that the heat by degrees may be again restored to the part and to that purpose strongly rubbing it with Snow or cold Water giving also to the Patient Treacle or Mithridate in warm Wine If the pain and cold remit let the part be embrocated very warm with Oyl of Dill Camomil bitter Almonds or Earth-worms c. A Decoction of congeal'd Turnips is good to foment withal then are required both stronger and hotter Medicines viz. Oyl of Earth of Tiles Turpentine Castor Treacle-water Mithridate Or use the following Fomentation Take Herbs of Scordium a handful and half Swallow-wort a handful Rue half a handful Seeds of Roman Nettle Cresses of each three Drams boyl them in White-wine let them be strained and to a Pint of the Liquor add Spirit of Wine two ounces Mingle it When the part hath begun to Mortifie Scarifie continue the use of the above prescribed Medicines Cure of a Gangrene from external Heat or hindred by Perspiration Let the cause of the Disease be removed if possible which if it happens from external Ligature Hot or two Astringent Medicines let them be forthwith removed from the part affected and let it be washed being first Scarified with the following Decoction Take the Water of Endive Night-shade of each six Ounces of Sorrel-water eight Ounces Vinegar half a pint Salt an Ounce and half Scordium a handful Lupines half an Ounce Mix them and boyl them to the Consumption of the third part Then let the Chirurgeon use Ung. Aegyptiacum or any other of the above prescribed Medicines Cure of a Gangrene from the Defect of Nutriment Let the Patient use nourishing Aliments all strong External or Internal Dryers hurt Friction of the part with moderately hot Medicines as with Oyl of Sweet Almonds Olives Earth-worms Scorpions Vipers Man's Fat Bears or Hens is good Scarifie if necessity require Discussives here are very injurious Cure of a Gangrene from a venemous Humor If the malignant Humor be in the Body it self Sudorifick cooling and Cordial Medicines are best For Purging and Bleeding I have seen them oftner to do hurt than good Outwardly Defensives are useless but Cupping-glasses Leeches and attractive Medicines are necessary But if the Malignant Humor come from an external Cause the surest remedy is an actual Cautery lest the Malignity spread it self which is to be used the very first time and also to put a further stop apply a Defensive to the sound part two fingers breadth distance from the wounded part so also it will put a stop to the Flux of Humors or else all the hope consists in Leeches Cupping-glasses Attractive Medicines and others set down above Cure of a Gangrene sprung from the Scurvy Internal Remedies we commit to the Physitian Externally these are commended Take Seeds of Broom Roman-Nettle Rue of each a Dram Tops of Wormwood two Drams Gum Galbanum Ammoniacum dissolv'd in Vinegar of each six drams Oyl of Juniper three drams Wax as much as is sufficient to make it into a Plaister Or Take Oyl of Earth-worms Bayes Rue of each two Drams Castor a Dram Spirit of Wine three Drams Make it into a Linament Or Take the Raspings of Guaiacum Sassafras of each an ounce Root of Angelica Celandines the greater Tamarisk-bark of each six Drams Leaves of Scurvy-grass Water-cresses of each a handful Fennel-seeds an ounce Spirit of Wine a pint and half Infuse them a Night then distil them in Balneo Mariae Foment the part affected with this and scarifie if there be occasion and let the Chirurgeon proceed according to Art Where a Gangrene hath degenerated into a Sphacelus especially in the Joynts let the Part be amputated concerning which look in the First Part. CHAP. XV. Of a Paronychia PAnaritium or Paronychia is a Tumor very painful in the end of the Finger from a sharp Malignant Humor corroding the Tendons Nerves Periostium and Bone it self Cause is a sharp humor proceeding from Choler or Serum Signs are an intollerable pain about the Nail tormenting the Patient day and night an Inflammation oftentimes extending over the whole Arm A Fever for the most part and sometimes Delirium Prognostick By how much the Humor is the more malignant the greater Symptoms it raiseth corrupting sometimes the Bone the Finger the whole Hand and sometimes from extream pain it occasions the death of the Patient Cure Foment the Finger a while in this Decoction Take Flowers of Camomile Mellilot Elder of each half a handful Linseed and Fenugreek each two drams Boil them in Milk Or let this Cataplasm be applied Take Flowers of Dill Elder Leaves of Hen-Bane of each a handful Poppy-seeds and Linseed of each three drams Marsh-mallow-powder an ounce and half Boil them in Milk to the consistence of a Cataplasm Then make Incision upon the Part affected according to the length of the Finger and for the most part there appears one or more red spots containing a sharp Matter but little in quantity which is the cause of the Disease After the Apertion of the Tumor at the first dressing apply to the Finger Treacle dissolv'd in Spirit of Wine and a Defensive to the whole Hand so in a day or two the Cure will be perfected But if this Part should be gangren'd or Sphacelated either by the neglect of Patient or Chirurgeon let it be taken off Except you will commit the business to Nature which oftentimes separates and throws out this Bone A great Inflammation sometimes here produceth a Fleshy Excrescency occult and sensless this is removed by Knife or exeding Medicines Then cure according to Art But if being too late call'd you find a great collection of Humors let Discussives or Suppuratives be applied then the Tumor being either broke or opened take great care lest the Tendons which do very easily putrifie or incline to putrefaction Separation is here necessary whether it be by Medicines or a cutting Instrument Repellents in this case greatly hurtful CHAP. XVI Of an Aneurism ANeurisma is a Tumor besides Nature from a Rupture of an Artery continually beating easily yielding to the Fingers and as suddenly returning Cause All Arteries except those that are dispersed through the Brain and upper parts consist of a double Tunicle the inmost of which being either corroded or broke the External may be extended so much without a Rupture of it whatsoever others say as to cause an Aneurism Nevertheless where the Tumor is of the bigness of ones Fist it cannot be but that the External also must be either corroded or broke Anatomy doth confirm this Opinion which the Studious in the Art of Chirurgery may enquire into This Tumor also may be caused where an Artery be divided so that the External Tunicle united to the Muscles the Internal by reason of the continual pulsation remains open Signs A Swelling increasing by degrees of the same colour as the skin a continual Pulsation If the Tumor be little it easily yields to the Fingers so that it altogether disappears but suddenly returns
thrusting Instrument and seldom passeth through both Tables A Contra-fissure is made when the part struck remaining whole the opposite part is cleft The Signs are Swimming of the Head dimness of the Eyes Vomiting Bleeding at the Mouth Nose and Ears The Patient grows dumb and suddenly falls to the ground whereupon follows Raving a Feaver Convulsions Palsie Any hard thing as a piece of Wood a Spoon c. being put into his Mouth he is not at all or hardly able to bite upon it Here it must also be carefully enquired in what manner and with what Instrument he hath been hurt Whether he be young or old tender or strong healthy or unhealthy Presently after the Fall or Stroke before the Part swells you may sometimes feel the hurt with your Fingers and if there be a Wound with it you may either see it or find it out with a Probe Prognosticks The Fractures of the Skull how fair soever they may look is never without danger but more dangerous when both the Tables are hurt or broken and more dangerous yet if the Dura Mater and most dangerous if the Pia Mater be also hurt The more Symptoms there are the less hope of a good event If the Bone grow black in the beginning that is a mortal Sign Cure If the Skin be yet whole or the wound not large enough make a cross incision and divide the Pericranium If under it you find a fissure put some Ink into it and bind up the wound The second day or as soon as the bleeding is ceased scrape the Skull at once or at several times until the Ink with the Fissure is altogether gone and the Bone grow somewhat bloody then throw the ensuing Powder upon it Take Dragons Blood burnt Harts-horn of each one dram and half Myrrhe half a dram Frankincense and Orrise roots of each a dram Make it into a very fine Powder If the Fissure pass through both Tables then are you to make use of Trepanning as likewise in the Contra-fissure Fracture and Contusion of the Skull or else you will quickly lose your Patient The Incision is healed like the Fissure In the Puncture you must put the Trepan just in the middle and not on the sides of the place hurt If you find a Fracture with a Cominution then take out all the small loose Bones committing to Nature those that are yet fast to the Pericranium or cannot be taken away without force And then if the Fracture be so large that you can free the Brains from the coagulated or corrupted Blood or from the pricking Bones Trepanning will be needless but if it should happen otherwise you must with great care apply the Trepan unless the Patient be strong and the matter very little The manner of Trepanning will be taught in another place 2. In a Fracture of the Nose what is raised is to be pressed down and what is pressed inward to be raised with a Spatule or other Instrument afterwards a Pipe or Quill is to be put up and continually kept there till the Cure be done and a Fracture-Plaister is to be laid on without If the Bone be not corrupted it will be healed in ten or twelve days 3. A broken Jaw-bone is restored by ones fingers used both within and without the Mouth and if those be too weak then one is to draw the Head backward and the Chirurgeon forward and so to put it in It is cured in twenty days 4. The Clavicle being broken there must be one to draw the Arm backward and another to draw the Neck or Shoulder forward the Chirurgeon himself in the mean time drawing upwards what was fallen down and downwards what was raised too high If a Ball be put into the Arm-pit and the Elbow be pressed against the Ribs the Operation will prove more easie It is cured in twenty four days 5. If the Shoulder-Blade be broken about the place where it is united to the Arm then is the hurt for the most part incurable If it break in the Acromion which may be easily felt then let the Arm or Shoulder be pulled down either with Hands or Ligatures and in the mean time set it in If it be broken into several pieces make an Incision and take them out unless they be yet fast to the Peri-estium in which case you must leave Nature to her self which will either make them unite again or throw them out It is healed in forty days 6. The Sternum or Breast-bone happens either to be broken and then you 'll find an unevenness which being toucht will yield to the Fingers and cause some cracking or to be pressed in and then you 'll feel a bending inwards which will cause pain a short breath coughing and spitting blood To restore the same lay the Patient on his Back upon a great stone pressing both his Shoulders downwards then press the Ribs backward and forward until the Bone be reduced again in its right place This is cured in twenty days 7. A simple Fracture of the Ribs which is without any great Contusion or Inflamation of the neighbouring parts may be healed in twenty days applying the Fracture-Plaister If the Ribs stand out they must with ones Hand be pressed in If they bend inward let the Patient keep in his Breath and so press the Rib outward in the mean time assisting him with your hand If that succeed not then lay a sticking Plaister upon it and pull the same off so often until the Rib return into its place Cupping-Glasses here are of no use 8. A simple Fracture of the Joynts of the Back-bone is easily set again with ones finger and is made whole in twenty days But if the Marrow of the Back-bone be so hurt or pressed in that the Arms or Legs of the Patient become lame or senseless that he cannot retain his Urine or his Excrement then he seldom escapeth death Yet you are to do your utmost and if one or more small Bones be altogether loose from the Periostium then make Incision and take them out 9. The same is to be understood of the Fracture of the Os sacrum which alone hath this peculiar that you may put your fingers into the Anus and restore it to its right place 10. The Hip-bone being broken is to be set as soon as possible may be and then it will heal in twenty four days otherwise you may expect various accidents But if it be fractured into many pieces then you are forthwith in the first dressing to make an Incision take out the small Splinters and re-place those that have yet any hold-fast Yet by reason of the multitude of the Tendons Muscles Veins Arteries and Nerves that are spread over the whole part such an Incision cannot be made without great danger 11. If the upper-Bone of the Arm be broken first bend the Elbow toward the Breast then take the lower part of that Bone close to the Elbow pulling it straight down towards the ground and so restore
Fissure and foul Bone in the Teeth also when they are crusted over with a Tartarous black substance the Bones are to be scraped till you come to the sound part which is white and solid and a little blood cast forth and to the Bone thus scraped some drying Powder is to be applied the Pericranium and Periostium must first be seperated from the Bone before you go about this Operation for by no means are they to be touched with the Instrumenr neither likewise the lips of the Wound Filing is used in the Teeth for when they unnaturally stand forth and either in Eating or Speaking are any hinderance to a man then that which thus sticks forth is with a File to be taken off which must be done carefully without any injury to the neighouring parts and by degrees neither with two great a Violence lest it loosen the Tooth The use of the Saw is in a mortified part when the Bone is to be cut a sunder concerning which Operation I shall suddenly speak Perforating or Trepanning is of great use when the Bones are extreamly soul but 't is of greatest use in those effects which the Fissure or a Fracture of the Skull or a Contusion may produce Seeing therefore this Operation is so full of danger 't is diligently to be enquired in what Cases 't is necessary and in what 't is not for a Fissure as a Fissure as likewise a Fracture as a Fracture requires not the Trepan as an operation without which they cannot be cured In like manner a slight Contusion doth not always occasion such dangerous symptoms that the Trepan may not cause worse for oftentimes a small quantity of extravasated Blood in Robust People is often discussed by the work of Nature her self except the innate heat be weakened by external Cold which in the use of the Trepan let what care possibly be had cannot be totally avoided besides this the Blood is more often extravasated between the two Membranes the Dura-Mater and the Pia Mater there the Trepan can seem to promise but little good but in this case I would not much matter to divide the Dura Mater Experience having taught us that by the help of Art and Nature hath an Incision nay Gangrene of the Part it self been cured Therefore for the most part but in three cases is the Trepan required 1. Where the loose pieces of the Bones prick and wound the Meninges which is to be known by the continual pricking pain presently from the very hurting perceived granted the Patient be sensible but if not he is always feeling the Part affected wirh his hands There happens likewise Contusions of the Eyes and Convulsions of the Limbs Besides the quality of the Instrument which the Fracture hath made will more plainly demonstrate it 2. Where the first Table is only depressed but the second broke there being no way to give passage to the pieces how well soever by Art or Nature separated The Signs of this are a Dimness a Giddiness a Fever Vomiting and sometimes an Apoplexy a feeble small Pulse and especially about the Temples the depressed Bone in some manner obstructing the Circulation of the Blood in the Brain 3. Extravasation of Blood upon which follows Putrefaction and if not remedied Death it self The Signs which declare this Putrefaction is a continued Fever a great Heat in the Head unquiet Sleep Watchings Inflammation of the Eyes and light Delirium and moreover the Temperaments of Bodies are diligently to be consider'd for in Plethorick People to those above-named Symptoms are joyned a Laughing Talking idly and Redness of â—he whole Face In the Cholerick appears a yellowness of the Face and Eyes great Heat and Madness In the Phlegmatick all the Symptoms are less but sometimes it is accompanied with a Palsie sometimes with an Apoplexy In Melancholy men a dread impertinent Talk and Laughing is usual Where the Trepan is necessary apply it as soon as possible lest the putrifying Blood causeth greater evils that is on the third fourth or fifth day The manner of Trepanning is thus The Hair being shav'd Let the Skin be divided with a double Incision inform of a Cross to the Pericranium avoiding with the greatest diligence always the temperal Muscles and the Sutures of the Head this done bind up the Wound except the Hemorage be small which very often is so violent that it hinders the Chirurgeon for some days from any further Operation if it will then give leave to divide likewise the Pericranium from the Skull After some few hours the Skull already bar'd of its Pericranium the Patient well plac'd his Head must by some Person be firmly held his Ears being stopt with Cotton then set on the Trepan with a Pin which must neither be upon the Fracture nor upon the Sutures although there are some that venture to apply it upon the very Sutures themselves the Surgeon holding in his left hand the Instrument and with his right let him gently turn about the Trepan until it hath taken good hold round then take out the Pin and set the Trepan on again without it moving it still about and if you see any small Filings of the Skull take off the Trepan and wipe them away and the Trepan it self is sometimes to be dipt in the Oyl that it may the easier be turned about and sometimes in Water that it grows not hot If any Blood appears you may be certain that the Trepan had past the first Table then are you to have a greater care lest the Trepan should unawares slip in and wound the Meninges from whence oftentimes follows sudden Death For the Dura Mater invests the inside of the Scull in the same manner as the Pericranium doth the out-side but yet not so strongly joined to it but that by a fall or blow it may be easily separated from the Skull When the piece of Bone separated by the Trepan begins to be loose you must with a little Instrument put in between the Skull and the Trepan'd part and free it from the whole and so gently take it out with a pair of Forceps If there remain any inequality from Trepanning in the inside of the inward Table that may cause injury to the Meninx 't is to be taken away with an Instrument called Lenticula And that there may be a discharge given to the coagulated Blood and Matter the Dura Mater is to be compressed with an Instrument called a Decussorium To effect the same 't is commended that the Patient if sensible his Mouth and Nose being shut hold his Breath so that the Brain being raised upward the concreted and corrupted Matter may be thrown forth but very seldom is the Matter discharg'd by this only remedy for the Chirurgion hath need enough of the Decussorium Spunges Lint and the like Instruments the description and delineation of the which you may find in Joh. Andr. Ã Cruce Paraeus and others Read the 4 th Chapter of this Chirurgery where Fractures of the
thrusting in one or two fingers into the Anus not only to search for the Stone but also understand its greatness But this searching was so very painful that it was difficult through fear of pain to have it permitted a second time and this thing gave occasion to have ready at the second time of searching all Instruments necessary for cutting out the Stone but the Omnipotent and great Prince of Physicians hath now granted to those miserable Patients those Chirurgeons who not only without Catheter but also without pain both in old People and Children which can most certainly find out the Stone and for this Reason they Excel the so much Esteem'd French-men I wish other places may may enjoy the same Artists Prognostick A crumbling Stone seldom a hard Stone can never be wasted by Medicines whatsoever boasting persons may say sometimes it is so soft that by the very Catheter it self it may be broke to pieces in the neck of the Bladder and be brought forth sometimes through its smalness it comes forth whole sometimes it sticks in the Urethra out of which without danger and great pain it cannot be removed if it sticks in the Tunicles of the Bladder or grows to the Superficies of the Interior Coat it cannot be taken away by Section without the death of the Patient By how much the greater the Stone is the Operation is the more dangerous and painful Stones are often drawn forth out of Womens Bladders about the bigness of an Olive or a Walnut without Incision but this way by Dilatation of Extracting the Stone is so dangerous that it ought not to be performed but by experienced Chirurgeons Cure Stones generated in the Kidneys Bladder or other parts of the Body for they may in any in general require the assistance of the Physician but we in this place treat only of the manner of drawing them forth out of the Bladder by Incision There are several ways by various Authors proposed but that which follows is the most common and most sure Let the Chirurgeon place his Patient on a soft Pillow in a strong mans Lap after he has three or four times jumpt from a high place then let him tie both his hands to the soles of his Feet and let two standers by hold each Knee extending them as far as may be one from the other then let him take the first Finger of his left-Hand or if necessity requires the two first anointed with Oyl of Lillies Roses or fresh Almonds and thrust them up the Fundament with his right hand gently compressing above the Os Pubis so that the Stone may slip down under the Os Pubis into the Perinaeum which when brought thither by the foresaid Fingers let him make Incision with a sharp Knife in the left side between the Testicles and the Anus near to the Suture of the Perinaeum cutting to the very Stone it self and if it comes not out of the Wound it self nor by the thrusting forth of the Fingers which are in the Intestinum rectum let him draw it forth with a pair of Forceps or which is better with the Lapidillum or Spoon The Stone being taken out and all the Ligatures loosed let the Wound be bound up according to Art applying Medicines stopping Blood viz. of Meal and Bole c. with the greatest care to consolidate it as soon as possible lest the Patient labour with a dropping of his Urine through the wounded part And this is the manner of drawing forth the Stone which Chirurgeons use to call Apparatus Minor which chiefly is used in Children although there are those which proceed thus in People of full growth But in our Country always this Incision is made by them whose Fingers are fitted for this Operation But in People of full Age it is sometimes very difficult to reach the Stone by the Fingers put up into the Fundament and after the same manner to bring it down into the Perinoeum if not altogether impossible as many think it therefore there is another way found out which they call Apparatus Major the Patient is put on a Table and bound and held as above the Chirurgeon through the Uretra passeth a Director into the Bladder to the Stone then Incision being made as obove in the hollow of the Director puts in the Conductor taking the Director out of the Uretra he passeth into the Wound the Forceps the Lapidillum or other Instrument convenient for drawing out the Stone by which he may both lay hold of it and draw it forth not making use of his Fingers in the Anus except great necessity compel him to it Where the Stone is bigger than the Orifice and cannot come forth the Wound is to be enlarged or the Stone to be broken into pieces by the Forceps and so drawn forth in parts This done the Binding and Consolidating the Wound ought to be the same as in Children giving it a stitch if it be too great putting in a Silver-Pipe for two or three days that may give passage to the Concreted Blood Slime and Sandy Urine The manner is the same in Women but only the Fingers are not put into the Anus but into the Privy-Parts and the Catheter must not be crooked but straight and much shorter than the other There is likewise another manner of drawing forth the Stone the Chirurgeon thrusting his Finger into the Anus presseth the Stone upwards to the Belly then through the Wound made in the right Muscle above the Os Pubis according to the ductus of its Fibres by the assistance of the Lapidillum or Forceps draw forth the Stone by this way is never observed any coming forth of the Urine and the place supposed convenient to draw forth the Stone But this Operation in it self is dangerous and troublesome and if the Lips of the Wound made in the Bladder unite not to the Muscles of the Abdomen there follows an Ulcer of the Bladder more painful but less cureable than the Stone it self which inconveniences have caused it not to be reckoned among other Operations by true Practisers CHAP. XXVII Of the Hare-Lip THe fourth and last Part of Chirurgery call'd Anaplerosis which restores what is deficient is chiefly used when any part of the Nose Lip or Ear is wanting whether it be from the Birth or from an External Cause As to the Lip in a little defect let it be first separated from the Gums then let the edges be scarified and joined together with a Needle laying over it an aglutinating Plaister and so in a short time the Cure will be performed In a greater Defect let the Lip be seperated from the Gums then put a Linnen Cloth between and let the Extremities be brought together by Bandage after some few days convenient Scarification being made by the help of a Stitch and Plaisters let the ends be united The Nose and Ears being depriv'd of any part after what manner they are cured Taliacotius in a particular Treatise hath largely
again but if great not so easily yielding to the touch not so strong a Pulsation but there is a noise observed as of boiling Water yet in the Head and Jaw I have found after death an Aneurism which while the man was alive there could be no Pulse perceived In the hard parts is greater Circumspection to be used than in the soft and fleshy Prognosticks It is difficultly cured if great not at all except with the taking off the Member for the most part it is a long Disease although I have seen it kill without any other accidental Cause within two years If Incision be made Death suddenly follows Cure In the beginning there may be some Hopes Astringents and Repellents and convenient Ligatures by which we do not seldom administer something of Remedy to the Patient as also the applying a piece of Lead straightly bound on have sometimes cured little Aneurisms But where the Tumor is encreased there are some would have the Skin divided and the Artery tied both above and below and cut out the middle with the Tumor and loosen not the Ligatures till the Wound is perfectly cured and there is no fear of an Hemorrage but this Operation is dangerous painful and troublesome and oft-times of little Benefit But to preserve Life I would take off the Member CHAP. XVII Of Opthalmia OPthalmia is an Inflammation of the Membranes of the Eye from Blood with Redness Pain and shedding of Tears Difference A light Inflammation and which depends from external Causes is called a Bastard Opthalmia Taraxis or Epiphora but a great Inflammation accompanied with pain and tears a true Opthalmia And if it be so great that the Eye-lids are so inflamed and as it were turned inward 't is called Chemosis Causes are two 1. Internal as Blood oft-times mixt with Serum or Choler seldom with Phlegm or Melancholy 2. External as Smoak Dust c. Signs vary according to the variety of Causes If it proceed from too great a quantity of Blood the Face looks red and the Vessels of the Eyes are extended If either from more of Serum or Choler the Redness of the Face is less but the Tears are more sharp and the pain greater if from more of Phlegm the reddish pain Heat and Acrimony of Tears are more remiss and the Eye-lids at night are as it were glewed together If from any thing of Melancholy there are but few Tears and the Eye-lids are not closed together the Inflammation is not great but stubborn Prognosticks An Opthalmia is flower cured in Children than in old people Continual pain menaceth Blindness by how much greater the Inflammation is so much the more dangerous it is Cure The Diet must be the same as in a Phlegmon all sharp things are carefully to be avoided as Garlick Radishes Mustard c. little or no Suppers profit Purging the use of Glisters Bleeding ought to be oft-times re-iterated as also Cupping-Glasses Leeches Blisters sometimes also Seatons Issues and Artereotomy it self which is not to be done by any but an expert Chirurgeon Sneezing is hurtful Provoking of Sweat is sometimes necessary sometimes not which the Physician must distinguish Dieureticks are of great use provided they are not too hot External Remedies vary according to the variety of Causes if from Smoke or Fire let them be extinguished If from Dust or any thing got into the Eyes 't is to be taken forth which is often performed by blowing or by the spurting in of Rose-water If from the inversion of the Eye-lids the Hairs are to be cut off or wholly to be pull'd out If the Eye-lids are glew'd together they are to be separated with Butter Beer or Cream the Rheum is gently to be wiped and let the Patient have a Care lest by the rubbing of his Eyes he increaseth his Disease Fat things are here hurtful Repellent Medicines except in the very beginning are not to be used or in a very slight Opthalmia Medicines good for the Eyes Roots of Valerian Solomons-Seal Orrise Vervain Herbs Betony Celandine the great Eyebright Fennel Fumitory Plantain Flowers of Roses Violets Anni-seeds Quince-seeds Linseeds Pippins boil'd or rotten Camphire Mussilage of Lin-seeds Tragacanth Fresh Veal Whites of Eggs all sorts of Milk especially Womans Tutty white and green Vitriol Saccharum Saturni Glass of Antimony White Troches of Rhasis fresh Cheese not salted Ung. Saturni A Water for the Eyes Take Waters of Eyebright and Celandine the greater of each an ounce and half White-wine six drams Glass of Antimony eight grains prepared Tutty fifteen grains White-Vitriol two grains Sugar-Candy two drams Camphire four grains Make it into a Collirium Another excellent one Take Wheat three handfuls Bruised Ginger three drams Common Salt a handful and half White-wine Water of Roses of Fennel Plantain of each ten ounces Infuse them in a Copper Vessel the space of forty days strain them and reserve the Liquor for your use Another very much esteemed Take a whole Egg boil it hard then the shell and Yolk being taking away put into the Cavity Sugar of Saturn six grains Camphire two grains White-Vitriol three Grains Honey of Roses half an ounce then press it very hard and let the prest out Liquor be dropt into the Eyes twice or thrice a day Another second to none Take Waters of Fennel and Eyebright of each a pint Common Salt six drams prepared Tutty white Vitriol of each half an ounce Let them boil a little and reserve for use Let not the great quantity of Vitriol afright any it causeth only a slight pain which suddenly vanisheth but 't is of so great virtue that it cannot sufficiently be extoll'd but its use will prove it true A Powder for the Eyes Take Dulcified Vitriol half a dram prepar'd Tutty fifteen grains Sugar-candy a scruple Make it into a fine Powder Unctious Medicines seldom are applied to the Eyes or else this Ointment is much commended Take Verdigrease twelve grains Camphire Lapis Calaminaris of each half an ounce prepared Tutty half a dram fresh-Butter washed in Rose-water two ounces Make it into an Ointment An Anodine Cataplasm Take Camomile and Melilot Flowers of each a pugil rotten Apples two ounces Fenugreek-seed an ounce Crums of Brown Bread three ounces two yolks of Eggs Saffron half a dram Boil them in Cows-milk to the consistence of a Poultice An Anodine Collirium Take the Juice of Housleek two drams Whites of Eggs half an ounce Womens-Milk two ounces Rose-water an ounce white Troches of Rhasis one scruple Opium three grains Mix them Another which I have often found excellent in the greatest pain Take Gum Tragacanth two drams Mussilage of the seeds of Fleawort three drams Rose-water and Plantain-water of each as much as sufficeth Make it into a Collyrium of an indifferent Consistence and let it be instilled by drops into the Eyes and Linnen-Cloaths wet in it outwardly applied CHAP. XVIII Of a Quinsie A Quinsie is a Tumor of the Jaws from Blood hindring Deglutition and
of the Flesh is taken away and then 't is call'd a compound or hollow Wound 3. From the Causes which shall presently be set down sometimes a wound happens to be poisoned and to have many Symptoms joined with it Causes are five-fold viz. 1. All things that cut as a Knife Sword Glass 2. Al things that prick as Needles Arrows Teeth 3. Which perforate as hot Iron Bullets 4. Which break as a Fall Stroke or the carrying or lifting of any great Burdens 5. All things which contuse as a Stone Stick c. Signs External Wounds are of themselves manifest enough but those of the Internal parts are not always so easily judged of these therefore are to be known by Anatomy 1. What is the situation of each part 2. What the use 3. The Symptoms are to be considered 4. The Quality of those things are to be noted that Nature ejected through the Wound The other Signs you shall have in their proper places Prognosticks To know the Events of Wounds especially to predict which are Mortal which not is a thing absolutely necessary for a Surgeon For from this judgment oft-times depends the Life of unfortunate Man A mortal Wound is that which in the space of few hours or days of necessity causes Death and cannot by any Art be cured For those that in themselves are curable yet by reason of ill Symptoms or through the neglect either of the Patient or Chirurgeon do occasion Death ought not to be accounted mortal Wounds Incurable Wounds themselves are not to be call'd Mortal if they are not the cause of Death suddenly to the Patient but that he not only lives many weeks but oftentimes many years after 1. Among the Wounds that are Mortal are to be accounted the Wounds of the Brain but not all of them for Experience hath taught us that part of the Brain hath been taken forth and the Life preserved though the Understanding lost Therefore those Wounds of the Brain that be absolutely mortal are 1. When besides the Brains a Nerve is also wounded 2. When Blood or some other Humor obstructs the beginning of the Nerves 3. When after a few days the concrete and putrified Blood produceth a Fever Delirium and Death it self By concreted Blood I understand not that which lies between the Dura-Mater and the Skull for that is to be taken forth by the Trepan and the Patient this way may be preserved but that which is included between the Dura and Pia-Mater or between the Pia and the Brain Although sometimes that which is detained between both Membranes by the dividing of the Dura may be taken forth and so the Patient preserved 2. The Wounds of the Spinal Marrow are also mortal which happens in the Neck or nearer to the Head but those which happen lower as about the Os Sacrum are of lesser danger 3. The Wounds of the Lungs are mortal if great and deep where the great Vessels or the Branches of the Aspera Arteria are hurt Where the Vessels are divided there follows a great effusion of Blood where the Branches of the Aspera Arteria the Breath comes forth more through the Wound than the Mouth 4. Wounds of the heart are always mortal for though one or two wounded in the heart have lived two three or four days it was never found yet that ever any escaped 5. The Wound of the Wind-pipe may be cured if the Membranes only behind to which the Cartilaginous Rings are join'd be hurt but if the Rings themselves are wounded there 's no cure to be expected yet sometimes those wounds being a lingering Death so that I have seen on so wounded live Eighteen weeks before he died 6. Wounds of the Diaphragma those that are inflicted in the fleshy Part of it are curable but those that are in the Nervous Part though these always occasion not sudden Death yet 't is impossible ever to cure them 7. Wounds of the Stomach are sometimes cured those chiefly being mortal that happen in the upper Orifice or in Nerves that are distributed over the Stomach 8. The Wounds of the Small Guts are seldom cured but the Wounds of the Great Guts much oftner especially if they are not great 9. Wounds of the Liver and Spleen are mortal where the Vessels themselves are wounded where not they may be cured 10. Wounds of the Kidneys are not mortal if the Wound penetrate into the Cavity it self for the most part an Ulcer follows which consumes the whole Kidney yet the Patient may continue many years If the Parachyma only be wounded sometimes through difficulty it may be cured 11. Wounds of the Bladder are seldom so perfectly cured but that for the most part there remains a Fistula but those that are made at the neck of the bladder are daily cured 12. Wounds of the great Veins and Arteries are often mortal but every Surgeon understands not rightly to bind up such Wounds therefore the cause of death is not always to be cast upon the guilty 13. Wounds of the great Nerves are for the most part incurable and sometimes mortal 14. Wounds from poisoned Instruments or Creatures generally are mortal Wounds of Nerves Veins Tendons and Membranes are more difficultly and longer of Cure than those of the fleshy parts A Wound from a pricking Instrument is of less danger than from a bruising A Nerve Vein or Artery if wholly divided are less dangerous than if they were but in part A great Inflamation coming upon a great Wound is of no great danger except it continue too long but a great Inflamation falling upon a little Wound is an ill sign The Inflamation for the most part vanisheth by the fifth day therefore if the Wound then appear white livid or black 't is not void of danger A Fever Vomiting and Convulsion are dangerous but a Fever and Vomiting of less danger than a Convulsion CHAP. II. Of the Cure of Wounds in general HEre are required four Intentions 1. To preserve the strength and native heat of the wounded Part. 2. To remove the Symptoms 3. To endeavour that nothing remains or be left behind in the Wound 4. That the gaping Lips of the Wound be joined together and being so joined be kept CHAP. III. Of the preservation of the strength and Native heat in the wounded Part. CHirurgery removes the impediments of Cure but Nature her self cures the Disease which it will scarce effect where the Native heat is weak or the Blood vitiated or where it flows in too great or too little quantity to the Wound in flowing in too great quantity it produceth an Inflammation Pain Putrefaction and many other Symptoms where in too little quantity the Wound is robbed of its Natural Balsam necessary to consolidate it The natural strength and native heat is preserved by a convenient Diet fitted to the temperament of Mans body in general and in particular to the Part affected Of the Diet of the Sanguine Cholerick Phlegmatick and Melancholick we have treated of before
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
answer will be various but most of them very idle and impertinent It hath by some been thought probable that a Plague might proceed from the Heavens they affirming that the Stars do actuate the Subluminary Bodies both by the influence of their Light and by several other qualities inherent in and peculiar unto them But the Conjectors raised from hence are very uncertain and the foundation of them unsecure We are not ignorant of the Fopperies of Astrology and of the vanity of those Predictions which have no other Foundation than the several Courses the Conjunction and Opposition of the Stars which are all so frivolous that we cannot think it worth our labour to refute them We acknowledge that the Air may be several ways corrupted from whence the Vapors which have been received from the Earth are sent down again amongst us which like Fire may inkindle our Blood Corrupt waters Carcasses either not at all buried or else shallowly interred the South-wind which may be supposed to promote the Putrefaction Men already infected successively imparting the Contagion to the sound by that means spreading the Venom through the Bodies of Men the Air itself This Pestilential Infection may likewise for a long time lie couched and concealed in Straw or Stubble amongst Garments Hangings and the Furniture of Beds which we have sometimes observed strangely to impart their Malignity to those that have handled them or approached unto them But all these things only inform us of the means by which this Pestilential Poyson is conveyed unto us but no one hath as yet declared what it is and wherein its Nature doth properly consist The Symptoms of it are these The sick persons are seized with a shivering all over their Body which is presently followed with an inward heat which is oft-times very intense yet without any great thirst somtimes the thirst is excessive the Fever moderate But whether the heat of the Fever be great or small it is most commonly accompanied with a dryness of the Tongue an Urine of the same constitution which you might expect from a man in perfect health They are taken sometimes with a great drowsiness sometimes with a Dilirium or with an excessive pain in the Head in this case the white of the Eyes appeareth of a Saffron-colour they are more wakeful than is consistent with their ease quiet great pain at the Heart the Pulse seems small if not at first when you touch it lightly for then it oftentimes appears to beat high yet at least when you press it closely with your Fingers The strength fails in the beginning of the Disease decreaseth much more visibly than in the most burning Fever which hath no Malignity attending it Some are taken with a Diarrhaea which can by no means be stopt Others bleed much at the Nose the Eyes the Ears or Mouth some at the Yard or Womb. Some are troubled with a continual Vomiting others with a Nauseousness On some Bodies there appear red or purple spots on others Buboes behind their Ears on their Neck under their Chin in the Groin and under the Arm-pits In some there break forth red Wheals or Pushes in others white Bladders or Carbuncles And wheresoever these Bladders Buboes Carbuncles c. do appear they are a most certain sign of the Plague although the bigness of them may be inconsiderable especially if they either accompany or are Consequents of a Fever As to the Prognosticks we must consider that the Plague is a very treacherous Disease and whilst it flatters us most it intends us the greatest mischief A Bubo is less dangerous than a Carbuncle and a Carbuncle than the Spots which very seldom portend less than present death wheresoever they are display'd A Bubo behind the Ears on the Neck or under the Arm-pits is more dangerous than that in the Groin Carbuncles on the Hands and Feet may by some be thought less pernicious because they are more remote from the Heart but since they happen amongst many Nerves and Tendons they are more to be feared than those which appear in other parts of the Body which are better covered with flesh A Carbuncle arising after a Bubo is a sign of Death If a Bubo or Carbuncle appear before the Fever there is less danger than if they follow it at a distance and arise slowly A blew Circle encompassing the Bubo the second day after its appearance is a sign of Death If a Bubo suddenly disappears the state of the Patient is dangerous unless Nature dispatcheth the Malignant Humour to some other Part. Thus we have often observed that upon the retreat of that Morbifick Matter which hath caused a Bubo in the Groin there hath appeared a Gangrene in the Foot and on the same side which was before affected and many have by that means escaped If a Cupping-glass applied to the Patient raiseth no Blister we may reasonably conclude his condition to be desperate It is an infallible sign of Death if after Cauterization or the application of a Cupping-glass the Carbuncle abates not in 12 or 24 hours as likewise if there is no moisture proceeding from it but if a Bladder appears or any separation of the matter be made which is so much the better by how much it is the greater with a sufficient purulency the Patient is then past danger A Carbuncle which seems to have a little tail or push at the end of it is very dangerous as are likewise those which look white which unless the Fever doth very much abate are certain forerunners of Death If the Patient that hath a Bubo in his Neck or behind his Ears be troubled with a pain in his Throat and a difficulty in swallowing and no considerable Inflammation appear we have always found it a certain Rule that in this case he outlives not 12 or 15 hours Sleep more sound than ordinary Diliriums waking often in the night inflammation of the Eyes pain at the Heart a trembling and convulsion of the Joynts are all very dangerous Symptoms but do not always portend Death A great Fever without a pain at the Heart is not so dangerous as a lesser which is accompanied with that Symptom The greatness of the danger may sometimes be judged from the great dryness of the Tongue If by the administration of Sudorificks Sweat is not provoked the Patient usually miscarrieth A Flux of Blood was heretofore held dangerous in all Plagues but in our Age all that can either bleed at the Nose or have their Menstrua's come off safe We have no president of any that have pissed Blood but a Dissentery is the sign of an approaching Death It is very certain although it but seldom happens that incurable Carbuncles do break out about the Eyes Nose Stomach even amidst the Entrails themselves If they seize on the Bladder they become mortal to the Patient and put him to excessive pain I can instance only in one who after he had for
it be not given cold lest Gripings Flux and a pain at the Heart such like Maladies should be caused thereby To such who have weak stomachs a pain at their heart I do use to give the liberty when their Fever abates to drink Mosel or Rhenish-wine with Sugar the juice of Limons provided that they take it in a moderate quantity But I believe they do err very much who prescribe to their Patients whilst the Fever continues still very high some sort of French Wine either alone by it self or mixt with their Sudorificks That Oriental Stone call'd Lapis Porcinus or Pedro Porco is of very great use if it be steeped for a while in your ordinary Drink for it strongly provokes Sweat and very much refresheth the Heart This Stone if I mistake not is generated in the Gall of an Hog for it is exceeding bitter and though it be very hard yet every time it is infused it abates somewhat of its quantity which is discoverable by the Tincture which it imparts to the Liquor Nor is the Gall of a man sometimes void of such Stones which are like unto those taken out of an Hog in savour hardness and colour and we might find them too perhaps in their efficacy likewise if we thought fit to make trial of them This Fever is often accompanied with drowsiness which forbids the use of the principal Sudorificks such as Treacle Mithridate Diascordium c. because there is Opium in their composition which makes them not so effectual for the preventing of sleep It is more requisite to use this following which is agreeable for dispelling the Vapours which infect the Head and the heat about the Heart Take Salt of Rue of Scordium Prunella of each half a scruple Vitriolated Tartar 8 grains our Prophylactick Water an ounce Balm-water as much as sufficeth Syrup of Betony an ounce Mix them for a draught Let Sweat be thereby provoked and let it be the care of the Attendants that after the first or second day the Patient may be kept from sleep if it be found that he hath strength to bear it There is sometimes joyn'd with the Fever continual Watchings and a great pain of the Head I do not use to be much concerned for the watchings although it should continue for the first three days without intermission for it often falls out that by the use of Sudorificks only the pain is the first day abated on the 2d becomes tolerable and on the third is quite taken away Opium hath in it the virtue of causing Sweat and is a great Ingredient in Treacle Diascordium and Mithridate which without it would not in my judgment have that Sudorifick quality for which they are now noted It is also reckoned by several Authors amongst those Medicines which are famous for dispelling of Poison whose use is very requisite in all malignant Fevers nor do I believe that there can any other Medicine be named which gives so present relief to the Patient as Opium concerning the operation whereof they are able to give a better account who have been frequent and curious in the use of it I have sometimes in this case though contrary to Custom given it sparingly when I have found the sick person not to sleep in the first second or third days But when he hath waked for six or seven days together and found a great decay of strength this following Prescription taken every quarter of an hour by a spoonful till sleep hath seized on him hath afforded great relief and the sleep produced thereby hath been undisturbed and of long continuance Take our Prophylactick-water an ounce half Borage-water an ounce Cinamon-water three drams Confection of Hyacinth a dram Lozenges of Sugar pearl'd three drams Laudanum Opiat two grains Mix them You may safely make use of Opium after the manner before mentioned but in Gachectick infirm Bodies whosoever gives it too boldly or is fearful of prescribing it at all discovers that he understands not its Virtue and Efficacy Before I come to the use of Opiat Laudanum I endeavour to ease the pain of the Head by these following viz. by applying Ground-Ivy bruised to the nape of the Neck and to the soles of the Feet and palms of the Hands this or some such like Composition Take Leaves of Rue a handful and half sowre Leaven two ounces Pigeons dung an ounce common Salt half an ounce Elder-Vinegar as much as sufficeth to make it into a Poultice to be applied to the soles of the Feet and palms of the Hands Or Take Bolearmenick seal'd Earth common white Chalk of each half an ounce Vinegar of Marigolds as much as sufficeth Apply it as before To the Forehead I have often applied the Powder of Cloves moistened with the Spirit of Wine for I take Vinegar to be hurtful as are also all Emulsions Vomiting and the Hiccough is another symptom of the Plague It hath been observed by several who have been so curious as to open Bodies which have died of the Plague that Carbuncles have often appear'd in the Stomach and amongst the Entrails whose testimony is not to be rejected since it is so agreeable both to Reason and Experience These If they are not the Cause of the Vomiting and Hiccough may be easily removed by a spoonful of this following Preparation taken cold every quarter of an hour Take Mint-water our Prophylactick-water of each an ounce and half Cinamon-water half an ounce Confection of Hyacinth a dram Salt of Coral a scruple Syrup of Myrtles half an ounce Rose-Julep half an ounce Mix them By the use hereof the Vomiting is usually stay'd especially if the Stomach be sometimes anointed with this following Oyl Take Oyl of Nutmegs by Expression a dram and half Oyl of distill'd Mace half a dram Oyl of Wormwood a dram Mix them In the mean while let the sick person forbear to drink too plentifully and as soon as the Vomit is stayed let him make use of some good Sudorifick Another Symptom of the Plague is a great Flux which is usually a sign that Death approacheth but when the sick person hath not voided meer blood nor any thing of a bloody substance I have sometimes found these following Prescriptions to be successful Let him abstain from all things that are either acid or salt which except in this case are of great use in the Plague and likewise from drinking much But if his thirst be so exceeding great that he cannot bear it let him take one two or three spoonfuls of this following Mixture Take Tormentil-Roots an ounce Red Roses a handful Shaving of Harts-horn a dram Seeds of Sorrel and Mirtle of each a dram Boil them in Smiths water and to nine ounces of the Liquor add of the Confection of Hyacinth a dram Syrup of Mirtles an ounce Mix them Many have also from Treacle alone received great benefit by swallowing a little of it every four hours till they have taken the quantity of a dram as likewise
even to her Head-cloaths and drank Whey in which Tamarinds had been boiled from whence proceeded her sudden change for the worse and upon that her Death and these are the effects of self-conceitedness VIII Helena van Wyngaerden a Servant of mine on the first day had some slight Symptoms of the Disease the next she was taken with Vomiting a pain in the Head and at her Heart especially when she endeavoured to rise from her Bed her Eyes look'd red but her Tongue was well enough and her Fever was but small a few dayes before without my knowledge she had been at an house that was visited I gave her presently a Sudorifick whereupon the third day after a Bubo appeared in the left Groin I continued the use of Sudorificks and the Chirurgeon took care of the Bubo by which means within a fortnight she perfectly recovered and went again about her business IX The Daughter of N. Domer on the second of September complained of a great pain in her head and at her Heart and her Tongue grew black and dry The first and second day we put her into a Sweat and on the third she told us that she was perfectly well her Tongue became moist her Pain her Fever Anxiety left her nevertheless I perswaded her to continue the Sudorificks but she arose and ate and drank went abroad and after that slept well all night but in the morning the former Symptoms returned and in the evening of the same day there appeared Spots and the next morning she died X. N. N. had lain very ill for six dayes at what time I was sent for to him on the twentieth of August he began to be light-headed his Tongue became black and dry and he had a great anxiety at his Heart his Eyes were fixed his Hands trembled and a great Carbuncle discovered it self on his Cheek whose Tail reached to his very Chin which was also hard and much swelled It seem'd to threaten a much greater increase for it was very dry much inflamed and not circumscribed within any bounds To this was added a pain in the Throat which Symptom I conjectured to be mortal and a very intense Fever This desperate case put us in mind of desperate Remedies wherefore being guided by my ow Reason and Experience and perswaded by the Authority of the most Eminent Physitians both Ancient and Modern I boldly recommended to him an actual Cautery which was presently applied by the Chirurgeon without any great pain to the Patient This Operation was perform'd in the Morning at ten of the Clock and between 4 and 5 in the Afternoon it appearâ—d purulent and the Crust began to be separated nor did the Core of it creep any further all which effects I know not from what means they could have been expected besides this In the mean while he sweat plentifully and all things gave his Friends to hope that he would again recover but I was of another mind as knowing well the nature of this treacherous Disease The same Evening he took another Sudorifick and slept quietly enough all night On the 21 day the Cheek that was affected discovered on it some moisture the Fever continued as it was Between his forefinger and his middle one there brake forth a very painful Carbuncle which affected the whole Arm. To this there was applied another actual Cautery without any great alteration discerned in the Patient then we prescribed him a Julep which might cause Sweat some food that was nourishing but no Sweat appear'd the affected places being drier than the rest fore-boded an ill event At 9 in the Morning another Chirurgeon was sent for who approved of whatsoever we had done in this case at midnight he fell into an high Delirium so that he could not be held in his Bed by those which attended about morning he betook himself to rest in one hour after departed Some of his Friends accused me of being negligent which ingratitude I can the better bear since I am conscious to my self and give thanks to God for it that I omitted nothing which the Rules of Art required to be done XI The Wife of Cornelius Janson being fifty years old was after she had been sick two dayes troubled with a Bubo in her Groin and a great anxiety of Heart but the Fever was but small Her Eyes which I do much observe in all sick persons look'd very well as soon as she sweat she began to confess her self better her anxiety was presently removed and her Fever also after few days The Bubo a Blister being first drawn was dressed by a Chirurgeon with the Magnetical Arsenick Plaister She fell sick on the eighteenth of September and her Son on the 23d who was taken with a pain in his Head and refusing all Medicines died within three dayes but she recovered XII Everard Tessalear a Vintner was taken on the 28th of September with a chilness all over him and then with a very great heat his anxiety was great and his breathing difficult accompanied with nauseating a pain in the Head a trembling of the Hands a burning of the Eyes and an intolerable pain on the right side of the Groin yet without an apparent swelling I gave in my Opinion that he was taken with a Pestilential Fever and prescribed some Remedies for that purpose after the first Sudorifick the pain in the Head and Groin abated and the Vomiting was stopped after the second the pain became tolerable and by the fourth it was wholly taken away and the Feaver cured Being so suddenly restored he believed not that there was any Malignity in it and went abroad forthwith which I did very much disallow accusing him of unthankfulness to God and foretelling that he was to suffer somewhat more severe because I could easily perceive his Health and Strength not to be confirmed and that there was need of a further course of Physick to settle it He still refused to hearken to me till on the day following he was attaqued by the same Enemy and his Wife also he first complained of a pain in his Groin and then of a Bubo which Symptoms confirmed the truth of what I had foretold and caused him to repent when it was too late The fear of Death made him now desirous of repeating the Sudorificks by means whereof through the Divine assistance they were both cured in nine dayes though the Bubo continued on the Woman for a Month after XIII Albert N. on the second of October was taken with a great pain at the Heart his Pulse was not to be discerned by a gentle touch his Countenance was like one in an Agony he was extream prone to Vomit and to Sleep but he was pretty well in his Senses his Eyes were not inflamed his Tongue moist the Fever but small and the Thirst not great The Vomiting was presently relieved by the use of those things which we have mentioned in their proper place but the Sweat came but slowly whereupon
which is a round Ligament comprehending the many Tendons of the Hand as it was in a Circle easily divisible into many others 2. Vagina Membranosa which hold in the Tendons contained in the Hand 3. Fissura oblonga framed in each Tendon for the passage of the Tendons of the Muscles moving the third Joynt this serves in nature of a Pully 4. Ossa Sesamoidea Chirurgical Considerations 1. The Shoulder oftentimes is broken or put out of joynt but is oftner afflicted with a Cathar and Gout In a cold Gout I never found any thing more efficacious than the Stiptick Plaister of Crollius mixt with Oyl of Bricks or Philosophers as also the following Plaister Take Naval-Pitch Colophony of each three ounces Mussilages of Marshmallow-roots two ounces and an half Ammoniacum Galbanum Mastick Mirrhe Frankincense of each an ounce and half Propoleos Misletoe of the Oak round Birthwort burnt Brass yellow-Wax Turpentine of each three ounces Oyl of Earth two ounces Make it into a Plaister according to Art In a hot Cathar or the like Gout I have always found this Fomentation of singular use Take Vitriol white and green of each half an ounce prepared Nitre six drams Crude Alom one dram Mirrhe two drams Opium a dram White-Wine half a pint rectified Spirit of Wine ten drams Elder-Vinegar three ounces Mix them for a Fomentation Under the Arm-pits Veneral Buboes appear as well as in the Groins 2. Often tough Phlegm seizeth upon the Joynt of the Shoulder and Elbow from whence comes a stiffness I have learnt by experience to esteem much in this case of Balsom of Peru as also of the following Ointment Take Fox-grease and Rams-grease Fresh-Butter of each two ounces Oyl of Earth-worms an ounce rectified Spirit of Wine four ounces boil them to the consumption of the Spirit of wine then add Oyl of Rosemary of Amber of each three drams of Tiles or of the Philosophers two drams Mix them and make it into an Ointment One or more of the little Bones of the Carpus oftentimes are dislocated which if not presently reduced becomes an incurable evil A Ganglion is here very frequent besides the Cathar and Gout whose cure we have but just now taught 4. In the Metacarpus and Fingers both above and below meet many Tendons which are easily injured in Wounds and Ulcers which is carefully to be observed lest a Palsie follow In which no other Medicines are needful than what we have already in the foregoing declared But these are chiefly to be considered of 1. That the Bandage is not to be bound too hard 2. You must not put in the Probe too deep nor too often 3. The Hand and Fingers are to be placed upright not depending 4. These Parts are easily affected with a Sphacelus which these signs certainly denounce When there is no matter in due time the Lips in the beginning are dry or yield a little thin moisture the heat pulsation and redness is greater here than in the fleshy parts afterwards the Lips are turned in and become livid and at length black In this case all those Medicines are to be applied that may put a stop to the Gangrene and as formerly we have set down CHAP. II. Of the Foot THe Foot is also divided into three parts to wit into the Thigh Leg and Lower Foot The Thigh hath but one Bone to whose motion serves fourteen Muscles Two Flexors Psoas and Illiacus Three Extensors Glutaeus Major Medius and Minimus Three Adductors Triceps Six Abductors Quadragemini obturatoris duo The Abductors and Adductores working together rowl about the Thigh The Thigh-Bone is the greatest of all the Bones of the Body outwardly it buncheth forth and is a little bended inwardly and so descends internally oblique to the Knee It hath three Processes easily separable in Infants The Leg consists of two Bones the greater of which is in the inside and is called Tibia or the greater focile the lesser which is in the outside is call'd Fibula or the lesser Focile both very much resembling the Bones of the Cubit they are a little distant one from the other but are tied together by a Ligament It is moved by eleven Muscles which are Four Extensors Rectus Crureus Vasti duo Four Flexors Biceps Semimembranosus Seminervosus Gracilis Two Adductors Longus and Poplitous One Abductor Fascialis Between the Thigh and Leg lies the Patella or Knee-pan in Infants Cartilaginous in old people hard and strong placed on the outside of the Joynt The Foot is divided into three parts the Tarsus Metatarsus and Toes The Tarsus is moved by six Muscles viz. Two Flevors Tibiaeus anticus Peronaeus Four Extensors Biceps two Gemelli and Soleâ—s to which many add a fifth Tibeaeus posticus Three of these Extensors from one very strong Tendon which is called Cordia Hipocraâ—â—â—a It is made up of seven Bones which are 1. Talus or Astragalus 2. Calx or Os Calcis 3. Os Naviculare or Cimbiforme 4. Os Tesserae or Cuboides 5 6 7. Ossa tria Cuneiformia or Shpaenoidea The Metatarsus consists of five Bones The Toes have fourteen Bones for the great Toe hath but two Joynts The Matacarpus hath no Muscles except Plantaris which is not unlike Palmaris The Muscles of the Toes are seventeen to wit Two Flexors One Extensor of the four Toes for which use 't is furnished with a fourfold Tendon Four Adductors or Lumbricales Ten Abductors or Interossei To the great Toe are peculiar One Flexor One Extensor Two Adductors One Abductor Here also as in the Hand are observed the Ossa sessamoidea which are always placed between the full grown Joynts partly that they may corroborate the Joynts partly that they may defend the tender Joynts in old people they are alwayes numbred from ten to twenty never in Children Chirurgical Considerations The Foot in its natural constitution as also in its Diseases hath many things agreeing with the Hand therefore it would be superfluous to repeat them over again 1. Considerable here is the Sciatick pain caused from a sharp Humor gathered in the Joynt where the Thigh-bone joyns with the Os Ischium when the Ligament tying these Bones together is from such an Humor relaxed the Bone recedes from the natural places and brings upon that part a lameness If the Bone or Cartilage be corroded and the Vessels comprest there follows an Atrophy of the Legs and sometimes of the whole Body 2. Tumors in the Knee are very dangerous and hard of Cure by reason of the firmness of Muscles the great number of Ligaments Tendons and Bones and the cold and dry nature of the parts not being of force sufficient to dissipate the moisture therefore 't is most necessary to assist it with warm Medicines as soon as possible and if any signs of Suppuration appear forthwith let it be opened lest otherwise the Patient becomes lame the Part wastes and at last happens death it self Upon the opening of the Abscess for the most part there follows a gleet
of some Humor which renders the Cure very difficult For this I commend the often praised Restorative Powder 3. A great Tendon is inserted in the Calcaneus or Bone of the Heel which being wounded or much contused brings Convulsions and death it self About this place comes Kibes whose cause is intense cold or heat with driness Here first are observed Fissures in the Skin then follows an Ulceration All fat things and Plaisters profit here especially the following Take Powder of Galls of round Birthwort of each half a dram red Lead a dram Mercury sublimate six grains Litharge Mirrhe of each a dram and half Camphire a scruple Franckincense two drams green Wax as much as sufficeth to make it into a Plaister In the room of green Wax you may take the Fat of Deer or of Rams 4. The Fingers or Toes being frozen must be rubb'd with Snow or with a bruised frozen Turnep then this following Plaister is much commended Take Hogs-grease fresh Oyl of Olives of each an ounce white Wax two ounces boil them a little and make a Plaister 5. Issues are often made in the Joynts we have formerly declared the place In the Arms between the Muscle Deltois and Biceps in the Thigh two fingers breadth above the Knee in the inside in the Leg the uppermost two fingers breadth below the Knee the lowermost two fingers or three above the Ankle That you may make these Issues without pain instead of a Conclusion take this Caustick which works without pain which is also very much to be commended in sordid and cancerous Ulcers and in Excrescencies Take Crude Brimstone white Arsnick Crude Antimony of each two ounces the Brimstone being melted by a gentle fire and stirred about with a Spatula add the Arsnick and Antimony powdred and mix them whilst they are incorporated with the Brimstone and look red Afterwards Take of this Mixture an ounce Caput mortuum of Vitriol half an ounce Mix them and make a Powder let it be washt six times in Spirit of wine and dried for your use A TREATISE OF THE PLAGUE THE Plague is a Disease whose nature is not to be comprehended by us the Cause thereof seems to proceed from a Spirituous and Infectious Vapour which is powerful enough to make a sudden dissolution of the consistence of the Blood by which means the Heart is deprived both of strength and life I do assert that the Nature of it is not to be comprehended by us as well because it is a Punishment inflicted on us by the immediate hand of Almighty God who vouchsafes not that his Incomprehensible Wisdom and Essence which is sometimes faintly described to us should be narrowly pryed into by his creatures as also that it is in it self so mutable that if we should seriously recollect our selves and recount the several Pestilences wherewith all former Ages have been visited we shall not thereby be able to instance in two of that whole number which have agreed with each other in all circumstances From whence we may easily infer that in the Cure of this Disease an Experienced Physician may much more safely follow the Dictates of his own Reason than adhire strictly to the Method Prescriptions of others For although it doth sometimes by the more remarkable symptoms sufficiently evidence it self yet we cannot likely discover its Nature and Essence although we should the most industriously attempt it But that we may cautiously enquire into it we must know that it is sometimes not accompanied by any Fever And it is necessary that what Physician soever is ignorant of this should either by perusing good Authors or his own Experience acquaint himself throughly with it I have been sent for to several Patients my self who although they appeared otherwise in good health not refusing their meat nor disturb'd in their sleep have nevertheless had Buboes arising in their Groin on their Neck under their Arm-pits or behind their Ears which have apparently discovered a greater Malignity than could be discerned in those Buboes which in other persons have been attended by a violent Fever And many hereupon who have been incredulous and lightly regarded the cautions which I have given them upon this account have with great danger to themselves experimented that as soon as those Buboes have sunk down the Pestilential Symptoms which have appear'd have been very dreadful and much more dangerous than in those that have carefully used the means prescribed to them who have been also much more easily and speedily cured than the other Sometimes the Plague is accompanied with a Fever and again there are some Pestilent Fevers without the Plague To distinguish this Fever from the Plague I used to observe that they that are seized with it complain of pain in their Head and Stomach which sometimes is dispersed over the whole Body sometimes it confines it self to the Arm-pits the Neck the Parts behind the Ears or to the Groin To outward appearance there is not the least swelling If the Patient by such means as is requisite be provoked to sweat at the beginning of the Disease the pain utterly ceaseth and in a few dayes he will be perfectly restored to his health the Disease not having at all discovered it self by any outward Symptoms Why such a Fever should be accounted a Species of the Plague I see no reason But there is no one but will confess it to have seized on that Body on which Buboes Carbuncles and Spots do outwardly appear The cause of the Plague is either Internal or External but unto which soever we impute it it is necessary to conclude that there is in it a power of dissolving the natural Consistence of the Blood and depriving the whole Body of its strength As to the Inward Cause which is Meat and Drink it is evident to all that it cannot produce in any Body whatsoever so great sudden a change but it is most certain that by a long continued course of bad Diet the Blood may by degrees be after such a manner dissolved weakned and corrupted that some part of it assuming to it self a malignant quality a man may be surprized by a sudden Disease sometimes be deprived of life it self which hath been observed in sick persons at several times when there hath been no contagion in the place nor any suspected who have been troubled with perfect Buboes and other Symptoms of the Plague much more intolerable than others have been at any time when the Air hath been infected As to the outward Causes every one confesseth that there are such but their Nature is known but to few The Chymists who are able by the force of Fire distinctly to separate the Parts of simple Drugs endeavour to find the Original of the Contagion in a Volatile Salt which suddenly dissolves the fixed Salt of the Blood which hath indeed some appearance of truth though it will not be relished by all men If you enquire into the Cause hereof from others their