty to discover the proper head of the Disease and the Method of curing it either in the Latines or the Greeks and Arabians themselves writing in the Latine Tongue Of the signs Diagnostick Prognostick and of the indications and Cure of Tumors in generall some there be that are wont to assert many things But in truth there is but very little that can be said as concerning Tumors in this manner that is generally considered but what for the most part is agreeable to certain species of them of all which we wil now speak in order and particularly in the Chapters following Chap. 2. Of Tumors arising from Humors in general THat kind of Tumors which is caused by the Humors is found to be most frequent and usual and therefore we wil treat of it in the first place The primary and nighest cause hereof is a humor elevating and raising up a part beyond Natures intention unto a greatness more than is ordinary Which said humor having for the most part a certain excess of qualities adjoyned wiâh it and thereupon becomes either hot or cold or moist or dry derives that quality unto the part affected the which quality since it differeth from the temper of the grieved Member must therefore necessarily excite in the same an unequal temper and hence it is that an intemperies or distemper is concomitant with a Tumor The Causes Now of the humors that cause these Tumors there is great diversity For both the Natural and preternatural humors whose differences we have already spoken to in their proper place excite Tumors hereunto belongs the matter that is wheyey and waterish filth and corrupt matter and all things else into which the humors degenerate and which are to be found in Tumors and yet are not in the number of the parts of the Body of which there is great variety Galen in his second Book to Glauco The variety of such things as are often found in Apostems and seventh Chapter writes that in Apostems there have been found to be substances conteined like unto Stones Sand Shels Wood Mud or Slime the filth of Baths the dregs and lees of Oyl together with many other such like resemblances And in his fourteenth Book of the Method of Physick and twelfth Chapter he further informs us that in Tumors have been discovered substances resembling Nails Hairs Bones Shels and Stones And that Worms also may be found in Tumors frequent experience testifieth Fallopius with others have seen such Tumors and I my self have more than once beheld the like Nicolaus Remigius in his third Book of the worship of Devils and first Chapter writes that
again forced unto some other parts until at length it come unto the weakest which is not able to expel these transmitted humors so that being here left they cause a Tumor For it cannot be that a Tumor should be caused by the matter transmitted and sent from divers places unless we grant as needs we must that there is a part which sends them a part receiving them and the passages by which the humors flow The parts do then transmit when the vigorous faculty by the quality or store of matter is incited to expulsion For unless the faculty were provoked it would never attemp this expulsion and unless it were strong and vigorous it could never effect it And this is likewise much furthered by the external causes exciting the fluxion to wit Heat which attenuates and dissolves the humors and cold that by constriction presseth the parts together and thereby causeth the greater afflux of the said humors Notwithstanding unto these two may be added also a third cause of the defluxion and that is a certain ãâã ãâã ãâã ãâã ãâã or violent issuing forth of the humor it self as usually it doth appear in persons that have the Dropsie where we find a water through its own weightiness descending into the Feet and Cods which motion notwithstanding is wont to cease in the night time but this would not be if the humor were expelled by Nature and not rather as in truth it is forced down by its own gravity Now as for the humors flowing together from elswhere the parts receiving they are received by such parts as are feeble and through their weakness altogether disposed for the reception of a fluxion For evermore the more vigorous Members send away that which is superfluous unto the weaker The weaker Members we account such as either have contracted a certain debility in their very first formation or being afterward hurt do contract unto themselves a kind of preternatural constitution or else they are such as Nature her self makes and intends for weak and so framed and constituted that they may the more easily receive the excrements of other parts such are the skin and the parts loose and porous For Nature that she might the better preserve the principal and more noble parts from Diseases hath purposely ordained in mans body some certain parts weak and feeble that so the principal parts oppressed and burdened with Humors might into them empty whatever is superfluous and burdensom and these as we have said are the skin and glandulous or kernelly parts And hence it is that the Heart transmits the peccant humors unto the Arm-pits the Brain sends them behind the Ears and the Liver thrusts them forth to the Groyns The parts ready to receive are al those that have any connexion with the part that transmits the humors and which have the passages through which the humors are conveyed alwaies patent and open but as for waies whereby to expel and drive them forth they are either none at al or otherwise such as are exceeding narrow and over streight or else lastly these passages are so scituated that they lie directly under the parts transmitting so that the conveyance of Humors unto them from the abovesaid parts is render'd the more facile and easie As for the waies and passages through which the humors run the passages by which the tumors flow they are either such as lie hid or else such as are open and very manifest For whereas the whol body is confluxile that is to say apt and ready to flow together hence it is that the humors have their fluxion out of one part into another by these occult or hidden passages So the Whey as we may term it being gotten in great abundance into the Abdomen or Cavity of the Belly commonly called the Paunch by these privy Passages descends into the Cods and the Thighs and lifts up the said parts even unto a Tumor or swelling the same which likewise very often happens in other parts Somtimes the humors assembled together betwixt the Skul and skin of the Head descend thence along under the skin into the inferior parts but very seldom and rare it is that from hence any tumors are produced But most an end those humors which excite and raise tumors flow through passages that are patent enough the Veins and Arteries But that we may briefly come to speak of the differences of Tumors arising from Humors the differences of tumors whence they are taken although very many of these differences are accidental yet notwithstanding those by which the tumors proceeding from humors are truly and properly distinguished among themselves are taken from the variety of the containing Cause or the Humor as an efficient cause producing the Tumor Now the Humors are divers Blood Choler Flegm Melancholly black Choler Choler adust and Whey From which likewise various sorts of Tumors are excited and caused And then again one while the humor exciting the tumor is as we use to say simple and sincere from whence also the tumor proceeding therefrom is said to be a pure tumor or assoon again divers humors concur to the making up of one Tumor and from hence the Tumors which we term spurious that is such as are improperly so called take their Original The Signs Diagnostick It is easily known whether the Tumor proceed from the falling down of any part and if this be not the Cause we may then safely conclude that the rise of it is from the afflux of humors unto the part affected But now whether or no the Tumor takes its beginning from congestion or rather from fluxion may by this be discerned to wit that those Tumors which are caused by congestion or the storeing up of humors are a longer while and by degrees arriving at their perfection neither take they up so much room in the part nor lastly was there any the least preceding cause or sign of a defluxion But now if the tumor be generated from a fluxion it wil be discerned by the presence of the contrary signs And certainly if so be there were not in the grieved part any foregoing pain or heat it manifestly shews that the said fluxion is caused by a transmission and not by means of an attraction like as on the other hand a preceding pain or heat of the affected part argues the Tumor to proceed from the attraction of humors For the Signs whereby to discern and understand the times take this advertisement viz. That the beginning of it is then when the part first of al is perceived to be distended and stretch'd forth The increment or growth when as the part appears now to be elevated into an indifferent big swelling and when the Symptoms that accompany al sorts of Tumors are evidently augmented The state or heighth of it is when the swelling and with it together al the symptoms are at their highest pitch The declination is then when both the bulk of the swelling and all the
about it The Prognosticks In an Inflammation there are two things that it mainly and principally behoves us to presage to wit The termination of an Inflammation Which is threefold its event or termination and then the exact and punctual time of the said termination Now the Event is said to be good when Nature overcometh the matter that breeds the Inflammation which hapneth when either the Tumor is resolved and the matter insensibly exhaled which is the best kind of solution of an Inflammation or else when the matter is suppurated and turned into that which we term Pus being a thick and purulent matter Or otherwise secondly The event may be said to be evil or if ye wil worst of all when Nature doth not overcome and master he peccant matter which hapneth when the Inflammation if it be external suddenly vanisheth and retires back to the internal parts or when the natural heat being overcome and extinguished the Member thereupon becomes putrified and seized upon by a Gangrene insomuch that if it be not forthwith cut off ruine and death it self threaten the whol body Or else in the third place there follows a Neutral Event as some cal it which is absolutely evil when the Tumor is hardened and when upon the resolution and discussion of the thinner parts the more thick and gross parts remaining behind the Inflammation degenerates into a Scirrhus But now which of these events is to be hoped for or expected may probably be guessed at by comparing together the vigour and strength of Nature with the matter that causeth the Disease For if the matter be not overmuch not thick not over deeply scituated not shut up under a hard and thick skin if the body be not greatly impure and Nature be strong then a resolution and an evacuation by an insensible transpiration may be hoped for But if the matter more abound be more than ordinary thick be contained in a deeper place than usually and be pent up under a thicker skin then a suppuration is to be expected That the matter is retreated unto the inward parts may be conjectured by this token to wit When we perceive the Tumor to be diminished albeit there were no repulsive remedies administred and applied to drive back the matter That the extinction and overthrow of the heat is neer approaching may be presaged by this whenas the heat redness of color pain and the pulse or beating is lessened the Tumor notwithstanding still remaining touching which more hereafter when we shal come to treat of a Gangrene But then lastly an Inflammation for the most part then degenerates into a Scirrhus when the matter is over viscous and clammy and hard therewithal and when the Natural heat being strong and vigorous forthwith even in the very beginning of the distemper remedies that discuss and dissipate over forcibly are thereunto applied which said remedies disperse and scatter the thinner parts thereof and leave the thicker still remaining That the time of the Event may be known The times of an Inflammation it is requisite that the times of the Inflammation be first of all known and they are likewise heedfully to be observed by us upon our knowledg of them in relation unto the Cure For unless the times of an Inflammation be well known and considered we may soon run our selves into an Error whilst we administer and apply Remedies that are any waies improper or incongruous unto any one particular of those several times Now then Inflammations like as all other Tumors and Diseases have four times or periods its beginning encrease state or perfection and its decay or declination It commenceth or begins when the parts are replenished with blood and when the swelling pain and stretching out are encreased this we cal the augmentation The state or perfection is then when the Tumor Distension Pain and all the other symptomes are most vehement and in the heighth of their extremity And lastly the declination is then said to be when the matter generating the Tumor is diminished and the pain heat together with the other symptoms are become more remiss and gentle or otherwise the matter is converted into Pus or purulent matter But the truth is these times are some while shorter somtimes longer and the Inflammations are somtimes sooner and somtimes more slowly terminated For as Galen tels us in the sixth Book of the Aphorisms Aphor. 49. that which is of a thinner substance is in a shorter space digested and that which is thick or tough requires a longer time for its digestion but that which is thick and viscous requires a far longer time And that Inflammation which hath seated it self in the fleshy parts is terminated according to the period of acute Diseases to wit fourteen daies for the substance of the flesh is more soft and permeable by reason of its thinness But the substance of the Ligaments Tendons and Nerves being more thick and hard and thereupon with greater difficulty receiving the fluxion for the same cause also doth with more difficulty discharge it self therof and hereupon the Inflammation in those parts is the longer time ere it attain unto its state and perfection and is not so soon curable but yet notwithstanding the Cure is in this case seldom or never prorogued beyond the term of fourty daies if both the Physitian rightly in al points discharge his part and likewise the patient be in al things willing to submit The Indications and Cure Whereas the containing cause of an Inflammation is the blood which hath preternaturally i. e. beyond or besides Natures intention flown in unto the part the Cure is effected if that blood be removed out of the diseased part and then great caution be had that it thenceforth flow no more unto the part affected that so by this means as wel the containing as the antecedent cause may be wholly taken away For whenas the affect cannot possibly be removed without a first removal of that which causeth it and the case so standing that the causes ought to be taken away in the very same order that they follow one the other in therefore we say that the Fluxion must first of all be extirpated The Cure of a fluxion or flowing of the blood Now this intention may be accomplished if care be taken to prevent the bloods abounding in the body and that that which is there in great plenty flow not unto the part affected The benefit of blood-letting in an Inflammation and this with most safety and speed is to be effected by opening a Vein For by this Venesection or blood-letting the great store of abounding blood is diminished and the same is likewise drawn back from the aggrieved place hence it is that there is an exceeding great benefit arising from and following upon this opening of a vein in an Inflammation so that it is seldom or never to be omitted if the strength of the patient wil permit it to be done And indeed hardly can
the beginning of the distemper it ought to be attempted from a far off but afterwards from the affected parts themselves Now what kind of remoteness and what sort of longitude he understands is explained in his fifth of the Method of Physick Chap. 3. A Revulsion saith he ought alwaies to be carried downward in those affects which are upward and upward evermore in those that are below and moreover also the Revulsion ought to be made from the right side unto those on the left and again in like manner from those unto these and semblably from those places that are internal unto such as are outwardly scituate and on the contrary from these unto those For when as the main scope of Revulsion is not to evacuate those humors which are already conteined in the part affected but those rather that are flowing thereunto and seeing it respects rather the part sending the blood than that which receives it from these premises it necessarily follows that questionless this is required in every revulsion to wit that it should by all means procure a motion contrary unto that which flows that so it may not any longer be moved unto the part affected and for this cause the revulsion must not be ordain'd either from the grieved part or from that next unto it but rather from the opposite yea and so far forth as possible it may be from the places most remote from the affected part And hence also it is that every opposition doth not constitute a contrariety neither hath every kind of opposition any place in a Revulsion but those oppositions alone which Galen in the before alleadged third Chapter of the fifth Book of his Method of Physick recites to wit upward and downward from the right side parts unto the left from the places that are within unto those that are external and so on the contrary Yet if there be only but a very smal inconsiderable distance we cannot safely nor conveniently draw back from the parts more inward to those more externally scituate but then only when the distance is greater But that opposition which is from before and behind or according to the fore parts and hinder parts hath no place in this kind of Revulsion which is so called singly and absolutely For neither if any affect shal chance to be in the backward part of the Head are the Forehead Veins forthwith to be opened by way of revulsion since that may not be done without manifest danger during the continuance of the Plethory and flowing of the humors But enough hath been said of Revulsion in the fifth Book of Institutions Part 2. Sect. 1. Chap. 18. But that we may in few words contract whatsoever hath there more at large been spoken Revulsion twofold and whatever else may be said upon this subject it is in the first place to be taken notice of that Revulsion is twofold one which is accomplished together with the evacuation of the humor such as is that which is effected by Blood-letting and Cupping-Glasses with Scarification the other which is wrought without the evacuation of the humor such as is that which is performed by Frictions or Rubbings Ligatures and Cupping-Glasses without Scarification This latter is never to be practised but when the Revulsion is to be made unto the parts most remote since that if it be instituted in the neer adjacent parts then the humor which is only stirred and not totally evacuated may without any difficulty or resistance rush upon the affected part And it is very rare and scarcely ever known that this kind of revulsion hath place or any thing to do in an Inflammation which requires a manifest sensible and suddain evacuation of the blood Furthermore Revulsion by opening of a Vein as for what concerns Revulsion which is effected by opening a Vein this one thing at least is to be observed which if it be wel heeded many intricate controversies touching the thing now in question may be determined to wit that the utmost endeavor must be used that a contrary motion may be procured unto the blood and that as much as possibly may be drawn back unto that Fountain from whence it flows And since that the Liver is the Fountain and Sourse of the blood and that the greatest store of the blood is conteined in the Vena Cava or great hollow Vein nigh about the Liver we must do our utmost that the blood which flows into the inflamed part may be drawn back towards its Spring-head yea also if it be possible unto the opposite part yet notwithstanding so that the blood which flows may be retracted and drawn back And therfore in every Revulsion this at least is to be wrought that the blood may obtain such a motion as that by it the part affected may not be injured by its immoderate conflux but that it may rather be again recalled from the diseased part But how this may be effected in every part here to declare unto you would be a business too tedious besides we have already elsewhere spoken to this very point in our treating of particular affects Revulsion when to be ordained after what manner And by what hath been said as I conjecture it is sufficiently apparent how and in what manner a revulsion is to be ordained in case of an Inflammation so that there wil not be any great need that we should add much as touching the right and due administration thereof For whereas revulsion is then only suitable and proper unto the Humors when they flow and unto them alone and not unto those which have done flowing and have seated themselves in the part affected it is hence manifest that it ought to be instituted and appointed in the very first rise of the distemper Notwithstanding this is not so to be understood as if in the first appearing of an Inflammation we were instantly to put revulsion in practice for if either there be no great store of blood or if its rushing in upon the part be not over violent and impetuous Medicaments that drive back and derive will be sufficient But then only is Revulsion to be put in practice when there is great plenty of blood and a more than usual violent and forcible rushing thereof unto the part affected and according to the greater or less proportion of this abundant blood and the more or less vehemency of its motion so answerably ought the Remedies and Medicaments that are prescribed for Revulsories or drawers back to be ordained so much the more or less strong and forcible But now that Revulsion which is made with an effusion or emptying forth of the matter must needs be greater than that which is made without it But amongst all the Remedies which we term Revulsories or drawers back the most prevalent and efficacious is the opening of a Vein which said Venesection doth more effectually or less strongly draw back accordingly as the Veins that are opened be greater or less The greater
be contained in the intervening middle spaces And in his second Chapter of a Tumor he thus writes It is saith he by Physitians found to be expedient in the case aforesaid not only to discuss by the means of heaters but likewise sensibly to evacuate at least some part or portion of the blood it self by making scarifications in the Skin But here then we are to know that great heed and circumspection ought to be taken and had whether or no the matter may be turned into Pus as we term it being the snotty fetid matter ensuing upon maturation For if we may probably hope for the said suppuration then the above mentioned scarifications have not any the least place But then on the other hand if the matter may not be changed into the said Pus or matter and that notwithstanding likewise there be little or no hope that possibly it may be wholly discussed or scattered by the application of Medicaments then in this case both Scarifications and Cupping-glasses may nay ought to be administred For these two are a very effectual and prevalent Remedy for the evacuation of the matter whatever it be that sticks and is deeply scituated and which seemeth forthwith to be in the ready way of conversion into a Scirrhus And therfore they are by no means to be administred in the beginning or first appearance of the Inflammation but at length after that the body is sufficiently emptied and that the Phlegmone is at a stay that so there may be further cause to fear that a new fluxion should be excited by that pain which originally proceeds from scarification and then only when we have a purpose to extract that which remains over and above after the use of other convenient Remedies Yet notwithstanding Scarification hath place only in those parts which in other cases likewise are fit to undergo and suffer the said Scarification For if an Inflammation happen unto any part unto the which in any other case scarification ought not to be administred I conceive that there wil be found no man so rash and unadvised as that he dare be so adventurous as after a Phlegmone for the evacuation of the residue of the matter to apply Cupping-glasses and administer scarifications unto the part affected But very rare it is that scarifications are admitted and allowed of for the use and purpose aforesaid But the safest and most usual way of curing an Inflammation is that the matter which hath flown in unto the part be discussed by the Medicaments before propounded But if thereby it may not be effected Suppuration we must then have recourse unto some other means for the curing of the Phlegmone and that is by Suppuration Now all this that hath been said must be understood as spoken of a pure and simple Phlegmone But if the Inflammation be not pure but that it rather decline unto the nature of an Erysipelas or an Oedema or a Scirrhus then those Medicaments that are proper and convenient for these and such like Tumors are to be intermingled with the other yet evermore with this Proviso that such of them as relate unto the Phlegmone be alwaies predominant The Cure of an Inflammation degenerating into an Impostume The generation of an Impostume If therefore there be no hope that the Inflammation may be compleatly cured by the helps and means hitherto propounded which will appear from the more intense signs of the Inflammation to wit grievous pain that encreases day after day a manifest Pulsation or beating and an evident discernable extension or stretching out of the part then we ought instantly to use our utmost endeavor that the matter that is the cause of the Inflammation may with all possible speed be concocted and brought unto suppuration that is converted into Pus For neither can the matter yet unconcocted and as yet not turn'd into matter be in a due manner evacuated and then again if any one open the inflamed part before the said Pus be compleated he shal thence draw forth nothing and shal encrease and add unto the Malady rather than relieve and cure it But if that same part shal be opened the purulent matter being already elaborated and thereby brought to a due perfection then all whatever is superfluous in the inflamed part may most commodiously be evacuated And therefore we conclude that the matter is first of al to be concocted and so far forth as possible may be digested by the native radical heat For although that matter which is conteined in a Phlegmone can never be so far forth concocted and elaborated that it may be rendred any waies useful and profitable to Nature and in any sort fit to nourish the parts Yet notwithstanding since that there are therein certain qualities which are to Nature very offensive and burdensome those may be taken away and a certain kind of equality and moderation of the qualities may be instituted and a separation of the corrupt humors from those that are good and such as are meet to nourish the Body may be wrought which said elaboration of the humor is here termed concoction and suppuration And when that that is superfluous and corrupt in the part inflamed is separated from what is useful good and serviceable and that the vitious qualities are now hereby corrected and amended and the very proper substance of the blood it self shal be changed into an equal whitish and smooth matter and gathered together into its proper and peculiar place so that now without any difficulty at all it may upon the opening of the part be evacuated then and not til then the Pus is said to be now already perfectly concocted and that same collection or gathering together of the snotty filth termed Pus or matter into some one particular place is by the Grecians called Apostema and by the Latines Abscessus with us in English it is named an Apostem or Impostume as hath been said before in the first Chapter Now that concoction in mans Body is Natures work alone the which by the help and assistance of the native heat digests the humors takes pains with them and as it were leads them along until it hath brought them unto that perfection which they ought to receive which said heat if it be strong and vigorous then we use to say that the Pus or matter thereby bred is good and laudable and it is as we may find in the first Prognostick Tom. 42. white equal smooth and not very sâânking and noysom But if the innate heat be weak then it wil be quite and clean contrary unto what was in the former case And therefore the Physitians office is and his main care must be to cherish or preserve and encrease the native or natural heat in the inflamed parts that so by means of it the generating and breeding of the said Pus may the better succeed and the more easily attain unto its perfection The innate heat is conserved and augmented if
Butter or with the fat of an Hog or with some other fit Digestive But if the hole be not wide and large enough it may very easily be dilated to wit if either a little piece of Spunge or Gentian root or Rape root dry be put thereinto For these things aforesaid when they are filled full with humidity they are then dilated and so consequently widen and enlarge the hole The Spunge is thus to be prepared the Spunge is to be wel soaked in the white of an Egg twice or thrice throughly shaken together then afterwards let it be close squeezed together on all sides and then let it be leisurely dried in the shade a smal portion of this when it is dried is to be taken and put upon the Ulcer But in regard that the crustiness thereof wil not fall off in a few daies time and that all this while the Pus or filthy corruption unless it stick immediately under the Skin is detained and imprisoned in the Impostume for this very cause if there were no other it is by far the safer way to open the Impostume with an Iron The Impostume being now opened whatever the way of opening it hath been the Pus or matter is to be evacuated but yet this needs not evermore to be wholly all at once or altogether For if the Impostume be great and contain much Pus within it neer unto the Arteries and Veins the whole matter and filth ought by no means to be evacuated all at once lest that together therewith much of the Spirits be likewise evacuated and dissipated and so by this means the sick Person should be caused to faint and swoon or be debilitated and weakned but rather the corruption is to be emptied forth by some and some especially if the Patient be weak or a Woman with Child or in case the Patient be a Child or lastly if the sick party be very aged When the Pus is evacuated if either pain manifest it self or else any reliques of the matter not suppurated appear in the circumference and it be so that the Pus it self be not wel and perfectly ripened then the pain is to be mitigated and more especially the remainder of the matter is speedily to be converted into the said Pus by some concocting Medicament which they commonly call a Digestive And such is that which is made of the Oyl of Roses and the Yelks of Eggs for it greatly mitigates the pain and helps forward the generating and breeding of the Pus so often mentioned Or Take Turpentine one ounce one Yelk of an Egg the Pouder or Dust of Frankincense one dram Oyl of Roses three drams mingle them wel together Likewise the Emplaster Diachylon simplex is very profitable in this case When this is once accomplished even while the concoction doth yet appear we must come to those things that throughly cleanse and purge it for neither can there flesh be bred nor any conglutination by drawing together the Lips of the Impostumated part be made unless the part be first cleansed Which to effect Take Clear Turpentine one ounce Honey of Roses six drams the Yelk of one Egg let them boyl together a little and afterward add of Saffron one scruple and a little quantity of Barley meal If there be need of a greater cleansing you may then add the juyce of Smallage As Take of crude Honey Barley meal of each alike one ounce of the Juyce of Smallage half an ounce Saffron half a scruple and mingle them If yet there be occasion for a more forcible cleanser there may be added of the Vngueut Egyptiack as much as wil suffice Centaury the less and round Birthwort is here likewise very useful As Take the juyce of the lesser Centaury two ounces Smallage one ounce Honey three ounces let them boyl together and after add of Barley meal and the Vetch Orobus of each six drams when they are taken from the fire add of Turpentine one ounce of the Pouder of the Flower-de-luce root one dram mingle them The Impostume being throughly cleansed such Medicaments as breed cause flesh are to be administred Now of what sort these are Galen in his third Book of the Method of Physick the second third and fourth Chapters teacheth us at larhe and we have likewise declared them in our Book of Institutions As for example Take Frankincense Mastick of each half an ounce Colophony two ounces Oyl of Roses and Honey of each as much as is sufficient let them be mingled Or Take The greater Comfrey one handful Betony Saint Johns-wort Hors-tail Grass of each half a handful boyl them in Wine and bruise them wel out of the mash of them squeez forth a Juyce and add of Frankincense and Mastick of each one ounce half Dragons blood an ounce Honey and Turpentine of each a sufficient quantity boyl them until the juyce be consumed and make an Vnguent Or Take Myrrh Aloes Sarcocol of each an ounce Honey six drams White Wine as much as wil suffice boyl them to an indifferent thickness When the Ulcer is filled up with Flesh then those Medicaments which we cal Epuloticks that is such as bring to a Scar are to be administred of which we have in like manner spoken in our Institutions such as are the Emplaster Diapalma or Diachalciteos de minio of Vigo and others which are every where known Chap. 6. Of the Sinus in the Tumor BUt it oftentimes so happeneth that although the said Pus or snotty filth be emptied forth of the Impostume yet notwithstanding it becomes again replenished from whence it comes to pass that the adjacent Skin doth not close fasten and grow together with the Flesh that is underneath it but there is a certain cavity or hollowness left to remain and at length there ariseth a certain difficulty if not impossibility of cementing and conjoyning the skin with the Bodies lying underneath which affect the Greeks cal Colpos and the Latines term it Sinus to wit when the enterance into the Impostume and Ulcer appears narrow enough but the deeper and more profound part thereof diffuseth it self into a breadth The Causes Now for the most part the Causes of this Sinus are Impostumes or Suppurated Tumors over-slowly opened or not wel cleansed For the corruption if it be longer deteined in the deep place than it ought to be acquireth a certain kind of sharp corroding quality and there causeth divers winding passages and turnings such like as we find in Coney-borrows and so unto the part in this manner affected there flow together from the neighboring parts yea from all the whole body such excrements and such humors as superabound from whence afterwards it chanceth that this kind of Sinus or windings to and fro can very hardly be conglutinated and filled up with Flesh The Differences But now of these Sinus there is an exceeding great diversity for they differ not only in the dimension of quantity that one should be less and shorter and another
tels us of another far more easie and compendious course that he himself had found out and discovered in curing Apostems newly opened whereby on the third or on the fourth day at the furthest all the aforesaid Cavity of Apostems might be remedied and perfectly cured by drawing together what was divided which operation we cal commission and conglutination of the Impostume so that nothing should be left gaping beside the opening or incision place which was made by Art to the end that thereby the Pus might flow out and be pressed forth and that al this should be effected without any the least danger to the sick party without much if any pains and labor or any other difficulty Now his way and method of Curing was as followeth If the Tumor or Apostem be great then saith he in the first place let it be opened in the best manner that may be so that the little finger may be put into the orifice and that thereby al the Pus that is contained within the Impostume may be permitted to flow forth and may likewise be thence expelled by a gentle compression of the place it self The Pus being once expelled and evacuated let the mouth of the Sinus be stopt with a Tent and then an artificial Pillow or Cushion being laid and fastened down thereon let it so remain without removal until the next day following The day following the Ligature being loosened let the Ulcer be purified and carefully cleansed from al the Pus if haply there be any left remaining underneath After this is done let a Pipe or smal Cane of Lead be put into the orifice the which let it be as big and large as is the Orifice it self and let it reach even unto the Cavity or hollow place but let it not by any means be forced any further Upon this let the Basilick Emplaster spread upon a Linen Cloth be imposed in the which also the pipe may be contained that it fal not forth yet nevertheless leave a hole at the very Orifice of the Leaden Pipe or Cane Afterwards on either side of the Cavity let there be put triangular Pillows or Cushions of which before on either side one so that al the hollow space may be filled up with either Pillow c. But let the Orifice of the Sinus in which is the Leaden Pipe be left free and open neither let it be stopt up by the aforesaid Pillow nor any waies obstructed by the Ligature or binding that so al the Pus that lieth underneath may be throughly purged out afterward let the place covered by the Pillows be rolled about with a Swathband so that it may be without the least pain and let it be so ordered that the Ligature may begin at or from the bottom and tend toward the orifice that so by this means al the Pus or filth that is within may be forced toward the Orifice and through it may be pressed forth The Sinus thus bound about is to be left in this manner until the day following on which the Ligature being loosened we ought by making strict enquiry to find out how much of the Cavity remains that so we may be throughly certified Whether or no the aforesaid Pillows or Cushions did touch upon the places For al those places which were subjected by the Pillows c. wil al of them be found conglutinated and fast closed together The which when we have discovered the Pillows are again to be tied and fastened after the same fashion as they lay before and so they are to continue until the next day But now if so be that any of the Humor or of the Pus seems to be left in any place this as before is to be pressed forth with the Pillows fastened by the Swathband together with which the gaping place doth coalesce and joyn close together In this manner so soon as the parts are closed together let the Pillows be removed and then let there be imposed upon the Ulcer a Linen cloth spread over with the Authors Leonine Emplaster or such other like Plaister as suppose the Emplaster Diapalma and you may not forget to wipe and cleanse it six or eight times every day But yet notwithstanding as touching this way and manner of curing the Sinus and Cavities it is first to be taken notice of that this same doth succeed most happily in Apozems newly opened and in them only for as for an old Sinus where all is not wel within and which almost declines unto callous Ulcers and Fistula's the former way and manner of curing it is far better and safer Moreover this is likewise to be observed that we ought wel to look whether or no there remain any relicks of the indigested matter spread thorow-out the part which easily comes to be known by some apparent Tumor or Swelling as also by its redness of colour For otherwise and as long as any thing preternatural sticks in the part agglutination as we term it or closing up of the Orifice is not to be expected neither is it to be so much as hoped for And therefore be sure that the Pus it self be likewise cleansed and purged in the best manner that possibly you can Thirdly This also is to be heeded to wit whether or no the place may conveniently enough be rolled about with Swath-bands and likewise whether the aforementioned Pillows or Cushions be streightly fastened and tied down close enough that so they may both compress and keep down the severed and disunited parts and also press forth the Pus or filthy snot-like matter For if so be that the Swath-bands gape and that the Pillows press not down the part as they ought then neither is there any Pus pressed forth nor doth the part coalesce and meet together Chap. 7. Of the Tumor Erysipelas or Rosa THat Tumor which the Greeke cal Erysipelas but we here of this Country commonly Rosa from its rosie color is altogether to be referred unto and so to be accounted in the number of the Tumors that take their original from the Blood All the Latines Celsus only excepted who retains the name Erysipelas term it Ignis Sacer we in English call it St. Anthonies fire or this Ignis Sacer the Poet Lucretius makes mention in his sixth Book The Body all at once with Vlcers brand grows red As 't is when Ignis Sacer hath the whol ore-spread This Tumor is most an end by Physitians ranked among the Cholerick But yet there is ground and cause enough of doubting from what humor it derives its beginning and Pedigree For Galen himself seems now and then to stagger and not alwaies to stand to what he had spoken concerning it For in his second Book to Glauco and first Chapter he expresly writes that the most thin and hot Blood or Choler together with Blood to wit when both of them are hotter than is behooful is the Cause of an exquisite Erysipelas and there he determines that meet pure Choler
their Ears with Snow or have plunged as we may so say their almost frozen feet into cold Water or Snow And the same Fabricius in the place alleadged relateth That a Noble man of good esteem and reputation told him that when he travelled in those Regions he himself on a time lighted upon one travelling as he was upon the Road whom finding to be stiff with cold and almost dead he caused to be put into a Cart and having brought him into an Iune his Host the man of the house immediately plunged him over head and ears as we say in cold water which was no sooner done but instantly there issued forth from al parts of him a kind of frostiness in such a manner that his whol body seemed as if it had been al over covered with Ice like as with an Iron shield and then he gave him to drink a Cup of Hydromel putting thereinto the pouder of Cinnamom Cloves and Mace upon which he fel into a swear in his Bed and soon after the sick person returned unto his former state and became perfectly wel recovered The Cure When now the said congelation is asswaged and qualified and the cold for the most part extracted and drawn forth or else hath exhaled of its own accord which is known by this that the pricking pain is much moderated if not quite ceased then the part is to be fomented and cherished with sweet Milk made blood warm in which there have been boyled Rosemary Organy Sage the Leaves of Rue and Bayberries It wil be likewise very commodious this being a remedy that is also very wel known to thrust deep into warm Water in which Rape Roots especially those that were formerly congealed and frozen with cold have been boyled the Hands or the Feet Or Take White Wine one pint Allum an ounce boyl the Allum with the Wine and let the part be wel washed therewith the Decoction also of Lupines is good and helpful and after it let the part be anointed over with Honey in which live Sulphur hath been boyled This is likewise very efficacious Take of the Oyl of Bayes two ounces Honey one ounce Turpentine half an ounce Mingle c. Or Take Turpentine unsalted Butter and Mace of each alike and what you please for the proportion Mingle them c. Or else Let the part be anointed with Oyl of Wax If the part be already exulcerated Allum poudered and mingled with a like portion of Frankincense pondered likewise is very helpful and wel approved of a little Wine being thereto added or the Oyl of Roses boyled in a Rape Root or in the Reddish Root made hollow and the pith taken al out and then squeezed and pressed forth Or else let an Unguent be made of River Crabs burnt with Honey and the Oyl of Roses Or Take Rue the Marrow of a Bull the Vnguent of Roses of each as much as you think fit mingle them c. Or Take Wax the fat of a Hog of each an ounce Litharge of Silver or Lead ten drams the rind of the Pine two ounces of Manna thur is one ounce Oyl of Roses a sufficient quantity Make an Vnguent Chap. 16. Of the Tumor Ecchymoma THere is likewise somtimes poured forth blood the Skin continuing stil whol and sound into the spaces of the parts from whence there ariseth an Affect which by the Greeks is termed Ecchymoma or Ecchymosis and by the Latines Effusio Suffusio Sugillatio For an Ecchymosis is nothing else but Chymeon ecchysis that is an Effusion or pouring forth of the Humors to wit the blood into the next adjoyning spaces by reason of the opening of the Veins to wit if the Skin abiding whol the Veins pour forth that juyce which they contain that is the blood as Galen speaketh in his second Book of Fractures Comment 16. and either the orifices of the Vessels gape which happeneth in an Anastomosis or else the blood doth as it were sweat forth and strain it self out through the Tunicles of the Vessels being rarefied which the Greeks cal Diapedesis or else by contusion the Vessels are loosened which chanceth if one fal from an high place or else be oppressed and over laid by the weight of somthing that is heavy lying upon him or else be smitten and hurt with a club stone stump of a Tree or else lastly that by some violent motion and extension a Vessel be broken Then the Skin remaining who the blood is poured forth into the neer adjoyning spaces whereupon the color of the part is changed and at first indeed it seemeth reddish afterward it becometh Leaden colored then yellowish green blackish whereupon it is that Galen in his Book of Preternatural Tumors Chap. 10. and tenth Book of the Composition of simple Medicaments Chap. 9. maketh two species of this Ecchymosis one which by the general name he calleth Ecchymoma when the part obtaineth a middle color betwixt red and black which indeed may properly be termed Pelidna that is of a livid or leaden color and the Affect may likewise be called Livor to wit paleness or wanness the other he termeth Melasmata that is blacknesses which latter are especially familiar unto old persons as often as their Veins are bruised or opened upon any other cause and these happen upon any smal or sleight occasion like as on the contrary Pelidna and Livores befal Children and those that are young and Women and such as are of a white color But now although oftentimes and indeed for the most part the part is not lift up into a Tumor or Swelling but the Blood poured forth doth so insinuate it self into the spaces of the parts that there is no Tumor at all appearing yet notwithstanding somtimes the part doth swell up if there be great store of Blood poured out and this also is now and then wont to happen after Venefection to wit if the whol Vein be smitten or if the Wound that is in the Skin shall be closed up but that which is in the Vein it self left open and unshut For from hence by that Wound that is in the Vein the blood is poured forth for which when there is no issue or passage open the Wound in the Skin being closed up it is oftentimes under the Skin poured out into the whole Arm and somtimes it exciteth also a certain swelling but however it alwaies dyeth the Skin of a Red and livid or leaden colour Ecchymosis But the Affect is various and different and the Ecchymosis ariseth in a different manner since that the blood is not evermore poured forth without the Veins but oftentimes by reason of the great abundance of the Spirits and Blood the Veins and Arteries that are terminated in the Skin are filled full of blood and thereupon the Body becometh coloured as appeareth out of Hippocrates Epid. 2. Sect. 4. in the end thereof where he writeth thus That all diligence and care must be taken that the passion and anger of the Mind may be
and Chap. 8. maketh a twofold sort of this Tumor differing according to the Nature and quality of their Causes The one he deriveth from cholerick blood the other from a salt and nitrous Flegm but this more rare Others there are that assert that this kind of Tumor doth arise from an exhalation or vapour of hot fervent Blood or else the admixture of the Cholerick and Salt humors The Causes Whosoever knoweth and understandeth the Nature of serous wheyish humors wil not deny that such like Tubercles may possibly be excited from serous or wheyish humors being such as are sharp and easily moved and likewise such as without much ado vanish and are discussed Which appeareth and may be confirmed even from hence that this Malady may be and is removed especially by Venesection or blood-letting which said Venesection doth chiefly and principally qualifie and allay that extream and fervent heat of the serous and wheyish part of the blood Yet notwithstanding the itch that is somtimes greater and somtimes less likewise teacheth us that there is not one alone difference of this wheyish humor but that somtimes this said whey is more mild and moderate and somtimes again more sharp and hot somtimes thinner and somtimes thicker as likewise thus much which I my self have very often observed that these Tubercles while the the Patients are in a hot place they then break forth and appear and that when they expose themselves unto a cold Air the Essere then vanish and as soon again on the contrary to bud forth in the cold Air and to vanish in a hot place the former whereof seemeth from hence to happen to wit because the humor is very thin and moveable and therefore is instantly driven in again by the cold ambient Air but the latter because the Humor is not altogether so movable and thin but somwhat more thick which for that very cause cannot transpire in a cold Air but in a hotter Air it wil transpire or breathe through But this wheyish and thin Humor is for the most part generated from the fault of the Liver which from some preternatural cause is disposed to generate and breed this humor Now that said Humor waxeth extreamly hot from the Causes Procatartick as they cal them that stir and move the blood And this happeneth likewise in the Winter time and in cold Regions rather than in hot Signs Diagnostick It is easily known by those notes and marks that are above mentioned to wit there somtimes goeth before an Ulcerous Lassitude and then there break forth in the whol body itchy Pustules as if the party had been pricked by Bees or stung with Nettles The Prognosticks 1. These Tubercles vanish of their own accord within a very short space although there be no course taken for the curing of them and they are not suppurated neither doth there issue forth of them any humidity at al. And if this should somtimes so happen yet this chanceth rather by reason of the scratching of them and also from the vehemency of the Itch which is extream troublesom to the sick persons than by means of the Tumor 2. Somtimes these Essere go before Cholerick Feavers and therefore such as are very frequently molested and grieved with these Tubercles ought not in any case to neglect the Cure lest that they fal into Feavers and some more grievous Disease The Cure For the most part there is no need at al to administer Topicks but if the fervent heat of the Blood and Humors be by Venesection and the administring of Medicaments that alter qualified and kept under the Tubercles wil then soon vanish and the smoothness and Natural color will forthwith return unto the Skin To wit in the first place a Vein is to be opened and so much of the blood drawn forth as the state and condition of the body requireth And afterwards if there be any need at al thereof the Cholerick and wheyish Humor is to be drawn forth by Tamarinds Myrobalans Rheubarb afterward let there be administred the Juyce and Syrup of Pomegranates Ribes Syrup de Agresta or Varjuyce Whey with the Emulsion of the four cold seeds and the like Milk tart and sowr c. It is likewise very requisite to put the sick person into a Bath of warm Water Let his Diet likewise be cooling and moistening Chap. 27. Of Scabies or Scabbiness SCabies or Scabbiness ariseth likewise from adust matter as doth also the Itch that is as it were a certain Praeludium and forerunner of Scabbiness and the like Affects Now Scabies by the Greeks and Latines is called Psora an Affect sufficiently known in the which there is not only present some kind of foulness and deformity of the body but a distemper also even of the very Skin together with a swelling and exulceration from whence it is that the actions of the Skin are likewise hurt But more especially in the Scabies or Scabbiness the top and utmost part of the Skin is affected insomuch that out of it as Galen tels us in his fourth upon the Aphorisms and the 17. Aphor. there is some such like thing cast forth that beareth a likeness and resemblance with the casting of Serpents From whence it likewise differeth from the Itch for in the Itch there is only a roughness of the Skin in which there is nothing that fals off notwithstanding the scratching whereas in the Scabies there is not only a roughness of the Skin but likewise a distemper with a swelling from which by scratching the bran-like bodies are easily and readily separated and together with them divers Ichores likewise and filthy purulent Excrements The Causes But what the Cause of the Scabies is in this Authors seem not so wel to agree Galen in his Book of Tumors Chap. 1. 3. tels us that Sabies also and Lepra are Melancholick Affects and likewise in the seventh Sect. Aphor. 40. that Cancers Elephantiases Lepra's and Psora's are al of them Melancholy Affects and the same he also tels us in other places But Avicen in the seventh Book of his fourth Tome Tract 3. Chap. 6. writeth that the matter of Scabies is the blood with the which Choler is mingled and that converted into Melancholy or salt flegm and with him the other Arabian Physitians agree But the very truth is that although in the Scabies the humor be not alwaies one and the same yet in every Scabies there is some kind of mixture of the adust and melancholy hot and dry humor And furthermore there is one sort of Scabies that is moist another that is dry The moist in the which there sloweth forth a certain matter that is moist and withal rotten filthy and purulent but the dry is that in which there is but little or none of the aforesaid matter cast forth And concerning this latter it is that Galen seems to speak as being such wherein that melancholy humor doth more superabound But Avicen and the rest of the Arabian
Physitians understand hereby al kind of Scabies whatsoever Now albeit the next cause of Scabies be a humor sharp and salt yet notwithstanding Avicen doth not altogether absurdly assert that blood is the matter of the Scabies For seeing that Scabies is an Univerversal Affect of the whol Body it cannot therefore easily proceed from any other humor unless that blood be likewise therewith mingled and yet notwithstanding the blood cannot properly be said to be simply the cause of Scabies to wit so long as it retaineth its benign and tempeperate Nature For whilest it continueth benign and good it can in no wise excite and cause the itching neither yet those Ulcerous Tumors or Swellings Wherefore before such time as the blood can possibly produce and breed the said Scabies it must of necessity be corrupted and other humors that are sharp and biting there with mingled And true it is indeed that yellow Choler is sharp and corroding but then it scarcely floweth in so great abundance or is of that thickness as to excite such like Tumors But black Choler and salt Flegm are Humors very fit and most apt to produce the said Scabies For these Humors being thick hot and dry and withal biting and corroding if they chance to be thrust forth unto the Skin there they stick fast in it and there they excite a hot and dry distemper an itching a swelling and an exulceration But now as for the primitive Causes and more especially for the generating and breeding of those salt biting and sharp humors the kind and ordinary course of Diet that is kept doth exceedingly advance and further the same Meats to wit of a bad juyce and that afford an unwholsom and corrupt aliment such as are salt sharp and that are easily corrupted And hence it is that the poorer sort of people who live upon these kind of unwholsom corrupt meats are most frequently infested with the Scabies or Scabbiness as likewise Children and yong people in general in regard that these are altogether careless and heedless in their Diet whereupon they contract great store of excrements that being retained in the outward part of the body are there corrupted and so they get an acrimonious quality But then from these bad and naughty meats those sharp and salt humors are the more easily bred if there be present a hot and dry distemper of the Liver And hitherunto likewise relateth the uncleanness and nastiness of the body to wit when there is altogether a neglect in the keeping it sweet and clean and if the foulness and impurities of the Skin be not duly washed off or the garments not shifted and changed often enough whereupon it is that filth and impurities sticking in the superficies of the body do not permit so free a passage forth unto the excrements and by this means the said excrements acquire a certain acrimony and so corrupt the other humors The Scabies ariseth likewise somtimes after a Crisis and after Diseases both acute and those also that are of a long continuance to wit when Nature expelleth forth unto the Skin those naughty and depraved humors which it is not able any other way to discuss and evacuate And lastly Congium is likewise accounted and reckoned up among the principal causes of Scabies which cause Galen also acknowledgeth in his first Book of the Differences of Feavers Chap. 2. and Book 4. of the Differences of Pulses Chap. 3. For in the Superficies of the Skin of those that are Scabby there is a certain viscous and clammy moisture gathered together which being either by the Apparel oâ by some other means communicated to the body corrupteth the humors therein after the like manner and produceth the like Affection and that especially in these bodies that are now already disposed unto the Scabies And indeed the humid or moist Scabies is the more contagious in regard that in this there is generated more of the aforesaid viscid and clammy humidity The Differences Some there are that reckon up very many Differences of Scabies as that one is new another old and inveterate and that one seizeth upon the whol Body another upon the Hands only and the Thighs but the main and special Difference is that which is taken from the Difference of the Humors that one ariseth from a black and melancholy humor and this is called a dry Scabies in which although there be a concurrence of other humors yet notwithstanding the greatest part thereof is of this last mentioned humor from whence it is that out of the parts affected with this Scabies either there is nothing at all sent forth or if there be any thing issuing our it is thick dry and the Ulcers themselves as likewise the prints and footsteps as we may so term them of these Ulcers are wan and pale and somtimes black another is humid and moist in which there aboundeth a salt flegm out of which there plentifully floweth forth much moist filth and corruption that is thin and subtile sharp and now and then likewise it wil be thick Signs Diagnostick The Scabies or Scabbiness is an Affect very wel known and it may easily be discerned as may also its Differences and from those signs and tokens especially that we but even now mentioned And yet notwithstanding those signs do now and then vary and are somthing changed according as the aduition of the other humors is greater or less Prognosticks 1. Now although the Scabies be in this respect troublesom to wit in regard of the foulness and deformity that it causeth in the Skin rather than that it bringeth with it or threateneth any other danger nigh at hand and that in youth it oftentimes preserveth and likewise freeth from other Diseases yet notwithstanding it is not alwaies secure and safe For if it be of any long continuance it may and somtimes doth turn into the Lepra or Leprosie and in Ancient persons it is contumacious and stubborn and hard to be cured 2. And among the several species and kinds of them the dry is more difficult in curing than the moist And therefore whatever kind or sort it be of it is not at any hand to be neglected but by a due and fit Cure even for the very deformities sake if there were no other cause speedily to be taken away and removed Of the Scabies retiring inwardly That Scabies that hath its rise and original not from any contagion but from some internal default of the humors for the most part breaketh forth as it were critically and ariseth from some internal vice of some one or other of the Bowels in which so soon as any vitious humors are generated they are immediately by Nature thrust forth unto the outward part of the body the which motion if Nature be not able to perfect and accomplish it or in case she be by Medicaments administred unseasonably hindered in her operation divers Diseases are from hence excited Many Diseases proceeding
or Guajacum Wood. To cleanse Galen in his sixth Book of the making of simple Medicaments doth especially commend a Myrepsick Suppository which in regard that it hath a very strong astringent power if Vinegar be therewith joyned having laid aside and put off its astringent power and virtue will excellently well discharge the office of Cleansing and deeply penetrating in all affects of the Skin Sulphur is here likewise very commodious by reason of its abstersive Virtue The rest of the Remedies are specified in the precedent discourse of Scabies And more likewise which may very fitly be here made use of shall be said below in Chap. 4. where we treat of the Elephantiasis Chap. 29. Of Vitiligo or Leuce and Alphus WHereas in the former Chapter we told you that the Lepra of the Greeks is by the Arabians called the black Albaras for the Arabians mention two kinds of Albaras the one white the other black and that the white Albaras of the Arabians is the same with Leuce of the Greeks and seeing that Leuce is a Species of Vitiligo we therefore judg it fit to subjoyn Vitiligo unto Lepra of the Greeks Vitiligo The truth is there be some that strenuously dispute whether or no Leuce and Alphus and the like Evils that we shal anon propound do belong unto Diseases or else unto Symptoms and they scrape together out of Galen divers places in which he seems to assert now this now that now one thing and then another But since our purpose in this Book is to treat both of the Diseases and likewise of the Symptoms of the extream parts we wil not therefore scrupulously dispute hereof Let it suffice that we give you notice of this that if the recess from the Natural state whether it be in the distemper or in the Organical Constitution be so smal that it hurteth no action it is then no Disease but only a symptom and hââherunto are to be referred the changed colours of the Skin For although in our former Books we propounded the Diseases and Symptoms of the parts severally and assunder yet notwithstanding it could not here fitly be done in regard that somtimes the same Affect according to the greatness of the recess from the Natural state is one while a Disease and another while a Symptom only Now unto the word Vitiligo from whence soever it be derived there is no general Greek word to be found that answereth unto it but it conteineth under it these three Affects Leuce and both the Alphus to wit the white and black For so Celsus writeth in his fifth Book Chap. 26. about the end thereof There are saith he three Species of Vitiligo Alphus where the white colour is somwhat rough and not continued so that there seem to be as it were certain smal drops dispersed And somtimes it creepeth broader and with certain intermissions Melas differeth from this colour in regard that it is black and like unto a shadow other things are the same Leuce hath somwhat like unto Alphus but it is more white and it descendeth deeper and in it there are white hairs soft and tender as wool or down feathers All these creep but in some faster in others more slowly But Galen as we have already said hath no common name under which to comprehend Leuce and Alphus but he propoundeth them as divers Affects in his second Book of the Causes of Symptoms and the second Chapter Among the Arabians we meet with the word Albaras which they divide into white and black not as one and the same Disease into its Species but as a word into its significations For different Affects they are and Albaras nigra or the black Albaras is nothing else than Lepra of the Greeks and the Impetigo of Celsus But Alba or the white the Greeks term Leuce which appellation Celsus doth both keep and maketh it a Species of Vitiligo Like as Pliny also maketh mention of the white Vitiligo in his Book 18. and Chap. 15. and in his Book 31. Chap. 10. But of Nigra or the black in his Book 22. and Chap. 25. For there is no word or name to be found among the Latines that may answer unto the Species of Vitiligo to wit Leuce and Alphus To wit Physitians do thus stile Leuce as Galen writeth in his third Book of the Causes of Symptoms and Chap. 2. from the Colour imposing the name thereon For look what kind of flesh Locusts have and so likewise almost al kind of Oysters the like hereunto have they also that have their Skins fouled and defiled with Leuce But Alphoi are so called from the Greek word signifying to change to wit because the colour of the Skin is changed and yet notwithstanding not of the whole Skin but up and down here and there great spots arise throughout the Skin and for the most part in the Body also And the truth is their generation as Galen there tels us is of the like kind to wit from a vitious nutriment Yet notwithstanding under these the whol flesh is not vitiated but only in the very superficies and top of the Skin there are as it were certain little scales fastened thereupon and the truth is that Alphi or the white arise from a flegmatick but the black from a melancholly Juyce And yet they are not true and right scales but there is a certain kind of roughness perceived in the Skin together with the change of colour For in this the black Alphus differeth from the Lepra or the black Albaras of the Arabians that in Albaras Nigra or the black Albaras there are both excoriation and scales whereas in the black Alphus there are neither Morphaea Alphus is likewise called Morphaea without all doubt from Morphe to wit because the colour of the Skin is changed into white and black Celsus hath used the Appellations of the Greeks in distinguishing the several species of Vitiligo and he hath named the first Species Leuce or Leuca but Alphus he calleth only by the single name Alphus and the black he stileth Melas But now this change of colour as wel in Leuca as in Alphus doth not only consist in the Skin but is extended likewise unto the Hairs and as Celsus in the place alleadged writeth in Leuca there are white Hairs such as are like unto the soft and tender Hair in new born Children and the white Alphi likewise as Paulus Aegineta tels us in his fourth Book and Chap. 6. produce white Hairs and the black Alphi black Hairs And Johannes Philippus Ingrassias in his first Tract of Tumors Chap. 1. P. 142. assureth us that he had more then once seen even old Gray-headed Men that have had some part either of their Beards or of their Eye-brows black like as it is in young Persons that are altogether black to wit when Melas is become inveterate or that there be present the black Alphus and yet notwithstanding all this while the part affected with the
is but seldom that it happeneth in these parts The Causes That it hath its original from a blow or from hard labor Paulus and Aetius teach us which is indeed to be understood of the evident cause But how these evident causes come to produce those Tumors is not so evident and manifest Vulgarly the greater part determine that they arise from a dull sluggish thick flegm or else from Melancholy But others assert and that more rightly that by means of some fal by reason of extension or of some extraordinary hard labor and over working by al or any of which either a Nerve or a Tendon is too far extended or likewise according to the Membrane even as is were broken the nutriment of the Nervous part doth as it were sweat forth and adhere neer about the Fibres and the substance of the same Nervous part and so becometh changed into this substance by reason of the formative faculty of the said parts and then covered with a peculiar Membrane After which manner if the Periostium be opened even in the Bones their nutriment is turned into a boney knot as Platerus giveth us to understand For look as it is in Trees if their Rind or Bark be wounded or in any other manner opened Nature sweating forth the aliment suffereth it not rashly to diffuse it self al abroad but changeth it into a knot so in like manner albeit the Membranes that wrap about the Bones or Nervous parts may be broken yet Nature permits not the aliment rashly to flow abroad through the open passages but from thence under the Skin formeth a Tumor included and shut up in a peculiar Membrane But now that Ganglion that Platerus describeth happeneth not from the default of one only Nerve or Tendon but chiefly in those places where there is a concourse of Tendons Ligaments and Nerves and especially about the knee either when those parts by reason of their overgreat motion are very much exercised or else while Wounds are in curing For if the juyce of these parts to wit of the Tendons Nerves Membranes and Ligaments shal chance upon the occasion of the aforesaid Causes to flow forth abroad out of the said parts and shal withal begin to be luxuriant and to abound and shal likewise adhere unto the Fibres of the same parts it is then changed into such a like fungous or Mushrom-like matter which oftentimes overspreadeth the whol joynt and is thereupon by the Germans called Der Gliedshevva And yet notwithstanding it may likewise so chance that a vitious humor abounding in the body may flow in into such a like weak part and may be mingled together with the said thick juyce that nourisheth these parts and may through that open passage flow together with it unto the aforesaid parts and may there augment the Tumor Signs Diagnostick This Tumor is bred in those parts that are not covered with much flesh but only by the Skin and therefore it lieth not hid very deep and it is now hard now soft now greater now less and somtimes it is in bigness equal unto and many times greater than an Egg it is void of al pain and yet notwithstanding if it be forcibly pressed together it then manifesteth a certain kind of dul and stupid sense it may be thrust and moved unto the sides but neither forward nor backward That Ganglium which Platerus describeth is a Tumor for the most part arising in the Knee soft without pain and of a different color from smal beginnings somtimes encreasing to so great a bulk and magnitude that it comprehendeth the whol joynt from whence it chanceth that the sick person can neither stand upright no go straight neither is he able in going to tread upon the ground or at least as it were only on tiptoe Prognosticks 1. This Disease is of long continuance and oftentimes lasteth for many yeers and accompaninieth the sick parties even unto their dying day 2. Those of them that are in the very junctures of the joynts impede and hinder the motion of the whol Member 3. The Ganglium likewise that is neer about the Joynt unless it may be taken away by Medicaments is altogether incurable For it admitteth not of Section or cutting in regard that it may easily happen that by Section a Nerve Tendon or Ligament may be hurt The Cure Universal or general Remedies having been first premised it is requisite that the Tumor be mollified and discussed or if this cannot wel be done that it be suppurated or cut out Therefore if Ganglium or Nodus the Knot be recent and new and the little Bladder within which it is included be yet tender we must then in the first place do our endeavor that the said bladder may be broken And therefore the Tumor is to be rubbed with the hand so long until it wax hot and become softer and afterward let it be close pressed together with some thin plate or some other solid thing so long that the bladder may be broken and that the matter therein included may be thereby dispersed And therefore let a thin plate of Lead be imposed upon the place affected and bound close upon it with a Swathe which is not to be removed until after ten daies Others there are that first of al anoint the Tumor with Ammoniacum dissolved in the form of an Emplaster and then after they apply a thin plate of Lead Oribasius made use of this that followeth Take Ceruss Pitchy Rosin old Oyl Ammoniacum Galbanum of each one ounce Wax four ounces mingle them c. Or Take Aloes and Myrrh of each six drams Litharge of Gold one ounce Ladanum half an ounce Ammoniacum the Fat of a Calf and of a Fox of each six drams Oyl of white Lillies two ounces Wax as much as wil suffice make an Emplaster Or Take of unslaked Lime the Fat of a Goose of each one ounce Ammoniacum half an ounce Turpentine one ounce mingle them c. Or Take of the Emplaster Oxycroceum one ounce the Mucilage of Marsh-mallow seed and Fenugreek seed of each half an ounce Galbanum Sagapenum and Ammoniacum dissolved in Vinegar of each three drams Rosin six drams white Wax half an ounce Mingle them and make an Emplaster Or Take Gum Ammoniacum Bdellium Galbanum dissolved in Vinegar of each one ounce and half Oyl of white Lillies of Camomile of Bays the Spirit of Wine of each half an ounce the pouder of the Flowerdeluce Root and live Sulphur of each half a dram mingle them and make an Emplaster If the Ganglia give not way unto these Medicaments we must then betake our selves unto those Remedies that cause suppuration As for Example Take the Roots of white Lillies and Marsh-mallow Roots of each an ounce and half the Root of Fern one ounce fat dried Figs in number ten the Root of Squils or the Sea Onion one ounce the Flowers of Melilote and Elder flowers of each one smal handful boyl them in the Broth of a
of theirs since that those who are affected with the Elephantiasis are not made hereby ever a whit the greater unless haply we have respect not so much unto the greatness of the body in such as are thus affected as unto the greatness of the danger of death thereby threatned to wit that look as the Elephant is the greatest of al the four-footed Creatures even so among diseases this appeareth to be the greaâest and an Affect almost remediless and incurable touching which thing Macer in his Book of the virtues of Herbs and Chap. 15. speaketh unto the same purpose Or else this Malady is so called because that creeping along upon the Thighs it causeth them to become as are those of an Elephant rough and unequal or else because that among other Diseases this is exceeding vehement strong and violent like as is the Elephant or otherwise it is so called and this indeed seemeth to be the most true and genuine reason thereof because the members the skin of those that are affected with this Disease are rendered tumid and swoln scaly rough and rugged ful of swellings and unequal like unto the skin of Elephants Galen in his Book of Tumors Chap. 14. writeth that this Malady when it first beginneth is likewise called Satyriasmus in regard that the face of those that are afflicted with this Disease is rendered like unto the face of the said Satyres For the lips of such as are troubled with Elephantiasis are thereby made thick and the Nose swelleth and thereupon it seemeth as if it were pressed down the Ears become flaggy and much wasted the Jaw bones are colored as it were and overspread with a certain kind of redness and in the Forehead there appear here and there Tumors or Swellings like as if they were certain Horns although there be others indeed that think the Satyriasmus to be so called even for this very cause that in the beginning of this Malady the sick parties are extreamly libidinous and lustful like as are the said Satyres And yet notwithstanding Aetius in Tetrab 4. Serm. 1. Chap. 120. out of Archigenes rendereth another kind of reason of this resemblance and that indeed different from the former to wit because the Cheeks and face in such as are thus affected are lifted up together with a certain redness and the Chin it self is dilated upon the Convulsion as it were of the Muscles of the Jaws even as we see it likewise to befal those that laugh in a certain kind of likeness and resemblance unto the Pictures of Satyres which Coelius Rhodiginus in his 19. Book of the reading of Antiquâties and Chap. 25. conceiveth to be âo called from the Greek word Seserenai because that these Satyres sing and sport themselves with their mouths wide open and gaping and their lipâ drawn forth like unto those that laugh A d there are some that give us a thâââ reâson and ground of this appellation to wit b cause thââ those who are affected wiâh thiâ Elephantiasis are like unto Satyres in their propension unto Venery and lustfulness It is likewise termed Leontiasis either in regard that this Malady is inviââible like as the Lyon or else because as Aetius hath it in Tetrab 4. Serm. 1. Chap. 30. the forehead of the sick person is with a certain swelling rendered and made more loose after the resemblance of the flexile skin of the Lions Eye-brows or else because the breath and the very spiriâs of such as are affected with this Malady do even stink like unto the breathing of Lions and their very excrements also or else because those that are affected with this Disease have a most filthy and terrible face insomuch that like as do Lions they strike a terror into those that come suddenly and unawares to behold it This Malady is by our Physitians called the Malady of St. Lazarus because that such as are Elephantiack do so abound and are ful of Ulcers like as was that Lazarus the beggar of whom there is mention made in the Evangelical History Luke Chap. 16. Now this is a very sad and grieâous Malady and as it were an Universal oâ Cancer of the whol body whereupon it comprehendeth under it many more sorts and kinds oâ Diseases For fi st of al there is present magnitude augmented and a âââlling up and down in the body especially in the external parts whose beauty feaâure and ãâã likewise is hereupon corrupted there is likewise present a hot and dry distemper by which the parts are so exulcerated and corrupted that as length they fal off Celsus in his third Book and Chap. 25. thus describeth the whol Idea of this Malady The whol Body saith he is affected so that the very Bones likewise may in a manner be said to be vitiated and corrupted The highest and utmost parts of the body have in them both spots and swellings that stand thick and close one by the other The redness of these parts is by little and little converted into a black color The top of the skin is unequally both thick and thin hard and soft and is exasperated by certain scales the body waxeth lean the mouth the calves of the legs and the feet swel and are puffed up When the disease comes once to be old the fingers and toes are quite hidden under the swelling there ariseth also a light and gentle Feaver that easily consumeth and wasteth the sick person that is already overwhelmed with the aforesaid evils and mischiefs The Causes The containing cause is black Choler and this not without malignity diffused and spread abroad throughout the whol body Now we find touching the generating of this humor viz. black choler a long and tedious dispute among Authors and we find them holding divers and different Opinions In this the truth is they al agree that this humor is generated from the adustion and burning of other humors but then in this they differ viz. from the adustion of what humors this proceedeth Avicen in the third Section of his fourth Book Tract 3. Chap. 1. seemeth to have comprehended them all whiles he mentioneth five Species or kinds of this humor The first is that which proceedeth from the Blood the second that from the melancholly humor the third that which is from the adustion of bitter Choler the fourth that which ariseth from Flegm burnt the fift and last that that proceedeth from the thick and hot part as being very apt to be burnt of the Chyle as to Instance from all salt Flesh Fish and the like But although it cannot be denied that there is here in this case an adustion of humors present and that salt humors are the cause of this Malady yet notwithstanding since that there are very many other Tumors and Ulcers that have their original from adust humors here therefore the very specifical cause is altogether to be sought for which notwithstanding cannot easily be explained but it consisteth in an occult i. e. an hidden and secret Malignity But
an extream troublesome palpitation and beating of his Heart For the removal of this great Distemper there were many Remedies prescribed and administred not only by my self but likewise by the most expert Physitians of our Vniversity there All which when they could not in the least prevail over this contumacious and head-strong Disease by reason of the Patients continuing and persevering in his accustomed ill course of Diet he grew the worse thereby and after some few months were passed in the which by the advice of the Physitians he took no Physick at all for they were willing to commit unto Nature a part of the Cure of this Chronical Affect he began to complain of that part that lieth under his left Shoulder-blade The place of his grief being lookt upon and throughly considered there appeared unto me a notable Tumor soft unto the touch and attended with a beating and when pressed down with the Fingers it was then seemingly wholly hid and non-apparent but these were no sooner taken off but forthwith it returneth as before In short the Disease having gotten deep rooting being now become incurable our Patient within a very short time after departed this life But now that we might get the truth and certainty both of the nature and constitution of this Disease as also of the Cause thereof we dissected that part that was affected with the Tumor out of which there issued forth great store of Blood unsavory and stinking as it was all which Blood being wholly evacuated and throughly cleansed there appeared the prime and principle Artery under the Heart having its original from the great Vein in its ascending up into the Head exceedingly dilated and extreamly torn This Vein descending downward creepeth along through the Region of the Intercostal Muscles the Blood that flowed forth of it being heaped up in the spaces of the Muscles and in tract of time putrefying and corrupting had so vitiated and marred the Vertebra and Rib of that place that it seemed unto us altogether rotten and putrefied And therefore say we some other way and means of the generating of this Tumor is to be sought and found out The Author of the Book of the Medicin Definitions defineth Aneurysma by the relaxation of an Artery And so likewise Fernelius in the seventh Book of his Patholog and Chap. 3. asserteth that Aneurysma is a dilatation of an Artery ful of spiritful blood but all this while they do not express the manner how this is done Neither is it ever a whit credible that Aneurisma is caused by the dilating of both the Tunicles of the Artery but only by the widening of one of them For the Atteries have indeed a double Membrane one external which is slender thin and soft having of straight Fibres very many but of oblique ones very few and of transverse ones none at all the other internal which is close thick and hard having transverse Fibres but wanting straight and oblique ones And therefore if the Internal Tunicle be either broken by extension as easily it may be in regard of its hardness or else if it be opened by Section it doth not easily Cement and close together again because it is hard but now the external Tunicle in regard of its softness doth easily and soon grow together again and because it is so soft and wanteth both oblique and transverse Fibres it is thereupon extended by the Blood and the vital Spirit seeking their passage forth in an imperious and violent manner and so this kind of Tumor cometh to be excited in the which the force and the impetuous violence of the blood and the vital spirit may be discovered by the very touch Neither is that which Platerus objecteth of any weight or moment to wiâ when he tels us that upon the alone bare Section that he saw made in the skin that covered over the Tumor the blood forthwith at first hid it self but then instantly sprang forth amain and this oftentimes saith he is in so great abundance that it cannot by any one use he what means he wil be any more stanched but that it issueth forth in greater abundance insomuch that the whol stock of Blood being almost spent it hath oftentimes brought a sudden Death upon the sick Person But indeed if we should determine that the Aneurisma proceedeth from the dilatation of these Tunicles of the Artery this Objection would then carry some weight along with it But in regard that according to the truth of the matter we have already asserted and determined that an Aneurysma ariseth from the dilatation of the exterior Tunicle alone of the Artery the internal being opened either by Section or by Rupture we cannot therefore by any means grant that the Arterial blood lieth hid under the whole Skin but because the external Tunicle is extraordinarily extended it cohereth and sticketh so close unto the Skin that it is extended together with it and is in a manner so become one therewith that it is almost impossible to cut the Skin without cutting the external Tunicle of the Artery And so then the result of al that hath been said wil be this to wit The nighest cause of Aneurisma That the proxime and nighest cause of Aneurysma is the opening of the interior Tunicle of the Artery and the dilatation of the external Now it is very frequently opened by Section when unexpert Chirurgeons instead of a Vein open an Artery or when at least together with the Vein they cut through the Artery that lieth under it Now if this at any time happen the external Tunicle in regard of its softness and neer alliance with the Tunicles of the Veins very easily and soon closeth together again but the interior by reason of its hardness remaineth open from whence through the patent and open place the Blood and vital Spirit endeavoreth to break forth and by this means distendeth the external Tunicle and causeth this kind of Tumor The same may likewise happen if the internal Tunicle of the Artery be broken either by the violent and impetuous motion of the Arterial blood or by any violent external cause and the overgreat distension of the Artery the external Tunicle that is more apt for extension being al this while safe and sound But now Whether or no that pulsation of the Arteries of which Platerus maketh mention in his Tract touching the palpitation of the Heart and touching which out of Fernelius and Ludovicus Mercatus we have already treated in the fourth Book of our Practice Part 2. Sect. 3. Chap. 9. may or ought properly to be referred unto Aneurysma I very much doubt For whenas the Membrane of either Artery is then whol and entire it seemeth rather to be an Affect in the Veins of kin to the swoln and distorted Veins that we cal Varices than this Tumor Aneurysma of which we are now treating Signs Diagnostick The Aneurysma is easily known and discerned from Ecchymosis because that in Aneurysma the color
Part 4. chap. 4. of the Inflation of the Liver ibid. Part 6. Sect. 1. chap. 3. of the Tympany ibid. Part 6. Sect. 2. chap. 4. of the windy Rupture ibid. Part 9. Sect. 1. chap. 7. of Satyriasis and Priapismus ibid. Sect. 2. chap. 3. of the Inflation of the Womb Book 4. chap. 10. of the Inflation of the Head Tract of Infants Diseases Part 2. chap. 6. Touching those Tumors that arise from the soft parts when they are removed out of their own proper places we have likewise spoken of them in special and first of all of the falling down of the Vvea in the first Book Part 3. Sect. 2. Chap. 25. of the Hernia of the Intestines Book 3. Part 2. Sect. 1. Ch. 6. of the Umbilical Hernia ibid. p. 10. Ch. 2. of the falling forth of the Womb and the Uterine Hernia B. 4. Part 1. Sect. 2. Chap. 16. and 17. And moreover as touching the Scorbutick Atrophy Of the Atrophy in general we have written sufficiently thereof in its proper place But now whereas we have in the general spoken of the augmentation of magnitude in the whol body and in general above Chap. 4. those things therefore which may in general be further spoken of the Atrophy we think it nor amiss to subjoyn them here in this place When the Body is not nourished so much as it ought to be Certain peculiar Species of an Atrophy but is diminished and lessened by reason of the denying of food unto it this may indeed in the general be called an Atrophy But yet notwithstanding the peculiar Species of an Atrophy have likewise their peculiar names That which proceedeth from the Ulcer of the Lungs is properly called Phthisis and Tabes that is from an Hectick Feaver is named Marasmus and Marcor And that which happeneth without these causes is called in general an extenuation of the Body We here in this place use the word Atrophy in a general signification and under it we will comprehend all and every preternatural Extenuation of the Body by reason of the defect of Nutriment But now an Atrophy is twofold Atrophy in general what it is the first is of the whol Body the other of some one particular part as of the Arm the Foot c. The Atrophy of the whole in general so taken is a preternatural extenuation of the whole Body by reason of its being frustrated of its food and its being denied its due and requisite Nutrition The Causes As touching the Causes of an Atrophy this in the first place is to be taken notice of viz. that the Cause that invadeth the whole body is either in its own quality and disposition according to Nature or else it is preternatural And then likewise that which is Natural or according to Nature is the Marasmus as we cal it in old age and in aged Persons For there was never yet that living Creature born or brought forth than was not obnoxious to old age and which in old age did not wither and consume away But since that this Atrophy cannot by any Art whatsoever be prevented we wil therefore in this place speak only of that Atrophy which happeneth preternaturally unto some Bodies alone and not unto all in general But now whereas there are two things that concur and are necessary unto Nutrition 1. By reason of the Nutriment to wit Nutriment and the nourishing faculty in both these likewise the Cause of Nutrition diminished and consequently of an Atrophy is to be sought after In regard of the Aliment the body consumeth and wasteth away by reason of its either defect or vitious quality which we may cal its pravity For if there be not dayly as much of this Aliment again taken into the body as is every day insensibly discussed then the body wasteth But if there be indeed a sufficient store and stock of blood treasured up in the Veins yet notwithstanding this is vitious and naught and either it is not at all attracted by the parts or if it be attracted yet can it not be assimilated The body is extenuated and pineth away in the defect and want of Food and Nutriment when in place of that Substance that is dayly wasted and diffused by an insensible transpiration and exhalation there is no other Nutriment or at least not a sufficient store thereof substituted and supplied Now whereas the blood is the proxime and nighest Nutriment of the whole body there the Nutrition is especially hurt through the defect and failing of the blood Now the blood faileth first of all in regard of some default and error in the first Concoction when there is not a sufficient quantity of Chyle from whence the blood ought to have its original generated and bred in the Stomack and this may happen unto such as are sound and in perfect health by reason of a dayly and continued scarceness of Food and their frequent spare Diet but it happeneth in such as are sick and unhealthy when by reason of the want of appetite it being now much dejected and weakned they are averse from all kind of Food and refuse to make any or else when by reason of their Disease they are fed with but little Food and that likewise not much nourishing Which may also happen if the Food that is taken in be presently sent and driven down into the Guts either Crude or Raw or else turn'd into Chyle and so is by the Belly ejected without its ever coming unto the Liver The same may likewise happen if by reason of any Disease whatsoever in the Stomack its Concoction being thereby much weakned the Chyle that is generated be either but little in quantity or that which is as bad or worse imperfect and not sufficiently elaborated Moreover Nutrition may be hindred because of the hurt of the sanguifying faculty to wit when by reason of something amiss in the Liver or Spleen the blood that is generated is impure and not good and this cometh to pass in the Cachexy Leucophlegmatia Tympany the Dropsie Ascites the Scorbutick atrophy and the long lasting Scabbiness Now as for the Causes of Sanguification they have been already in the third Book of our Pract. mentioned and explained From whence it happeneth that albeit there be a sufficient quantity of Food taken into the body yet notwithstanding there followeth no Nutrition and this again happeneth for two Causes to wit because either there is no aliment appointed by Nature for the nourishing of the parts or if there be any appointed for this purpose yet notwithstanding it cannot be rightly assimilated There is no aliment appointed unto the parts either because the Chyle is not so exactly elaborated in the Stomack that it may be converted into good blood or else because although the Chyle be sufficiently and rightly elaborated in the Stomack yet by reason of some fault in the Liver it is not converted into good blood or else because that although there be Chyle generated
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
order following to wit 1. If we first of all treat of a simple Ulcer or an Ulcer considered in the General 2. Of an Ulcer with a Distemper 3. Of an Ulcer with an afflux of humors 4. Of a sordid and foul Ulcer 5. Of an Ulcer with Tumors 6. Of Flesh growing forth luxuriant and proud 7. Of an Ulcer that is wan or Leaden coloured and withall Callous 8. Of an Ulcer that is hollow and fistulous which we commonly call the Fistula 9. Of an Ulcer with Worms 10. Of an Ulcer with a rottenness of the Bones 11. Of the Ulcer by the Greeks called Dysepulot Malignant the Ulcers Telephia and Chironia and Phagedaena 12. Of pain with an Ulcer 13. Of the Ulcers of the Legs and other parts 14. Unto which we wil add something touching Burnings 15. We wil conclude all with a short Discourse touching a Gangrene and Sphacelus Chap. 2. Of a simple or single Vlcer IN the first place therefore we wil handle a simple Ulcer and shew you what are the Causes of an Ulcer considered in the general and what differences it hath according to its form its causes and the place affected by what signs the Ulcer and its essential differences may be known and what is to be pre-advised as touching the cure and what the Ulcer in general indicateth and pointeth out and lastly what kind of Method and course it requireth for the curing of it The Causes We have already told you in the precedent Chapter that the neerest cause of an Ulcer is a matter that hath in it a corroding quality whether it be bred in the Body or whether it happen unto the body from without Of the first sort are al Humors whatsoever that are sharp and endued with a corroding Faculty bred in the body But now this humor is either bred without the part affected or else it is generated in the very part it self that is affected Without the affected part there is generated a cholerick humor a salt flegm a Whey that is salt nitrous and sharp and black Choler or Melancholy For these if they be bred in the body and flow unto any one part they may corrode and exulcerate the said part But from what Causes such like humors may be generated in the body we have already shewn you in the second Book of our Institutions touching the causes of Diseases and elsewhere Now they flow unto the part affected either by transmission or by attraction both which from what causes they proceed we have declared above in the first Part and Chap. 5. of an Inflammation And more especially in the Spring time various Ulcers are wont to arise from some internal vice of the Humors as likewise from unseasonable and immoderate exercises For if as Galen writeth in his third Book upon the Aphorisms Aphor. 20. in the Spring the Body be impure there happeneth indeed then some such like thing in the Spring time even as we see there is wont to be in the exercises of the Body For although these exercises be never so safe and healthful in themselvs yet nevertheles if you bring forth a man that is full either of flegm or yellow choler or black choler or even also of blood it self to exercise you shal undoubtedly by this exercising of him procure unto him either the Falling-sickness or the Apoplexy or if not these yet most assuredly the rupture of some Vessel in the Lungs or a most acute and violent Feaver But unto such as have had exercise enjoyn'd them for the purging out of humors that lie low and deep this their exercise drawing forth unto the skin a Gacochymy that is to say abundance of bad and offensive humors and scattering it throughout the parts doth for the most part excite and cause Vlcers and the Scabies or Scabbiness For this is that which Hippocrates hinteth unto us when he saith That if we exercise an impure and impurged body Vlcers wil from thence arise And so indeed in the very like manner in the Spring time the heat of the ambient Air dissolving the humors calleth them forth unto the skin by an effect altogether like unto that of exercises For the effects of the Spring do not only resemble the effects of Exercises but they are also most like unto the works and operations even of Nature her self For indeed the parts that the Spring time acteth like as doth Nature her self are as wel to cause that occult and secret perspiration throughout the whol body by the which all the superfluities of the body are emptied forth as throughly to purge the body also by diseases after a various and different manner Thus âaâ Galen But then these Humors get their acrimony in the part it self by reason of some distemper in the said part And after this manner like as even the Pus or puââlent matter it self by its concoction and long abode in the part becometh more sharp and stil so much the sharper and corroding by how much the humor out of which it is generated is more tart and sharp so likewise doth the blood which is corrupted by the part affected and so putrefieth But now the Causes that happen unto the body from without are Septick or putrefying and Caustick Medicaments Neither do I here exclude the very actual fire it self from bearing a part in the number of the external causes in regard that the Eschar that is left remaining appertaineth rather unto ulcers than unto wounds And hither likewise is to be referred that contagion by means whereof the vapors exhaling from the Lungs of Phthisical persons by others attracted drawn in with the breath do likewise exulcerate their Lungs and so cause in them a Phthisis or Consumption and also the nastiness and infections of such as are scabbed Leprous and affected with the foul Disease being communicated unto the skin do exulcerate it and there generate a like disease But that attraction which is caused in gauling interfairing or in wearing of the skin by the wringing and streightness of the shoo is not rightly and fitly referred unto and reckoned up amongst the nighest and most immediate Causes For by the said attrition the humor only is attracted that afterwards corrodeth the Skin and exciteth therein little bladders or blisters But now what the special causes of special Ulcers are we shal afterwards shew you in its proper place where the peculiar causes of each particular Ulcer shal be explained of the Ulcer cannot be filled up neither can there flesh enough grow forth from whence it is that an hollow Cicatrice is caused 19. If the Ulcer after such time as it is filled up with flesh and that a Cicatrice ought to have been brought thereupon wax crude and raw again there is then great cause to fear that the Ulcer wil turn into a Fistula 20. Ulcers that are in the Feet and in the Hands are wont somtimes to hasten on Inflammations of the Glandules in the Arm-pits or in the
Groins and Tumors in bodies that are plethorical and cacochymical For the matter flowing down unto the ulcer in the Hand or in the Foot those very parts themselves likewise being become more loose and weak do first of al receive and drink it in 21. The ulcers of the Thighs are for the most part hard to be cured and especially if they be cherished by any distemper and default in the Spleen for then the thick and melancholy humors that flow unto the ulcer do hinder the Cute thereof 22. Ulcers that have continued long and are now become inveterate are not to be cured without much danger unless the body be first of all carefully purged and a good course of Diet be observed of which very thing Gulielmus Fabricius in his third Century and Observ 39. giveth us an instance in a certain man who having had an inveterate ulcer cured in his left Thigh by an unskilful and immethodical Empirick after some few months was surprized with a Pleurisie in his left side upon which he died and that during his sickness he spit forth just such stuff and excrements as before were wont to flow forth of the ulcer See likewise Ambrose Parry in his seventeenth Book and Chap. 51. touching Pus likewise from an ulcer in the Arm evacuated by the Urine The rest of the Prognosticks shal be handled in the special differences of the ulcers Indications Since that the Essence of an ulcer consisteth in the solution of unity and the diminution of the magnitude of the affected part the solution of unity sheweth that union must be endeavored and that which is lost and diminished indicateth its own restauration to wit the ulcer as an ulcer is to be filled up with flesh and united and then shut up with a Cicatrice But then when the ulcer is conjoyned with its cause that either excited the ulcer from the very beginning or else if in the Cure it obtain the Nature of that cause without which the ulcer had not been the said cause is then first of al to be removed But then it is requisite likewise that the temper of the part affected as also the blood that floweth thereto be such as it ought to be but if there chance to be any thing amiss in these it is to be corrected touching which we shal hereafter speak further in the special differences of Ulcers If therefore that Humor that excited the ulcer be stil present it is to be evacuated for in every affect in which the cause is stil present the Cure is evermore to be begun from the removal of the Cause And moreover because that in the beginning there wil alwaies fal forth some of the blood without their proper vessels and because that oftentimes together with it other vitious humors in the body flow thither lest therefore that which stâcketh in the pores of the parts should putrefie and breed an Inflammation this blood is to be concocted and changed into good and laudable Pus From whence likewise it is that Galen in his Book of the times of the whol Disease and Chap. 3. writeth that ulcers have their peculiar times and that in the beginning there iâ thrust forth a thin inconcocted and waterish Sanies which in the augmentation by the help and benefit of concoction becometh thicker and at length in the state is changed into Pus that is good and white And therefore in the beginning of an ulcer it wil be requisite to use Concocters which they commonly cal Digestives And furthermore the filth and impurities which are wont to be generated in an ulcer in regard that they hinder the curing thereof are to be wiped clean away So soon as the ulcer is cleansed the Cavity thereof is to be filled up with flesh and at the length the ulcer is to be shut up with a Cicatrice There is yet nevertheless likewise regard to be had unto the parts affected For in the ulcers of the external parts the green iust of Brass burnt Brass Vitriol Antimony and the like have their place which nevertheless are by no means to be admitted of in the internal parts If likewise the part be so constituted and framed that it may give a passage unto other things like as the Gullet doth the Medicaments are then so to be ordered that they adhere unto the part Those parts that are endued with an exquisite sense wil not admit of sharp Medicaments which those parts that are of a more dul sense wil wel enough sustain touching which we shal speak here and there in the particular ulcerâ But now how an ulcer may be filled up with flesh Galen teacheth us in his third Book of the Method of Physick and Chap. 3. To wit unto the generating of flesh there are necessarily required the efficient Cause and the matter The efficient is Nature which as it doth in the whol body so likewise in each particular part doth attract and draw so much Aliment as is necessary and there she retaineth it concocteth applieth and assimilateth it The matter is a pure and sincere blood that is generated from meat and drink But because in every concoction there is generated a twofold excrement one more thin that insensibly exhaleth or else is discussed by Sweat the other more thick the same likewise happeneth in the generation of Flesh in the Ulcer and if they be left remaining in the part they wil moisten it and hinder the generation of Flesh And therefore these Excrements in the Ulcers are to be clean wiped away and dried up And this is that which is so frequently commonly alleadged out of Galen in his third Book of the Method of Physick and Chap. 4. and in his fourth Book of the Method of Physick and Chap. 5. and in other places here and there where he saith that every Ulcer requireth exsiccation And Hippocrates in the beginning of his Book of Ulcers thus writeth That which is dry saith he commeth neer unto that which is sound but that which is moist cometh very nigh unto that that is vitiated And so the Cure of an Ulcer it is indeed the work of Nature that restoreth the flesh that is lost from the Blood flowing unto the part and bringeth a Cicatrice over the Ulcer being silled up with flesh The Physitian he only removeth those impediments that are an obstacle to Nature in her operation whilest he cleanseth away the Excrements and drieth the Ulcer and when he doth this he is then said to generate Flesh and to introduce a Cicatrice The Cure At the beginning therefore if the body be plethorical or Cacochymical then the abundance of Blood is to be diminished or the Body evacuated lest that the humors flow yet longer unto the part affected And withall let there likewise be a good and wholsome Course of Diet appointed unto the Patient that so there may no more of these bad humors be generated in the Body And for all those things likewise that we call not natural there
thin there is no unsavory and stinking smel neither in the Vlcer nor in its Tumor There is no Inflammation the pain is but little and moderate nothing creepeth therein and therefore it bringeth along with it no great danger yet however it is not easily cured There it somtimes a thin Cicatrice brought all over it but this is again soon broken and the Vlcer renewed It happeneth most especially in the Feet and in the Thighs The same Celsus seeing that he maketh no mention of Telephian Ulcers it is not to be doubted but that he thought them to be the same with the Chironia as likewise Paulus Aegineta doth when in his fourth Book and 26. Chap. he thus writeth Inveterate Vlcers saith he and such as hardly admit of a Cicatrice some cal them Chironia as though they needed a Chiron himself to heal them others there are that cal them Telephia because that Telephus continued long troubled with such a like Vlcer Those that think that both the Chironium and the Telephium Ulcers consist not so much in their corrosion as in this that they are both of them malignant and contumacious so that they are wont to continue with the sick persons even unto their old age these dissent from Galen who in the second Book of the Method of Healing Chap. 2. and 14. of the said Method Chap. 17. thinketh that Phagedaena consisteth in erosion and that Chironium and Telephium are a species hereof Where we must know as Galen acquaints us in his Commentary upon the sixth of the Aphorism Aphor. 45. that al Ulcers that become greater and worse the Ancients called al these Ulcers Phagedaenae and if in this manner we take Phagedaenae then Chironia and Telephia may be called a Species or lând of Phagedaena But there are some certain of the latter Writers that have endeavered to distinguish them giving unto each of them a proper and peculiar appellation and some of these they cal Chironia others of them they term Telephia and a third sort Phagedaenae So that Phagedaena being taken for a corroding Ulcer is one while the Genus of Chironium and Telephiuns Ulcers and another while a certain determinate Species of a corroding Ulcer differing from Chironium and Telephium which to wit besides the skin eateth through the flesh it self and yet nevertheless is not altogether so malignant as Chironium or Telephium or the Cancer To wit Telephian Ulcers are the same with Chironia so called from Telephus who was a long time afflicted with such an ulcer And what Galen in the fourth Book of the Composition of Medicaments according to their kinds Chap. 4. hath written touching Chironia to wit They cal saith he those Chironian Vlcers that are not meanly and indifferently malignant or contumacious but such as are so in the highest degree The same is likewise to be taken and understood of the ulcers Telephia The Causes Now such like Ulcers have their original from a Melancholy humor having some though not much black Choler mingled together with it Signs Diagnostick Such like Ulcers are known in that they have their lips il colored and for the most part they are red and itching and although the Ulcer be never so lightly and gently handled or wiped yet there is a pain perceived the parts lying round about it swel up and the Ulcer is from day to day dilated and not only the skin but the flesh likewise that lieth under it is eaten through Prognosticks Every sort of these Ulcers is Contumacious and hard to be cured as we told you before The Cure As touching the Cure Universals being premised and the body emptied of the vitious humor and a fit course of Diet prescribed there are to be applied unto the Ulcer Medicaments that are compounded of such things as are cold and dry astringent and withall Dicussive and such are Plantane Nightshade the tops of the Black-berry or Dog-berry bush the Flowers of Roses Cypress Nuts Pomegranate flowers and rinds Mastick the bark of Frankincense burnt Lead Litharge and the like And therefore in the first place let the Ulcer be washed and fomented with this or the like Decoction Take Plantane one handful Flowers of red Roses Pomegranate flowers and Cypress Nuts of each half an ounce Myrtle berries Pomegranate rinds Sumach of each three drams Alum burnt half an ounce boyl them in Water and wash the Vlcer wel therewith Or Take the Juyce of the Bramble Plantane Nightshade Shepherds-staff of each four ounces the whites of six Eggs Alum four ounces destil them in a Leaden Alembick Let the Ulcer be washed and fomented with this Water and let the parts likewise that lie neer unto it be anoynted over with some Defensive After the Ulcer is thus washed let the Unguent Diapompholyx be laid thereon as also the white Camphorate Unguent and the Unguent de Minio Or Take Tutty prepared half an ounce burnt Lead Ceruss washed of each an ounce let them be wel mingled together in a Leaden Mortar pouring in unto them by little and little the Juyce or water of Plantane and make hereof a Mass afterwards add of Bolearmenick three drams Oyl of Roses and Wax of each as much as will suffice and make an Vnguent More of these like Medicaments shal be declared in the Chapter following Chap. 15. Of the Ulcer Phagedaena Phagedaena what it is ANd because as we have told you there is likewise mention made of Phagedaena among the Ulcers we shal therefore here in this Chapter explain it and shew you what it is It is so called from the Greek word Phagein from its Eating and this whether Tumor or Ulcer hath received its name from eating through and corroding because it eateth through the parts lying neer unto it And indeed it is properly an Ulcer But yet nevertheless in regard that the Lips of the Ulcer strutting forth with black Choler are lifted up into a Tumor it is therefore by some referred unto Tumors and there is mention hereof made by Galen in his Book of Tumors Chap. 14. But we wil treat here of it among Ulcers But yet nevertheless as touching its name this is to be noted that it is not alwaies taken in one and the same signification For somtimes as Galen tels us in Epidem 6. Comment 3. Text 37. Phagedaena signifieth an appetite unto and eating of much meat and hence by the Author of the Medicinal Definitions it is defined to be a Constitution in which Persons having an appetite unto much Food and devouring much thereof are not able to retein and keep it but when they have cast it up they again desire more and in this manner it is also defined by Aurelianus in the third Book of his Chronic. Chap. 3. So that Phagedaena being taken in this manner and in this sence is nothing else but that we cal the Dog-like appetite And therefore Pliny in his Book 20. Chap. 5. 13. and in his Book 30. Chap. 9. and Book 35. Chap. 13.
a wollen Cloth be wee therein and so imposed upon the place affected it hath likewise been happily and successfully administred in the Gangrene of the Cods of which we have spoken above Take Vitriol one ounce the tops of the Oake one handful Frankincense half an ounce Camphyre two drams Vrine two pints and half boyl them to the Consumption of a third part and then strain them But the Aegypriack Unguent is not alone to be applied but upon the Unguent that Cataplasm is also to be imposed which resolveth drieth and hindreth putrefaction such an one as Johannes de Vigo in his second Book first Tract and seventh Chapter describeth and commendeth and which many other Physitians and Chirurgeons now a daies likewise make use of And all these are to be applied blood-warm and they are so long to be continued untill the putridness be removed But if the Malady wil not yield unto these Remedies then we are to have recourse unto those that are stronger to wit Causticks such as those Trochisques of Andro Polyidas Musa and Pafio which dissolved in Vinegar and Wine may be imposed upon the part Many indeed do here commend and prefer Arsenick before all other Remedies but Gulielmus Fabricius doth and not without good Cause reject and altogether disallow of it in the Cure of a Gangrene as that that not only hath in it a Septick and putrefying faculty and a quality of melting the flesh as it were but that likewise produceth very great and grievous Symptoms vehement pain Dotings Syncope's and the like the malignant vapours being communicated unto the principal part It is therefore more safe to make use of an actuall Cautery as that which hindereth and preventeth putridness drieth and corroborateth the part This is also much commended Take Mercury dissolve it in Aqua fortis when it is dissolved precipitate it the Oyl of Tartar after it is precipitated wash it Or Mercury alone dissolved and mingled with the Water of the Trinity Flowers and wollen Cloaths wet in this Liquor may be imposed on the part The Crust in what manner soever it be produced is to be taken away by those Medicaments that have been above declared in the first Part and Chap. 13. touching a Carbuncle Neither are we to wait so long til Nature shal altogether have separated the Corrupt from the Sound but the highest part of the Crust is with the edge of a Knife or a Penknife to be cut even unto the sound part that so there may be a way made for the Medicaments unto the deeper parts and the rest that are corrupted For if we expect until the Crust shal be freed of its own accord it may possibly happen that under the Crust a new putridness may be contracted The rest of the Cure is in the same order to be proceeded in as is fit to be done in Ulcers Fourthly If the Gangrene happen from overmuch heat A Gangrene from too much heat then a Cold Diet being prescribed and the hot humors being duly qualified and evacuated if the Malady take its original from an internal Cause the Member affected is to be scarified and then washed with such a Decoction as this Take the Water of Endive Sorrel Lettice Nightshade and Vinegar of each one pint Syrup of Sorrel two pound of Lupines half an ounce Water Germander half a handful Salt three ounces boyl them till a third part be consumed After this the Aegyptiack Unguent and the Cataplasm but even now mentioned is to be imposed and the rest which were before prescribed are speedily to follow Where notwithstanding this is to be observed that unless in case of urgent necessity we must not have recourse unto the actual Câutery lest that hereby to wit by the power and force of the fire the extraneous heat which is the Cause of the Gangrene be augmented Fifthly and lastly If the Gangrene arise from the defect of Aliment and Blood and Spirits A Gangrene by reason of an Atrophy in the part and chiefly in truth if it be by reason of a Driness and an Atrophy necessaâry Nutriment being denied unto the part then meats that are hot and moist easie of Digestion and such as generate much and good blood are to be given unto the sick Person and outwardly the body is likewise to be moistened with Oyntmentâ of sweet Oyl or with Oyl of sweet Almonds and all things are carefully to be avoided that exsiccate and dry the body And unto the part it self that is already affected with the Gangrene the Aliment is by all manner of means to be attracted And therefore here there is no place left for Defensives in regard that they shut and stop up all passage of the blood and Spirits unto the part affected And therefore we are not only to anoynt the part affected and the other members with the Juyce of Earth-worms which is made of the said Earth-worms first washed in Water and then in Wine so put into a great Vessel with good store of the Oyl of sweet Almonds Violets and melted by a gentle and moderate heat over hot Embers and afterwards strained which is a sprecial and soveraign Remedy in the Atrophy and extenuation of the parts but the part affected is therwith likewise gently to be rubbed and chafed unto which also Cupping-glasses not scarified are to be applied But it wil be most fit and requisite if there be already present a putridness to administer those things that do alike both attract and resist putridness such as are Salt Water boyled with Water-Germander Liquid Pitch with the meal of Lupines of the bitter Vetch Orobus Myrrh and the like But if the Gangrene hath already made any progress the part is then to be scarified and the Aegyptiack Unguent and that likewise that is compounded of Pitch and those other things a little before mentioned are to be laid thereon A Gangrene from the interception of the blood spirits Moreover If the Gangrene happen from the interception of the Blood and the Spirits likewise whatsoever the Cause then be that thus intercepteth the blood and the spirits it is immediately to be taken away as if the said interception be from the binding of the part it is forthwith to be loosened and withal those Medicaments that resist putridness as likewise those that discuss that that is corrupted such as are those that are made of the Meal of Beans of the bitter Vetch Orobus of Lupines Aloes Water-Germander and the like are to be imposed And if the Gangrene hath already gotten unto any heighth the place is to be scarified and those other things that are required in al Gangrenes are to be done If an astringent and repelling Medicament be the Cause the said Medicament being removed the heat is to be recalled by Frictions Lotions and Anointings And so we must also proceed in the Gangrene that hath its original from other Causes that intercept the Spirits For the Cure of the Gangrene
arise thereupon the Trunk or Stump of the part that hath been cut assunder yea and the Neck likewise and all the Spinal Marrow is to be anoynted with those Medicaments that are otherwise also wont to be applied unto affects of a Nervous Nature made of Sage Rosemary Marjoram Rue Lavender Dil Camomile St. Johns wort Bayberries the Oyl of Earth-worms the Oyl of a Fox Turpentine and the like We must not here pass by in silence the Scoâbutick Gangrene The Scorbutick Gangrene touching which we have already spoken something in the third Book of our Practise Part 5. Sect. 2. Chap. 4. Which most usually beginneth about the extream part of the Foot with black and purple spots and a little after this there appeareth from hence a crusty and Gangrenous Ulcer dry and yielding forth neither the thin Excrement Sanies nor yet the thicker which we term Pus and then one or other of the Toes beginneth to die and then there appear red lines and purple spots upon the juncture of the Foot according to the length of the Leg. I have my self seen some examples of this Disease But both this Gangrene and Sphacelus differ from that Gangrene and Sphacelus that are both of them wel and commonly known and that in many things For that Gangrene that is so wel and commonly known hath its original for the most part from Causes that are manifest and apparent and there alwaies floweth forth of the Member that is dead in such a like Sphacelus a stinking and waterish humor the Member becometh soft and putrid and it sendeth forth from it a grievous and noysom stench like unto that of a dead Carkass and it creepeth much in a very short time and most commonly it soon destroyes and kils the man that hath it But now the Scorbutick Gangrene almost ever appeareth and invadeth the person without any manifest cause creepeth forward but very gently and slowly and doth not destroy the person therewith affected until after a long time for I knew a Noble-man that lived above three months but a certain School-Master I saw that lived above six months notwithstanding this Malady The part affected with this Gangrene is altogether dry so that there floweth out of it nothing at al and when the corrupt part is taken away by the Iron although a red flesh offer it self unto the view yet nevertheless that same red color is withal somwhat dark and blackish and the day following it likewise is even found to be dead also and there is here no stink at al perceived that offendeth And moreover so soon as ever the Malady hath first of al seized upon one of the feet only then presently after without any manifest cause at al there begin to appear in the other Leg and Foot also certain spots and blemishes of a red or purple color and then likewise not long after this one or other of the Toes of that Foot becometh wan and leaden colored and in a very short time it is found to be quite dead and at length most commonly the party as it befel that Noble person before mentioned being taken either with the Apoplexy or with the Epilepsie upon the first approach thereof dieth And yet notwithstanding this Malady somtimes invadeth suddenly to wit when the peccant humors are by wrath terror or the like Cause first disturbed and then afterwards thrust down suddenly and as it were in a moment unto the Toes and first of al to some one of them only after the very same manner as the Erysipelas or Rosa is wont suddenly to arise and this humor in regard that it hath in it a very bad and destructive quality or else hath received it from some affect of the mind causeth that part that it seizeth upon instantly to die and hence it is that by some this kind of Gangrene and Sphacelus is in special called Syderatio whereas otherwise the Gangrene is wont in the general also to be termed Syderatio Now this said humor seizeth upon the Tendons most usually from whence there arise most terrible and intolerable pains that torment and grieve the sick person both day and night which said Tendons in regard that they do not so easily and soon putrefie as doth the flesh hence it is that this Gangrene likewise or repeth on so slowly that somtimes unto the external view it is a whol months space in overspreading one only joynt and ere it seize upon another albeit that within almost al the Tendous of the Foot are already infected and this Malady continueth somtimes a quarter of a year before it kil the person and it is seldom or never cured in regard that this depraved humor hath insinuated it self more deep than usually into the Tendons and therefore cannot be so easily taken away So a certain Noble person that had otherwise a Cacochymical and foul body and was subject unto the Erysipelas upon a fear and terror Nature then suddenly thrusting down the vitious humors unto the little Toe was surprised with a Gangrene which afterwards by little and little overspread likewise al the rest of the Toes and almosâ the whol Foor with extream great pain upâ which after the space of three months ãâã died Of this kind was that Gangrene also with which a certain Citizen here about thirty yeers of age was taken in the month of January 1633. He first of al complained of a pain in his left Arm neer unto the Elbow which he making light of the pain descended unto his Hand and it was presently taken with a cold Tumor or Swelling and at length became suddenly overspread with a purple color so that now there appeared manifest signs and tokens of mortification and a Gangrene Yet notwithstanding upon the administring of fit and proper Medicaments of which we shal speak more hereafter his Hand had its natural color again restored unto it and the swelling vanished away so that there was nothing further to be seen but only in the very tip of the little Finger the Scarf-skin appeared to be somwhat wrinkled upon the opening of which here flowed forth a little of an humor and the Skin underneath appeared pale and so the very tip of the finger was taken with a Gangrene which yet nevertheless without any diminution of the Joynt was cured In the curing whereof we found this one thing wel worth our observation that from the said finger most sharp and exquisite pains were extended into the whol Hand insomuch that the sick person was even afraid to betake himself unto his bed but that rest and sleep he took was in the night time as he sate When his finger likewise was handled by the Chirurgeons the pains that he felt were so great that he could not endure the least touch the feet moreover swelled much and his face was somthing more swoln than usually Neither indeed wil any man that is not a stranger unto what is done in the practice of Physick admire that some vitious
Womb from the pollution of the blood and the corrupted seed and that it did consist and was nourished in the Womb of the Mother or that this Maiden being then but an Embryo in the Womb of the Mother while it yet lay therein suffered somthing from the nauseousness and vomiting of the Mother and from affrightment befalling her or from some grievous Affect that she lay under He conceiveth moreover that the Mother might be affrighted and terrified upon the sight of some Sepulchre or that she happened to come in place where they were anointing some dead body or that she took conceit and a loathing from the putrid and stinking Excrements that flow from such as lie in child-bed or else that she was some way or other greatly affected by these and the like accidents You may read more hereof in the alleadged Epistle of Libavius And another Example of the stink of the whol body the same Libavius hath in the following Epistle where he writeth that he wel knew a certain yong woman that after she was married and living in Wedlock while she had her Courses had such a stink coming from her as never Jakes had worse and that during this time her Husband lived very discontentedly as one much afflicted therewith THE FIFTH BOOK THE THIRD PART SECT II. Of things amiss in the Hair and Nails Chap. 1. Of the Nature of the Hairs AFter the faults of the Skin we wil and that not unfitly subjoyn those things that are amiss in the Hair For the Hair is fixed in the Skin neither is it any where else to be found but in the Skin Neither indeed are the Vices of the Hair to be passed over in silence in regard that even these are although ignoble yet parts of the body For as no man can wel deny That the Nails the Hoofs and Horns of al living Creatures and likewise that the Feathers in Birds are parts of their body and that none can wel say that a Peacocks Tail and al the various Feathers in Birds that are of so many several colors I say as none can wel affirm that these Feathers affording so great variety are a thing meerly excrementitious and not parts of their body so likewise it is in no wise to be denied that the Hairs are also a part of the body And this we are sufficiently taught by the conformation of them by their various figure and their different colors The same is likewise proved by the use of them and so also by their diseases touching which we shal speak hereafter and especially that we cal Plica Polonica And lastly That very effective and conformative power that the Hair hath as wel as other parts as we shal by and by shew you cleerly demonstrateth the truth of this And the growing of the Hairs again after their being cut doth not in the least prove that they therefore are no parts For both the Nails and the Hoofs the Claws of Lobsters and in certain bruit Beasts the Horns after they are shed and fallen off yet they grow forth again and so do likewise the Teeth in Men and Women We are indeed vulgarly but erroneously taught That Hairs are generated when from the heat of our bodies fuliginous and thick vapors are out of the third Concoction elevated in the parts of our body and are driven unto the pores of the Skin in the streight passages whereof whiles they stick they are there conglutinated until at the length the pore being filled up other vapors coming underneath drive it forward and these vapors are likewise followed close by other vapors and after them by more and so in the end they are thrust forth out of the pore and the hair is formed which afterward the like vapors succeeding and thrusting forth the hair and agglutinating themselves unto the root thereof it thence cometh to be prolonged But now if the Hair should be generated in this manner The breeding of the Hair a reason could not then be given why hair should not alike be bred in al parts of the body and in those parts where they are bred why there should be in some places more store thereof in some less and why some of them are alwaies growing when others grow not at al. In the Neck and Face there grow no hairs naturally but in the Head and Cheeks there are great abundance of them as also in the privy Parts in the Armpits Eyelids and above the Eyelids on the Eye-brows The hair in the head and beard is ever growing and is continually lengthened out but those hairs that are in the Eyelids ever keep at one and the same length and moreover they evermore remain straight And furthermore no cause could at al be given wherefore men only should have Beards and that women should not likewise have them whenas notwithstanding women have on their heads most usually the longer hair Moreover the hair is by Aristotle in his third Book of the History of living Creature Chap. 12. distinguished into that which is bred toegther with us such as is the hair of the head eyelids eyebrows and that that is afterwards bred to wit such as at length ariseth in process of time as age comes on of which there could no cause at al be rendered if according to the vulgar opinion the hairs had their original out of those vapors that break forth And therefore there is some other cause of the hairs original to be sought for in the discovery of which Galen hath also been very curious and taken great pains insomuch that he here taketh occasion which otherwise he doth but very seldom to make mention of the wisdom power and goodness of Almighty God the Author and Framer of al things and he hath here endeavored to examine his Omnipotency and Wisdom in this particular and to confute Moses as we may see in his eleventh Book of the use of the Parts Chap. 14. But if we seriously weigh the matter we cannot by any means grant that the hairs are bred only from the excrements or the vapors exhaling out of the body and sticking in some certain places but we are rather to determine that they are generated from the formative we may term it the pilifique or hair-breeding faculty for the causes a little before mentioned And that the hairs are generated not only from some kind of fuliginous vapors but from a matter that is far more solid and neerly allied unto the matter of the Nails and Horns we are taught even by this that the hairs are not easily corrupted but are even after death preserved a long while whol and entire Touching which Gabriel de Zerbis relateth a History in his Book of the Anatomy of Mans Body in the Title of the Anatomy of the Hair fol. 15. in these very words At Rome we both saw and touched saith he the dead body of a Woman buried in the way called Appia just opposite unto the why where Cicero was buried and
Species of the shedding of the Hair as we shal hereafter shew you As for Baldness in the first place look what Patos that is to say the falling down of the Leaves is in Trees the like is baldness in Animals yea also in the very Trees themselves whereupon Aristotle in his sixth Book of the generation of Animals and Chap. 3. writeth Men saith he of all living Creatures are mostly subject unto baldness and they evidently become so sooner then any other Creature whatsoever Which kind of Affect is in a manner general For of Plants likewise some of them have allwaies green Leaves others of them lose their Leaves The like Affect is baldness in those men unto whom it happeneth that they should be Bald. For whenas by little and little some now some then both the Leaves and the Feathers and the Hairs all off when this same Affect shal happen universally then it receiveth these words Baldness falling of the Leaf and shedding of the Feathers And Columella in his fourth Book of Husbandry Chap. 33. saith that the young and tender Chesnut Tree that is infested by Mice and Moles doth oftentimes become bald Now baldness in a man is a certain smoothness Baldness what it is or defect of Hair in the fore part of the Head taking its original from the want of Aliment And this most commonly chanceth naturally in the progress of yeers but yet nevertheless unto some it happeneth preternaturally which is thereupon to be accounted preternatural and vitious The Causes Touching the Causes of Baldness Physitians do indeed very much differ in their Opinions But if we wel weigh the manner how Hairs are generated in the Head the business in Controversie wil not seem at all difficult For whereas both the matter and the Aliment is sent and supplied unto the Hairs from the Brain more especially therefore we say indeed that the defect of the necessary Aliment is the neerest cause of this shedding or falling off of the Hair yet nevertheless this Affect proceedeth oftentimes from the Constitution of the Brain to wit if it become more dry then is meet Hippocrates tels us the same in the sixth of his Epidem Comment 3. Tit. 1. where he thus writeth the Consumption of the Brain and by reason thereof baldness c. Where as Galen tels us in his Comment upon the place by the Consumption of the Brain that diminution thereof is to be understood that happeneth unto old men from its extraordinary driness For if the Brain once become extreamly dry then there will be nothing superfluous therein remaining that may suffice for the nourishing of the Hairs And Aristotle teacheth us the same who in his fifth Book of the Generation of living Creatures Chap. 3. writeth that baldness is caused from the scarcity of the moist heat and fatness that is to say of the moist Aliment For there is in old People an excrementitious humidity that is rather too much abounding then any want thereof And indeed as we have already said baldness is natural unto the most because that in the progress of their yeers and as old age comes on the Brain in every one becometh more dry then is meet but yet unto some this baldness happeneth in their Youth and green yeers to wit unto those that from some preternatural or violent cause have their Brains overdried before the time which Causes may be many The Chief and most principal of them al is the immoderate use of Venus that powerfully drieth the Brain Whereupon it is that before the use of Venus none groweth bald Neither are Eunuchs bald at all in the sixth Sect. of the Aphorisms Aphor. 28. in regard they lose not neither cast forth any Seed and so the like may be said of Youths and until they attain unto ripeness of yeers Women likewise are seldom or never bald and yet nevertheless Albertus Magnus testifieth that he saw two Women that were bald in his nineteenth Book of Animals Chap. 6. in regard that their Constitution is naturally more moist and therefore the Brain also in them is not so easily and soon dryed and because that Women eject not such store of Seed as the Men do The Brain is likewise overmuch and oversoon dried by too much Watching Study and Cares As for that opinion of Actaurius who in the first Book of his Method Chap. 5. assigneth overmuch humidity for the Cause of baldness if any one hath a mind to reconcile it with the opinion of Hippocrates Galen and Aristotle he cannot more fitly explain it then by saying that the defect of Alimental humidity is indeed the Cause of Baldness and yet notwithstanding that excrementitious humidity causeth that this baldness happeneth so much the sooner and more easily after the very same manner that Leaves of Trees fal off indeed by reason of the want of necessary Aliment and yet nevertheless they fal off sooner and faster if any adventitious and Accidental humidity Rain or the like happen Signs Diagnostick The very Truth is that baldness of self appeareth sufficiendy unto the Eyes But yet nevertheless in what respect it differeth from the other species of the falling away of the Hairs we shal now explain unto you This Baldness we now speak of differeth from the Apolecia and the Ophiasis or Area in this that these Vices are fleeting from place to place neither in them do the Hairs fal off from any certain parts of the Head whereas baldness happeneth evermore in the fore-part of the Head But from the falling off of the Hair in special so called this baldness differeth because that in the shedding and falling of the Hair the Hair al generally or at least the greater part of them here and there up and down throughout the whole Head fal off but in baldness this falling of the Hair is only in the fore part of the Head Prognosticks 1. Baldness indeed in it self bringeth no danger at all but that it causeth that the Head lieth the more open to be hurt by the externall injuries of the Air and that it is as it were the forerunner and sign of the hastening of our Mortall Nature towards her dissolution and yet notwithstanding it causeth a great deformity and unsightliness especially if it happen early in the time of Youth and that that is resented and disliked by the most of those that behold it and it is reported that Caâus Julius Caesar the Emperor famous both for his learning and likewise for his warlike exploits could so il brook and bear the baldness wherewith he was affected that after his making triall of very many Remedies to no purpose it was at length granted unto him by the Senate that he might perpetually wear the Lawrel who if he were now at this day living might easily cover his baldness with a Coveting of Hair made of other mens Hair we in England cal it a Perriwig which is now adaies in very great and common use 2. But that baldness that ariseth
is that these Medicaments that even now we named and those that we shal hereafter further mention do not al of them generate hairs only by their manifest qualities and by taking away the Causes of the falling off of the hair but that they likewise produce hair by some occult quality that is in them such like Medicaments are therefore especially to take place in the production of a Beard not where there hath been a shedding or falling off of the hairs of the Beard but where they never as yet grew It is also wel known that it much conduceth unto the speedy growing of the Beard if the first soft hairy down upon the Chin be often shaved off by which means the Aliment is the more abundantly allured and drawn unto the Roots of the hair For the furthering and hastening of the Beard these following Medicaments are likewise commended Take Oyl of Dill Oyl of Spike of each five ounces the tender Sprigs of Southernwood two handfuls Squils three drams the best Wine three ounces let them boyl until the Wine be consumed and then use it Or Take Oyl of Garden Pinks and sweet smelling Spike of each three ounces Oyl of Roses four ounces of Cloves one dram of Ladanum two drams sweet smelling Wine two ounces Let them boyl al of them unto the consumption of the Wine Add of Musk one scruple and mingle them Chap. 3. Of the shedding of the Hair ALthough as we have already said al shedding of the Hair may be termed a Defluvium or falling off yet nevertheless use and custom have so far prevailed that the shedding of the Hair here and there in the Head in al or most parts thereof is in special termed a Defluvium or falling of the Hair so that they fal not only in one place but either they al fal off throughout the whol head or at least they most of them fal away in most parts of the Head The Causes There is not one Cause alone of this Defluvium of the Hair but the Causes are many to wit Either the want of Aliment or the pravity of the humors corroding the roots of the hair or the thinness of the skin not admitting the aliment of the hair The two former Causes have their place in those that are Phthifical in whom if the hair fal off this cometh to pass as Galen tels us in his Comment Aphotism 10. Sect. 5. because there is here both the greatest defect of Aliment and somtimes also the corruption of the humors The same happeneth for the most part in malignant Feavers such especially of them in which the Brain being withal affected the sick persons are seized on by a Delirye or Dotage For even in these Feavers also the sick parties are greatly extenuated and there is wanting unto the body a necessary aliment and the depraved humors likewise lie gnawing at the roots of the hair and eat them asunder The hair also falleth off in those that have the French Disease by reason of the pravity of the humors which somtimes happeneth likewise unto those that have drunk poyson and it is reported for a truth That whosoever toucheth the Salamander his hairs wil shed and fal away Bun somtimes also the hair fals off by reason of the thinness of the skin and this happeneth unto Women and especially in the Summer time And hence it is that those who travel out of Germany into Italy or other hot Regions find now and then this shedding of their hair for by the heat of the Ambient Air the Skin is made thin and it chanceth also that the matter out of which the hair ought to be generated doth withal transpire Signs Diagnostick The Defluvium or falling of the hair that is in special so called is easily known by the continual shedding of the hair But it is distinguished from baldness the Alopecia and Ophiasis because that in Baldness the hair fals off in the fore part of the head only but in Alopecia and Ophiasis the hair fals from al parts of the head and the head alone but then in this Defluvium the Affect we now speak of the hairs fal off in al parts of the body equally one while more and another while fewer of them But from what cause it is that they fal off may be known from the causes that went before For if there went before any sickness that was in it self apt to consume the aliment of the Body it is then credible that the shedding of the hair proceedeth from the scarcity of the Aliment But if vitious malignant and depraved humors excite and cause any disease it is then an argument that the falling of the hair proceedeth likewise from the pravity of the humors If lastly there went before causes rarefying the skin it is then probable that the said Defluvium of the hair proceedeth from the thinness of the Skin Prognosticks 1. Among al other the species of the shedding of the hair this Defluvium in special so called is most easily cured unless the cause be such as is not to be removed For the skin hath not as yet contracted any preternatural disposition that is difficultly cured And therefore it is that the Defluvium or falling of the hair that happeneth after acure and malignant Feavers is easily cured when the Feaver being healed there is an Aliment again supplied unto the body and the hair that is already fallen off is for the most part restored without the use of any Medicaments 2. But in the Consumption such a defect of the Aliment and such a vice of the humors cannot by any means be amended And therefore in this case there is not only no cure to be had for this shedding of the hair but the sick persons die also And therefore in such as are in Consumptions the falling of the hair is a sure and certain sign of Death approaching as in the fiftth of the Aphorisms Aphor. 11. 3. If the hair fal off by reason of the skins thinness it may then by the use of thickness be restored without any great difficulty The Cure The shedding of the hair is cured by taking away the cause upon which if dependeth If therefore the hairs fal away from the scarcity and want of Aliment it sheweth us that we must use our endeavor that there may be sufficient aliment bred in the body and that that which is bred may be drawn unto the skin of the head If this Defluvium be from the depraved humors and these be supplied from al parts of the body they are then to be evacuated but if they lie only at the roots of the hair they are then to be discussed If these humors be of a poysonous Nature as in the French Disease we ought then to meet with and oppose that poyson If the Affect proceed from the thinness of the skin the skin is then to be thickened If therefore this Defluvium or falling of the hair arise from the want of Aliment we ought then especially to
take care that by appointing a due meet course of Diet there may be generated sufficient store of good blood But for the drawing of this unto the place affected frictions are more especially to be made use of Yea indeed almost before the use of any Topicks the frictions or rubbing of the head are to be administred as Galen teacheth us in his first Book of the Composition of Medicaments according to the places Chap. 2. For Friction doth both attract the Aliment unto the head and also strengthen and thicken the skin If this falling of the hair proceed from the pravity of the humors then universal purgations if need require being first premised the head is often to be rubbed and discussives are to be administred but yet let the Discussers be moderate especially if there be a concurrence of an abundant aliment left that by the excessive and overmuch use of them the aliment be likewise dissipated and the skin rendered over thin and therefore Ladanum is very fitly mingled together with the Unguents If the Defluvium depend wholly upon the thinness of the skin then we ought to apply those things that condense and thicken the skin Galen commendeth especially Ladanum the Oyl of Mastick and the Oyl of Myrtle mingled together Or else let Ladanum be dissolved in Wine and so made use of And Ladanum is also very fitly administred in almost every falling off of the hair But in regard that it is of too thick consistence in it self to be anointed with it is therefore to be dissolved in somthing that is liquid Wine or Oyl and indeed such an Oyl is to be made choyce of that may satisfie and answer the cause But seeing that Unguents and Oyls are troublesom unto many who wil not endure that their heads should be anointed with Oyntments or Oyls therefore for these we must provide Lotions for the head that please them better which are to be made or Southernwood Maidenhair Golden Maidenhair Mastick Roses Rosemary Ladanum And we must here again repeat what we gave you notice of about the end of the foregoing Chapter to wit That there are some who appoint and not without good reason such kind of Medicaments to be made for the recovery of the hair that do not only by a manifest quality take away the cause of the shedding of the hair but such as also by an occult and peculiar faculty do conduce unto the breeding of hair and such as these are only known by experience And these are al the Capillary Herbs Southernwood Reed root sharp-dock root the root of the greater Bur Asarabacca Ladanum Honey and Water destilled from it Bees beaten together with the Honey-combs or the pouder and ashes of them aâ also of Wasps Flyes Moles Mice the Land Urchin Bears fat and Serpents fat Of which there are made many Compositions As for instance Take the Rind of the Reed root burnt Bees ashes of each two drams Southernwood burnt one dram Ladanum two drains Honey half an ounce Oyl of sweet Almonds and Bears fat of each as much as wil suffice and make a Liniment For the shedding of the hair after sicknesses this following is found to be good Take Maidenhair Southernwood Golden Maidenhair of each half a handful the Leaves of Myrtle of Roses and of Wormwood of each two pugils boyl them in a sufficient quantity of common Oyl and red Wine until the Wine be wasted then strain and squeeze them hard Take of the aforesaid Oyl four ounces Ladanum one ounce Mastick half an ounce and mingle them according to art Or Take Root of the Bur-dock six ounces Maidenhair three handfuls Southernwood one handful Pour thereunto as much white Wine as wil suffice and let them be destilled in a bladder Vnto what is thus destilled if you please you may add the Water of Honey Or else let the Roots of the Bur-dock be boyled in Ley and the head washed therewith Chap. 4. Of Alopecia and Ophiasis Alopecia THat which is called Alopecia and Ophiasis is a peculiar kind of the falling of the Hair Alopecia is so termed from Foxes because that this kind of shedding of the Hair is familiar unto them But Ophiasis is so called from its figure Ophiasis because that the bald and smooth parts destitute of their Hair and writhed seem like unto Serpents It is common unto both these Affects that in them the Hairs fall off areatim as they term it and hence it is likewise that this Malady is in the general called Area And Celsus in one and the same Chapter treateth of Area Area Alopecia and Ophiasis Now the name of Area is imposed upon this Affect from Country Garden-plats For as there the Beds or quarters are distinct and in certain places only and as these Beds when they are void of Plants are Naked and bare so it is likewise in these Areae for here in certain places the Skin appeareth smooth bare and slippery These Affects differ only in their figure For Alopecia hath no certain figure but as Celsus saith is dilated under any kind of figure But the Ophiasis creepeth up and down writhingly like unto a Serpent and one while being extended from the hinder part of the Head it creepeth along on both sides the Head even unto the Ears the breadth almost of two fingers and as soon again being carried beyond the Ears it creepeth forward Serpent-like even unto the very Forehead it self And moreover there is in the Ophiasis far more hurt and danger in the Cause thereof so that not only the roots of the Hair but even the Skin it self also is eaten and gnawn thorow to wit as far as the roots of the Hair reach The definition of Alopecia and Ophiasis And so Alopecia and Ophiasis may be thus defined that they are a falling off of the Hair after the aforesaid manner areatim having its Original from a corrupt and depraved humor gnawing assunder the roots of the Hair The Author of the Book of Medicaments soon provided referreth the Alopecia and Ophiasis unto those Affections that vitiate and marr the Colour of the Hair But we are to know that this is not proper unto the said Areal falling off of the Hair but that this change of Color in the Hair doth either precede the Alopecia and Ophiasis to wit when from a vitious Nutriment the Hair first becometh white but afterwards they fall off or else the colors of the Hair are changed after the Alopecia and Ophiasis For when after the Areae Hairs are again bred they are then either white or yellow like as it is in Horses after that the hair is fallen off by reason of some Ulcer caused by attrition or gauling there is wont in the place thereof to appear and grow again white hairs which happeneth from a vitious Nutriment and the weakness of the Skin And of this Celsus gives us notice in his sixth Book Chapter 1. to wit that the Ophiasis is extended unto the Hair
and dressed up her hair somwhat long as her custom was with warm ordinary Spring water But upon the very first pouring on of the water all the Locks of one side of the Head as it were all besmeared with Birdlime become on a sudden so intricate and intangled that afterward as long as she lived they could by no means wit or device be extricated and severed as formerly but continued thus in long entangled Locks very frightful to behold even unto her dying day And this we conceive to be wrought meerly by Witchcraft But I think this to be very rare and that this Vice proceedeth from some internal Cause we are taught even by this that in those places Bruits likewise are taken with this affect But now what kind of humor that is we shall find it very difficult to explain Very many there are and indeed the most who refer the Cause of this malady unto a certain viscid and slimy humor But these fal short of the truth For in many bodies and many Regions likewise these viscid Clammy humors are generated which yet notwithstanding produce no such Disease For neither may these pains of the Limbs Convulsions and other Symptoms be referred only unto a viscid humor neither can any reason be rendered why this matter should be thrust forth only unto the hairs and unto no other parts But what the Nature of this humor is the nourishing of our body and the generating of other Diseases may in some measure instruct us For although all the parts are nourished by the blood yet nevertheless as divers Plants do from the same Earth attract each one of them that Aliment that is proper and familiar unto them as Hippocrates testifieth in his Book de Natur. human Text. 31. even so likewise one of the same Mass of blood contained in the Veins every one of the parts attracteth unto it self that Nutriment that is most familiar unto it It happeneth moreover that if the blood be less pure that excrementitious aliment is carried more unto one part then unto another And this is plainly to be seen even in the Joynt-Gout Arthritis where that same serous wheyish matter salt and tartareous or cal it how you please is carried more unto the Joynts then to the fleshy parts A proof of this we have likewise from the stone Osteocolla which is very fitly administred in the fractures of the Bones where we find that the very bones themselves attract unto them the said Stone so that it is by experience found that from the overmuch use thereof there have grown forth Callous substances extraordinary great and unsightly of which see Gulielmus Fubricius in his first Century and Observat 91. And therefore I am of Opinion that in those places where this Disease is Epidemical the fault is in the Genius of the place and in the Waters which flow down from the mountains of Hungary into Polonia and in Bisgoia if this Disease be likewise familiar in that Region from the Alps which supplieth unto the hair an abundant Nutriment but unto al other parts of the body such an aliment as is altogether unuseful and which is worse very hurtful which when Nature expelleth unto the hairs the rest of the body is thereby freed from all other grief whatsoever and the hairs alone become vitious And I am the more confirmed in this my Opinion by what was related unto me by the aforesaid Illustrious Lord Count Nicolaus Sapieha that he knew a Boor in Polonia that by bathing Cured such as were troubled with this Disease by the use of which the first seven daies the sick persons became very hairy all their body over the hairs breaking forth in all parts which upon continuing the use of the same Bath for seven daies more fell off again and so the Diseased persons recovered their health And indeed that some Waters have in them an extraordinary and admirable virtues will every where appear unto us in the Writers of Naturall History So in the Alpes Styria and Carinthia by the fault of the Water the Tumors Bronchocelae and Strumae we cal this last being a swelling in the Neck the Kings Evil the former being a swelling in the throat are Natural and as it were bred together with the Inhabitants the vitious matter being thrust forth unto the Glandules in the Neck and into no other places And yet nevertheless I would not have it thought that I do hereby altogether exclude the Air which it must be confessed hath likewise a very great power in altering our bodies and it causeth that in these or those Regions and bodies these or those humors are generated Although it be likewise true that the said Air hath not this power from it self but that it receiveth the same from whose vapors that are lift up and raised from the Waters and out of the Earth which the Water washeth upon and passeth through And for this reason it is that this Malady is not general and Universal throughout the whole Kingdom of Polonia but only familiar unto some certain places thereof in regard that it alwaies spreadeth and rageth there and yet is not from thence dispersed into any other Regions and this Disease Hercules Saxonia acknowledgeth to be Endemick but he wil by no means have it to be Epidemick as we may see in the tenth Book of his Practice of Physick and Chap. 7. of Plica But we have already told you in the second Book of our Institutions Part 1. Chap. 11. that he did not wel understand and therefore could not rightly describe unto us the Nature of a Disease Epidemick and Endemick Now the said Matter is carried unto the hair not as some would have it in the form of vapors but together with the blood it self which as it is of all other parts so it is likewise the Nutriment of the hairs as we told above in the tenth Chapter Which appeareth even from hence that the hairs in the Plica if at any time they be cut they yield forth blood That notwithstanding what hath been said there are now and then some certain persons even in the neer neighboring Regions that are likewise troubled with this Disease this may possibly proceed either from the natural neer allied Genius of that place or else from the Parents For look as Arthritical persons beget the like so also it is not impossible but that those which are affected with the Plica may transfuse into their Issue a vitious disposition unto the generating of the same Disease and Experience teacheth us the truth of this The Son of the aforesaid Lord Count Sapieha when he was six yeers of age had at the first some few intangled Locks of hair among the hairs on his head and the same hath also happened unto others I knew a Souldier an old man that had a Plica in the hinder part of his Head who being demanded as touching the Cause of the Disease for he was a German and horn at Thuringia
made long but they likewise become thick unequal and rugged And this happeneth from strong and hard labor by which the Nails about the roots of them are as it were moved together and so they attract the aliment in greater abundance This Vice cannot easily be amended unless that the external Cause cease But if the said external Cause be removed then in process of time those thick and unequal Nails being by degrees cut off other that are better wil succeed in the stead of them The Roughness of the Nails Moreover the Nails also become rough and ill colored and thick Scabrities and Lepra of the Nails which Vice is called the Scabrities and Lepra of the Nails in which Vice not only the magnitude but likewise the figure and Conformation of them is vitiated This Vice is generated from the vitious and excrementitious humors mingling themselves with the aliment of the Nails Now those humors are more especially Melancholick which is shewn even from the color it self of the Nails they having in them somthing of Tartar from whence the said hardness proceedeth This Vice is manifest unto the Eyes and bringeth along with it rather a deformity than any dang r and yet nevertheless it may hurt and hinder the laying hold upon any thing which is wont to be done by the Nails and it likewise sheweth withal that there is some vitious humor lying hid and concealed in the body that Nature thrusteth forth unto the Nails like as we have before told you that those who are affected with Plica Polonica have also this evil befalling them This Vice is cured if what cannot be amended be by degrees pared away and the excrementitious humor discussed If the Vice be but new begun then the Decoction of the Vetch Orobus and Lentiles wil be very convenient or else a Cataplasm formed of their meal or else let Sulphur with Oyl and Vinegar be laid upon them Pliny writeth that Orach or Arrach wil take away the Nails without any Ulcer as we find it in his 20. Book and Chap. 20. And the lesser Celandine with Pitch doth perform the very same Or else let an Unguent be imposed or an Emplaster made of Pitch Wax Rosin Mastick Burgony Pitch or else lay on Raisins with Opopanax or Cresses with Lin-seed stronger are the Roots and Leaves of Crowfoot Or Take Rosin half an ounce Turpentine two drams new Wax and Goats Suet of each five drams Mastick one dram and half Frankincense two drams Make an Emplaster See more of these in Paulus Aegineta his second Book and 81. Chapter And in Avicen in the seventh part of his fourth Book last Tract and 14. Chapâ The color of the Nails changed But somtimes only the color of the Nails is vitiated so that they become leaden colored yellow and black Which Vice happeneth nor only by reason of the change of the color of the flesh lying underneath as some have thought but because the very aliment of the Nails is vitious and endued with such a color And now and then likewise the Nails ar here and there marked wi h certain smal white spots especially in the younger sort of people which arising for the most part about the Roots of them together with the growing Nail they change their place until at the length they are pared off with the Nail and they have their original from the thick juyce that mingleth it self with the aliment In Curriers also by reason of their handling of Lime and Ley and in Dyers by means of their handling their Dying stuff the Natural color of the Nails is frequently changed into another which oftentimes lasteth and continueth long This Vice indeed bringeth with it no danger at al but yet it causeth a deformity and is very offensive and troublesom unto Men but especially unto Women But now that this Vice may be taken away the vitious humors if they lie hid in the whol body are to be evacuated and then after they are to be taken away out of the Nails themselves This may be done if the new growing nails be very often pared until al that is viciated be quite taken away And unto the Nail it self that Emplaster that ere while we mentioned in the Lepra of the Nails is to be applied But there is then a peculiar change of the color of the Nails when by reason of a Contusion there is blood shed forth under the Nail and when shining through the Nail it produceth a red or a blackish color as it is wont to happen in Suffusions Which if it chance Avicen adviseth to make a hole through the same and so to let out the blood that lieth underneath the Nail And yet nevertheless there is in thus doing great care to be had lest that in the perforation the nervous skin lying underneath be hurt and so a pain be thereby excited The Nail having a hole made through it or if it hath not it maketh no matter lay upon it Candy Dittany with the Glue or Gelly of fish Or the Basilick Emplaster of the Root of Solomons Seal wel bruised Or Take Sagapenum as much as you please mingle it in a Mortar with the Oyl of Nuts that an Emplaster may be made and laid thereon The Crooking of the Nails There are some likewise that make mention of the crooking of the Nails among the Vices of the Nails and indeed it is of that crooking wherein the Nails in their extremities are rendered crooked and as it were hooked lâke as we see it to be in Birds and this crooking they say proceedeth from a driness that doth overmuch contract the substance of the Nails But this Affect is very rare neither when any such there is doth it proceed from driness but from a vitious matter by reason of the abundant flowing of which the Nails come to grow in that vitious and uncouth manner and this as we have already told you happeneth in the Plica Polonica And therefore there is no other way or method of Curing of this Evil than that of Rough and Leprous Nails This is not unusual especially in the Feet that the Nails grow forth too much at the sides and make a hole through the skin lying underneath upon which the flesh there in that place beginneth to grow luxuriant and to become proud and proveth a very great impediment both in putting on of the shoos and also in going Which if it happen we are then to sprinkle upon the place burnt Alum which taketh away whatsoever of the flesh is superfluous and afterwards the Nail that hath grown forth too long is to be pared off The Cleaving of the Nails And now and then likewise solution of Unity happeneth unto the Nails so that they are cleft either longwaies or else transversly and as it were cut into two thin plates And this cometh to pass either from Causes external as Wounds or else from the vitiousness of the Humor which somtimes falleth out in the French Disease
likewise hurt in the Wounded parts The Skin being Wounded can no longer cover the parts lying underneath it neither the dissected Peritonaeum the Intestines the Cornea Tunicle of the Eye can no longer contain the Humors neither can the Arteries when they are once cut in sunder any longer contain or convey the Blood neither can the Nerves carry the Animal Spirits The Differences The Differences of Wounds some of them are Essential and others of them Accidental The Essential are taken from the very Nature of the Wound to wit from the form thereof in which respect according to the Figure some of them are straight other of them oblique and these indeed likewise of a very various Figure in respect of their Magnitude some of them are smal and others great some deep others of them only superficial and hither also may this be referr'd that a wound being inflicted either there is âomwhat cut off from the substance of the part or else there is not any thing at all cut away Although if we would but rightly and accurately Judg of the thing these are no proper and Essential Differences in regard that they are taken not ãâã the very Essence of the Wound but rather from some certain Accidents that happen thereto to wit the greatness the figure c. From the part affected which is somtimes the Musculous Flesh somtimes a Nerve now and then a Ligament and very often a âendon now this or that part is affected And indeed in one and the same part there is great respect to be had in what particle of the part the wound is as for example whether the Wound be in the beginning or in the end or else in the middle of the Muscle and whether or no in the Wound of any Bowel the Parenchyma or the Vâssels therein be wounded From the Cause because that the wound afflicted is either by cutâing which is in special call d a wound or by pricking which in special is called a ãâã or pr âking or else together with the ãâã there is likewise present an incision ãâ¦ã or else all these three incisâââ pââeking and Contusion are Joyned together But the Accidental Differences are such as are drawn from those things that are without the Definition of the Wound Galen in the Third B. of his Meth. of Physick and last Chap. hath reduced them to three Chapters and he teacheth us that they are taken either from the manner of their Generation to wit that there is a total incision or a total disruption or else that there is only a part cut or a part broken Secondly From the situation of the Wound to wit when in a wound obliquely inflicted one part of the Wound is in sight and another part lieth hid under the Skin And âhirdly From the time that one wound is fresh and new made another old and inveterate There are likewise certain other Accidental Differences we may rather call them improper taken from those things that are conjoyned with the Wound to wit that that wound is poysonous that is inflicted by a poysoned sword or else by the biting of some venemous beast that there hath chanced unto the wound some inflammation or an Eryfipelas or that there is a Fracture or disioynting Joyned therewithall or else that there is conjoyned an Hemorrhage Pain or some other Symptom The Causes We need not say much touching the Causes of Wounds The Causes of a Wound that is made by cutting are al those things that have in them a power of Cutting Swords Glass and the like Of a Puncture or pricking the Causes are whatsoever things are sharp-pointed as Arrows Needles and the teeth of living Creatures Of Ruptures such things as distend the soft parts and pul them into Contrary parts such as the lifting or carrying of some extraordinary weight a Fall Blow lowd speaking and the like Those things that bruise are all things Heavy Hard and Blunt as Stones Wood Lead and among these Leaden Bullets shot out of Guns have in them a power of perforating Chap 2. Of the Diagnostick Signs THe Truth is that the wound it self is of it self sufficiently manifest unto the senses and therefore needeth not any signs whereby it may be known But although that place in the Skin that is wounded be obvious and open to the sense yet nevertheless if the Wound penetrate unto the more inward parts what parts they are that are wounded within is oftentimes very obscure and hidden from us But this may be known first from the situation of the parts Secondly from the Action that is hurt and the Use Thirdly From the supervening Symptoms and Fourthly from the Excrements For if the wound of the Head be so inflicted that it be very deep it sheweth that the Brain is wounded and if the whole Thorax or Chest be run through with a Sword it argueth that the Lungs are likewise wounded and so of all the other parts For the exact and perfect knowledg of which the Scituation of the parts is to be learnt from Anatomy Secondly the Actions that are hurt do demonstrate the Wounded part And so after a Wound received in the Privy parts if the Urine flow forth of its own accord it sheweth that the Sphincter of the Bladder is hurt But here notwithstanding we are wisely and carefully to consider in case any Action be hurt whether the hurt of the said Action be not by Consent of some other part And therefore other Signs are to be conjoyned If a wound being received in the Abdomen the Intestines fall forth it is an Argument that the Peritonaeum is cut a asunder As for what concerneth the Excrements if Chyle flow forth upon the receiving of a Wound it is a sign that the Stomach is wounded or the smal Bowels if the Excrements of the Belly that the greater and thicker Intestines are wounded if Urine flow forth of the Wound then it sheweth that the bladder is wounded if out of the Wound of the Thorax or Chest Air pass forth it is a sign that the Lungs are wounded Whether it be a Vein or an Artery that is hurt and wounded the efflux of the Blood will shew since that what floweth forth from an Artery cometh forth Leaping and Dancing as it were and is more Red then that from the Veins We have notice likewise given us of the part that is wounded from the supervening Accidents And so a vehement pain suddenly happening manifesteth that some Nerve is wounded Chap. 3. Of the Prognosticks and foretelling of the Event of Wounds BEfore the Physitian attempt the Cure of a Wound he ought First to be very Sollicitous and Inquisitive touching the Prognosticks To wit in the first place he ought to foreknow whether the Wound be Curable or altogether incurable And then if it be indeed curable whether the Cure will be easie or difficult and whether or no the wounded person be like to have his former perfect soundness restored unto him or else whether
ceased and his strength by degrees returned there being no purulent spittle at all that offered to come forth his Cough likewise and difficult breathing were not very urgent and troublesom neither for the first Week did any heat and thirst very much affect the sick person in the interim the wounds being handled after the Vsual manner there daily flowed forth an indifferent Quantity of well concocted pus or purulent matter These means being continued unto the second month and the External wounds being purified and consolidated the sick person was suddenly taken with a most dangerous suffocation so that he was in great peril of being strangled by an Asthma as it were and he was likewise very much afflicted with a cough Atrophy and Hectick Feaver until at length the imposthume of the Lungs brake and with the Cough five or six pints of purulent matter were cast up at his mouth after which the exulceration of the Lungs being cured by fit and proper Remedies the consumption Fever Hectick and all the rest of the symptoms remitted and the Patient was restored unto his perfect health To wit those Wounds of the Lungs are not mortal in which only the substance of the Lungs is hurt and not the great vessels and such as are not so great that they abolish respiration or suddenly destroy the vital faculty either by their dislipating the sprits through some notable Hemorrhage or else suffocating the heart by pouring out the blood upon the Lungs and upon the heart On the contrary if the wound of the Lungs be great and that not only the substance of the Lungs but likewise the great vessels that are therein to wit those notable and observable branches of the Arterial vein and the veiny Artery be wounded those wounds are mortal being such as in which the blood and vital spirit is poured forth and dissipated or else through the overgreat abundance of the blood the Lungs and heart are oppressed and the Patient suffocated Hippocrates in the place alleadged in Coacis addeth yet another cause of death which yet nevertheless doth not bring so sudden a destruction unto any person as those in the former case even now mentioned where the wound being great it is not the vessels containing the blood that are indeed hurt but the great and rough Artery so that by reason of the largness of the wound there is more breath that goeth forth by the wound then by the mouth for then by reason of the sympathy the heart is affected the vital spirits dissipated the Lungs and heart by the ambient Air altered and offended And indeed those wounds of the Lungs bring death likewise in which either the substance of the Lungs beginneth to be exulcerated and that a Consumption is excited or in which the blood is poured forth into the Cavity of the Thorax where it beginneth to putrefy and where it causeth either a feaver or an Empyema But in regard that this doth not alwaies happen and not at al in some wounds of the Lungs and that likewise when it doth happen there is no necessity that the Patient die for this cause therefore those wounds of the Lungs are not to be accounted necessarily Mortal For Felix Platerus in his 3. B. of Obsrv Page 690. relateth that a certain person that he knew falling into a Consumption from a Wound of the Lungs was yet nevertheless Cured and perfectly recovered A certain Coffermaker sayth he one of our Citizens having from a servant of his received a wound very deep in the lowest part of the Thorax by a prick from the point of a knife by the wound he voided forth a most stinking and loathsom pus or matter by the ill savor whereof the whol neighborhood was infected and offended and likewise some certain smal parcells of his Lungs in which the cartilaginous branches of the rough Artery did manifestly appear which persevering a long time albeit that he was in a manner wholly wasted away yet nevertheless at the length the flowing forth of the purulent matter remitting the wound was closed and he restored unto perfect soundness living after this many years as a foot-post in carrying of letters and thus he prolonged his life for forty years safe and found as we say although as it is very probable he wanted great part of his Lungs in one side The wounds of the rough Artery Fifthly That the wounds of the great rough Artery commonly called Aspera Arteria are not mortal but that they may be cured even the Laryngotomy or Cutting of the Laryinx of which we have spoken before in the Second Book of our Pract Part. 1. Chap. 24. doth evidently demonstrate To wit those of them are cured that are not great and in which the membranes only by which the rings of the rough Artery are fastened and linked together are wounded examples of which Schenkius in the Second Book Of his Observat hath collected And I my self also have twice seen such like wounds cured But if those very cartilaginous rings be wounded by reason of their hardness the part cannot again be made to grow together as formerly as Hippocrates teacheth us in the sixth of his Aphorisms Aph. 19. And in the seventh of his Aphorisms Aph. 28. and Galen in Book 5. of his method of Physick Chapt. 7. And yet notwithstanding such like Wounds do not cause a sudden death but a flow and lingering one while that the Lungs are either altered and weakned by that Air that violently breaketh in upon the Lungs thorow the wound or else that a certain smal gobbet of flesh grow unto the wound which by intercepting the breath at the length choaketh the Person But those wounds alone of the rough Artery throttle the Party in which the jugular veins and Arteries being hurt the blood violently and al at once rusheth into the Lungs intercepteth the breathing and so suffocateth the wounded person which yet nevertheless happeneth not by reason of the wound of the said rough Artery but by reason of the wound of the Jugular vein or the soporal i. e. more plainly the sleep-conveying Artery that is very neer unto it Wounds of the Diaphragm Sixthly Hippocrates reckoneth up the Wounds of the Diaphragm among those wounds that are mortal But Galen in his Book 5. of the Method of Physick Chapt. 9. distinguisheth between those wounds of the diaphragm that are inflicted upon the nervous part therof those that are made in its fleshy part and those he wil have to be mortal but these latter Curable And yet nevertheless in the Sixth of the Aphorism Aph. 18. he writeth that the wounds of the nervous part of the Diaphragm are not alwaies mortal but that the great wounds therein are only so For then it is indeed that those grievous symptoms plainly appear viz. a deliry or stupid dotage difficult breathing Feavers Convulsions and as Aristotle hath likewise observed in his third Book of the parts of living Creatures and tenth Chapt. the
Sardonian Laughter wherin the sick persons die laughing For whereas the Diaphragm receiveth Nerves from the third and fourth vertebra of the Neck and that these are mingled with those smal branches that are propagated throughout the Muscles that move the Jawbones and the Lips if they suffer a Convulsion in that part by which they reach even unto the Diaphragm they then contract and draw together along with them those little branches of the Muscles of the face by which the Jawbones and the lips being involuntarily moved to and fro hither and theither cause a resemblance and seeming appearance of laughter which Hippocrates in the 5 of his Epidem accounteth among those signs that are deadly by the Example of Tycho whom he bringeth in for an instance And yet nevertheless neither are those very wounds that are also in the nervous part of the Diaphragm alwaies mortal so far forth indeed that the party wounded in that place must of necessity presently die albeit we grant it to be a thing altogether impossible that those who are thus wounded should ever be perfectly cured or live long in that manner A notable instance and history of this which I have likewise before related in the second Book of my Institutions part 2. Chap. 13. and in the second Book of my Pract. Part. 2. Ch. 15. was given me by my Father in law Doctor Andreas Schato somtimes Physick Professor in this University of Witteberg which I must not here in this place pass over in silence Take it therefore thus In the year 1582 the 20. of September a certain Student by name Henricus Euscherhovius returning out of the lower Saxony unto Witteberg and much addicted to Melancholy before the gate ran himself through with his own sword But yet notwithstanding with in two monthes he was cured of this wound But the yeer following the 28. of April he began again to be much amiss and the days following he vomited very often first a certain water and whatsoever food he had eaten then after that such things as were green and at length on the second of May his vomitings were altogether black and that in very great abundance and so after the last vomit the same second day of May he died We opened his Body and there we found that the wound had penetrated thorow the Lungs and the Diaphragm and as it seemed to us the Diaphragm was run thorow in the Nervous circle We found very little or nothing of his Lungs on the left side that was run thorow but only a very smal portion thereof which stuck above unto the short Ribs the rest of it no doubt had gone forth thorow the wound together with the purulent matter The whole stomack was ascended into the left side of the Thorax and it had driven the Heart with its Case out of its proper place into the right side where while he was yet alive and after the wound was restored unto a good degree of health he would wish us to observe the motion of his heart by putting our hands there An instance not much unlike unto this we have in Ambrosius Paraeus his ninth Book And Chapt. 30. Of a certain Captain that was by a bullet shot out of an hand-gun wounded and shot quit thorow the Diaphragm but it was in the fleshly part thereof who dying eight months after this wound received we found in his dead body when we had opened it that a very great part of the Gut Colon being puffed and swoln up with much wind had thorow the wound of the Diaphragm gotten up into his Thorax VVounds of the Stomack Seventhly As for the wounds of the Stomack for the most part they are not to be recounted in the number of the wounds simply Mortal and which suddenly strangle and destroy a man since that we have every where exstant examples of wounds in the stomack that have been cured That History is generally wel knowen which is related both by Julius Alexandrius in the fourth chapter of his sixth Book of Galen his Therapeutick method and likewise by Matthias Cornax in his Epist in answer unto Dr. Aegid Hertogh of a certain Bohemian Boor who received a wound in his stomack and that from a broad hunting spear and yet notwithstanding lived a long while after this story we told you a little before and therefore shall say no more of it here Neither is that other history unknown of a certain Boor in Bohemia which as others have related it so we find it likewise mentioned by Crollius in the preface to his Basilica Chimica in these very words In the year 1602. at Prague in the new Town we saw a certain Bohemian Boor by name Matthaeus about thirty six years old who for two years together by an admirable and unheard of dexterity that he had in his throat would oftentimes in the company of his drunken companions hide in his wide throat as it were in a sheath an Iron knife of a fit size First of al thrusting in the horn haft thereof with the wonted sleight of a Jugler drinking upon it a large draught of beer that they gave him for this purpose and afterward he would pul it back again by the point thereof at his pleasure by a singular art and dexterity that he had but at length the morrow after Easter I know not by what unhappy and mad rashness of his he had swallowed it so far down that it wholly descended into his stomack and could no more by al his art and cunning be from thence drawn back And after that half dead in a manner with the apprehension of death undoubtedly and suddenly to follow he had lodged in his stomack the said knife seven wol weeks and two days by the use and help of attractive emplasters of the Loadstone and other the like the point of the knife by a natural impulse began to make its way forth neer unto the orifice of the stomack which was no sooner perceived by the patient but he instantly and earnestly requested of the Chirurgeons who notwithstanding disswaded him from it by reason of the extream hazard of his life thereby that it might by cutting be drawn forth Which at the length upon his continual importunate desires and yet not untill such time as he was come unto a most desperate Condition both in respect of his poverty and weakness was yielded unto and the business undertaken by the principal Chirurgeon both of the kingdom and that City Florianus Matthias by name a Brandeburger on the thursday after the feast of Pentecost at seven of the clock in the morning and by him with Gods assistance it was happily effected The colour of the knife after he had cut it forth it being as long as nine thumbs in breadth was so changed in his stomack as if it had layn all that while in the fire and was immediatly laid up among the Rarities of the Emperour having been first shewn a thing most strange incredible and
miraculous unto many men as well Courtiers as Citizens And thus this Boor in the space of a few weeks by the use of fit and convenient remedies administred unto him by that most expert Chirurgeon without any further sickness and trouble alwaies eating wel and drinking and sleeping as somtimes he told me himself by the blessing of God and the liberal Charity of many people toward him in his low and poor condition contrary unto the determinate assertion of Physical Aphorisms fully recovered his wonted perfect health and soundness and not long after he married a Wife But those wounds of the Stomack are especially mortal that are inflicted upon the superiour orifice thereof in regard that it hath those considerable Nerves that arise from the sixth Conjugation of the Brain and thereby obteineth a very neer consent with the Brain and Heart so that it being wounded most grievous Symptoms may very easily be excited And Benivenius in his tenth B. of the hidden Causes of Diseases that are curable Chap. 110. reporteth that a certain Fuller with one blow of his fist upon the Stomack of a young Man smote him so violently that he immediatly died thereof Eightly The wounds of the smal Guts The Wounds of the smaller Guts are by Hippocrates accounted and reckoned up among those that are Mortal And more especially the wounds of the Jejunum or hungry Gut among al the wounds of the Intestines are especially Mortal by Reason of the greatness of the Vessels and the almost Nervous substance of the Tunicle of that Gut from whence for the most part there follow great torments and pains of the Intestines Sobbings and Faintings as is to be seen in the Histories related by Valleriola in his 2 B. Observat 8. and 9. And indeed the wounds of the smaller Guts are then most especially incurable when the said Guts are wholly cut assunder in a transverse manner since that the Lips thereof standing wide one from the other cannot possibly by any means be Joyned and made to grow together But now the wounds of the thicker Guts are less dangerous and especially if they be not great and that oftentimes such like wounds have been Cured appeareth from the many extant Observations of Physitians which Schenckius in his Observations hath Collected Ninthly VVounds of the Liver Hippocrates likewise accounteth the wounds of the Liver in the number of such as are Mortal which yet nevertheless wanteth a limitation For Aegineta hath truly told us in his 6. B. and 28. Chap. that the Liver having been wounded and a part thereof cut away yet that the wounded person may be preserved And Gemma relateth in the first B. of his Cosmocrit and 6. Chap. that a Spanish youth a great part of whose Liver brake forth by the wound of the right Gut was yet notwithstanding Cured And Bertinus also in his 13. B. and 7. Chap. writeth that a Noble person after a wound inflicted neer about the Region of his Liver and a smal part of the substance thereof drawn forth and cut off yet escaped and became sound again And the same hath likewise been observed by others Guilhelmus Fabricius in his 2. Cent. Observ 34. relateth that a certain Helvetian thirty years old in a Duel was with an Helvetian Sword hurt in that part that is opposite unto the Liver and that he received a very great wound one span long and that hereupon there was taken from him a good big piece of his Liver And yet nevertheless this Man notwithstanding the superveising of most grievous and violent Symptoms by the blessing of God was perfeââly recovered And Matthias Glandorpius in his Speculum Chirurgic Observ 34. Page 160 hath a History of a youth dangerously wounded in his Liver who yet nevertheless recovered perfect soundness And yet notwithstanding we say that they only recover who have the superficies alone or the substance of their Liver only wounded without any hurt at all of the great Vessels For if there be wounded any one of the greater Vessels the wounded person cannot possibly escape and by reason of the large effusion of the Blood the Man before that the wound can be Sodered and Agglutinated dieth And of these some indeed for a very short time have their life protracted but others of them die in an instant or at least in a very short space For as Hippocrates in his 5. Epidem telleth the story a certain person having had a dart thrust into his Liver immediatly the colour of a dead Carcass was dispersed all his Body over his Eyes sunk in his Head a difficulty of breathing together with an aestuation or sudden vehement passions followed after this and the same day he died Another Boy being strucken upon his Liver by a Mule died the fourth day after and before his Death he was troubled with a short and thick breathing neither understood he any thing but all the while until he died lay under a feaver Wounds of the spleen Tenthly The Wounds of the Spleen are almost of the same Nature and alike dangerous as those of the Liver For if only the Parenchyma of the Spleen be wounded without any hurt of the Vessels the wounded person may possibly escape But if the Vessels of the Spleen be wounded such like wounds are not only dangerous but also deadly and Mortal For seeing that the Spleen hath stâre of Veins and especially of Arteries these being wounded by Reason of the great effusion of Blood and Dissipation of the Spirits the wounded person must of necessity perish VVounds of the Bladder Eleventhly The Wounds of the Bladder are likewise found in Hippocrates his Catalogue of Mortal Wounds But yet nevertheless here also a distinction is requisite For a smal wound is soon sodered together by the intervening of flesh as Galen in the 6. of the Aphorism Aph. 18. and Experience teach us But if the whole Bladder chance to be cut quite through which wound Hippocrates calleth Diacope the Wound is then yet more dangerous And indeed that is most especially perillous which is inflicted at the very bottom of the Bladder and the Nervous paâ thereof for by Reason of the sharpness and extremity of the pain the inflammation following thereupon and the continual feaver the party dyeth soon after But as for these Wounds that are inflicted at the Neck of the Bladder which is fleshly they are Curable as we are taught even by the Cutting of the Stone And yet nevertheless it hath been observed that the Bladder wounded even in the very bottom thereof hath likewise been Cured the truth of which we have confirmed unto us by those examples we meet with in the Observations of Schenckius For the whole Bladder is not altogether Nervous but the Exterior Membrance thereof is more fleshy whereupon Hieronymus Fabricius ab Aquapendente and Spigelius account the said Membrane for the Muscle that shutteth the Bladder But it is very rare that such a like wound of the Bladder is
perfectly Cured albeit that the wounded person die not thereof but a Callousness being brought over it the Pipe still remaineth by which the Urine is voided forth But yet nevertheless it is not long that a man can continue to live with such a like wound and therefore we say here again as we said also before that there is a difference to be made between a wound Mortal and a wound incurable But yet notwithstanding touching al the Wounds of the bowels hitherto mentioned this is to be observed that albeit there have been observed some examples of such like wounds that have been Cured yet that this hath happened very rarely and that among these those are to be numbered touching which Averrhoes saith that in the Cure of Diseases there are somtimes Miracles wrought For when fit and proper Medicaments cannot be applied unto internal wounds but that the whole work must be committed unto Nature if in this Case Nature be not very strong and Vigorous the wounded person is very hardly Cured but for the most part an inflammation Convulsions Faintings and Swoundings and other the like Symptoms supervening the party dieth And therefore Hippocrates saith rightly in the sixth of his Aphorism Aphor. 18. that such wounds are Mortal and in his Coaca that most commonly and for the most part men die of such Wounds And therefore if upon the receiving of such a wound the sick person die within a short time after the Cause of his Death ought to be imputed unto the Wound since that much help is not to be hoped for from the Physitian as we shal also anon shew you And Lastly Hippocrates reckoneth up the Wounds of the greater Veins among those that are Mortal Wounds of the great Veins and indeed rightly But now by the word Phlebae he understandeth both the Veins and Arteries and by Pacheis he meaneth great and lying hid within which elsewhere he termeth Aimorrhous that is to say pouring forth Blood such as are the great hollow Vein and the great Artery and the great branches of these For such veins and arteries seeing that they cannot be shut close by any ligature whatsoever the blood and the spirits plentifully flowing forth of them the strength and powers of the Body are soon dejected or else the blood that is fallen forth without its own proper Vessels if it hath no passage forth but that it be still deteined in the Body it Clotteth together and putrefieth and getteth unto it self a very evil corrupt and Malignant Nature causeth a Gangreen and exciteth most grievous Symptoms and at length bringeth even death it self upon the party And indeed this danger is most grievous and formidable in the Arteries when the Blood and vital spirits being poured forth the powers of the Body are dejected and the mans life endangered neither can the Arteries be easily brought to close by Reason of their continual motion and hard substance And these are the Wounds that as Hippocrates rightly saith are Mortal Of which notwithstanding as I told you before some are simply or altogether Mortal which Prosper Farinaceus Tit. de Homicidis Quest 125. Part 3. defineth that they are such that require not the Care and advice of Physitians but are such of which the Wounded person dyeth that is by Reason of which although they be Cured by all the Art and industry of the most skilful Physician yet nevertheless the Wounded person instantly dieth thereof And others of them are not altogether Mortal and certain in their causing of death which the same Prosper Farinacius defineth to be such of which the Wounded party dieth not suddenly and of which somtimes he dieth not at all But what Wounds of the latter sort are Mortal that is of which although some are now and then cured and recover their perfect health and strength yet nevertheless this or that particular person may truly be said to have died of them will indeed plainly appear from what we said before touching the Mortal Wounds of each single and particular part And yet nevertheless this is likewise to be added that we are especially to Judg by the Event whether any such Wound be actually Mortal or not For although some strong and lusty Boor or a Man otherwise exactly found and healthful shall recover of some such wound yet Nevertheless it will not necessarily follow that therefore an old person a Child a Woman or any other that is but of a weak constitution must recover of the like wound but albeit the former of these was cured of the like wound yet this latter may necessarily die of the same But now whether or no such dangerous Wounds be Mortal in this or that particular person Nicolaus Boerius in his 323. Decision Num. 11. teacheth us how we may discover it by fix Conjectures The first whereof is the shortness of the time to wit if the sick person die very suddenly after the Wound of which space of time albeit there be very many opinions touching it yet notwithstanding he saith that the principal is this if the wounded person shall die within three daies after the wound received But yet however there are some that extend this space of time unto the fifth or even also unto the eighth day But others notwithstanding extend this term even unto the eighth month or a whole year and this seemeth unto me most probable And unto this space of time the Mosaical Law Exod. Chap. 21. seemeth to have respect The Second Conjecture is the persevering of the vomiting and feaver and other Symptoms that from the very first signifyed and threatened death And this is a right Conjecture and according to the Opinion of all Physicians yea even of Galen and Hippocrates himself For those great and mortal Wounds have their Decretory and Critical daies like as Acute Diseases have as Hippocrates tels us 2 Prorrhet in the which good or evil Symptoms are wont to happen And therefore if grievous Symptoms such as are Convulsions Vomitings sobbings Dotages Syncopes and the like which otherwhiles also are wont to presage Death in such as are wounded presently and even from the very first invade the wounded person or else appear upon him on the Critical day and after continually persevere they then signifie that they were necessarily brought upon the Party by the Wound and therefore that the Wound is altogether mortal The third Conjecture is the breadth and depth of the Wound For a Wound that is very great and dangerous in it self may yet although it be great yet not be dangerous if by it no Noble part be hurt The fourth Conjecture is the quality of the instrument with which the Wound is given and by which the person inflicting the Wound is convinced that he had a will and purpose to kil the party Wounded But this conjecture concerneth rather the Court of Justice then the Colledg of Physitians who inquire not so much after the will and intention of the person wounding as simply and
solely after the quality of the Wound it self The fifth and sixth is the Continual pain from whence the Convulsion is brought upon the wounded person But these conjectures belong unto the Second And thus whether or no any one die of a dangerous Wound and of that kind of them which almost alwaies are Mortal the Physitian out of those six aforesaid Conjectures maketh use of two of them especially whereby he Concludeth that that wound touching which the inquiry is made was in it self Mortal and deadly First from the shortness of the time that the wounded party lived after his Wound And then next of all from the State and Condition of the wounded person who alwaies after his Wound falleth from bad to worse until his Death and those grievous and deadly Symptoms which either presently or on the Critical day followed upon the wound and continually afflicted the sick wounded person And unto the two former we may not unfitly add likewise a third to wit if nothing hath been either committed or omitted that might render the Wound Mortal For from these we may Collect both that the Condition of the Wound was such that it might bring death unto the Party and that the wounded person had such a disposition that was not able to master the Wound And these in all the aforesaid particular parts are those Wounds that are deservedly to be accounted Mortal As for the wounds of the rest of the parts Hippocrates rightly pronounceth them not mortal indeed experience teacheth us that somtimes the greatest and most dangerous wounds have been cured of which there are divers Histories recited by Valleriola in his fourth Book Observat 10. And there are every where the like extant in the observat of Guilhel Fabricius and the writings of other Physitians But yet notwithstanding it oftentimes so happeneth that those very wounds of which some have recovered have proved mortal unto some others and that very many also die of most sleight and inconsiderable wounds And Hippocrates in 2. Prorrhet writeth that a man may chance to die of any kind of wounds Of which we meet with examples almost in every Author Touching the Child of Philias Hippocrates in the seventh Book of his epidem writeth that he died of only the making bare of the forehead bone a feaver supervening for one day and a certain wan leaden color contracted in the sad bone And the same Hippocrates likewise relateth that the Child of one Theodorus upon the making bare of a bone almost of no moment died the 23. day after And that a certain person Master of a great ship having hurt and bruised his fore-finger on the right hand and his mouth with an Anchor an inflammation and convulsion supervening on the thirteenth day following died thereof And that Telephanes also the son of Harpalus by his free woman received a blow in the great toe of one of his feet upon which an inflammation a vehement pain followed which remitting the sick person fell into a convulsion and died the third day And so Pliny writeth in the seventh Book of his Natur Hist Chapt. 53. That Aemilius Lepidus Crushing but his thumb against the bedpost breathed his last And that Caius Aufidius going into the Senate house only hurting his foot died of the same ere he could be carried home to his own house Petrus Forestus in the sixth Book of his Chirurgical observat Observat 50. reporteth that a certain Consul Alcmarianus by name washing his feet as he was wont to do and endeavoring to cut and pare away the thick Callous skin in the sole of his foot wounded himself and that a spasm following upon it he died immediatly And oftentimes likewise a Gangreen followeth upon the wounds and make them deadly And so Petrus Forestus in the sixth Book of his Chirurgic observations Obser 49. telleth us of a certain person that hurt his Leg by hitting of it against somthing that was hard and that upon this bruise and wound of his Leg a Gangrene soon after following took his life from him And Guilhel Fabricius in the fifth Cent. of his observat Obser 2. mentioneth two examples One of a certain Labourour who prickt his foot with a thorn and the other of a woman that with a thorn likewise wounded the very tip of her right forefinger both which upon the supervening of a Gangrene died And Johannes Matthaeus in his Physick Quaest quaest 27. writeth that at Freudenberg a town of the Dominion of Nassaw receiving but a sleight wound in one of his shoulders died thereof And that another in the County of Oldenburg being but very sleightly wounded with a knife in the middle of his Thigh died immediatly And that at Lemgovia a certain Citizens son being but sleightly hurt in his Arm by the sword of a Student Contrary unto the expectation of all that saw him died within one hour after And Horatius Augenius in the first Tomâ of his Epist Book 9. Epist 2. relateth very many histories of them that have perished upon sleight and inconsiderable wounds And examples to confirm this truth we very frequently meet with in the reading of Authors and more especially those before mentioned Now this happeneth for divers Causes which Hippocrates likewise in 2. Prorrhet toucheth upon in these words Whosoever saith he would know concerning wounds in what manner they shal end each of them Particularly in the first place he ought indâed to make a narrow search strict inquiry into the several kinds of men which of them are better able to bear out a wound and which of them are worse able to undergo the same He ought moreover to know the several ages in which every particular is difficult to be cured and to be wel acquainted likewise with the several parts and places in all kind of bodyes how far forth they differ each from other He ought also to know even these other things that happen in each of them of what nature and quality they are and whether they be good or evil For if any one shall know and wel understand all these things he may indeed then likewise know the several events of each particular wound But he that shall be ignorant of these things can never know what shall be the ends and events of Wounds I shall reckon them up in this order following VVounds Curable from what causes they are made Mortal For First of all if the Sword dart or whatsoever it be that inflicteth the Wound be poysoned a Wound then that seemeth but sleight in it self may yet bring death Secondly The Idaea of Men as Hippocrates speaketh ought heedfully to be attended for such as are of a Robust strong body and sound these likewise bear and undergoe the most grievous Wounds and they are oftentimes cured of them without any great a doe and although that many times very grievous Symptoms may supervene insomuch that you would judg them even ready to die yet notwithstanding beyond all hope
and expectation they escape and recover again And hitherto apperteineth the vitious disposition of the body and the present Cacochymy For if any Wound shall befall unto Such a like Body Nature being irritated and stirred up is wont to thrust forth those vitious humors unto the Wound whereupon other diseases and symptoms happening that wound which in a sound and pure body was Curable here becometh Mortal concerning which Galen thus speaketh in his sixth Book of the Places affected Chapt. 2. suppose saith he that one came unto us that had only his skin pricked with a Needle this Man if he be one whose wounds are wont to be easily healed although without any medicament administred with his Member naked and bare you send him to his accustomed labour and imployment will yet take no hurt nor feel no evil whereas those whose Wounds are not cured without much difficulty and that are either Plâthorical or oppressed with vitious Juyces these in the first place feel indeed a certain pain in the Wound and afterward a part thereof will infested both with a beating pulse as also with a Phlegmone and it is found that of such like smal and sleight wounds oftentimes Convulsions inflammations a Gangrene yea death it self hath followed Thirdly The Age is wel to be considered in regard of which also there may be a very various Event of Wounds For those Wounds that are grievous and difficult yea Mortal in an old man or a Child these in a man that is young and strong are not mortal yea are somtimes accounted very slight inconsiderable Fourthly A Wound that otherwise is curable may yet become Mortal by reason that either the Surgeon is wanting or if he come he chance to prove either negligent or unskilful and so by reason of the hemorrhage in the want of a Chirurgeon whose part it was to stanch and stop it by ligatures and otherwise a man may often run a great hazard of his life although the wound were not otherwise Mortal And so if the Wounds of the brain of the Nerves of the Joynts be unskilfully and negligently handled an inflammation Convulsion Gangrene and the like evils befalling the Party the man may miscarry and perish notwithstanding that the Wound had it been rightly handled were in it self Curable Fifthly Sometimes there happen grievous symptoms so suddenly that although both the Physitian and the Chirurgeon bestir themselves with al possible diligence before these can be calmed and quieted other diseases and symptoms happen by which the man is quite destroyed And therefore oftentimes the very pain in the part wounded it being of a very exquisite sense causeth an afflux of humors the afflux of humors an inflammation the inflammation a Fever a Gangrene and then death And this indeed happeneth the more easily if the wound be in a part that is in it self indeed ignoble but yet such as can very easily draw a part that is Noble into a consent with it Sixthly Both the Constitution of the Air and the propriety of the place have here a peculiar power So the Wounds in the Head that in many yea the most places are not Mortal in other places are Mortal which yet nevertheless some there are that reckon them up otherwise Vidus Vidius in his sixth Book of the Cure of diseases Chap. 10. Page 249. writeth that at Florence the Wounds of the head are Mortal to most men and he ascribeth the cause unto the cold thin Air but that at Pisa and Lions very few die of them in regard the Air is there thicker and warmer Amatus Lusitanus in his sixth Cent. Curat 100. Writeth that at Florence and Bononia the Wounds of the head are extremely dangerous but not so at Ragusum And Ambrosius Paraeus testifieth that wounds of the head are far more difficult to cure at Paris then they are at Avignion Seventhly An ill course of Diet may render those wounds deadly that in themselves are not very dangerous to wit if the wounded party either eat meats of an ill Juice be much moved with anger terrified with fear Laugh immoderately and use venery Examples of this truth as we meet with them in others so especially Guilhem Fabricius in the first Cent. of his observat Obser 22. and in his 5 Cent. Observ 75. and in the 1 Cent. of his Epist n. 1. reciteth certain of them as they are there to be seen And unto this kind of cause and in special to a sudden fear and affrightment or vehement wrath those wounds are to be referred that being in themselves but sleight scarcely considerable yet notwithstanding many have been known to die of them within the space of a very few hours For although that the Nerves being pricked and a Convulsion excited a man may suddenly die yet nevertheless in regard that in these there is happening neither any Convulsion nor yet any other such like grievous symptom appearing it is therefore credible that they died by reason of the vehemency of the Passions of Wrath and fear in regard that these Affects of the Minde have in them a very great power of affecting the Body Of which thing we have every where examples extant Suidas writeth that a certain person naturally timerous and fearful hearing but the bare report of Hercules his coming hid himself for fear in a private place from whence now and then looking forth and it length seeing Hercules by chance passing by he fell down dead with fear And so Julia the Wife of Pompey died suddenly upon the sight only of her husbands Garment spotted with blood And as Plutarch testifieth Lentulus also hearing unexpectedly of the death of Pompey fel down dead suddenly And some there are that upon the fight of their own blood in venesection or when they have received any Wound have presently swounded and sunk away And Manlius in his Common places Sub. 5. Praecept relateth this history A Fool or Natural saith he for some fault by him committed was brought forth unto a pretended and feigned but not really intended punishment as if he should have been beheaded The Headsman cometh and shews him the sword indeed thereby only to terrify and scare him and withal lightly striketh him on the neck with a little wand and thereby makes the Man fearful and faint-hearted fool as he was to fall down dead to the admiration and astonishment of al the Beholders And Johannes Matthaeus in his Physical Quest Quest 27. telleth us this story When saith he in the Court of the most illustrious Prince Ernestus Fredericus Marquess of Bada his Highnesses Chief Gentleman of his Chamber Johan Beckber a Plethorick young man was but lightly touched in his lower eyelid with a blunt-pointed sword such as they were wont altogether to exercise themselves with in their fencing schools from the hand of a young beardless youth possessed with rage and indignation and taking it most heynously thus to be foyld by a boy and his own scholar fell suddenly into a
there happeneth unto it a pain an Inflammation a Deliry a Convulsion and other Symptoms Thirdly From the very greatness of the Wound And Fourthly From those things that usually happen and befal the Wound To wit Prognosticks 1. The more Noble the part affected is or which may likewise draw a more Noble part into Consent with it by so much the more dangerous is the Wound 2. Those Wounds that are in the muscles far from the Joynts and the Temples are more easily Cured then those that are in the Nerves Tendons Membranous parts and the Joynts For the wounds of the Nerves and of the nervous parts are for the most part dangerous in regard that by Reason of the pain and inflammations a Convulsion and other grievous Symptoms do easily happen and therefore they require a very expert and diligent Chirurgeon 3. All the Wounds of the internal parts are more dangerous then the Wounds of the external parts 4. Great Wounds are more dangerous then smal ones all things else being answerable 5. Moreover saith Celsus in his 5. B and 26. Chap. that which may much conduce hereunto is the Age and the Body and the order and Course of life and the time of the yeer for sooner is Cured a Child Youth or young man then one that is Ancient and in years and one that is of a strong Constitution is more easily and sooner Cured then he that is of a weak and infirm Body and one that is not over fat nor over lean sooner then if he were one of these and he that is of an intire and sound habit then that man that hath an unsound and Corrupt habit of Body And sooner likewise is that person to be Cured that is given to exercise then the slothful and sluggish person the sober and temperate then one addicted to Wine and Venery 6. Wounds are more easily Cured in the spring time then in the Winter or the hot Summer 7. That Wound likewise that hath a Contusion Joyned with it is the more dangerous And therefore it is of the two better to be wounded with a sharp-pointed or sharp edged then with a blunt and dull Weapon 8. Those Wounds are most safe and most easie to Cure that are made in a straight and direct line but those with more difficulty that are oblique and those most difficultly of all that are round and orbicular 9. If a Nerve or a Vein or an Artery shall be wholly Cut there is less danger impending then if it be cut but only in part alwaies provided that they are none of the more notable Veins and Arteries and Scituate in the deeper parts of the Body For if a Nerve be wholly cut assunder there is then no danger of a Convulsion which we may well fear is night at hand if the Nerve be cut but only in part And so if a principal Vein and Artery be wholly Cut the danger of the Hemorrhage is then wholly taken away when the Vessel is Contracted and drawn together but if a Vein or an Artery be only wounded and not wholly cut assunder very dangerous Hemorrhages do then oftentimes arise And yet nevertheless if it be one of the most Notable and Observable either of the Veins or Arteries that is cut assunder then that part unto which this befalleth is deprived of its wonted Native and necessary heat and is somtimes likewise taken with an Atrophy 10. Those wounds that have passed beyond the last and untmost term of Acute Diseases and especially the fourtieth day are not in themselves Mortal but if the sick person die this may proceed either from all ill disposition of the Body or else by Reason of Errors committed in the Diet of the sick person or the Physitians Errors in the curing thereof Yet nevertheless such like wounds are not Cured without much difficulty in regard that they indicate that there is present some grievous Cause which hindereth the Conglutination of the wound 11. That wound is alwaies evil by which there is somthing cut off and by which the flesh that is cut off from one part hangeth upon some other 12. Such as together with their Vlcers are troubled with Conspicuous and apparent Tumors these are not subject unto any dangerous Convulsion or Madness but those in whom they presently vanish and disappear if this indeed be done in the hinder part then Convulsions and Cramps follow but if in the forepart then there happeneth Madness an Acute pain of the side Empyema and Dysentery if the Tumors be more red then ordinary in the 5. of the Aphor. Aph. 65. And ibid. Aphor. 66. If the Wounds being great and depraved there appear no Tumor this betokeneth much evil which Celsus in his 5. B. and 26. Chap thus rendereth But for a Wound overmuch to swel up is somwhat dangerous but not at all to swel up is far more dangerous Yea most of all perillous The former is an evidence of a great Inflammation and the latter a token of a dead and mortified Body 13. That an Inflammation should supervene upon a great Wound is no wonder at all and therefore it ought not in the least to terrifie us if it do not long continue But for an Inflammation to follow upon a small wound and for it long Continue this indeed is very dangerous being such as is wont to excite Convulsion and Deliries or Dotings 14. When the fifth day is now come how great the Inflammation it like to be it will then shew it self On which said day the Wound being again uncovered the color thereof ought well to be considered Which if it be Pale and Wan Leaden-colored of a various colour or black we are then to know for a truth that this wound is evil and dangerous and this whensoever we well consider it cannot much terrifie and affrighten us Cornel. Cellus Lib. 5. Chap. 26. 15. A Convulsion in a Wound is very pernitious Hippocrat Sect. 5. Aphorism 2. 16. A Vomiting also of Choler that is neither voluntary nor yet accustomed unto even presently so soon as ever a man is wounded or while the Inflammation remaineth this is an ill sign because it betokeneth that the Nervous parts are wounded 17. If the wound in the Arm Hand or other part be so great that by Reason of the Veins and Arteries cut assunder it can no longer possibly receive any influx from the Liver and the heart the extream part then dieth and therefore lest that the Gangrene should be communicated unto the sound part it is maturely even with all speed to be cut off 18. Those wounds that happen unto Cathectical and Hydropical persons are very hardly Cured because that as Hippocrates speaks of Vlcers Whatsoever is dry cometh neerer unto that that is sound and whatsoever is moist approacheth very neer unto that that is vitiated 19. The greater the Wound is the more time all things else being answerable is required for the curing thereof and the lâss it is the less time it
requireth for its Cure so that some wounds indeed are cured in twenty four hours time but others require the space of many daies for their perfect Cure 20. That wound that is not purged and cleansed but with much difficulty is likewise hard to Cure and flow in the Curing in regard that that which is an impediment unto the Curing thereof is not taken away without much difficulty 21. A wound in that part that is apt and ready to receive the influx of the Humors is very hardly Cured 22. All wounds that have any other affects complicated and inâerwoven with them are the more difficultly cured For the more the Affects are the more Nature is hurt and it is easier for her to take away and correct one only affect then many and in very deed the more the affect that is conjoyned doth hurt the temperament of the part so much the more difficult will the wound be to Cure 23. All things extraneous and that coming from without stick in the wound if at the very first they cannot be drawn forth they much retard the Cure 24. Wounds have likewise their Critical daies touching which Hyppocrat in Coacis Praenat faith That for a seave in the wounds of the Head to begin the fourth day or the seventh or the eleventh is very fatal and dangerous but that for the most part it is to be Fudged of if it begin on the fourth day of the wound and so continue unto the eleventh or that it begin on the seventh day continue unto the fourteenth or seventeenth or if it begin on the eleventh and continue unto the twentieth And in his B. of the Wounds of the Head he ' faith that when any Error is committed in the Cure of a wound that then for the most part if it be in the winter a Feaver cometh upon it before the fourteenth day but if it be in the Summer after the seventh day and there he also asserteth that some perish either in the Summer time before the seventh or in the winter before the fourteenth And in his 4 B. de Popular he there relareth that unto the Son of Metrophantus being wounded in his Head there happened unto him a Feaver on the twelfth day and that he died about the twenty fourth day And in ' the popular he reporteth that Antonoius of a Wound in his head died the sixteenth day and a servant Maid in Omylum on the fourteenth day unto whom a Feaver had befaln on the eighth day and that the Daughter of Nereus by a friend of hers being in sport and merriment struck on the forepart of her Head at that very time affected with the Vertigo presently became breathless and as soon as she was come home she was forthwith taken with a vehement Feaver and with a pain in her head and a redness about her face and that she died on the nineth day when on the seventh day about her right ear there proceeded forth a great quantity more then a Porringer ful of filthy stinking Pus or Mattier being somwhat red but very offensive And that the Son of Phile after a wound in his head had a Feaver surprizing him on the ninth day and upon this he soon after dyed And that Aristippus receâving a violent and grievous blow by the stroke of an Arrow upon the upper part of his Belly died in seven daies after And all along in Hippocrates we shall find that he also in wounds did observe the Critical daies The truth is that wounds as wounds have no Critical daies since that a wound is a Disease without matter But as there may happen unto it some certain matter that ought to be Concocted or some kind of disturbance of the Humors upon occasion of the wound in this regard it may likewise have some Crisis For even Nature her self upon some certain fixed and set daies both concocteth that that ought to be concocted and calmeth the disturbance of the Humors And therefore whensoever on the Critical daies there is no change nor alteration for the worse but that all things proceed in a right manner and that the Symptoms which before were present are now quieted and Calmed it then affords great hopes of a happy Cure to ensue But if on the Contrary in these daies there supervene any evil as pain Inflammation or Feaver or if those Symptoms that were before present are not lessened but are rather become more intense and greater then before it then betokeneth either Death or a very difficult Cure And it is altogether a very rare thing that any such kind of motion in wounds ever bode any good unto the party since that it declareth that Nature is not able to quiet and Calm that Motion of the Humors that happeneth in a wound but that being stird up and set on work she endeavoureth the expulsion of these Humors either unto the wounded part or some other principal part And therefore when any such motion as this is taken notice of in a wound rather much evil then any good at all is from thence to be presaged And therefore it will be to very good purpose to observe those Critical daies in wounds that so by them we may come to know the useful actions of Nature and that so we may not hinder them We are likewise on these daies to abstain from all those things that may excite any motion of the Humors on the said Critical daies Chap. 4. Of the Cure of Wounds and first of all touching the Indications The first and Common indication of the solution of unity is the uniting thereof or unity dissolved sheweth that the parts that are separated and disjoyned should again be united and brought together so far forth indeed as the wound is a simple affect But if there be conjoyned other Affects whether they be causes or diseases or symptoms there are then so many indications given us as those several things are that are conjoyned with the Wound and so constitute a compound Affect and these may be very many For somtimes the weapon or some other body sticketh in the Wound which because that it is extraneous it hath the nature of a cause and as those things that are from internal causes and in their whol kind preternatural indicateth its removal If there be any of the substance of the flesh lost there is then a double indication given to wit that which is divided is again to be united and that which is wanting again to be renewed If the flesh and the skin be bruised that that is bruised is to be converted into Pus that so it may separate and fall off And so likewise of al other affects that are conjoined with the Wound the case is one and the same Now we will first of all treat of a simple Wound and the solution of continuity that is caused by a weapon upon which there hath as yet followed no other evil but yet because that somtimes the Weapon or some other strange
of the wounded part be by all manner of means preserved 6. That all the symptoms and whatsoever may possibly hinder the uniting and Coalition of the part may be taken away and removed And thus although that a wound only considered as a wound is one simple Affect and seemeth to indicate and require one only uniting yet nevertheless the very truth is that there are herein couched very many indications as before we told you Chap. 5. Of things extraneous and from without that are to be taken forth of the VVound IN the first place therefore we must use our endeavour that there may be nothing extraneous in the wound that may hinder the union and glutination thereof And therefore first of all the blood is not instantly to be suppressed and we must permit whatsoever we find sticking in the lesser veines cut assunder freely to flow forth For so by this means there will both a less quantity of Pus be generated and all the danger of putrefaction and inflammation be prevented Which is likewise very well known by him who out of simple wounds is wont either to extract the blood by sucking it forth with his mouth or to squeez it out by the compression of the wounded part with his finger Moreover when there are any hayres neer about the wound they are to be shaven away lest that they fall within the lips of the wound Thirdly if sand or earth or any such like thing stick within the lips of the wound it is to be cleansed away with wine Fourthly if there shal be any Clods of blood in the wound seeing that they may hinder the uniting excite pain and putrefying may cause a fever they are therefore to be wiped away with a piece of a soft Linen Cloth or a lock of wool or if need require they may likewise and must be taken forth with an iron instrument In which action notwithstanding we must use no manner of violence at the first setting upon the cure neither is all the Clotted blood at once to be taken forth and especially if a Hemorrhage be feared since that the clods of blood may stop the orifices of the veins and the vessells may grow together under them but this is to be deferred until the second or third dressing when we have afterward nature her self which beginneth to expel whatsoever is extraneous helping and assisting Fifthly the little broken bones likewise if any such be in the Wound are to be taken forth In the first dressing nevertheless only those things are to be taken forth that are altogether free and loose so that they may be taken out of the Wound without offering any violence thereunto but as for such smal pieces as yet stick fast unto other bones in these Natures endeavour is to be expected and so it wil soon be seen whether she intend to unite these fragments that are broken with the rest of the bone or else whether she purpose to make a separation Sixthly if Glass be broken in the wound it is to be taken forth and this is also to be done if any other kind of Weapon or Arms wherewith the wound is inflicted stick in the Wound But before we assay the extraction of the said weapons we are to look and consider whether or no the wounded person be likely to live after the drawing forth of those things aforesaid For if there be no hopes of life remaining there is no such taking forth of any thing to be attempted no not of the weapon it self lest that the Chirurgeon should be thought to have hastened on the parties death and lest the wounded person dye under the very hands of the Chirurgeon which happeneth sometimes in the wounds of the Heart of the Brain the basis thereof especially the Vena Cava or great hollow vein or the great Artery For it hath been observed that such wounded persons though the weapon hath been left in the wound have yet lived for the space of a whole day but that upon the drawing forth of the weapon by reason of the Hemorrhage following thereupon they have instantly died But where there is any hope that the sick person may be recovered of his wound we ought then to labour that first of al the weapon be drawn forth For the weapons as likewise leaden bullets although they may somtimes stick very long in the body yet notwithstanding it is a very rare thing that a wound should be perfectly cured the weapon stil secretly abiding in the body But now to draw forth the weapons aright is a thing of much difficulty The drawing forth of the Weapons and this difficulty ariseth especially from the place into which these weapons being thrust into the body have penetrated And therefore for him that wil attempt rightly to draw out the weapons forth of the body there are two things mainly necessary First wel to consider and mind the substance and nature the figure situation and connexion of each several part of the body and then Secondly to know the diversity of the weapons from their matter magnitude and figure and it is likewise altogether necessary in the drawing out of the Weapons to be cautious that the veins Arteries Nerves and tendons be not torn or violated For as Ambrose Parry saith truly it would be a thing very shameful and much unbecoming an Artist that the hand of the Chirurgeon should do more hurt then the iron weapon But that the weapons may the more fitly and expeditely be drawn forth let the wounded person be set in such a posture and figure as he was in when he received his wound Which if it cannot altogether be done yet lying along let him so be placed that he may come as neer as is possible unto that figure Now the Weapons are taken forth in a twofold manner How many ways the Weapons may be drawn forth either by extraction or impulsion that is to say either the same way that the weapon went in or else that way that it tendeth It is extracted the same way that it was thrust in either without making any section or else by a section made in the part For if the weapon hath not pierced very deep if it hath not passed thorow the great vessells and Nervous places and if that either right opposite unto it or the way that it tendeth it hath bones veins arteries or nerves and lastly if there be no great fear of any danger to follow upon a wide opening of the part then in this case it may be drawn back the same way by which it pierced into the body and that without any section at all But if there be any danger and cause to fear lest that the body may be torn if the weapon be drawn back the same way by the which it entered in the wound is then to be dilated either by section or else even without it to wit with that instrument which Celsus in his fifth Book and Chap. 7. calleth Ypsiloeides or
consistence And when the Needle is passed through one lip of the Wound it is then likewise to be put through the other Lip of the Wound and lest that the Lip through which the Needle ought in the Second place to be passed through should in following fal under the other and so be drawn aside too much from the other therefore without there is an instrument laid unto it which they term Cannula or Canalicus To wit a little Pipe partly Gold The Instrument Cannula and partly Brass or else all of Silver having holes through one end thereof that so through the holes the Needle may pass and that the Lip of the Wound may rest it self upon the Pipe lest that whiles the Needle is passing through it should be moved and so not follow upon the drawing forward of the Needle and Thread And yet nevertheless the Lip of the Wound may likewise be held together by the tops of the Fingers to wit the fore Finger and the middle Finger and with the other it may be sewed together if so be that the Thread pass through readily which will be if in the Tayl the Needle be hollow about the hole as we have said and that the Thread in respect of its thickness bear a proportion with the Needle Now the sewing is performed after this manner The First way of sewing In the middle of the Wound the Needle drawing after it a double Thread if the Wound be great the Lips of the Wound are to be thrust through and a knot being tied the Thread is to be cut off a little above the knot And then in the middle spaces on either side other holes are to be made with a Needle and single Thread and a knot being then likewise made the Thread is to be cut off and this is to be continued until the Lips of the Wound be rightly sewed together And this Suture is termed Intercissa because that after every prick a knot is tied The Suture intercissa and the Thread cut off But we are well to look that the stitches stand neither too wide nor yet too close for if they be too thin they will not rightly hold the Lips of the Wound together and if they be over thick they then cause pains and Inflammations And therefore between one prick and another let the space that is left be such that the Skin may as it were follow the Needle drawing it Some will have it that betwixt every stitch there ought to be a ful Fingers breadth But it is very seldom that there is need of so many stitches neither do all Wounds require one and the same number of stitches but according as the Wounds do gape more or less so there will be need of more or fewer stitches And yet notwithstanding it will not somtimes be amiss that not only the Skin but likewise that some of the flesh if it lie underneath be taken in to the end that the sewing may be so much the more firm and that the Skin be not broken thereby And yet nevertheless we are to look well unto it and to be exceeding Cautious that the Tendons be not prickt with the Needle And this is altogether the most usual and most Convenient manner and way of stitching and sewing of wounds in which this is likewise to be understood for all other cases this only we are yet to acquaint you with out of Celsus his 5. B. and 26. Chap. that the stitches ought so to be made that the very Lips are not indeed quite to touch one the other that so if there chance to be any humor gotten together within there may be made a passage whereby it may flow forth And hence it is that the Chirurgeons are likewise wont to thrust in Tents anoynted with some fit and convenient Unguents that so the Humors that are wont to be gathered together in the wounded part may flow forth and then also that the Medicaments may the better penetrate unto the bottom of the Wound Indeed Felix Wirtzius rejecteth the Use of Tents in Wounds of the Joynts The Vse of Tents and of the Hands in his second B. of Chirurgery and 13. Chap. But Guilhelm Fabricius upon very good ground refuteth this Opinion in his 4. Cent. Observat 76. and by four Examples he proveth the same to be both absurd and dangerous The First Example is of a certain Citizen of Colen who neglecting these Tents a Wound that he had received in his Hand closed up in the supersicies thereof whereupon about the fourth day a great pain arose which was followed by a Feaver an Inflammation and a Phlegmone so that the Hand was in many places exulcerated and it was not to be restored again without much labor and long time The Second Example is of a Citizen of Lausanna who pricked the hollow of his Hand with a Pen-knife And because the Chirurgeon by reason of the narrowness of the Wound could not by Tents keep it open there followed thereupon most grievous Symptoms and the sick person could hardly be restored to his former soundness until he had long endured much Pain and Torture The Third is of a certain Country Woman one Hildena by Name who with a Thorn prickt the very tip of her fore Finger But when as for the cause aforesaid the superficies of the Wound had closed up and the Pus or filthy corrupt mattier was gotten together about the Nervous parts there arose a great pain and upon this there soon followed an Inflammation and a Gangrene and from thence a Sphacelus And yet notwithstanding this Woman having had her Finger cut off even unto the Hand-Wrist at length recovered The Fourth Example is of a certain Boor nigh unto Lausanna who had a Thorn run into his Ankle-bone But he neglecting the same and the Orifice of the part where the Thorn went in shutting up too soon there arose first a pain and then there followed soon after an Inflammation and a Gangrene and at length a Sphacelus invaded and seized upon his whol Leg and refusing to give consent that the Leg should be cut off he died within few daies after It appeareth therefore from these Examples that Narrow Wounds albeit they are in the Nervous parts are so long to be kept open until the Wound shall be sufficiently purged For so it is that in every Wound whatsoever there wil get together more or less of this Pus or purulent mattier as we shal afterward more fully shew you and this if there be not opened for it a passage forth must needs be there reteined and this by little and little groweth hot and becometh very sharp whereupon in the wounded part especially if it be Nervous there followeth a pain which by attracting the Blood and the Humors exciteth and causeth most grievous Symptoms And yet nevertheless Fabricius here adviseth us that the Tents are with such Art and industry so to be sitted and fabricated that at the least they may
certain portion of Wax that it may acquire a Consistence They commend likewise for this end Tacamahaca which that it may the more easily be spread they soften it with the Oyl of the Male Balsam Apple or of St. Johns-wort a fourth or fifth part thereof They commend also the Balsam of Peru unto which if it be more solid they give a Consistence by adding of Wax They use likewise the Juyce that is contained in the smal Leaves of the Elm thickned as also the Cerote Barbarous as they cal it the Cerote Diapalma and the Cerote of Betony with Tacamahaca or some other Emplaster made of the Juyces or Decoctions of Vulnerary Plants adding thereto Aloes Sarcocol Dragons blood Rosin Turpentine and Rosin of the Fir-Tree Of these Medicaments they spread somwhat thereof upon a Linen Cloth that may answer the greatness of the Wound and may likewise take in somwhat of the adjacent parts and this they impose upon the Wound And then upon this they apply as many linen Clothes doubled or trebled as are sufficient for the preserving of the Natural heat of the part and the keeping off the injuries of the Ambient Air. And the Wound being after this manner bound up they open it not until the fourth fifth or somtimes even the seventh day and so as they write a wound such as it may be is now and then Cured with once binding up and that very frequently two or three dressings do suffice And yet notwithstanding that the Linen when it is all foul and nasty may somtimes be taken off and clean Clothes be imposed in stead thereof this they allow of provided alwaies that this be done without any uncovering of the Wound And withal they likewise make exceptions in some certain Cases in which this way of Curing simply hath not place but that we ought in those Cases to use the old way of Curing touching which we shall anon speak further And that new way of Curing they prefer far before the former old manner Whether Wounds be often or but seldom to be opened and first of al they endeavour to prove by certain Arguments and Reasons that it is both more easie and more safe and then by certain Reasons they impugne and oppose that Ancient way and then Thirdly they endeavour to weaken and invalidate those Causes that are alleadged by the Ancients and whereby they seem to be drawn unto the more frequent opening and uncovering of the Wound and then lastly they attempt the answering of whatsoever hath been by any objected against this new way of theirs unto all which we shall speak in order And in the first place therefore that this their new way and Method is both more easie and more safe also and by which far many more have been and may be Cured then by the old common way they first of al appeal unto experience and in special Ludovicus Septalius writeth touching the Wounds of the Head that when in a time of great weakness and sickliness at Millain in the space of one year very many of those that were wounded in the Head and were ordered after the old wonted manner to wit by often opening of the Wounds Tents Liniments and more frequent Terebrations and Scrapings miscarried and perished and that afterwards this new way of curing being put in practise to wit by imposing an Unguent upon the Wound anointing the Lips thereof with the Oyl of the Fir-Tree and the wound only twice or thrice uncovered and but one only Terebration or piercing with the Wimble being instituted of fourteen that were wounded in their Heads there died but only one of them And Caesar Magatus in his 1. B. and 40. Chap. writeth that the wounds inflicted upon the Head with the falling in of the bone within the space of twenty daies were perfectly cured in that manner And likewise that in the same manner and in the same space of time a wound of the head with a cutting of the Membranes was healed And that a Wound inflicted on the Head with a Leaden bullet shot out of an Engine of War so that the bullet pierced even to the more inward parts of the Brain before neither could be found or drawn forth in thirty daies after two or three openings and dressings was perfectly Cured I. And then in the next place Caesar Magatus in his 1. Book Chap. 7. alleadgeth these Reasons which we will briefly propound The First is that this new way of Curing wounds doth best and with the most security perform all those things that are required in Curing The Reasons that moved Magatus to prefer his new way of Curing Wounds before the old To wit as for the Native heat that Nature useth for suppuration generating of Flesh and the glutinating of the Wound as its chief Agent and which by Reason of the effusion of Blood and the uncovering and wounding of the Natural Covering is dissipated and rendered very weak and by the external Air is offended and altered is made more strong and vigorous whereas in this new way and Method of Curing the Wounds are kept covered For when the Wounds are but seldom uncovered that Artificial Covering supplieth the defect of the Natural covering which is the Skin and so neither the Native heat is scattered and dissolved neither is it at al altered by the Ambient Air. And for this Reason Septalius wondereth that Galen should omit this main and principal scope which is to preserve the Native heat and that his care and study is only to take away the Impediments And Secondly He therefore thinketh that Wounds are most happily cured in this new way of theirs because that in this way those things that retarde and hinder the Curing of Wounds are soonest and best of all turned and taken out of the way For whereas one main impediment among all those other that chiefly hinder the speedy and safe curing of Wounds is the conflux of Humors unto the wounded part they think that that impediment is by this their new way best of all prevented For since that the afflux is caused either by transmission or else by attraction by Reason of the pain and heat both these are best turned away by this their new manner of curing For if the Wound be but seldom opened the heat is then by the covering preserved and fortifyed neither is there any pain excited as it is wont to happen by the frequent handling and cleansing of Wounds For all those inconveniences and discommodities are avoided by this new way of curing whilest that the part is but very rarely moved from its due and proper Scituation is very seldom loosned and unbound so that likewise there is not often occasion for its binding up and as he addeth in the 32. Chap. if any winde or Humor distend the part so that there be great pain caused thereby it is speedily discussed by the strong and more Vigorous heat Thirdly Of all those things that impede and withstand the Cure
of Wounds the chiefest of them is the exposing of the Wound unto the Ambient Air by which the innate heat is altered and weakned But now this is prevented if the Wound be but seldom uncovered by opening thereof Fourthly whereas Hippocrates in his 2. Sect. of Fractures Title 7. commendeth that Cure under which there is little or no impostumation and loss of the bones this appeareth to be so in this new way of curing and therefore he determineth that this is the most perfect and this Magatus proveth by an example of his own for that in this manner he had Cured Wounds of the Head wherein there was likewise an extraordinary hurt of the bone in so much that any one would have Judged that a great part thereof would have dropt out without any impostumation and abscession of the bone or any thing else Fifthly He therefore thinketh that this new way of curing is to be preferred because that under it fewer Excrements are generated then under the common and wonted manner which as he writeth is manifest by experience Sixthly Caesar Magatus in his first B. and 32. Chap. bringeth this likewise for a Reason because that those things that are extraneous and strangers to the Body and which at the first could not be drawn forth by the Chirurgeons being such as require the work of Nature may more easily be driven forth if the Wounds be but seldom uncovered and that for this very Reason to wit because that in this new way and Method the Natural heat is more rightly preserved cherished and augmented as was said before in the first Reason And Seventhly in the place alleadged he produceth this for one of his Reasons that in this his new way the virtue of the Medicament that was administred in the first dressing is best of all continued and made to endure even unto the perfect agglutination of the Wound and especially if it be of such an essence that it cannot hastily be dissipated And as for those Excrements that usually are here to be found he thinketh also that it cannot be by them corrupted since that the Excrements that are generated are not worth a speaking of II. They in Like manner reject the Ancient Way and Method of Curing Wound as drawn thereunto both by experience and Reason Experience indeed because that as is said before under the Ancient way of Cure fewer Patients and with far more difficulty do recover of their Wounds then under their new way And as for the Reasons they alleadg they are these The First is this because that under the ordinary and wonted way of curing The Reasons moving Magatus and Septalius to reject the Ancient way of Curing Wounds the wounded part is exposed unto the Ambient Air and by it the Natural heat therof may be dissolved offended and weakned and that thereupon the part is rendered the more apt and Obnoxious unto a reception of the Afflux of Humors and the Concoction therein is less happily perfected and so there are generated greater store of Excrements that in time prove a great impediment unto Nature in her work Secondly They say that from this frequent unbinding and loosening of the wound the handling thereof and the moving of the part the cleansing thereof and the laying on of new Medicaments and by means likewise of the new binding up a pain is oftentimes excited which they say may very well be the cause of a Fluxion For it can no waies be saith Caesar Magatus in his 1. B. and 32. Chap. but that while we handle the part there will be some pain excited and indeed the greater by how much the greater the Wound is and the part wherein it is endued with an exquisite sense For we are forced in the opening of the Wound and the new binding it up again to move the part from its former Scituation We take away the Medicaments we cleanse and wipe away the Pus we impose new Medicaments and then we binde up the Wound again al which operations cannot possibly be performed without pain Thirdly They object that if the Wound be too often opened and uncovered there will then Exhale much of the heat and Spirits Fourthly and last of all That Nature also as often as the Wound is loosned and uncovered so often is she disturbed and d stracted from her proper work and office III. Caesar Magatus in his 1. B. and first Chap. and Ludovicus Septalius in the 1. B. of his Physical Ammadversions after this manner endeavour to infringe those causes and Reasons Magatus his Confutation of the Reasons of the Ancients for their often uncovering of VVounds for which it seemed necessary unto the Ancients and at this day doth seem altogether needful and requisite that Wounds should often be uncovered and new Medicaments imposed and laid on And first of all this is brought for a common and received opinion that in hollow wounds there is evermore generated a double kind of Excrements thick and thin as it appeareth from Galen his 3. B. of the Meth. of Curing and 9. Chap. and that therefore we are alwaies so to reckon that it ought to be throughly dried up and wiped away and that therefore the Wound is daily to be opened that so the Pus may be cleansed away and new Medicaments applied For those that were at first laid on cannot long keep entire their strength and virtues in regard that they are dissolved by the heat of the part and also corrupted by the mingling of the Excrements But if the Excrements be not throughly dried up and purged forth being reteined in the Wound they hinder the generating of Flesh and the conglutination of the Wound and become likewise more sharp and Corrosive Yea further they often acquire a putridness from whence may proceed Pains Inflammations Impostumations Worms and Gangrenes The Answers Now unto this they thus Answer first of all that there is no great danger threatened from the Pus since that there is no neccessity that there should be any great store thereof bred in Wounds but then only when by Reason of the frequent uncovering of them the Native heat is debilitated Neither is there any need say they that these Excrements should be consumed by the imposing of various Medicaments seeing that the Wounds of the internal parts the Liver the Lungs the Tongue and other parts in which we cannot possibly come to apply Tents or Liniments spread over with unguents they are yet nevertheless healed by Nature And albeit as Caesar Magatus writes in his 1. B. and 44. Chap. it may be admitted that two Excrements to wit a thick and a thin may be generated in the Wound yet nevertheless he thinks not this a sufficient Reason why the wound should be often uncovered For the thin Excrement may partly be digested by insensible exhalation and partly driven quite forth of the Wound by the heat of the part and for the thick there is so little thereof at the very first that it
this that that new way of theirs hath place only in a simple Wound the wounded person being of a sound and good habit in which there is neither any great Vessel cut nor yet any Nerve hurt and we likewise admit the same for a truth For such Wounds as these in regard that they have no danger at all attending them and that they may likewise be Cured by Nature alone without any help at all from Medicaments we do no way approve of either the Curiosity or the unseasonable diligence of those that without any urgent cause at all will be often uncovering the Wound every day not once only but twice or thrice and we grant also as a thing very commonly known that such like sleight Wounds if you lay but a little Lard thereon or some such like thing and with one or two bindings up are cured of their own accord and by the strength of Nature But on the contrary they themselves acknowledg and of necessity it must be confessed that there are many wounds in the curing of which there are so many obstacles and hinderances in Natures way that if they be not removed by the Physitian Nature will never be able of her self to unite the wound and therefore that simple provision is not sufficient in those Wounds And they likewise altogether grant and allow of an opening of the Wound if there be any thing to be done therein that cannot be performed without a Manual operation and if there be any necessary Medicament to be imposed and that there be danger in the omission thereof which they grant ought instantly to be remedied and prevented all that may be For if as Septalius puts these cases the body be Cacochymical or that some one or other of the greater Vessels be cut or a Nerve hurt if withal the flesh shall be battered and bruised which may have need of Suppuration if the Wound hath so narrow an Orifice that the Pus hath no passage forth of it if any bone shall be hurt or any Noble and principal part uncovered so that there shall therefore be need of Manual operation if there shal be much Pus and Excrements generated in the wound from whence a pain a corruption of the part an Inflammation and breeding of Worms may proceed if proud flesh shall abound if there shall be present a vehement pain if an Inflammation or a Gangrene be feared if any smal bone or any other substance stick fast in the wound that is to be taken forth or if as Caesar Magatus in his 1. B. and 38. Chap. puts the case the flesh groweth forth too much if an Hemorrhage be urgent and require it if there be nigh at hand a Gangrene and corruption of the part if there be present an extraordinary putridness and nastiness of the part if there be many Excrements heaped up an Inflammation of the part nigh at hand if any Heterogeneous and Extraneous Body stick in the Wound if an Impostumation follow thereupon and that there be present any Pain Itching ill savour or any bones be broken in all these cases they of their own accord grant that this simple binding up of the wound in this their new way will not suffice but that the other more laborious provision and operation of the Ancients is necessary and to be preferred before this their new way and Method of curing And therefore since that the exceptions are too many for the Rule and derogate much from the same I conceive that this their new way of Curing wounds is very rarely sufficient and that for the most part many destructive Symptoms and evils if the wound be not opened until the fourth fifth or seventh day may ensue and happen thereupon And therfore we likewise willingly grant that Wounds without urgent necessity are not too often to be opened and over rashly to be exposed unto the Ambient Air and yet withal likewise understand me with this caution that if the Wound be over seldom and but now and then uncovered cleansed and necessary Medicaments laid thereon much damage and danger may befal the Patient And therefore it is affirmed indeed that this new way of curing Wounds is easier shorter less troublesom and more safe then the Ancient Method but it is not in the least proved And be it so that it is less troublesom more compendious and short and likewise more easie it cannot this notwithstanding be proved neither will it follow that it is alwaies the more safe and secure way For who is he that dareth or can safely admit of this new way of curing in those deep and narrow Wounds that are by pricking and by Weapons that have sharp and not thick points and that will adventure to commit unto Nature such a like Wound imposing only some covering thereupon and so not open it before the seventh day For true it is indeed that Natures intention in endeavouring the Conglutination of the Wound is at that time likewise right as well as at other times and in other wounds but it may so happen that the Wound may Conglutinate in the superficies before it be conglutinated in the bottom thereof from whence Pus cometh to be collected in the bottom of the Wound which bringeth with it many and great dangers and therefore such a like wound is again to be opened as sad experience hath often taught us But that we may in special weigh and consider the Arguments on both sides we wil first of all examine those Arguments that drew those eminent Men Caesar Magatus and Ludovicus Septalius into this Opinion A more special examination of the Reasons of Magatus and Septallus And First of all as for the experience they talk of the Ancient way of curing hath likewise the same to plead for it seeing that none dares deny that infinite numbers even of such as have been most dangerously and desperately wounded have been cured thereby And yet nevertheless I hinder none but let every man consult experience and make inquiry whether he can find out any thing that is better yet alwaies provided that what he hath so found out may be practised without any damage or danger unto the sick party But as for that which Ludov. Septalius alleadgeth in special touching the Wounds of the Head and that many in a very sickly time at Milain this way recovered thereof Yea as he writeth more then those that were cured in the former old way he doth not here sufficiently explain himself what kind of Wounds these or those were For of the Wounds of the Head it is possible that some of them may be mortal and others of them curable But Caesar Magatus although he describeth the qualities of those Wounds in the Head of which he bringeth a few examples yet nevertheless he doth not prove this to wit that those wounded persons were cured by reason of that new way of curing and that they might not as wel have recovered if the old Ancient way and
that Galen where he treateth of those Medicaments that are necessary for the curing of Wounds maketh no particular mention in special of those Medicaments that cherish and preserve the Natural heat which that he ought to have done I deny not yet notwithstanding he elsewhere very frequently tels us that the heat and temper of the wounded part is to be preserved and that unless the temper of the part be in a right frame and Condition it is not possible that the Cure of the Wound should ever succeed happily and those very Medicaments themselves that he often propoundeth for the drying up of the Excrements of the wounds do Cherish the heat and as I said in the foregoing Chap. it seems to me that those Digestive and Sarcotick and Glutinating Medicaments are made and provided rather for the conservation of the native heat then for the doing of any thing else The second Reason that Magatus brings for his new way of Curing wounds is this that there cannot be excited any Afflux of humors since that in this way the heat of the part is preserved and that by the often handling of the wound there is not any pain caused that may excite a Fluxion But as we shall further shew you in the following Reason the truth is that in this more rare and seldom opening of the wound the heat of the part is not better preserved then in the former old way But then as touching the pain that may be excited by the more frequent uncovering of the Wound the Cleansing and purifying thereof the imposing of new Medicaments and the new binding of it up it is the part and office of the skilful Chirurgeon so to handle the wounded part that the least pain and as little as possibly may be excited Neither in the evacuation of the Pus is the part to be pressed down hard together but the said Pus is most lightly and gently to be wiped away unless haply the Wound be sinuous and full of turnings For in such wounds the pressing together of the Sinuous winding part is both useful and necessary yea moreover for the better pressing forth of the Pus from the very bottom of the Sinus there are likewise little pillows or Cushions to be imposed And then the benefit and commodity that ariseth from that short and momentany pain will not only countervail but likewise far exceed the discommodity and inconvenience Thirdly Neither is this that he alleadgeeth for his third Reason of any weight or moment to wit that in this new way the wounded part is more rarely exposed unto the Ambient Air then in the ordinary and usual way For the good and Benefit that proceedeth from the Cleansing of the Wound and the imposing of Necessary Medicaments is far greater then the hurt and damage that is brought thereunto by the admission and letting in of the Ambient Air. And this discommodity may likewise in great part be prevented if the Wound be not uncovered in a cold Air but in that that is somwhat warm or temperate and that this be no oftner done then urgent necessity shall require and that before ever we begin to open the wound all things Necessary and Requisite for this new binding up be at hand and in such a readiness that the whol business may be performed with al possible speed Fourthly Neither is this any sufficient Reason for the preferring of this new way of curing before the old to wit that in a wound of the head the bone that was impostumated and no hopes but that it would be lost hath yet in this new way been preserved For it is not as yet proved that the same might not as wel have been in the Ancient way and Method of curing and it is daily observed that in the use of the old way those bones that seemed to be impostumated and like to fall out have yet again been Agglutinated unto the rest Fifthly Magatus affirmeth indeed that under that new way there will be fewer Excrements collected then under the Ancient way but he doth not prove this and he evermore presupposeth that the innate heat is more rightly and better preserved in the more rare and seldom opening of the wounds then in the frequent uncovering of the same And we grant indeed that by the vitious and faulty concoction of the part many the more Excrements may be bred therein but this notwithstanding we deny that these Excrements proceed only from the debility of the heat caused and contracted from the Air in regard that there may be very many causes thereof to wit the abundance of vitious humors in the Body and the conflux of them unto the wounded part some of the greater vessels hurt and pouring forth much blood a contusion and bruising of the part and many other such like Sixthly Unto the sixth Argument we Answer and grant indeed that there is also a more happy expulsion made by Nature of smal bones and other Extraneous bodies if the innate heat of the part be strong and vigorous but then notwithstanding this is yet again to be proved and it is not to be presupposed that the Native heat is more rightly to be preserved and corroborated in this more rare uncovering of the wound as we said before in answer unto the first Argument Seventhly and lastly Magatus alleadgeth likewise this for an Argument but without any proof at all that the virtue of the Medicament at first imposed for the perfect agglutination of the Wound will the better endure and be kept intire touching which hereafter in the causes for which Wounds are often to be uncovered in the first Reason we shal speak further And now likewise in the next place those Arguments for which they reject the Ancient Method of curing Wounds are by us well to be weighed and considered And as for what concerns experience the question is stil in Controversie and not as yet determined to whether of these two waies the better is to be ascribed seeing that it cannot be denied that hitherto infinite numbers have in the old way been cured And here we are to take special notice that many things in the curing of Wounds are oftentimes attributed unto Art and the skil of the Artist that are rather to be ascribed unto Nature that is the alone curer of Wounds as of all Diseases whatsoever And Caesar Magatus himself confesseth in his 1. B. and 31. Chap. that a strong and vigorous Nature correcteth likewise many errors that have been by the Artist committed sleighting and overmastering those things that might have proved prejudicial unto her through the ignorance and inconsiderateness of the Chirurgeon and this he saith that himself hath frequently found by experience whiles of set purpose he took little pains nor much troubled himself thereabout as being minded and resolved to observe what Nature in those stronger bodies was able of her self to perform and that therfore he somtimes administred those Medicaments that were not altogether so fit
and convenient and that yet notwithstanding the sick party by the help and assistance of Nature recovered and became sound again But now as for those Reasons that he objecteth against the Ancient way the first of them is this that the wounded part is too often exposed unto the Ambient Air from whence its heat is weakned and so thereupon great store of Excrements bred and treasured up But as for this that is so often imputed unto the Ambient Air frequently admitted into the Wound and that for this cause alone the greater abundance of Excrements are collected this is only said but no waies proved For these Copious and abundant Excrements do not proceed from the Air but they have other causes For that smal and inconsiderable appulse of the Air which yet notwithstanding as I have said is by all means possible and as much as may be to be avoided and the operation therefore to be performed in a warm place it cannot cause so great an alteration And moreover also the Excrements are likewise collected because that the Blood and Humors faln forth of the Vessels are necessarily converted into Pus and Sanies that is to say thick and thin Excrements although the temperament of the part be sound and unhurt But that the very temperament of the part may be hurt even by the Wound it self as also by the cutting and opening of the Vessels and likewise by the efflux of the Blood and Spirits is a truth that cannot be denied and Caesar Magatus himself in his first B. and 9. Chap. taketh upon him to prove the same at large And this very weakning of the part by Reason of the wound inflicted and the change and alteration of the temperament is the cause that not presently and on the very first day the Pus is generated in the Wound but for the most part on the fourth day to wit when Nature hath recovered and gotten her strength again and the heat of the part is renewed And furthermore the Bodies on which Wounds are inflicted are not evermore exactly found and pure but oftentimes Cacochymical albeit they may seem exactly sound which although they receive but some very light and sleight wound yet this in these Cacochymical bodies degenerateth into an Ulcer by reason of the vitious humors that abundantly flow unto the wounded part As for what is in the Second place objected that from the frequent loosening of the wound the often handling and moving of the part a pain and thence a fluxion may be caused in the part affected with the Wound unto this objection we have already before given an Answer To wit that the experienced and skilful Chirurgeon may very easily prevent the said pain and although that some pain should chance to be excited from the uncovering of the Wound yet nevertheless the inconvenience and pain that would arise from the reteining and not cleansing away of those Excrements might prove far greater and of a more dangerous Consequence Thirdly Magatus although without cause feareth lest that in the uncovering of the Wound there should happen a dissipation of the spirits and Native heat For if there be any such dissipation of the Spirits and heat this happeneth together with the very effusion of the blood But then so soon as this flux of the Blood stoppeth the orifices of the Vessels do again shut close so that there needs no fear at all of any such dissipation of the Spirits and Nature being otherwise sollicitous and careful about the preservation of the spirit and the Radical heat expelleth the offensive and hurtful Excrements and stil reteineth those that are useful as we may plainly see it to be done in Critical Evacuations Fourthly and lastly they object this also that as often as wounds are unbound and opened so often is Nature disturbed and distracted from her proper Office and Work But there is no ground at all for this fear For Nature cannot in so short a space of time as while the Wound is opened and bound up again possibly be disturbed unless there happen a very great and extraordinary alteration But it will be rather disturbed if the Wound be not cleansed from those Excrements III. Caesar Magatus and Ludovicus Septalius do not solidly confute those causes by which the Ancients and all the Chirurgeons even unto our very times were moved and drawn unto this often opening and unbinding of Wounds For First of all that they determine and conclude that Wounds are therefore often to be uncovered that so those Excrements that are necessarily generated may be evacuated this say these is not indeed Requisite and altogether needful in regard that the thin Excrement may partly be digested by exhalation and partly be driven out of the wound by the heat but as for the thick if any such be generated it is confounded and mingled together with the Pus and so by Nature expelled together with the said Pus But experience it self teacheth us that this is most false that the thin Excrement is alwaies digested by exhalation seeing that oftentimes we find that it rendereth the Wound exceeding moist and that there floweth forth great store thereof And for the thick Excrement although it be mingled with the Pus yet notwithstanding it is not of its own accord wholly evacuated or if it be evacuated it is but very slowly and therefore being retained it acquireth an Acrimony and so causeth a pain and a new afflux and therefore it is speedily and seasonably before this shal happen to be evacuated and cleansed away and for this Reason the Wound is to be uncovered as oft as need shall require For neither indeed doth Nature her self expel these Excrements Nature the truth is doth separate the useful Excrement from that that is altogether unuseful But when the Excrements are thus separated the useful from the unuseful and stick in the Cavity of the wound Nature hath then no more that she can do for it is not in her power to expel them but the Excrement either of its own accord and by reason of its weight floweth forth or else it is thrust out by the flesh growing underneath it and this if it be not done it is left stil to remain in the wound Neither also can the wounded part be alwaies kept in such a Scituation and so placed that the Pus by its weight tending downward should of its own accord flow forth For all wounds whatsoever that are inflicted in the fore parts of the Body are altogether unfit for such a Scituation as is requisite for a Spontaneous efflux of the Pus or Noisom purulent Mattier seeing that it is no waies convenient that the Patient should lie upon his face And so likewise the Wounds of the hinder part although that they be so Scituated that the Pus may easily flow forth from them yet nevertheless a lying upon the wounded part is no waies fit and convenient but painful and troublesom in regard that the whole bulk of
the Body presseth and weigheth down the part affected And in Wounds of the Head that pierce through the Skul it is much more difficult to find such a Scituation that all the Pus of its own accord and by reason of its gravity should easily slow forth albeit the Wound be but seldom uncovered But Magatus wil not yet yield for al this but in the 33. Chapter throughout of his first B. he endeavoureth to prove that it is not necessary that Wounds should be oâten uncovered to the end that the thick Excrements should be cleansed away he endeavoreth likewise to demonstrate that the thick Excrements as also the very Pus it self may be evacuated without the use of abstersives And first of all indeed he alleadgeth this out of Galen that he writeth in the 13. B. of his Method of Curing and 5. Chap. after this manner But if there be some notable Pus contained in the suppurating particle it is not expedient as some do forthwith to cut and make an incision but rather we ought to attempt an exhalation by Medicaments avayleable for this purpose the use whereof may be conjectured from the affect it self From hence he concludeth that there is no need of Abstersives where the Pus may be dissipated by Discussives But that I may not now dispute this question whether or no we may safely and securely endeavour in Impostumes to wast and consume the Pus with Discussives alone be it so indeed that this may possibly be done yet as he himself writeth for the effecting of this there will be need of Medicaments that are strong and prevalent and fit for this purpose But when I pray you shall such like Medicaments be administred in Wounds to the end that the Pus may be discussed He writeth moreover that in Impostumations when they are broken oftentimes the Sinns though they have been very notable and such as have sent forth great store of Pus have been filled up with flesh no Abstersive at all having been put into the Cavity thereof but only some Medicament laid unto the very mouth of the same of which it was not possible that any thing should reach so low as the bottom thereof But unto this I answer that this is not alwaies done but that there is oftentimes need of casting in Abstersive Medicaments or if such may not be administred that then the Sinus is to be pressed together that the Pus may both flow and be pressed forth and that this is often to be done and for this Cause the Wound is also often to be uncovered and that the Pus is by no means to be deteined in such a Sinus And lastly He writeth that even internal Wounds may be also cured although the impurities and Excrements thereof be not cleansed and done away But I answer that neither is this alwaies done but in those parts only in which there are but few Excrements collected and such as have an open and prone passage forth of them Otherwise it the Excrements be long detained those Wounds are not to be Cured and this we see to be often done in the Lungs in which from the Excrements retained Ulcers and at length the Phthisis or consumption is generated And indeed oftentimes the Pus and Excrements stick so close and fast unto the sides of the Wound that they cannot possibly of themselves flow forth but that they must of necessity be cleansed away by a manual operation Thirdly That therefore the Wound is often to be uncovered that so according to the various state of the Wound somtimes digestives and somtimes abstersives somtimes those that generate flesh and somtimes again those that wast and eat away superfluous and proud flesh may be adminstred unto this indeed Caesar Magatus answereth that there is no need at all of that change of Medicaments in regard that the whole business is to be committed to Nature And that it is sufficient if there be only a covering imposed upon the wound that by its corpulency may prevent and hinder the efflux of the Radical heat and that may preserve and cherish the same and that therefore with one only Medicament divers times a Wound may be healed But here false Principles are presupposed The First is this that Nature of her self alone is able to perform all those things that are necessarily required for the healing of a Wound Indeed it is true that Nature doth concoct separate such things as are of a heterogeneous and different quality and generateth flesh but the Excrements when she hath separated them she cannot alone and of her self expel them but they are oftentimes so pertinacious that they will st ck unto the part do she what possibly she can Neither do they also flow forth of themselves and of their own accord or is the Member indeed so to be placed that they may of their own accord flow forth as a little before we likewise told you And therfore then in that Case there is need of Medicaments that may keep them from being over nasty yea and oftentimes also of a Manual operation whereby they may be throughly cleansed Another of his false Principles is this that Nature in her work standeth in no need of any Medicaments whatsoever that so she may be holpen and assisted thereby which that it is false even experience it self teacheth us wherein we see most manifestly that Digestives that in the beginning are of singular use in the progress of the Disease prove very hurtful and this Caesar Magatus himself likewise confesseth for in his 1. B. and 37. Chap. he writeth that he had observed that by the use of a digestive the most grievous Wounds inflicted by Bullets shot from Guns have been suppurated throughly purged and filled up with flesh but that afterward by reason of the over great humidity there hath grown a flesh upon it that hath wanted Corrosives to eat it out and consume it His third principle that by consequence followeth from hence is likewise false to wit that one only Medicament is sufficient all the whole time of the Disease provided that by its Corpulency it may be unto it instead of a Covering For if this should be so and were indeed true then instead of an Emplaster we may as wel put any piece of Leather upon the Wound or make use of one kinde of Emplaster for another so that it be not deadly and poysonous sharp and Corroding and yet notwithstanding he never as hitherto heard of any wise Physitian that ever did thus And in this very point likewise Magatus expressly contradicteth himself who in the â6 Chap. of the same B. writeth most truly that not every kind of covering how ever it be made and provided is fit for the defence and corroborating of the Natural heat or that it is convenient for the temper of every part and that what is a very fit and convenient covering in one part may in another part be altogether unfit inconvenient and indecent yea
likewise that it may be a very hurtful dangerous covering Fourthly Whereas it is the common Tenet and that we are usually taught that therefore likewise Wounds ought often to be uncovered that so the virtue and effect of the Medicament may be known what it is and whether the Wound be moist yea or no that so Convenient driers may be laid thereto according as there shal be occasion unto this Caesar Magatus answereth that there is no need at all of any such ado or that we trouble our selves so much thereabout in regard that the whol business and the issue therof is to be committed to Nature But he doth not well in so determining For the truth is that Nature doth indeed evermore intend that which is best but yet notwithstanding she cannot alwaies obtain what it intendeth either because she is weak or else in regard that she is oppressed and overwhelmed with too great an abundance of that Object on which she acteth and therefore both the temperament of the wounded part is to be cherished with Medicaments and these indeed some at one time and some at another and the Excrements also by which Nature is oppressed and overburthened are to be dried up and evacuated And therefore we conclude that it is overrash and altogether unsafe to Commit the whole business unto Nature and to stand looking on as an idle Spectator since that it may easily so happen that overmuch Humidity abounding in the Wound it may soon degenerate into an Ulcer Fifthly And for this Cause likewise somwhat the more frequent uncovering of the Wound is held to be necessary that so the State of the Wound may be known and the Symptoms likely to happen thereupon may be prevented Caesar Magatus rejecteth also this Cause and asserteth that from other Signs to wit Itching Pain and the fear scent that cometh from the Wound we may give a shrewd guess and he positively determineth that an Artificial Conjecture is the best and that we may more rightly make our conjecture by the Eyes of our mind then by those of our Body since that they are sharper sighted then these But those conjectures are oftentimes very uncertain yea somthings may now and then happen unto a Wound that will no way be taken Notice of but only by ocular inspection and such are the Fungi of the Brain Worms in Wounds and flesh growing upon them And though it be true that at the length there will some certain signs discover themselves yet it is no way safe that the Physitian stand as an idle Spectator until such time as those signs to wit Pains Feaver Noysom smels and the like shall happen and manifest themselves For when these once come upon the Patient he is then most commonly in the greatest danger which by ocular Inspection might have been easily foreknown and safely prevented and oftentimes in the space of one day yea of a few hours some grievous evil may befal the sick person And so Paraeus relateth that he had seen Wounds in which unless they were daily opened and new Medicaments laid on Worms would continually be breeding Sixthly And for this cause also the wound is to be frequently uncovered that so the Swaths little Pillows and Linen Clothes may be made clean But Caesar Magatus and Ludovicus Septalius sleight and account of this as of a thing of no reckoning or if we may a any time change the Swathes they allow it only with this Proviso that the wound be no uncovered But these should have considered with themselves that if the Swathes be soul and unclean much more the Wound and the coverings neerer unto the same must needs be Nasty and unclean since that the sanies or thin Excrement doth first and most of all defile those things that do neerest touch upon the Wound Seventhly And Lastly whereas even for this cause the more frequent opening of the Wound seemeth to be necessary as is also the change of the Swathes and little Pillows that so the stinking Vapors in the Wound bred of the Pus and Excrements may the better exhale which if they be stil detained shut up in the wound they affect the wounded part and much change and alter the same unto this Septalius Answereth that the Wound is not to be bound up with so many and such Linen Clothes that those Vapors should be suppressed and if that the Pus find a passage forth he thinks then that those Vaporous Excrements may much rather be blown abroad and dissipated and if they be altogether retained that they are not likely to bring so much damage unto the Patient as may befal him from the uncovering of the Wound and the alteration of the Ambient Air. But in whatsoever manner the Wound is bound up which yet notwithstanding they themselves grant that it ought so to be bound up that it may be defended from all external injuries those Vapors may easily be detained yea they may insinuate themselves into the Linen Clothes and the Swathes and hence they may offend the wounded part by their stench and noysomness And this is that very thing that is now in Question whether all the Pus may be evacuated unless the Wound be often uncovered The alteration also that is caused from the external Air cannot be so hurtful and offensive in regard that it partaketh not of any ill quality as is that which proceedeth from those putrid and stinking vapors arising from the Pus and Sanies Whether there be any use at all to be made of Tents or Pensils in the Curing of Wounds The other thing where in Caesar Magatus and Ludodicus Septalius dissent from the Ancients and from other Physitians and Chirurgeous is this that they assert and endeavour to maintain this their opinion that there is no use at all to be made of Tents in the Curing of Wounds Magatus to prove this in his 1. B. and 5. Chap. useth these Reasons The Reasons the move Magatus to reject the use of Tents The First Reason is this because that Tents are neither therefore to be instituted that they may keep open the mouth of the Wound neither that by them Medicaments may stick unto the sides of the Wound The former of these he proveth in this manner that before the Wound is conglutinated the orifice thereof is alwaies patent and open so indeed that if we desire and endeavour it never so much yet we are not able to shut close the mouth of the Wound And he thinketh likewise that there is no need of Tents for any other use or purpose since that the Medicaments may be so melted that they may very conveniently be instilled into the Wound The Second Reason is this because that they are injurious and by their weight very troublesom and grievous unto the Nature of the wounded part whereupon it is likewise that Nature is alwaies laboring to expel them The Third is because that they distend the part press it together excite pain
and thereupon produce new fluxions The Fourth is because that these Pensils and Tents may be filled with base corrupt Humors and so defiled therewith that they may acquire an ill quality by which they may hurt the wounded part and they do moreover hinder the Evacuation of the Pus and cause that the said Pus acquire and get it self a depraved and Malignant quality Fifthly They say that Hippocrates and Galen when they write of the curing of Wounds do never make any mention of these Tents as we may see in Galens 14. B. of the Meth. of Curing Chap. 4. and in Galen his B. of Fracturers Sect. 3. Comment The Reasons of those that make use of Tents in the Curing of Wounds But now on the contrary Those that make use of Tents give these Reasons for their so doing The First is this that in the wounds the use of Tents is therefore necessary that by the help of them the orifice of the Wound may be kept open and a passage may be made for the Pus ãâã flow forth The Second is this that for this cause Tâârs are to be made use of that so by meanâ of them the Medicaments may every where touch the Wound and that they may peââtrate even to the very bottom thereof Thirdly For this Cause likewise Tâââs seem to be necessary because by them it maâ be prevented that the upper part of tâe Wound be not closed up before the deeâââ parts thereof be filled up with flesh Unto these Reasons they Answer unto the First thus The Answer of Magaâus ãâã the said Reasons that there will not be more Excrements geâârated in the Wound if there be a due Course taken in the curing thereof then what may caââây be expelled forth by Nature And then that although Excrements should be generates that yet Tents do rather shut up the passâââ forth of the Pus then any waies keep it opââ And unto the Second they Answer that there is no need of Tents since that the Medicaments if they be liquid they will of themselves penetrate unto the bottom of the Wound neither therefore is there any âââd of so often repeating and imposing of ãâã Medicaments Unto the Third they Answer that the continual efflux of the Excrements by the external wounded parts doth hâââr the meeting together and uniting of the Lips before the Cavity be filled up wiâh flesh But that I may briefly shew you my opinion touching this Controversie Myââen Opiâââa I do indeed willingly grant them that in such Wounds as are superficial straight and such as generate but little Pus Tents are not at all necessary neither is the curing of the Wound rashly to be retarded by the putting in of the Teââs But if the Wound be deep and oblique so that there be no right and straight passage for the slowing forth of the Pus and that there be much Pus generated in this Case Tents seem to be altogether necessary that so by them there may be made an open and free passage forth for the purulent mattier and that a way may be left by which the Medicaments may penetrate unto the more inward parts of the Wound and that by this means the orifice of the Wound may be kept from Conglutinating and closing togââher until such time as that which is in the bââtom of the wound shall be first Conglutinaâed which if they be neglected and that the Pus and Excrements be still retained in the Wound they may easily prove the Causes of the extreamest pains and dangers as a little above in the 7. Chapter we gave you some instances and examples of this very thing out of Guilhelm Fabricius his Observations Answers unto the Reasons of Magatus Now as for what they Answer unto these Arguments and what they likewise object they are neither of them of any great moment For First of all whereas it is said that Tents are not necessary that by them the Wound may he kept open since that the orifice is of it self alwaies open this we altogether deny For oftentimes Wounds according to the various Scituation of the Patient that he then had when he was wounded are oblique and ful of turnings and windings so that although the sides and lips of the wound be not as yet closed up they yet nevertheless so touch and lie one upon the other yea and oftentimes so press one another that there is no open passage left for the Pus to flow forth Secondly For this very cause and when the Wounds are not straight the Medicaments cannot so easily penetrate unto the bottom And albeit that the wound be not writhing and oblique yet notwithstanding it wil not alwaies be Convenient to instil into the Wound Medicaments that are over fluid seeing that they may be easily washed away again by the Sanies or thin Excrement but there will be oftentimes occasion to make use of the thicker and more viscid sort of Medicaments which being conveyed into the Wound by the Tents will stick so much the longer and more firmly unto the wounded parts and thereupon they will the more rightly put forth their Virtue and efficacy Thirdly That the superior orifice of the Wound is never Conglutinated before such time as the inferior Cavity is closed up and that therefore the orifice of the Wound needeth not to be kept open with Tents this is false and experience very often teacheth us the Contrary and Guilhelm Fabricius in his 4. Cent. Observat 7. reciteth two Examples of Wounds whose orifices were very suddenly healed and yet the Wound within all this while not cured from whence it happened that there was abundance of Pus collected within and from thence many grievous and dangerous Maladies excited And wheras they say that the continual efflux of the Excrements wil cause that the orifice of the wound shal not be closed up herein they contradict their own former presupposals when as they asserted before that there would be altogether very smal store of Pus generated in the Wound Fourthly The Tents ought not neither to be over thick that so they may not press the part nor distend it nor by any means whatsoever cause unto it any trouble grief or pain and that they likewise shut not up the passage of the Pus or purulent mattier And if now and then any such thing should happen such as that that Ludovicus Septalius in his 8. B. of Animadversions Num. 10. alleadgeth out of Hippocrates in his History of a certain person at Massilium the Errors of the Artists are not to be imputed unto the Art it self when as haply they uncovered not the Wound so oft as was requisite And yet nevertheless we are here to give you to understand that albeit we are to use our utmost endeavour that Wounds may be Cured without all kind of trouble and pain or at least that they may be healed with as little as possibly may be yet notwithstanding it is not to be
expected that in the curing of Wounds there should be at any time a total and absolute freedom from all pain and trouble no more then there is in the curing of other diseases And indeed if al things were to be omitted and for born that are any waies the Cause of any trouble whatsoever then the sewing of the Wound as likewise the Swaths and binding up of the Wound were all of them to be omitted But the Rule is good in this case that alwaies of two Evils the less is to be chosen Fifthly Neither are Tents therefore to be omitted because that being defiled by the Pus they may hurt the wounded part For as often as they shal be thus fouled and made nasty they are to be drawn forth and this very thing impugns the rare and seldom opening of the Wound Sixthly And last of all although that Hippocrates and Galen where they treat of the Curing of Wounds do not make express mention of these Tents so neither yet do they forbid the use of them but rather out of the precepts of Galen as touching the Curing of Wounds it may be proved that the use of Tents is oftentimes by him allowed and approved of All the premises being therefore thus agitated and discussed Pro and Con the thing seems to come to this and the whole sum and substance of this Controversie amounteth to thus much that light and sleight Wounds and such wherein there is not much Pus generated may be committed unto Nature and that it matters not much if such Wounds as these be but seldom concovered But yet I would not in the least perswade any Man that in those Wounds that are more grievous and in which there is generated great store of Pus and Excrements he stand as an idle Spectator and Trisler doing little or nothing himself but committing the whole business to Nature in regard that from the neglect and omission of the necessary opening of the Wound there may more danger and damage arise in one day then can afterwards be removed in a whole Month. And so likewise for Tents as on the one side where there is no need of them I would not perswade to the putting of any into the Wound much less that there should be such Tents made use of that may cause pain excite a fluxion or hinder the flowing forth of the Pus so on the other hand where necessity urgeth and the Causes before mentioned require the use of them there I conceive they cannot possibly be omitted without damage and danger But yet nevertheless in regard that experience perfecteth Art example shewing us the way I shall not withstand or oppose any man in his making trial and experience even of this way likewise so that it be as I have said before without any danger unto the Patient and as Magatus himself adviseth in his 1 B. and 40. Ch. about the end thereof beginning alwaies from those more light and easie and from these by degrees proceeding unto those that are more grievous and difficult Chap. 10. Of the VVeapon Salve THose things that have been in the precedent Chapter spoken touching the opinion of Caesar Magatus and Ludovicus Septalius as concerning the curing of Wounds put me now in minde of that Unguent they commonly cal the Weapon Salve For as those siple Wounds of the flesh as hath been said in the foregoing Chapter are Cured by the benefit of Nature alone without any other great provision without any frequent opening of the Wound and without the applying of many Medicaments So those Wounds likewise that are said to be cured by this Weapon-Salve my Opinion is that they are cured by the help and assistance of Nature alone But in regard that there are many who have asserted the contrary therefore we think it not amiss in this place to make some enquiry into this Opinion of theirs and to tel you what I conceive is to be thought as touching this Weapon-Salve Now we shall First of all give you the descriptions of this Unguent or Weapon-salve and then we shall acquaint you with the use of it and what Arguments are usually brought for the defence therof Now most are of Opinion that Paracelsus was the first that found out this Weapon-Salve and therefore the invention thereof is by very many ascribed unto him but whether he were the first that we find to have made mention hereof or not of this there is no question but that he hath been very forward in the divulging of it Paracelsus himself in his 1. B. Archidox Magicae hath this description of it Take The Moss of a Dead mans Skul two ounces Paâââcisus his description thereof Mummy half an ounce Mans fat two ounces Mans blood half an ounce Oyl of Linseed two drams Oyl of Roses and Bole-Armenick of each one dram mingle them and make an Vnguent Into which he puts a piece of Wood that hath been soaked in the Blood that comes from the wound and then throughly dryed and every day constantly he covereth the Wound with a new Swathe that had been throughly moystened in the Urine of the wounded person But then for the anoynting of the Weapon he addeth yet further Honey one ounce and Bulls fat one dram John Baptista Porta in his 8. B. of Natural Magick and 12. Chap. writeth thus of it The Weapon Salve saith he was a good while since by Paracelsus given to Maximilian the Emperor who having made trial of it esteemed it very highly all his Life after of which there was some bestowed on me by a certain noble person then living in this Emperors Court. If the Sword that gave the Wound were brought or a piece of Wood wet in the blood of the said Wound the wounded person was then cured albeit he were never so far off Take Vsnea Porta his description of the weapon salve or the Moss that groweth upon a skul left in the open Air and mans fat of each two ounces Mummy and mans blood of each an ounce and half Oyl of Linseed Turpentine and Bole Armenick of each one ounce let them be all wel mingled together in a mortar and then preserved in an Earthen Vessel somwhat long and narrow Dip the Sword into the Vnguent and so leave it let the wounded person in the morning wash the wound with his own Water and so adding nothing at all thereto let the wound be bound up and it shall be cured without any pain And Crollius himself likewise attributeth this Unguent or Weapon Salve unto Paracelsus Crollius his Description and he cals it the Sympathetick Unguent of Paracelsus and thus he describeth it Take the fat of a Bore Pig or Brawner and Bears fat of each four ounces The older these Creatures are the better it their fat Let both these fats first of all for the space of half an hour boyl in red wine over a gentle fire After this it is to be poured out upon cold water and the fat swimming
a top is to be taken off with a speon and whatsoever sinke to the bottom throw it away Then afterwards Take of Earth worms washed in Wine or Water two sextaries let them be put for a while into the Bakers oven in an Earthen pot covered where as they must be baked so you must have a great care that they be not burnt and after this beat them into a pouder Take Of this Pouder the dryed brains of a Brawner Red Saunders that smells sweet Mummie and the Haematites or Blood stone as he calls it of each one ounce After this Take Vsnea or Moss from the skul of one that died a violent death let this Moss be cut off from the skul in the increase of the Moon and she being then in a good house as that of venus if it be possible but not of Mars or Saturn the weight of two filberds or thereabout And all of them being bruised together and well mingled with the fat let there be an unguent made according to art and then in a Glass vessel stopt or if you think good in a Box let it be carefully kept for use If after long time the unguent happen to be over dry it may be a new moystened and softened with the aforesaid fat or virgin hony Let the Vnguent be made the Sun being in the sign Libra The Vse of this Ungruent Now as touching the Efficacy and use of it he thus writeth This cure is performed by the Magnetick attractive virtue of this Medicament caused by the constellations which thorow the medium of the Air is brought unto the wound and Joyned therewith that so the spiritual operation may be drawn forth into effect It s wrought I say by means of the Astral and Elementary conjunction There are therefore three things that by this unguent cause so admirable an Effect 1. The Sympathy of Nature 2. The influence of the heavenly Bodies perfecting their operations by the Elements 3. The Balsam which being endued with a virtue of healing is naturally applyed unto any man without any difference With this unguent are cured all Wounds by what weapon soever they be inflicted and whatsoever the sâx he and yet so notwithstanding that neither the Nerves Arteries nor yet any one of the three more principal members be hurt so that the Weapon may but possibly be had although the patient be many miles distant from us And in regard that it is of a Couglutinating Suppurating and renewing Nature it doth not permit if it be rightly applyed any hurtful symptom to follow upon it The manner of applying the Unguent or Weapon salve First Let the Weapon wherewith the man is Wounded be anoynted every day once if necessity require it and the wound be great but otherwise it will be sufficient if the Weapon be anoynted every other or third day and then let it be kept in a Clean Linen Cloth and in a place a little warm but not over hot lest that any damage should thereby be brought upon the Patient We must likewise be very careful that the Weapon fall not down from on high neither that the wind blow upon it in a cold place for if this should happen the Patient wil run mad Secondly Before you anoynt the Weapon Consider whether the Wound were made with the point by pricking and if it were let the Weapon be first anoynted upwards and not below and so descending toward the point thereof for otherwise much hurt may be brought upon the Patient Thirdly But if thou canst not certainly know how deep or in what manner the Weapon entered into the flesh thou mayst then anoynt it all over but otherwise it will be sufficient to anoynt that part of the Weapon wherewith any one is hurt Fourthly There is no Necessity of sewing the wound together after the manner of Barber Surgeons but every day only to bind it up with a clean linen Cloth first wet in the Patients Vrine Fifthly That day that any one anoynts the Weapon let him abstain from Venery Sixthly Before the anoynting of the Weapon let the Wounded persons blood be with al speed stanched Seventhly In fractures and ruptures of bones you may add unto the unguent some of the powder of the greater comfry or the roots of black Hellebor Having the weapon wherewith the Patient was hurt if thou be desirous to know whether the Patient be likely to live or to die of his Wound thou art to make the trial in this manner Take the weapon and make it hot over the coals so hot that thou can hardly endure thy hand upon it and then sprinkle upon it some powder of Red Sanders and the blood stone and if the Weapon then sweat drops of blood the patient will die but if not he wil escape it But if we would know whether the Patient order himself aright in his drink and other Requisites this may thus be known if there be in the weapon spots of blood he is disordered but if no such spots then the Patient ordereth himself aright We are moreover to take notice first that if we have not the Weapon or instrument whatsoever it were yet nevertheless that any violent opening of the Skin and hurting of the flesh by which any Blood goeth forth may be Cured with this unguent so that a little piece of Sallow Wood be moystened in the bloody opening and after that the Blood sticking thereto be dryed not by the heat of the Sun or the fire but of it self and own accord it be then put into the above mentioned Vnguent kept close covered in the Box and there left Secondly If the Wound should be great and deep it may then be cleansed every morning and bound up with a new Linen Cloth without any other use of Extraneous Oyls Vnguents and the like and then this wound how ever it were inflicted will heal of it self and it sufficeth that the little piece of Wood once only moystened in the opening of the Bloody wound be then put into the Box of Vnguent as aforesaid and there left to remain until the Wound be perfectly Cured Thirdly But yet notwithstanding as oft as any new Wound is to be healed there is alwaies required a new piece of Wood. Fourthly But if it be so that the Wound wil not bleed it is then with the Wood so long to be scarified until the blood flow forth and so likewise in the curing of the Tooth-ach the pained Tooth is so long to be scraped with a Pen-knife until it bleed and then the Pen-knife after the blood is dryed up it to be anoynted with this Vnguent and so the pain is presently asswaged If a Horse be prickt with a Nail in his Foot let the Nail be first of all drawn forth and anoynted with this Vugment and the Horses Foot shall immediately be cured without any suppuration at all And so in this same manner all living Creatures having flesh and Bones may be Cured The description
unto that Woman out of whom they flowed Although they do not likewise here sufficiently and cleerly explain themselves For Crollius writeth that this Cure is performed by the Magnetick attractive virtue of the said Medicament caused by the Constellations which virtue say they by the Medium of the Air may be brought unto the Wound and conjoyned therewith and then immediatly he addeth that there are three things that by this Medicament Cause so admirable an effect 1. The Sympathy of Nature 2. The influence of the Celestial Bodies performing its operations by the Elements 3. The Balsam that being endued with a healing virtue is Naturally put upon any one whatsoever without any distinction of either Person or Sex Reasons against the defenders of the Weapon-salve But in very truth that we may briefly open unto you and shew you our Opinion touching this Unguent that which in the first place rendereth it very suspicious is this that they give us not one only way for the composition of this Unguent but very many and in some of them those things are omitted and wholly left out from which others derive al the virture of this Medicament as is apparent from the many descriptions above mentioned And so Wittichius leaveth out of the Composition the Vsnea or moss the Fat and Blood of man which yet nevertheless others make the very Basis and Foundation of all the virtue of this Medicament and it is with them the principal part thereof And yet nevertheless they will all of them promise you the very same effect and every of them extolleth his own as sit and proper for al Wounds whatsoever the Weapon be wherewith they are inflicted and whether they be by pricking or by Cutting or by any thing cast at the party or by a fal albeit that Goclenius indeed and Crollius do except those Wounds that are in the Nerves Arteries or any of the more principal Members as the Heart Brain c. What others object against the Composition of this Medicament to wit that the Authors of this Unguent require the Vsnea or Moss that is cut off from the Skul of a Man hanged as also joyning therewith Mummy Mans Blood a little warm and Mans fat and that in the Mans Blood and fat they think the marrow and pith of the whole business that is to say the whole virtue of this Unguent to consist whâch these Judg to be superstitious this Objection I no waies own neither will I defend it it being so well known that Mans fat and Skul Mummy and Vsnea are made use of by other Physitians without any superstition in the Curing of Diseases And yet notwithstanding of this I must here admonish you that seeing that Magitians and Wizards as will appear out of Apuleius upon the 2. and 3. B. of Ovids Metamorphosis and Nicolaus Remigius in his 1. B. of Daemonolatry and â6 Chap. and 2. B. Ch. 1. and others also that have written of witches and Sorcerers seeing I say that these are wont in their sorcery to use mans Blood and Flesh and other parts of Mans Body every one ought to be careful who will make use of such Medicaments that he do not superstitiously use the said Medicament for the procuring of a Natural effect and so thereby gratifie the Devil who is the enemy of Mans both Soul and Body and so unawares do him Service which may be done if he use such Medicaments for those effects that are not in the Natural power of those things and therfore if those effects shal follow they are to be imputed and ascribed unto the Devil by such like superstitious practises laying snares for mankinde rather then unto the thing it self As touching the effect of this Medicament that it doth not evermore answer the desire and expectation we are shewn by Guilbel Gabricius in his third Cent. and 25. Observation And be it so that as many great and eminent persons have testified divers who have made use hereof have recovered yet nevertheless these can attest no more but this that the person was wounded that unto him there was administred this kind of Cure by the Weapon-Salve and that this person recovered but that he recovered by the virtue of this Medicament this they cannot testifie For there may be oftentimes many things conjoyned with some effect that are not the Cause thereof And therefore as it doth not follow that such a person walking it Lightened therefore his walking was the cause of the Lightening so no more will it follow this wounded person was healed and he applied the Weapon-Salve therefore the Weapon-Salve was the cause of the cure unless it be demonstrated that from the said Unguent this effect necessarily followed And in nothing indeed is the fallacy of the cause more frequent then in Physick where oftentimes the healing of some Disease is attributed unto this or that Medicament whereas the truth is it proceeded not from the said Medicament but either from Nature her self or else from such other Medicaments as were administred before together with or after the said Medicament whereunto the Cure is ascribed And a very great difference there is between Physick and other Arts. For in other Arts the effect being upon somthing that is solid dependeth wholly upon the Artificer and if there be any thing well or ill done by him all this is to be imputed and ascribed unto the Artist unless it so fal out as happily it may and often doth that by reason of the unfitness of the subject matter for as we use to say a Mercury or Statue is not made of every piece of Wood or else by reason of some fault in the Instrument somwhat may happen to be done amiss since that as we told you before in the first B. of our Institutions and 1. Chap. the subjects of other Arts do nothing at all but only obey the will of the workman whereas in Physick the subject matter thereof hath a certain innate power by which being assisted by the Physitian for the most part of its own accord it tendeth unto health from whence it is that by Hippocrates 6. Epid. Comm. 5. Text 1. they are said to be the Curers of the Diseases of Nature So that the whol business in short comes to this that the State of the Controversie here is not whether in a person wounded and recovered again the Cure were done by the Weapon-Salve but this whether or no the Weapon-Salve were the Cause of the healing of the Wound touching which we are now to make a little further enquiry Now it being so that Nature as we shewed you above is the Cause of the Wounds Conglutination but without the virtue of any Medicament under what Notion or Consideration soever and that oftentimes likewise even by Lard or some other thing of no great moment laid on many Wounds without the help of any other Medicaments or any assistance from the Physitian have been Cured therefore in the Cure likewise that is by
some thought to be done by this Weapon-Salve the Conglutination of the Wound is to be ascribed unto Nature alone as the next and principal cause Which being so and the truth thereof being such that it cannot be denied now in the next place we are to enquire whether in the said Cure the healing of the Wound be to be ascribed unto Nature alone or else indeed whether or no there be not likewise some Concurrent efficacy of the Weapon-Salve Unto me the former seemeth the more probable therefore because that it is a truth most certain as but now we told you that Wounds are oftentimes Cured by Nature alone without the Concurrence of any Medicament the truth whereof is sufficiently attested likewise by internal Wounds unto which there cannot possibly be any Medicaments administred And hitherto tendeth the whole business in the curing of Wounds according to Caesar Magatus his way touching which we have spoken in the foregoing Chapter to wit that the whole work be committed to Nature that the heat and temper of the part it being the instrument be kept entire and that without urgent necessity it be not molested and disquieted by Medicaments And somtimes we see that such dangerous Wounds chiefly and especially by the benefit of Nature without the application of any Medicament or such as is of no great moment are cured so that it seems to be ascribed rather unto a Miracle then the Medicaments Of which very thing the Observations and Examples are every where sufficiently known Neither yet notwithstanding are the Patrons of this Unguent so bold as to extend the virtue thereof unto al Wounds for as a little before we told you Crollius and Goclenius do except the Wounds of the more principal Members as also of the Nerves and Arteries and there was never yet found any that durst make use of this Unguent in Wounds caused by Gun shot And who is there that dares deny that other lighter and sleighter Wounds may be cured by Nature alone And if any thing extraordinary and that which seemeth to exceed the power of Nature happen at any time in the said Cure by the Weapon-Salve we ought well to consider and look unto it whether it be not wrought by the assistance of the Devil thereunto engaged by a Compact and agreement either explicite or implicite And now therefore it being a known truth that Nature alone and as the next Cause may agglutinate Wounds and that Medicaments as above we shewed you do perform nothing else then the preservation of the native heat and the Natural Temperament of the part or the removal of those impediments that hinder Nature in her work we are now in the next place to see whether the Weapon-Salve can perform those things Where we instantly meet with this first difficulty to wit Whether the Weapon Salve can Act at a distance whether possibly the Medicament that is not anoynted upon the Wound it self but upon the Weapon or any thing else that is besmeared with Blood from the Wound can yield any benefit especially if the wounded person be absent and many miles distant from the anoynted Weapon And indeed to prove this they use two Reasons as we also told you formerly the first is this that there may be actions from occult and hidden qualities and at a distance which they cal Magnetick actions because that by the spirit of the world the virtue of the Unguent may be conveyed unto the Wound as we see it to be done by the Sympathy and Antipathy of many things But neither proveth the thing that it ought to prove For first of all albeit we grant that such Actions there are and that those things that mutually Act and are passive do not alwaies corporeally touch one the other yet nevertheless that this is so in the Weapon-Salve and whether or no any virtue can be derived from the Weapon anoynted unto the Wound at so great a distance and interval of places this is yet to be proved For it doth not follow there are such admirable actions of other things and therefore also the Weapon-Salve hath such a vertue And that this is not done he shal easily perceive that will but consider those other Actions of this Nature that are performed at a distance Since that the operation followeth the being of a thing it is therefore necessary that between the Agent and the Patient there should be a certain conjunction and mutual Contact But now in regard that the things between which the Action is do not all of them touch one the other with their Bodies there is a necessity that they should touch in some other manner And this is twofold Action at a distance twofold for either the thing that is said to act at a distance sendeth forth somthing from its own Body and substance which the Ancients called Effluvium or Aporrhoia and Physitians where they treat of Contagion cal it Miasmos touching which see further in the fourth B. of Feavers Chap. 4. and the 2. B. of our Institutions Part 2. Chap. 12. to wit when there flow forth of the Body the smallest imaginable parts and Atomes and by the Medium of the Air or some other body are transfered unto another body and affect it with that virtue which it hath in common with the whol entire body But now as for such small bodies as these they have no Regular motion at al but according to the motion of the Air they move inordinatly this way and that way and by every blast they are variously dispersed like as we may see in the smoak of Candles when they are extinguished and of other things when they are first lighted and kindled But other bodies there are that Acting at a distance do not indeed send forth from their own body any thing that may be transferred unto another body but only they send forth a species as we may call it and in this manner by means of these sensible species as light sound smel and the like even the distant bodies are affected And very probable it is that there are more of these like sensible species then what are perceived by our senses And this is commonly sayd so be done by a virtue or virtual contact And yet nevertheless virtue doth always presuppose a substance from which the said virtue floweth So the flame being extinguished the illumination or light that comes from it that also ceaseth And moreover secondly there is likewise a fit subject required thorow which it may be propagated which if there be not the Action ceaseth And so an opacous and thick body being interposed betwixt the light body and our sight the Illumination ceaseth Thirdly this virtue is likewise diffused orbicularly and at a certain distance Naturalists term it the sphere of Activity which in some things is greater and in others less The greatest of all is in light or lucid bodies but a less in those bodies that yield a sound But yet the greater the
that is in the blood the virtue of the Medicament is carried and conveyed unto the wound For if all that whol blood were resolved into Atomes it would not be sufficient to fil up all that so great a space Neither have they as yet proved that the blood can send forth out of it self any such species And if by the benefit of the blood the virtue of the Medicament may be carried unto the wound why should it not then likewise carry to the wound the virtues of other things into the which out of wounded persons the blood is oftentimes abundantly poured out which yet we see that it doth not But now as for those things that they alleadg in special touching the Secundines and the first menstruous blood of Virgins and as for their asserting that if this blood be not rightly handled there is much hurt and damage brought unto those maydens these things are to be imputed unto the superstition of these young Women And if in woman kind the Secundines being cast forth into some unclean places bring damage unto these women from whom they came why is not the like done in bruit Creatures whose Secundines or after births being cast forth and buried in dung do oftentimes putrefy And in what place soever you dig and bury these secundines they yet notwithstanding rot and putrefy And why also do not the Molae or false conceptions which women use to burn bring any hurt and damage unto the Woman from whom it proceeded And why should the first menstruous blood if it be burnt bring damage unto the virgin and none of the rest These things being as we have said and the case thus standing there is no need of any further tedious dispute touching those virtues that this unguent is said to have in curing the Wound seeing that it is hitherto sufficiently proved that there cometh no virtue at all from this Unguent unto the Wound And if this Unguent had indeed any virtue at all in it either of preserving and cherishing the temperament or the innate heat of the part they commonly cal it the Balsam or of drying up the Excrements it would better and more commodiously exercise and put forth this virtue being anoynted upon the wounded part it self then upon the Weapon And besides all this if as some will have it the virtue and strength of this Medicament consist in the Blood and fat of Man why then do some of them likewise apply it unto the Wounds of other living Creatures to wit of Horses c. For how great is the Difference between a Man and a Horse But that Crollius and some others that I may not here altogether omit the mentioning of this also derive the vertue of this Medicament from the Heaven and therefore command the preparing of it in such a certain position of the Heavens Neither will that at al patronize this Cause For they have not as yet proved that there is in the Heavens or any of the Stars any virtue at all to heal Wounds or that if there were any such virtue in these that it doth so mingle it self with this Unguent that as if it were in a manner bound and shut up it may be carried up and down about with us and drawn forth into use and Act when we please And so likewise as touching the manner of using this Medicament this also hath no Foundation to uphold it neither doth it want for superstition For first of al seeing that they place the whole Cause of the Cure in this that the virtue of the Medicament is derived unto the Wound by the benefit of the natural Balsam that is in the Blood why then do they anoynt only the Weapon with the which the man was wounded or some other Weapon or a piece of Wood bloodied with the Blood of the Wound and why do they not as well anoynt his shirt or the other Garments of the wounded party or a Stone or any thing else what ever it be upon which the Blood hath been spilt or poured out and if not there is then some implicite underhand compact with the Devil to be suspected And moreover why if the wound be made with the pricking of a Sword do they anoynt the Sword in the point therof towards the hilt but if the wound be made by the Cut of a Sword then they anoynt it from the edge towards the back and if it appear how far and deep the Sword penetrated into the wound so far they anoynt it and no farther but if it doth not appear how far it pierced they then anoynt the Sword all over all which are no better then Superstitious Ceremonies and of which no Reason can be rendered For if the power and faculty of the Medicament be Natural what doth this or that manner of using it in the anoynting make to the thing it self and whether or no doth it add any new virtue and quality thereto If the vertues be Natural there is no need of any such Ceremonies as it plainly appeareth in all Natural things whatsoever The Load-stone draweth the Iron and the Iron being touched with the Load-stone is moved unto the North-pole without any of the aforesaid Ceremonies And furthermore some there are that anoynt the Weapon once every day others every Second or Third day and some content themselves with once only anoynting And some there are who that so they may not Erre in the anoynting wholly dip and plunge the Weapon or Sallow Wood that now and then serves in stead thereof into the Unguent kept in along Box or little Chest until the Wound be perfectly healed but they altogether neglect the Weapon it self that dip the Arms or that they make use of in their stead all over in the Unguent But others there are that keep the anoynted Weapon in any temperate place what ever it be and others likewise shut it up in a little Chest But al of them generally are exceeding Cautious in this that the Weapon be never kept in any place that is over hot or over cold and that it be not polluted with filth and impurities for if this should happen the Cure will by this means be hindered and a most grievous pain in the Wound procured unto the sick person All which are meerly frivolous and superstitious For seeing that as it is before sufficiently proved there cannot possibly be any action of the Weapon-Salve upon the wound at a far distance and interval of place from the Wound so likewise we say that it cannot possibly excite any pain And therefore we conclude that if this at any time happen it is then caused and procured by the help and assistance of some evil spirit And most certain it is that the Blood of wounded persons is not alwaies poured forth into clean places but oftentimes into places very noysom and unclean and that in the Winter time it is frozen and that the Bloody Linen Clothes are washed with warm Water and the wood be sprinkled
they obstruct the Liver and the other more noble bowels But in very truth it is not indeed to be denied that among the more Ancient Physitians to the best of my Remembrance we scarcely meet with any mention made as touching these Medicaments and yet among the Physitians of latter times very frequent and common hath been the use of them And yet nevertheless those things that Galen hath in the 5. of this Method Chap. 9. touching potions in Wounds of the Thorax those things I say seem to come very neer unto these and to suit and answer unto these potions And the Author of the B. de Dynamidiis Tit. de Plaga maketh mention of these potions who administreth out of Wine Mouse-Ear Planâânâ Strawberry Leaves Avens Pimpeânel Ground Ivy Betony Agrimony And in his Title touching the Curing of Wounds he prescribeth Mouse-Ear Agrimony Ground Ivy. And in the Antidotary of Mesues about the end of the 11. Distinction after the Emplasters there is extant such a potion Take Avens Root of Mug-wort Pimpernel Camomile fiv leâââd Gââss Black French Horchound Violets Hemp stalks the tender topâ of the Bramble hush of each one handful Madder according to the weight of al the other Let all these boyl in Wine unto the one half and afterwards let them be strained unto the straining addââ third part of Honey and then boyl them again and strain them The truth is Christophorus Georgius in his Comment writeth that this Medicament is no where to be met with in Ancient writings or Books and Johannes Manardus in his Comment upon this place writeth that he knew not by what accident this mixture had crept into this place and that the potion wa added unto the Emplasters And yet nevertheless the same Christoph Gâorgius de Honestis confesseth in the same place whether it be Missues his potion or any ones else that it is to be found described in many other Authors and Johannes Manardus in the same place writeth that these kind of Potions are very useful both for new and old wounds and that he himself had more then once made trial of them and that with them alone he had cured the worst and most desperate Ulcers And these have been likewise used by others and those not only Empiricks but also most learned able and skilful Physitians and Chirurgeons Guido part 2. of his little Chirurgery Chap. 9. John de Vigo Lib. 3. Chap. 10. Johannes Anglicus Nicolaus Massa Epist 38. Johannes Tragant B. 2. of his Chirurgical Institutions Johannes Andreas a Cruce of Wounds Tract 2. B. 4. Chap. 4. Fallopius in his B. of Wounds Chap 24. Petrus Andreas Matthiolus in his fourth B. upon Dioscorides and Chap. 16. Ambrose Parry B. 18. Chap. 28. Hieronymus Fabricius ab Aquapendente in B. 2. of his Chirurgery Chap. 23. Ludovicus Septalius in his 8. B. of Medicinal Animadvers Num. 181. And others a great many more of them whom experience taught that these potions were exceeding useful in the Curing of Wounds And therefore to oppose and thwart experience and to reject or neglect Medicaments approved of by long use and practise it is a thing no way fit to be done For as Galen writeth in his 5. B. of the affected places and 3. Chap. It is better saith he to seek out how things that are done are wrought and affected then to deny that they may at all be done Neither is this sufficient for the rejection of Medicaments that there hath bin no mention made of them in the Books of the Ancients for many most useful Medicaments have been found out by those of latter times that the Ancients were altogether ignorant of Neither are they administred for that end that Topicks are or those potions of which Galen maketh mention in his 4. B. of the Meth. of Curing Chap. 7. And therefore albeit that they do not externally reach so far as the wounded parts as other Topicks yet nevertheless they may through the Veins penetrate even unto the very Wounds themselves Neither by Reason of their astringent virtue which certain of them have from those Medicaments is there any cause to fear that therefore they cannot penetrate unto the exterior Members or that they are likely to breed obstructions in the Bowels For this inconvenience may easily be Remedied and avoided by the admixture of other things that have in them rather a power of opening then binding Neither lastly are the virtues of all Medicaments to be valued only from the first qualities and such as arise from and depend upon them but from the properties that arise from the whole substance which are suggested unto us only by experience But now the virtues of these Medicaments although they cannot easily he defined but may be manifested by experience yet notwithstanding in this all Authors agree among themselves that these ought not to be made use of in the beginning and when there is as yet no danger appearing by reason of the Wound and that Topicks are sufficient for the ful and perfect Cure as likewise where there is present a fever and an Inflammation which by the use of these they being for the most part hot may easily be augmented but as for other Causes so especially for this to wit the vitious Constitution of the part Wounds oftentimes do not easily receive a Cure and thereupon it is that they may happily and succesfully be made use of not only in Wounds but likewise in Ulcers and Fistula's For it is a thing that is very much Material how the wounded part and the blood therein are disposed and what things soever they are that hurt the Wound they all of them are for the most part communicated unto the Wound by the fault of the Blood as Tragautius tels us in the 2. B. of his Chirurgical Institut Chap. 12. And it being so as we see that some kind of meats are more fit and Convenient for wounded persons and some again offensive and hurtful why may we not therefore give the Patient to drink such Medicaments as cause that all things in the Blood and about the affected part may be rightly disposed and in good order Touching which Ambrose Parry in the place before alleadged thus writteth Nature being assisted saith he by such a potion hath often seemed to me to work effects wonderful and Miraculous in the recovery of bones rotten and impostumated and the Consolidation of Vlcers For these potions albeit that they do not by the Belly purge away the Noxious and offensive Humors yet nevertheless they are very efficacious in the cleansing of Vlcers and the preserving and freeâng of them from all that filth of the Excrementitious Humors the defecating and carrying away the dregs of the Blood and the purging of the Wound from the thin Ichorous Excrements and all impurity in the agglutinating also of broken bones and the restoring of the Nerves unto their pristine Vnion And preâently he addeth this further by this admirable and laudable Medicament the
of blood and the matter of the inflammation may be withdrawn and kept back And indeed by how much the danger in the wound is the greater by so much the more spare ought his diet to be but so soon as the danger of the wound is diminished then his diet may be by degrees augmented so that he may feed somwhat more fully but yet stil with a due moderation And therefore albeit that Hippocrates in his B. of Affects saith that Wounded persons ought to be pinched and afflicted with hunger this is not simply so to be taken but that we are alwayes to heed the danger of the wound and especially of the inflammation conjoyned therewith and according as this danger shal be greater or less so the diet prescribed may be more ful or ought to be more sparing as we may see out of the same Hippocrates in his Book of Fractures comment â Text. 44. and Comment 3. Text. 12. as also out of Galen in his Commentary upon those Texts of Hippocrates But yet notwithstanding there is some consideration and respect to be had unto the Age time of the year Region Custome and Temperature according to that 17. Aphorism of the first Section As touching the Patients drink in our Regions Beer may fitly and conveniently enough be drunk His Drink I mean that drink that is made either of Barly or of Wheat and this is to be made somtimes weaker and somtimes stronger according to the state and condition of the wounded party and the wound it self Wine is not allowable in those wounds that are dangerous and where there is present or the danger of an Inflammation threatened and neer at hand in regard that it may by reason of its heat and thinness be a vehicle or means to convey the humors unto the part affected And therefore Hippocrates in his Book of Ulcers text 1. writeth in this manner A small and moderate quantity of Meat and the drinking of water is mostly fit and requisite in all Wounds whatsoever but yet rather in those that are new and fresh then in those that are old and of a long standing and then especially when in the wound there is present an Inflammation or if there shal be any feared or when there is any danger lest that any thing may be vitiated or when the wounds of a joynt are attempted by an inflammation or when there is any fear of a convulsion at hand and lastly when the Belly hath received a Wound And therefore for those that have been long accustomed to drink water and where there is no great plenty of beer either simple and pure water may be administred unto the patient or else a Medicate water destilled out of the juice of Pomgranates Coriander seed Citron rinds of Barley water or the water destilled out of the whol Citron When the danger of the inflammation as past then that wine that is thin and weak may be allowed the patient how and then In wounds that are more grievous and ful of danger Medicate drinks may be provided and made of vulnerary herbs As for what Concerns the motion and rest of the body Motion and rest which of them fittest for those that are wounded Rst is most convenient for wounded persons but more especially for the wounded part For motion moveth and scattereth the humors and rendereth them apt to flow and the moving of the wounded Member exciteth a pain in it and yet nevertheless for the Patient to walk casily and gently his leggs being sound unhurt it wil be no way amiss but very good for him so to do touching which Celsus in his fifth Book and Chapt. 26. thus gives us his opinion The best Medicament likewise saith he is Rest and quietness and to More and walk unless for those that are sound and in health is not so fit and convenient but yet nevertheless it is least dangerous in those that are wounded in their head or Arms but more unto such as are wounded in their inferior parts But motion or walking is then least of all convenient when the wound is either in the Thigh or the Leg or the Foot The Commotions likewise and all perturbations of the mind are carefully to be avoyded Affects of the mind how they are to be ordered and more especially wrath and Anger And therefore those persons that may be an occasion of incensing and provoking to anger the sick person are not to be permitted to come where he is nor so much as any mention to be made of them in his hearing But the Patient ought rather to be moved and stirred up unto a moderate and fitting mirth and cherefulness and all possible tranquillity and calmness of Mind And of all other things that are prejudicial unto the Patient at this time the use of Venus and the company of women is the most hurtful Immoderate and overlong watchings are also very offensive in regard that they inflame and cause a commotion in the humors The sick persons belly must be kept open and soluble and if it chance at any time to be stopt and shut up it is then again to be opened and loosened with mild and gentle Clysters Chap. 13. Of keeping the flux of humors from the Wounded part And thus much touching the general cure of Wounds which yet notwithstanding is somtimes to be varyed according to the variety of the subjects the Nature of the wounded part and the condition of the diseases and the symptoms that flow thereupon and of this we shall now speak And first of all indeed it oftentimes happeneth that the body that is wounded may not be exactly and perfectly sound but that it may be either Plethorical or cacochymical so that there may be great cause to fear lest that either great abundance of blood or the vitious humors that have been long treasuring up in the body may by occasion of the wound rush unto the affected part and there excite various evils And therefore we are to use our utmost endeavour to hinder and prevent the afflux of the humors unto the wounded part Now this flux is especially prevented if care be taken to hinder all those causes that may excite the said flux and moreover al those things that may overmuch and prâternaturally heat the wounded part excise a pain therein or render the same soft loose and so consequently the more apt to receive the flux or overheat the humors disperse them and so render them the more fit for motion are wholly to be removed and taken quite away And such a care and orderly course there ought also to be taken in point of dyet that it may not in any wise generate either too great abundance of blood or had and corrupt humors And furthermore we are likewise to succour and help the weak and infirm part by those things that corroborate and strengthen it the pain if there shall be any is to be mitigated if there be present any heat it is to be
the Nerves although that there shall be no pain felt neither any Inflammation appearing yet notwithstanding we are not to trust to this but for all this the Cure is carefully to be heeded and attended The Cure Touching the Curing of the Wounded Nerves Galen in his sixth Book of his Method of healing Chap. 2. taketh a great deal of pains in treating thereof But seeing that in all Wounds of the Nerves pains and inflammations easily make their approach and threaten the patient we must endeavor that the pain may be mitigated and the inflammation prevented And therefore if need require both by letting forth of the blood as also by a purging out of the sharp and thin humors their afflux unto the affected part is to be restrained and prevented but the wound it self is to be kept open that so the excrements may the more freely flow forth For the Chiefest cause of pain in Wounds of the nerves is the excrementitious matter shut up which being over long detayned getteth to it self a depraved quality pulleth and twingeth the Nerves and at length putrifieth And therefore those Medicaments that are called Enemata although they may be very fit and proper in bloody Wounds and those of the fleshy parts in regard that they speedily close shut up the wound yet here in this case are no waies convenient Neither is water fit proper nor yet any thing that is cold since that as Hippocrates writeth in his fifth section Aphoris 18. every thing that is cold is an enemy to the bones teeth Nerves Brain spinal marrow but that which is warm a friend unto them Yea neither ought other Medicaments that are actually cold to be administred unto the wounded parts For seeing that the Nerves are parts voyd of blood and having in them but very little natural and inhate heat and endued with a most exquisite sense they are soon and easily offended by any thing that is cold it being biting and causing pain as Hippocrates writeth in the 20. Aphor. of his fifth Section and as Galen likewise teacheth thus in the sixth Book of his Method of Curing Chapt. 3. But yet things that are blood-warm are not sufficiently commodious touching which Galen in his sixth Book of the Composit of Medicaments according to the kind Chapt. 2. thus writeth Let the oyl sayth he with which we cherish the wound be sufficiently hot lest that otherwise it offend such a wounded part For like as that which is cold is most of all contrary unto these kind of Affects so likewise that that is but blood warm is not very much a friend unto them And a little after and for this Reason sayth be I my self chuse rather to make use of a fomentation of oyl that is sufficiently hot alwaies shunning that which is but luke-warm but most of al refusing that which is quite cold And yet Nevertheless if there be a nerve discovered and made bare Galen then administreth rather such things as are but tepid or Luke-warm then those things that are very hot as we may find in the sixth Book of his Method of Curing and Chapt. 3. But although that for the asswaging of the pain that which is hot and withal moyst is most useful and convenient yet nevertheless in regard that under those things that humectate and moysten the Nerves do easily putrefy therefore for all Wounds of the Nerves those Medicaments are most accomodate and proper that in their activity are temperate or somwhat tending unto heat but that in passives do dry and that are of thin parts that may corroborate the weak heat of the Nerves by consuming and drying up the excrements touching which Galen in his sixth Book of the Method of Curing and 2 Chapt. writeth in this manner The faculty of the Medicaments of the wounded Nerves ought to be both thin and also moderatly heating and such as may dry without any pain in regard that this alone can draw the Sanier or thin excrements from the bottom of the Wound without either contracting or biting of the particle And then a little after the Wounded Nerves sayth he require such Medicaments that may excite a tepid or luke-warm heat and may strongly dry and which from the Nature of their own substance have both a power of drawing and are of thin parts And the same he teacheth us in his third Book of the Composition of Medicaments according to the kinds Chapt. 2. And such like Medicaments have in them this benefit likewise that although they are endued with a faculty of drying yet notwithstanding they do not conglutinate the orifice of the Wound seeing that they have both an attractive power and yet nevertheless are free from and void of an Astringent faculty And yet notwithstanding regard ought to be had unto the nature of the Wounded person and unto the softer and more tender bodies the weaker Medicaments are to be administred but unto hard and strong bodies those medicaments that we administer may be the stronger And there is also regard to be had unto the matter that is to be dryed up and according to the store of the humidity we are to make choice of Medicaments that are conveniently drying For as Galen in the place last alleadge to wit the third Book of the Composition of Medicam according to the places and Chapt. 2. sayth that in a very copious humidity the increase thereof requireth to be dryed up by a Medicament that is more then ordinary drying if it be buy little then by a medicament that doth this moderately and if it be much hen by a Medicament that dryeth much and yet nevertheless not extremly neither in the highest degree For there ought to be a proportion answerable between the quantity of the humidity and the drying of the Medicament And if there be also any of those drying Medicaments and of thin parts which are of fit use in all Wounds of the Nerves that have adjoyned with them a Notable heat and a biting Acrimony and thereupon may easily excite both pain and fluxions such as are destilled Balsams spirits and oyls their heat and acrimony unless of its own accord it soon vanisheth as it commonly happeneth in the spirit of Wine is to be tempred and Mitigated by the mingling together of other things with them Such like Medicaments as these that are useful in all Wounds of the Nerves are propounded by Galen in his sixth Book of the Method of Curing Chapt. 2. and in his third Book of the Composite of Medicam according to the kinds Chapt. 3. 4. and 7. and they shal be likewise declared by us anon when we come to speak of the pricking of the Nerves But now that the pain may be asswaged the temperament of the part preserved and the Afflux of humors and the inflammation may be prevented there are not only convenient Medicaments to be imposed upon the part affected of which we shal speak by and by but even al the parts also that lie in
be taken But if the Contrary shall happen then the strength of the Medicament is to be augmented either by mingling a greater quantity of the old or else by the admixture of the newer Euphorbium for that mixture that hath in it a triple proportion of Wax is the strongest that which hath a five-fold quantity of the said Wax the weakest and the mixture having but a quadruple proportion of the Wax is in a mean betwixt both Galen as we may see in his third B. of the Compositâ of Medicaments according to their kinds and 2. Chap. mentioneth likewise other things that are to be made use of as live Sulphur unslaked Lime washed Arsenick Sandarach Pompholyx the scourings of Brass Chalcitis or red Vitriol burnt But in all these he had only a regard unto their drying faculty and he would only have the Medicaments to be so made and Compounded that they might be able to cal forth and consume the Excrements out of the Wounds of the Nerves But unto me as I told you before it seemeth far more probable that such Medicaments are to be made choice of that may withal Corroborate and Augment the Native heat of the Nerves which of it self and especially in the wounded Nerves is very weak And therefore this latter Age hath found out Medicaments that are far more safe both such as are prepared by the Chymical Art as also such as are brought unto us out of other Countries yea and such as are very ordinary at home among our selves and such as do their office without causing any pain that is easily brought upon the Patient by the use of those stronger Medicaments that the Ancients made use of and which may be safely applied whether the Nerve be naked and bare or whether it be covered whereas in the Nerve that is bare all those Medicaments of the Ancients cannot be made use of with any safety such as are these Balsam of Peru the distilled Oyl of Rosin Turpentine and the Rosin of the Fir-Tree Wax Oyl or Balsam of St. Johns wort the spirit of Wine Gum Elemi Gum Tacamahaca and Gum Caranna All which obtain that faculty which by Galen and the Ancients is propounded and have in them no Corroding quality at all and withal obtain a Balsamick virtue as those of our times term it which those other of the Ancients are void of and they do not only consume the Excrements but they likewise greatly strengthen the Native heat of the wounded part and are all of them very agreeable and suitable unto the Nerves Caesar Magatus in his second B. of Wounds 5. Chapter mentioneth these several forms following Take Ammoniacum Opopanax Sagapenum dissolved in hot water Propolis and Turpentine of each half an ounce Oyl of thin parts two or three yeers old in which Earth-worms have been boyled one ounce and half Mingle them and make an Vnguent Or Take Cleer Turpentine the exsudation or tear of the fir tree of each one ounce Tacamahaca half an ounce Caranna two drams Balsam of Peru three drams Propolis six drams our oyl of St. Johns wort one ounce Mingle them and make an Vnguent Or Take Sagapenum Opopanax Propolis of each half an ounce Tacamahaca three drams the destilled oyl of Turpentine or the sweat of the fir tree one ounce Sulphur that hath not come neer the fire one dram and haâf Mingle them and make an Vnguent Or Take Tacamahaca Opopanax Propolis the sweat of the Firtree of each two drams Artificial Balsam six drams Mingle them and make an Vnguent Or Take Artificial Balsam our oyl of St. Johns Wort of each half an ounce Burning water which the Latines call Aquâ ardens or the water of Balsam three drams and mingle them Or Take Diachylon with Gums one ounce Tacamahaca Caranna Sagapenum Propolis Rosin of the Pine Ship-pitch of each three drams Artificial Balsam half an ounce Euphorbium two scruples Mingle them and make a cerot Or Take The oldest Leaven one ounce and half Doves dung or Brimstone one dram Aqua Ardens or Water of Balsam as much as wil suffice that the Medicament may have the consistence of Honey and so mingle them Or Take Oyl of Turpentine or the sweat of the Fir tree one ounce Sagapenum Propolis of each half an ounce Euphorbium one dram mingle them And if the Medicament that is layd on be of a thin substance or as the Chymists speak volatile which may easily be dissipated then we are to mingle therewith all Turpentine and Gum Elemi or else we must impose an Emplaster of Gum Caranna Tacamahaca dissolved in the compound Oyl St. Johns wort The Diet. There is likewise regard to be had unto the diet The Air in which the Patient is most conversant ought to be somewhat more warm then ordinary since that the Cold is an Enemy unto the Nerves as in the fifth Sect. Aphoris 18. And therefore likewise the Wounds of the Nerves are not over often and without very great cause to be uncovered and when they are uncovered a Candle nmst be lighted and a pan ful of hot coals must be in a readiness and this new binding up must be hastened and performed with all possible speed Let the sick person abstain from wine The affected part is softly and gently to be placed and kept in quietness For as Celsus saith in his fifth Book and Chapt. 26. the best of all Medicaments is Rest and quietness and to move and walk unless for such as are sound is altogether unfit and improper Yea moreover we have two histories that tells us that Laughter may bring very much danger and damage in the wounds of the Nervous parts These Histories we find taken notice of by Guilhelm Fabricius in his first Century Observat 23. Let Anger likewise and the passions of the mind be avoyded And let the patient at this time abstain from Venery that which is of all other things most hurtful unto him as we are sufficiently taught by the history of that young man in Guilhelm Fabricius his first Cent. Observat 22. who being now almost perfectly wel and recovered dyed upon this very cause and no other Chap. 16. Of the downright Wounds of the Nerves as also of the Ligaments by Cutting But now if the Nerve or Tendon be wounded not by pricking but by a downright cut we are then to look whether the wound be long waies or whether it be transverse and overthwart and then whether the Nerve be wholly cut assunder or else be but only in part Wounded and how much of the skin lying over it is divided Signs Diagnostick The pain if the Nerve be Wounded by a Cut but not wholly divided and cut assunder is not so great as if it be Wounded by a prick and yet nevertheless for the most part it is even great enough But if the Nerve be wholly cut assunder there is then no pain at all felt but yet nevertheless the sense and feeling or else the motion of the part into which the Nerve
upon his back and with fit little Pillows and bindings let the Huckle-bone in the head thereof be contained and kept in its proper place and until the Cicatrice be brought over it the sick person must be commanded that he somtimes move and stir his Thigh this way and that way lest that the Cicatrice being brought over it there should happen a hurt of the motion by means of the said Cicatrice The Knee when it is wounded must be stretched forth and placed in a right and straight Figure that so Lameness may be prevented But now if the Wound be with a Luxation or loosening of the Joynt A Wound with Luxation if the Joynt that is loosened be great the putting of it back again into its place is to be omitted and the sick person is to be told before hand of the Lameness and danger that would follow thereupon and the fluxion is by all manner of means to be turned away and the pain to be mitigated and the Member to be placed in such a posture as may seem most grateful and convenient unto the Patient and such as may bring the least pain unto him provided stil that the Member hang not down lest that there should be an occasion for an afflux of the Humors But the wound is to be Cured like as other Wounds but yet nevertheless it is not to be bound up in the same manner as other wounds are And great care must likewise be taken that it be not offended by the external cold of the Air. Cataplasms are likewise to be imposed not upon the Wound it self But upon the parts that lie neer unto it lest that by any means the part should by the weight thereof be grieved and burthened And in regard that fluxions are easily caused in this case unto these parts and thereupon the Cure the longer ere it be perfected therefore the Body is by often purgations and likewise by swears to be purged and cleansed from all its vitious and superfluous Humors Chap. 18. Of a Wound with a Contusion AND seeing likewise that the quality and Condition of the instrument wherewith the Wound is inflicted may cause a difference of the Wound we are therefore here not to pass this over in silence without speaking somthing unto it For some wounds are inflicted by sharp Instruments or weapons and others by those that are obtuse and blunt which doth not a little vary the Cure And indeed the Cure of Wounds made with sharp Instruments may sufficiently appear by what hath hitherunto been said and as for what is peculiar unto Wounds that are inflicted by blunt Weapons we will here in this Chapter declare it Now that kind of Unity dissolved that obtuse and blunt Weapons cause in a soft part is called a Contusion And indeed it is properly termed a Contusion A Wound with a Contusion when the superficies of the part or the Skin being whole and entire those soft parts that lie under it are bruised and as it were battered together of which Contusion some mention hath likewise been made above in the first Part and sixteenth Chapter And yet nevertheless now and then the part is not only bruised within but it is also externally wounded in the superficies where the Wound is joyned with a Contusion and touching this Contusion it is that we intend here to treat of which we shal notwithstanding so order our discourse that what is to be done in every Contusion may manifestly appear The Causes Now a Contusion is caused in Wounds when the Weapon or Instrument wherewith the Wound is inflicted hath not only a power of cutting and making an incision but likewise of bruising and battering the part upon which it lighteth and this is done when the Weapon or Instrument is blunt or heavy or when a man is thrown against somthing that is hard in which manner also the soft part may be bruised without a Wound or else with a Wound Signs Diagnostick Wounds with a Contusion are known by the instrument with the which the wound was made to wit if it be blunt and heavy and then in the next place from the pain and the black and blew color of the part Prognosticks 1. A Wound with a Contusion is more dangerous and more difficult to Cure then that which is without a Contusion For the bruised parts and the blood that is poured forth if they be not discussed they must of necessity be turned into Pus or otherwise before this is done the Wound cannot be Cured 2. And if the bruised part and the blood poured forth of the broken Vessels begin to putrefie it may excite and cause a Gangrene The Cure In regard that no wound that hath any other affect that hindereth the Curing thereof Joyned with it can be cured until the said Affect be removed and that the part it self be rightly disposed it from hence easily appeareth that our first care must be directed unto the cure of the Contusion And when the Contusion or bruise is once taken away the rest of the Cure is to be performed in the manner and form aforesaid But then seeing that what is bruised cannot be restored again and made entire as before and that the Blood which is poured forth of the Vessels may stick in another place where it ought not to be and so may be easily corrupted therefore we ought first of all to endeavour that both of then may be taken away and that they may either be discussed or else converted into Pus And because that there is evermore caused an afflux of the Humors unto the bruised part by reason of the pain that attendeth the said Contusion therefore first of all Universal Revulsions and chiefly Venefection or opening of a Vein if need so require are to be administred And then in the next place that there may flow no more of the Humor unto the part affected Defensives and Repellers are to be administred touching which we have spoken above in the 1 Part Chap. 16. which ought to be such that they will no way admit of the afflux of the Humor and withal that they may consume and dry up some part thereof And when there shall be no further cause to fear an afflux of Humors then we are to do our endeavour that that which is bruised and the Blood which being forth of the Vessels sticketh in the bruised part may speedily be turned into Pus as Hippocrates teacheth us in his B. of Vlcers If saith he any of the flesh shall be battered and bruised by the Weapon we are then to take care that it be as soon as may be converted into Pus for as it is less dangerous then an Inflammation so there is also a necessity that the flesh being battered and bruised by the Weapon should being converted into Pus waste and consume away and then a new Flesh be bred instead thereof Now what those Medicaments are that move and forward the Pus we have elsewhere told
Pus begins again to be diminished in its abundance it will suffice then twice a day to open and cleanse the Wound And at length when there floweth forth very little of the said Pus and that the Wound beginneth to be filled up with flesh it will then be sufficient to open cleanse and binde up the Wound once a day as at the first But First of all we must endeavour that here there may be a passage opened for the Sanies or thin Excrement to flow forth which in these Wounds is in great abundance heaped up and gathered together by reason of the Contusion of the parts as also because of the fragments of the bones that Nature endeavoureth to expel and this may be performed by Tents that if need require may be hollow And if Splenia as they term them or Linen thicker then ordinary three or four times doubled be imposed upon the bottom of the sinus and that afterward the Pus and Sanies be pressed forth by a harder and closer binding this will very much advance and help forward the flowing forth of the said Pus and Sanies But there is somtimes so great an abundance of the Sanies gotten together in the Wound and the Sinu's are so deep and winding that the Sanies cannot all of it either flow forth or be pressed forth of the wound and therefore then the Sinus is to be cut that so the Sanies may flow forth and the Sinus may be cleansed Neither are the vulnerary potions here in this case altogether useless and to no purpose for in regard that they cleanse the Ulcers and free them from the filth of the Excrementions Humors and cause that all things in the Wounds that are from without and Heterogeneous may by Nature the more easily and sooner be thrust forth of the said wounds if there be need of these potions in any other kind of Wounds then certainly they are here most of all necessary But touching these vulnerary potions we have spoken before in the eleventh Chapter After that Concoction beginneth now to appear in the wound which seldom happeneth before the third or fourth day in regard that by reason of the vehement Contusion of the part its heat was greatly weakned and the spirits exhausted and when there is now appearing neither any notable pain and Inflammation and that which is bruised is for the greatest part turned into Pus then the Wound is to be cleansed filled with flesh and at length shut up with a Cicatrice And the truth is when the wound is once become pure and clean then it is very necessary that flesh be generated because that the bruised flesh is all of it converted into Pus and so the wound must necessarily become hollow And indeed as touching Cleansers these ought to be either weaker or stronger Cleansers according as there floweth forth a greater or less abundance of the Pus and according as the Wound is either more pure and clear or else more foul and polluted As Take the Decoction of Barley the Juyce of Plantane Smallage Agrimony and the lesser Centaury of each one ounce boyl them and in the end add of Turpentine three ounces Honey of Roses two ounces Frankincense and Mastick of each one dram Saffron one scruple and mingle them Or Take Meal of the bitter Vetch Orebus one ounce and half Frankincense and Orrace Root of each six drams Juyce of Smallagâ four ounces Honey as much as will sufficâ Mingle them over the fire or Take The Meal of Barly and of Lupines of each one ounce Frankincense Myrrh Aloes of each half an ounce the pouder of Orrace Root two drams Juice of Smallage and Wormwood of each three ounces Turpentine two ounces Hony one ounce let then be boyled unto the consumption of the Juices If the Wound be fouler then ordinary you may then add some of the Aegyptiack Vnguent As Take The Meal of the Vetch Orobus one ounce Myrrh and Frankincense of each half an ounce Turpentine and the Juice of Smallage of each two ounces Vnguent Aegyptiack half an ounce Mingle them If the Sinus be very deep it will be good then to wash it with the Decoction of the lesser Centaury Horse-tayle the greater Consound Birthwort Orrace Frankincense this Decoction must be made with Wine adding thereto a sufficient quantity of Hony But then for the breeding of flesh Medicaments that breed flesh let the Medicaments that were before propounded be made use of And this following is likewise very useful in these Wounds Take Oyl of Mastick one ounce and half Rosin of the fir tree one ounce Manna Thuris or the fine flouer of Frankincense half an ounce the herb Horstayl Tormentil the greater Consound St. Johns wort Plantane and Betony of each half a handful Earthworms washed in Wine two ounces Wine as much as wil suffice Boyl then until the Wine be consumed and afterwards strain them with a strong expression and squeezing of them and then add of Wax and of Goats sewet of each four ounces Frankincense Myrrh Mastick and Aloes of each half an Ounce Mingle and make an unguent which may be layd upon the Wound and this Vnguent may be covered with the Emplaster Diapalma If the Wound be infected with poyson then the Wound caused therby is to be referred unto the poysoned wounds touching which we shal speak further in the following Chapter But if the wounded part begin once to be taken with a Gangrene then the cure is so to be ordered as we told you before in the last Chapter of the second part touching a Gangrene But now this is one thing that especially renders wounds inflicted by Guns difficult to be cured Wounds with a fracture of the Bones when in the Arms the thighes and the Ankles bones are broken yea and many times shattered into divers fragments in which since that for the most part the Nervous parts are hurt when these come to be purged from these fragments of the bones there wil from thence arise most sharp and acute pains convulsions yea and the Gangrene it self after all Which if it happen the Common Chirurgeons frequently hasten all they can to the amputation and cutting off of the whole Member But although notwithstanding that this may somtimes be done yet nevertheless this is not to be put in practise so long as there is any the least hope left of a Cure seeing that Nature is wont even in these wounds also to work miracles as it were The way of Curing is the same as of fractures with a wound of which we shal treat further in the next part to wit the fifth and the Second Chapter The first and main care therefore must be that the great fragments of the bones be restored again unto their places and that they may be there Joyned together But yet nevertheless in administring of the splinters which are otherwise wont to be applyed in the fractures of the bones there ought great caution to
already spoken in our first B. of Feavers and especially that in the Quotidian the Signs of putridness disappear in the Urine whereas in putrid Feavers they appear therin And so the heat in putrid Feavers is far greater and sharper then in Quotidians and so are also the Symptoms more grievous and withal there is a greater dejection of the strength and powers of the Body Prognostick Now these Feavers in regard that they wholly depend upon the Inflammation they are therefore greater or less according to the greatness of the inflammation and so likewise more or less dangerous Cure These Feavers are taken away and Cured upon the removal of the Inflammation like as al other Symptomatick Feavers touching which we have already spoken in their proper place And therefore we ought in the first place to do our endeavour that by coolers and other convenient altering Medicaments this Feaver may be Cured lest that otherwise a putridness be excited in the Humors or if there be now already present any putridness that it may be restrained and kept under And Fourthly There happen likewise feavers unto Wounds Feavers from the putridness of the Humors kindled even by the putridness of the Humors that are in the Wound it self as being neerly related and allied unto those things that are raised and have their rise from the Pus or thick purulent matter Signs Such Feavers as these are known from the Quantity quality of the Excrements of the wound For there floweth forth great store of Sanies and this resembleth somthing that is putrid rather than good laudable Pus and it is of a various and evil colour and of a very unsavoury and offensive smel And although there should not flow forth any great store of Pus or Sanies yet nevertheless if the matter that floweth forth be naught and corrupt if the colour of the part be changed and if there be present any pain and heaviness in the part it is then indeed a sign and token that there is present a vitious matter and that it hath not been sufficiently purged forth But in the mean time there will be present and appear the signs of a Feaver which will shew unto us in the Urine the Notes and Marks of putridness or it may be they shew us none according as the matter is more or less communicated unto the Veins and Arteries Prognostick And as for these kinde of Feavers they are more or less dangerous according as the putridness is greater or less and likewise as it is in a part more or less noble and accompanied with more milde and gentle or else more sad and grievous Symptoms and according as there may be made a passage for the more easie or more difficult flowing forth of the vitious matter Cure The Cure consisteth in this especially that the putridness in the part affected be with all speed and as much as may be restrained and kept under and that by all means possible there be a way and passage made for the vitious matter to flow forth For the putridness being taken away and removed the Feaver soon after easily vanisheth of its own accord And Lastly There is also a kinde of Feaver A Feaver from the vitious preparation of the Humors which ariseth in wounded persons from the storing up and the great provision that hath been made of vitious and naughty Humors and the ill preparation of them For if the wounded Body be impure it may then easily be that a Feaver may be kindled in it upon the occasion of the Wound Now this is done in a twofold manner and upon a double account First of all from the commotion and disturbance of the Spirits and Humors after the receiving of the Wound For as in Bodies otherwise impure there are Feavers oftentimes kindled from the passions of the minde and Commotion of the Body even as we see it to befal Women that have hard labour in Child-bed so the very same may likewise happen in those that are wounded And furthermore a Feaver is also kindled from a putridness in the wounded part For as in Child-bearing Women there are Feavers oftentimes kindled from the retention of the Secundine and the blood that usually floweth from them after the Childe is born and this so much the more easily if their Bodies be impure even so if any putridness be kindled in the wounded part and that the depraved Vapors communicated unto the Veins do finde any vitious Humors in these Veins then a Feaver ariseth thereupon Now these Feavers are various according to the different preparation of the vitious Humors somtimes intermitting and sometimes continual according as this treasury of the vitious Humors is laid up either without the Vena Cava viz. the great hollow Vein or else sticketh fast in the same and indeed for the most part they are Tertians either continued or intermitting single or double and very rarely Quotidians and most seldom Quartans Signs These Feavers are known in that both the heat and the Urine and the pulse do all of them discover sure signs and tokens of a putridness But now whether these Feavers are kindled only by the commotion and disturbance of the Humors or else from the putridness in the wounded part it is known by this to wit that if the Feaver proceed meerly and only from the Commotion of the Humors then such a Feaver invadeth the person immediatly and in the very beginning and there is no vitiousness or fault at all to be found in the Wound But if it proceed from any putridness in the Wound then the Feaver appeareth not instantly and at the very first but after a short time and then there are Signs and tokens of Putridness in the Wound it self But then for the Nature and Quality of the Feaver it is to be known from the proper Signs of Feavers Prognostick Of these Feavers some of them are more dangerous then other some as we have already told you before in its proper place touching Feavers and intermitting Feavers they are of themselves altogether void of danger but the Continual are somwhat more dangerous and that likewise more or less according to the quality and condition of the putridness But yet because that these Feavers happen and follow upon Wounds they al of them therefore bring some danger along with them more or less For whereas the wounded part was weak before now the Feaver happening thereupon increaseth the debility and so augmenteth the danger thereupon depending and thus it may very easily come to pass that at the part affected there may be a fluxion excited or else by reason of the heat weakned upon the aforesaid Cause very many Excrements may be generated in the part and from hence other evils may be excited Their Cure Now as for the Cure of these Feavers albeit that they are occasioned by the Wound yet nevertheless because that the vitious provision of Humors is the principal cause of them therefore these Feavers are
pain there be perceived a certain heat in the Wound Prognosticks Now these extraordinary and over vehement pains in Wounds are wont to be the Causes of grievous Evils For besides that they cause a restlesness and want of sleep and deject the stength of the sick person they are likewise the Causes of the afflux of Humors unto the wounded part whereupon Inflammations a Feaver somtimes also the Gangrene are excited and brought upon the party Touching which Galen also very frequently giveth us notice There is nothing saith he that more increaseth the Phlegmone then pain as he writeth in his 5. B of the Meth. of Curing and 4. Chapt. and in the 3. B. of his Method Chapt. 2. and 6. By reason of pains saith he the parts aâe troubled with and lie under fluxious And in the 13. of his Method Chapt. 5. Pain and the heat of the member in which the Erysipelas resideth although the whole Body be pure and free from Excrements become the Causes of a Fluxion That therefore the pain may be taken away we are to make diligent enquiry and finde out whether this pain proceed from any Errour and fault in the sick person or else from the Carelesness of the Chirurgeon and if any such Cause shall be discovered it is to be removed before any thing else be done But if no such Cause shall appear but only that somthing extraneous sticketh in the Wound this is without any delay to be drawn forth If the pain proceed from the abundant store of the Pus retained and kept in then a free and open passage is to be made for it that so it may freely flow forth But if it proceed from the overgreat Afflux of the humors like as it is wont to be in an Inflammation then we are to make use of those Medicaments that restrain the immoderatâ excessive afflux of the humors as also we are to administer Medicaments both rarifying and Anodyne And very useful here is the Oyl of Roses with the white of an Egge and the yelk of an Egge according as the Case shal require and in which Earth worms have been boyled as likewise the Oyl of Camomile of Linseed of sweet Almonds of Earth worms and of Elder A Cataplasm of the Leaves of Mallows the Roots of Marshmallows Barly meal Bean Meal and bran But if the pain be greater then ordinary we may then make use of the Oyl of Poppy and of Water-Lilye as likewise of the Cataplasm that is made of the Leaves or Root of Nightshade and Hoggs grease As for Example Take Oyl of sweet Almonds Oyl of Roses and of Camomil of each one ounce the yelk of one Egg and Saffron half a scruple Mingle them c. or Take Root of Marshmallows half an ounce Mallow Leaves one handful Elder flowers two pugills boyl them all unto a softness and then pass them thorow a hayre sâeve adding unto them the powder of Camomile flowers half an ounce Barley Meal one ounce Bean Meal and the Meal of Linseed of each half an ounce Make a Cataplasm hereof Vnto which if you please there may be added the Oyl of Roses of Camomile of white Lilyes of Mastick and the Vnguent Dialthaea If the pain be not asswaged by all these Medicaments it is a sign that some Nerve is greatly hurt And so then the cure ought in all respects to be carryed on as that we mentioned above in the 15. Chapter touching the wounds of the Nerves Of Convulsions and Convulsion Fits There happeneth likewise now and then a very grievous and dangerous symptom unto Wounds to wit a Convulsion or Convulsion Fits the Latines term them Convulsive motions touching which symptom many are wont to treat at large touching Wounds But in regard time we have already in the first Book of our Practise Part. 2. Chapt. 20. spoken enough of a Convulsion in general we shall here only set before you those things that are proper unto that Convulsion which is wont to follow up on Wounds Causes As for the Causeâ of the Convulsion Convulsions are caused in Wounds either from a pricking of the Nerves and then extreme vehement pain or else from some sharp and Malignant either humor or or vapour pulling and swinging some Nervous part or the Membranes of the Brain for the expulsion of which when Nature beginneth to best â her self the then exâââth this Contraction and Convulsive Motions Touching which Hippocrates in his ãâã Aphorism of the fifth Sect. thus writeth Those saith he that together with their Wounds have conspicuous Tumors their are not greatly troubled with Convulsion fits but they are taken with a kind of Madness But these tumors suddenly vanishing if this indeed happen on the hinder part then Convulsions and Cramps follow thereupon And Galen in Art Mâdica Chap. ââ saith that the pricking of a Nerve and Tendon by reason of the vehemency of the sense and because this part is knit together with the principium that is the Brain it is therefore very apt to excite and cause a Convulsion of the nerves and then especially when nothing breatheth forth outwardly the wound of the skin being closed and shut up And indeed the matter exciting a Convulsion doth it sometimes only by its Atrimony and somtimes also by its malignity like as we see the very same to happen in Wounds and strokes and bitings of venemous Creatures Prognostick Now these Convulsions or Convulsive Motions are very dangerous in wounds touching which Hippocrates Sect. 5. Aphor. 2. sayth thus The Convulsion that followeth upon a Wound is Mortal and in the 5. Sect. Aphor. 3. The Convulsion that followeth upon an extraordinary Flux of the blood or a sighing and sobbing upon the same occasion is very evil and dangerous Cure But now as for the manner and method of Curing these Convulsions we have shewed it unto you in our 1 B. Part. 2. Chapt. 28 and there you may see enough hereof And therefore here in this place we shall only give you notice of these things following First of al that in Convulsions and Convulsive Motions that happen unto Wounds whether it be of themselves or by Consent with some other part how and in what manner soever it be we ought to have a special regard unto the Brain spinal Marrow and the Nerves that proceed from these and thereupon we are to anoynt the Neck both before and behind and the whole spinal Marrow with Convenient Medicaments such as we have already mentioned in the place alleadged Caesar Magatus in his first B. Chap. 77. Commendeth this following Take Oyl of Bays of Juniper Wood of Juniper Berryes Mans Fat and Oyl of Earth Worms of each four ounces Oyl of Rosemary flowers Lavender flowers and Sage flowers of each two ounces Oyl of Peter and of Turpentine of each half a pound Oyl of Tile and the oyl of Been of each three ounces and an half Myrrh Frankincense Ladanum Benzoin and Gum Juniper of each three ounces Oyl of Cinamom
doubt these poor Flies are more likely to obey his Commands then the Stars There is Another who tels us how we may make a Seal with the Figure of old Father Saturn digging up the Earth with a Spade which say they ought to represent unto us the Planet Saturn and this Seal if any one shall carry about him in his left Boot and why not I pray as well in his right Boot or on his Arm he writeth that it will then so preserue a man that he shall suffer no hurt at all from his Horse and moreover that it wil speed and hasten the hard labor in Child-bearing Women And moreover how and from whence will they be able to prove that those strange and uncouth Characters that are to be seen in Corn. Agrippa Paracelsus and others are the Characters of certain Stars And not Characters only but even other Figures also They paint Saturn in the likeness of an old man with a Pruning Hook Sythe Spade or Plow-share They paint or Picture Jupiter like a King with a Scepter in his Hand Now what agreement is there between these Figures and those Planets which they Represent And what I pray may the Reason be that the Planets communicate their virtues and influences unto Metals only if they be engraven and inscribed with these Figures and not with others And who was the first that taught us that this Star taketh a delight in this kind of Character and that Star in another kind of Character different from the former And the Reason is the same for al other Figures touching all which they ought to prove unto us that these are the Figures of certain Stars And moreover besides these Characters what mean they by so many Words which they not only pronounce in the framing and fashioning of these Seals but they are likewise engraven and imprinted upon these Seals as we may see in Paracels his B. Archidox Magic and in the Seals of Arnold de villa Nova But others there are that endeavour to free themselves and clear the controversie by saying that individuals when they begin to be under some determinate Constellation they then receive a certain admirable faculty of operating or of suffering over and beside that they have in special or from the species But let this be granted yet notwithstanding it cannot be said that the precious stone or Metal do then begin to have their being when they have these Characters engraven upon them for they were and had their being before and indeed their substance was likewise individual and according also to their own opinion the Astral Spirit virtue insinuateth it self into that substance wherewith it hath a Sympathy For there is to wit between natural substances themselves a certain occult and secret familiarity and Sympathy but yet no such thing between Natural Substances and Artificial Figures But others are of this opinion that the Figure is not indeed the principle of operation but yet notwithstanding that it conduceth very much unto the said operation For the conception of a deformed Figure in the minde of Man or Woman we see what sadness it produceth unto them and on the contrary what Joy and cheerfulness the conception of a fair and delightful Figure and representation causeth in their Minds and Countenances And by the Instruments of Artificers according to the variety of the Figures so are the operations various some of them by the Saw and some others of them by the Hatchet or Axe But neither is there any thing of weight or moment in this that they alleadg For I demand what Beauty or Deformity there is in these Images and Characters And whereas fair things delight the minde while they are seen and lookt upon how I pray can these things delight the mind of a Man when they are carried and worn about him covered and seldom look'd upon And what do those various Names and indeed oftentimes such as are altogether unknown to us confer and add unto the fair and pleasant conception before mentioned And as for the Instruments of Artificers the Figure indeed maketh much unto the operations which are by a local motion but nothing at all unto those operations that are wrought by alterations for in these the Figure doth nothing at all neither can it and precious Stones if they have any natural virtues at al in them they put forth these their virtues under any Figure whatsoever it be And Galen writeth as touching the Jasper stone in the place above alleadged that he himself had found by experience that the virtue thereof was stil one and the same with or without the Figure of the Celestial Dragon or the sign Scorpio Neither yet are there any other that hitherto have been able to bring any the least shew of probability for the virtues of these Characters and Seals And how indeed could they possibly render any Reasons and give us the causes of such their absurd Tenets whenas they write that these Seals do not only expel and drive away Diseases but that some of them wil likewise make a Man gracious unto al Men whatsoever and that others of them will procure for a man knowledg Wit and Memory others the favour of Princes others victory in War and Civil Causes others good fortune as they cal it in Hawking Hunting Fishing and Merchandising and that others wil make friends to stand faithful unto them others advance a Man unto the highest Honors and preferments and that there are some of these Seals that wil make a Man Master of his with whatsoever it be and I know not what other things that these Seals are able to accomplish for him that weareth them Rodolphus Goclenius the younger taketh here a great deal of pains and troubleth himself exceedingly in his Magnetick Synarthrosis and at length he distinguisheth between these Seals and those whose Authors are said to be Ragael Chael Terel Hermes Salomon these he rejecteth but there are others of them that he commendeth to wit those Seals that are framed and fashioned under some certain position and concourse of the Stars and receive naturally all their virtues from the influence of these Stars and from the Connexion and Continuation of the Natural Causes without any impiety or Superstition at al. But now what this Connexion of the Natural Causes is and in what manner these Seals and Images receive their virtues from Heaven these things he no where telleth us neither doth he sufficiently explain himself only he saith indeed that these things are very clear and sufficiently manifested by Experiments But the very same may be said by Chael Ragael and the rest of the Magitians in the behalf and for the Justifying of their Seals also And who is there that now adaies knoweth not that even by such like Seals very many have been made inviolable and not to be hurt by any Weapons And therefore the Question is not here what may be done but the Question is only from what agent these things
turned into Pus abundance of the said Pus must necessarily be bred which if it be reteined as needs it must if the Wound be wholly bound up soon becometh sharp and so exciteth an iâching and pain and divers other mischiefs although that Nature be strong and vigorous yet nevertheless the generating of abundance of the said Pus cannot be avoided since that all whatsoever is bruised must of necessity be converted into Pus And although that Magatus doth cut and make little slits in all the Linen that he putteth upon the Wound that so there may be a free and ready passage for the Pus yet notwithstanding all the inconveniences that proceed from the retention of the Pus cannot by this means be prevented For if those Swathes and Linen Clothes shal not be shifted before the fifteenth and somtimes even the thirtieth day they must certainly be very much desiled and polluted by the Pus and Sanies whereupon in the wounded part an itching pain and exulceration may follow But then on the other side if the Swathes be still kept whole and not at all cut and thereupon to be loosned every third day it is then to be feared lest that the Pus reteined may in the mean time excite some mischief or other and also lest that in so many loosenings and new bindings up again the bones may be removed out of their places and having been wel set and joyned together they should again be depraved and disordered which may easily be avoided if the binding be but seldom loosened and the Wound kept open And yet notwithstanding as often as the Wound is dressed it may be covered over with a new Swathe which may contain both Medicaments and those Coverings they cal Splenia and may defend the Wound from the external Air and it may be loosened as often as there is any need thereof but then indeed it must be without any agitation shaking or violent moving of the broken Member And there must also no Splinters be applied lest that they too much compress the Wound and beget a pain and Inflammation And if any will needs apply them yet notwithstanding they are not to be put upon the very Wound but neer unto the same Yet the truth is the number of the Swathes may very well supply the use of these Ferulae or Splinters And these things are thus simply to be performed if there be neither any bone naked and bare and that we fear not the impostumating and falling cut of any broken piece and fragment of the bone Chap. 3. Of a Fracture with a Wound in which there is no bone made bare and yet nevertheless a Cause to fear the falling forth of some fragments of the broken bone IT happeneth oftentimes notwithstanding in Fractures with Wounds that there is no bone at all left naked and bare and yet nevertheless we may have great cause to fear that some broken bone may impostumate and drop forth and this is done when the bones are made dry and withered so that they cannot be agglutinated unto the sound bone or in a Fracture when they are so separated from the rest of the bone that they can no more be joyned therewith For then Nature endeavoureth to thrust forth whatsoever is troublesom and burdensom unto her and what cannot be united unto the rest of the bones neither is she at rest until whatsoever offendeth be wholly expelled out of the Body and this oftentimes she doth at length perform although it be a long time first Now this happeneth when the bones are either corrupted by the Sanies or else when they are altered by the external Air or else likewise when they are so separated in a Fracture from the rest of the bones that they cannot possibly be any more conjoyned with them Signs Diagnostick Now what the Signs are of a bone like to be impostumated and to drop forth we are told by Hippocrates in his 3. B. of Fractures Text 18. The First Sign is this that there floweth forth a greater abundance of the Sanies or thin Excrement then could rationally be expected from the greatness and Constitution of the Wound Secondly That the Lips of the wound do not meet together or if they do at any time meet together yet they soon seem as it were to be broken and to be stirred up and provoked to excretion and they become as it were loose and spungy and there is perceived in the wounded part a certain silent motion For Nature doth not entirely heal a Wound when there is somthing remaining within that cannot possibly be agglutinated with the rest Thirdly If the bone be left bare of Flesh it is then altogether a Sign of its separation and dropping forth in regard that then it may be altered and corrupted by the external Air and that the Veins and Arteries which convey the Aliment can no longer run forth unto it And Fourthly It is then likewise a Sign that the bones will fal out if they be broken and shattered into many smal pieces and fragments for then they cannot all of them be easily Conglutinated Prognosticks 1. It is a Sign of an Abscession instantly to follow if there be good Flesh bred in the sides of the sound bone 2. But the time in which the bones are wont to recede and fal forth is various and not at all times alike For in those of a tender Age and in the Summer and if the bone be not very great it is twenty thirty or perhaps fourty daies ere the bone will be separated and fall forth But if the bone be any thing great in one of a ful and ripe Age and in the Winter time it is usually threescore daies yea and somtimes longer ere it impostumate and drop forth The Cure If the bone that is like to fal forth be moved out of its place and that it stick in the very Wound it is immediatly as we told you before to be drawn forth with the Volsella or Pincers if it may indeed be so drawn forth without any pain and violence but otherwise the whole business is to be committed unto Nature which by degrees wil at the length separate that which cannot be agglutinated And yet nevertheless she is to be assisted and holpen by the Physitian and therefore the binding ought to be instituted in a loole manner and often unbound that so the Pus and filth may not be deteined but that it may freely and easily flow forth And likewise there are no Splinters to be imposed upon that place by which the bone is like to fal forth lest that by compression they cause pain And so also there are Medicaments to be laid upon the Wound that have in them a power of drawing forth of the Wound the bones and whatsoever is extraneous and no way belonging unto the part affected and such Medicaments we have above mentioned in the place alleadged But if there be some great and extraordinary portion of the bone like to
out into three scituations viz. The inward outward and hinder part towards the ham but the opposition of the patel bone hinders its falling out to the fore part of which shal be spoke hereafter in the Luxations of the particular parts The Difference is taken from the Efficient Cause From the Efficient Cause because the Luxation is somtimes from external Causes as fals blows jumpings running and from a violent distorsion extension and impulsion of the part but somtimes from internal causes as while a humor sliding into the cavity of the joynt drives it out of its place There are also certain improper Differences Improper Differences or rather complications of other preternatural Affects with Luxations as that an Inflammation fracture wound or somwhat else is joyned with the Luxation Signs Diagnostick A Joynt being fallen forth into another place is easily known by the sight and touch for there appears a Tumor in the part into which the joynt is fallen but a hollowness in the place from whence the joynt is fallen and that appears so much the easier if the body be not very thick and fat or the place be void of flesh Again if the Luxation be perfect that Member is made shorter whenas the joynt no longer included in its Cavity but falling out of it is drawn upwards yet somtimes the Member becomes longer as is afterwards said in particular When then the Member luxated is alwaies unlike to the sound one in scituation figure and longitude we must alwaies compare the Member affected with the like sound part of the same name Arm with Arm Thigh with Thigh in the same man where yet we must observe that the Member with which we compare it be found and have no fault Thirdly because Articulations are made for motion if a joynt fal out of its natural seat it must needs be that the motion of the joynt is hurt therefore where there is a suspition of a Luxation yet the motion is not hurt we must conclude that there is yet no luxation made Lastly because a joynt falling forth of its seat doth compress the sensible parts into which it is fallen as the Tendons Nerves Muscles from thence there is raised a pain And these are the signs of a perfect Luxation but if there be only a Subluxation the Signs propounded wil either be more gentle or some of them wil be wanting If there be a Luxation of a joynt joyned by a Synarthrosis in which the Bones do gape it is known by the thickness of the Member greater than usual and by a greater bunching out than the heads of the bones do consist of As concerning the Causes The signs of the Causes the external and violent are apparent by the relation of the Patient and the Luxation proceeding from thence happen suddenly but if the Luxation he by reason of the loosness of the Ligaments it happens by degrees and the luxated Member is moved and totters up and down with inordinate motions and whiles the joynt is forced into its seat the Member indeed acquires its natural longitude which being let alone again presently it becomes longer Also if the head of the Bone luxated be thrust with the fingers to the contrary part it easily recoil back every where about the joynt there is a Cavity begotten that if the finger be thrust into the joynt it easily goes in no body resisting as if al were empty When some Epiphysis is pulled off from its being it is known by the impotency of motion and by the crackling when they are handled and moved Prognosticks 1. In the Bodies of Children and yong folks and those that are softer the bones luxated are easily restored yet being restored are not so faithfully retained the contrary happens in riper and harder bodies 2. The Joynts which are dedicated to fewer differences of motions are more difficultly replaced but better contained 3. By how much the further the joynt is fallen from its bosom by so much the more difficultly 't is restored by how much the neerer by so much the sooner 4. The Luxations in which the brows of the bones are broken are worst of al for though the joynts be restored to their places yet they continue not long but fal out again upon the sleightest cause 5. The joynts which are fallen forth by reason of the Laxness of the Ligaments though they be replaced yet do easily fal forth again 6. Those Luxations which have a great pain inflammation or wound happen on them are hard to be cured and want not their danger and cannot be restored without danger of Convulsions nay of death Wherefore if the bone being reduced the Nerves be distended it must presently be forced out again as Celsus doth counsel 7. Old Luxations and which are grown hard with a Callus and which have a clammy humor filling up the Cavities of the Bones are never or very hardly cured therefore every Luxation must presently be replaced 8. They who in their Childhood have had their joynts fal forth and are not replaced they grow less than others 9. What Member also soever hath been troubled with a long continued Luxation by how much 't is the less able to be moved by a natural motion by so much the more 't is extenuated and wasted both because by intermission of motion the Native heat of the part is dulled and because the Vessels are comprest by the luxated joynt and the necessary influence of blood and spirits is hindered 10. A Luxation of the head brings death by reason of the compression of the Spinal Marrow presently at its first rise and the prohibition of the influx of animal Spirits We shal afterwards speak in particular of the Prognosticks of the rest of the joynts The Cure The Bone luxated and which is fallen out of its natural seat shews a reposition to its natural place and this Indication is satisfied and Luxations are cured by straining and forcing them to the part opposite to that from whence the change is made which replacing of the joynts fallen forth of their seats is called ton arthron embole and arthrembole But the replacing of luxated Bones is compleated three waies either by the hands of the Chirurgeon and his Servants which is the most simple and is called Palestrical because 't was used in the wrestling places if at any time the Fencers Limbs were luxated and 't is convenient in soft bodies and where the evil is fresh or by some vulgar instruments the joynts are forced into their seats as by the help of reins swathes ropes ladders seats two leav'd doors which is called the Methodical way and is convenient for children women and the stronger males and for old luxacions or 't is performed by instruments and certain singular engines and 't is called organical and 't is applied to stronger bodies and old Luxations and altogether to those which cannot be restored the two former waies But concerning such Engines see Hippocrates de artic et
for if it be fallen to the fore part the Arm is extended and cannot be bent in the fore part there is seen an unusual Tumor but in the hinder part an unusual Cavity things contrary to these do happen if it be luxated in the hinder part to wit the Arm is crooked and can by no means be extended the Tumor appears in the hinder part but the Cavity in the fore part A Luxation to the outward part makes also a bunching out in the outer part but a bosom in the inner part but on the contrary if the Elbow be fallen to the inward part there is an eminency less then should be in the inward part and a Cavity in the outer part If the Radius follow the Elbow 't is known by the same Signs but if it only depart from the Elbow without a Luxation a gaping and disjoyning shews it the place is hollow and 't is easie to find a bosom with the Finger Prognosticks 1. The Elbow as it doth not easily fal forth by reason of its firm and fast coarticulation with the Shoulder and its plenty and strength of Ligaments so being fallen forth it is hardly restored 2. The Elbow luxated unless it be most speedily reduced doth not only bring divers and dangerous Symptoms to wit a most exceeding pain Inflammation Fever Convulsion but sometimes also Death 3. Of all Luxations which happen in the Gibbous part of the Elbow the most dangerous and painful is that which is to the hinder part Paulus Aegineta de re medic l. 6. c. 115. 4. When the Bone of the Elbow is divided from the other Bone it is not easily restored for neither do two bones which are joyned together when they once gape easily return to their ancient place but it must needs be that the Bones being so divided the part becomes swelled and the bones are quickly compast with a Callus The Cure The Elbow being imperfectly luxated or subluxated to the fore part is most easily restored by moderate extension and only bending of the Arm but a perfect Luxation is harder to be reduced and requires greater provision for first there must be extension made and that obliquely lest the high brow of the Elbow hurt the head of the Shoulder by two Servants one of which must draw the top of the Shoulder upwards but the other the Elbow downwards either with their Hands only or if need be with Reins then some round body must be placed by the brawny part over which afterwards the Chirurgeon bending his Arm and suddenly forcing the Elbow to the hinder parts may restore it into its place Hippocrates 3. de fractu affirms that he hath somtimes cured the Elbow luxated to the hinder part only by a sudden and continued extension of the Arm which if it suffice not convenient extension being made the Elbow must be driven inwards The Elbow fallen forth to the outer or inner part is most easily reduced if extension being made it be forced from that part into which it is fallen into the contrary The same manner of reducing is to be observed in replacing the Radius if it hath followed the Luxation of the Elbow but if it be only departted from it it must be prest with the prominent parts of the Hands and the Arm must be reduced to the natural figure it being reduced convenient Medicines must be applied and it must be bound up fitly as was said in general before c. 7. Chap. 8. Of a Luxation of the Hand and its Fingers HEre by the name of Hand we understand the Wrist and After-wrist but the Wrist is joyned with the Elbow bone and Radius by a Diarthrosis whenas there is a manifest motion but with the After-wrist whenas there is no manifest motion by a Synarthrosis or doubtful articulation the Metacarpium or After-wrist is joyned again with the bones of the Fingers by a Diarthrosis because the round heads of the four bones of the After-wrist do conspicuously enter the superficies of the first bones of the Fingers lightly hollowed and after this manner also the bones of the Fingers themselves are joyned one to another The Differences Whence we may easily collect that the Wrist may be luxated into all four parts to wit the fore the hinder and to the sides all the bones of the After-wrist indeed are luxated inwards and outwards but the falling of the two middle bones to the sides is hindred by the two extream bones that have respect to the little and Fore-finger the which two only may fall forth to that side which is free from bordering bones The bones of the Fingers again are luxated four waies to wit inwardly outwardly and to the sides The Causes The Cause of the Luxation of the Wrist After-wrist and Fingers as of other luxations is some violent Motion Blow Fall Perversion and Contorsion Signs Diagnostick The Signs of all parts of the Hands luxated are almost common for whether the bones of the Wrist After-wrist or Fingers be luxated to the fore part a Tumor appears as that place in the fore part and the Fingers cannot be bent If they be fallen to the hinder part a Tumor also is perceived in the hinder part and the Fingers by reason of the compression of the Tendous and Nerves going to them cannot be extended But if a Luxation be made to the sides a Tumor appears in that part into which the fall is made and a depression into that from which the Joynt is fallen The Prognostick The Luxation of these parts is not dangerous whenas they may easily be restored into their place The Cure The bones of the Wrist into what part soever they be luxated may be without any extension at all reduced into their place after this manner let the Hand of the Patient be placed upon a Board or Table and that with the palm downward if the luxation be to the hinder parts but with the back downwards if it be to the fore parts afterwards let the Chirurgeon most strongly force the luxated Joynt to the contrary part either with the palm of his Hand in more tender bodies or with his Heel in bodies that are stronger The same rule is observed in replacing the bones of the After-wrist and Fingers except that some servant holding with one Hand the Fingers with the other Hand the Arm doth make a light extension the bones being reduced Medicines that hinder an Inflammation and strengthen the Joynts must be applied and the part must be conveniently bound up and placed Chap. 9. Of a Luxation of the Thigh THe Thigh-bone the longest and greatest in the Body of Man at its upper part with its head sufficiently great thick and exactly half Globous is not only most exactly half joyned by an Enarthrosis to the bosom of the Hip sufficiently large and deep to receive this head but also is most strongly united to it by a most firm Ligament arising from the bosom of the Hip and implanted into the narrow
bosom of the head of the Thigh to the end that the Thigh might by so much the easier and more readily be bowed extended moved to the sides and turned about and not easily slip forth The Causes The Causes of a perfect Luxation of the Thigh are the same as of the Luxation of the Shoulder to wit external and violent a fal a blow or some other violent and indecent extension and distorsion of the Thigh but the causes of an imperfect Luxation are the humors flowing to this joynt and by degrees thrusting it out of its seat The Differences But this joynt fals forth to four parts the former hinder but seldom whenas the brow of the Cavity in this part is higher to the outer and inward part most often whenas at that place the brow is lower and somtimes the Thigh admits of a Subluxation from an internal cause whence when Paulus Aegineta lib. 6. de remed c. 118. writes that the Articulation of the Hip doth only suffer a Luxation and not a Subluxation that is to be understood of that only which is from an external and violent cause for we see oftentimes that by a flux of humors some have the Ligaments in the Thigh relaxt and mollefied that they cannot retain the head of the Thigh-bone firmly in its Cavity whence follows a certain Subluxation Signs Diagnostick the Diagnostick signs of a thigh luxated to the fore part If the Thigh be luxated to the fore part a Tumor appears about the Groins whenas the head of the Thigh leans to the Pubes the Buttocks on the contrary by reason of the Muscles contracted with the Thigh to the Pubes seem wrinkled the Urine is supprest by reason of the compression of the bladder by the head of the Thigh the external Thigh can neither be bent nor brought to the Groin whenas the head of the Thigh is in the very bending place the man is also in pain if he be forced to bend his Knee by reason of the former Muscle which ariseth from the bone which belongeth to the Loyns for that is comprest and being retcht is lift up by the head of the Thigh and whenas it can be no further extended it resists otherwise it equals in length the whol sound Thigh to the Heel for the Thigh going forth of its Cavity comes to the fore part and a little lower by which it comes to pass that the Thigh hurt equals the length of the sound one which especially fals out so at the Heel the Toes of the Foot cannot easily be extended nor turned to the ground whence in walking the Patient is compelled to tread only on the Heel But in them who at strong age have this joynt fallen forth into this part and not restored they when the pain ceaseth and the joynt is accustomed to be contained in that place into which it is fallen can forthwith go upright without a staff and wholly upright for by reason of the inflexibility of the Groyn they use the whol Thigh more straight in going than when it was sound somtimes also they draw their foot upon the ground whenas they cannot easily bend the upper iunctures which are at the Groyn and Knee although they walk upon the whol foot but in those at whose render age this joynt fallen forth is not restored their Thigh-bone is more diminished than that of the Leg or Foot but the Thigh is little diminished only the flesh every where is abated especially at the hinder part to the hinder part If the Thigh-bone be luxated to the hinder part there are contrary signs to those mentioned to wit The Head of the Thigh being fallen to the Buttocks is discovered by a Tumor about those parts both by the sight and touch the Groyns on the contrary appear more loose the affected Thigh by reason of the compression and distension of the Muscles compassing the head of the Thigh cannot be extended and 't is rendered shorter than the sound one the heel doth not touch the ground whence the Patients can neither stand nor go but fal headlong backwards because the body slides to that part and the head of the Thigh being out of its proper place is not directly opposed to under-prop the body yet the man may bend his Thigh if he be not hindered by pain for whenas the head of the Thighs is by force with its whol neck expelled into the great Muscle of the Buttocks which extends this Articulation this Muscle admitting the head of the Thigh fallen forth is most of al tormented whenas 't is distended and prest under it and of necessity must be seized on by an Inflammation but in process of time when this Muscle is freed from an Inflammation and contracts a certain glutinous humor that part of it which toucheth the joynt grows to a Callus and the Knee is bent without any pain moreover the head of the Thigh being luxated to the hinder part the Thigh and Foot appear moderately straight and do not incline much one way nor other But when in ripe age the Thigh-bone fallen forth is not restored when the pain is ceased and the joynt accustomed to be turned in the flesh the man indeed may walk yet he is forced to bow very much towards the Groyn when he walks and that for two reasons Because the Thigh is rendered much shorter and the heel is far off from touching the ground for if he try never so much to stand on that foot leaning upon no other thing he wil every where fal backwards but if in tender age this joynt luxated after this manner be not reduced the Thigh-bone is made short and the whol Thigh is spoiled and is less increased and made slenderer being for no use To the outer If the Thigh be luxated to the outer part it is known by these signs Between the Anus and Cod there is seen a Cavity and leanness on the contrary in the buttocks a certain Tumor the Thigh by how much the head of it is fallen forth to a higher place is rendered shorter the Knee with the Leg looks inwards the Heel toucheth not the ground whence when the Patient would walk he goes only a tiptoes And if in those of ripe age this Joynt be not restored but the flesh into which the Joynt is fallen grows callous and the pain therefore ceaseth they may go without a Staff and therefore when they use their Thigh in these the flesh is less offended but they to whom in tender age this misfortune happens require a diligent care for if they be neglected the whole Thigh becomes unprofitable and is little increased the flesh also of the whole Thigh is more abated then in the sound one Lastly a Luxation of the Thigh to the inner part is known this way to the inner the Thigh is longer if it be compared with the other and that for two reasons for the head of the Thigh sticks to the bone which proceeds from the Hip upwards
bent and moved Prognosticks Whenas this Articulation is more loose the Patel Bone may easily be restored to its seat The Cure That the Patel bone may be reduced into its seat let the Patient stand firmly upright upon a place but let the Chirurgeon with his hands force the Patel Bone from that part into which it is fallen to that from whence it is fallen when the Bone is restored to its place fit Medicines must be laid upon it and the hollow of the Knee must be filled up with Bolsters that the Thigh cannot be bent then a hollow piece of the figure of the Patel Bone must be placed about it especially on the side to which it fel that the Patient may not bend his Knee When there is no more danger lest the Parel Bone fal out again let the Patient by degrees accustom to bend his Knee again Chap. 11. Of the Knee Luxated THe Knee may not only be Subluxated but it may suffer a perfect Luxation and truly oftentimes fals to the inward and outward part seldom to the hinder part but seldomest of al to the fore part and not unless from a most violent cause in regard that the opposition of the Patel Bone doth hinder it The Causes This Luxation also happens from blows fals jumping vehement running and an uncomely extension or contraction and distorsion of the Legg Signs Diagnostick To what part the Knee is Luxated is easily known for in the side to which the joynt is broke forth a bunching out but a Cavity in the side from which it is departed is discoverable both by the sight and touch its figure is depraved the Thigh is extended and cannot be bent whence the motion is necessarily depraved or wholly lost Prognosticks 1. The Knee if it be compared with the Elbow the joynt in the Knee by reason of its manner of juncture oftener fals out and is easier reduced For the structure of the Bones with which both joynts are contained is more straight in the Elbow more loose in the Knee besides many processes and many bosoms joyned to one another do every where bind up the joynting of the Elbow but in the Knee the bunchings forth of the Thigh are cast into the smal Bosoms of the Leg. 2. For the same cause a Luxation of the knee is less dangerous nor doth an Inflammation easily happen for whenas an Inflammation ariseth from the force with which the bones are expelled and reduced again and the pain arising from hence because in the Knee the joynt may fal forth and be reduced without any great force there is no fear of an Inflammation The Cure The Knee luxated to the inward and outward part is not hard to be restored by moderate extension made either with the hands in a new Luxation and childs body or with reins in a Luxation not so late and stronger bodies and with forcing the bones with the hand into the contrary part from which they sel But a Luxation made backwards is commodiously restored if the Patient be placed with his Face on a Bench and some servant put a Linen Globe into the hollow of the Ham at what part the Bone sticks forth and strongly force the bone fallen forth towards the fore parts but let the Chirurgeon take hold of the lame Leg with both hands and of a sudden so bend and bow it that his Heel touch his Buttocks A Knee Subluxated by none or very little extension made and forcing it to the contrary part is reduced into its place When the Bone is reduced which is known by the free exten sion of the Leg and comparing it with the other Knee convenient Medicines must be laid upon it and binding up must be ordered and the Patient must forbear going til there be no more fear of a new Luxation Chap. 12 Of the Distraction of the Bracer THe Bracer adheres to the greater Bone of the Leg and as it was said in the former Chapter above to the Knee below the Ankle but 't is drawn from the great Bone three waies to wit To the fore part and both sides The Causes But this Divulsion comes from those Causes from which we said the Knee was luxated especially when walking in a slippery place the foot is not firm but dubiously is wrinched inwardly or outwardly the same may be by a fal from on high or by a blow Signs Diagnostick A Tumor appears in the part to which the Bracer is distracted and is discovered by the sight and touch and motion is hurt The Prognostick The reducing of the Bracer is easie The Cure For by the hands of the Chirurgeon it may easily be compelled and brought back into its seat by forcing it into that part contrary to its fal afterwards convenient binding up must be ordered putting bolsters to that part to which the Bracer is fallen and rest for some weeks must be commanded the Patient til the Ligaments are confirmed again Chap. 13 Of a Luxation of the Foot and its Bones and of the Toes BY the word Foot we understand al that part of Mans Body reaching out from the lower part of the Leg to the very ends of the Toes which contains divers Bones after divers manners joynted together and united by Membranous Ligaments to wit The Ankle the Heel the Ship-like Bone the Tarsus Metatarsus and Bones of the Toes of the Luxations of al which we should now speak but because the Bones of the Tarsus Metatarsus and Toes are here united almost after the same manner as the Bones of the Wrist after-Wrist and Fingers are to one another they are subject also to the same Luxations have the same causes are known by the same signs and are reduced the same way but the ship-like bone may suffer the same things as the Bones of the Tarsus it is not worth our labor to add much of these but those things which are said of the bones of the Hand may also be applied to these Luxation of the Ankle and Heel Some things only we shal add of the Luxation of the Ankle and Heel whenas no Bones in the Hand do answer unto these The Differences The Ankle joyned with the greater and lesser focil by a Ginglymus may be luxated perfectly and imperfectly to every part to wit The outward inward fore and back part But the Heel lying under the Ankle is often moved indeed more forward and backward but seldom to the sides The Causes The Luxation of these parts is from a violent fal a blow or some other inconvenient distorsion of the Foor But in particular the Heel is luxated and pulled from the Ankle if one leaping from on high do fal and stick heavily upon the Heel or in dancing doth insist much upon the Heel The Signs Diagnostick The Ankle if it be fallen to the outward part the lower part of the Foot is turned inwardly if to the inward part there are contrary signs if it be luxated to the fore part the broad Tendon
of the Head alone but that Alopecia may be extended even unto the very Beard also The Causes The Cause of both these Maladies is a depraved and sharp humor of eating assunder the roots the Hair of whatsoever kind it he But for the most part notwithstanding this Malady iâ caused by a salt flegm adust or putrified Whereupon Galen in his Book of the differences of Symptoms and Chap. 4. writeth that these Vices follow a depraved Nutrition of the Skin of the Head But that one while the Alopecia another while the Ophiasis is excited and that the Hairs do sometimes constitute a strait and direct Area and sometimes that that is winding and writhed the Cause of this is the great abundance and the quality of the matter For if there be an extraordinary great store thereof and it be likewise thin then it equally and alike eateth through the Hair in the more and greater places but if the Matter be less and mingled with a thick humor then there followeth an unequal and writhed Defluvium or shedding of the Hair because that the humors being unequal and mingled do not flow right forward but creeping along obliquely they gnaw assunder the hair The more remote Causes are the heat of the Liver and Head and especially the fault of the first and second Concoction by reason whereof salt and sharp humors are generated which although it may happen in every age yet nevertheless it happeneth more especially in Childhood and Youth and it followeth the Affects Tinea Achores and Favi by reason of the Causes that we mentioned in the Diseases of Children And somtimes likewise External and Malignant Causes make very much for the generating of this Disease among which Galen in his first Book of the Composit of Medicam according to the places Chap. 2. reckoneth up Mushroms because that they make very much for the generating of vitious and corrupt humors And hither likewise belongeth the poyson of the French Disease in regard that this also eateth through the roots of the hair which other poysons may likewise do Signs Diagnostick We have already before told you in what respects this falling of the Hair differeth from baldness and that shedding of the Hair that we call Defluvium But Alopecia differeth and is known from Ophiasis by the very figure of the Area and because that in the Alopecia the hair only falleth off without any hurt as all of the Skin But in the Ophiasis there is not only a falling off of the hair but likewise an excoriation of the Skin And the very color of the skin is also changed and in some it appeareth more whitish in some more pale and in others more black and if it be pricked there floweth forth a serous whitish blood Touching the difference between Alopecia and Ophiasis Celsus in his sixth Book and Chap. 4. hath these words That Area saith he that is termed Alopecia is dilated under all kind of Figures and it happeneth in the hair of the Head and in the Beard But that which from the likeness of a Serpent is called Ophiasis beginneth from the binder part of the Head and is not extended above two fingers in length it Creepeth on both sides the Head even unto the Ears and in some unto their Foreheads also the former of these in all Ages but this latter only in Infants But Alopecia and Ophiasis differ from Tinea in this because that in Ophiasis the Excoriation of the Skin is superficial and when it is cured the hair groweth again But in Tinea the excoriation and Ulceration is more deep and the skin is oftentimes so corrupted that the hair never groweth again As for what concerneth the signs of the Causes the Skin it self sheweth what kind of humor it is that offendeth which that it may be the more exactly known the hair that remaineth behind is to be shaven away and the Skin to be gently rubbed there are other signs also that wil instruct and teach us what kind of humor it is that aboundeth in the body The hairs likewise that grow anew by the various colour that they have according to the Nature of the peccant humor wil shew us what humor is the Cause of this Malady Prognosticks 1. Alopecia and Ophiasis although they bring not much danger along with them yet nevertheless they cause a great deformity and among the Romans those Slaves that were disfigured by the said Area and especially by the Alopecia were sold at a far lower rate then other Slaves And in our daies also these Areae in regard that they cause a suspition of the French Pox are therfore accounted very disgraceful unto him that is affected therewith 2. But whether the Ophiasis or the Alopecia may be soonest and most easily cured it is a great question among Authors and they herein much differ Celsus and Avenzoar are of Opinion that Ophiasis is more easily cured then Alopecia And on the Contrary Alexander in his first Book Chap. 2. and Serapio in his first Book Chap. 1. teach us that the Alopecia is more easily cured then Ophiasis But Celsus seemeth to speak only of the Alopecia of Infants which in the course of yeers and change of age is of it self oftentimes cured But if Alopecia and Ophiasis be such as are grown to maturity or likewise in one and the same age be compared the one with the other then the Ophiasis seemeth to be altogether the more difficult to be cured in regard that it hath its original from a matter more thick and far worse then the former and such as doth not only eat assunder the roots of the hairs but likewise even the very Skin it self which is never done in the Alopecia 3. Yet notwithstanding by how much the longer either of these Maladies hath been and continued by so much the more difficult is the Cure thereof and by how much the less while they have continued by so much the more easily are they cured 4. If by Rubbing the place become red there is then hope of Cure the sooner it is thus the more easie the Cure but if it wax not red at all then there remaineth no hope at all of any Cure 5. That kind of Areae is also the worst that hath made the Skin thick and somwhat fat and slick or slippery in all the parts affected 6. Alopecia and Ophiasis that proceed from the Leprosie are altogether incurable and that that hath its original from the French Disease is not to be Cured untill the Disease it self be Cured 7. There then shines forth some hope of a Cure to follow when the excremities of the Areae that are neerest unto the remaining hairs do again begin to send forth other hair For then those parts that are nigh unto the sound have the less receded from their Naturall State and so consequently will the sooner again return unto their Natural State and begin to produce hair The Cure If a Vitious humor abound in the whole body