marke it with inke then taking the skin up betweene your fingers cut it longwayes according as you have marked it then free the bared veine from the adjacent bodies and put thereunder a blunt pointed needle least you pricke the veine thred with a strong double thred and so binde it fast and then let it be opened with a Lancet in the middle under the Ligature just as you open a veine and draw as much therehence as shall be fit Then straight make a Ligature in the lower part of the forementioned Veine and then cut away as much of the sayd Veine as is convenient betweene the Ligatures and so let the ends thereof withdraw themselves into the flesh above and below let these ligatures alone untill such time as they fall away of themselves The operation being performed let an astringent medicine be applyed to the wound and the neighbouring parts neither must you stirre the wound any more for the space of three dayes Then doe all other things as are fit to be done to other such affects CHAP. XXI Of Fistula's A Fistula is a sinuous white narrow callous and not seldome unperceivable Vlcer It tooke its denomination from the similitude of a reeden Fistula that is a pipe like whose hollownes it is A Fistula is bred in sundry parts of the body and commonly followes upon Abscesses or Vlcers not well cured A Callous is a certaine fleshy substance white solid or dense and hard dry and without paine generated by heaping up of dryed excrementitious phlegme or else adult melancholy encompassing the circuite of the Vlcer and substituting its selfe into the place of laudible flesh The Sinus or cavity of a Fistula is sometimes dry and otherwhile drops with continuall moisture sometimes the dropping of the matter sodainly ceases and the orifice thereof is shut up that so it may deceive both the Chirurgion and the Patient with a false shew of an absolute cure for within a while after it will open againe and run as formerly it did Some Fistula's are bred by the corruption of a bone others of a nerve others of membranes and others of other parts of the body Some run straight in others and that the greater part have turnings and windings some have one others have more orifices and windings some are at the Ioynts others penetrate into some capaoity of the body as into the chest belly guts womb bladder some are easily others difficultly cured and some wholly uncurable There are divers signes of Fistula's according to the variety of the parts they possesse for if that which you touch with the end of your probe make resistance and resound then you may know that it is come to the bone and then if the end of the probe slip up and downe as on a smooth and polite superficies it is a signe that the bone is yet sound but if it stop and stay in any place as in a rough way then know that the bone is eaten rough and perished sometimes the bone lies bare and then you neede not use the probe Besides also it is a signe that the bone is affected if there be a purulent efflux of an unctuous or oily matter not much unlike that marrow wherewith the bone is nourished For every excrement shewes the condition of the nourishment of the part whence it is sent in a Fistula which penetrates to a Nerve the patient is troubled with a pricking paine especially when you come to search it with a probe especially if the matter which flowes downe be more acrid Oft times if it be cold the member is stupified the motion being weakned besides also the matter which flowes from thence is more subtle and somewhat like unto that which flowes from the bones yet not oily nor fat but sanious and viscous resembling the condition of the alimentary humor of the Nerves The same usually appeares and happens in Fistula's which penetrate to the Tendons and those membranes which involve the muscles If the Fistula bee within the flesh the matter flowing thence is more thicke and plentifull smooth white and equall If it descend into the Veines or Arteries the same happen as in those of the Nerves but that there is no such great paine in searching with your probe nor no offence or impediment in the use of any member yet if the matter of the Fistulous Vlcer be so acrid as that it corrode the vessells blood will flow forth and that more thicke if it be from a veine but more subtle and with some murmuring if from an Artery Old Fistula's and such as have run for many yeares if suddainly shut up cause death especially in an ancient and weake body CHAP. XXII Of the cure of Fistula's FOr the cure in the first place it will be expedient to search the Fistula that either with a waxe size a probe of lead gold or silver to find out the depth and windings or corners thereof But if the Fistula be hollowed with two or more orifices and those cuniculous so that you cannot possibly and certainly search or finde them all out with your probe then must you cast an injection into some one of these holes and so observe the places where it comes forth for so you may learne how many and how deepe or superficiary cavities there be then by making incisions you must lay open and cut away the callous parts You must make incisions with an incision knife or razour or else apply actuall or potentiall cauteries for nature cannot unlesse the Callous substance bee first taken away restore or generate flesh or agglutinate the distant bodies For hard things cannot grow together unlesse by the interposition of glue such as is laudible blood but a callous body on all sides possessing the surface of the ulcerated flesh hinders the flowing of the blood out of the capillary veines for the restoring of the lost substance and uniting of the disjoyned parts If you at any time make causticke injections into the Fistula you must presently stop the orifice thereof that so they may have time to worke the effect for which they are intended Which thing we may conjecture by the tumor of the part the digesture of the flowing matter and its lesser quantity Then you must hasten the falling away of the Eschar and then the Vlcer must be dressed like other Vlcers But oft times the Callous which possesses the sinuous cavity of a Fistula overcome by the power of acrid and escharoticke medicines comes whole forth and falls out like a pipe and so leaves a pure Vlcer underneath it Which I observed in a certaine Gentleman when I had washed with strong Aegyptiacum divers times a Fistulous Vlcer in his thigh shot through with a bullet then presently by putting in my Balsame formerly described he grew well in a short time Fistula's which are neare great vessells Nerves or principall intrailes must not bee medled with unlesse with great
if his hands bee forth already so that it may seeme hee may bee drawne forth easily that way yet it must not be so done for so his head would double backwards over his shoulders to the great danger of his mother Once I was called unto the birth of an infant whom the midwives had assayed to draw out by the arme so that the arme had been so long forth that it was gangrenate whereby the childe dyed I told them presently that his arme must bee put in againe and hee must bee turned otherwise But when it could not bee put backe by reason of the great swelling thereof and also of the mothers genitals I determined to cut it off with an incision knife cutting the muscles as neare as I could to the shoulder yet drawing the flesh upwards that when I had taken off the bone with a paire of cutting pincers it might come downe againe to cover the shivered end of the bone lest otherwise when it were thrust in againe into the wombe it might hurt the mother Which being done I turned him with his feete forwards and drew him out as is before sayd But if the tumour either naturally or by some accident that is to say by putrefaction which may perchance come bee so great that hee cannot bee turned according to the Chirurgions intention nor be drawne out according as hee lyeth the tumour must bee diminished and then hee must bee drawne out as is aforesaid and that must bee done at once As for example if the dead infant appeare at the orifice of the wombe which our mydwives call the Garland when it gapeth is open and dilated but yet his head being more great and puffed up with winde so that it cannot come forth as caused to bee so through that disease which the Greeks call Mucrophisocephalos the Chirurgion must fasten a hooke under his chinne or in his mouth or else in the hole of his eye or else which is better and more expedient in the hinder part of his head For when the scull is so opened there will bee a passage whereat the winde may passe out and so when the tumour falleth and decreaseth let him draw the infant out by little and little but not rashly lest he should break that whereon he hath taken hold the figure of those hookes is thus The forme of hookes for drawing out the infant that is dead in the wombe But if the breast bee troubled with the like fault the hookes must bee fastened about the chanell bone if there bee a Dropsie or a Tympany in the belly the hooks must bee fastned either in the short ribs that is to say in the muscles that are betweene the ribbes or especially if the disease doe also descend into the feete about the bones that are above the groine or else putting the crooked knife here pictured iâ—…he wombe with his left hand let him make incision in the childs belly and so get out all his entrals by the incision for when hee is so bowelled all the water that caused the dropsie will out But the Chirurgion must do none of all these things but when the child is dead and the woman that travelleth in such danger that shee cannot otherwise be holpen But if by any meanes it happeneth that all the infants members bee cut away by little and little and that the head onely remaineth behinde in the wombe which I have sometimes against my will and with great sorrow seene then the left hand being anoynted with oyle of Lillies or fresh butter must bee put into the wombe wherewith the Chirurgion must find out the mouth putting his fingers into it then with his right hand hee must put up the hooke according to the direction of the left hand gently by little little and so fasten it in the mouth eye or under the chin and when hee hath firmely fixed or fastened it hee must therewith draw out the head by little and little for feare of loosening or breaking the part whereon hee hath hold In stead of this hooke you may use the instruments that are here described which therefore I have taken out of the Chirurgery of Francis Dalechamps for they are so made that they may easily take hold of a sphaericall and round body with the branches as with fingers Gryphons Talons that is to say instruments made to draw out the head of a dead infant that is separated in the wombe from the rest of the body But it is not very easie to take hold on the head when it remaineth alone in the wombe by reason of the roundnesse thereof for it will slip and slide up and downe unlesse the belly be pressed downe and on both sides thereby to hold it unto the instrument that it may with more facility take hold thereon CHAP. XXVII What must bee done unto the woman in travell presently after her deliverance THere is nothing so great an enemy to a woman in travell especially to her whose child is drawne away by violence as cold wherefore with all care and diligence shee must bee kept and defended from cold For after the birth her body being voyde and empty doth easily receive the ayre that will enter into every thing that is empty and hence shee waxeth cold her wombe is distended and puffed up and the orifices of the vessels thereof are shut and closed whereof commeth suppression of the after-birth or other after purgations And thereof commeth many grievous accidents as hystericall suffocation painefull fretting of the guts feavers and other mortall diseases What woman soever will avoyde that discommodity let her hold her legges or thighes acrosse for in so doing those parts that were separated will bee joyned and close together againe Let her belly bee also bound or rowled with a ligature of an indifferent breadth and length which may keep the cold ayre from the wombe and also presse the bloud out that is contained in all the substance thereof Then give her some Capon broth or Caudle with Saffron or with the powder called Pulvis ducis or else bread toasted and dipped in wine wherein spice is brewed for to restore her strength and to keepe away the fretting of the guts When the secundine is drawne out and is yet hot from the wombe it must bee layd warme unto the region of the wombe especially in the winter but in the summer the hot skinne of a Weather newly killed must be laid unto all the whole belly and unto the region of the loynes But then the curtaines of the bed must bee kept drawne and all the windowes and doores of the chamber must bee kept shut with all diligence that no cold ayre may come unto the woman that travelleth but that shee may lye and take her rest quietly The Weathers skinne must bee taken away after that it hath lyen five or sixe houres and then all the region of her belly must bee annointed with the oyntment following â„ž
are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it selfe as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animall parts to performe voluntary motions others upon the vitall to performe the agitation of the Heart and Arteries others upon the naturall for attraction retention and expulsion Yet we must observe that the attraction of no simular part is performed by the helpe of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of Emptinesse or the familiarity of the substance The flesh also is a simple and soft part composed of the purer portion of the blood insinuating it selfe into the spaces betweene the fibers so to invest them for the uses formerly mentioned This is as it were a certaine wall and Bulwarke against the injuries of heat and cold against all falls and bruises as it were a certaine soft pillow or cushion yeelding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kinde is more pallid even in perfect creatures having blood such is the flesh of the heart stomacke weasond guts bladder wombe The third is belonging to the entrails or the proper substance of each entrail as that which remaines of the Liver the veines arteries and coate being taken away of the bladder of the Gall braine kidneys milt Some adde a fourth sort of flesh which is spongy and that they say is proper to the tongue alone A veine is the vessel pipe or channel of the blood or bloody matter it hath a spermaticke substance consists of one coate composed of 3 sorts of fibers An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermaticke substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thicke and dense than the utmost interwoven with transverse fibers and it doth not onely conteine blood and spirit but also a serous humor which wee may beleeve because there bee two emulgent Arteryes aswell as veines But the inner coat of an Artery is therefore more thick because it may containe blood which is more hot subtle and spirituous for the spirit seeing it is naturally more thin and light and in perpetuall motion would quickly flye away unlesse it were held in a stronger hold There is other reason for a veine as that which containes blood grosse ponderous and slow of motion Wherefore if it had acquired a dense and grosse coate it could scarse bee distributed to the neighbouring parts God the maker of the universe foreseeing this made the coats of the vessels contrary to the consistance of the bodyes contained in them The Anastomosis of the veines and Arteryes that is to say the application of the mouthes of the one to the other is very remarkeable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that anastomosis is apparent in the veine and artery that meet together at the Ioint and bending of the Arme which I haue sometimes shewed in the Physicke schooles at such time as I there dissected Anatomyes But the action or function of a muscle is either to move or confirme the parte according to our will into which it is implanted which it doth when it drawes it selfe towards its originall that is to say it 's head But wee define the head by the insertion of the nerve which wee understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower belly NOw seeing that wee haue taught what a muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remaines that wee come to the particular explication of each Muscle begining with those of the lower belly as those which we first meet withall in dissection These are 8 in number 4 oblique 2 on each side two right or direct one on the right another on the left side and in like manner 2 transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may adde to this number the 2 little Supplying or Assisting muscles which are of a Pyramidal forme and arise from the share-bone above the insertion of the right muscles Of the oblique muscles of each side the one ascends the other descends whereupon it comes to passe that they are called the Oblique descendant and Ascendant Muscles Those oblique which wee first meet with are the descendant whose substance is partly sanguine partly spermaticke for they are fleshy nervous ligamentous veinous arterious and membranous Yet the fle shy portion is predominant in them out of which respect Hippocrates is wont to expresse the muscles by the name of fleshes their greatnes is indifferent betweene the large and the small muscles their figure 3 square They are composed of the fore-mentioned parts they are two in number their site is oblique taking their beginning from the touching of the great saw Muscle and from the sixt and seventh true ribbes or rather from the spaces between the sixe lower ribbes and rather on the forepart of the muscles than of the ribbes themselues from whence shunning the Veriebra's of the loines the fleshy parts of them are terminated in the externall and upper eminency of the Haunch-bone and the Membranous end in the lower eminency of the share-bone and the white-White-line Yet Columbus dissenting from this common description of the oblique Muscles thinks that they are onely terminated in the White line and not in the share-bone For saith he wherefore should they be inserted into the share-bone which is not moved But because it would bee an infinite labour and trouble to set downe at large the severall opinions of all Authors of Anatomy I haue thought it sufficient for me to touch them lightly by the way Their connexion is with the oblique ascendant lying vnder them and with the direct or right Their temperament is twofold the one hot and moist by reason of the belly and the fleshy portion of them the other cold dry in respect of their ligamentous and tendinous portion Their action is to draw the parts into which they are inserted towards their originall or els to unite them firmely Yet each of these
privately and properly drawes the hip in an oblique manner towards the Cartilago Scutiformis or brest-blade Then follow the oblique ascendant who haue the same substance quantity figure composure number and temper the descendant have They are scituate between the descendant and transverse with whom they have connexion especially by the vessels which are brought from the parts beneath All the fleshy parts arise from the rackbones of the Haunch to the ends of the bastard ribs which they seeme to admit above and below being fleshy even to the fourth and then becomming membranous they take their way to the white line with a double aponeurôsis which passes through the right Muscles above and below as wee may plainely see from the navill downewards In their fleshy part they draw their originall from the spine of the Haunch bones a little lower than the descendent end in their fleshy parte But for their membranous parts they arise before from the share bone but behinde from the spondiles of the Holy bone and Vertebra's of the loines obliquely ascending vpwards to the white line into which they are terminated by an aponeourôsis or membranous tendon which seemes to penetrate the right Muscle vpwards and downewards especially vnder the navil but by their fleshy part at the ends of all the bastard ribbes which they seeme to receive above and below And because these muscles are terminated in the white line they have also another use yet such as is common to all the muscles of the Epigastrium that is to presse down the Guts Their action is if they performe it together to draw downe the chest and dilate the brest but if their actions be separate they draw the chest to the hip with an oblique motion After these follow the right muscles so called because they descend according to the length of the body because they have right or streight fibers Wee will say nothing to shunne prolixitie which in all other places wee will avoid of their substance and other conditions which they have common with the fore mentioned Muscles They are scituate in the eminentest or extuberating region of the belly bounding the Epigastrium taken in generall or the superficiary belly they are devided by the manifest intercourse of the white line even to the Navell in which place they seeme to be united even to the place of their insertion They draw their originall not from the share bone as some would have it but according to the insertion of their nerves from the sides of the Cartilago scutiformis the ends of the sixt seventh and eight ribbs but they end in the share bone where they make a common tendon sufficiently strong and short Syluius Vesalius and Columbus thinke they arise from the share bone because they cannot be inserted into that bone because it is immoveable You may perceive in these Muscles certaine nervous transverse intersections often times three in number for the strength of these Muscles of which Galen makes no mention although they may be seene in Apes And also in the inner side of these muscles you may see foure veines and as many arteryes of which some creepe upwards others run downwards The upper called the Mamillary descend from the Axillarie by the side and lower partes of the Sternon the slenderer portions thereof being distributed by the way to the Mediastinum and about the fourth and fift rib to the Dugges from whence they take their name That which remaines breaking out by the sides of the Brest-blade inserts it selfe into those muscles creeping along euen almost to the navell in which place they are manifestly united that is the veines with the veines and arteries with the arteryes with the Epigastricke which ascend from the vpper part of the Iliackes on each side under the said muscles untill they meet with these 4 mamillary vessels That you may finde this concourse of the veines and arteryes about the navill you must follow both the upper and the lower somewhat deepe into the flesh pressing the blood on both sides from above downewards and from below upward untill you shall finde the exosculation of these vessels which will appeare by this that the blood will flow from this into that and from that into this otherwise you can scarce perceiue it by reason of the smallnes of such vessels which want blood But that by the benefit of such concourse of the vessels the matters may be communicated and transported both from the wombe to the dugs and againe from the dugs to the wombe appeares in Nurses who want their courses when the milke comes into their dugs and on the contrary lose their milke when their courses flow plentifully Otherwise to what purpose should there be such concourse betweene the vessels of the pappes and wombe for there are veines and arteries diffused to the sides of the wombe from the roote of the Epigastrickes for indeed the Epigastrickes which in their ascent meete with the mamillary goe not to the wombe though they be next to them and arise from the same truncke with the Hypogastricke veine of the wombe The Action of these muscles is to move or drawe neere together the parts of the Hypogastrium to the praecordia or Hypochondryes Their use in Columbus opinion is to draw the Brest downewards so to dilate it At the ends of these Nature hath produced two other small Muscles from the upper part of the share bone of a triangular figure for the safety of the thicke and common tendon of the right Muscles whereupon they are called Succenturiati or assisters Some moved with I know not what reason would haue these two small Muscles to help the erection of the yeard Columbus thinkes they should not be separated from the right and that they only are the fleshy beginnings of the right But on the contrary Fallopius manifestly proves them different and separate from the right and shewes their vse The Transverse remine to be spoken of so called by reason of their fibers which make right angles with the fibers of the right Muscles They haue a quadrangular figure scituate vpon the greatest part of the Peritonaeum to which they sticke so close that they scarse can be separated They take their originall from the production of the loines the Eminency of the Haunch-bone the transverse productions of the vertebra's of the loynes and the ends of the bastard ribs contrary to the opinion of many whom the insertion of the nerve convinces but they end in the white line as all the rest doe Their action is to presse the guts especially for the expulsion of excrements But all the 8 recited Muscles besides their proper use haue another common that is they stand for a defence of Bulwarke for all the parts lying under them and serve for the expulsion both of the excrements infant and vapoures and also for the strenghtening of the voice as experience
which it somewhat resembles in the compasse and forme of the tumor or else because it most commonly breeds in the Glandules or Emunctories of mans body The Nodus or knot is a round tumor hard and immoveable named from a rope tied on a knot Guido Cauliacensis affirmes knots commonly to grow in nervous bodies but at this time they more usually arise on the bones of such as have the French disease CHAP. XX. Of the cure of Lupiae that is Wens or Ganglions A Wen or Ganglion is a tumor sometimes hard sometimes soft yet alwayes round using to breed in dry hard and nervous parts And seeing that some of the tumors mentioned before in the former Chapter sticke immoveable to the part to which they grow because they are contained in no cyste or bag othersome are moved up and down by the touch of your fingers because they are contained in a bag or bladder it commonly comes to passe that Wens have their bladder wherein to containe them and therefore we thinke fit the rather more freely and particularly to treate of their cure because they are more difficultly cured especially where they are inveterate and of long standing The primitiue causes of these are dull blowes fallings from high places straines and other such like occasions But the antecedent and conjunct causes are the same with those of an Atheroma Meliceris and Steatoma The description formerly set downe will furnish you with the signes by which you may know when they are present certainely from very small beginnings they grow by little and little to a great bignesse in the space of sixe or seaven yeares some of them yeeld much to the touch and almost all of them are without paine You may hinder such as are beginning and first growing from encrease by some-what a strong and frequent rubbing with your fingers For so their bagge or bladder together with the skinne waxe thin and the contained humor growes hot is attenuated and resolved But if so you nothing prevaile you must lie upon them with your whole hand or a flatted peece of wood as heavy as you can untill such time as the cyste or bagge be broken by your impression Then apply and strongly binde unto it a plate of lead rubbed over with Quick-silver for I have many times found by experience that it hath a wonderfull force to resolve and waste the subject humor But if the Wen be in such a place in which you can make no strong impression as in the face chest belly and throat let there be applied an Emplaister which hath a resolving force such as this following hath ℞ gummi ammon bdelij galban an ℥ iij liquefiant in aceto traijciantur per setaceum addendo olei liliorum lauri an ℥ j anʒss let them be all incorporated together and make an Emplaister according to Art But if the tumor cannot be thus resolved it must be opened with a knife or cautery And after the Eschar is removed and the bagge waisted by Aegyptiacum Mercury and the like the ulcer must be cleansed replenished with flesh and cicatrized Sometimes Wens grow to so great a masse that they cannot be cured by the described remedies wherefore they must be taken away by the roote by your hand and instrument if so be that there be no danger by reason of their greatnesse and so that they adhere not too closely to the adjacent parts and if they be not too nigh to the greater veines and arteries for it will be better in such a cause to let them alone This shal be your way to cut thē off or take them away A smal incision must be made even to the bladder or bag by which thrust in a probe of a fingers thicknes hollowed in the midst round at the end and as long as neede shall require then draw it many times about betweene the skinne and the bagge even to theroote of the Wen that so the skinne may be devided long wayes then it will be requisite to make another incision overthwarte so that they may intersect each other like a crosse then presently draw the skinne from the bladder from the corners of the Wen towards the roote and that with your finger covered with a fine linnen cloath or else with a Razor if neede require But you must observe that in a Wen there are alwayes certaine vessels which are small in the beginning but much encreased in processe of time according to the encrease of the Wen whereof they are as it were the rootes wherefore if any Haemorrhagie or fluxe of bloud happen let it be stopped by binding the vessels at their heads and roots or make a strait ligature at the roots of the Wen with a peece of whipcord or with a manytimes doubled thred and let the ends hang forth untill it fall away of its owne accord Neither will it be sufficient to have cut away all this tumor but also it will be fit to cut away portion of the skinne wherewith the tumor was covered and onely to leave so much as shall suffice to cover the part then with a needle and threed draw together the lips of the incision but in the interim let tents be put into the bottome of the ulcer untill it be perfectly clensed and the rest of the cure be workemanlike performed even to the cicatrizing thereof The Chirurgion Collo and I using this method in the presence of Master Dr. Violanius the Kings Physition tooke away a Wen from Martiall Colard the Major of Burbon it hanged at his necke as bigge as a mans head and it weighed eight pounds which made it so troublesome and burdensome to him that he was forced to carry it bound up in a towell as in a scrip Verily if these kinde of tumors have a slender roote and broade top they must be straitly tied and so cut off But it is very difficult and full of dangerous chance to take away such Wens as are seated in the necke neareunto the Iugular veines these under the armeholes in the groines and such as are under the ham by reason of the deadly force of such symptomes as may thence arise We can onely conjecture not certainely say what kind of matter may be contained in them We can onely know of what sort it is when by incision it is presented to our sight Yet in such as are very hard and doe much resist the touch there are often found matters which in consistence may be resembled to little stones or pebles I being on a time called to open the body of a great Lady found in one of her breasts a body which might equall the bignesse of an Hens egge hard and compact like a rough peble it was held whilst she lived both by the Physitions and Chirurgions to be a Cancer because this hardnesse was very painefull to her when it was but gently pressed downe But also some few
length of the production that so with a sharpe knife we may divide the processe of the Peritonaeum according to that cavity separated from the guts there contained by the benefit of the Cane in a right line not hurting the guts When you have made an indifferent incision the guts must gently be put up into the belly with your fingers and then so much of the cut Peritonaeum must be sowed up as shall seeme sufficient that by that passage made more straight nothing may fall into the Codde after it is cicatrized But if there be such abundance of excrements hardned either by the stay or heate of inflammation that that incision is not sufficient to force the excrements into their place the incision must be made longer your Cane being thrust up towards the belly so that it may be sufficient for the free regresse of the guts into the belly Then sow it up as is fit and the way will be shut up against the falling downe of the guts or kall the processe of the Peritonaeum being made more straight by reason of the future for the rest the wound shall be cured according to Art But before you undertake this worke consider diligenly whether the strength of the Patient be sufficient neither attempt any thing before you have foretold and declared the danger to the Patients friends CHAP. XVI Of the golden Ligature or the Punctus Aureus as they call it IF the Rupture will not be cured by all these meanes by reason of the great solution of the continuity of the relaxt or broken Peritonaeum and the Patient by the consent of his friends there present is ready to undergoe the danger in hope of recovery the cure shall be attempted by that which they call the Punctus Aureus or Golden tie For which purpose a Chirurgion which hath a skilfull and sure hand is to be imploied He shall make an incision about the share bone into which he shall thrust a Probe like to the Cane a little before described and thrust it long wayes under the processe of the Peritonaeum and by lifting it up separate it from the the adjoining fibrous and nervous bodies to which it adheres then presently draw aside the spermatique vessels with the Cremaster or hanging muscle of the testicle which being done he shall draw aside the processe it selfe alone by it selfe And he shall take as much thereof as is too lax with small and gentle mullets perforated in the middest and shall with a needle having five or sixe threeds thrust it through as neere as hee can to the spermaticke vessels and cremaster muscles But the needle also must be drawne againe into the middest of the remnant of the processe taking up with it the lipps of the wound then the threed must be tied on a strait knot and so much thereof must be left after the section as may be sufficient to hang out of the wound This threed will of it selfe be dissolved by little and little by putrefaction neither must it be drawne out before that nature shall regenerate and restore flesh into the place of the ligature otherwise all our labour shall be spent in vaine And lastly let the wound be clensed filled with fiesh and cicatrized whose callous hardnesse may withstand the falling of the gut or kall There are some Chirurgians who would performe this golden Ligature after anoothe manner They cut the skinne above the share-bone where the falling downe commonly is even to the processe of the Peritonaeum and they wrap once or twice about it being uncovered a small golden wyre and onely straiten the passage as much as may suffice to amend the loosenesse of this processe leaving the spermatique vessels at liberty Then they twist the ends of the wyre twice or thrice with small mullets and cut off the remnant thereof that which remaines after the cutting they turne in least with the sharpnesse it should prick the flesh growing upon it Then leaving the golden wyre there they cure the wound like to other simple wounds and they keepe the Patient some fifteene or twenty day in his bed with his knees some thing higher and his head some thing lower Many are healed by this meanes others have fallen againe into the disease by reason of the ill twisting of the wire A. Shewes a croked needle having an eye not farre from the point through which you may put the golden wyre B. B The golden wyre put through the eye of the needle C. The mullets or Pincers to cut away the wast or superfluous ends of the wyre D. The springe of the mullets E The mullets to twist the ends of the wyre together Another more easie and safe way to restore the Gut and Kall THeodoricke and Guido have invented another way of performing this operation They put backe into their places the Gut and Kall being fallen downe the Patient being so placed that his thighs are high and his head is somewhat low then they draw aside the lower portion of the production of the Peritonaeum and also the spermaticke vessels and cremaster muscle to the Ischium then by applying a causticke fitted to the age and disease they burne the other part of the processe directly perpendicular to the share-bone where the Gut did fall downe Then they pull off the eschar thus made with a knife even to the quicke then they apply another causticke in the same place which may go even to the bone then procure the falling of this Eschar made on the foresaid processe And afterwards they heale the ulcer which remaines which presently contracting somewhat a thicke Callus so keeps up the Guts and Kall that it bindes them from falling down into the Cod. This way of restoring the Gut and Kall though it be safer and more facile yet the Chirurgion must not attempt it if the Guts or Kall sticke so fast agglutinated to the processe of the Peritonaeum that they cannot be severed nor put backe into their places for from the guts so burnt and violated greater mischiefe would ensue if by the broken and too much dilated processe the bodies thereby restrained make an exceeding great tumor by their falling downe if the testicle yet lying in the groine as in a Bubonocele a kinde of Enterocele being not yet descended into the Scrotum or Codde if the Patients be not come to such age as they can keepe themselves from stirring or hold their excrements whiles the operation is performed CHAP. XVII Of the cure of other kinds of Ruptures EPiplocele is the falling downe of the Kall into the Groine or Codde it hath the same causes as an Enterocele The signes have beene explained It is not so dangerous nor infers a consequence of so many evill symptomes as the Enterocele doth yet the cure is the same with the other Hydrocele is a waterish tumor in the Codde which is gathered by little and little betweene the membranes encompassing the testicles especially the
Dartos and Erythroides it may be called a particular dropsie for it proceeds from the same causes but chiefely from the defect of native heate The signes are a tumor encreasing slowly without much paine heavy and almost of a glassie clearenesse which you may perceive by holding a candle on the other side by pressing the Codde above the water flowes downe and by pressing it below it rises upwards unlesse peradventure in too great a quantity it fills up the whole capacity of the Codde yet it can never be forced or put up into the belly as the Kall or Guts may for oft times it is contained in a Cyste or bagge it is distinguished from a Saycocele by the smoothnesse and equality thereof The cure must first be tried with resolving drying and discussing medicines repeated often before and in the Chapter of the Dropsie this which followes I have often tried and with good successe â„ž Vng. comitissa desiccat rub an â„¥ ij malaxentur simul and make a medicine for your ease The water by this kinde of remedy is digested and resolved or rather dried up especially if it be not in too great quantity But if the swelling by reason of the great quantity of water will not yeeld to those remedies there is neede of Chirurgery the Cod and membranes wherein the water is contained must be thrust through with a Seton that is with a large three square pointed needle thred with a skeane of silke you must thrust your needle presently through the holes of the mullets made for that purpose not touching the substance of the Testicles The skean of thred must be left there or removed twise or thrise a day that the humor may drop downe and be evacuated by little and little But if the paine be more vehement by reason of the Seton and inflammation come upon it it must be taken away and neglecting the proper cure of the disease we must resist the symptomes Some Practitioners use not a Seton but with a Razor or incision knife they open the lower part of the Cod making an incision some halfe fingers breadth long penetrating even to the contained water alwayes leaving untouched the substance of the Testicles and vessels and they keepe the wound open untill all the water seemes evacuated truly by this onely way the cure of a watery rupture whose matter is contained in a Cyste is safe and to be expected as wee have said in our Treatise of Tumors in generall The Pneumatocele is a flatulent tumor in the Codde generated by the imbecility of heate residing in the part It is knowne by the roundnesse lenity renitencie and shining It is cured by prescribing a convenient diet by the application of medicines which resolve and discusse flatulencies as the seeds of Annis Fennell Faenugreeke Agnus Castus Rue Origanum other things set downe by Avicen in his Treatise of Ruptures I have often used with good successe for this purpose Emplastrum Vigonis cum mercurio and Emplastrum Diacalcitheos dissolved in some good wine as Muscadine with oyle of Bayes A Sarcocele is a tumor against nature which is generated about the stones by a schyrrhus flesh Grosse and viscide humors breed such kind of flesh which the part could not overcome and assimulate to it selfe whence this over-abundance of flesh proceeds like as Warts doe Varices or swollen veines often associate this tumor and it increases with paine It is knowne by the hardnesse asperitie inequality and roughnesse It cannot be cured but by amputation or cutting it away but you must diligently observe that the flesh be not growne too high and have already seazed upon the Groine for so nothing can be attempted without the danger of life But if any may thinke that he in such a case may somewhat ease the patient by the cutting away of some portion of this same soft flesh he is deceived For a Fungt will grow if the least portion thereof be but left being an evill fure worse than the former but if the tumor be either small or indifferent the Chirurgion taking the whole tumor that is the testicle tumefied through the whole substance with the processe encompassing it and adhering thereto on every side and make an incision in the Codde even to the tumor then separate all the tumid body that is the testicle from the Codde then let him thrust a needle with a strong threed in it through the middest of the processe above the region of the swolne testicle and then presently let him thrust it the second time through the same part of the processe then shall both the ends of the threed be tied on a knot the other middle portion of the Peritonaeum being comprehended in the same knot This being done he must cut away the whole processe with the testicle comprehended therein But the ends of the threed with which the upper part of the processe was bound must be suffered to hang some length out of the wound or incision of the Codde Then a repercussive medicine shall be applied to the wound and the neighbouring parts with a convenient ligature And the cure must be performed as we have formely mentioned The Cirsocele is a tumor of veines dilated and woven with a various and mutuall implication about the testicle and codde and swelling with a grosse and melancholy bloud The causes are the same as those of the Varices But the signes are manifest To heale this tumor you must make an incision in the codde the bredth of two fingers to the Varix Then you must put under the varicous veine a needle having a double threed in it as high as you can that you may binde the rootes thereof then let the needle be againe put after the same manner about the lower part of the same veine leaving the space of two fingers betweene the Ligatures But before you binde the thread of this lowest Ligature the Varix must bee opened in the middest almost after the same manner as you open a veine in the arme to let bloud That so this grosse blood causing a tumor in the Cod may be evacuated as is usually done in the Cure of the varices The wound that remaines shall be cured by the rules of Art after the manner of other wounds Leaving the threads in it which will presently fall away of themselves To conclude then it being growne callous especially in the upper part thereof where the veine was bound it must be Cicatrized for so afterwards the bloud cannot be strained or run that way Hernia Humoralis is a tumor generated by the confused mixture of many humors in the Cod or betweene the tunicles which involue the testicles often also in the proper substance of the testicles It hath like causes signes and cure as other tumors While the cure is in hand rest trusses and fit rowlers to sustaine and beare up the testicles are to be used CHAP. XVIII Of the falling
their figures that you may use either as occasion shall serve The Figure of Pipes with fenestels in them and Needles fit for Sutures The second Suture is made just after the same manner as the Skinners sowe their â—els or forrs And the guts must be sowed with this kind of Suture if they shall be at any time wounded that the excrements come not forth by the wound The third Suture is made by one or more needles having threed in them thrust through the wound the threed being wrapped to and againe at the head and the point of the needle as boyes use to fasten their needle for feare of losing it in their caps or clothes This kind of Suture is fit in the curing and healing of Hare-lips as we shall shew you hereafter expressed by a Figure The fourth kind of Suture is tearmed Gastroraphia invented for the restoring and uniting the great Muscles of the Epigastrium or lower belly cut with a great wound together with the Peritonaeum lying under them The manner whereof we will shew in due place The fifth kind is called the Dry Suture which we use onely in the wounds of the face which also we will describe in its proper place CHAP. VII Of the Flux of blood which usually happens in wounds OFt times great bleeding followes upon wounds by reason of some vessell cut broken or torne which there is neede to heale and helpe diligently because the blood is the treasure of nature without which life cannot consist The Blood which floweth from an Artery is thus knowne It is more subtile it runs forth as it were leaping by reason of the vitall spirit contained together with it in the Arteries On the contrary that which floweth from a Veine is more grosse blacke and slow Now there are many wayes of stenching blood The first and most usuall is that by which the lips of the wound are closed and unlesse it be somewhat deepe are contained by Medicines which have an astringent cooling drying and glutinous faculty As terrae sigill Boli Armeni ana â„¥ ss thuris Mastichis Myr hae Aloes ana Ê’ ij Farinae volat molend â„¥ j. Fiat pulvis qui albumine ovi excipiatur r Or â„ž Thuris Aloes ana partes aequales Let them bee mixt with the white of an Egge and the downe of a hare and let the pledgets bee dipped in these Medicines as well those which are put unto the wound as those which are applied about it Then let the wound be bound up with a double clop and fit Ligature and the part bee so seated as may seeme the least troublesome and most free from paine But if the blood cannot be stayed by this meanes when you have taken off all that covereth it you shall presse the wound and the orifice of the Vessell with your thumbe so long untill the blood shall bee concrete about it into so thick a clott as may stop the passage But if it cannot be thus staied then the Suture if any be must be opened and the mouth of the Vessell towards the originall or roote must bee taken hold of and bound with your needle and threed with as great a portion of the flesh as the condition of the part will permit For thus I have staid great bleedings even in the amputation of members as I shall shew in fit place To performe this worke wee are often forced to divide the skin which covereth the wounded Vessell For if the Iugular veine or Artery be cut it will contract and withdraw it selfe upwards and down-wards Then the skinne it selfe must bee laid open under which it lieth and thrusting a needle and threed under it it must be bound as I have offen done But before you loose the knot it is fit the flesh be growne up that it may stop the mouth of the Vessell least it should then bleed But if the condition of the part shall be such as may forbid this comprehension and binding of the Vessell we must come to Escharoticks such as are the powder of burnt Vitriol the powder of Mercury with a small quantity of burnt Allume and Cawsticks which cause an Escar The falling away of which must be left to Nature and not procured by art least it should fall away before that the orifice of the Vessel shall be stopt with the flesh or clotted blood But some times it happens that the Chirurgion is forced wholly to cut off the vessell it selfe that thus the ends of the cut vessell withdrawing themselves and shrincking upwards and downewards being hidden by the quantity of the adjacent and incompassing parts the fluxe of blood which was before not to bee staid may bee stopped with lesse labour Yet this is an extreame remedy and not to bee used unlesse you have in vaine attempted the former CHAP. VIII Of the paine which happens upon wounds THe paines which followes upon wounds ought to be quickly aswaged because nothing so quickly dejects the powers and it alwayes causes a defluxion of how good soever a habite and temper the body be of for Nature ready to yeeld assistance to the wounded part alwayes sends more humours to it than are needfull for the nourishment thereof whereby it comes to passe that the defluxion is easily encreased either by the quantity or quality or by both Therefore to take away this paine the author of defluxion let such Medicines bee applyed to the part as have a repelling and mitigating faculty as â„ž Olei Myrtini Rosarum ana â„¥ ij Cerae alb â„¥ j. Farinae hordei â„¥ ss Boli armeni terra sigillat ana Ê’ vj. Melt the Waxe in the Oyles then incorporate all the rest and according to Art make a Medicine to be applyed about the part or â„ž Emplast Diacalcith â„¥ iv Ole Rosar aceti ana â„¥ ss liquefiant simul and let a Medicine be made for the fore mentioned use Irrigations of oyle of Roses and Mirtiles with the white of an Egge or a whole Egge added thereto may serve for lenitives if there be no great inflammation Rowlers and double cloathes moistened in Oxycrate will be also convenient for the same purpose But the force of such Medicines must be often renewed for when they are dryed they augment the paine But if the paine yeld not to these we must come to narcoticke Medicines such as are the Oyle of Poppy of Mandrake a Caraplasme of Henbane and Sorrell adding thereto Mallowes and Marsh-mallows of which we spoke formerly in treating of a Phlegmon Lastly we must give heed to the cause of the paine to the kind and nature of the humour that flowes down and to the way which Nature affects for according to the variety of these things the Medicines must be varied as if heat cause paine it will be aswaged by application of cooling things and the like reason observed in the contrary if Nature intend suppuration you must helpe forwards
Goldsmith who dwelt neere the Austine Friers For he having used many medicines of diverse Physitions and Chirurgions in vaine when he was almost blinde he applying a Seton by mine advice began by little and little to see better according to the quantity of the matter which was evacuated untill at length he perfectly recovered his sight But at last growing wearie of the Seton which he had worne for a yeere although matter came dayly forth thereof yet he would have it taken forth and healed up but this way of evacuation being shut up and the humor againe beginning to flow into his eyes so that he was in danger to become blinde hee called me and made me againe to apply the Seton in his necke Whereby recovering his former soundnesse and perfection of sight he yet weares the Seton I also once freed by this kinde of remedy by the appointment of the most learned Physition Hollerius a certaine young man of twenty yeeres old from the falling sickenesse who before had many fits thereof the Ichorous humors the feeders of this disease being by this meanes as it is most probable drawne away and evacuated Wherefore seeing a Seton is of this use I have thought good in this place to set downe in writing and by figure the manner of making thereof for the behoofe of young practitioners Wish the patient to sit on a low stoole and to bend downe his head that so the skinne and fleshy pannicle may be relaxed then must you with your fingers plucke up and sever the skinne from the muscles and take hold of as much hereof as you can with your pincers not touching the muscles of the necke for feare of a convulsion and other symptomes you shall then twitch the skinne which is held in the pincers most hard when you shall thrust the hot Iron through the holes made in the midst of them that also the nerves being so twitched the dolorificke sense may the lesse come to the part The wound must be made or burnt in long wayes and not twharting that so the matters may be the better evacuated by the straight fibers But the cautery or hot Iron must have a three or else a foure-square point and that sharpe that so it may the more easily and speedily enter Then keeping the pincers immoveable let him draw through the passage made by the cautery a needle thred with a three or foure doubled threed of Cotton or rather a skeane of silke moistned in the white of an egge and oyle of Roses then after you have applyed pledgets dipped in the same medicine binde up the part with a convenient ligature The day following the necke must be annointed with oyle of Roses and the pledgets dipped in the former medicine applyed for some dayes after But it will bee convenient to moisten the Seton with a digestive made of the yolke of an Egge and oyle of Roses untill the ulcer cast forth much matter then you shall annoint the Cotton thred with this following remedie â„ž terebinthinae ven â„¥ iiij syrupirosat absinthij an â„¥ ss pulveris Ireos diacrydij agarici trochiscati Rhei an â„¥ ss incorporentur omnia simul siat medicamentum Which you shall use so long as you intend to keepe open the ulcer For it hath a facultie to draw the humors from the face and clense without biting A figure of the Pincers actuall Cautery and Needle used in making a Seten I have found not long since by experience that the apertion made with a long thicke Triangular needle of a good length like to a large Pack-needle is lesse painefull than that which is performed with the actuall cautery which I formerly mentioned Wherefore I would advise the young Chirurgion that hee no more use the foresayd actuall cauterie I have here given you the figure of the Needle The Figure of a Triangular Needle CHAP. XXV Of Wounds of the Cheeke SEeing a wound of the cheeke seemes to require a suture it must have a dry suture as they terme it least that the scarre should become deformed For that deformity is very greevous to many as to women who are highly pleased with their beauties Therefore you shall spread two peeces of new cloath of an indifferent finenesse and proportionable bignesse with this ensuing medicine â„ž pulveris mastichini sanguinis Draconis thuris farinae volatilis tragacantha contusae gypsi picis sarcocollae an Ê’ij nigraÊ’iss albumina ovorum quae sufficiant fiat medicamentum Apply the peices of cloath spread with this on each side of the wound one some fingers breadth asunder and let it alone till it be hard dryed to the skinne Then you shall so draw them together with your needle and thred that the flesh by their sticking may also follow and bee mutually adjoyned as you may see it here exprest The wound shall be agglutinated by this meanes together with the use of fit medicines pledgets ligatures But all the ligatures and stayes which shall be used for that purpose must be fastened to the patients night-lappe But when the wound is great and deep and the lips thereof are much distant the on from the other there can be no use of such a dry suture Wherefore you must use a three or foure square needle that so it may the more readily and easily enter into the flesh being thred with a waxed thred and with this you must thrust through the lips of the wound and leave the needle sticking in the wound and then wrappe the thred to and againe over the ends thereof eight or ten times just after that manner which women use to fasten a needle with thred in it upon their sleeves or Tailors to their hatts or capps that they may not lose them The needle thus fastened shall bee there untill the perfect agglutination of the wound this kind of suture is used in the wounds of the lips as also in hare-lips for so we commonly call lips which are cleft from the first conformation in the wombe by the error of the forming faculty But such a suture will helpe nothing to agglutination if there lye or remaine any skin betweene the lips of the wound Wherefore you shall cut away whatsoever thereof shall be there other-wise you must expect no union Other kinde of sutures are of no great use in wounds of these parts for out of the necessity of eating and speaking they are in perpetuall motion wherefore a thrid would cut the flesh for which reason you shall take up much flesh with such Needles mentioned in this last described kinde of Suture as this following figure shewes The figure of the suture fit for cloven or Hare lips as also the dilineation of the Needle about whose ends the thrid is wrapped over and under to and againe To this purpose I will recite a history to the end that if any such thing happen to come to your hands you may doe the like A certaine
Gascoine in the battell at Saint Laurence had his upper jaw cut overthwart even to his mouth to the great disfiguring of his face The wound had many wormes in it and stanke exceedingly because he could get no Chirurgion untill three dayes after he was hurt Wherefore I washed it with a decoction of wormewood Aloes and a little Aegyptiacum both to kill the wormes and to fetch away all the putride matter I discussed the tumor with a dissolving fomentation and cataplasime I joyned together the lippes of the wound with the last described suture But I applyed this following medicine to the whole part ℞ Terebinth venet a ℥ vj. gumml elemi ℥ ij pulver is boli armeni san drac Mastiches myrrhae aloes an ʒss incorporentur simul fiat medicamentum The wound was agglutinated within a few dayes but that there remained a certaine little whole at the joyning of the lower jaw with the upper wherein you could scarse put the head of a pinne out whereof neverthelesse much serous and thinne moysture flowed especially when he either eate or spake which I have also observed in many others But for staying of this watrish humidity I dropped Aqua fortis into the bottome of the ulcer and divers times put therein a little of the powder of burnt vitriole Thus by Gods grace he recovered and became whole CHAP. XXVI Of the wounds of the Nose THe Nose many wayes suffers solution of continuity as by a wound fracture and contusion and it is sometimes battered and broken on the upper part which when it happens you shall restore the deprest bones to their native seat and figure with the end of a spatula or fit sticke wrapped about with towe cotton or a linnen ragge Then with pledgets dipped in an astringent medicine composed ex albumine ovi mastich bole armeno sanguine drac Alumine ufto and applyed to the side of the nose hee shall labour to strengthen the restored bones and then binde them with a convenient ligature which may not presse them too much lest the nose should become flat as it happens to many through the unskilfulnesse of Chirurgions Then must you put little pipes into the nose-thrills and these not exactly round but somewhat flat and deprest tyed to the night-cappe on each side with a thred least they should fall out By the helpe of these pipes the bones of the nose will be kept in their place and there will be pastage forth for the matter and for inspiration and exspiration But if all the nose or some portion thereof shall bee wholy cut off wee must not hope to restore it But if the Nose bee so cut that as yet it adheres to much of the adjacent flesh from whence it may receive life and nourishment then sow it up For the lower part of the nose it may be shaken deprest and wrested aside seeing it is gristly but it cannot be broken as the other which is of a bony nature The Figure of pipes to be put into the Nose-thrills CHAP. XXVII Of the Wounds of the tongue THe tongue may bee so wounded that either it may bee wholely cut off and deprived of some portion of the substance or onelyslit long wayes or atwhart The losse of the substance cannot bee rapaired because every part separated and pluckt from the living body from whence it had life spirit and blood presently dyes For as the Philosophers say A privatione ad habitum non est regressus But when it is cut or slit longwayes or sidewayes it is easily restored by suture if so bee that the cloven part yet adhere to the living body from whence it may draw both matter and forme of life Therefore a carefull servant shall straitly hold with a soft and cleane linnen cloth the body of the tongue least it should slip away by reason of its slipperinesse whilst the Chirurgion stitch it above and below when he thinkes hee hath sufficiently sowed it let him cut off the threed as neere to the knot as he can least being left too long it might bee tangled with the teeth as hee eates and so cause a hurtfull laceration or rending of the sowed parts In the meane time let the patient eate barly creames almond milkes Gelleyes cullisses and broathes and the yolkes of egges and let him often hold in his mouth Sugar of Roses and syrupe of Quinces for such things besides their nourishing faculty performe the part of an aggluttinating and detergent medicine I have learned these things I have here set downe neither from my Masters whom I have heard with attention nor by reading of bookes but they have beene such as I have tryed with happy successe in many as in the sonne of Monsieur de Marigny president of the Inquisition in Iohn Piet a Carpenter dwelling in the suburbs of Saint German But most apparently in a child of three yeeres old the sonne of the great Lawyer Monsier Couet who fell with his chin upon a stone and so cut off a large peece of the end of his tongue which chanced to be betweene his teeth it hung but at a very small fiber of flesh so that I had very little or no hope to agglutinate and unite it which thing almost made me to plucke it quit away yet I changed that determination by considering the losse of the most noble action of speaking which would thereupon ensue and weighing the providence of nature often working wonders and such things as exceed the expectation of the physition in curing diseases I also thought thus with my selfe the flesh of the tongue is soft loose 〈◊〉 and spungie neither is it altogether obvious to the externall injuries of the ayre wherefore after that I had once or twise thrust through the needle and thred upwards and downewards and for the rest ordered the child to be used and after the manner I lately mentioned he grew well within a short time and yet remaines so speaking well and distinctly CHAP. XXVIII Of the Wounds of the Eares THe eares are sometimes wholly cut off sometimes but in part otherwhiles they are onely slit so that the rent portion as yet adhearing to the rest is joyned with it in communion of life In this last cafe it is fit to use a suture but yet so that you touch not the gristle with your needle for thence there would be in danger of a gangraene which happens to many by foolish curing therefore you shall take up and comprehend with your needle only the skin and that little flesh which encompasses the gristle You shall performe the rest of the cure with pledgets and ligatures artificially fitted and shall resist inflammation and other symptomes with fit medicines But you must take speciall care that no superfluous flesh grow in the auditory passage which may hinder the hearing wherefore you shall keepe that passage free by stopping it with a peece of spunge But you shall procure
of Reeds some are blunt headed others have piles or heads of Iron Brasse Lead Tinne Horne Glasse Bone In figure for that some are round others cornered some are sharpe pointed some barbed with the barbs standing either to the point or shafts or else acrosse or both wayes but some are broad aad cut like a Chissell For their bignesse some are three foote long some lesse For their number they differ in that because some have one head others more But they varie in making for that some of them have the shaft put into the head others the head into the shaft some have their heads nailed to the shaft others not but have their heads so loosely set on that by gentle plucking the shaft they leave their heads behind them whence dangerous wounds proceede But they differ in force for that some hurt by their Iron onely others besides that by poyson wherewith they are infected You may see the other various shapes here represented to you in the following Figure The Figures of divers sorts of Arrowes CHAP. XVII Of the difference of the wounded parts THe Wounded parts are eyther fleshy or bony some are neare the joynts others seated upon the very joynts some are principall others serve them some are externall others internall Now in wounds where deadly signes appeare its fit you give an absolute judgement to that effect least you make the Art to be scandalled by the ignorant But it is an inhumane part and much digressing from Art to leave the Iron in the wound it is sometimes difficult to take it out yet a charitable and artificiall worke For it is much better to try a doubtfull remedy than none at all CHAP. XVIII Of drawing forth Arrowes YOu must in drawing forth Arrowes shun incisions and dilacerations of Veines and Arteries Nerves and Tendons For it is a shamefull and bungling part to doe more harme with your hand than the Iron hath done Now Arrowes are drawne forth two wayes that is either by extraction or impulsion Now you must presently at the first dressing pull forth all strange bodies which that you may more easily and happily performe you shall set the Patient in the same posture as hee stood when he received his wound and hee must also have his Instruments in a readinesse chiefely that which hath a slit pipe and toothed without into which there is put a sharpe iron style like the Gimblets we formerly mentioned for the taking forth of Bullets but that it hath no scrue at the end but is larger and thicker so to widen the pipe that so widened it may fill up the hole of the Arrowes head where into the shaft was put and so bring it forth with it both out of the fleshy as also out of the bony parts if so bee that the end of the shaft be not broken and left in the hole of the head That also is a fit Instrument for this purpose which opens the other end toothed on the outside by pressing together of the handle You shall finde the Iron or head that lies hid by these signes there will be a certaine roughnesse and inequalitie observable on that part if you feele it up and downe with your hand the flesh there will be bruised livid or blacke and there is heavinesse and paine felt by the patient both there and in the wound A deliniation of Instruments fit to draw forth the heads of Arrowes and Darts which are left in the wound without their shafts A hooked Instrument fit for to draw forth strange bodies as peices of Maile and such other things as it can catch hold of which may also bee used in wounds made by Gunshot But if by chance either Arrowes Darts or Lances or any winged head of any other weapon bee run through and left sticking in any part of the body as the Thigh with a portion of the shaft or staffe slivered in peices or broken off then it is fit the Chirurgion with his cutting mullets should cut off the end of the staffe or shaft and then with his other mullets plucke forth the head as you may see by this Figure CHAP. XIX How Arrowes broken in a wound may be drawne forth BVt if it chance that the weapon is so broken in the wound that it cannot bee taken hold on by the formerly mentioned Mullets then must you draw or plucke it out with your Crane or Crowes bill and other formerly described Instruments But if the shaft be broken neare the head so that you cannot take hold thereof with your Cranes bill then you shall draw it forth with your Gimblet which we described before to draw forth bullets for if such a Gimblet can be fastened in Bullets it may farre better take hold of wood But if the head be barbed as usually the English arrowes are then if it may be conveniently done it will be very fitting to thrust them through the parts For if they should be drawne out the same way they went in there would bee no small danger of breaking or tearing the Vessells and Nerves by these hooked barbes Wherefore it is better to make a section on the other side whither the head tended and so give it passage forth if it may bee easily done for so the wound will bee the more easily clensed and consolidated But on the the contrary if the point tend to any bone or have many muscles or thicke flesh against the head thereof as it happens sometimes in the Thighes Legges and Armes then you must not thrust the head thorough but rather draw it out the same way it came in dilating the wound with fit Instruments and by skill in Anatomie shunning the larger Nerves and Vessells Therefore for this purpose put a hollow Dilater into the wound and therewith take hold of both the barbes or wings of the head and then take fast hold of the head with your Cranes-bill and so draw them forth all three together A Dilater hollowed on the inside with a Cranes-bill to take hold of the barbed head CHAP. XX. What to be done when an Arrow is left fastned or sticking in a bone BVt if the weapon be so depact and fastned in a bone that you cannot drive it forth on the other side neither get it forth by any other way than that it entred in by you must first gently moove it up and downe if it sticke very fast in but have a speciall care that you doe not breake it and so leave some fragment thereof in the bone then take it forth with your Crowes bill or some other fit Instrument formerly described Then presse forth the blood and suffer it to bleed somewhat largely yet according to the strength of the Patient and nature of the wounded part For thus the part shall be eased of the fulnesse and illnesse of humors and lesse molested with inflammation putrefaction and other symptomes which are customarily feared When the weapon is drawne forth and the
is cause of many accidents in men for the perpetuall effluxe of blood extinguisheth the vivide and lively colour of the face calls on a dropsie overthrowes the strength of the whole body The fluxe of Haemorrhoides is commonly every moneth sometimes onely foure times in a yeare Great paine inflammation an Abscesse which may at length end in a Fistula unlesse it be resisted by convenient remedies doe oft times forerunne the evacuation of the Haemorrhoides But if the Haemorrhoides flow in a moderate quantity if the patients brooke it well they ought not to be stayed for that they free the patients from the feare of imminent evills as melancholy leprosie strangury and the like Besides if they bee stopped without a cause they by their refluxe into the Lungs cause their inflammation or else breake the vessells thereof and by flowing to the Liver cause a dropsie by the suffocation of the native heate they cause a dropsie and universall leanenesse on the contrary if they flow immoderately by refrigerating the Liver by losse of too much blood wherefore when as they flow too immoderately they must be stayed with a pledget of hares downe dipped in the ensuing medicine ℞ pul aloes thuris balaust sang draconis an ℥ ss incorporentur simul cum ovi albumine fiat medicamentum ad usum When they are stretched out and swollne without bleeding it is convenient to beate an Onion roasted in the embers with an Oxes gall and apply this medicine to the swolne places and renew it every five houres This kind of remedy is very prevalent for internall Haemorrhoides but such as are manifest may be opened with horsleaches or a Lancet The juyce or masse of the hearbe called commonly Dead nettle or Arkeangell applyed to the swolne Haemorrhoides opens them and makes the congealed blood flow there hence The Fungus and Thymus being diseases about the fundament are cured by the same remedy If acrimony heate and paine doe too cruelly afflict the patient you must make him enter into a bath and presently after apply to the ulcers if any such be this following remedy ℞ Olei ros ℥ iiij cerusae ℥ j. Litharg ℥ ss cerae novae ʒvj opij ℈ j. fiaet unguent secundum artem Or else ℞ an.ʒj. opij ℈ j. fiat unguentum cum oleo rosarum mucagine sem psilij addendo vitellum unius ovt You may easily prosequute the residue of the cure according to the generall rules of Art The end of the Thirteenth Booke OF BANDAGES OR LIGATURES THE FOURTEENTH BOOK CHAP. I. Of the differences of Bandages BAndages wherewith we use to binde doe much differ amongst themselves But their differences in Galens opinion are chiefly drawne from sixe things to wit their matter figure length breadth making and parts whereof they consist Now the matter of Bandages is threefold Membranous or of skinnes which is accommodated peculiarly to the fractured grisles of the Nose of Woollen proper to inflamed parts as those which have neede of no astriction of Linnen as when anie thing is to be fast bound and of Linnen cloathes some are made of flaxe othersome of hempe as Hippocrates observes But Bandages doe thus differ amongst themselves in structure for that some thereof consist of that matter which is sufficiently close and strong of it selfe such are the membranous others are woven as the linnen ones But that Linnen is to bee made choice of for this use and judged the best not which is new and never formerly used but that which hath alreadie beene worne and served for other uses that so the Bandages made thereof may be the more soft and pliable yet must they bee of such strength that they may not breake with stretching and that they may straitly containe and repell the humour readie to flow downe and so hinder it from entring the part These besides must not bee hemmed nor stitched must have no lace nor seame for hems and seames by their hardnesse presse into and hurt the flesh that lyes under them Lace whether in the midst or edges of the rowler makes the Ligature unequall For the Member where it is touched with the Lace as that which will not yeeld is pressed more hard but with the cloth in the middle more gently as that which is more laxe Furthermore these Ligatures must bee of cleane cloth that if occasion bee they may bee moystened or steeped in liquour appropriate to the disease and that they may not corrupt or make worse that liquour by their moistening therein Now the Bandages which are made of Linnen cloathes must be cut long-waies and not athwart for so they shall keepe more firme and strong that which they binde and besides they will be alwaies alike and not broader in one place than in another But they thus differ in figure for that some of them are rowled up to which nothing must be sowed for that they ought to be of a due length to binde up the member others are cut or divided which truly consist of one piece but that divided in the end such are usually taken to bind up the breasts or else in the midst others are sowed together which consist of many branches sowed together and ending in divers heads and representing divers figures such are the Bandages appropriated to the head But they thus differ in length for that some of them are shorter others longer so in like sort for breadth for some are broader others narrower Yet wee cannot certainly define nor set downe neither the length nor breadth of Rowlers for that they must be various according to the different length and thicknesse of the members or parts Generally they ought both in length and breadth to fit the parts whereunto they are used For these parts require a binding different each from other the head the necke shoulders armes breasts groines testicles fundament hips thighes legs feet and toes For the parts of Bandages wee terme one part their bodie another their heads By the bodie we mean their due length breadth but their ends whether they run long-waies or a-crosse wee according to Galen terme them their heads CHAP. II. Sheweth the indications and generall precepts of fitting of Bandages and Ligatures THere are in Hippocrates opinion two indications of fitting Bandages or Ligatures the one whereof is taken from the part affected the other from the affect it selfe From the part affected so the legge if you at any time binde it up must bee bound long-waies for if you binde it overthwart the binding will loosen as soone as the patient beginnes to goe and put forth his legge for then the muscles take upon them another figure On the contrarie the Arme or Elbow must be bound up bending in and turned to the breast for otherwise at the first bending if it bee bound when it is stretched forth the Ligature will be slacked for that as we formerly said the figure of the muscles is perverted Now
handsomely fashioned and wrapped about with cotten or a linnen ragge so to avoyd paine Therefore you shall hold the spatherne in one hand and reduce and order it with the other The bone being restored directories or tents of a convenient bignesse shall be put into the nose which tents shall bee made of sponge or flaxe or a peece of a beasts or sheeps lungs For these things are soft and doe not onely hinder the bones of the Nose that they fall no more but also lift them up higher And then the Nose shall be in some sort stayed with boulsters on each side even untill the perfect agglutination of the bones lest the figure and straitnesse should be vitiated and spoyled I have oft times put golden silver and leaden pipes into fractured noses and fastned them with a thred to the Patients night cap which by one and the same means kept the bones from being again deprest gave the matter free passage forth and nothing hindred the breathing In the mean time we must see that we do not presse the Nose with too strait binding unlesse peradventure some other thing perswade lest they become eyther too wide too flat or crooked If any wound accompany the fracture that shall bee cured after the same manner as the wounds of the head The fracture restored the following medicine which hath a facultie to repell and represse the defluxion to strengthen and keep the part in its due posture and to dry up and waste the matter which hath alreadie fallen downe shall bee applyed to the Nose and all the other dry parts ℞ thuris mastiches boli armeniae sanguinis draconis an ℥ ss aluminis rochae resinae pini an ʒ ij pulverisentur subtilissimè Or else ℞ farinae volatilis ℥ ss albuminum ovorum quantum sufficit incorporentur simul fiat medicamentum Neither shall you use any other art to cure the cartilagineous part of the nose being fractured Wherefore Hippocrates termes that solution of continuitie that there happens A fracture as if it were in a bone because hee could finde no other name more fitly to expresse it for a gristle next to a bone is the hardest of all the parts of our bodie A Callus uses to grow in fractured noses unlesse something hinder within the space of twelve or fifteene dayes CHAP. VII Of the Fracture of the lower Jaw THe lower Jaw runnes into two as it were horns or tops the one whereof ends sharpe and receives a tendon from the temporall muscle the other ends blunt and round under the mammillarie processe and it is there implanted in a small cavitie it is joyned together in the middle of the chin by Symphysis and is marrowie within The Fracture which happens thereto is restored by putting your fingers into the Patients mouth and pressing them on the inside and outside that so the fractured bones put together may be smoothed and united But if they be broken wholly athwart so that the bones lye over each other extension must be made on both sides on contrary parts upwards and downwards whereby the bones may be composed and joyned more easily to one another The teeth in the meane while if they be eyther shaken or removed out of their sockets must be restored to their former places and tyed with a gold or silver wyar or else an ordinary threed to the next firme teeth untill such time as they shall be fastened and the bones perfectly knit by a Callus To which purpose the ordered fragments of the fractured bone shall bee stayed by putting a splint on the outside made of such leather as shoe soales are made the midst thereof being divided at the Chin and of such length and breadth as may serve the Jaw then you shall make ligation with a ligature two fingers broad and of such length as shall be sufficient divided at both the ends and cut long-waies in the midst thereof that so it may engirt the chin on both sides Then there will be foure heads of such a ligature so divided at the ends the two lower whereof being brought to the crown of the head shall bee there fastened and sowed to the Patients night-cap The two upper drawne athwart shall likewise be sowed as artificially as may bee to the cap in the nappe of the necke It is a most certaine signe that the Jaw is restored and well set if the teeth fastened therein stand in their due ranke and order The patient shall not lye downe upon his broken jaw lest the fragments of the bones should againe fall out and cause a greater defluxion Unlesse inflammation or some other grievous symptome shall happen it is strengthned with a Callus within twentie dayes for that it is spongious hollow and full of marrow especially in the midst thereof yet sometimes it heales more slowly according as the temper of the patient is which takes also place in other fractured bones The agglutinating and repelling medicine described in the former chapter shall be used as also others as occasion shall offer it selfe The Patient must be fed with liquid meats which stand not in need of chewing untill such time as the Callus shall grow hard lest the scarce or ill-joyned fragments should fly insunder with the labour of chewing Therefore shall hee bee nourished with water-grewell ponadoes cullasses barley creames gellies brothes reare egges restaurative liquors and other things of the like nature CHAP. VIII Of the Fracture of the Clavicle or Collar-bone AS the nature and kinde of the fractured Clavicle shall bee so must the cure and restoring thereof bee performed But howsoever this bone shall be broken alwaies the end fastened to the shoulder and shoulder-blade is lower than that which is joyned to the chest for that the arme drawes it downe-wards The collar-bone if broken athwart is more easily restored and healed than if it be cloven long-wayes For everie bone broken athwart doth more easily returne into its former state or seat whiles you lift it up on this or that side with your fingers But that which is broken schidacidon or into splinters or long-waies is more difficultly joyned and united to the ends and fragments for those peeces which were set will be plucked asunder even by the least motion of the armes and that which was knit with the shoulder will fall downe to the lower part of the breast The reason of which is the Collar-bone is not moved of its selfe but consents in motion with the arme In restoring this or any other fracture you must have a care that the bones ride not one over another neyther be drawn nor depart too far in sunder therfore it will be here convenient that one servant draw the arme backwards and another pull the shoulder towards him the contrarie way for so there will be made as I may so terme it a counter-extension While which is in doing the Surgeon with his fingers shall restore the fracture pressing downe
attempt to set inveterate dislocations wee must endevour to humect the ligaments tendons and muscles by fomentations cataplasmes emplaisters liniments and other remedies that so these parts may be more obedient to the Surgeons hand then must the dislocated bones be moved with a gentle motion up and down to and againe that by this meanes the excrementitious humor which by continuance of time hath flowed downe may waxe hot be attenuated resolved or made slipperie and also the fibres of the muscles ligaments and nervous bodies placed about the joynt for the defence thereof may be loosed that so they may presently be more freely extended But if a great swelling paine and inflammation urge we must first think of asswaging and curing them then of the restoring the Dislocation CHAP. VII The description of certaine engines serving for the restoring of Dislocations BEfore I come to the particular kinds of Dislocations I thinke it not amisse to describe three sorts of Bandages and give you their figures as those which are most fit to hold and extend Dislocations The first Ligature designed by this letter A is made for holding the member The second marked with the letter B is fit for drawing or extension and consists of one knot The third whereto the letter C is put consisting of two knots is to hold or binde more straitly The delineation of the three Ligatures I have thought good also to delineate the following Engine made for to draw and extend more powerfully when the hand will not serve It is made like a Pulley marked with these letters D D. Within this there lye hid three wheeles through whose furrowes runnes the rope which is to be drawne marked with this letter H. At the ends of the Pulley are hooks fastened the one of which is to fasten the Pulley to a Poste the other is to draw the ligature fastened to the part The Boxes or Cases wherein the Pulley is kept is maked with B B. Their covers are marked with A A. A screw pin which may be twined and so fastened to a Poste that so one of the ends of the Pulley may be hooked thereto is signed with C. A Gimlet marked by F. to make a hole in a Poste so to let in the screw pin You may see all these things exprest in this following figure A Pulley Some Practitioners in stead of this Pulley make use of the hereafter described Instrument which they terme Manubrium versatile or a Hand-vice The end therof is fashioned like a Gimblet and is to be twined into a Poste Within that handle lyes a screw with a hooked end whereto the string or ligature must be fastened Now the screw-rod or male-screw runnes into the female by the twining about of the handle and thus the ligature is drawne as much as will suffice for the setting the dislocated bone Manubrium versatile or A Hand-vice Having delivered these things thus in generall now I come to treate of the Luxations of each part from the Jaw-bone even to the toes of the feet CHAP. VIII Of the Dislocation of the Jaw-bone THe Jaw-bone is dislocated by many occasions and not seldome by yawning and other more strong openings of the mouth It is more frequently luxated into the fore than into the hinde part by reason of the mammillarie additaments which hinder it from falling backe-wards The dislocation is sometimes but on one side otherwhiles on both If the one side only be luxated it together with the chin is drawne awrie unto the contrarie side which is not dislocated the place is hollow from whence it is flowne but swolne whither it is gone the Patient cannot shut his mouth but is forc't to gape so that he cannot eate the Jaw together with the teeth therein hangs some-what forwards neyther doe the teeth answer fitly to one another but the Dogge-teeth are under the shearers But if both sides be dislocated all the Jaw and Chin hang forwards and towards the breast besides also the temporall muscles appeare distended spittle runnes out of the Patients mouth against his will the lower teeth stand further forth than the upper which is the occasion that the mouth cannot be shut neither the tongue have free volubilitie to speake the Patient stammering in his speech When it is dislocated on both sides it is more difficultly restored and all the symptomes are more vehement wherefore it must bee set with all speed otherwise the Patient will presently have grievous paine about his throat inflammation a fever whereupon oft times death ensues within ten dayes by reason of the five branches of nerves which arising from the second and fifth conjugation of the braine are distributed into the moving muscles thereof which too violently extended bring the forementioned symptomes Practitioners affirme that the Jaw twelve dayes after it is set is free from the danger of relapse If it have beene dislocated some few daies before you goe about to restore it you must use softening and relaxing medicines to it but when it is put in the joynt apply a medicine made of the whites of egges and oyle of roses to asswage paine and apply clothes dipped in oxycrate At the second dressing you shall apply such things as have power to agglutinate and strengthen the ligaments and other relaxed parts and also to keep it being restored in its place This shall be the forme of such a medicine â„ž Pulv. boli armeni sang draconis farinae volat mastich picis resinae an â„¥ ss albuminis ovorum q. s fiat medicamentum afterwards you may use Emplast Diacalcitheos dissolved in oyle of Roses and Vinegar and other things as occasion shall bee CHAP. IX How to set the Jaw dislocated forwards on both sides FIrst of all the Patient must bee placed upon the ground or some low seat with his face upwards and his head must be firmely held by your servant that so it may be the more immoveable then the Surgeon shall put both his thumbs wrapped in clothes left hee hurt them by rubbing them upon the Patients teeth as also to keep them from slipping into the Patients mouth and presse with them the larger teeth of the luxated Jaw but put his other fingers without under his chin so lift up the whole Jaw with them But if the operation cannot be thus done for that the mouth on the inside is so shut and closed that the thumbs cannot bee put thereinto then must you thrust in woodden wedges made of soft wood as hazle or firre being cut square and of some fingers thicknesse These shall bee wedged in on each side above the grinders then cast a ligature under his chin whose ends your servant shall hold in his hands and setting his knees upon the Patients shoulders shall pull them upwards then at the same time the Surgeon shall presse downwards the woodden wedges The Jaw-bones thus restored shal be kept so by convenient ligation and dressed with medicines
if wee cannot attaine to the restitution thereof with our hands alone you must cause the dislocated arme lightly bended to embrace a poste then must the end of the cubit called Olecranum be tyed or bound about with a strong ligature or line and then wrested into its cavity by putting a battoon or staffe into the ligature as is demonstrated by this ensuing figure A figure which shewes the way how to restore the Elbow by putting it about a poste with a battoone A figure which shewes how to restore the elbow by only casting a line about it There is also another more exquisite way of restoring it which is expressed by the latter figure wherein a line of some inch breadth is cast about the Olecranum of the arme embracing a poste or pillar and it is drawn so long untill the dislocated bone be brought into its seat Now wee know that the bone is returned into its place and restored when the paine ceaseth and the figure and whole naturall conformation is restored to the arme and the bending and extending thereof is easie and not painefull CHAP. XXXIII Of the dislocation of the Elbow to the inside and of a compleat and uncompleat luxation IF the Elbow be dislocated to the inner part the arme must be strongly and powerfully extended then bended quickly and with sudden violence so that his hand may smite upon his shoulder Some put some round thing into the bought of the Elbow and upon that doe suddenly force the Elbow to the shoulder as we have formerly said If the Cubit bone be onely lightly moved out of its place into the upper or lower place it is easily restored by drawing and forcing it into its cavity after this following manner Let two extend the arme taking holde thereof at the shoulder and wrest and each draw towards himselfe and also the Surgeon who shall there be present shall force the bone which is dislocated from that part whereunto it is bended unto the contrary after he shall thus have restored it he shall lay the arme in a straight angle and so binde it up and apply fit medicines formerly mentioned and so let him carry it in a scarfe put about his necke as wee said in the dislocation of the shoulder Hippocrates bids that the patient after it is set shall often endeavour to bend his hand upwards and downewards and also extend and bend his arme yea and also to attempt to lift up some heavie thing with his hand for so it will come to passe that the ligaments of this joynt may become more softe ready and able to performe their accustomed functions and also the bones of the cubite and shoulder shall bee freed from the affect termed Ancylosis whereto they are incident by the luxations of this part Now Ancylosis is a certaine preternaturall agglutination co-agmentation and as it were union of sundry and severall bones in the same joynt which afterwards hinders the bending and extension thereof Now a Callus is generated in the Elbow sooner than in any other articulation whether it remaineth out or be put into joynt by reason that by rest and cessation from the accustomed actions a viscide humor which is placed naturally in the joynts as also another which is preternaturall drawne thither by paine floweth downe and is hardned and gleweth the bones together as I have observed in many by reason of the Idlenesse and too long rest of this part Wherefore that we may withstand this affect the whole ligation must be loosed sooner and oftner than otherwise that is to say every third day and then the patients arme must bee gently moved every way Within the space of twenty or twenty five dayes these restored bones recover their strength sooner or later according to the happening accidents It is necessary also that the Surgeon know that the Radius or Wand sometimes falleth out when the cubite or Ell is wholly dislocated wherefore hee must bee mindfull in setting the cubit that hee also restore the Wand to its place in the upper part it hath a round processe lightly hollowed wherein it receiveth the shoulder-bone it hath also an eminencie which admitteth the two-headed muscle CHAP. XXXIV Of the dislocation of the Styliformis or bodkin-like processe of the cubit or ell THe processe of the Ell called Styloides being articulated to the wrest by Diathrosis by which it is received in a small cavity is dislocated and falleth out sometimes inwards somewhiles outwards The cause usually is the falling of the body from high upon the hands It is restored if that you force it into its seat diligently bind it apply thereto very astringent drying medicines But yet though you shall diligently performe all things which may bee done in dislocations yet you shall never so bring it to passe that this bone shall bee perfectly restored and absolutely put into the place where hence it went which thing we have read observed by Hippocrates when saith he the greater bone to wit the Ell is removed from the other that is the wand it is not easily restored to its owne nature againe for that seeing that neither any other common connexion of two bones which they call Symphysis or union when it is drawne asunder and destroyed may bee reduced into its former nature by reason these ligaments wherewith they were formerly contained and as it were continued are too violently distended and relaxed whence it happens that I have in these cases often observed that the diligence and care of the Surgeon hath nothing availed CHAP. XXXV Of the dislocation of the Wrest WEe understand by the wrest a certaine bony body consisting of a composure of eight bones knit to the whole cubit by Diarthrosis For the wrest considered wholly in its selfe is knit and articulated with the Ell wand with that against the little finger with this against the thumb for thus as it were by two connexions the joint is made more firme Yet may it be dislocated inwardly outwardly towards the sides We say it is luxated inwardly when the hand stands upwards but outwardly when it is crookt in cannot be extended But if it chance to be dislocated sidewayes it stands awry either towards the little finger or else towards the thumbe as the luxation befals to this or that side The cause hereof may seem to depend upon the different dearticulation of the Ell and wand with the hand or wrest For the wand which is articulated on the lower part with the wrest at the thumbe by its upper part whilest it receives the outward swelling or condyle of the Ell in its cavity performs the circular motions of the hands But the cubit or ell which in like sort is connected on the lower part by Diarthrosis at the little finger with the wrest being articulated on the upper part with the shoulder-bone bends and extends or stretches forth the hand There is one way to restore the
to the condition of the part and the conteined matter But to those parts whereto these cannot by reason of their greatnesse be applyed you may fit hornes for the same purpose The figures of Cupping-glasses of different bignesse with little holes in their bottomes which shall be stopped with waxe when you apply them to the part but opened when you would take them off that so the aire may enter in with the more ease A Lancet Hornes which without fire by onely sucking at the upper hole draw from the part lying under them CHAP. LXII Of Leaches and their use IN those parts of the body whereto Cupping-glasses and hornes cannot be applyed to those Leaches may for the most part be put as to the fundament to open the coat of the haemorrhoide veines to the mouth of the wombe the gums lips nose fingers After the Leach being filled with bloud shal fal off if the disease require a large evacuation of bloud and the part affected may endure it Cupping-glasses or hornes or other Leaches shall be substituted If the Leaches bee handled with the bare hand they are angred and become so stomackfull as that they will not bite wherefore you shall hold them in a white clean linnen cloath apply them to the skin being first lightly scarified or besmeared with the bloud of some other creature for thus they will take hold of the flesh together with the skin more greedily fully To cause them fall off you shall put some powder of Aloes salt or ashes upon their heads If any desire to know how much bloud they have drawne let him sprinkle them with salt made into powder as soone as they are come off for thus they will vomit up what bloud soever they have sucked If you desire they should sucke more bloud than they are able to containe cut off their tailes as they suck for thus they will make no end of sucking for that it runs out as they suck it The Leaches by sucking draw the bloud not onely from the affected part whereto they are applyed but also from the adjacent and distant parts Also sometimes the part bleeds a good while after the Leaches be fallen away which happens not by scarification after the application of Cupping-glasses or hornes If you cannot stop the bleeding after the falling away of the Leaches then presse the halfe of a beane upon the wound untill it stick of it self for thus it will stay also a burnt rag may be fitly applyed with a little boulster and fit ligature The end of the seventeenth Booke OF THE GOUTE THE EIGHTEENTH BOOKE CHAP. I. The description of the Goute THE Goute is a disease occupying and harming the substance of the Joints by the falling downe and collection of a virulent matter accompanied by the foure humors This word Arthritus or Goute is generall for every joint so affected yet it enjoyes divers particular names in sundry joints of the body as that which falleth upon the joint of the Jaw is termed Siagonagra for that the Greekes call the Jaw Siagon that which affects the necke is termed Trachelagra for that the neck is in Greek termed Trachelos that which troubles the backe bone is called Rhachisagra for the spine is termed Rhachis that which molests the shoulders Omagra for the joint of the shoulder is stiled Omos that which affects the joints of the Collar-bones Cleisagra for that the Greeks call this bone Cleis that in the Elbow Pâ—chyagra for Pechis signifieth the elbow the goute in the hand is called Chiragra in the Hippe Ischias in the knee Gonagra in the feet Podagra for that the Hand Hippe Knee and Foote are in Greeke termed Cheir Ischion Gony and Pous When as there is great abundance of humours in a body and the patient leads a sedentary life not some one but all the joints of the body are at once troubled with the Goute CHAP. II. Of the occult causes of the Goute THe humor causing the Goute is not of a more knowne or easily exprest nature than that which causeth the plague Lues venerea or falling sickenesse For it is of a kind and nature cleane different from that which causeth a Phlegmon oedema erysipelas or Scirrbus for as Aëtius saith it never commeth to suppuration like other humours not for that as I thinke because it happens in bloodles parts but through the occasion of some occlut malignity Hereto may be added that the humours which cause the forementioned tumors when as they fall downe upon any part not then truly when they are turned into pus or matter do they cause so sharpe paines as that which causeth the Goute for the panic thereof is farre more sharpe than of that humour which breedeth an ulcerated Cancer Besides these humours when they fall upon the joints through any other occasion never turne into knots onely that which causeth the Goute in the joints after it hath fallen thither is at length hardened into a certaine knotty and as it were plaister-like substance to bee amended by no remedies But seing it offends not the parts by which it flowes downe no more than the matter which creeping upwards from the lower parts to the braine causeth the Epilepsie as soone as it falleth into the spaces of the Joints it causeth cruell paine one while with heate another while with cold For you may see some troubled with the Goute who complaine that their pained Joints are burnt there are others to whom they seeme colder than any ice so that they cannot bee sufficiently heated to their hearts desire verily you may sometimes see in the same body troubled with the Goute that the Joints of the right side will as it were burne with heat but on the left side will be stiffe with cold or which is more the knee in the same side to be tormented with a hot distemper and the ancle troubled with a cold Lastly there sometimes happens a succession of paine 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 wee need not marvaile to see Physitians 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 humour doth not onely not yield to medicines but is rather made worse so that the patients affirme that they are far better when they have none than when they have any remedyes applyed For all things being rightly done and according to reason yet the disease will come againe at certain seasons by fits and hereupon it is sayd by Horace Qui cupit aut metuit juvat illum sic domus aut res Ut lippum pict ae tabulae fomenta podagram Riches the covetous and fearefull so doe please As pictures sore eyes Bathes the Goute doe ease Certainely such as have this disease hereditarily can no more bee helped and throughly freed therefrom
tasteth nor the hands that they touch For all these things are the offices and functions of the common sense for this sense knoweth that the eye hath seene some thing either white blacke red a man horse sheepe or some such like materiall thing yea even when the sight is gone and past and so likewise the nose to have smelled this or that savour the eare to have heard this or that sound the tongue to have tasted this or that tast and the hand to have touched this or that thing bee they never so diverse For all the externall senses and all the functions thereof do end and are referred to the common sense as it were the lines of a circle from the circumference into the centre as it is expressed in this figure For which cause it is called the common or principll sense for that therein the primitive power of feeling or perceiving is situated for it useth the ministery or service of the externall senses to know many and divers things whose differences it doth discerne and judge but simple things that are of themselves and without any composition and connexion which may constitute any thing true or false or any argumentation belongeth onely to the minde understanding or reason For this was the counsell of nature that the externall senses should receive the formes of things superficially lightly and gently onely like as a glasse not to any other end but that they should presently send them unto the common sense as it were unto their center and prince which he that is to say the common sense at length delivereth to be collected unto the understanding or reasoning faculty of the soule which Avicen and Averrois have supposed to be situated in the former part of the braine Next unto the common sense followeth the phantasie or imagination so called because of it arise the formes and Ideas that are conceived in the minde called of the Geekes Phantasmata This doth never rest but in those that sleepe neither alwaies in them for oft-times in them it causeth dreames and causeth them to suppose they see and perceive such things as were never perceived by the senses nor which the nature of things nor the order of the world will permit The power of this faculty of the minde is so great in us that often it bringeth the whole body in subjection unto it For it is recorded in history that Alexander the Great sitting at Table and hearing Timotheus the Musician fing a martiall Sonnet unto his Citherne that hee presently leaped from the table and called for armes but when againe the Musician mollifyed his tune hee returned to the Table and sate downe as before The power of Imagination caused by musicall harmony was so great that it subjected to it the courage of the Worlds conquerour by whose various motion it would now as it were cause him to runne headlong to armes and then pacifie and quiet him and so cause him to returne to his chaire and banquetting againe And there was one whosoever it was who some few yeares agone seeing the Turke dance on a rope on high with both his feet fastened in a bason turned his eyes from so dangerous a sight or spectacle although hee came to the place of purpose to see it and was stricken with such feare that his body shooke and heart quaked for feare lest that by sudden falling downe headlong hee should breake his necke Many looking downe from an high and lofty place are so stricken with feare that suddenly they fall downe headlong being so overcome and bound with the imagination of the danger that their owne strength is not able to sustaine them Therefore it manifestly appeareth that God hath dealt most graciously and lovingly with us who unto this power of imagination hath joyned another that is the faculty or power of reason and understanding which discerning false dangers and perils from true doth sustain and hold up a man that he may not be overthrowne by them After this appeareth and approacheth to performe his function the faculty of Reason being the Prince of all the principall faculties of the soule which bringeth together composeth joyneth and reduceth all the simple and divided formes or images of things into one heape that by dividing collecting and reasoning it might discerne and try truth from falshood This faculty of Understanding or Reason is subject to no faculty or instrument of the body but is free and penetrateth into every secret intricate and hidden thing with an incredible celerity by which a man seeth what will follow perceiveth the originalls and causes of things is not ignorant of the proceedings of things he compareth things that are past with those that are present and to come decreeing what to follow and what to avoyde This bridleth and with-holdeth the furious motions of the minde bridleth the overhasty motions of the tongue and admonisheth the speaker that before the words passe out of his mouth hee ought with diligence and discretion to ponder and consider the thing whereof hee is about to speake After Reason and Judgement followeth Memory which keeping and conserving all formes and images that it receiveth of the senses and which Reason shall appoint and as a faithfull keeper and conserver receiveth all things and imprinteth and sealeth them as well by their owne vertue and power as by the impulsion and adherence of those things in the body of the braine without any impression of the matter that when occasion serveth we may bring them forth therehence as out of a treasurie or store-house For otherwise to what purpose were it to reade heare and note so many things unlesse wee were able to keepe and retaine them in minde by the care and custody of the Memory or Braine Therefore assuredly God hath given us this one onely remedy and preservative against the oblivion and ignorance of things which although of it selfe and of its owne nature it bee of greater efficacie yet by daily and often meditation it is trimmed and made more exquifite and perfect And hence it was that the Ancients termed wisedome the daughter of memory and experience Many have supposed that the mansion or seate of the Memory is in the hinder part or in the ventricle of the Cerebellum by reason that it is apt to receive the formes of things because of the engrafted drynesse and hardnesse thereof CHAP. XII Of the naturall excrements in generall and especially of those that the childe or infant being in the wombe excludeth BEfore I declare what excrements the infant excludeth in the wombe and by what passages I thinke it good to speak of the excrements which all men doe naturally voyde All that is called an excrement which nature is accustomed to separate and cast out from the laudible and nourishing juice There are many kinds of those excrements The first is of the first concoction which is performed in the stomacke which being driven downe into
with a little swelling with a knife or lancet so breaking and opening a way for them notwithstanding that a little fluxe of blood will follow by the tension of the gummes of which kind of remedy I have with prosperous and happy successe made tryall in some of mine owne children in the presence of Feureus Altinus and Cortinus Doctors of Physick and Guillemeau the Kings Chirurgian which is much better and more safe than to doe as some nurses doe who taught onely by the instinct of nature with their nailes and scratching breake and teare or rent the childrens gummes The Duke of Nevers had a sonne of eight moneths old which died of late and when wee with the Physitians that were present diligently sought for the cause of his death we could impute it unto nothing else than to the contumacious hardnesse of the gums which was greater than was convenient for a childe of that age for therefore the teeth could not breake forth nor make a passage for themselves to come forth of which our judgement this was the tryall that when we cut his gummes with a knife we found all his teeth appearing as it were in an array ready to come forth which if it had bin done when he lived doubtlesse he might have beene preserved The End of the twenty fourth Booke OF MONSTERS AND PRODIGIES THE TWENTY FIFTH BOOK THE PREFACE WEe call Monsters what things soever are brought forth contrary to the common decree and order of nature So wee terme that infant monstrous which is borne with one arme alone or with two heads But we define Prodigies those things which happen contrary to the whole course of nature that is altogether differing and dissenting from nature as if a woman should bee delivered of a Snake or a Dogge Of the first sort are thought all those in which any of those things which ought and are accustomed to bee according to nature is wanting or doth abound is changed worne covered or defended hurt or not put in his right place for somtimes some are born with more fingers than they should other some but with one finger some with those parts devided which should be joyned others with those parts joyned which should bee devided some are borne with the privityes of both sexes male and female And Aristotle saw a Goate with a horne upon her knee No living creature was ever borne which wanted the Heart but some have beene seene wanting the Spleene others with two Spleenes and some wanting one of the Reines And none have bin known to have wanted the whole Liver although some have bin found that had it not perfect and whole and there have beene those which wanted the Gall when by nature they should have had it and besides it hath beene seene that the Liver contrary to his naturall site hath lien on the left side and the Spleene on the right Some women also have had their privities closed and not perforated the membranous obstacle which they call the Hymen hindering And men are sometimes borne with their fundaments eares noses and the rest of the passages shut and are accounted monstrous nature erring from its entended scope But to conclude those Monsters are thought to portend some ill which are much differing from their nature CHAP. I. Of the cause of Monsters and first of those Monsters which appeare for the glory of God and the punishent of mens wickednesse THere are reckoned up many causes of monsters the first whereof is the glory of God that his immense power may be manifested to those which are ignorant of it by the sending of those things which happen contrary to nature for thus our Saviour Christ answered the Disciples asking whether he or his parents had offended who being born blind received his sight from him that neither he nor his parents had committed any fault so great but this to have happened onely that the glory and majesty of God should be divulged by that miracle and such great workes Another cause is that God may either punish mens wickednesse or shew signes of punishment at hand because parents sometimes lye and joine themselves together without law and measure or luxuriously and beastly or at such times as they ought to forbeare by the command of God and the Church such monstrous horrid and unnaturall births doe happen At Verona Anno Dom. 1254. a mare foaled a colt with the perfect face of a man but all the rest of the body like an horse a little after that the warre betweene the Florentines and Pisans began by which all Italy was in a combustion The figure of a Colt with a mans face About the time that Pope Julius the second raised up all Italy and the greatest part of Christendome against Lewis the twelfth the King of France in the yeere of our Lord 1512. in which yeere upon Easter day neere Ravenna was fought that mortall battell in which the Popes forces were overthrowne a monster was borne in Ravenna having a horne upon the crowne of his head and besides two wings and one foot alone most like to the feet of birds of prey and in the knee thereof an eye the privities of male and female the rest of the body like a man as you may see by the following figure The figure of awinged Monster The third cause is an abundance of seed overflowing matter The fourth the same in too little quantity and deficient The fift the force and efficacy of imagination The sixt the straightnesse of the wombe The seaventh the disorderly site of the party with childe and the position of the parts of the body The eighth a fall straine or stroake especially upon the belly of a woman with child The ninth hereditary diseases or affects by any other accident The tenth the confusion and mingling together of the seed The eleventh the craft and wickednesse of the divell There are some others which are accounted for monsters because they have their originall or essence full of admiration or doe assume a certaine prodigious forme by the craft of some begging companions therefore we will speak briefly of them in their place in this our treatise of monsters CHAP. II. Of monsters caused by too great abundance of seed SEeing wee have already handled the two former and truely finall causes of monsters we must now come to those which are the matereall corporeall and efficient causes taking our beginning from that we call the too great abundance of the matter of seed It is the opinion of those Philosophers which have written of monsters that if at any time a creature bearing one at once as man shall cast forth more seed in copulation than is necessary to the generation of one body it cannot be that onely one should bee begot of all that therefore from thence either two or more must arise whereby it commeth to passe that these are rather judged wonders because they happen seldome and contrary to common custome Superfluous parts
but yet was not in a consumption untill at length an abscesse rising in his groine with great store of very stinking quitture the knife was there taken forth in the presence of the Justices and left with Joubert the Physitian of Mompelier Mounsieur the Duke of Rohan had a Foole called Guido who swallowed the point of a sword of the length of three fingers and hee voided it at his fundament on the twelfth day following yet with much adoe there are yet living many Gentlemen of Britanie who were eye-witnesses thereof There have been sundry women with childe who have so cast forth piece-meale children that have died in their wombes as that the bones have broke themselves a passage forth at the navill but the flesh dissolved as it were into quitture flowed out by the necke of the wombe and the fundament the mothers remaining alive as Dalechampius observes out of Albucrosis Is it not very strange that there have bin women who troubled with a fit of the Mother have lien three whole dayes without motion without breathing or pulse that were any way apparent and so have beene carried out for dead A certaine young man as Fernelius tells by somewhat too vehement exercise was taken with such a cough that it left him not for a moment of time untill hee therewith had cast forth a whole impostume of the bigness of a pidgeons egg wherein being opened there was found quitture exquisitely white and equall He spit blood two dayes after had a great feaver and was much distempered yet notwithstanding he recovered his health Anno Dom. 1578. Stephana Chartier dwelling at St. Maure des Faussez a widow of fourty yeeres old being sicke of a tertian Feaver in the beginning of her fit vomited up a great quantity of choler and together therewith three hairy wormes in figure colour and magnitude like the wormes called Beare-wormes yet somewhat blacker they lived eight whole daies after without any food the Chirurgian of this towne brought them to Dr. Milot who shewed them to Feure Le Gros Marescot and Courtin Physitians and to me also This following history taken out of the Chronicles of Monstrele exceeds all admiration A certaine Franck-Archer of Meudon foure miles from Paris was for robbery condemned to bee hanged in the meane time it was told the King by the Physitians that many in Paris at that time were troubled with the stone and amongst the rest the Lord of Boscage and that it would be for the good of many if they might view and discerne with their eyes the parts themselves wherein so cruell a disease did breed and that it might be done much better in a living than in a dead body and that they might make try all upon the body of the Franck-Archer who had formerly beene troubled with these paines The King granted their request wherefore opening his body they viewed the breathing parts and satisfied themselves as much as they desired and having diligently and exactly restored each part to its proper place the body by the Kings command was sewed up againe and dressed and cured with great care It came so to passe that this Franck-Archer recovered in a few daies and getting his pardon got good store of mony besides Alexander Benedictus tells that hee saw a woman called Victoria who having lost all her teeth and being bald yet had others came up in their places when as she was fourescore yeeres old Stephen Tessier a Chirurgian of Orleance told me that not long agoe he cured one Charles Veriguell a Serjeant of Orleance of a wound received in his hamme whereby the two tendons bending the ham were quite cut in sunder He took this order in the cure hee caused the patient to bend his legge then hee sewed together the ends of the cut rendons then placed the member in that site and handled it with that art that at length he healed the wound the patient not halting at all Truely this is very memorable thing and carefully and heedfully to be imitated by the young Chirurgian How many have I seen who wounded and thrust through the body with swords arrowes pikes bullets have had portion of the braine cut off by a wound of the head an arme or legge taken away by a cannon bullet yet have recovered and how many on the contrary have died of light and small wounds not worth the speaking of A certaine man was shot in neare to his groine with an arrow whom we have seen saith Hippocrates and he recovered beyond all mens expectation The arrow head was not taken forth for it was very deep in neither did the wound bleed very much neither was it enflamed neither did he halt but wee found the head and tooke it forth sixe yeeres after he was hurt Now Hippocrates gives no other reason of its so long stay but that he saith it might be suspected it lay hid betweene the nerves and that no veine nor artery was cut thereby CHAP. XX. Of the wonderfull originall or breeding of some creatures WEE have read in Boistey that a certaine workeman of Avignion when as hee lived in that city opened a leaden coffin wherein a dead body lay that was so closely soudered that the aire could not get in and as he opened it he was bitten by a serpent that lay therein with so venemous and deadly a bite that it had neere to have cost him his life Yet the originall of this creature is not so prodigious as hee supposeth for it is an usuall thing for a Serpent to breed of any putrefyed carcasse but chiefly of a mans Baptista Leo writes that in the time of Pope Martin the fift there was a live serpent found enclosed in a vaste but solid Marble no chinke appearing in such dense solidity whereby this living creature might breath Whilest in my vine-yard that is at Meudon I caused certain huge stones to be broken to pieces a Toad was found in the midst of one of them When as I much admired thereat because there was no space wherein this creature could be generated encrease or live the Stone-cutter wished mee not to marvaile thereat for it was a common thing and that he saw it almost every day Certainly it may come to passe that from the more moist portion of stones contained in places moist and under ground and the celestiall heat mixing and diffusing it selfe over the whole masse of the world the matter may be animated for the generation of these creatures CHAP. XXI Of the wondrous nature of some marine things and other living creatures THE last mentioned creatures were wonderfull in their originall or rather in their growth but these which follow though they be not wonderfull of themselves as those that consist of their owne proper nature and that working well and after an ordinary manner yet they are wondrous to us or rather monstrous for that they are not very familiar to us For the rarity
to the ground and sayd then Now is the Rat taken I dressed him and God healed him We entred the throng in the Citty and passed over the dead bodyes and some which were not yet dead we heard them cry under our horses feete which made my heart relent to heare them And truely I repented to have forsaken Paris to see so pittifull a spectacle Being in the Citty I entred into a stable thinking to lodge my owne and my mans horse where I found foure dead souldiers and three which were leaning against the wall their faces wholly disfigured and neither saw nor heard nor spoake and their cloathes did yet flame with the gunpowder which had burnt them Beholding them with pitty there happened to come an old souldier who asked me if there were any possible meanes to cure them I told him no he presently approached to them and gently cut their throates without choler Seeing this great cruelty I told him he was a wicked man he answered me that he prayed to God that whensoever he should be in such a case that he might finde some one that would doe as much to him to the end he might not miserably languish And to returne to our former discourse the enemie was soÌ„moned to render which they soon did went out their lives onely saved with a white staffe in their hands the greatest part whereof went and got to the Castle of Villane where there was about 200. Spaniards Monsieur the Constable would not leave them behind to the end that the way might be made free This Castle is seated upon a little mountaine which gave great assurance to them within that one could not plant the Ordinance to beate upon it and were sommoned to render or that they should be cut in peeces which they flatly refused making answere that they were as good and faithfull servants to the Emperor as Monsieur the Constable could bee to the King his master Their answere heard they made by force of arme two great Cannons to be mounted in the night with cords and ropes by the Swissers and Lansquenets when as the ill lucke would have it the two Cannons being seated a Gunner by great negligence set on fire a great bagge of Gunpowder wherewith he was burned together with toâ— or twelve souldiers and moreover the flame of the powder was a cause of discovering the Artillery which made them that all night they of the Castle did nothing but shoote at that place where they discovered the two peeces of Ordinance wherewith they kild and hurt a great number of our people The next day early in the morning a Battery was made which in a few houres made a breach which being made they demanded to parly with us but t was too late for them For in the meane time our French foote seeing them amazed mounted to the breach and cut them all in peeces except a faire young lusty mayd of Piedmount which a great Lord would have kept and preserved for him to keepe him company in the night for feare of the greedy wolfe The Captaine and Ensigne were taken alive but soone after were hanged upon the gate of the Citty to the end they might give example and feare to the Imperiall souldiers not to bee so rash and foolish to be willing to hold such places against so great a Army Now all the sayd souldiers of the Castle seeing our people comming with a most violent fury did all their endeavour to defend themselves they kild and hurt a great company of our souldiers with Pikes Muskets and stones where the Chirurgions had good store of worke cut out Now at that time I was a fresh water Souldier I had not yet seene wouuds made by gun-shot at the first dressing It is true I had read in Iohn de Vigo in the first booke of wounds in generall the eighth chapter that wounds made by weapons of fire did participate of Venenosity by reason of the pouder and for their cure commands to cauterize them with oyle of Elders scalding hot in which should be mingled a little Treackle and not to faile before I would apply of the sayd oyle knowing that such a thing might bring to the Patient great paine I was willing to know first before I applyed it how the other Chirurgions did for the first dressing which was to apply the sayd oyle the hottest that was possible into the wounds with tents and setons insomuch that I tooke courage to doe as they did At last I wanted oyle and was constrained in steed thereof to apply a disgestive of yolkes of egges oyle of Roses and Turpentine In the night I could not sleepe in quiet fearing some default in not cauterizing that I should finde those to whom I had not used the burning oyle dead impoysoned which made me rise very early to visit them where beyond my expectation I found those to whom I had applyed my digestive medicine to feele little paine and their wounds without inflammation or tumor having rested reasonable well in the night the other to whom was used the sayd burning oyle I found them feverish with great paine and tumour about the edges of their wounds And then I resolved with my selfe never so cruelly to burne poore men wounded with gunshot Being at Thurin I found a Chirurgion who had the â—ame above all others for the curing of wounds of Gunshot into whose favour I found meanes to insinuate my selfe to have the receipt of his balme as he called it wherewith he dressed wounds of that kind and hee held me off the space of two yeeres before I could possible draw the receipt from him In the end by gifts and presents he gave it me which was this to boyle young whelpes new pupped in oyle of Lillies prepared earth wormes with Turpentine of Venice Then was I joyfull and my heart made glad that I had understood his remedy which was like to that which I had obtained by great chance See then how I have learned to dresse wounds made with gunshot not by bookes My Lord Marshall of Montian remained Lievtenant generall for the King in Piedmont having ten or twelve thousand men in garrison through the Cittyes and Castles who often combated with swords and other weapons as also with muskets and if there were foure hurt I had alwayes three of them and if there were question of cutting off an arme or a legge or to â—repan or to reduce a fracture or dislocation I brought it well to passe The sayd Lord Marshall sent me one while this way another while that way for to dresse the appointed Souldiers which were beaten aswell in other Citties as that of Thurin insomuch that I was alwayes in the Countrey one way or other Monsieur the Marshall sent for a Physition to Milan who had no lesse reputation in the medicinall Art than the deceased Monsieur le Grand to take him in hand for an hepaticall flux whereof at last he dyed