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

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Saffron make a Cataplasme Note that though this be the general Cure of Impostumes they have nevertheless a more proper and particular one according to their several differences but this is as 't were a Rule whereby to proceed in it CHAP. III. Of Wounds THE General Practice of Impostumes being sufficiently treated of in the former Chapter this shall be adapted to expound such Notions as belong to the Cure of Wounds whereof this is the Definition A Wound is a Solution of Continuity caused by an external Instrument in any part of the Body but the Bones Their Causes are all such things as may violate the outward circumference of the Body and unnaturally enter in it and they are either animated as the biting and stinging of Beasts or inanimated as Swords Darts Bullets c. The difference of Wounds is manifold and as Samoicus saith Tam varia humanae sunt vulnera conditionis Ut nequeant proprias cunctis adscribere curas The Wounds of Men are seen so manifold The proper Cure of each cannot be told Nevertheless I have endeavoured to include the most General in the following Paragraphs The Differences of Wounds are drawn either I. From the nature of the wounded part which is First Similary and that 1. Soft as the Glandules and Flesh. 2. Hard as the Gristles 3. Mean as the Membranes and Ligaments Secondly Diss●milary which is either 1. Principal as 1. The Brains 2. The Heart 3. The Liver 2. Ministring to the principal as 1. Aspera Arteria 2. The Lungs 3. Neither of the foresaid as 1. The Eyes 2. The Hands 3. The Feet II. From their own Essence whereby they are termed First Simple when there is no Complication of other Diseases or Accidents Secondly Composed when there is some other Disease or Accident indicating a peculiar Curation III. From their Quantity by which they are termed First Great that is 1. Long 2. Broad 3. Deep Secondly Mean in all Dimensions Thirdly Little that is 1. Short 2. Narrow 3. Superficious IV. From their Figure whence we call them 1. Strait 2. Round 3. Crooked c. When a Wound doth pierce the Skul ●s known by these following Signs The wounded party doth presently ●all lying without sense as if he were a sleep the Ex●rements are not retain●ed and surely if the blood floweth by the Ears Nostrils or the Mouth and if ●he Vomits Choler c. Whether the Wound penetrates into the Thorax is known if the Air com●eth forth at the Wound with a difficulty of Respiration if there be a gravative ●ain on the Diaphragme which is caused by much Blood lying on that part that must afterward be rejected by coughing A little after cometh a Feaver and stinking breath the Patient can lye but on the Back and hath a perpetual desire of Vomiting it often degenerates in a Fistula When the Lungs are hurt there issueth a Spumous Blood at the Wound with Co●ghing there is a great difficulty of Respiration and pain of the 〈◊〉 We know the Heart to be Wounded by the great quantity of Blood that cometh out at the Wound by a trembling of the whole Body a little Pulse a Paleness of the Face and a cold Sweat and ●requent Swounings a coldness of the Extremities and a hasty Death When the Diaphragme is hurt there is a gravati● pain in that part with Phrensie difficulty of Breath Cough with a sharp pain and a contraction of the flanks upwards These signs appearing one may pronounce Death to be near The Vena Cava or great Artery being hurt Death speedily followeth because of the great loss of Blood and Spirits whence the Function of the Heart and Lungs do cease When the Medulla Spinalis is wounded a Paralysis or Conv●lsion presently hapneth the motion of the lower part is abolished the Excrements of the Belly and Bladder either flow unwittingly or are wholly suppressed The Liver being wounded there cometh a great deal of Blood out at the Wound and a Pungitive pain is felt as far as the Cartilage Xiphoides which Death often followeth When the Stomach is wounded the meat and drink cometh out at the Wound then come Sweats and Cold of the extremities fore-runners of Death If the Spleen be wounded there floweth a blackish blood at the Wound Thirst troubleth the Patient with a pain of the left side and the blood flowing into the Belly causeth many accidents and often Death The Gutts being wounded a great pain torments the Bowels the Excrements issue out at the Wound and sometimes the Gutts out of the Abdomen which afterwards pain and swell When the Kidneys are hurt there is a great pain in making Water the Blood coming out therewith and the pain stretching it self to the Yard and Testicles The Bladder and Ureters being wounded the pain reacheth to the Flanks the parts of the Nombril are extended the Urine cometh out bloody and sometimes out at the wound When the Womb is hurt the Blood cometh out at the Privities the same accidents appearing as when the Bladder is wounded The Nerves being prickt or half cut a sharp pain is felt in the wounded part with a sudden inflammation fluxion tumor feaver and convulsion often with gangrene and death unless it be remedied in time Those Wounds are esteemed dangerous which do affect some principal Sinew Vein or Artery Whereunto are added those that are in●licted in the Privities of Man or Woman or in their parts dedicated to natural excretion as also those that hurt either end of any muscle but such as are in the fleshy parts according to the length of the fibres are esteemed the least considerable If a Bone Sinew Tendrel or a portion of the Face or Prepuce be cut off it cannot be repaired All Wounds in the Bladder Brain Heart Liver Lungs Stomach and smal● Guts are deemed mortal The general indication in the Cure of Wounds is the adjunction of what is separated wherein the Chirurgeon ought to be furnished with five Intentions The first whereof is to extract all strange Bodies as Bullets Darts Arrows Splinters c. if any do hinder the Wounds agglutination The second to bring the divided extremities together The third to keep them so The fourth to preserve the wounded parts temperature The fifth to correct such accidents as may fall out The first of these intentions is performed either with the Fingers or some material Instrument at the first dressing unless the extraction of the foresaid things might occasion an Hemoragy or some other dreadful accident for then the safest is to leave their expulsion to Nature but since it may sometimes not little be advanced by Medicaments take this following description Recipe The Root of Iris of Florence of Panacis and Capers of each three Drachms round Aristaloch Manna and Frankincense of each one Drachm beat them to a powder and incorporate them with Honey of Roses and Turpentine of Venice of each two Ounces Make a Salve thereof The second and third intention in the Cure
and hurtful and is either of the whole body chiefly performed by Phlebotomy Sweat and Purgation or of the several parts by their respective Conduits as the Brains by the Eyes Nose and Eares the Lungs by the Wind-pipe c. In all Evacuation three things are to be observ'd and considered The Quantity Quality and manner of Excretion V. g. The Empieme being opened the excluded matter ought to be answerable in quantity to that which is included The most laudable is white even and as little stinking as may be And lastly all must be purged out at one time least the Patient suffer too great an Effusion of Spirits The Passions of the Soul or Perturbations of the Mind are very prevalent to alter the Bodies Constitution for as the Banished Poet saith Unda locusque nocent causa valentior istis Anxietas animi quae mihi semper adest The Sea and place do hurt but yet I find A greater Cause the torment of my mind We wil therefore brie●ly expound their Effects A moderate Ioy dilates the heart and distributes abundance of Spirits to the Face and other parts it helps Concoction and renders our habitude more chearful and pleasant Anger or Wrath performs the like effusion but much more rapid and swift● It kindleth sometimes the Humours so much that it makes them apt to receive a sharp volatile Salt which is thought the cause of putrid Feavers and produceth also other Symptoms yet it may be profitably used to quicken the natural heat and render it more active when it is almost prostrated Sorrow and Fear draw heat and blood suddenly to the Heart whence the forces do presently fall and sometimes death immediately follows the Vital Faculty being over whelmed with Blood and Spirits This I conceive sufficient since all other Passions of the mind may be referred to these three or four Those things are termed against nature which may procure the destroying and ruine of the Body They are the cause of Diseases Disease it self and its Accidents or Symptoms The Cause of a Disease is Whatsoever doth any way contribute to the being or increase of it Which though Physitians give them many distinctions may nevertheless all be referred to the efficient especially divided in 1. External 2. Internal For Alas How many things may extinguish our light The humours within us maintain an equal fight and least it be too long Death hath a Pike a Ball a Sword a Knife a Stone and an Arrow to cut our feeble thred c. The External Cause cometh from without the Internal hath its seat in the Body and is either 1. Antecedent that yeilds aptitude to a sickness Or 2. Conjoyn'd which immediately and of it self perfects it They are also co-ingendred with the Patient or have accesse to him after his Birth A Disease is A disposition against Nature immediately and of it self hurting the actions The same is Simple or Complicated The first is when there is no plurality or composition of Diseases The second When it is followed of many Symptoms or when the Cause is so connexed with it that it may be lookt upon as a particular Sickness Diseases are of a threefold species 1. Intempery 2. Evil Conformation 3. Solution of Continuity The first is an Indisposition of the Similary parts caused by the excess of a single Humour or the Exuberance of more The last whereof is called naked or conjoyned with a Vice of the same Humours and is termed equal as being ●qually spread throughout the whole Body or inequal as affecting only some particular part of it There are four sorts of evil Conformation Namely in 1. Figure 2. Magnitude 3. Number 4. Scituation Solution of Continuity is a common Disease of the Similary and Organical parts which hath several Names according to the places where it is incident For in the Flesh it is called Helcos in the Bones Cathagma in the Nerves Spasma The Symptoms of a Disease are the Effects and Productions of it To wit 1. A hurt action that is 1. Abolished 2. Diminished Or 3. Depraved 2. A Vice in the Bodyes Habitude 3. Vitiated Excretions Of the aforesaid Precepts are collected two Intentions 1. What is to be done 2. And if it may be done But the third belongs to Art viz. How it must be done The Practice whereof is better declared in the Words annexed and the following Chapters that do briefly comprehend what doth belong to a Chirurgeon The Indications are of three first and principal Species viz. 1. The first is drawn from the natural things which do Indicate their conservation by the use of things like to themselves and of this kind are the Indications drawn from 1. The strength and forces of the Patient which to preserve the proper Cure is often to be delayed for without them the Chirurgeon can effect but little 2. His Temper viz. 1. Sanguine 2. Cholerick 3. Phlegmatick 4. Melancholy 3. The Habitude of his Body 1. Soft and delicate 2. Lean or Fat. 3. Tall or Short Least he lose that Symetry which Nahath allotted him 4. The Condition and Nature of the part affected Wherein we consider 1. It s Substance whether if Similary it be 1. Hot. 2. Cold. 3. Moist 4. Dry. If Organical 1. Principal 2. Or Ignoble If it be 1. Of a quick Sense 2. Or Stupid and Dull And lastly it s 1. Form 2. Figure 3. Magnitude 4. Number 5. Connexion 6. Action or Use. 5. The Age for many Diseases cannot be Cured in Old Age. 6. The Sex for Women are easier purged than Men. 7. The Season of the Year for Hot meat is convenient in Winter Cold in Summer Moist in Autumn and Dry in the Spring 8. The time of the Disease for what is convenient in the beginning is not so in the progress state or end II. The second is drawn from the things not Natural Which do indicate their Alteration as if Air does conspire with Nature against the Disease it ought to be kept otherwise it must be altered III. The third is taken from the things against Nature which indicate their Ablation and are 1. The Cause of a Disease 2. The Disease it self 3. The Symptoms Which do often indicate contrary things but then this is the Rule When there is Complication the first Remedies ought to take away 1. The most Dangerous 2. The Cause 3. That without which nothing can be done As 1. Loss of Blood 2. Fluxion 3. Intempery A SHORT Compendium OF The PRACTICAL Part OF CHIRURGERY CHAP. II. Of Impostumes HAving thus far treated of such Theorems and Institutions as are wholly necessary to be known of all Well wishers to Chirurgery let us now say something of the Practical part thereof since it is almost impossible to treat perfectly of the Theorical unless the same do give some urgent occasion of it and in this it resembles the three Parts of Curative Physick that can hardly be separated from one another for as a French Poet doth intricately say Quand