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A51662 A rational practice of chyrurgery, or, Chyrurgical observations resolved according to the solid fundamentals of true philosophy by John Muys : in five decades. Muys, John, b. 1654. 1686 (1686) Wing M3165; ESTC R32112 102,986 270

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of Motions that are made in this Corporeal Universe and according to the rules of these Motions giving heed onely to the magnitude of Bodies to the figure and position of them not onely the Phaenomenons of this Disease but also many other far more wonderful than these may very accurately be explained If you be desirous to know how Plants proceed from a Grane or Seed it will behove you attently to peruse the Anatomy of Plants made by Mr. Grews Microscope published both in English and in French There in the greater Bean you may behold the Rudiment both of Root and Plant already formed there you may perceive how the Juice strained through the Membranes of the Bean committed to the earth is fermented in the Body of the Bean also how there through a small hole of the Bean admittance is given to the Air and an exit also permitted to the superfluous Vapours how the Juice thus fermented is constringed into the Rudiment of a Root and converts that Rudiment into a true Root which then receiving nutriment from the Earth repels the other Juice coming from the other part upwards to the Rudiment of the Plant that so at length it may present it self to the sight as a true Plant. If you desire to know the causes of the stupendious powers in the Magnet of the Ignis Fatuus Rainbow and other things consult Cartesius who will clearly explain them to you The same Philosopher in his Treatise of Meteors will also there teach you that Souldiers sometimes seen fighting in the Air touching which the ignorant Vulgar tells so many tales are no other than certain Clouds I know not indeed whence arose this so evily-founded Judgement of the people by which such cases as this of ours is are accounted Inchantments and Mawworms so frequently ejected from the Bodies of men by Vomit and Seidg esteemed meerly natural whereas the generation of Mawworms is far more wonderful than that of these Eggs in the Humane Body Vigelius professor of the Mathematicks is reported to have formed an Horse of Metal which in one day for several hours could by the help of Rotula's walk like a living Beast Rayselius is reported to have fabricated an Engine like a man in which a certain Liquor poured into the mouth was seen to circulate like our Bloud the more thin part of which Liquor was expelled by the Yard as Urine but the more gross part as Dregs or Dung of the Belly by the Fundament If Man can do such things what cannot GOD the supream Architect effect according to the ordinary rules of Motions Therefore how were these Eggs produced in this Woman I answer In the Thigh of this Woman from this or that cause many Pores of this or that Artery were distorted and enlarged so that many Humors flowed out and were collected in one place in which when they began to be fermented the Particles stringy and less apt for motion were thrust out to the sides where they were not compelled to so swift a motion and there cohering and twisting themselves one within the other were formed into that sufficiently gross Membrane which did include all the Eggs afterward generated But because the Pores of the above-mentioned Artery were diversly distorted therefore some of the Particles contained in this gross Membrane did in some measure differ from the other in figure and magnitude and perhaps the Particles like each other flowed into almost an hundred divers places and so every of those Particles besides the Congesture of their like still exercising a certain kind of Fermentation did again thrust out the more stringy Particles to the sides and so were formed the Membranes in which were included all the Eggs. Thus I suppose I have produced a sufficiently intelligible cause of this Phaenomenon which I beheld with my own Eyes OBSERVAT. V. Of a vast Tumor of the Neck A Young Maid aged Fifteen years being otherwise very well had now for six years sustained an hard round Tumor in her Neck of the same colour with the Skin and void of pain equalizing in magnitude a white Loaf that is wont to be sold at the price of half a Sesterce and miserably defacing the Patients Countenance I judged the humidity of this Tumor to be very viscous and divided almost after the same manner as we see the Juice in a Pome-Citron or Orange contained in many Cells By reason of the viscosity of the Humor this Tumor could not be discussed nor in the common way brought to suppuration therefore I applied a Corrosive and the Eschar being removed put in a Tent anointed with the Unguent Basilicon mixt with common Turpentine By this means some part of the viscous Pus issued out daily and so the Bulk of this horrid Tumor began to be diminished the viscous Humor nearest the hole was first evacuated and afterward that also which lay far remote from the Ulcer But when the small passages round about this hole made by Art were obstructed by the viscosity of the Humor as it often hapned then with the Unguent wherewith the Tent was anointed I mixed some Crocus Metallorum that so an Eschar might be induced which being separated the small passages were again opened and so this young Maid in the space of three Months was wholly freed from this Tumor and that great deformity attending it I shall not in this place speak of the way or manner of the Corrosives operating having already discoursed of that in the First Observation of this Third Decade nor will I at this time further explain by what means the Eschar is separated because this may sufficiently be understood by the Second Observation of this Decade where I teach how the rotten Fragments of Bones may be separated from the sound part Perhaps some one will wonder that I use Medicaments so few and so little compounded but to what purpose are so many Simples and so many composed Forms of Remedies which many Physicians use at this day for no other cause than to boast of their vain Learning before the Ignorant If Gun-powder made of Cole-dust Nitre and Sulphur onely produceth such stupendious effects in the Macrocosm that omitting all other it can blow up into the Air vast and heavy Ships and also if put under the Earth cause the same to tremble and cleave in sunder why may not a few Medicines seasonable taken be sufficient to heal very many Diseases in the Microcosm I do indeed assent to Bacon Verulam great Chancellor of England who is by some called the Day-star of Cartesius thus speaking Variety of Medicaments is the daughter of Ignorance OBSERVAT. VI. Of a wonderful Abscess A Man Fifty years of age was vexed with an Abscess arising below his Ear which was round painful waterish and soft with this he had been afflicted some days before he came to me I being certainly perswaded that ripe Pus was contained in this Abscess made an Aperture with my Lancet and so presently issued out no small
or giving Suck because the matter fit is withdrawn by the young in the Womb or by the Infant sucking So Fabritius Hildanus relates in the 87th Observation of his Fifth Century that for this cause in a Fracture of the Tibia with a wound the Bones were yet loose the 23d week after the hurt received In a Fracture as well Simple as Compound when a Callus hath again conjoyned the broken Bone the Patients are commonly sensible of some trouble in motion which happens because the newly-generated Callus occupies the place of some Muscles moving this or that part Before I put an end to this Observation two very intricate Problems seem very fit to be here unfolded by me The one is why Bones in clear Frosty-weather are more easily and sooner broken than at any other time The other whence proceeds the Terrour that generally invades the Sick afflicted with a Simple or Compounded Fracture presently after a short sleep To the First Some perhaps will answer the slipperiness of the Ice is the cause that men often fall to the Earth and so the Bones may happen to be easily broken But this doth not untye the Knot this removes not the Difficulty For not onely Bones but also Iron Wood and other hard Bodies are more easily broken in the Winter-season than at any other time Whence then doth this happen Attend a while and I will tell you The more pertinaciously and firmly the parts of hard Bodies are conjoyned each with other the more difficultly they are broken This is certain But what is that which effects coherency in the parts of hard Bodies Not Rest as some think because that is not any thing positive in the Body but onely a privation of motion Therefore Rest proproduceth not this Effect but the Air compressing the parts of hard Bodies conjoyns and causeth them to cohere as is evident by the Experiment cited in the Seventh Observation of the Third Decade The Air whilst Summer's Heat is most vehement presseth more than in Mid-winter partly because at that time it is more forcibly agitated by the heat of the Sun partly because then it is more heavy by reason it is mixt with very many gross Vapours forced upwards by the Solar heat Hence it is now manifest why Bones and other hard Bodies are more easily broken in Winter than in Summer Hence also it may readily be understood why Wood is much sooner consumed by burning in the extream cold Winter-season than whilst we enjoy the pleasant Summer The Winter-Air by its more weak pressure cannot very pertinaciously conjoyn the Particles of the Wood whence these Particles are easily separated from the Wood when they suffer violence by certain terrestrial Particles floating upon the onely most subtile matter of the World therefore most swiftly agitated Hence it is that the Winter-Air as being less pressing and containing fewer Vapours permits the Flame freely to enlarge it self We now come to the other Problem by which it is asked Whence ariseth Terrour invading the sick suffering a Fracture of the Bone in sleep and not while waking and often again distorting the broken Bones Parey a man endowed with great Experience in the Chyrurgic Art who himself once suffered a Fracture of the Tibia and Fibula with a Wound and in his own Body plainly enough experienced this Terrour as he saith a reason of which he endeavours to render in the 26th Chapter of his Book of Fractures but he there miserably philosophizeth producing nothing but Impertinencies and Chimoera's Therefore let us see whether we can give a more probable Reason that may come nearer to the truth We will at least attempt it When the Sick are not sleeping they see they hear they eat they drink and stir their Arms and by this means consume much of the Nervous Juice so that that cannot flow in so great abundance into the parts irritated c. but when the Sick indulge their Members with sleep the matter is far otherwise The Ears at that time hear not the Eyes are closed the Nosethrils perform not their wonted Office the Tongue is silent and the Arms rest Therefore when at such a time the Humors stagnizing and waxing acid about the Fracture with their distention molest the Fibrils and by their cutting property irritate them then I say the Nervous Juice which in the time of the Patients waking is not imployed in great abundance falls down upon the irritated Muscles which by this means swollen vehemently move the Leg and miserably distort the Extremities of the broken Bone one to this part the other to another whence ariseth pain cruel enough by which the Patient after a short sleep is awakened with terrour But that you may more readily give credit to the reason of this Phoenomenon I judge it fit to advise you to attend to these few Words following When you are awake and not sleepy and when your Semenary Vessels contain much fruitful Seed imagine to your self as strongly as you can some beautiful Maid yet as I judge you shall not by this means eject your Seed unless you use some other excitation But if whilst in a sound and pleasant sleep a very beautiful young Woman be by imagination presented to your Phantasie and if in the mean while your Semenary Vessels be sufficiently distended with the Seed the Seed not seldom by such means flows out with very great pleasure viz. because the Seminary Vessels are very much contracted by the Nervous Juice which in great abundance whilst you sleep is carried from the Brain into the Seminary Vessels distended and very much irritated by the Seed because it is not now imployed about other works to be done whilst waking So I knew two Epileptick Persons who never had Fit whilst awake but always when they soundly slept which doth not a little confirm my Opinion OBSERVAT. VI. Of Dislocation of the Talus or Ankle-bone with a Wound A Man aged Forty years fell from on high to the Ground and suffered a Dislocation in the interior Ankle-bone of his Left-leg conjoyned with a vast Wound out of which the Bone was prominent the breadth of three fingers and the dolour was almost intolerable This case is very perilous For not without great danger of life a Gangrene sometimes invades the great Toe infected by the Dislocation and Wound concomitant as I remember not long since to have happened But such horrid Symptomes are not to be feared if in the great Article of the Talus a Dislocation also be with a very large Wound This Affect is not onely perilous but also rare so that Parey Pigreus Aquapendens Barbette and other scarcely so much as mention the same in their Books although Scultetus in his Chyrurgic Armory speaks of it but whether credit is to be given to his Words or his Counsel followed we shall see after we have pondered the following Words written by himself If an Article be luxuriant so as it is either uncovered or be a little
I have often observed in fat Boys a Vein presently after the usual Ligature to be sufficiently tumid and manifest but if not quickly opened hath soon disappeared viz. when the Bloud pressed downwards the subjected and readily-yielding Fatness that so notwithstanding the Ligature it might again freely pass through the Vein After the cutting of a Vein when the Vein seemed sufficiently closed I have often beheld the Bloud issuing out thence with great violence and indeed from no other cause than that the Chyrurgeons first applied their Ligature and Lint compressing and afterward inbowed the Arm For by this means the Lips of the Orifice which before in the extension of the Arm were conjoyned again separated each from other when the Arm was inbowed Oftentimes a certain Lividness is found left after the cutting of a Vein the cause of which is too frequently the evil use of Vinegar in which is imbibed the Lint compressing which is put upon the Aperture of the Vein whereas it is indeed sufficiently manifest that the Bloud is coagulated by Acidity and acquires a Livid and black colour Before I put an end to this Observation I think fit to add the counsel of Peter Pigraeus that we may thence if possible reap some further benefit That very famous and most dexterous Chyrurgeon commands that after the cutting of a Vein the Aperture should be anointed with Oyl if it be intended again to extract Bloud the same day from the same Orifice without a new made Aperture But if Oyl can though for a short time applied hinder the closure of the Orifice of a Vein cut how evilly do they act who use Oyl in the cure of Wounds and for no other reason than because they have seen the same thing done by their Masters As for Example Oyl of Saint-Johns-Wort For if Saint-Johns-Wort profits Wounds by reason of its Volatile Salt temperating Acidity why do they not rather extract the Tincture of Saint-Johns-Wort by Spirit of Wine into which it much more easily and more copiously transfers its Volatile Salt than into Oyl which hurts Wounds because that obstructing the Pores and Passages stops the Circulation of the Bloud and Humors whereas that Circulation should rather be excited to which excitation Spirit of Wine is not a little available For it egregiously temperates Acidity which usually coagulates the Bloud and Humors in Wounds and renders them unfit for Circulation But least I should be found too prolix in this matter I here put an end to this Observation OBSERVAT. V. Of the Cracking of a Tendon A Woman aged Forty three years after greater Labour than usual in her right Hand suffered an impotency to motion with Tumor and Dolour and when the Tendon sited in the Hand was pressed with the Finger it gave a sound This is an Affect which often occurs in the Practice of Chyrurgy though it hath hitherto been treated of by no man that I have heard of therefore I shall call it Crepitus Tendinis or the Cracking of a Tendon By this Woman's unaccustomed Labour the Fibrils of the Tendon were so distorted that the Humors impeded in their Circulation there subsisted and were coagulated whence the Impotency of Motion Tumor Dolour and Cracking of the Tendon were most readily induced I feared that the Humors stagnizing in the Tendon would be daily more and more coagulated and thence that Tumor take beginning which is known to many by the name of a Ganglion Yea I suspected that certain Particles of the subsisting Humors would be received within the Pores of the Fibrils compounding the Tendon and obstruct them so as in the Third Observation of this Decade we shewed to be apt to render them too propense to induce both Contracture and rigidness of the Tendon Wherefore judging it high time to set about the Cure I ordered Spirit of Wine to be enkindled in such wise that the Vapour arising thence might surround the hand affected and this being done commanded a Plaister of Frogs with Mercury to be applied By this means the coagulated Humors were dissolved the Obstructions removed and the Patient in a few days restored to her pristine state of health OBSERVAT. VI. Of an Haemorrhagia from a Varicous Vlcer of the Tibia IN the right Tibia of a Woman aged Forty years from an Internal cause an Ulcer was formed upon a sufficiently large Varix which yielded to no Remedies This Evil was also attended with a Tumor and a large Erysipelas very troublesome which in like manner could not be removed by any Medicaments After a few days the Varix was unexpectedly opened by the Acido-corrosive Humor there inherent from which issued out at least lib. ij of black and as the standers by affirmed very stinking Bloud I ordered that Placentula in a form somewhat hard composed of Medicaments temperating Acidity which I commended in the Sixth Observation of the First Decade to be applied by the Chyrurgeon and so not onely closed up the Varix but also temperated that Acidity inherent in the Ulcer which otherwise by its corrosion would easily again have opened the Varix and besides have much impeded the cure of the Ulcer It was wonderful to see that after the Varix unexpectedly opened had cast out so great abundance of Bloud the Erysipelas and other Symptomes soon vanished and the Ulcer daily shewed it self in a state more and more meliorated so that within the space of three Weeks by the onely help of the aforesaid Placentula it wholly closed I now intend not here to treat of the Original and Cure of the Varix Ulcer and Erysipelas having accurately enough discoursed of that in the Sixth Observation of the First Decade because a dish of Crambe twice cocted was always deadly to me if to any other man But my intention here is to confirm what I have spoken by Experience and hath been before by me treated of in the said Sixth Observation of the First Decade viz. to shew that undoubtedly the Erysipelas and Ulcer derived their Original from Acidity and likewise how opportunely I instituted the Section of the Varix in that varicous Ulcer of the Tibia But from the Example before-alleadged these Conclusions may easily be drawn for neither the Erysipelas nor the Ulcer would give place to any Remedies so long as that Varix was replete with so great abundance of black and undoubtedly by its long delay acid Bloud which no sooner issued out but the Erysipelas vanished and the Ulcer closed in a short time after OBSERVAT. VII Of a vast Contusion of the Arm. A Matron aged Fifty six years after a Fall from on high complained of an unaptness to motion and very great dolour of her left Arm which appeared very much swoln although of the same colour with the sound skin I perceived by the Pulse a more than usual swiftness of motion in the Bloud viz. by reason of the Terrour which the Patient had conceived by the Fall After we had very acurately inquired into the
shot A Young man aged Twenty four years complained of a Wound of his Leg inflicted with a Shot which was round blackish and very painful The Leaden bullet could not perforate this young Man's Leg but did egregiously contuse the same whence arose that Dolour and blackness It is not my purpose in this place to describe the means by which Gun-powder is inflamed and excited to a motion so very vehement and swift that it can impress on a Leaden-bullet force sufficient to produce such a Wound seeing Cartesius hath exactly and elegantly enough writ of this matter in his Fourth Part of the Principles of Philosophy Therefore after the Patient came to me I commanded him to set his Body in the same posture he stood in when he was wounded and then with a leaden Probe yea also with a Wax-candle which we in Dutch call een was-lichtien I sought very industriously for the Bullet but in vain because it had descended too deeply and absconded it self so that I could not draw it out If any man be desirous to see instruments fit for extracting Bullets let him consult Fabritius Hildanus Scultetus and others What then was here to be done The Bloud and Humors by reason of the Contusion stagnizing and by reason of the Acidity coagulated were to be dissolved by things temperating Acidity that by such means the Circulation of the Bloud and Humors in such wise impeded might be again restored and by that restoration the Fibrils inherent and plainly dead in the Wound be separated from the living Flesh and the Wound again be filled up and repleat with new Flesh and cured which notwithstanding the Leaden-bullet remaining in the Leg was effected in a short space of time by applying this Unguent and superpositing the following Plaister ℞ Turpentine ℥ ij White of Egg No 1. Myrrh Aloes of eachʒ ss Oyl of Wax Drops 10 Make an Vnguent ℞ Emplas Diapalma ℥ ij Common Chalk Bolus of each ℈ ss Diaphoretick Antimony ℈ j. Oyl of Tartar per Deliquium ℈ ss Of Cammomil q. s Mix according to art and make a Plaister But in the mean time we contributed help to the external Remedies by internal Medicines also given and often gave to the sick instead of a Vulnerary Potion one Scruple of Crabs-Eyes and as much of White Coral The Ancients about Wounds made by Gun-shot laboured with great prejudice thinking them to be venomous and Johannes de Vigo had imbibed the same opinion for he therefore touched such Wounds with hot Oyl No less false is the Opinion of those men who believe a Leaden-bullet shot out of a Gun doth in perforating the Flesh egregiously burn the same For a Leaden-bullet shot against a Wall and presently taken up will exhibit no sensible heat But whence is it that Lead hath often been known to remain in the Humane Body without any sensible hurt for a long series of years but Brass Iron and many other things from without forced inwards not so Do we not daily see in the Macrocosm how easily Brass is infected with an Aerugo and Iron with Rust by the Air Water Vinegar and other things whereas on the contrary Lead is infected with no Rubigo Moreover Tin is likewise said to be infected with no Rustiness wherefore this also may perhaps for a very long time lie hid in our Bodies without damage Helmont Kenelm Digby and others much glory of the Symphatick cure of Wounds but they are miserably deceived Sir Kenelm Digby set a Vessel full of Water in a cold place and in that Water dissolved common Vitriol and then in that Solution put a Linnen-cloath that had before received the Bloud issuing from the Wound and doing this thought that many Particles of the Vitriol would by the Air be carried to the Patients Wound but perhaps these Particles could they be conveyed so far would do more hurt than good This seems to be very probable because those Effluviums which the Air can convey from the Vitriol set in a cold place must needs be very few Before I put an end to this Observation there remains one Problem yet to be discussed viz. whether it be true as many men at this time do firmly perswade themselves viz. that there are such men in the world who by reason of a Compact made with the Devil have Bodies impenetrable by any Bullets Swords or other things impressing Wounds Although I have with great scrutiny examined this matter yet I could never unto this day find any man who by proper experience in his own Body could ascertain me of the truth of this matter But it is sufficiently evident to be repugnant to reason that the Humane Body which is so very soft cannot be wounded by Leaden-bullets Swords and other Weapons agitated with very great force whenas a Pellet of Wax shot out of a Gun can sufficiently penetrate solid and hard Boards Whatsoever is so repugnant to Reason cannot be consentaneous to the Will of God for otherwise he must needs will somewhat that is repugnant to his own Nature seeing 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The WORD or Reason is GOD himself Whatsoever GOD wills not that the Devil cannot effect therefore I judge this thing to be wholly impossible and shall never be induced to believe that such men can be any where found OBSERVAT. IV. Of a very strange Vlcer OUt of the City Arnhemium beyond the Rhine in that place which in Dutch is called de Praest a Woman of Seventy years of age asked Counsel of my Father Doctor of Physick and Chyrurgery whilst he lived because she was afflicted in that part of the Thigh which is about six fingers breadth distant from the Groin with an Ulcer the Cavity of which exceeded four hands breadths From this Ulcer at one time proceeded thirty Eggs full of a limpid Humor afterward for several days many other came forth all which numbred together exceeded one hundred some of which were equal in magnitude to Hens-Eggs others as large as Pidgeons-Eggs and some of them no larger than Sparrows-Eggs all of them each apart from the other separated were enclosed with their proper Membrane white and as thick as a Playing-card These Eggs appeared very like to subventaneous or windy Eggs and lay all together included in a Common and gross Membrane These Eggs being by Intervals thus evacuated from the Ulcers I used the following or like Injection ℞ Root of round Birthwort ʒij Herb Carduus Benedictus Veronica of each M j. ss Crabs-Eyes ℥ j. Myrrh Aloes of eachʒj ss Boyl these according to Art in French Wine and use the Colature By this means that common and gross Membrane was gradually consumed and the Patient at length restored to her pristine sanity Many that were present thought this Woman to be bewitched and therefore affirmed the Devil to be the Author of this Disease evily attributing that honour and power to the Devil which ought to be ascribed to the Omnipotent GOD onely For GOD is the primary cause
the dilated Artery For by this means I have certainly known some to have augmented the number of the Dead Moreover Ligatures must not be tyed too close for by this means I remember a mortal Sphacelus hath unexpectedly been introduced But if the Patient from the wound of an Artery lose so much Bloud as he suffers great Swoonings and Death seems to stand at the door what is then to be done Cannot the Transfusion of Bloud so much praised in this case profit especially seeing it is declared by credible men that a Dog from whom in one day so much Bloud was taken that he could scarcely move by Calves-Bloud received the next day in a moment of time shewed recovery of strength and incredible vigour I answer I cannot remember this Operation to have been at any time instituted by our Country-men therefore warily suspended my judgement about this matter OBSERVAT. V. Of a Fracture of the Tibia with a Wound A Virgin Twenty years of age by the sudden and unexpected discharge of a Gun I know not by what misfortune happening charged with Small-shot received a wound on the inside of her Leg a little below the Knee Which wound presented it self in length and breadth very large yea so large that it exceeded an hands breadth There was also present a very great Contrition and Commination of the Bone of the Tibia broken into very small pieces which extended it self the whole length of the Wound and thickness of the Bone of the Tibia Whence the sick Maid was afflicted with most cruel dolour which caused her to pass many Nights without sleep or if she at any time slept for a very little while she would suddenly awake not without very great terrour attended with a Convulsion as it were of her wounded Leg by which means the broken Bones were often distorted The broken Bones were reposited without great Extension and the Fragments which were wholly separated loose and at liberty were presently taken out without much trouble the remaining Fragments yet somewhat adhering were left till in process of time they should be separated Then was applied a digestive prepared of Turpentine the Yolk of an Egg Powder of the Roots of Flower de Luce and Birthwort with Myrrh and other things together with a Plaister and Lavament temperating Acidity After these was used a common Ligature and at length the affected Leg included in a case of Wood was aptly placed in the Bed over which hung a Rope by which the Patient might raise her body when necessity was and at her Feet was erected a Semi-circle of Wood lest the weight of the Bed-clothes should create any trouble to the wounded Leg. The cutting of a Vein which very many are wont to commend in such a case was wholly omitted because no benefit can thence arise nor were Purgers here according to the vulgar method revoked into use because in this Evil nothing is more desirable than Rest and nothing more pernitions than Motion Therefore whensoever the Patient was necessitated to discharge her Belly a four-doubled Cloath was laid under her to receive the Excrements In the mean while the Patient eat Foods easie of digestion drank new Beer and the first Evenings after she was wounded assumed a certain gentle Anodine for mitigating the dolour and removing that terror of which I spake The Bones were reposited as often as they were found distorted by that Nocturnal terror The Wound by reason of great abundance of Pus was dressed twice a day and so in process of time very many Fragments were separated And then we could daily see the Generation and Accretion of a Callus arising not from the Marrow but from the very small Pores or passages of the Bone through which are conveyed the nourishing Humors coming from the small Arteries This Wound so very perilous was closed up in a Months space and the Patient could again as well stand and walk as she had done before this wound was inflicted I remember another Woman afflicted with the same Evil to have been cured by my Father But these two Examples should not render any Artist so secure as slightly to regard a Fracture with a Wound For I have known that to have caused death in many So when in the Hospital as Rotterdam I was present with others daily for almost whole days dressing very many wounded Men which came from the Siege of the City of Graaf I remember all they that laboured with a Fracture and Wound of the Tibia died and among others one was afflicted with a Fracture and wound of the Tibia in whose wound I beheld not without Admiration very many broad thick and white shining Worms But whence had these Worms their Original I answer From Eggs fallen from the Air into the wound out of which the Worms were excluded when a certain Fermentation was excited in the stagnizing Humors So not a few Eggs fall from the Air into Milk of which Cheese is afterward made As long as that Cheese is new these Eggs are not excluded but when the Cheese putrifies that is when in process of time a certain Fermentation is produced in the Cheese then do the Worms crawl out of the Eggs. So in a very great contrition of a Bone the Fracture with the wound attending I remember to have been cured no otherwise than by cutting off the Leg a little below the Knee In a Fracture of the Tibia with a wound some are wont to use the Ligature of eighteen Heads which is in Dutch called een boexwiise Ligatuur but we have happily used the common which we changed twice a day by reason of the great quantity of out flowing Pus I knew a Chyrurgeon who instead of the wooden Case of which I spake used a certain Iron-Instrument into which the Leg affected was put and so kept extended and unmovable but I cannot here in words give a description of that Instrument In a simple Fracture of the Tibia Ferula's made of Pastboard are generally applied but in our Patient these were wholly omitted because in a wound so vast they seemed not convenient With our Digestive which was put upon the Wound by reason of the bared Bone no Fatness was admixed For that Fatness hurts the Bones Experience doth abundantly testifie the reason of which we have before given Parey in the Chyrurgick Practice was very deserving and had much Experience yet in a Fracture with a Wound he improperly commends Astringents which why and how much they hurt we have often shewed I suppose no man will take it in evil part that I should dare to reprehend so great a Man seeing the more famous any man is the more dangerous are his Errours because very many moved by the onely Authority of so great a Man with a certain blind force follow him treading a Path that hath been trod but not that which should be trod It is to be observed that a Callus is most difficultly produced in Fractures of women with Child