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A59999 A short compendium of chirurgery containing its grounds & principles : more particularly treating of imposthumes, wounds, ulcers, fractures & dislocations : also a discourse of the generation and birth of man, very necessary to be understood by all midwives and child-bearing women : with the several methods of curing the French pox, the cure of baldness, inflammation of the eyes, and toothach, and an account of blood-letting, cup-setting, and blooding with leeches / by J.S., M.D. J. S. (John Shirley), M.D.; Shirley, John, 1648-1679. 1678 (1678) Wing S3496; ESTC R38236 39,001 140

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of Eggs which the Antients esteemed to be produced by an intense heat but is more truly atributed to the mixture of some acid humour as can be perceived when a little spirit of Vitriol is powred into some Gall it often degenerates in Poraceous rus●y and glasteous according to its degrees of acidity The Melancholy humour or thickest Blood is by some thought to turn by adustion into black choler but according to Regnerus de Graaf this last proceeds from the mixture of Choler with a too acid pancreatical juice whereby it is turned into a greenish black colour as the Antients describe the atrabiliary humour The Excrementitious humours are also 1. Phlegm 2. Choler 3. Melancholly 4. And Serum They are called excrementitious because they can yield no nourishment to the Body and therefore are expelled 1. Phlegm not to the Brains as the Antients conceived but to the Maxillar Glandules and thence through the Mouth and Nostrils out of the Body 2. Choler by the Cystick arteries to the Gall whence the superfluous part is expelled to the Duodenum and thence evacuated at the Seat 3. Melancholly which is not attracted by the Spleen as the Antients supposed but is an Excrement of the grossest Blood which is often evacuated by the Haemorrhoides and is also sent to the Atrabiliary Capsuls to be perhaps voided with the Urine which therefore appears sometimes of a black colour 4. Serum which is either evacuated First In the form of Vapours by transpiration whereby according to Sanct●rius more than the half part of our Aliments are dissipated Secondly Or in the consistence of Urine which being separated from the bloud in the Kidneys and filtred through the Papillar Caruncles into the Pilorus is powred through the Uriters into the Bladder and having received the thinnest and most serous part of the Chylus immediately from the Stomack by the Gastrick Vein is thence evacuated out of the Body To Serum is also referred Sweat and the Tears we shed A Part or Limb is defined A Body adhering to the whole and partaking of the same life with it being created for the exercising of certain Functions They are distinguished in Similaries and Dissimilaries A Similary part is that which cannot be divided in other parts of a different species and it is twofold Spermatick and Carnal 1. The Spermatick are constructed in the first conformation of the body out of the grossest part of the Seed 2. The Carnal out of the MenstrualBlood The Similary parts are Eleven in number 1. Bones 2. Tendrels 3. Ligaments 4. Tendons 5. Membranes 6. Fibres 7. A threefold flesh the Musculous the Parenchyme and the Glandules 8. The Skin 9. The Veines 10. The Arteries 11. And the Nerves or Sinews The Bones are joyned either by I. Diarthrosis or Articulation with some motion either by 1. Enarthosis when there is a considerable quantity of the Bone received in a large Cavity 2. Arthrodia when the receiving cavity is but Supersiciary 3. Ginglime when a Bone receives and is received II. Symphosis or Coalition without Motion 1. Sutures as in the Bones of the Head 2. Harmony as in the Bones of the Nose and upper Jaw 3. Gomphosis as the Teeth And they are bound either by First Syncondrosis or with a Tendrel Secondly Syndeurosis or a Ligament Thirdly Sysarcosis or with some flesh or muscle Note that to the exercising of the Similary parts Functions there needs only their due temper and commoderation A Dissimilary part is that which may be divided in parts of a different Species Many do confound them with the Organical Nevertheless there is this difference that all Dissimilary parts are Organical but not all Organical Dissimilary for the Bones Veins and Arteries are Similary and yet produce Organical actions Four conditions are requisite to the perfect exercising of the Dissimilaries actions namely 1. A due Conformation 2. Magnitude 3. Number 4. And Conjunction Whereof the last comprehends two others to wit Seat and Connexion These parts are distinguished in First Containing and Secondly Contained And then again in 1. Common and 2. Proper Distinguished in 1. Nobles 2. Ignobles First The Noble or principal parts distributing the Spirits and Faculties to the whole Body are absolutely necessary to it They are three Viz. 1. The Brains 2. Heart 3. Liver Which being excepted all the rest are Ignoble as being subservient to them and they are the other parts of 1. the Head 2. Trunk And 3. 〈◊〉 1. The Head is divided in the Soul and Face the common containing parts whereof are the thin and the hairy Skin the fat and the ●leshy Membrane It s proper parts are the Scalp or Pericrane the Perioste the Muscles the Bones and two Meninges The contained parts of it are the Brain the A●ter-brain and the Marrow The second hath in its upper part the sore-head in the lower the mouth and the instruments of the Senses as the Eyes the Eares the Nose c. 2. The Trunk is distinguished in the Breast and lower Belly the proper containing parts of the first besides the Muscles Bones c. Being the Pap the Midriff the Pleure and the Mediastin The contained are either Bowels as the Heart with its purse the Lungs a part of the Weazon and of the throat or Vessels as some branches of the Vena Cava and great Artery sustained by the thymus in the Throat and several Sinews The lower Bellies proper containing parts are the Muscles of the Panch and the Belly-rim The contained are either employed to Nutrition namely to Chylification as the Stomack the Kall the Sweet-bread the Guts and the Mesentery or to Sanguisication as the Mesaraick Veins the post Vein and the Cava the Liver the Gall the Bladder and the Milt 3. The Ioints are divided in the uppermost containing the great Hand namely the Arm that is the Shoulder from the upper shoulder to the Elbow and the Cubit from the Elbow to the Wrist The lesser Hand divided in the Wrist between the Cubit and the Palm and the fist between the Wrist and the beginning of the Fingers whose inward part is called the Palm and the outward the Back of the Hand The undermost contain the great Foot comprehending the Thigh from the Britch to the Knee the Leg from the Knee to the lesser foot which is divided in the Foot Pedium Metapedium and Toes Before we come to Faculties and Functions it will not be amiss to say what the Soul is They define it The substantial Form of a living Body and the inward principle of the actions thereof For The Soul a Substance and a Spirit is Which God himself doth in the Body make Which makes the man for every man from this The Nature of a Man and Name doth take It s connexion with the Body is called Life and its separation Death Neither is this last greatly to be feared of a Christian since it is but a passage to a better Life and that as saith the Italian Poet. Altro
Saffron make a Cataplasme Note that though this be the general Cure of Impostumes they have nevertheless a more proper and particular one according to their several differences but this is as 't were a Rule whereby to proceed in it CHAP. III. Of Wounds THE General Practice of Impostumes being sufficiently treated of in the former Chapter this shall be adapted to expound such Notions as belong to the Cure of Wounds whereof this is the Definition A Wound is a Solution of Continuity caused by an external Instrument in any part of the Body but the Bones Their Causes are all such things as may violate the outward circumference of the Body and unnaturally enter in it and they are either animated as the biting and stinging of Beasts or inanimated as Swords Darts Bullets c. The difference of Wounds is manifold and as Samoicus saith Tam varia humanae sunt vulnera conditionis Ut nequeant proprias cunctis adscribere curas The Wounds of Men are seen so manifold The proper Cure of each cannot be told Nevertheless I have endeavoured to include the most General in the following Paragraphs The Differences of Wounds are drawn either I. From the nature of the wounded part which is First Similary and that 1. Soft as the Glandules and Flesh. 2. Hard as the Gristles 3. Mean as the Membranes and Ligaments Secondly Diss●milary which is either 1. Principal as 1. The Brains 2. The Heart 3. The Liver 2. Ministring to the principal as 1. Aspera Arteria 2. The Lungs 3. Neither of the foresaid as 1. The Eyes 2. The Hands 3. The Feet II. From their own Essence whereby they are termed First Simple when there is no Complication of other Diseases or Accidents Secondly Composed when there is some other Disease or Accident indicating a peculiar Curation III. From their Quantity by which they are termed First Great that is 1. Long 2. Broad 3. Deep Secondly Mean in all Dimensions Thirdly Little that is 1. Short 2. Narrow 3. Superficious IV. From their Figure whence we call them 1. Strait 2. Round 3. Crooked c. When a Wound doth pierce the Skul ●s known by these following Signs The wounded party doth presently ●all lying without sense as if he were a sleep the Ex●rements are not retain●ed and surely if the blood floweth by the Ears Nostrils or the Mouth and if ●he Vomits Choler c. Whether the Wound penetrates into the Thorax is known if the Air com●eth forth at the Wound with a difficulty of Respiration if there be a gravative ●ain on the Diaphragme which is caused by much Blood lying on that part that must afterward be rejected by coughing A little after cometh a Feaver and stinking breath the Patient can lye but on the Back and hath a perpetual desire of Vomiting it often degenerates in a Fistula When the Lungs are hurt there issueth a Spumous Blood at the Wound with Co●ghing there is a great difficulty of Respiration and pain of the 〈◊〉 We know the Heart to be Wounded by the great quantity of Blood that cometh out at the Wound by a trembling of the whole Body a little Pulse a Paleness of the Face and a cold Sweat and ●requent Swounings a coldness of the Extremities and a hasty Death When the Diaphragme is hurt there is a gravati● pain in that part with Phrensie difficulty of Breath Cough with a sharp pain and a contraction of the flanks upwards These signs appearing one may pronounce Death to be near The Vena Cava or great Artery being hurt Death speedily followeth because of the great loss of Blood and Spirits whence the Function of the Heart and Lungs do cease When the Medulla Spinalis is wounded a Paralysis or Conv●lsion presently hapneth the motion of the lower part is abolished the Excrements of the Belly and Bladder either flow unwittingly or are wholly suppressed The Liver being wounded there cometh a great deal of Blood out at the Wound and a Pungitive pain is felt as far as the Cartilage Xiphoides which Death often followeth When the Stomach is wounded the meat and drink cometh out at the Wound then come Sweats and Cold of the extremities fore-runners of Death If the Spleen be wounded there floweth a blackish blood at the Wound Thirst troubleth the Patient with a pain of the left side and the blood flowing into the Belly causeth many accidents and often Death The Gutts being wounded a great pain torments the Bowels the Excrements issue out at the Wound and sometimes the Gutts out of the Abdomen which afterwards pain and swell When the Kidneys are hurt there is a great pain in making Water the Blood coming out therewith and the pain stretching it self to the Yard and Testicles The Bladder and Ureters being wounded the pain reacheth to the Flanks the parts of the Nombril are extended the Urine cometh out bloody and sometimes out at the wound When the Womb is hurt the Blood cometh out at the Privities the same accidents appearing as when the Bladder is wounded The Nerves being prickt or half cut a sharp pain is felt in the wounded part with a sudden inflammation fluxion tumor feaver and convulsion often with gangrene and death unless it be remedied in time Those Wounds are esteemed dangerous which do affect some principal Sinew Vein or Artery Whereunto are added those that are in●licted in the Privities of Man or Woman or in their parts dedicated to natural excretion as also those that hurt either end of any muscle but such as are in the fleshy parts according to the length of the fibres are esteemed the least considerable If a Bone Sinew Tendrel or a portion of the Face or Prepuce be cut off it cannot be repaired All Wounds in the Bladder Brain Heart Liver Lungs Stomach and smal● Guts are deemed mortal The general indication in the Cure of Wounds is the adjunction of what is separated wherein the Chirurgeon ought to be furnished with five Intentions The first whereof is to extract all strange Bodies as Bullets Darts Arrows Splinters c. if any do hinder the Wounds agglutination The second to bring the divided extremities together The third to keep them so The fourth to preserve the wounded parts temperature The fifth to correct such accidents as may fall out The first of these intentions is performed either with the Fingers or some material Instrument at the first dressing unless the extraction of the foresaid things might occasion an Hemoragy or some other dreadful accident for then the safest is to leave their expulsion to Nature but since it may sometimes not little be advanced by Medicaments take this following description Recipe The Root of Iris of Florence of Panacis and Capers of each three Drachms round Aristaloch Manna and Frankincense of each one Drachm beat them to a powder and incorporate them with Honey of Roses and Turpentine of Venice of each two Ounces Make a Salve thereof The second and third intention in the Cure
Tincture of Aloes extracted with Spirit of Wine and to fortify the part they boyl Aromatick Herbs in Red Wine c. CHAP. IV. Of Ulcers ACcording to our intended scope this Chapter is dedicated to ex●plicate the Theorems of Ulcers and the manner of Curing them They are defined Solutions of Conti●nuity caused by the Mordacity of corrodin● humours rather hurting in quality than in quantity Their external Causes are the excesse● of cold and heat for as saith the Physians Poet. Sunt diversa quidem mala frigoris atque caloris Sed tamen amborum simili nocet Ulcere virus The pain of heat and cold are different To make an Ulcer yet they both conse●● Whereunto is added the apposition of ●harp medicaments blowes contusions and the touching of impure things Their disterences are expressed in the following Discourse An Ulcer is either 1. Simple Varying either by First Proper differences as 1. Figure 2. Quantity 3. Quality Whence it is termed Round Angular Strait Crooked Long Short Broad Deep c. Or Secondly By differences Common and A●cidentar As 1. It s Durance 2. Aspect 3. Generation 4. Affected part And thus they are New Old Appearing Hid Incult Burnt Fleshy Nervous c. 11. Or Composed either with First A Diseases Cause whence it is called 1. Cachochymical 2. Cathartick 3. Poysonous c. Secondly A Disease it self as 1. Intempery 2. Tumor 3. Incommoderation Hot or Moist Phlegmous or Erisipelous Burnt Callous Thirdly Its Symptoms whence it is called Gnawing Filthy Painful c. A gnawing Depascence Ulcer is discerned by the parts exesion attrition cavity and hollowness The stinking exhaleth a putrid unpleasant and cadaverous smell The Sordid is discerned by the crassity and viscosity of its Excrements and the softness of the flesh overgrowing it whereunto if a hardness of the lips be joyned it is deservedly termed Fistulous A Cancrous Ulcer is horrible to look on its lips being overturned are hard livid and moist That which is called Discrative is caused by the humours Intempery And Cacoethes is so termed for the difficulty of healing it The Catherick receives nourishment of some broken or dirupted Vessel or proceeds from an evil disposition of the whole Body Ulcers having had their beginning during a Disease or before it growing livid pale or dry plainly indicate the proximity of Death their livid or pale colour being not only the sing of Cholerick or Atrabiliary humours causing them but also manifesting an extinction of the natural heat That which renders the Cure of Ulcers difficult is commonly a penury of Blood the Bodies evil constitution as also that of the Air the sordidness of the Ulcer and the rottenness of some Bones In simple Ulcers Desiccation is only required and the breeding of flesh in them whereunto the red desiccative Salve and Unguentum Aureum are convenient But in composed ones we must have an eye to the most urgent then to the Cause and lastly to the Disposition without whose taking away the Ulcer cannot be cured Pain is often an accident of Ulcers whereunto must be provided as is declared in the Chapter of Impostumes having a special regard to the humour causing it If there be any Bone corrupted it must be touched with an actual Caustick of hot Iron and such Remedies used to breed flesh in the Ulcer as are above declared in doing which two sorts of excrements do commonly appear namely a thin matter and a thick sordity both which must be purged by drying and detersive Medicaments Whereof take that mentioned in the former Chapter But sublimate Water or the Brown Salve of Felix-●urts are more powerful Then the Cicatice must be induced over the Ulcer to which end the powder of Burnt Alum and Caleanthum are wont to produce speedy and wished Effects CHAP. V. Of Fractures and Dislocations A Fracture or Bone breaking is an accident so dreadful that not without cause the Physitians Poet being about to speak of it makes this deprecation Infandum dictu cunctis procul absit amicis Sed fortuna potens omen convertat in hostes That cursed evil light on none but Foes And Fourtune keep our Friends from the like blows A Fracture is defined A solution of continuity in the Bones and its Causes are all such things as may break cut bruise and quash whereby are also to be understood falls from high places and the like Their differences are manifold for some are termed perfect others imperfect some are simples others composed with hemoragy inflammation gangrene c. They receive a common difference from their figures long transverse strait or crooked Whereunto are added that which is called in Greek Raphanidon when the bone is broken short in two pieces Cariedon when it falls in small Fragments loose from one another and Asphitidon when it is ground small as meal or flower A Fractures existence is known by a vehement pain of the affected part the impotency of it the change of its natural Figure and chiefly by the vacuity which appears to the fingers touching it For the Prognostick in moist weather and in youth Fractures are sooner healed than in dry weather and in old age But the precise time of the over-growing Callus cannot be positively assertained that depending of the Body's and ambient Air 's disposition as also of the Bone's thickness Yet Hippocrates saies the Nose is glutinated in three days the Iaws the Clavicles and Ribs in six the Cubit in nine the Brachium in twelve and the Tibia in fifteen Which may be a Rule for the rest When the Bones are broken near the Joynts their motion is thereby rendred stiff and difficult and if there be great Contusions the part loseth its motion and the Patient is in danger of Death The Cure of Fractures and Dislocations being in many respects one and the same we shall speak joyntly of them both in the end of this Chapter A Dislocation therefore is defined The detrasion of a Bone out of its proper place And it is either Simple by it self or Composed with other Diseases Its Signes are the same as those of Fractures the place of indisposition and its Cavity being the chief differenees Dislocations affecting but the Joynts and causing but an imperfect vacuity in the Dislocated Place If the H●●d be luxated Death immediately follows Recent luxations are easier and sooner cured than Old ones those that are invetcrated are wholly incurable and such as are not far divided are easier reduced in their Seat than far separated ones The common and general Cure of Fractures and Dislocations is performed by 1. Setting the Bones in their natural position 2. Retaining them there 3. Correcting the accidents The first of these is performed by extending the broken or dislocated part from its origin either with the Hands or some fit Instrument then setting it in its due place so that no eminency or roughness be found to alter the figure of it The second point is obtained by the application of restraining and