with a cap stuffed with cotton on that side CHAP. XXIX Of the Wounds of the Neck and Throat THe Wounds of the Neck and Throat are somewhiles simple The differences of wounds of the neck and throat as those which only use the continuity of the muscles otherwhiles compound such as those which have conjoyned with them a fracture of the Bones as of the Vertebrae or hurt of the internal and external jugular Veins or sleepy Arteries sometimes the Trachea Arteria or Weazon and the oesophagus or gullet are wounded sometimes wholly cut off whence present death ensues Wherefore let not the Chirurgeon meddle with such wounds unless he first foretel the danger of death or the loss of some motion to those that are present The Palsie follows upon wounds of the neck For it often happens that some notable nerve or tendon is violated by a wound in the neck whence a Palsie ensues and that absolutely incurable if the wound shall penetrate to the spinal marrow also hurt therewith Wounds of the Gullet and Weazon are difficultly cured because they are in perpetual motion and chiefly of the latter by reason it is gristly and without bloud The wounds of the gullet are known by spitting of bloud Signs that the gullet is wounded by the breaking forth of meat and drink by the wound but if the Gullet be quite cut asunder the Patient cannot swallow at all For the cut parts are both contracted in themselves the one upwards and the other downwards But we know the weazon is hurt by casting up bloud at the mouth with a continual cough and by the coming forth of the breath or wind by the Wound The wounds of the jugular veins and sleepy Arteries are deadly by accident The Wounds of the jugular Veins and sleepy Arteries if they be great are usually deadly because they cannot be straitly bound up for you cannot bind the throat hard without danger of choaking or strangling the Patient But for defect of a strait ligature in this case the flux of bloud proves deadly If the recurrent Nerve of either side be cut it makes the voyce hoarse if cut on both sides it takes away the use of speech by hurting those instruments which impart motion to the muscles of the Larinx For the cure if the wound be small and not associated with the hurt of any notable vessel By hurting the recurrent Nerve the voyce is hurt nor of the Weazon and Gullet it is speedily and easily cured and if there shall be need you shall use a Suture then you shall put therein a sufficient quantity of Venice-Turpentine mixed with Bole-Armenick or else some of my Balsam of which this the Receipt â„ž Terebinth venetae lb ss gum elemi â„¥ iiij olei hypericonis â„¥ iij. boli armen sang draconis an â„¥ j. aqua vitae â„¥ ij The description of the Author's Balsom liquefiant simul omnia lento igne fiat Balsamum ut artis est ad dendo pulveris ireos florent aloes mastiches myrrhae an Ê’ j. I have done wonders with this Balsom in the agglutination of simple wounds wherein no strange body hath been Now when you have put it in The faculty of Diacalcitheos lay upon it a plaister of Diacalcitheos dissolved in Oyl of Roses and Vinegar as that which hath power to repress the flowing down of humors and hinder inflammation or in stead thereof you may apply Emp. de Gratia Dei or Emp. de Janua But if the jugular Veins and sleepy Arteries be cut let the bleeding be stayed as we have shewed in a chapter treating thereof When the Weazon or Gullet are wounded The cure of the wounded Weazon and Gullet the Chirurgeon shall sow them up as neatly as he can and the Patient shall not endeavour to swallow any hard thing but be content to be fed with gellies and broths When a gargarism is needful this following is very good â„ž hordei M. j. florum rosar p. j. passul mund juâ—ubarum an â„¥ ss glycyrhizae â„¥ j. bulliant omnia simul addendo mellis ros Julep ros an â„¥ ij fiat gargarisma ut artis est A Gargarism With which being warm the Patient shall moisten his mouth and throat for it will mitigate the harshness of the part asswage pain cleanse and agglutinate and make him breathe more freely But that the Chirurgeon may not despair of or leave any thing unattempted in such like wounds The manifold use thereof I have thought good to demonstrate by some examples how wonderful the works of Nature are if they be assisted by Art A certain servant of Monsieur de Champaigne a gentleman of Anjou was wounded in the throat with a sword whereby one of the Jugular-veins was cut together with his Weazon A History He bled much and could not speak and these symptoms remained until such time as the wound was sowed up and covered with medicines But if medicines at any time were more liquid he as it were sucked them by the wound and spaces between the stitches and presently put forth at his mouth that which he had sucked or drawn in Wherefore more exactly considering with my self the greatness of the wound the spermatick and therefore dry and bloudless nature unapt to agglutination of the affected part but chiefly of the Weazon and Jugular-vein as also for that the rough Artery is obnoxious to those motions which the gullet performs in swallowing by reason of the inner coat which is continued to the coat of the gullet by which means these parts mutually serve each other with a reciprocal motion even as the ropes which run to the wheel of a pulley furthermore weighing that the Artery was necessary for the breathing and tempering the heat of the heart as the Jugular-veins served for the nourishment of the upper parts and lastly weighing with my self the great quantity of bloud he had lost which is as it were the treasure of Nature I told those which were present that death was near and certainly at hand And yet beyond exceptation rather by divine favour then our Art he recovered his health A strange History Equally admirable is this History following Two Englishmen walked out of the City of Paris for their recreation to the wood of Vincenne but one of them lying in wait to rob the other of his money and a massie chain of gold which he wore set upon him at unawares cut his throat and robbed him and so left him amongst the Vines which were in the way supposing he had kill'd him having with his dagger câ—t the Weazon and Gullet This murderer came back to the City the other half-dead crawled with much ado to a certain Peasant's house and being dressed with such medicines as were present and at hand he was brought to the City and by his acquaintants committed to my care to be cured I at the first as diligently as I could sowed up the Weazon
can for two or three hours in his bed when he wakes let him take some Ptisan or some such like thing and then repeat his bath after the foresaid manner Things strengthening the ventricle He shal use this bath thrice in ten days But if the Patient be subject to crudities of the stomach so that he cannot sit in the bath without fear of swooning and such symptoms his stomach must be strengthened with oyl of quinces wormwood and mastich or else with a crust of bread toasted and steeped in muskadine and strewed over with the powders of roses sanders and so laid to the stomach or behind neer to â—e 13. verteâ—ra of the back under which place Anatomy teaches that the mouth of the stomach lies Epithems shall be applyed to the liver and heart to temper the too acrid heat of these parts Epithems and correct the immoderate dryness by their moderate humidity Now they shal be made of refrigerating and humecting things but chiefly humecting for too great coldness would hinder the penetration of the humidity into the part lying within The waters of bugloss and violets of each a quartern with a little white wine is convenient for this purpose But that which is made of French barly the seeds of gourds pompious or cowcumbers of each three drams in the decoction mixed with much tempering with oyl of Violets or of sweet Almonds is most excellent of all other Let cloaths be dipped and steeped in such epithems and laid upon the part and renewed as oft as they become hot by the heat of the part And because in hectick bodies by reason of the weakness of the digestive faculty many excrements are usually heaped up and dryed in the guts it will be convenient all the time of the disease to use frequently clysters made of the decoction of cooling and humecting herbs flowers and seeds wherein you shall dissolve Cassia with Sugar and Oyl of Violets or Water-lillies What a flux happening in a hect ck feaver indicates But because there often happen very dangerous fluxes in a confirmed hectick Feaver which shew the decay of all the faculties of the body and wasting of the corporeal substance you shall resist them with refrigerating and assisting medicins and meats of grosser nourishment as Rice and Cicers and application of astringent and strengthening remedies and using the decoction of Oats or parched Barly for drink Let the Patient be kept quiet and sleeping as much as may be especially if he be a child For this Feaver frequently invades children by anger great and long fear or the too hot milk of the nurse over-heating in the Sun the use of wine and other such like causes they shall be kept in a hot and moist air have another Nurse and be anointed with oyl of violets to conclude you shal apply medicins which are contrary to the morbifick cause CHAP. XXXIII Of the Wounds of the Epigastrium and of the whole lower Belly How children be cured THe wounds of the lower Belly are sometimes before sometimes behind some only touch the surface thereof others enter in some pass quite through the body so that they often leave the weapon therein some happen without hurting the contained parts others grievously offend these parts the Liver Spleen Stomach Guts Kidneys Womb Bladder Ureters and great Vessels Their differences so that oft-times a great portion of the Kall falls forth We know the Liver is wounded when a great quantity of bloud comes forth of the wound when a pricking pain reaches even to the Sword-like gristle Signs of a wounded liver Signs that the stomach and smaller guts are wounded Signs to know when the greater Guts are wounded Signs that the Kidneys are hurt Signs that the Bladder is wounded Signs that the womb is wounded to which the Liver adheres Oft-times more choler is cast up by vomit and the Patient lyes on his Belly with more ease and content When the Stomach or any of the small Guts are wounded the meat and drink break out at the wound the Ilia or flanks swell and become hard the Hicket troubles the Patient and oft-times he casts up more choler and grievous pain wrings his Belly and he is taken with cold sweats and his extream parts wax cold If any of the greater Guts shall be hurt the excrements come forth at the wound When the Spleen is wounded there flows out thick and black bloud the Patient is oppressed with thirst and there are also the other signs which we said use to accompany the wounded Liver A difficulty of making water troubles the Patient whose reins are wounded bloud is pissed forth with the Urin and he hath a pain stretched to his groins and the regions of the Bladder and Testicles The Bladder or Ureters being wounded the flanks are pained and there is a Tension of the Pecten or Share Bloud is made instead of Urin or else the Urin is very bloudy which also divers times comes forth at the wound When the Womb is wounded the Bloud breaks forth by the Privities and the symptoms are like those of the Bladder The wounds of the Liver are deadly for this part is the work-house of the bloud wherefore necessary for life besides by wounds of the Liver the branches of the Gate or Hollow-veins are cut whence ensues a great flux of bloud not only inwardly but also outwardly and consequently a dissipation of the spirits and strength Prognosticks Lib. 6. cap. 88. But the bloud which is shed inwardly amongst the Bowels putrefies and corrupts whence follows pain a feaver inflammation and lastly death Yet Paulus Aegineta writes that the lobe of the Liver may be cut away without necessary consequence of death Also the wounds of the Ventricle and of the small Guts but chiefly of the Jejunum are deadly for many vessels run to the Jejunum or empty Gut and it is of a very nervous and slender substance and besides it receives the cholerick humor from the Bladder of the Gall. So also the wounds of the Spleen Kidneys Ureters Bladder Womb and Gall are commonly deadly but alwayes ill for that the actions of such parts are necessary for life besides divers of these are without bloud and nervous others of them receive the moist excrements of the whole body and lye in the innermost part of the body so that they do not easily admit of medicins Furthermore all wounds which penetrate into the capacity of the Belly are judged very dangerous though they do not touch the contained Bowels for the encompassing and new air entring in amongst the Bowels greatly hurts them as never used to the feeling thereof add hereto the dissipation of the spirits which much weakens the strength Neither can the filth of such wounds be wasted away according to the mind of the Chirurgeon whereby it happens they divers times turn into Fistula's as we said of wounds of the Chest and so at length by collection of matter cause death
out by putting in of warm water made it credible that the plant was poysoned by their spittle and urine whereby you may understand how unwisely they do who devour herbs and fruits newly gathered without washing Also we must take heed lest falling asleep in the fields we lie not near the holes which toads or other venomous beasts of the same nature have made their habitation For thence a venomous or deadly air may be drawn into the lungs May frogs For the same cause we must abstain from eating of frogs in the month of May because then they engender with toads Oxen in feeding somtimes lick up smalltoads together with the grass which presently will breed their great harm for thereupon the Oxen swell so big that they often burst withall Neither is the venom of toads deadly only being taken inwardly but even sprinkled upon the skin unless they forthwith wipe the place and wash it with urine water and salt Such as are poysoned by a toad turn yellow swell over all their bodies are taken with an Asthmatick difficulty of breathing a Vertigo convulsion swounding and lastly by death it self These so horrid symptoms are judged inherent in the poyson of toads not only by reason of the elementary qualities thereof coldness and moisture which are chiefly predominant therein but much rather by the occult property which is apt to putrefie the humors of that body whereto it shall happen The cure Therefore it will be convenient to procure vomit especially if the poyson be taken by the mouth to give glysters and to weaken the strength of the poyson by hot and attenuating Antidotes as treacle and mithridate dissolved in good wine but in conclusion to digest it by baths stoves and much and great exercise Rondeletius in his book de piscibus affirms the same things of the cursed venom of toads as we have formerly delivered yet that they seldom bite but that they cast forth either their urine the which they gather in a great quantity in a large bladder or else their venomous spittle or breath against such as they meet withall or assail besides the herbs which are tainted by their poysonous breath but much more such as are sprinkled with their spittle or urine are sufficient to kill such as eat them Antidotes against the poyson of Toads The Antidotes are juice of betony plantane mug-wort as also the blood of Tortoises made with flower into pils and forthwith dissolved in wine and drunken Plinye writes that the hearts and spleens of Toads resist poyson The vulgar opinion is false who think that the Toad-stone is found in their heads which is good against poyson CHAP. XXV Of the Stinging of a Scorpion The description of a Scorpion His tail A Scorpion is a small creature with a round body in form of an egg with many feet and a long tail consisting of many joynts the last whereof is thicker and a little longer then the rest at the very end thereof is a sting it casts in some two hollow and replete with cold poyson the which by the sting it casts into the obvious body it hath five legs on each side forked with strong claws not unlike to a Crab or Lobster but the two foremost are bigger then the rest they are of a blackish or sooy colour they go aside aside and oft-times fasten themselves with their mouths and feet so fast to them Winged Scorpions that they can scarce be plucked there-hence There be some who have wings like the wings of Locusts wasting the corn and all green things with their biting and burning Such are unknown in France These flie in divers countries like winged Ants. This is likely to be true by that which Matthiolus writes that the husband-men in Castile in Spain in digging the earth oft-times finde a swarm of Scorpions which betake themselves thither against winter Plinie writes that Scorpions laid waste a certain part of Ethiopia by chasing away the inhabitants The Antients made divers kinds of Scorpions according to their variety or difference of colours some being yellow others brown reddish ash-coloured green whitish black dusky some have wings and some are without They are more or lesse deadly according to the countries they inhabit In Tuscany and Scithia they are absolutely deadly but at Trent and in the Iland Pharos their stinging is harmless Symptoms The place stung by a Scorpion presently begins to be inflamed it waxeth red grows hard and swells and the patient is again pained he is one while hot another while cold labour presently wearies him and his pain is some-whiles more and som-whiles less he sweats and shakes as if he had an Ague his hair stands upright paleness dis-colours his members and he feels a pain as if he were pricked with needles over all his skin winde flieth out backwards he strives to vomit and go to stool but doth nothing he is molested with a continual fever and swounding which at length proves deadly unless it be remedied Dioscorides writes Lib. 2. cap. 44. lib 6. ca. 10. that a Scorpion beaten and laid to the place where he is stung is a remedy thereto as also eaten rosted to the same purpose It is an usual but certain remedy to annoint the stung place with the oil of Scorpions There be some who drop into the wound the milky juice of figs others apply calamint beaten other-some use barly-meal mixed with a decoction of Rue Snails beaten together with their shells and laid thereon presently asswage pain Sulphur vivum mixed with Turpentine and applied plaster-wise is good as also the leaves of Rue beaten and laid thereto In like sort also the herb Scorpioides which thence took its name is convenient as also a briony-root boiled and mixed with a little sulphur and old oil Lib. 3. cap. 1. Dioscorides affirms Agarick in powder or taken in wine to be an Antidote against poysons verily it is exceeding good against the stingings or bitings of Serpents Yet the continual use of a bath stands in stead of all these as also sweat and drinking wine some-what allaid Now Scorpions may be chased away by a fumigation of Sulphur and Galbanum also oil of Scorpions dropped into their holes hinders then coming forth Juice of raddish doth the same For they will never touch one that is besmeared with the juice of radish or garlick yea verily they will not dare to come near him CHAP. XXVI Of the stinging of Bees Wasps c. BEes Wasps Hornets and such like cause great pain in the skin wounded by their stinging by reason of the curstness of the venom which they send into the body by the wound yet are they seldom deadly but yet if they set upon a man by multitudes they may come to kill him For thus they have sometimes been the death of horses Wherefore because such as are stung by these by reason of the cruelty of pain may think they are wounded by a more
Christ and love toward his neighbors with hope of life everlasting left that he being carried away by favor or corrupted with money or rewards should affirm or testifie those wounds to be small that are great and those great that are small for the report of the wound is received of the Surgeon according to the Civil Law Wounds termes great for three respects It is recorded in the works of antient Physicians that wounds may be called great for three respect The first is by reason of the greatness of the dissolved Unity or resolution of Continuity and such are these wounds which made by a violent stroke with a back-sword have cut off the arm or leg or overthwart the breast The second is by reason of the dignity or worthiness of the paâ—t now this dignity dependeth on the excellency of the action therefore thus any little wound made with a bodkin knife in any part whose substance is noble as in the brai Heart Liver or any other part whose action and function is necessary to preserve life as in the Weasant Lungs or Bladder is iudged great The third is by reason of the greatness and ill habit or the abundance of ill humors or debility of all the wounded body so those wounds that are made in the nervous parts and old decayed people are said to be great But in seaching of wounds let the surgeon take heed that he be not deceived by his probe For many times it cannot go into the bottom of the wound but stoppeth and sticketh in the way either because he hath not placed the patient in the same posture wherein he was when he received his hurt or else for that the stroke being made down right slipt aside to the right or left hand or else from below upwards or from above downwards and then he may expect that the wound is but little and will be cured in a short time How long a Surgeon must suspend his judgment in some cases when it is like to be long in curing or else mortal Therefore from the first day it behooveth him to suspend his judgment of the wound until the ninth for in time the accidents will shew themselves manifestly whether they he small or great according to the condition of the wound or wounded bodies and the state of the air according to his prinitive qualities or venemous corruption General signs whereby we judg of diseases But generally the signs whereby we may judg of diseases whether they be great or small of long or short continuance mortal or not mortal are four For they are drawn either from the nature and essence of the disease or from the cause or effects thereof or else from the similitude proportion and comparison of those diseases with the season or present constitution of the times Therefore if we are called to the cure of a green wound whose nature and danger is no other but a simple solution of Continuity in the musculous flesh we may presently pronounce that wound to be of no danger and that it will soon be cured But if it have an Ulcer annexed unto it that is if it be fanious then we may say it will be more difficult and long in curing and so we may pronounce of all diseases taking a sign of their essence and nature But of the signs that are taken of the causes let this be an example A wound that is made with a sharp-pointed and heavy weapon as with an halberd being stricken with great violence must be accounted great yea and also mortal if the accidents be correspondent But if the patient fall to the ground through the violence of the stroke if a cholerick vomiting following thereon if his sight fail him together with a giddiness if blood come forth at his eyes and nostrils if distraction follow with loss of memory and sense of feeling we may say that all the hope of life remaineth in one small sign which is to be deduced from the affects of the wound But by comparing it unto the season that then is and diseases that then assault mans body Wounds deadly by the fault of the air we may say that all those that are wounded with Gun-shot are in danger of death as it happened in the skirmishes at the siege of Rean and at the battle of Saint Denis For at that time whether it were by reason of the sault of the heavens or air through the evil humors of mans body and the disturbance of them all wounds that were made by Gun-shot were for the most part mortal So likewise at certain seasons of the year we see the small-pocks and meazles break forth in children as it were by a certain pestilent contagion to the destruction of children only inferring a most cruel vomit and lask and in such a season the judgment of those diseases is not difficult Signs of a fractured scull But you by the following signs may know what parts are wounded If the patient fall down with the stroke if he lye â—ensless as it were asleep if he avoid his excrements unwittingly if he be taken with giddiness if blood come out at his ears mouth and nose and if he vomit choler you may understand that the scull is fractured or pierced through by the defect in his understanding and discourse You also may know when the scull is fractured by the judgment of your external senses as if by feeling it with your finger you finde it elevated or depressed beyond the natural limits if by striking it with the end of a probe when the Perictanium or nervous film that investeth the scull is cut cross-wise and so divided there from it it yield a base and unperfect sound like unto a pot-sheard that is broken or rather like to an earthen-pitcher that hath a cleft or rent therein But we may say that death is at hand if his reason and understanding fail him Signs of death by a wound on the head if he be speechless if his sight forsake him if he would tumble head-long out of his bed being not at all able to remove the other parts of his body if he have a continual fever if his tongue be black with driness if the edges of the wound be black or drye and cast forth no sanions matter if they resemble the colour of salted-flesh if he have an apoplexy phrensie convulsion or palsie with an involuntary excretion or absolute suppression of the urine and excrements Signs that the throat is cut You may know that a man hath his throat that is his weason and winde-pipe cut First by the sight of his wound and next by the abolishment of the function or office thereof both wayes for the patient can neither speak nor swallow any meat or drink and the parts that are cut asunder divide themselves by retraction upwards or downwards one from another whereof cometh sudden or present death You may know that a wound hath pierced into the brest or
concavity of the body Signs that a wound hath pierced in the concavity of the chest if the air come forth at the wound making a certain whizzing noise if the patient breathe with great difficulty if he feel a great heaviness or weight on or about the midriff whereby it may be gathered that a great quantity of blood lieth upon the place or midriff and so causeth him to feel a weight or heaviness which by little and little will be cast up by vomiting But a little after a fever commeth and the breath is unsavory and stinking by reason that the putrifying blood is turned into sanies the patient cannot lye but on his back and he hath an often desire to vomit but if he escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting Signs that the Lungs are wounded That the Heart is wounded he is vexed with a grievous shortness of breath and with pain in his sides We may perceive the heart to be wounded by the abundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse paleness of the face cold sweat with often swooning coldness of the extreme parts and sudden death When the midriff which the Latins call Diaphragma is wounded The Midriff the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortness of winde a cough and fit of grievous pain and drawing of the intrals upwards Wherefore when all these accidents appear we may certainly pronounce that death is at hand Death appeareth suddenly by a wound of the hollow Vein or the great Artery The Vena Cava and great Artery by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindered The marrow of the back bone being pierced The spinal marrow the patient is assaulted with a palsie or convulsion very suddenly and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood cometh out at the wound The Liver and pricking-pain disperseth it self even unto the sword-like gristle which hath its situation at the lower end of the breast-bone called Sternon the blood that followeth from thence down into the intestines doth oft-times infer most malign accidents yea and sometimes death When the stomach is wounded the meat and drink come out at the wound The Stomach there followeth a vomiting of pure choler then commeth swearing and coldness of the extreme parts and therefore we ought to prognosticate death to follow such a wound When the Milt or Splene is wounded black and gross blood cometh out at the wound The spleen the patient will be very thirsty with pain on the left side and the blood breaks forth into the belly and there purrifying causeth most malign and grievous accidents and often-times death to follow When the guts are wounded the whole body is griped and pained The Guts the excrements come out at the wound whereat also oft-times the guts break forth with great violence When the reins of Kidnies are wounded the patient will have great pain in making his urine The Kidnies and the blood commeth out together therewith the pain commeth down even unto the groin and yard and testicles When the Bladder and Ureters are wounded the pain goeth even unto the entrails The Bladder the parts all about and belonging to the groin are d stended the urine is bloody that is made and the same also commeth oftentimes out of the wound When the womb is wounded the blood commeth out at the privities The womb and all other accidents appear like as when the bladder is wounded The nerves When the sinews are pricked or cut half asunder there is great pain in the affected place and there followeth a sudden inflammation flux abscess fever convulsion and oftentimes a gangrene or mortification of the part whereof commeth death unless it be speedily prevented Having declared the signs and tokens of wounded parts it now remaineth that we set down other signs of certain kindes of death that are not common or natural whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgment of the descreet Physician or Surgeon Signs that an infant is smothered or over-laid Therefore if it chance that a nurse either through drunkenness or negligence lies upon the infant lying in bed with her and so stifles or smothers it to death If your judgment be required whether the infant died through the default or negligence of the nurse or through some violent or sudden disease that lay hidden and lurking in the body thereof you shall finde out the truth of the matter by these signs following For if the infant were in good health before if he were not froward or crying if his mouth and nostrils now being dead be moistened or bedewed with a certain foam if his face be not pale but of a Violet or Purple colour if when the body is opened the Lungs be found swoln and puffed up as it were with a certain vaporous foam and all other intrails sound it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corps of a man be found lying in a field or house alone and you be called by a Magistrate to deliver your opinion whether the man were slain by lightning or some other violent death you may by the following signs finde out the certainty hereof Signs of such as are slain by lightning For every body that is blasted or stricken with lightning doth cast forth or breathe out an unwholsome stinking or sulphureous smell so that the birds and sowls of the air or dogs will not once touch it much less prey or feed upon it the part that was stricken oftentimes sound and without a wound but if you search it well you shall finde the bones under the skin to be bruised broken or shivered in pieces Lib. 2. cap. 54. But if the lightning hath pierced into the body with making a wound therein according to the judgment of Pliny the wounded part is far colder then all the rest of the body For lightning driveth the most thin and fiery air before it and striketh it into the body with great violence by the force whereof the heat that was in the part is soon dispersed wasted and consumed Lightning doth alwaies leave some impression or sign of some fire either by ustion or blackness for no Lightning is without fire Moreover whereas all other living creatures when they are
the meanest of the common people is not ignorant that the solution of continuity is to be cured by repairing that which is lost But in what parts we may hope for restitution of the lost substance and in which not is the part of a skilful Chirurgeon to know and pronounce Wherefore he will not vainly bestow his labour to cure the nervous part of the Diaphragma or Midriffe being wounded or the Heart or small Guts Lungs Liver Stomach Brain or Bladder and that I may speak in a word Empericks are not much more skilful than the common people although they do so much extol themselves above others by the name of Experience For although experience be another instrument to find out things with reason Experience without reason is like a blind man without a guide yet without reason it will never teach what the substance of the part in which the disease lies may be or what the action use site connexion from whence special and proper Indications are drawn With which the Chirurgeon being provided and instructed shall not only know by what means to find out a remedy but also lest he may seem to mock any with vain promises he shall discern what diseases are uncurable and therefore not to be medled withal Indications in implicit diseases But implicit or intricate diseases require each to be cured in their several order except some one of them be desperate or so urge and press that the Physitian think it necessary after a preposterous order to begin with it although often he be forced to make some one of these diseases incurable or give occasion of causing some new one into which straits we are necessarily compelled to fall when for example we determine to pull or take away some extraneous body for the performance whereof we are compelled to inlarge the wound So we are forced by necessary to open the neck of the bladder that so we may draw forth the stone therein contained with a wound which oâ—ten degenerates into an uncurable Fistula For that disease which threatens danger of present death is of such moment that to shun that it may be counted a small matter and commodious for the sick to bring in other diseases though uncurable For if a convulsion happen by pricking a Nerve which we cannot heal by any remedies then by cutting the Nerve asunder we end the convulsion but deprive the part into which that Nerve did go of the use of some voluntary motion So if in any great joynt there happen a Luxation with a wound because there is danger of convulsion by trying to restore and set right the luxated part we are forc'd for shunning thereof to attend the wound only and in the mean time to let alone the Luxation Otherwise in implicit diseases if there be nothing which may urge or call us from the ordinary cure we must observe this order that beginning with that affect which hinders the cure of the principal disease we prosecute the rest in the same their proper order until all the diseases being overcome we shall restore the part affected to its integrity An example of Indications in implicit diseases Therefore let us take for an example an ulcer in the Leg a Varix or big-swollen vein and a Phlegmonous tumor round about it and lastly a body wholly plethorick and filled with ill humors order and reason require this that using the advice of some learned Physitian we prescribe a convenient dyet and by what means we may bring him to an equality by purging and blood-letting and then we will scarifie in divers places the part where it is most swollen then presently apply Leeches that so we may free it from the burden of the conjunct matter then use Cauteries to help the corruption of the bone and in the mean time change the circular figure of the ulcer into an oval or triangular then at the length we will undertake the cutting of the Varix and cure the ulcer which remains according to Art and so at the length cicatrize it In all this whole time the Patient shall neither walk nor stand nor sit What we must do when the temper of the part is different from the temper of the whole body but ly quietly having his Leg orderly and decently rowled up But if as it often happens the temper of the hurt part be different from the temper of the whole body the manner of curing must be so tempered that we increase the doâ—â—s of hot or cold medicines according to the ratable proportion of the indications requiring this or that therefore imagine the part ulcerated to be such as that it is two degrees dryer than the just temper but the whole body to exceed the same temper in one degree of humidity Reason and Art will require that the medicine applyed to the ulcer be dryer by one degree than that which the part would otherwise require if it were temperate But on the contrary let us suppose thus the whole body to be one degree more moist then the temper requires and the ulcerated part to be one degree dryer An artificial conjecture is of much force in Indications truly in this case the medicine that is applyed to the ulcer by reason of the part it self shall not be increased in dryness but wholly composed and tempered to the Indication of the ulcer because the force of the moisture exceeding in the like degree doth counterpoise the superfluous degree of dryness But it is more easie by an artificial conjecture to determine of all such things than by any rules or precepts To these so many and various Indications I think good to add two other the one from similitude the other of a certain crafty devise and as the latter Physitians term it a certain subtile stratagem We draw Indication from similitude in diseases which newly spring up and arise Indications from similitude as which cannot be cured by Indications drawn from their contraries as long as their Essence is unknown and hid wherefore they think it necessary to cure them by a way and Art like those diseases with which they seem to have an agreeing similitude of Symptomes and Accidents Our Ancestors did the same in curing the French-Pocks at the first beginning thereof as long as they assimilated the cure to that of the Leprosie by reason of that affinity which both the diseases seem to have But we follow crafty devices and subtile counsels Indication of a subtile device when the Essence of the disease we meet with is wholly secret and hid either because it is altogether of a hidden and secret nature and which cannot be unfolded by manifest qualities or else resides in a subject which is not sufficiently known to us nor of a physical contemplation as the Mind For then we being destitute of Indications taken from the nature of the thing are compelled to turn our cogitations to impostures and crafty counsels and they say this
a notable Knave and one of those Impostors who would pawn his life that he would make him sound wherefore this Honourable Personage being in this desperate case was committed unto his care First of all he bid they should give him the Patient's shirt which he tore into shreds and pieces which presently framing into a Cross he laid upon the wounds whispering some conceived or coined words with a low murmur For all other things he wished the Patient to rest content and to use what diet he pleased for he would do that for him which truly he did For he eat nothing but a few prunes and drunk nothing but small Beer yet for all this the wounded Prince died within two days the Spaniard slipt away and so scaped hanging And whilest I opened the body in the sight of the Physitians and Chirurgeons to embalm him the signs and accidents of the wound did evidently and plainly appear to be as we had pronounced before And there be also other Jugling companions of this Tribe What wounds may be cured only by lint or by tents and Water who promise to cure all wounds with Lint or Tents either dry or macerated in oyl or water and bound to the wound having murmured over some charm or other who have had sometimes good success as I can witness But the wounds upon which tryal was made were simple ones which only required union or closing for to perfect the cure So verily the bones of beasts when they be broke grow together by the only benefit of nature But when the affect shall be compound by diversity of Symptoms as a wound with an ulcer inflammation contusion and fracture of a bone you must hope for no other from Tents or Lints nor Charms than death Therefore the common sort who commit themselves to these Impostors to be cured do not only injure themselves but also hurt the Common-wealth and the common profit of the Citizens for whose good and justice sake a prudent Magistrate ought to deprive Impostors of all freedom in a free and Christian Commonweal Witches Conjurers Diviners Soothsayers Magicians and such like boast of curing many diseases but if they do or perform any thing in this kind they do it all by sleights subtilties and forbidden Arts as Charms Conjurations Witcheries Characters Knots Magical Ligatures Rings Images Poysons Laces tied across and other damnable tricks with which they pollute pervert and defame the prime and sacred Art of Physick and that with the danger of mens lives Who certainly are to be banished by the Laws of our Countrey especially seeing it is decreed in Moses Law Leâ— nâ—ne be found amâ—ng you that useth witchcraft or a regarder of times Deut. 18. or a marker of the flying of Fowls or a Sorcerer or a Charmer or that counsulteth with Spirits or a Soothsayer or that asketh counsel at the dead for all that do such things are abomination to the Lord and because of these abominations the Lord thy God doth cast them out before thee But the Miracles of our Lord Jesus Christ the Son of God and of his Saints and Apostles in curing diseases beyond nature and all Art are of another kind which we ought to believe so firmly and constantly that it should be counted an impiety for a Christian to doubt of them All holy Writings are full of these as to give sight to the blind hearing to the deaf power to go to those sick of the Palsie to drive forth Devils to cure the Leprosie to give fruitfulness to women to raise the Dead and perform by the holy Ghost other Miracles which exceed the condition and law of Naâ—re whom here we earnestly intreat to free and protect us from unclean Devils and the spirits of diabolical deceit and to give us the mind that we may will and be able always to aspire to Heaven and fasten the hope safety and anchor of all our fortunes in God alone Amen The End of the first Book The Second BOOK Of Living Creatures and of the Excellency of Man The difference of brute beasts BEfore I come to speak of the Anatomy of Man's body I have thought fit to say a little of the nature of brute Beasts There is between Beasts a great deal of difference by nature for of these some are hardy and bold others fearful some wilde and savage others tame some walking in herds others wandring alone some covered and defended with shels and scales as the Crocodile the Tortois and many kinds of fish others have stings and pricles The Horse hath his hard and strong hoofs his crest as being a generous beast beset with a thick and harsh mane The defence of the magnanimous Lion are his teeth his crooked paws and tail Buls are formidable by their horns The Boar by his tusks standing out as it were natural hunting-spears The Hare being a timerous creature is naked and unarmed but in recompence thereof Nature hath made her nimble and swift of foot For what the more noble and courageous Beasts have in arms is supplyed in the fearful by nimbleness and celerity Infinite are the other endowments of brute Beasts and such as can hardly be imagined or described For if we diligently search into their nature Some shadow of vertue in beasts we shall observe the impressions and shadows of many vertues as of magnanimity prudence fortitude clemency and docility for they entirely love one another follow those things that are good shun those that are hurtful and gather and lay up in store those things that are necessary for life and food Lastly they give undoubted presages of the weather and air They have taught men many things and are of a most exquisit and quick sense of rare art in vocal musick prudent and careful for their young and faithful lovers of their native soil They are religiously observant of the rights of friendship and chastity They have their weapons whereby they are prepared both to invade and to defend themselves being invaded They submit themselves to the discipline of man practise and imitate his speech and mutually prattle chant one to another They have a kind of weal-publick amongst themselves and know how to preserve their present welfare and to depel the contrary being in this their own counsellors and not tutored by man Yea man is beholden to them for the knowledge of many wholsom things The consideration of which bred so great a doubt amongst the antient Philosophers that it was a question amongst them whether Beasts had use of reason or no Therefore also the wise Solomon sends us for examples of parsimony and diligence unto the Ant or Pismire and Esaias in exprobration of the people of Israel for their ingratitude and rebellion against God sends them to the Ox and Ass for they do not only know but reverence their Masters Liâ— 8. cap. 27. But from whence is the knowledge of these Medicins wherewith the Art of Physick is so richly adorned but from
the upper lip that so it may draw it to the lower The other broader and shorter begins at the lower part of the chin and the hollowness thereof and ends at the lower lip which it makes opening it within and without by its internal and external fibers as we also said of its opposite And that I may speak in a word Nature hath framed three sorts of Muscles for the motion of the Mouth of which some open the Mouth others shut it and othersome wrest it and draw it awry but you must note that when the Muscles of one kind joyntly perform their functions as the two upper which we described in the first place on each side one which draw the lower lip to the upper and the Muscles opposite to them they make a right or streight motion but when either of them moves severally it moves obliquely as when we draw our mouth aside But these Muscles are so fastned and fixed to the skin that they cannot be separated so that it is no great matter whether you call it a musculous skin or a skinny Muscle Which also takes place in the palms of the hands and soles of the feet but these muscles move the lips the upper jaw being not moved at all CHAP. IX Of the Muscles of the lower Jaw WE have said these Muscles are five in number that is four which shut it Their number and one which opens it and these are alike on both sides The first and greater of these four Muscles which shut the Jaw is called Crotophita or Temporal muscle The Temporal muscle it arises from the sides of the fore-head and Bregma-bones and adhering to the same and the stony-bone it descends under the yoke-bone from whence it inserts it self to the process of the lower Jaw which the Greeks call Corone that it may draw it directly to the upper so to shut the Mouth But you must note that this Muscle is tendinous even to his Belly VVhy the wounds of the temporal muscle are deadly and that it fils and makes both the Temples It is more subject to deadly wounds than the rest by reason of the multitude of nerves dispersed over the substance thereof which because they are neer their original that is the Brain they infer danger of sodain death by a Convulsion which usually follows the affects of this Muscle but also in like manner it causes a Feaver the Phrensie and Coma. The Figure of the chief Muscles of the Face A The Muscle of the Fore-head and the right fibers thereof B the Temporal Muscle α β γ his semicircular original D the Muscle of the upper lip G the Yoke-bone under which the Temporal Muscles pass I the Masseter or Grinding-Muscle K the upper Gristle of the Nose M a Muscle forming the Cheeks N the Muscle of the lower-lip O a part of the fifth Muscle of the lower Jaw called Digastricus that is double-bellyed Q R the first Muscle of the Bone Hyoides growing unto the rough Artery S the second Muscle of the Bone Hyoides under the Chin. T the third Muscle of the Bone Hyoides stretched to the Jaw T K the seventh Muscle of the Head and his insertion at T. V V the two venters of the fourth Muscle of the Bone Hyoides φ the place where the Vessels pass which go to the head and the Nerves which are sent to the Arm. Therefore that it should be less subject or obvious to external injuries Nature hath as it were made it a retiring place in the Bone and fortified it with a wall of Bone raised somewhat higher about it The Masseter or Grinding-Muscle The other Muscle almost equal to the former in bigness being called the Masseter or Grinding-Muscle makes the Cheek it descends from the lowest part of the greatest Bone of the Orb which bends it self as it were back that it may make part of the Yoak-bone and inserts it self into the lower Jaw from the corner thereof to the end of the root of the process Corone that so it may draw this Jaw forward and backward and move it like a Hand-mill Wherefore Nature hath composed it of two sorts of fibers of the which some from the Neck the Cheek in that place under the Eyes standing somewhat out like an Apple arising from the concourse of the greater Bones of the Orb and upper Jaw descend obliquely to the corner and hinder-part of the lower Jaw that it may move it forwards Othersome arise from the lower-part of the same yoke-bone and descending obliquely intersect the former fibers after the similitude of the letter X and insert themselves into the same lower Jaw at the roots of the process Corone that so they may draw it back Truly by reason of these contrary motions it is likely this Muscle was called The Masseter or Grinder The Round-muscle The third which is the round Muscle arises from all the Gums of the upper Jaw and is inserted into all the Gums of the lower investing the sides of all the Mouth with the Coat with which it is covered on the inside being otherwise covered on the out-side with more fat than any other Muscle The action thereof is not only to draw the lower Jaw to the upper but also as with a shovel to bring the meat dispersed over all the mouth under the Teeth no otherwise than the Tongue draws it in The lesser muscle of the lower jaw The fourth being shorter and less than the rest arising from all the hollowness of the winged process of the Wedge-bone is inserted within into the broadest part of the lower Jaw that so in like manner it may draw the same to the upper This is the Muscle through whose occasion we said this lower Jaw is sometimes dislocated The Figure of the Muscles of the lower Jaw A A hole in the Fore-head Bone in the brim of the seat of the Eye sending a small Nerve of the third pair to the Muscles of the Fore-head and the upper Eye-brow B. The Temporal Muscle The fift and last muscle The fifth and last Muscle of the lower Jaw from the process Styloides of the Stony-bone ascends to the fore-part of the Chin neer to the connexion of the two bones of this Jaw to draw this Jaw downwards from the upper in opening the mouth This Muscle is slender and tendinous in the midst The use of these mentioned muscles that so it might be stronger but it is fleshy at the ends All these Muscles were made by the singular Providence of Nature and engraffed into this part for the performance of many uses and actions as biting asunder chawing grinding and severing the meat into small particles which the tongue by a various and harmless motion puts under the teeth Thus much I thought good to say of the parts of the Face as well containing as contained CHAP. X. Of the Ears and Parotides or Kernels of the Ears The nature and composition of the ears VVhat the Fibra
within by the stroak may cast forth some bloud upon the Membranes of the Brain which being there concrete may cause great pain by reason whereof it blinds the Eyes if soâ—e that the place can be found against which the pain is and when the skin is opened the bone look pale it must presently be cut out as Celsus hath written Now it remains that we tell you how to make your Prognosticks in all the fore-mentioned fractures of the Skull CHAP. X. Of Prognosticks to be made in fractures of the Skull Hip. de vul cap. WE must not neglect any Wounds in the Head no not those which cut or bruise but only the hairy scalp but certainly much less those which are accompanyed by a fracture in the skull for oft-times all horrid symptoms follow upon them consequently death it self especially in bodies full of ill humors or of an ill habit such as are these which are affected with the Lues venerea Leprosie Dropsie Pthysick Consumption for in these simple wounds are hardly or never cured for union is the cure of wounds but this is not performed unless by the strength of nature and sufficient store of laudable bloud but those which are sick of hectick Feavers and Consumptions want store of bloud and those bodies which are repleat with ill humors and of an ill habit have no afflux or plenty of laudable bloud but all of them want the strength of nature the reason is almost the same in those also which are lately recovered of some disease Whether the wounds of children or old people are better to heal Those wounds which are bruised are more difficult to cure than those which are cut When the Skull is broken then the continuity of the flesh lying over it must necessarily be hurt and broken unless it be in a Resonitus The bones of children are more soft thin and replenished with a sanguine humidity than those of old men and therefore more subject to putrefaction Wherefore the wounds which happen to the bones of children though of themselves and their own nature they may be more easily healed because they are more soft wherby it comes to pass that they may be more easily agglutinated neither is there fit matter wanting for their agglutination by reason of the plenty of bloud laudable both in consistence and quality than in old men whose Bones are dryer and harder and so resist union which comes by mixture and their bloud is serous and consequently a more unfit bond of unity and agglutination yet oft-times through occasion of the symptoms which follow upon them that is putrefaction and corruption which sooner arise in a hot and moist body and are more speedily encreased in a soft and tender they usually are more suspected and difficult to heal The Patient lives longer of a deadly fracture in the Skull in Winter than in Summer for that the native heat is more vigorous in that time than in this besides also the humors putrefie sooner in Summer because then unnatural heat is then easily inflamed and more predominant as many have observed out of Hippocrates Aph. 15. sect 1. The wounds of the Brain and of the Meninges or Membranes thereof are most commonly deadly because the action of the Muscles of the Chest and others serving for respiration is divers times disturbed and intercepted whence death insues If a swelling happening upon a wound of the head presently vanish away it is an ill sign unless there be some good reason therefore as bloud-letting Aph. 65. sect 5. purging or the use of resolving local medicines as may be gathered by Hippocrates in his Aphorisms If a Feaver ensue presently after the beginning of a wound of the head that is upon the fourth or seventh day which usually happens you must judg it to be occasioned by the generating of Pus Aph. 47. sect 2. or Matter as it is recited by Hippocrates Neither is such a Feaver so much to be feared as that which happens after the seventh day in which time it ought to be terminated but if it happen upon the tenth or fourteenth day with cold or shaking it is dangerous because it makes us conjecture that there is putrefaction in the Brain the Meninges or Skull through which occasion it may arise chiefly if other signs shall also concurr which may shew any putrefaction as if the wound shall be pallid and of a faint yellowish colour as flesh looks after it is washed Wounds which are dry rough livid and black are evil For as it is in Hippocrates Aphoris 2. Sect. 7. It is an ill sign if the flesh look livid when the Bone is affected for that colour portends the extinction of the heat through which occasion the lively or indifferently red colour of the part faints and dyes and the flesh thereabout is dissolved into a viscid Pus or filth Commonly another worse affect follows hereon wherein the wound becoming withered and dry looks like salted flesh sends forth no matter is livid and black whence you may conjecture that the Bone is corrupted especially if it become rough whereas it was formerly smooth and plain for it is made rough when Caries or corruption invades it but as the Caries increases it becomes livid and black sanious matter with all sweating out of the Diploe as I have observed in many all which are signs that the native heat is decayed and therefore death at hand but if such a Feaver be occasioned from an Erysipelas which is either present or at hand it is usually less terrible The signs of a Feaver caused by an Erysipelas But you shall know by these signs that the Feaver is caused by an Erysipelas and conflux of cholerick matter if it keep the form of a Tertian if the fit take them with coldness and end in a sweat if it be not terminated before the cholerick matter is either converted into Pus or else resolved if the lips of the wound be somewhat swoln as also all the face if the eyes be red and fiery if the neck and chaps be so stiffe that he can scarse bend the one or open the other if there be great excess of biting and pricking pain and heat and that far greater than in a Phlegmon Why an Erysipâ—las chiâ—fly assâ—ils the face For such an Erysipelous disposition generated of thin and hot bloud chiefly assails the face and that for two causes The first is by reason of the natural levity of the cholerick humor the other because of the rarity of the skin of these parts The cure of an Erysipelas on the â—â—ce The cure of such an affect must be performed by two means that is evacuation and cooling with humectation If choler alone cause this tumor we must easily be induced to let bloud but we must purge him with medicines evacuating choler If it be an Erysipelas Phlegmonodes you must draw bloud from the Cephalick-vein of that side which is most affected
alwayes using advice of a Physitian Having used these general means you must apply refrigerating and humecting things such as are the juyce of Night-shade Housleek Purslane Lettuce Navel-wort Water-Lentil or Ducks-meat Gourds a Liniment made of two handfuls of Sorrel boyled in fair water then beaten or drawn through a searse with Oyntment of Roses or some unguent Populeon added thereto will be very commodious Such and the like remedies must be often and so long renewed until the unnatural heat be extinguished But we must be careful to abstain from all unctuous Oyly things Why Oyly things must not be used in an Erysipelas of the face because they may easily be inflamed and so encrease the disease Next we must come to resolving Medicines but it is good when any thing comes from within to without but on the contrary it is ill when it runs from without inwards as experience and the Authority of Hippocrates testifie If when the bone shall become purulent Aph. 25. sect 6. pustules shall break out on the tongue by the dropping down of the acrid filth or matter by the holes of the palat upon the tongue which lyes under now when this symptom appears few escape Also it is deadly when one becomes dumb and stupid that is Apoplectick by a stroak or wound on the Head for it is a sign that not only the Bone but also the Brain it self is hurt But oft-times the hurt of the Brain proceeds so far Deadly signs in wounds of the head that from corruption it turns to a Sphacel in which case they all have not only pustules on their tongues but some of them dye stupid and mute othersome with a convulsion of the opposite part neither as yet I have observed any which have dyed with either of these symptoms by reason of a wound in the head who have not had the substance of their Brain tainted with a Sphacel as it hath appeared when their Skulls have been opened after their death CHAP. XI Why when the Brain is hurt by a Wound of the Head there may follow a Convulsion of the opposite part MAny have to this day enquired A Convulsion is cauâ—ed by dryness but as yet as far as I know it hath not been sufficiently explained why a Convulsion in wounds of the head seizes on the part opposite to the blow Therefore I have thought good to end that controversie in this place My reason is this A twofold câ—use of Convulsifick dryness that kind of Symptom happens in the sound part by reason of emptiness and dryness but there is a twofold cause and that wholly in the wounded part of this emptiness and dryness of the sound or opposite part to wit pain and the concourse of the spirits and humors thither by the occasion of the wound and by reason of the pains drawing and natures violently sending help to the afflicted part The sound part exhausted by this means both of the spirits humors easily falls into a Convulsion For thus Galen writes God the Creator of Nature hath so knit together Lib. 4. de usâ—e partium the triple spirituous substance of our bodies with that tye and league of concord by the production of the passages to wit of Nerves Veins and Arteries that if one of these forsake any part the rest presently neglect it whereby it languisheth and by little and little dyes through defect of nourishment But if any object that Nature hath made the body double for this purpose that when one part is hurt the other remaining safe and sound might suffice for life and necessity but I say this axiom hath no truth in the vessels and passages of the body For it hath not every where doubled the vessels for there is but one only vein appointed for the nourishment of the Brain and the Membranes thereof which is that they call the Torcular by which when the left part is wounded it may exhaust the nourishment of the right and sound part and through that occasion cause it to have a Convulsion by too much dryness Verily it is true that when in the opposite parts the Muscles of one kind are equal in magnitude strength and number the resolution of one part makes the convulsion of the other by accident but it is not so in the Brain For the two parts of the Brain the right and left each by its self performs that which belongs thereto without the consent conspiration or commerce of the opposite part for otherwise it should follow that the Palsie properly so called that is of half the body which happens by resolution caused either by mollification or obstruction residing in either part of the Brain should inferr together with it a Convulsion of the opposite part Which notwithstanding dayly experience convinceth as false Wherefore we must certainly think that in wounds of the Head wherein the Brain is hurt that Inanition and want of nourishment are the causes that the sound and opposite part suffers a Convulsion Francis Dalechampius in his French Chirurgery renders another reason of this question That Opinion of Dalechampius saith he the truth of this proposition may stand firm and ratified we must suppose that the Convulsion of the opposite part mentioned by Hippocrates doth then only happen when by reason of the greatness of the inflammation in the hurt part of the Brain which hath already inferred corruption and a Gangrene to the Brain and Membranes thereof and within a short time is ready to cause a sphacel in the Skull so that the disease must be terminated by death for in this defined state of the disease and these conditions the sense and motion must necessarily perish in the affected part as we see it happens in other Gangrens through the extinction of the native heat Besides the passages of the animal Spirit must necessarily be so obstructed by the greatness of such an inflammation or phlegmon that it cannot flow from thence to the parts of the same side lying there-under and to the neighbouring parts of the Brain and if it should flow thither it will be unprofitable to carry the strength and faculty of sense and motion as that which is infected and changed by admixture of putrid and Gangrenous vapours Whereby it cometh to pass that the wounded part destitute of sense is not stirred up to expel that which would be troublesome to it if it had sense wherefore neither are the Nerves thence arising seised upon or contracted by a Convulsion It furthermore comes to pass that because these same Nerves are deprived of the presence and comfort of the Animal Spirit and in like manner the parts of the same side drawing from thence their sense and motion are possessed with a Palsie for a Palsie is caused either by the cutting or obstruction of a Nerve or the madefaction or mollification thereof by a thin and watry humor or so affected by some vehement distemper that it cannot receive the
in the parts thereunder an unvoluntary excretion of the Urine and other excrements Signs that the Spine is wounded or a totall suppression of them seises upon the Patient When the hollow vein and great Artery are wounded the Patient will dye in a short time by reason of the sodain and aboundant effusion of the blood and spirits which intercepts the motion of the Lungs and heart whence the party dies suffocated CHAP. XXX Of the cure of the Wounds of the Chest WE have read in John de Vigo that it is disputed amongst Chirurgeons concerning the consolidation of wounds of the Chest For some think that such wounds must be closed up Vigo tract de vuln thoraâ— cap. 10. and cicatrized with all possible speed lest the cold air come to the heart and the vitall spirits fly away and be dissipated Others on the contrary think that such wounds ought to be long kept open and also if they be not sufficiently large of themselves that then they must be inlarged by Chirurgery that so the blood poured forth into the capacity of the Chest may have passage forth which otherwise by delay would putrefie whence would ensue an increase of the feaver a fistulous ulcer and other pernicious accidents The first opinion is grounded upon reason and truth if so be that there is little or no blood poured forth into the capacity of the Chest But the latter takes place where there is much more blood contained in the empty spaces of the Chest Which lest I may seem rashly to determin I think it not amiss to ratifie each opinion with a history thereto agreeable Whilst I was at Turin Chirurgeon to the Marshall of Montejan the King of France his General A History I had in cure a Souldier of Paris whose name was Levesque he served under captain Renovart He had three wounds but one more grievous than the rest went under the right brest somewhat deep into the capacity of the Chest whence much blood was poured forth upon the midriff which caused such difficulty of breathing that it even took away the liberty of his speech besides through this occasion he had a vehement feaver coughed up blood and a sharp pain on the wounded side The Chirurgeon which first drest him had so bound up the wound with a strait and thick suture that nothing could flow out thereat But I being called the day after and weighing the present symptoms which threatned speedy death judged that the sowing of the wound must straight be loosed which being done there instantly appeared a clot of blood at the orifice thereof which made me to cause the Patient to lye half out of his bed with his head downwards and to stay his hands on a Settle which was lower than the bed and keeping himself in this posture to shut his mouth and nose that so his Lungs should swell the midriffe be stretched forth and the intercostal muscles and those of the Abdomen should be compressed that the blood poured into the Chest might be evacuated by the wound but also that this excretion might succeed more happily I thrust my finger somewhat deep into the wound that so I might open the orifice thereof being stopped up with the congealed blood and certainly I drew out some seven or eight ounces of putrefied and stinking blood by this means When he was laid in his bed I caused frequent injections to be made into the wound of a decoction of Barly with Honey of Roses and red Sugar which being injected I wisht him to turn first on the one and then on the other side and then again to lye out of his bed as before for thus he evacuated small but very many clots of blood together with the liquor lately injected which being done the symptomes were mitigated and left him by little and little The next day I made another more detergent injection adding thereto wormwood Why bitter things must not be cast into the Chest centaury and Aloes but such a bitterness did rise up to his mouth together with a desire to cast that he could no longer indure it Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris in one who had a fistulous ulcer in his Chest Therefore when I had considered with my self that such bitter things may easily pass into the Lungs and so may from thence rise into the Weazon and mouth I determined that thenceforwards I would never use such bitter things to my Patients for the use of them is much more troublesome than any way good and advantagious But at the length this Patient by this and the like means recovered his health beyond my expectation Read the History of Maryllus in Galen lib. 7. de Anaâ—om administra But on the contrary I was called on a time to a certain Germain gentleman who was run with a sword into the capacity of his Chest the neighbouring Chirurgeon had put a great tent into the wound at the first dressing which I made to be taken forth for that I certainly understood there was no blood powred forth into the capacity of the Chest because the Patient had no feaver no weight upon the Diâ—phrâ—gma nor spitted forth any blood Wherefore I cured him in few dayes by only dropping in some of my balsome and laying a plaister of Diacalcitheos upon the wound What harm ensues the too long use of Tents The like cure I have happily performed in many others To conclude this I dare boldly affirm that wounds of the Chest by the too long use of tents degenerate into Fistula's Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest you shall not presently shut them up at the first dressing No liniments must be used in wounds of the Chest but keep them open for two or three dayes but when you shall find that the Patient is troubled with none or very little pain and that the midriffe is pressed down with no weight and that he breathes freely then let the tent be taken forth and the wound healed up as speedily as you can by covering it only with lint dipped in some balsome which hath a glutinative faculty and laid somewhat broader than the wound never apply liniments to wounds of this kind lest the Patient by breathing draw them into the capacity of the Chest Wherefore also you must have a care that the tent put into those kinds of wounds may be fastned to the pledgets and also have somewhat a large head lest they should be drawn as we said into the capacity of the Chest for if they fall in they will cause putrefaction and death Let Emplast Diacalcitheos or some such like be applyed to the wound But if on the contrary you know by proper and certain signs that there is much blood fallen into the spaces of the Chest then let the orifice of
But for the wounds of the Testicles and genital part because they are necessary instruments for the preserving the species by generation of a succession of Individuals and to keep all things quiet at home therefore the Chirurgeon ought to be very diligent and careful for their preservation Wherefore if they should chance at any time to be wounded they shall be dressed as we have formerly delivered the medicines being varyed according to the state of the wound and the appearing and happening symptoms for it would be a thing of immense labour to handle all things in particular CHAP. XXXVI Of the Wounds of the Thighs and Legs Why wounds of the inside of the thigh are oft-times deadly WOunds which have been received on the inside of the Thighs have often caused sodain death if they have come to the vein Saphena or the great Artery or the Nerves the associates of these vessels But when they are simple there is nothing which may alter the usual manner of cure Yet the Patient must be careful to lye in his bed for the vulgar Italian Proverb is true La mano al petto la gamba al letto that is The hand on the breast and the leg on the bed But when they penetrate more deeply into the substance of the part they bring horrid and fearful symptoms as an inflammation an abscess from whence oft-times such aboundance of matter issues forth that the Patient fals into an Atrophia and consumption Wherefore such wounds and ulcers require a careful and industrious Chirurgeon who may fitly make Incisions necessary for the corrupt parts and callosity of the fistulous ulcer Some Chirurgeons have been so bold as to sow together the end of the Tendons of the Ham and of other joynts when they have been quite cut asunder The large Tendon of the heel hard to consolidate But I durst never attempt it for fear of pain convulsions and the like horrid symptoms For the wounds of that large Tendon which is composed in the calf of the Leg by the concourse of three muscles and goes to the heel I have observed that when it hath been cut with the Sword that the wounds have been long and hard to cure and besides when at the last they have been healed as soon as the Patient hath got out of his bed and indeavoured to go they have grown ill and broke open again Wherefore in such like wounds let the Patient have a care that he begin not to go or too boldly to use his hurt leg before it be perfectly cicatrized and the scar grown hard Therefore that the Patient may be in more safety I judge it altogether necessary that he use to go with Crutches for a good while after the wound is perfectly healed up CHAP. XXXVII Of the Wounds of the Nerves and nervous parts Differences drawn from things woulded THe continuity of the nervous parts is divers ways loosed by the violent incursion of external things as by things which contuse batter and grind in sunder as by the blow of a stone cudgel hammer lance bullet out of a Gun or Cross-bow by the biting of greater teeth or the pricking of some sharp thing as a Needle Bodkin Pen-knife Arrow Splinter or the puncture of some venemous thing as of a Sea-Dragon or the edg of some cutting thing as a Sword or Rapier or of stretching things which violently tear asunder the nervous bodies Hence therefore it is that of such wounds some are simple others compound and the compound some more compound than other For of these some are superficiary and short others deep and long some run alongst the nervous body others run broad-ways some cut the part quite asunder others only a portion thereof Their symptoms The symptoms which follow upon such wounds are vehement pain and defluxion inflammation abscess feaver delirium swooning convulsion gangrene sphacel whence often death insues by reason of that sympathy which all the nervous parts have with the brain Why a puncture of a nerve is deadly Amongst all the wounds of the nervous parts there is none more to be feared then a puncture or prick nor any which causeth more cruel and dangerous symptoms For by reason of the straitness of the wound medicines can neither be put in nor the sanious matter pass forth now the sanious matter by long stay acquires virulency whereby the nervous parts are tainted and swoln suffer pain inflammation convulsions and infinite other symptoms of these the wounds are most dangerous by which the nervous and membranous bodies are but half cut asunder For the portion thereof which remains whole by its drawing and contracting it self towards the original causeth great pain and convulsion by sympathy The truth hereof is evident in wounds of the head as when the Pericranium is half cut or when it is cut to apply a trepan For the cutting thereof infers far greater pain than when it is cut quite asunder Wherefore it is safer to have the nervous body quite cut off for so it hath no community nor consent with the upper parts neither doth it labour or strive to resist the contraction of its self now this contrariety and as it were fight is the cause of pain yet there arises another misery from such a wound for the part whereinto the nerve which is thus cut insunder passes thence forwards loseth its action CHAP. XXXVIII Of the cure of Wounds of the Nervous parts IT is the ancient doctrine of the antient Physitians that the wounds of the nervous parts should not presently be agglutinated which notwithstanding the general and first indication usually taken from the solution of continuity requires but rather chiefly if they be too strait A wound of the nervous parts indicates contrary to the general cure of wounds that the punctures should be dilated by cutting the parts which are above them and let them be kept long open that the filth may pass freely forth and the medicine enter well in Yet I in many cures have not followed this counsel but rather that which the common indication requires That cure is in fresh memory which I performed upon Monsieur le Coâ—q a Proctor of the spiritual Court who dwelt in our Ladies-street he gathering and binding up some loose Papers A History run a Penknife which was hid amongst them through his hand Also one of his neighbours who went to spit a piece of Bief thrust the spit through the midst of his hand But I presently agglutinated both their wounds without any danger dropping presently in at the first dressing a little of my Balsom warm and putting about it a repelling and astringent medicine and by this means they were both of them healed in a short time no symptom thereupon happening Yet I would not have the young Chirurgeon to run this hazard for first he must be well practised and accustomed to know the tempers and habit of men for this manner of curing would not do
putrefaction as you may learn by those Countries which are blown upon by a wind from Sea For in these flesh which is kept for food putrefies in the space of an hour Flesh quickly putrefies in maritine places and such ulcers as in other places are easily and quickly healed do there by the conflux and collection of matter become inveterate and contumacious Therefore as when the seasons of the year successively fall out agreeable to their nature and when each season is seasonable then either we are not sick at all or assuredly with less danger So on the contrary the perfect constitution and health of our Bodies becomes worse and decays when the seasons of the year are depraved perverted in time and temper Now seeing that these many years the four seasons of the year have wanted their seasonableness the Summer wanting his usual heat and the Winter its cold and all things by moisture and the dominion of the Southern winds have been humid and languid I think there is none so ignorant in natural Philosophy and Astrology who will not think but that the causes of the malignity and contumacy of those diseases which have so long afflicted all France are to be attributed to the Air and Heavens For otherwise whence have so many pestilent and contagious diseases tyrannized over so many people of every age sex and condition whence have so many Catarrhes Coughs and heavinesses of the head so many Pleurisies Tumors small Poxes Measles and Itches not admitting of digestion and remedies prescribed by Art Whence have we had so many venemous creatures as Toads Grashoppers Caterpillers Spiders Wasps Hornets Beetles Snails Vipers Snakes Lizards Scorpions and Efts or Nutes unless from excessive putrefaction which the humidity of the air our native heat being liquid and dull hath caused in us and the whole Kingdom of France Hence also proceeds the infirmity of our native heat and the corruption of the bloud and humors whereof we consist which the rainy Southwind hath caused with its sultry heat Wherefore in these last years I have drawn little bloud which hath not presently shewed the corruption of its substance by the black or greenish colour as I have diligently observed in all such as I have bled by the direction of the Physitians either for prevention of suture or cure of present diseases Whence it comes to pass that the fleshy substance of our bodies could not but be faulty both in temper and consistence seeing that the bloud whence it is generated had drawn the seeds of corruption from the defiled air In what bodies ulcers and wounds are not easily cured Whence it fell out that the wounds which happened with loss of substance could be scarse healed or united because of the depraved nature of the bloud For so the Wounds and Ulcers of those which are troubled with the Dropsie whose bloud is more cold or wholly waterish so of Leprous persons whose bloud is corrupt and lastly of all such as have their bodies replete with ill juyce or else are Cachectick will not easily admit of cure Yea assuredly if but the very part which is hurt swerve from its native temper the wound will not easily be cured Therefore seeing all these things both the putrefaction of the Air and depraved humors of the body and also the distemper of the affected parts conspired together to the destruction of the wounded what marvail was it if in these late civil wars the wounds which were for their quantity small for the condition of the wounded parts but little have caused so many and grievous accidents and lastly death it self Especially seeing that the Air which encompasseth us tainted with putrefaction corrupts and defiles the wounds by inspiration and exspiration the body and humors being already disposed or inclined to putrefaction Now there came such a stink which is a most assured sign of putrefaction from these Wounds when they were dressed that such as stood by could scarse endure it neither could this stink be attributed to the want of dressing or fault of the Chirurgeon for the wounds of the Princes and Nobility stunk as ill as those of the common Souldiers An argument of great putrefaction of the humors And the corruption was such that if any chanced to be undrest for one day which sometimes happened amongst such a multitude of wounded persons the next day the wound would be full of worms Besides also which furthermore argues a great putrefaction of humors many had abscesses in parts opposite to their wounds as in the left knee when as the right shoulder was wounded in the left arm when as the right leg was hurt Which I remember befel the King of Navarre the Duke of Nevers the Lord Reden and divers others For all men had nature so over-charged with abundance of vicious humors that if it expelled not part thereof by imposthumes to the habit of the Body it certainly otherwise disposed of it amongst the inner parts of the Body for in dissecting dead Bodies we observed that the Spleen Liver Lungs and other Bowels were purulent and hence it was that the Patients by reason of vapours sent from them to the heart were troubled with continual Feavers But the Liver and all the veinous parts being polluted and so the generation of the laudable Bloud hindered they languished for want of fitting nourishment But when the Brain by vapours was drawn in to sympathize with the rest they were molested with Ravenings Convulsions Wherefore if any thing succeeded unprosperously in so great malignancy of wounds the Chirurgeon was not to be blamed for that it were a crime to fight against God and the Air wherein the hidden scourges of the divine justice lye hid Therefore if according to the mind of the great Hippocrates who commands to bring all contused wounds to suppuration that so they may be healed we indeavoured to cure with such medicins wounds made with Gunshot and therefore contused who can rightly be angry with us if we performed it not so well by reason of those putrefactions gangrenes All contused wounds must be brought to suppuration and mortifications which proceeded from the corrupt Air for all that we used not only suppuratives but were oft-times forced to use other medecins so long turning aside from the cure of the disease until we had orecome the symptoms which much indanger the Patient and customarily happen upon such wounds as also upon those which are made with a sword or any other kind of weapon as shall plainly appear in the following Treatise to which it now seems high time that we betake our selves CHAP. I. A division of Wounds drawn from the variety of the wounded parts and the Bullets which wound A division of wounds from the variety of the wounded parts ALl Wounds which are made in mans Body by Gunshot whether simple or compound are accompanyed with contusion dilaceration distemper and swelling I say all these possess either the
noble parts or ignoble the fleshy nervous or bony some whiles with rending and tearing asunder the larger vessels sometimes without harming them Now these wounds are only superficiary or else pierce deep and pass quite through the Body But there is also another division of these wounds taken from the variety of the Bullets wherewith they are made For some Bullets are bigger From the difference of Bullets Wounds made by Gunshot are usually round some less some between both they are usually made of Lead yet sometimes of Steel Iron Brass Tin scarse any of Silver much less of Gold There arises no difference from their figure for almost all kinds of wounds of this nature are round From these differences the Chirurgeon must take his Indications what to do and what medicins to apply The first care must be that he think not these horrid and malign symptoms which usually happen upon these kinds of wounds to arise from combustion or poyson carryed with the Bullet into the wounded part and that for those reasons we have formerly handled at large But rather let him judg they proceed from the vehemency of the contusion dilaceration and fracture caused by the Bullet's too violent entry into the nervous and bony Bodies For if at any time the Bullet shall only light upon the fleshy parts the wounds will be as easily cured as any other wound usually is which is made with a contusing and round kind of weapon as I have often found by frequent experience whilst I have followed the wars and performed the part of a Chirurgeon to many Noblemen and common Souldiers according to the counsel of such Physitians as were there overseers of the cure CHAP. II. Of the signs of Wounds made by Gunshot WOunds made by Gunshot are known by their figure which is usually round Signs of wounds from their figure by their colour as when the native colour of the part decays and in stead thereof a livid greenish violet or other colour succeeds by the feeling or sense of the stroke when in the very instant of the receiving thereof he feels a heavy sense as if some great stone From their colour or piece of timber or some such other weighty thing had faln upon it by the small quantity of bloud which issues out thereat for when the parts are contused From the feeling of the blow within some small while after the stroke they swell up so that they will scarse admit a Tent whence it is that the bloud is stopped which otherwise would flow forth of the orifice of the Wound by heat which happens eitner by the violentness of the motion or the vehement impulsion of the air From the bleeding or the attrition of the contused parts as the flesh and nerves Also you may conjecture that the wounds have been made by Gunshot if the Bones shall be broken From the heat of the wound and the splinters thereof by pricking the neighbouring bodies cause defluxion and inflammation But the cause that the Bullet makes so great a contusion is for that it enters the body without any points or corners Whence these wounds are so much contused but with its round and spherical body which cannot penetrate but with mighty force whence it cometh to pass that the wound looks black and the adjacent parts livid hence also proceed so many grievous symptoms as Pain Defluxion Inflammation Apostumation Convulsion Phrensie Palsie Gangrene and Mortification whence lastly Death ensues Now the Wounds do often cast forth virulent and very much stincking filth by reason of the great contusion and the rending and tearing of the neighbouring particles A great abundance of humors flow from the whole Body and fall down upon the affected parts which the native heat thereof being diminished forsakes and presently an unnatural heat seises upon it Hither also tend an universal or particular repletion of ill humors chiefly if the wounds possess the nervous parts as the joynts Verily neither a Stag with his horn nor a Flint out of a sling can give so great a blow or make so large a wound as a Leaden or Iron Bullet shot out of a Gun as that which going with mighty violence pierces the body like a Thunderbolt CHAP. III. How these Wounds must be ordered at the first dressing THe Wound must forthwith be inlarged unless the condition of the part resist Sâ—range bodies must first be pulled forth that so there may be free passage forth both for the Sanies or matter as also for such things as are farced or otherwise contained therein such as are pieces of their Cloaths Bombast Linnen Paper pieces of Mail or Armour Bullets Hail-shot splinters of Bones bruised flesh and the like all which must be plucked forth with as much celerity and gentleness as may be For presently after the receiving of the wound the pain and inflammation are not so great as they will be within a short time after This is the principal thing in performance of this work The manner how to draw them forth that you place the Patient just in such a posture as he was in at the receiving of the wound for otherwise the various motion and turning of the Muscles will either hinder or straiten the passage forth of the contained bodies You shall if it be possible search for these Bodies with your finger that so you may the more certainly and exactly perceive them Yet if the Bullet be entred somewhat deep in then you shall search for it with a round and blunt probe lest you put the Patient to pain yet oftentimes you shall scarce by this means find the Bullet As it happened to the Marshal of Brissac in the siege of Parpignan who was wounded in his right shoulder with a Bullet which the Chirurgeons thought to have entered into the capacity of his body But I wishing the Patient to stand just in the same manner as he did when he received the wound found at length the place where the Bullet lay by gently pressing with my fingers the parts near the wounds and the rest which I suspected as also by the swelling hardness pain and blackness of the part which was the lower part of the shoulder near unto the eighth or ninth spondil of the back Wherefore the Bullet being taken forth by making Incision in the place the wound was quickly healed and the Gentleman recovered You shall observe this and rather believe the judgment of your fingers than of your Probe CHAP. IV. A description of fit Instruments to draw forth Bullets and other strange Bodies BOth the magnitude and figure of Instruments fit for drawing forth of Bullets and other strange Bodies are various according to the diversity of the incident occasions For some are toothed others smooth others of another figure and bigness of all which sorts the Chirurgeon must have divers in a readiness that the may fit them to the Bodies and Wounds and not the Wounds and Bodies to
Cathaereticks which is excellent in these kinds of Wounds whether by it self or mixed with others You shall use these and such like even unto the perfect agglutination and cicatrization of the wound and you may of your self devise other things such as these as occasion shall offer its self CHAP. XXIV What just occasion moved the Author to devise this new form of remedy to stanch the blood after the amputation of a member and to forsake the common way used almost by all Chirurgeons which is by application of actual Cauteries VErily I confess I formerly have used to stanch the bleeding of members after amputation Hot Irons not to be used after another manner than that I have a little before mentioned Whereof I am ashamed and agrieved But what should I do I have observed my masters whose method I intended to follow alwayes to doe the like who thought themselves singularly well appointed to stanch a flux of blood when they were furnished with various store of hot Irons and caustick medicins which they would use to the dismembred part now one then another as they themselves thoâ—ght meet Which thing cannot be spoken or but thought upon without great horror much less acted For this kind of remedy could not but bring great and tormenting pain to the Patient seeing such fresh wounds made in the quick and sound flesh are endured with exquisite sense Neither can any caustick be applyed to nervous bodies but that this horrid impression of the fire will be presently communicated to the inward parts whence horrid symptoms ensue and oft-times death it self And verily of such as were burnt the third part scarce ever recovered and that with much adoe for that combust wounds difficultly come to cicatrization for by this burning are caused cruel pains whence a Feaver Convulsion and oft-times other accidents worse than these Add hereunto that when the eschar fell away oft-times a new haemorrhage ensued for stanching whereof they were forced to use other caustick and burning Instruments Neither did these good men know any other course so by this repetition there was great loss and waste made of the fleshy and nervous substance of the part Through which occasion the bones were laid bare whence many were out of hope of cicatrization being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembred which also took away the opportunity of fitting or putting to of an artificial leg or arm instead of that which was taken off Wherefore I must earnestly entreat all Chirurgeons that leaving this old and too too cruel way of healing they would embrace this new which I think was taught me by the special favour of the sacred Deity for I learnt it not of my masters nor of any other neither have I at any time found it used by any Only I have read in Galen Lib. 5. Meth. that there was no speedier remedy for stanching of blood than to binde the Vessels through which it flowed towards their roots to wit the Liver and Heart This precept of Galen of binding and sowing the Veins and Arteries in the new wounds when as I thought it might be drawn to these which are made by the amputation of members I attempted it in many yet so that at first in my budding practice thereof I alwayes had my Cauteries and hot Irons in a readiness that if any thing hapned otherwise then I expected in this my new work I might fetch succour from the ancient practice untill at length confirmed by the happy experience of almost an infinite number of particulars I bid eternally adieu to all hot Irons and Cauteries which were commonly used in this work And I think it fit that Chirurgeons do the like For antiquity and custom in such things as are performed by Art ought not to have any sway authority or place contrary to reason as they oft-times have in civil affairs wherefore let no man say unto us that the Ancients have alwayes done thus CHAP. XXV The practice of the former precepts is declared together with a memorable history of a certain Souldier whose Arm was taken off at the Elbow I Think it fit to confirm by an example the prescribed method of curing a Gangrene and Mortification A History Whilest I was Chirurgeon to the Marshall of Montejan at Turin a certain common souldier received a wound on his wrist with a musket-bullet by which the bones and tendons being much broken and the nervous bodies cruelly torn there followed a Gangrene and at length a mortification even to the Elbow besides also an inflammation seised upon the middle part of his Chest and there was as it were a certain disposition to a Gangrene whereby it followed that he was painfully and dangerously troubled with belchings hicketings watchings unquietnesse and frequent swoundings which occasioned many Chirurgeons to leave him as desperate But it so fell out that I orecome by his friends intreaty undertook the cure of this wretched person destitute of all humane help Wherefore knowing the mortification by its signs I cut off the arm by the Elbow as speedily as I could making first the ligature whereof I made mention I say I took it off not with a saw Dismembring at a joynt but only with an incision-knife cutting in sunder the ligaments which held the bones together because the sphacell was not passed the joynt of the Elbow Neither ought this section to be counted strange which is made in a joint for Hippocrates much commends it Sect. 4. Lib. de Art and saith that it is easily healed and that there is nothing to be feared therein besides swounding by reason of the pain caused by cutting the common tendons and ligaments But such incision being made the former ligature could not hinder but much blood must flow from thence by reason of the large vessels that run that way Wherefore I let the blood to flow plentifully so to disburden the part and so afterwards to free it from the danger and fear of inflammation and a Gangrene then presently I stanched the blood with an hot Iron for as yet I knew no other course Then gently loosing the ligature I scarified that part of the brawn of the Arm which was gangrenated with many and deep incisions shunning and not touching the inner part by reason of the multitude of the large vessels and Nerves which run that way then I presently applyed a cautery to some of the incisions both to stanch the bleeding and draw forth the virulent sanies which remained in the part And then I assailed and overcame the spreading putrefaction by putting and applying the formerly prescribed medicins I used all sorts of restrictive medicins to stay the inflammation of the Chest I also applyed Epithemaes to the region of the heart and gave him cordiall potions and boles neither did I desist from using them untill such time as his belching hicketting and swoundings had left him
Whilst I more attentively intended these things another mischief assails my Patient to wit Convulsions and that not through any fault of him or me but by the naughtiness of the place wherein he lay which was in a Barn every where full of chinks and open on every side and then also it was in the midst of Winter raging with frost and snow and all sorts of cold neither had he any fire or other thing necessary for preservation of life to lessen these injuries of the air and place Now his joints were contracted his teeth set and his mouth and face were drawn awry when as I pitying his case made him to be carried into the neighbouring Stable which smoaked with much horse dung and bringing in fire in two chafendishes I presently anointed his neck and all the spine of his back shunning the parts of the Chest with liniments formerly described for convulsions then straight way I wrapped him in a warm linnen cloth Burying in hot horse-dung helps Convulsions and buried him even to the neck in hot dung putting a little fresh straw about him when he had stayed there some three dayes having at length a gentle scouring or flux of his belly and plentiful shut he begun by little and little to open his mouth and teeth which before were set and close shut Having got by this means some opportunity better to do my business I opened his mouth as much as I pleased by putting this following Instrument between his teeth A Dilater made for to open the mouth and teeth by the means of a Screw in the end thereof Now drawing out the Instrument I kept his mouth open by putting in a willow stick on each side thereof that so I might the more easily feed him with meats soon made as with Cows milk and rear egs untill he had recovered power to eat the convulsion having left him He by this means freed from the Convulsion I then again begun the cure of his arm and with an actual cautery seared the end of the bone so to dry up the perpetual afflux of corrupt matter It is not altogether unworthy of your knowledg that he said how that he was wondrously delighted by the application of such actual cauteries a certain tickling running the whole length of the arm by reason of the gentle diffusion of the heat by the applying the caustick which same thing I have observed in many others especially in such as lay upon the like occasion in the Hospital of Paris After this cauterizing there fell away many and large scales of the bone the freer appalse of the air than was fit making much thereto A fomentation for a Convulsion besides when there was place for fomentation with the decoction of red Rose leaves Wormwood Sage Bay-leaves flowers of Camomil Melilote Dill I so comforted the part that I also at the same time by the same means drew and took away the virulent Sanies which firmly adhered to the flesh and bones Lastly it came to passe that by Gods assistance these means I used and my careful diligence he at length rocovered Wherefore I would admonish the young Chirurgeon Monsters or miracles in diseases that he never account any so desperate as to give him for lost content to have let him go with prognosticks for as an ancient Doctor writes that as in Nature so in diseases there are also Monsters The End of the Twelfth Book The THIRTEENTH BOOK Of Vlcers Fistulaes and Haemorrhoides CHAP. I. Of the nature causes and differences of Ulcers HAving already handled and treated of the nature differences causes The divers acceptions of an Ulcer Sent. 34. sect 3. lib. de fract signs and cure of fresh and bloody wounds reason and order seem to require that we now speak of Ulcers taking our beginning from the ambiguity of the name For according to Hippocrates the name of Ulcer most generally taken may signifie all or any solution of Countinuity In which sence it is read that all pain is an Ulcer Generally for a wound and Ulcer properly so called as appears by his Book de Ulceribus Properly Sect. 1. prog as when he saith it is a sign of death when an Ulcer is dryed up through an Atrophia or defect of nourishment What an Ulcer properly is We have here determined to speak of an Ulcer in this last and proper signification And according thereto we define an Ulcer to be the solution of Continuity in a soft part and that not bloody but sordid and unpure flowing with quitture Sanies or any such like corruption associated with one or more affects against nature Lib. de constit Artis cap. 6. which hinder the healing and agglutination thereof or that we may give it you in fewer words according to Galens opinion An ulcer is a solution of Continuity caused by Erosion The causes of Ulcers are either internal or external The internal causes The internal are through the default of humours peccant in quality rather than in quantity or else in both and so making erosion in the skin and softer parts by their acrimony and malignity now these things happen either by naughty and irregular diet or by the ill disposition of the entrails sending forth and emptying into the habit of the body this their ill disposure The external causes are the excess of cold seising upon any part The external causes especially more remote from the fountain of heat whence followes pain whereunto succeeds an attraction of humors and spirits into the part and the corruption of these so drawn thither by reason of the debility or extinction of the native heat in that part whence lastly ulceration proceeds In this number of external causes may be ranged a stroak contusion the application of sharp and acrid medicins as causticks burns as also impure contagion as appears by the virulent Ulcers acquired by the filthy copulation or too familiar conversation of such as have the French disease How many and what the differences of Ulcers are you may see here described in this following Scheme A Table of the differences of Ulcers An Ulcer is an impure solution of continuity in a soft part flowing with filth and matter or other corruptition whereof there are two chief differences for one Is simple and solitary without complication of any other affect against nature and this varies in differences either Proper which are usually drawn from three things to wit Figure whence one Ulcer is called Round or circular Sinuous and variously spread Right or oblique Cornered as triangular Quantity and that either according to their Length whence an Ulcer is long short indifferent Breadth whence an Ulcer is broad narrow indifferent Profundity whence an Ulcer is deep superficiary indifferent Equality or inequality which consists In those differences of dimensions whereof we last treated I say in length breadth and profundity wherein they are either alike or of the same manner or else unlike and so
as there is great abundance of humors in a body and the patient leads a sedentarie life not some one but all the joints of the bodie are at once troubled with the Gout CHAP. II. Of the occult causes of the Gout THe humor causing the Gout is not of a more known or easily exprest nature then that which causeth the plague Lues venerea or falling sickness For it is of a kinde and nature clean different from that which causeth a Phlegmon oedema erysipelas or Scirrhus for as Aetius saith Lib. 12. Cap. 12. it never cometh to suppuration like other humors not for that as I think because it happens in bloodless parts but through the occasion of some occult malignitie Hereto may be added that the humors which cause the fore-mentioned tumors when as they fall down upon any part not then truly when they are turned into pus or matter do they cause so sharp pains as that which causeth the Gout for the pain thereof is far more sharp then of that humor which causeth an ulcerated Cancer Besides these humors when they fall upon the joints through any other occasion never turn into knots only that which causeth the Gout in the joints after it hath fallen thither is at length hardned into a certain knotty and as it were plaister-like substance to be amended by no remedies But seeing it offends not the parts by which it flows down The resemblance of the Gout to the Epilepsie no more then the matter which creeping upwards from the lower parts to the brain causeth the Epilepsie as soon as it falleth into the spaces of the Joynts it causeth cruel pain one while with heat another while with cold For you may see some troubled with the Gout who complain that their ruined joints are burnt there are others to whom they seem colder than any ice so that they cannot be sufficiently heated to their hearts desire verily you may sometimes see in the same body troubled with the Gout that the Joints of the right side will as it were burn with heat but on the left side will be stiff with cold or which is more the knee in the same side to be tormented with a hot distemper and the ankle troubled with a cold Lastly The strange variety of the Gout there sometimes happens a succession of pain in a succession of dayes as the same joints will be this day troubled with a hot to morrow with a cold distemper so that we need noâ— marvel to see Physicians prescribe one while hot another while cold medicines against the same disease of the same part and body Also it sometimes happens that the malignity of this humor doth not only not yield to medicines but it is rather made worse so that the patients affirm that they are far better when they have none than when they have any remedies applyed For all things being rightly done and according to reason yet the disease will come again at certain seasons by fits and hereupon it is said by Horace Qui cupit aut metuit juvat illum sic domus aut res Vt lippum pictae tabulae fomenta podagram Riches the covetous and fearfull so do please As pictures sore eyes Bathes the Gout do ease Certainly such as have this disease hereditarily can no more be helped and throughly freed therefrom than those in whom the matter of the disease is become knotty whereof Ovid thus speaketh Tollere nodosam nescit medicina podagram Physick the knotty Gout it cannot heal These reasons have induced many to believe that the essence of this disease is unknown for there is a certain occult and inexplicable virulency the author of so great malignity and contumacy Which Avicen seems to acknowledge Lib. 3. sect 22. tract 2. cap. when he writes that there is a certain kinde of Gout whose matter is so acute and malign that if it at any time be augmented by the force of anger it may suffice to kill the party by sudden death Lib de thâ—r ad Pisonem c. 15. Therefore Galen himself writes that Treacle must be used in all Arthritical and gouty affects and as I think for no other reason then for that it dries wasts and weakens the malignity thereof Gordonius is of the same opinion but addeth withall that the body must be prepared and purged before we use Treakle The matter of the Goâ—â— partakes of occult malignity Therefore the matter of the Gout is a thin and virulent humor yet not contagious offending in quality rather than quantity causing extreme pains and therefore instigating the humours together with the caliginous and flatulent spirits prepared or ready for defluxion upon the affected parts Therefore as the bitings of Asps and stingings of Wasps cause cruel pain with sudden swelling and blistering which is by the heat of the humors which the poyson hath tainted and not by the simple solution of continuity seeing that we daily see Shoo-makers and Tailors pricking their flesh with auls and needles without having any such symptom So the virulency of the Gout causeth intolerable tormenting pain not by the abundance because it happens to many who have the Gout no sign of defluxion appearing in the joynts but only by a malign and inexplicable quality by reason whereof these pains do not cease unless abated by the help of medicines or nature or both The recital of the following histories will give much light to that inexplicable and virulent malignity of the matter causing the Gout Whilest King Charles the ninth of happy memory An History was at Burdeaux there was brought to Chappellain and Castellan the Kings Physicians and Taste a Physician of Burdeaux Nicholas Lambert and my self Surgeons a certain Gentlewoman some forty years old exceedingly troubled for many years by reason of a tumour scarce equalling the bigness of a pease on the outside of the joint of the left Hip A terrible fit one of her tormenting fits took her in my presence she presently began to cry and roar and rashly and violently to throw her body this way and that way with motions and gestures above a womans yea a mans nature For she thrust her head between her legs laid her feet upon her shoulders you would have said she had been possessed of the Divel This fit held her some quarter of an hour during all which time I â—eedfully observed whether the grieved part swelled any bigger than it was accustomed whether there hapned any new inflammation but there was no alteration as far as I could gather by sight or feeling but only that she cried out more loudly when as I touched it The fit passed a great heat took her all her body ran down with sweat with so great wearinesse and weaknesse of all her members that she could not so much as stir her little finger There could be no suspicion of an Epileptick for this woman all the time of her agony did perfectly make use of all
of Serpents in the curstness of its poyson The efficacie of the poyson of the Basilisk Therefore it is affirmed by Nicander that into what place soever he comes other venomous creatures do forthwith flie thence for that none of them can so much as endure his hissing for he is thought to kill all things even with this and not with his biting and touch only besides if any of them hasten to get any meat or drink and perceive that the Basilisk is not far from thence he flies back and neglects the getting of nourishment necessary for life Galen writes Lib. de Theriac that the Basilisk is a yellowish Serpent with a sharp head and three risings distinguished with white spots and rising up in form of a Crown by reason whereof he is stilled the King of Serpents Why the Basilisk is thought to kill by his onely sight Certainly the violence of his poyson in killing men is so great that he is therefore thought to kill men and other creatures by his sight only Solinus affirms that the body of a Basilisk hath wondrous faculties Wherefore the inhabitants of Pergamum in ancient times gave a mighty price for one to hang upon the joists of the temple of Apollo so to drive away the Spiders and Birds lest they should weave their webs or the other build their nests in that sacred place Verily no ravenous creature will touch their carkcass but if constrained by hunger they do touch it then they forthwith fall down dead in the same place and this happens not only by eating their body Plin. lib. 8. c. 21. but also by devouring of the bodies of such beasts as are killed by their bitings They kill the trees and shrubs by which they pass not only by their touch but even with their breath Among the western Aethiopians is the fountain Nigris near which there is a Serpent called Catablepas The Catablepas small in body and slow having a great head which it scarce can carry but that it lies alwaies upon the ground otherwise it would kill abundance of people for it forthwith kills all that sees the eies thereof the Basilisk hath the same force he is bred in the province of Cyrene of the length of some twelve fingers with a white spot in his head resembling a crown he chaseth away all serpents with his hiss Weasels are the destruction of such monsters thâ—s it pleased nature Nothing in nature without its equal that nothing should be without its equal they assail them in their dens being easily known by the barrenness or consumption of the soil These kill them also by their sent and they die and the sight of nature is ended thus nature to the magnanimous Lion lest there should be nothing which he might fear hath opposed the weak creature the Cock by whose crowing only he is terrified and put to flight Erasistratus writes Symptoms that a golden yellowness affects the bitten part of such as are hurt by a Basilisk but a blackness and tumor possesseth the rest of the body all the flesh of the muscles within a while after falling away piece-meal Cure An antidote against this must be made of a dram of Castoreum dissolved in wine and drunken or in the juice of poppy But Aetius thinks it superflous to write remedies against the Basilisk when as the sight and hearing only kills such as either see or hear her The figure of a Basilisk CHAP. XX. Of the Salamander THe Salamander kills not only such as it bites by making a venomous impression The malignity of a Salamander but it also infects the fruits and herbs over which it creeps with a spittle or gross moisture which sweats out of all the body to the great danger of the health and life of such as eat these things at unawares wherefore it need not seem strange which is received by some late writers that some families have all died by drinking water out of the pits whereinto a Salamander by accident was fallen For if it shall creep upon a tree The temper of her it infects all the fruit with the qualities of cold and moist poison wherein it yields not to Aconite Aetius writes that such as are infected with the poison of a Salamander certain parts of their body grow livid so that they fall away often being putrefied At the first there appear white spots Symptoms over the body then red after wards black with putrefaction and the falling away of the hairs The cure is The cure to procure vomit to loose the belly with a glyster and to give them Treacle and Mithridate in potions Avicen prescribes the same things against this kind of poison as against opium Lib. 2 cap. 54. by reason of the cold nature of them both the proper antidote is turpentine styrax nettle seeds and cypress-leaves Dioscorides writes that the Salamander is a kind of Lizard dull variegated and which is falsly reputed not to be burnt by fire But Pliny saith she is so cold that she extinguisheth the fire by her touch only being laied upon hot coles On the contrary Matthiolus saith How a Salamander may be said to live in the fire that cast into a great flame they are quickly consumed It is easie out of Actiuâ— to reconcile these disagreeing opinions This creature saith he passeth through a burning flame and is not hurt the flame dividing it self and giving her way but if she continue any time in the fire the cold humor being consumed in her she is burnt Now the Salamander is black variegated with yellow spots star-fashion The figure of a Salamander CHAP. XXI Of the Torpedo The craft of the Torpedo THe Torpedo hath his name from the effect by reason that by his touch and power the members become torpid and numme in muddy shoars it lives upon fish which the catcheth by craft His stupefying force For lying in the mud she so stupefies those that are nigh her that she easily preys upon them she hath the same power over men for she sends a numness not only into the arm of the fisher-man but also over all his body although his fishers pole be between them The effigies of a Torpedo CHAP. XXII Of the bitings of Asps Symptoms THe wound which is made by an Asp is very small as if a needle were thrust into the part and without any swelling These symptoms follow upon her bite sudden darkness clouds their eies much agitation in all their bodies but gentle notwithstanding a moderate pain of the stomach troubles them their fore-heads are continually troubled with convulsive twitchings their cheeks tremble and their eie-lids fall gently to rest and sleep the blood which flows from the wound is little but black death no longer deserred then the third part of a day will take them away by convulsions unless you make resistance with fitting remedies The male Asp makes two wounds Cu cing the
hinder natures diligence and care of concoction For as in the Dog-Dayes the lees of wine subsiding to the bottom are by the strength and efficacie of heat drawn up to the top and mixed with the whole substance of the wine as it were by a certain ebullition or working so melancholick humors being the dregs or lees of the blood stirred by the passions of the minde defile or taint all the blood with their seculent impurity We found that some years agon by experience at the battle of S. Dennis For all wounds by what weapon soever they were made degenerated into great and filthy putrefactions and corruptions with severs of the like nature and were commonly determined by death what medicines and how diligently soever they were applied which caused many to have a false suspicion that the weapons on both sides were poysoned But there were manifest signs of corruption and putrefaction in the blood let the same day that any were hurt and in the principal parts disected afterwards that it was from no other cause then an evil constitution of the air and the mindes of the Souldiers perverted by hate anger and fear CHAP. V. What signs in the Air and Earth prognosticate a Plague WEe may know a plague to be at hand and hang over us if at any time the air and seasons of the year swerve from their natural constitution after those waies I have mentioned before if frequent and long continuing Meteors or sulphureous Thunders infect the air Why abortions are frequent in a pestilent season if fruits seeds and pulie be worm-eaten If birds forsake their nests eggs or young without any manifest cause if we perceive women commonly to abort by continual breathing in the vaporous air being corrupted and hurtful both to the Embryon and original of life and by which it being suffocated is presently cast forth and expelled Yet notwithstanding those airy impressions do not solely courrupt the air but there may be also others raised by the Sun from the filthy exhalations and poysonous vapors of the earth and waters or of dead carkasses which by their unnatural mixture easily corrupt the air subject to alteration as that which is thin and moist from whence divers Epidemial diseases and such as are every-where seize upon the common sort according to the several kinds of corruptions A Catarrh with difficulty of breathing killing many such as that famous Catarrh with difficulty of breathing which in the year 1510 went almost all over the world and raged over all the Cities and Towns of France with great heaviness of the head whereupon the French named it Cuculla with a straitness of the heart and lungs and a cough a continual fever and sometimes raving This although it seized upon many more then it killed yet because they commonly died who were either let blood or purged it shewed it self pestilent by that violent and peculiar and unheard of kinde of malignity The English Sweating-sickness Such also was the English Sweating-sickness or Sweating-fever which unusual with a great deal of terror invaded all the lower parts of Germany and the Low-Countries from the year 1525 unto the year 1530 and that chiefly in Autumn As soon as this pestilent disease entred into any City suddenly two or three hundred fell sick on one day then it departed thence to some other place The people strucken with it languishing fel down in a swound and lying in their beds sweat continually having a fever a frequent quick and unequal pulse neither did they leave sweating till the disease left them which was in one or two daies at the most yet freed of it they languished long after they all had a beating or palpitation of the heart which held some two or three years and others all their life after At the first beginning it killed many before the force of it was known but afterwards very few when it was found out by practice and use that those who furthered and continued their sweats and strengthened themselves with cordials were all restored But at certain times many other popular diseases sprung up as putrid fevers fluxes bloody-fluxes catarrhs coughs phrenzies squinances plurisies inflamations of the lungs inflamations of the eies apoplexies lithargies The Plague is not the definite name of one disease small pox and meazles scabs carbuncles and malign pustles Wherefore the Plague is not alwaies nor every-where of one and the same kinde but of divers which is the cause that divers names are imposed upon it according to the variety of the effects it brings and symptoms which accompany it and kinds of putrefaction and hidden qualities of the air What signs in the earth foreteâ—l a plague They affirm when the Plague is at hand that Mushroms grow in greater abundance out of the Earth and upon the surface thereof many kinds of poysonous insecta creep in great numbers as Spiders Catterpillers Butter-flies Grass-hoppers Beetles Hornets Wasps Flies Scorpions Snails Locusts Toads Worms and such things as are the off-spring of putrefaction And also wilde beasts tired with the voporous malignity of their dens and caves in the Earth forsake them and Moles Toads Vipers Snakes Lizards Asps and Crocodiles are seen to flie away and remove their habitations in great troops For these as also some other creatures have a manifest power by the gift of God and the instinct of Nature to presage changes of weather as rains showrs and fair weather and seasons of the year as the Spring Summer Autumn Winter which they testifie by their singing chirping crying flying playing and bearing with their wings and such like signs so also they have a perception of a Plague at hand And moreover the carkasses of some of them which took less heed of themselves suffocated by the pestiferous poyson of the ill air contained in the earth may be every-where found not onely in their dens but also in the plain fields These vapors corrupted not by a simple putrefaction but an occult malignity How pestilent vapors may kill plants and trees are drawn out of the bowels of the earth into the air by the force of the Sun and Stars and thence condensed into clouds which by their falling upon corn trees and grass infect and corrupt all things which the earth produceth and also kills those creatures which feed upon them yet brute beasts sooner then men as which stoop and hold their heads down towards the ground the maintainer and breeder of this poyson that they may get their food from thence Therefore at such times skilful husbandmen taught by long experience never drive their Cattle or Sheep to pasture before that the Sun by the force of his beams hath wasted and dissipated into air this pestiferous dew hanging and abiding upon the boughs and leaves of trees herbs corn and fruits But on the contrary that pestilence which proceeds from some malign quality from above by reason of evil and certain conjunction of the Stars is
Sena at one time brought forth seven children of which four were baptized In our time betweeen Sarte and Main in the parish of Seaux not far from Chambellay there is a family and noble house called Maldemeure the wife of the Lord of Maldemure the first year she was married brought forth twins the second year she had three children the third year four the fourth year five the fifth year six and of that birth she died of those six one is yet alive and is Lord of Maldemeure In the valley of Beaufort in the countie of Anjou a young woman the daughter of Mace Channiere when at one perfect birth she had brought forth one childe the tenth day following she fell in labor of another but could not be delivered untill it was pulled from her by force and was the death of the mother The Picture of Dorithie great with childe with many children Martin Comerus the author of the Polish historie writeth that one Margaret The ninth Book of the Polish Historie a woman sprung from a noble and ancient familie neer Cracovia and wife to Count Virboslaus brought forth at one birth thirtie five live children upon the twentieth daie of Jan. in the year 1296. Franciscus Picus Mirandula writeth that one Dorothie an Italian had twentie children at two births at the first nine and at the second eleven and that she was so big that she was forced to bear up her bellie which lay upon her knees with a broad and large scarf tied about her neck as you may see by this figure And they are to be reprehended here again who affirm the cause of numerous births to consist in the variety of the cels of the womb for they feign a womans womb to have seven cels or partitions three on the right side for males three on the left side for females and one in the midst for Hermophrodites or Scrats and this untruth hath gone so far that there have been some that affirmed every of the seven cels to have been divided into ten partitions into which the seed dispersed doth bring forth a divers and numerous encrease according to the varietie of cels furnished with the matter of seed which though it may seem to have been the opinion of Hippocrates in his Book De natura Pueri notwithstanding it is repugnant to reason and to those things which are manifestly apparent to the eies and senses The opinion of Aristotle is more probable who saith twins and more at one birth Lib. 4. de gen anim cap. 4. are begot and brought forth by the same cause that the sixth finger groweth on the hand that is by the abundant plentie of the seed which is greater and more copious then can be all taken up in the natural framing of one bodie for if it all be forced into one it maketh one with the parts encreased more then is fit either in greatness or number but if it be as it weâ—e cloven into divers parts it causeth more then one at one birth CHAP. IV. Of Hermophrodites or Scrats ANd here also we must speak of Hermophrodites because they draw the cause of their generation and conformation from the abundance of seed and are called so because they are of both sexes the woman yeelding as much seed as the man For hereupon it commeth to pass that the forming facultie which alwaies endeavors to produce something like it self doth labor both the matters almost with equal force and is the cause that one bodie is of both sexes Yet some make four differences of Hermophrodites the first of which is the male Hermophrodite who is a perfect and absolute male and hath only a slit in the Perinaeum not perforated and from which neither urine nor seed doth flow The second is the female which besides her natural privitie hath a fleshie and skinnie similitude of a mans yard but unapt for erection and ejaculation of seed and wanteth the cod and stones the third difference is of those which albeit they bear the express figures of members belonging to both sexes commonly set the one against the other yet are found unapt for generation the one of them only serving for making of water the fourth difference is of those who are able in both sexes throughly perform the part of both man and woman because they have the genitals of both sexes complete and perfect and also the right brest like a man and the left like a woman the laws command those to chuse the sex which they will use and in which they will remain and live judgeing them to death if they be found to have departed from the sex they made choice of for some are thought to have abused both and promiscuously to have had their pleasure with men and women There are signs by which the Physicians may discern whether the Hermophrodites are able in the male or female sex or whether they are impotent in both these signs are most apparent in the privities and face for if the matrix be exact in all its demensions and so perforated that it may admit a mans yard if the courses flow that way if the hair of the head be long slender and soft and to conclude if to this tender habit of the body a timid and weak condition of the minde be added the female sex is predominant and they are plainly to be judged women But if they have the Perinaeum and fundament full of hairs the which in women are commonly without any if they have a a yard of a convenient largeness if it stand well and readily and yeeld seed the male sex hath the preheminence and they are to be judged men But if the conformation of both the genitals be alike in figure quantity and efficacy it is thought to be equally able in both sexes although by the opinion of Aristotle Lib. 4. de gener anim cap. 5. those who have double genitals the one of the male the other of the female the one of them is alwaies perfect the other imperfect The figure of Hermophrodite twins cleaving together with their backs Anno Dom. 1486. in the Palatinate at the village Robach near Heidelberg there were twins both Hermophrodites born with their backs sticking together The effigies of an Hermophrodite having four hands and feet The same day the Venetians and Geneses entred into league there was a monster born in Italy having four arms and feet and but one head it lived a little after it was baptized James Ruef a Helvetian Cirurgian saith he saw the like but which besides had the privities of both sexes whose figure I have therefore set forth Pag. 647. CHAP. V. Of the changing of Sex AMatus Lusitanus reports that in the village Esquina there was a maid named Maria Pateca who at the appointed age for her courses to flow had instead of them a mans yard laying before that time hid and covered so that of a woman she became a man and therefore laying
cut even to the hollowness thereof Whilst Pus or matter is in generating pains and fevers happen rather then when it is already made 18. 5. Cold things are hurtful to the bones teeth nerves brain spinal marrow but hot things are good 46. 2. Two pains infesting together but not the same place the more vehement obscures the other 74. 7. A corruption an abscess of the bone is caused by the corruption of the flesh 50 6. Coacar praenot A livid or drie ulcer or yellowish is deadly 19. 6. When as a bone or gristle or nerve or small portion of the cheek or the prepuce is cut a sunder it neither increases nor grows together 24. 6. Aph. 513. Coacar If any of the small guts be cut it knits not again 50. 7 Those that have the brain sphacelate that is corrupt they die with in three daies if they escape these they recover 9. 7. Bleeding at a wound causing a convulsion is the fore-teller of death 20. 5. Cold is biting to ulcers hardens the skin causes pain not easily comming to supputation blackness aguish shakings convulsions cramps 508. Coac Those who have the temples cut have a convulsion upon the parts contrary to the section 44. 7. Whosoever being suppurate are burnt or cut if pure and white quiture shall flow forth they escape but if that which is bloody feculent and stinking then they dye Galen Comment ad Aphor. 29. 2. It is not fit to take in hand to cure such as are in a desperate case but to leave them one fore-telling the end of the disease Celsus cap. 10. Lib. 20. It is better to trie a doubtful remedy them none at all The Effigies of GALEN the Prince of Physicians next to HIPPOCRATES AEQuum erat Hippocratem divino è semine Divûm Orbem muneribus conciliare sibi Scripta sed involvit tam multo aenigmate verum Ut quamvis solers nullus habere queat Pergamei auxilio nisi sint monimenta Galeni Qui doctâ ambages sustulit arte senis Ergò macte esto virtute arcana resolvens Quae nulli fuerant nota Galene priûs Obstringens que orbem aeterno tibi munere totum Aeternis sacras te quoque temporibus BON. GRA. PARIS MEDIC Rules of Surgery by the Author 1 PRactice is an operation agreeable to the Rules and Laws of the Theory 2 Health is not received by Words but by Remedies fitly used 3 Remedies known and approved by use and reason are to be preferred before such as are unknown or but lately found out 4 Science without experience gets the Physician no great credit with the Patient 5 He that would perform any great and notable work must diligently apply himself to the knowledg of his subject 6 It is the part of a good Physician to heal the disease or certainly to bring it to a better pass as nature shall give leave 7 The Surgeon must be active industrious and well-handed and not trust too much to Books 8 He that hath not been versed in the operations of the Art not a frequent auditor of the Lectures of such as are leaned therein and sets forth himself for a Brave Surgeon for that he hath read much he is either much deceived or impudent 9 He shall never do any thing proise-worthy that hath got his mastery in Surgery by gold not by use 10 You shall comfort the patient with hope of Recovery even when as there is danger of death 11 To charge Physicians and Surgeons is troublesome but not good for the Patient 12 Though the disease prove long yet it is not fit that the Physician give over the Patient 13 Great wounds of large vessels are to be jadged deadly 14 Every contusion must be brought to suppuration 15 As the nature or kinde of the disease must be known so also must the remedy 16 An Abscess of the bone of the palat is in danger to cause a stinking breath 17 Bleeding caused by heat must be represt by cold 18 Wounds of nervous parts require medicines which by the subtilty of the parts may enter in and draw from far 19 It is not fit for such as have Ulcers in their Legs either to walk stand or fit but to rest themselves in bed 20 All biting and acrid medicines are offensive to clean Ulcers 21 For restoring of dislocations you must hold them fast them out and force them in 22 A great Gangrene admits no cure but cutting 23 A monster is a thing dissenting from the laws of nature 24 Wounds of the Chest presently become famous and purulent 25 The wounds made by all venemous creatures are dangerous 26 The south-winde blowing wounded members easily become mortified 27 Such as are wounded and desire to be quickly whole must keep a spare diet 28 Untemperate bodies do not easily recover of diseases 29. Round Ulcers unless they be drawn into another figure do not easily heal up 30 An Erysipelatous Ulcer requires purgation by stool 31 Crying is good for an infant for it serves in stead of exercise and evacuation 32 Grief is good for none but such as are very fat 33 Idleness weakens and extinguisheth the native heat 34 An ill-natured Ulcer yields not unless to a powerful remedy 35 A bath resolves and discusses humors and gently procures sweat 36 Cold diseases are troublesome to cold people and hard to be helped but in young bodies they are neither so troublesome not contumacious 37 Exercised bodies are less subject to diseases 38 Moist bodies though they need small nourishment yet stand they in need of large evacuation 39 Sick people dye sooner of an hot distemper then of a cold by reason of the quick and active operation of fire 40 The quitture that flows from an ulcer is laudable which is white smooth and equal The end of the Twenty Seventh Book The EIGHT and TWENTIETH BOOK How to Make Reports and to Embalm the Dead Why a surgeon must be careful in making of Reports NOw it only remains that we instruct the Surgeon in making and framing his Report or opinion either of the death of any person or of the weakness of deprivation of any member in the function or execution of its proper office and duty Herein it is meet that he be very considerate that is to say ingenious or wise in making his Report because the events or diseases are often-times doubtful and uncertain neither can any man fore-tel them certainly whether they will be for life or death by reason of the manifold nature of the subject of which we speak and also the uncertain condition of the humors both in their kinde and motion What judgment is difficult Which was the cause why Hippocrates even in the first of his Aphorisms pronounceth that judgment is difficult But first of all is is very expedient that a Surgeon be of an honest minde that he must alwayes have before his eyes a careful regard of the piety that is to say the fear of God and faith in
stricken with lightning fall on the contrary side only man falleth on the affected side if he be not turned with violence toward the coast or region from whence the lightning came If a man be stricken with lightning while he is asleep he will be found with eyes open contrariwise if he be stricken while he is awake his eyes will be closed as Pliny writeth Philip Commines writeth that those bodies that are stricken with lightning are not subject to corruption as others are Therefore in antient time it was their custom neither to burn nor bury them for the brimstone which the lightning bringeth with it was unto them in stead of salt for that by the driness and fiery heat thereof it did preserve them from putrefaction Signs of wounds given to a living or dead man Also it may be inquired in judgment Whether any that is dead and wounded received these wounds alive or dead Truly the wounds that ate made of a living man if he dye of them after his death will appear red and bloody with the sides or edges swoln or pale round about contrariwise those that are made in a dead man will be neither red bloody swoln nor puffed up For all the faculties and functions of life in the body do cease and fall together by death so that thenceforth no spirits nor blood can be sent or flow into the wounded place Therefore by these signs which shall appear it may be declared that he was wounded dead or alive Signs whether one be hanged alive or dead The like question may come in judgment when a man is found hanged whether he were dead or alive Therefore if he were hanged alive the impression or print of the rope will appear red pale or black and the skin round about it will bee contracted or wrinkled by reason of the compression which the cord hath made also oftentimes the head of the aspera arteria is rent and toâ—n and the second spondyl and the neck luxated or moved out of his place Also the arms and leggs will be pale by reason of the violent and sudden suffocation of the spirits moreover there will be a foam about his mouth and a foamy and filthy matter hanging out of his nostrils begin sent thither both by reason that the Lungs are suddenly heated and suffocated as also by the convulsion and concussion of the brain like as it were in the falling-sickness Contrariwise if he be hanged dead none of these signs appear for neither the print of the rope appears red or pale but of the same color as the other parts of the body are because in dead men the blood and spirits do not flow to the greived parts Whether one found dead in the water câ—me therein alive or dead Whosoever is found dead in the waters you shall know whether they were thrown into the water alive or dead For all the belly of him that was thrown in alive will be swollâ— and puffed up by reason of the water that is contained therein certain clammy excrements come out at his mouth and nostrils the ends of his fingers will be woâ—â— and excoriated because that he died striving and digging or scraping in the sand or bottom of the river seeking somewhat whereon he might take hold to save himself from drowning Contrarywise if he be thrown into the waters being dead before his belly will not be swoln because that in a dead man all the passages and conduits of the body do fall together and are stopped and closed and for that a dead man breaths not there appeareth no foam nor â—â—lthy matter about his mouth and nose and much less can the tops of his fingers be worn and excoriated for when a man is already dead he cannot strive against death But as concerning the bodies of those that are drowned those that swim on the upper part of the water being swoln or puffed up they are not so by reason of the water that is conteined in the belly but by reason of a certain vapor into which a great portion of the humors of the body are converted by the efficacy of the putrifying heat Therefore this swelling appeareth not in all men which do perish or else are cast out dead into the waters but only in them which are corrupted with the filthiness or muddiness of the water long time after they were drowned and cast on the shore But now I will declare the accidents that come to those that are suffocated and stifled or smothered with the vapor of kindled or burning charcoals Of such as are smothered by Charcoal and how you may fore-tel the causes thereof by the history following In the year of our Lord God 1575. the tenth day of May I with Robert Gleauline Doctor of Physick was sent for by Master Hamel an Advocate of the Court of Parliament of Paris to see and shew my opinion on two of his servants of whom the one was his Clerk and the other his Horse-keeper All his family supposed them dead because they could not perceive or feel their Arteries to beat all the extreme parts of their bodies were cold they could neither speak nor move their faces were pale and wan neither could they be raised up with any violent beating or plucking by the hair Therefore all men accounted them dead and the question was only of what kinde of death they died for their Master suspected that some body had strangled them others thought that each of them had stopped one anothers winde with their hands and others judged that they were taken with a sudden apoplexy But I presently inquired Whether there had been any fire made with coals in the house lately whereunto their master giving ear sought about all the corners of the chamber for the chamber was very little and close and at last found an earthen-pan with charcoal half burned which when we once saw we all affirmed with one voyce that it was the cause of all this misfortune and that it was the malign fume and venemous vapor which had smothered them as it were by stopping the passages of their breath Therefore I put my hand to the regions of their hearts where I might perceive that there was some life remaining by the heat and pulsation that I felt though it were very little wherefore we thought it convenient to augment and increase it Therefoâ—e first of all artificially opened their mouths which were very fast closed and sticking obstinately together and thereinto both with a spoon and also with a silver-pipe we put aqua vitae often distilled with dissolved hiera and triacle when we had injected these medicines often into their mouths they begâ—n to move and to stretch themselves and to cast up and expel many viscous excremental and filthy humors at their mouths and nostrils and their lungs seemed to be hot as it were in their throats Therefore then we gave them vomitories of a great quantity of Oxymel and beat them often
affirm that he is in danger of his life by reason of the malign symptoms that usually happen upon such wounds such as are great pain a fever inflammation abscess convulsion grangrene and the like Wherefore he stands in need of provident careful dressing by benefit whereof if he escape death without doubt he will continue lame during the remainder of his life by reason of the impotency of the wounded part And this I affirm under my hand Another in the hurts of divers parts We the Surgeons of Paris by the command of the Senate this twentieth day of March have visited Master Lewis Vertoman whom we found hurt with five wounds The first inflicted on his head in the middle of his fore-head-bone to the bigness of three fingers and it penetrates even to the second table so that we were forced to pluck away three splinters of the same bone The other was athwart his right cheek and reacheth from his ear to the midst of his nose wherefore we stiched it with four stitches The third is on the midst of his belly of the bigness of two fingers but so deep that it ascends into the capacity of the belly so that we were forced to cut away portion of the Kall comâ—ing out thereat to the bigness of a walnut because having lost its natural colour it grew black and putrified The fourth was upon the back of his left hand the bigness almost of four fingers with the cutting of the veins arteries nerves and part of the bones of that part whence it is that he will be lame of that hand howsoever carefully and diligently healed Now because by hurting the spinal marrow men become lame sometimes of a leg it is fit you know that the spinal marrow descends from the brain like a rivulet for the distribution of the nerves which might distribute sence and motion to all the parts under the head wherefore if by hâ—â—ing the spinal marrow the patients arms or hands are resolved or numb or wholly without sense it is a sign these nerves are hurt which come forth of the fifth sixth seventh vertebrae of the neck But if the same accidents happen to the thigh leg or foot with refrigeration so that the excrements flow voluntarily without the patients knowledg or else are totally supprest it is a sign that the sinews which proceed from the vertebrae of the loins and holy-bone are hurt or in fault so that the animal faculty bestowing sence â—nd motion upon the whole body and the benefit of opening and shutting of the sphincter-muscle of the bladder and fundament cannot shew its self in these parts by which means sudden death happens especially if there be difficulty of breathing therewith A caution in making report of a woman with chi de being killed Being tâ— make report of a childe killed with the mother have a care that you make a discreet report whether the childe were perfect in all the parts and members thereof that the Judge may equally punish the author thereof For he meriteth far greater punishment who hath killed a childe perfectly shaped and made in all the members that is he which hath killed a live-childe then he which hath killed an Embryon that is a certain concretion of the spermatick body For Moses punisheth the former with death as that he should give life for life but the other with a pecuniary mulct But I judg it fit to exemplifie this report by a President I. A. P. By the judges command visited Mistris Margaret Vlmargy whom I found sick in bed having a strong fever upon her with a convulsion and efflux of blood out of her womb by reason of a wound in her lower belly below her navel on the right side penetrating into the capacity of her belly and the wound therein whence it hath come to pass that she was delivered before her time of a male childe perfect in all his members but dead being killed by the same wound piercing through his scull into the marrow of the brain Which in a short time will be the death of the mother also In testimony whereof I have put my hand and seal The manner how to Embalm the dead I Had determined to finish this my tedious work with the precedent Treatise of Reports but a better thought came into my head which was to bring Man whose cure I had undertaken from his infancy to his End and even to his Grave so that nothing might be here defective which the Surgeon might by his proâ—ession perform about mans body either alive or dead Verily there hath scarce ever been a Nation so barbarous which hath not only been careful for the Burial but also for the Embalm ng or preserving of their dead bodies For the very Scythians who have seemed to exceed other Nations in barbarousness and inhumanity have done this for according to Heredâ—tus the Scythians bury not the corps of their King The caâ—e of the Sâ—â—â—ians in the Embalming their deâ—d The like care of the Ethiopians before that being emboweled stuffed full of beaten Cypress Frankinsence the seeds of Parsley and Aâ—ise he be also wrapped in sear-cloths The lâ—ke care hath also possessed the mindes of the Ethi pians for having disburdened the corps of their friends of their entrails and flesh they plastered them over and then having thus rough-cast them they painted them over with colors so to express the dead to the life they inclosed them thus adorned in a hollow pillar of glass that thus inclosed they might be seen and yet not annoy the spect tors with their smell Then were they kept for the space of a year in the hands of their next kindred who during this space offered and sacrificed to them The year ended they carried them forth of the city and placed them about the walls each in his proper vault Lib. 3. Oâ— the Egyptians as Herod tus affi ms But this pious care of the dead did far otherwise affect the Egyptians then it did other nations For they were so studious to preserve the memory of their ancestors that they Embalmed their whole body with aromatick ointments and set them in translucent Urns or glass-Cells in the more emâ—nent and honored part of their houses that so they might have them daily in their sight and might be as monuments and inciters to stir up them to imitate their Fathers and Grandsiâ—es virtues Besides also the bodies thus embalmed with aromatick and balsamick ointments were in â—â—eâ—d of a most sure pawn so that iâ— any Egyptian had need of a great sum of mony they might easily procure it of such as knew them and their neighbors by pawning the dead body of some of their dead parents For by this means the creditor was certain that he which pawned it would sooner lose his life then break his promise But if all th ngs so unhappily succeeded with any so that through poverty he could not fetch home his pawn again but