the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
the Birth If any one of these be wanting then one of these four things necessarily happens either 1. Both the Mother and the Child although they may live yet there follows no Exclusion 2. Or the Mother lives and the Child dies 3. Or the Child lives and the Mother dies 4. Or both the Mother and Infant dies Causes hindering Labour are 1. When the Pains of the Birth are none or not sufficient 2. The great weakness of the Mother 3. The greatness and strength of the Child and on the contrary the slender and tender Constitution of the Mother or when the passages are so straight that the Infant cannot come through them 4. The number of Children especially if they endeavor to come forth at the same time 5. The transverse or any other preternatural posture of the Child 6. If the Child in the Birth it self be fallen down with its Head upon the fore-port of the Ossa-Pubis which case Authors of the greatest account whom I know and our Midwives have not at all observed so by how much the greater the Pains of the Birth are there is so much the less hope of coming out except the Head be first a little raised and the Foetus be turned towards the back and so into its true passage by the hand of the Midwife 7. The Weakness of the Child it self which makes it not able to add any thing towards its Exclusion 8. The Death of the Child 9. The not sufficient recesses of the Hip-bones towards the Back for the Ossa-Pubis except in the very hardest Labours and then but very seldom do divide The Signs of a Dead Child are as followeth The Mother feels no more the Motion of the Infant although strengthening Cordials be exhibit'd but in this case when the Infant is as it were tir'd stirs it self a little you have a much more certain Sign Take a piece of the Crum of Bread and dip it in Canary Wine and apply it to the Navel of the Mother then open a Vein in the Foot and if by the use of these things there follows not a motion of the Infant it is a very ill Sign When the Mother turns her self from one side to the other and perceives the Child to fall on the side laid upon like a stone or a great weight the Face and chiefly the Lips grow pale the extream parts cold as likewise the lower Belly the Paps begin to grow lank the Breath becomes fetid great pains of the Head Faintings and Fevers Water and stinking Gleet flows out of the Womb If the After-Birth be excluded before the Child 't is impossible the Child can live long but the surest sign of all is if the Membrane of the Head of the Child be not observed to be any longer tense for as long as it is tense the Infant lives Prognostick Except the dead Child be suddenly drawn forth it puts the Mother in great hazard of Life The Fever not being great other Symptoms though great and fearful yet take not away the hope of recovery The Cure If Medicines with the aid of Mother and Midwife profit little then must the business be committed wholly to the Chirurgeon except the Woman be too weak or the Child having been dead for many days which he ought to consider lest he lose both his Credit and Labour But first it is diligently to be enquired into which of the Causes it is that hinders the Birth If the Child be greater and the passage straighter than usually they ought to be dilated this some Midwives do with convenient Instruments and so draw forth the Child alive but where they are wanting the Midwife must clutch her hand very close and thrust through the Internal Orifice into the Womb it self then putting her Fingers one after another through the Orifice into the inner part of the Womb to discover the situation of the Child and if she finds the Arms or Feet to come inconveniently let her gently raise it up bringing the Head downwards which if she finds to be next the Orifice if possible let her put in her other hand through the Pudenda into the Womb and so with both her hands laying hold of it draw it forth But if this Operation cannot be performed then with a hook firmly fixt lest it injure the inside of the Womb in the Mouth Eye or Ear of the Child and so gently draw it forth and if the Faetus will not follow then with another Hook blunt on the out-side and sharp within let him cut in pieces the Belly Breast or Head of the Child and if the Arms or Legs cannot be brought forth let him cut them off so at length being deprived of its Limbs the remainder may be drawn forth But if by this way the Woman can neither be deliver'd with a sharp and strong Knife the Limbs one after another are to be cut out and so the Child be drawn forth by piece-meal It is necessary that this be perform'd by none but a good Anatomist The Secundine will presently follow the Birth for it 's of no use that being excluded for the Mouth of the Womb suddenly after delivery is so closly shut that not without great pain it can admit the Hand of the Midwife therefore the Midwife as soon as may be is to draw it forth and with her fingers if it sticks very close to the Womb gently to separate it but not pluck it a way forcibly which is mortal and although many Writers and Midwives of inferior Rank little regard the retention of the After-Birth for some time after delivery yet I think I have good reason to pronounce it one of the greatest Symptoms of Womens Labour CHAP. XXIV Of the Extirpating of a Mortified Part. WHen a Dead Part altogether becomes useless that it may not do any injury to the neighboring Parts it is to be taken away But in what place Most convenient is the Joynt but the cure by such Extirpation is render'd more difficult and the use of the Part altogether lost therefore the Extirpation is better to be made two or three or more fingers breadth below the Joynt except the Mortification hath extended it self to the uppermost part of the Arms or Thighs for then we are forced to take the Joynt it self But again in what Part whether in the whole or Mortified The Amputation is more safe in the sound Part although accompanied with greater Pain The common way both of the Ancient and Modern The Patient having receiv'd convenient nourishment is to be placed upon a Form then let the Skin and fubjacent Muscles be drawn up as much as possible by a strong Man and there kept and an inch above the place where the Member is design'd to be taken off with a narrow Ligature is the Part to be very hard bound this done with a dismembring Knife the Skin with the Flesh is speedily to be cut all round to the Part and the Periostium by scraping is to be separated from the Bone
10. Of Nerves 233 11. Of the Flesh 237 12. Of the Skin 243 13. Of the Fat Nails and Hair 247 14. Of the generation of the Blood and its Circulation 250 15. The division of the Parts of the Body 266 The second Book of the Head 1. OF the outward parts of the Head 268 2. Of the inward parts of the Head 292 3. Of the Neck 296 The Third Book Of the Breast 1. OF the External parts of the Breast 300 2. Of the Internal parts of the Breast 305 The Fourth Book Of the lower Belly 1. OF the outward parts of this Belly 311 2. Of the Internal parts of the Abdomen 314 The Fifth Book Of the Joynts 1. OF the Hands 332 2. Of the Feet 337 An Index to the Treatise of the Plague A Description of the Plague Page 1 It 's Cause 3 It 's Diagnostick 5 Prognostick 6 It 's Cure 9 Whether Bleeding and Purging is convenient 9 10 The use of Sudorificks 11 Medicaments against the Plague 12 Symptoms of the Plague are 18 Feaver Ibid. Drowsiness 20 Continual watchings 21 Great pain of the Head Ibid. Vomiting and the Hicough 22 A Loosness 23 Spots 25 Bubo Ibid. Preservatives against the Plague 32 Practical Observation 36 BARBETTY'S CHIRURGERY The First Part. CHAP. I. Of Manual Operations in general ALthough the word Chirurgery signifies all Manual Operations in general yet by reason of its pre-eminence above all the rest it is now only given to that Art which endeavours to remove the Diseases of the Body by the assistance of the Hands 'T is true that External Accidents require not only the help of the Hands but also Internal Means therefore it is no wonder for a Part of Physick to require the whole Chirurgery being a Part which depends upon the Body of Physick But these internal Medicines we impart to you not as Chirurgeons but as Physicians The General Operations of this Art to which all the particular ones may be reduced are of four sorts 1. Synthesis which teacheth how to unite parts disjointed 2. Diaeresis To separate parts unnaturally joyned 3. Exaeresis To remove what is superfluous 4. Anaplerosis To supply those that are wanting CHAP. II. Of Synthesis or Vnition UNition is of two sorts one regards the Hard and Boney the other the Soft and Fleshy parts of the Body The Unition of Bones is again twofold the one setting Bones broken the other reducing Bones wrenched or disjointed We will begin with Fractures CHAP. III. Of the Nature Difference Signs Prognosticks and Cure of Fractures in general A Fracture is a Solution of Continuity in the hard parts of the Body caused by an hard Instrument externally forced upon the part The Differences are taken 1. From the Manner there being some transverse which are properly called Fractures others that are made according to the length of the Bone called Fissures and others are Comminutions when the Bone is broken into many small parts 2. From the Part it being some times in the Head sometimes in the Shoulders Ribs Arms Legs c. 3. From the Accidents there being sometimes a Wound accompanying it at other times a Dislocation Inflamation Gangrene c. Cause is Whatever is able to break bruise or cut Sometimes also a Bone corrupted by the Pox Gout or otherwise hath been broken without any external force Signs A Bone being transversly or obliquely broke by handling it you perceive an inequality the Patient is scarce able to move the Part affected and sometimes that Part is shorter than the other the Thigh Leg or Foot being broken the Patient cannot stand at all but he may somewhat though with pain in a Dislocation And this is the surest difference between a Fracture and a Dislocation A Fissure is discerned by the thickness pain and unevenness of the Part and requireth the judgment of a skilful Chirurgion A Comminution is easie to be perceived the Bone being very unequal and here and there yielding to the Fingers Prognosticks A Transverse Fracture is more easie to cure than an Oblique or when accompanied with apparent Inequalities that where but one Bone is broken than where two are or where the Bones are much shattered that which â—s made in the midst of the Bone than what happens to be near the Head and a single one than a compound If the Patient remain undressed beyond the seventh day the Member is in danger of mortifying especially if that the Part be too â—ard bound The Cure A broken Bone requires these four Operations Extention Conjoining Ligature Well-placing and withal the application of outward and inward Remedies Extention can hardly be performed without pain which yet will be much less if the Member be so extended that the Muscles do not labour that is to say The Part must be so laid that when in health they could hold out longest without tiring Sometimes the extension must be greater sometimes lesser which will be performed aright if regard be had to the time of the Fracture to the Age of the Patient and to the greatness of the Bone A recent Fracture a tender Patient a small Bone require a gentler Extention on the contrary an old Fracture a strong Patient and a big Bone a greater The manner of extending I describe not because it is better learnt by the frequent view of Practice than by Reading After Extention you are to join the Bones together in the doing of which the Muscles must not be wrested but retain their natural position and figure Then the Part must be bound with a double Rowler the first is to be rowled thrice about the Fracture and then upwards The second which must be twice as long is to be once wound about the Fracture proceeding downwards and then upwards again a little higher than the first Rowler to which you will give more firmness if you bind some convenient Splints of Wood or rather of Past-board round about the Member The Ligature ought not to be too strait lest it cause pain and rob the Part of its nourishment nor too loose lest the Bones slip out of their place And unless great pain or other symptoms require it must not be opened before the third day and at the second dressing it must be bound somewhat closer and afterwards changed but once every four five or six dayes Lastly The Part ought to be well placed that is softly evenly and a little raised If you lay it too low the Bone will bend outwards if too high it will bend inwards Wherefore you must observe a mean Now whether these four Operations have been duly performed may be known by the ensuing Signs The Extention is well done if the part be strait and as long as its fellow if it appear to outward view every where even and a little hollow about the Fracture The joining together is duly made if the Bone be any thing firm and all about the Fracture be found equal The Ligature is as it ought to be if the Patient as soon
Skull is described CHAP. XIX Of Vstion or Burning ENough hath been said of Cutting now a little of Burning when neither Medicine nor Knife bring relief we must then come to the Fire as well in the soft as hard parts In all Burning great care is to be taken that the neighboring parts be not hurt therefore it is very necessary to defend them against it with Lint That burning is certainest which is made by an actual Cautery viz. a red hot Iron than that which is performed a Potential that is by Corrosive Medicines yet for the most part the Patients fearfulness makes choice of this whichsoever you use beware of applying Oyl alone or Butter to remove the Escar for it hath been observed not once only to to have occasioned a Gangrene Diapalma Plaister or Lint wet in Wine will be sufficient CHAP. XX. Of Issues ISsues are little Ulcers made by Art in a sound part of the Body by a red-hot Iron Launcet Scissars or corrosive Medicine to evacuate superfluous humors and so either to cure or prevent Diseases These troublesome Guests are rarely courted and are chiefly prescribed when we see gentler Medicines to profit nothing and after the Body hath been well purged In what part soever they are made it is always to be observ'd they never ought to be inserted in the beginning middle or end of a Muscle but always in the space between two Muscles which requireth the knowledge of Anatomy except according to the example of Quacks whose custom hath taught them to find out a place ev'n blindfold In the Head the place is the middle of the Coronal Suture made oftner by other Nations than is a practice amongst us In the Neck they are not so often made how necessary soever they may appear The Italians use to make them between the Shoulders with success In other places they are either very troublesome or inconvenient The Manner of making Issues is divers If you make use of the Potential Cautery apply a Plaister to the part having a hole in the middle about the bigness of a Pea in which lay a little Costick and over that a Bolster and another Plaister and after three or four hours take off the Plaisters and laying on the Escar a Plaister of Diapalma dress it twice a day that it may the sooner separate Those which desire it rather by Incision the Skin being taken up either by the Forceps or by the Hand divide it with a pair of Scissars or Launcet If Burning be preferred before the other ways burn the Skin but not the subjacent Muscles for indeed the Skin it self is not to be wholly penetrated oftentimes the touching only the Superficies of it is enough When the Scar falls off take little hard Dossels made of Lint spred upon them some Detersive Medicine and press them into the Ulcer until they have made a sufficient Impression then afterward keep in this Cavity a Ball of Wax Wood or Silver or a Pea which is to be often taken out and another put in and so is to be continued till the Disease be cured or Weakness hinder CHAP. XXI Of the Seton ALthough the application of a Seton be with greater trouble than an Issue yet it brings much greater advantage to the sick Patient for what two Issues cannot remove oftentimes is performed by one Seton It may be made in the Arms and Legs and many other parts of the Body but in the Nape of the Neck between the first and second Vertebra or second and third yea between the third and fourth is only in use amongst us but I could wish it was more frequent There are three Instruments necessary to perform this Operation A pair of Forceps a Needle and String The Forceps which are to hold up the Skin must be perforated of each side the Needle must be three-pointed and answer to the hole of the Forceps which it must pass through The String is to be of Silk not exceeding the thickness of the Needle Let the Chirurgion take up the Skin with the Forceps and gripe it hard which being somewhat stupified the Patient will feel the less pain then let him pass the Needle red-hot through both the holes of the Forceps Skin and all after which with another Needle let him bring through the thread The first day to ease pain apply to the Part Lint dipt in Whites of Eggs and Rose-water mixt together Afterward let Digestion be procured by the use of convenient Medicines when digested let the String be drawn every day sometimes to this side sometimes to that so that the mattery part may hang out of the Wound Thus the Operation being perfected the Ulcer may be kept open as long as occasion requires or the Patient pleaseth After this manner many Authors both Antient and Modern order the making the Seton but this Oparation is much easier perform'd if in the right place the Chirurgion take up the Skin with one hand and his Servant with another and so pass it through with a sharp-pointed Needle but not made hot the String being of Thread not Silk of convenient Thickness and rubb'd with Wax CHAP. XXII Of the drawing forth of Bullets NOw we are come to the Third Part of Chirurgery call'd Exeresis which removes things superfluous They are of a two-fold Nature either they are generated in the Body it self or else brought thither by Accident We treat of the last first to wit The Extraction of Bullets out of the Body which is not difficult if it appears whether it be nearer to the part where it made its entrance or to the opposite to which it hath penetrated If it be observed to be near the Orifice let it be drawn forth with a convenient Instrument if nearer to the opposite part let the Incision be made upon it and there taken forth But if the Bullet cannot be found out by a Probe the Member is to be so placed that the Bullet by its own weight may come forth which if it happens not to do the Wound is to be cured and let the Chirurgeon expect until the Bullet shews it self near the Skin which very often requires a long time CHAP. XXIII Of the Extraction of a Dead Child and the Secundine THat the Birth may be Natural it is necessary That the Infant the whole time of its continuance in its Mothers-womb lies in such a posture that the Arms and Feet being contracted the Head downwards having the Face towards the Mothers Back the whole Foetus lying transverse in the bottom of the Womb until requiring greater room which happens in the seventh sometimes in the eighth or tenth for the most part in the ninth Month the head of the Infant descends towards the mouth of the womb the Limbs which were before contracted being extended it breaks through the Membranes wherein it was included by which the water that is contained in them flows forth which serve to make the parts slippery and so is convenient to facilitate
of Baths is excellent and their Waters taken at fit times safely Cure this Disease The Decoctions of China Salsa c. also benefit much Outwardly Fasting-Spittle oftentimes doth good because if it should be repelled to the Internal parts it causeth a Feaver and other ill Symptoms With great success many times have I seen applyed the Powder of Lapis Scisilis mixt with Vinegar some used Mustard boyl'd in Butter to which they add some Gunpowder Lye also and Urine have helpt many Unguent Fuscum of Felix Wurtz is excellent here as also the following Plaister Take Sarcocols Crude Brimstone of each two drrms Mastick Frankincense Lapis Calaminaris of each half an ounce white Troches of Rhasis Litharge of Gold Myrrhe of each three drams Goats Suit half an ounce Wax and Turpentine so much as is sufficient to make it into a Plaister according to Art Take the Powder of Chalk mixt with Cream and anoint the part fomenting it before with the hot Lees of White-wine In a Rebellious Herpes Take the brown Oyntment of Felix Wurtz three drams white Ointment with Camphire one dram and half Cerase Brimstone Myrrhe of each a dram Litharge a dram and half Mercurius dulcis Verdigrease of each a scruple and half Oyl of Roses as much as sufficeth Make it into an Oyntment Or Take Lapis Prunella one dram Flower of Brimstone half an ounce Salt of Saturn a dram and half old Oyl of Rape as much as sufficeth to make it into a Linament CHAP. IX Of Atheroma Steatoma and Meliceris A Theroma is a Tumor besides Nature contained in a proper Cist caused from a Humor like to the Pap of a sodden Barley without pain of the colour of the skin not yeilding to the singers nor when they are removed suddenly swelling out again Steatoma is a Tumor besides Nature contained in its own proper Tunicle caused from a Matter like to Suet and of the same colour soft from a small beginning by degrees increasing difficulty yielding to to the Fingers but they being removed returning again to its former greatness Meliceris is a Tumor besides Nature included in its proper Tunicle engendered from a Humor like to Hony without pain round easily yeilding to the Fingers which being removed returns again to its first Figure Differences This Matter like to Honey Suet or Pap if gathered about the Joynts is call'd a Ganglion if about the Glandules of the Neck a Glandula Scrophula or Struma if in the Arms Legs or Head Turberculum if from the Pox Tophus Cause of these Tumors is Phlegm in the one more in the other less receding from its Natural Constitution and sometimes but very seldom mixt with Melancholy Signs are declared in their Definition Prognosticks They are scarce ever cured but by Manual Operation If the Vesicle be broken or not all taken out there remains a Fistula or a foul Ulcer The Cure of which will be both difficult and tedious Cure They are sometimes but very rare removed by strong Resolvents I have Cured some with Balsom of Peru some use Oxicroceum Plaister or the following Take Laudanum an ounce Red Myrrhe three drams Camphire a dram Mix them and make it into a Plaister according to Art Another Take Gum Sagapenum Ammoniacum of each half an ounce Roots of Pellitory Euphorbium of each a scruple and half Brimstone three drams Oyl of Amber a dram Make it into a Plaister If it break and the Matter discharge out of the Tunicle then must you use Corrosives for other Medicines are too weak Corrosives and Cathereticks Roots of the black Hellebore burnt Galls burnt Date-stones Verdigrease burnt Alum Quick Lime Vitriol Mercury Sublimate and Precipitate Spirit and Oyl of Vitriol Spirit of Salt the Liquor of Tartar Oyntments of Aegyptiacum Fuscum of Felix Wurtz Ashes of Oak and Vine branches Some use Arsnick and Orpment but they are not used but with the greatest danger in those places known by Anatomy under which the Nerves lye to the Skin and Carnous Excrescencies they may be applyed with the less danger The following Ointment will suffice Take Vitriol well sweetned a dram Verdigrease a scruple Ointment of Aegyptiacum half an ounce Make it into an Oyntment If they tend to Suppuration which is very seldom let the Surgeon assist Nature with Maturatives but the safest Method of taking away these Tumors we have shewn in the twelfth Chapter of the first Part. CHAP. X. Of Scrophula Struma or King's-Evil STruma or Scrophula are Tumors besides Nature contained in a proper Tunicle of their own from a Melancholick or Pituitous Humor shewing themselves in manner of Tubercles in the Neck and adjoyning Parts Difference They are sometimes noveable sometimes fixt sometimes but one sometimes many Cause is Melancholy or Phlegm or both mixt together Signs Are Hardness Inequality and seldom painful Prognosticks These Tumors are of long and difficult Cure especially if many or fixt they are dangerous when they grow painful and threaten to become cancerous or if fixt to any great Nerve or Vein sometimes they are Hereditary and sometimes peculiar to a Region or City when cured they for the most part leave behind them great Skars where the recurrent Nerve is divided the Speech is lost and oftentimes Life it self Cure Diet must be here the same as in a Oedema or Scirrhus Purging is necessary but not Bleeding provoking Sweat by the same way and means as in the French-Pox effects much yea it alone cures the King's-Evil Sometimes they are consumed by Internal Remedies that have appropriated Qualities of curing Scrophulas Such are these Roots of round Birthwort Briony Sow-Bread Dropwort Devil's-bit Orrise Pimpernel Pellitory of Spain Squills Vervain Figwort Leaves of Cypress Bawm Rue Savory Flowers of Broom burnt Crabs burnt Egg-shells Sal Gemmae Spunges New Spunges are much commended if boiled in Ale drinking thereof three or four times a day or calcined and taking half a dram of the Powder Morning and Evening The following Powder is likewise very much praised Take the Ashes of Sea-Spunges Os Sepiae Long Pepper Cinamon Sal Gemmae Pellitory of Spain Cypress-Nuts Galls Red-Rose Leaves of each half an ounce Make a Powder Dose two Scruples or a Dram. Or Take of Spunge-stone three drams Sal Gemmae two drams Salt of Tartar a dram Make a Powder Dose two scruples or a dram Outwardly Resolving and Emollient Medicines are applied which if they effect it not then use Suppuratives when 't is suppurated it is to be cured as a malignant Ulcer But if the above-named Medicines signifie nothing then we come to corrosive Medicines and to the Incision-Knife An excellent Resolving Emollient Plaister Take Gum Galbanum Ammoniacum Bdellium of each half an ounce Bay-berries Stavesacre Pellitory of Spain Cummin of each six drams Pigeon's dung a dram Goat's-dung three drams Hog's-grease an Ounce and half Oyl of Camomile an ounce Wax and Pitch as much as is sufficient to make it into a Plaister A Liniment that stops the Flux of Humors and
How the Internal Vlcers of the Yard ought to be cured we have set down in the Chapter of particular Vlcers But in this we may describe this Medicine by the use of which a Cancerous Yard was cured An Vnguent of Peter Baierus Take the juice of the tops of Bramble Stalks of Roses Vinegar of each two ounces Franckincense Mastick of each three drams Litharge of Gold an ounce Sack four ounces Juice of Housleek three ounces Aqua vitae four ounces Verdigreece two ounces and half Vitriol Burnt-alom of each a dram and half Camphire a dram Oyl of Roses four ounces Powder those things that are to be powdred very fine and being searched let them boil all together upon a gentle fire except the Camphire which is to be put in at the end to the consumption of the Juices then add the Wax and make it into an Ointment 11. The Spermatick Vessels sometimes in Women are so greatly obstructed that together with the Testicles in the side of Hypogastrium they swell to the bigness of ones Fist 12. In the Tubes of the Womb the Womans Seed is sometimes corrupted from which arise grievous Symptoms the Courses being for some Months obstructed oftentimes there follows a Dropsie the Water here collected we have observed in dead Bodies that have been opened to flow directly through the Tubes into the Duplicature of the Peritonaeum 13. The Womb from the preternatural afflux of Blood is often inflamed especially in lying-in Women and in those whose Courses flow disorderly this Inflammation oftentimes is changed into an Abscess if negligently handled whose Cure belongs to the Physitian But a Sphacelus is incurable For what the Ancients relate concerning the extirpation of the Womb to wit that it may all be taken off without any great danger is to be reckoned amongst their other Errors but whether this Animal in living Creatures this necessary part joyning to so many other parts and furnished with such abundance of Arteries may be cut out without danger of Life The same thing I believe hath hapned to them in this case as hath hapned in the describing and curing the falling down of the Womb who here and there have taken the extended Tunicles of the Vagina Vteri for the Womb it self for I easily grant these Tunicles may without any great danger be taken away But I truly esteem a Sphacelus of the whole Womb to cause certain death 14. The Neck of the Womb is subject to Haemorrhoids in the same manner as the straight Gut is these flowing may be distinguished from the Courses by these following signs in the flowing of the Courses we can observe no Branches of the Vessels in the Neck of the Womb they come out of the Womb it self and they cause no pain except in the Hypogastrium these Vessels by which the Evacuation is made are the Hypogastrick and Spermatick Arteries but the Haemorrhoids are the Branches of Vena pudenda they may be known both by the sight and feeling and there is no pain but in the privy part it self They ought to be treated in the same manner as the other Haemorrhoids are to ease pain this Ointment is excellent Take Mussilages of the Seed of Quinces Marshmallows of each half an ounce Saffron Oyl of Roses Hens-grease of each a dram the Yolk of an Egg Make it into an Ointment This Mixture is excellent Take Litharge of Gold washt Oeruse burnt-Lead of each a scruple Purslane-water five ounces Mix them Let the Haemorrhoids be washt with it and let a Linnen Cloth dipt in it be applied to the Part affected The End of the fourth Book of the third Part. The FIFTH BOOK Of the Joynts CHAP. I. Of the Hand UNder the name of the Hand we comprehend also the Arm whose Teguments both proper and common as also its Vessels are already sufficiently described It is commonly divided into three parts 1. The Shoulder 2. The Cubit 3. The Hand properly so call'd The Shoulder or upper part of the Arm consists of one Bone and nine Muscles The Muscles are 1 2. Deltoides and Supra spinatus which two raise it upward 3 4. Aniscalptor Latissimus and Rotundus major which two pull it downward 5 6. Pectoralis Perforatus or Coracoidaeus which two draw it forward 7 8 9. Infra-spinatus Rotundus minor and Immersus or Subscapularis which three move it backward By these three last moving together the Arm is as it were turned about and obliquely outwardly raised up The Bone is great and long its Head or upper extremity is invested with a Cartilage Membranous Ligament and four Tendons and furnished with a particular Cavity in which the Tendon of the Muscle Triceps lies The Lower Extremity is like unto a Pulley which permits the Cubit to be bent very much inwardly but not to extend beyond the right Line The Cubit consists of two Bones which are by proper Muscles properly moved which although out of order we are forced to set down in this place The Lower Bone which is greater and longer than the other is call'd Vlnae in its upper extremity are two triangular processes observed which are call'd Rostra or Glandes The Lower Extremity ends with a round Knob to which is joyned a sharp Process which is call'd Styloides It is moved by four Muscles of which two are Flexors 1. Biceps 2. Brachiaeus Two Extensors 1. Longus 2. Brevis The upper Bone which is less and shorter is call'd Radius or the lesser Focil it is received in the upper part by the Vlna in the lower part it receives the Vlna in the middle they are a little distant from one another which space is yet fill'd with a thin Ligament It is also moved by four Muscles whereof two are Pronatores or pullers down 1. Rotundus 2. Quadratus The other two are Supinatores or raisers up 3. Longior 4. Brevior Some add to these two other Muscles but they are very seldom found and diversly described The Hand is divided into three parts the Carpus or Wrist the Metacarpus or the distance between the Wrist and Fingers and the Fingers themselves The Carpus hath four Muscles Two Flexors the Cubitaeus and the Radiaeus internus Two Extensors the Cubitaeus and Radiaeus externus Under these lie eight little Bones as yet without name which are in the first years Cartilaginous and soft but afterwards become harder they are tied and joyned together with strong Ligaments The Metacarpus hath two Muscles call'd Palmares longus brevis And four Bones fastened to the Carpus by the assistance of the Cartilaginous Ligaments The Fingers consist of fifteen Bones which as yet have no certain names given them and fourteen Muscles whereof Two are Flexors sublimis profundus Two Extensors Four Adductors Lumbricales Six Abductors or Interossei Three are External and as many Internal Besides these the Thumb and Little Finger have a particular Flexor and Extensor These are besides to be considered in the Hand 1. The Armilla Membranosa
I gave him the next day a more powerful Sudorifick whereof we found very notable effects but his thirst by that means being increased made him drink a great quantity of Beer whereby the vomiting returned and because he complained of a pain in his Belly we were afraid of a Diarhaea wherefore instead of Beer we gave him this following Mixture by Spoonfuls Take Rose-water two ounces Holy-Thistle-water four ounces Mint-water an ounce Cinamon-water three drams our Prophylactick-Water an ounce and half Syrup of Myrtles two ounces Mix them And in the Evening he took this Sudorifick Take Confection of Hyacinth a scruple Treacle Diascordium of each two scruples Salt of Coral fifteen grains our Prophylactick-Water ten drams Mix it for a draught The night after passed quietly the Vomiting ceased the third day after there was a Carbuncle discovered on the inside of the left Nostril We applied to it our Divine Plaister and inwardly we gave Sudorificks and such things as might refrigerate on the 4th day his Nose was observed to be cold and to look of a purple colour the Carbuncle extending it self to the Processus Mammiformis the Pulse beat low and unequal nevertheless he took another Sudorofick but without success for about Noon many mortal signs discovered themselves and although he was all along of a sound mind yet after two hours he departed XIV The Wife of John N. Chirurgeon in September was suddenly taken with a Fever with drowsiness and anxiety of heart I prescribed this Sudorifick Take Diascordium of Fracastorius a dram Confection of Hyacinth Lapis Prunellae Salt of Scordium of each a scruple our Prophylactick Water an ounce Betony Water as much as sufficeth Syrup of the juyce of Holy-Thistle half an ounce Mix it for a draught It produced no Sweat which was an ill Omen The next day therefore she took this which is somewhat stronger Take Treacle Diascordium of each a dram half our Prophylactick Water an ounce and half Salt of Holy-Thistle a scruple Syrup of Limons six drams Mix it for a Potion And this also effected nothing For variety sake in the Evening I gave her this following Take Salt of Wormwood Scordium Prunella Antimony Diaphoretick of each a scruple Syrup of the Juice of Holy-Thistle an ounce Our Prophylactick Water two ounces Mix it for a Draught By the help whereof she began to sweat the Fever to abate together with the anxiety but the third day after the Spots appear'd which carried her off immediately Her Husband after eight days beginning to visit his Patients again came about eight in the morning to one that was sick when sitting down on a Stool he was suddenly so taken that he could not rise again about Noon by the help of his Son and his Man he went home where taking his Bed he was presently seized with a great drowsiness which I call'd a Coma because whatever I did or said to him I could not get two words from him I presently prescribed him a Clyster and this Ointment for his Head Take Oil of Marjoram a scruple Oil of Rue a dram of Amber rectified a scruple Rosemary half a scruple Mix them I advised also that they should endeavour to make him sneeze by putting Tobacco to his Nose and give him inwardly some of this Mixture Take Anti-Epileptick water of our Porphylactick water of Betony and Rosewater Syrup of Stoechas of each an ounce The Clyster came from him without any effect and Tobacco did no good he took a little of the Mixture and about evening I prescribed him another Clyster and this Sneezing-Powder following was blown up his Nostrils with a Quill Take the flower of Lillies of the Valley Leaves of Marjoram of each half a scruple white Hellebore three grains Make them into fine Powder By the help hereof he sneezed 3 or 4 times and a purulent Matter came from him at his Mouth but a greater quantity of it went down his Throat besides which there remained a great deal of it in his Mouth which we could easily squeeze forth by pressing his Cheeks These were sufficient signs of an Abscessus in the Brain and consequently of certain Death especially when we could not perceive that his Senses returned to him not that he was any other way reliev'd but on the contrary his voice quite failed him and he began to rattle in the Throat nor was I deceived in my conjecture for in a short space he died Four of his Children and a Maid-servant followed him his Man was cured of a Bubo under his Arm-pit by drawing a Blister and by applying some drawing Medicines His eldest Daughter and youngest Son still survived He had a Fever but was not very sick but she was handled more severely She had a Thrush appeared on the eighth day which took off not only the Fever but the whole Disease and thus of ten in Family but three escaped You have here an account of the true Signs and Effects of Malignity which none but such as are possess'd with the Spirit of contradiction can deny to be Contagious POST-SCRIPT I Intended to have published at least forty of these Observations but being taken up with giving an account of other things which will conduce very much to the illustrating of our Art which in their due time may be made publick I could make no further progress in this Make use of these for the benefit of your Friends and if you desire to see them put us in mind of the other FINIS An Index of Things and Words A. ABdomen or the lower Belly pag. 266. Hardened and Inflamed pag. 263 Abscesses or Imposthumes their manner of opening pag. 42 Acetabulum or Pixis pag. 312 Achor see Porrigo Aegylops pag. 284 Alae Anaplerosis what it is pag. 2 Aneurism its Cause and Sign pag. 135 Anodins pag. 94 Antrophy pag. 238 Anus fallen down 35. Imperforated and Cure pag. 46 Aperientes what pag. 277 Armilla the Hand Arsnick its Quintessence pag. 124 Artery its difference c. Aorta Pulmoniack 228. Humeraria Axillares Carotis Cervicalis Coeliaca Emulgens Gastro Epiploica Intercostalis superior Lumbaris Phrenica Scapularis Spermatica Splenica Subclavialis Thoracica 229. Cruralis Epigastrica Hypogastrica Iliaca Pudenda Vmbilicalis 230 Venosa 226 How to be opened pag. 231 Arthrodia what pag. 208 Articulation what Ibid. Astragalus pag. 211 Atheroma its Cause and Cure pag. 111 Atlas pag. 210 Auricles pag. 307 B. BAsis of the Tongue pag. 279 Batrachios pag. 291 Beensuyger pag. 211 Beenureeter pag. 212 Bleeding on whom and how to be performed pag. 37 Bones what their Nutriment 207. Their Connection Number Vse 208. Of the Arm 210. Hammer of the Ear 210 276. Of the Heel 211. Of the Hip Coccygis Ilium Innominatum Iscium of the Breast of the Temples 210. Ethmoides Forehead of the Head pag. 209 Bone of the Breast its Fracture 14. Of the Collar pag. 210 Breast what 266. Hardned Inflam'd Apostemated pag. 303 Bronchole pag. 34 Bubo its Cause
little red Hounds-tongue Salve and Oyl of Myrrh and Deer-suet Let all be boiled together till the cracking cease and the Juice be boiled in Then strain it through a Linnen Cloth and add to it some Venice-Turpentine Gum Elemi and a little Bees-wax both the latter melted each a part Of the Wax there needs no more than to bring the Salve to a due consistence Then is this Unguent prepared to which may be added a little refined Verdigrease which will make it perfect It is of great efficacy in foul Wounds for both cleansing and healing as experience will shew A Chirurgeon in meeting with Ulcers is to observe well the purulent matter that issues since he may from thence learn the condition of the evil whether it proceed from foul Blood Gall corrupt Phlegm or Adust Melancholy If the evil grow worse and the Humors of the Body force their way copiously thorow then beware and withal exhort the Patient to purge or to sweat with taking some Sassafrass or the like The Sanies or matter that is thick white and well digested is the best but when there runs but a sharp water out of the Ulcer this is not good and is withal painful Which to obviate you must use Litharge Ceruse and the like putting also beaten Lead upon the place and cleansing the fistulat holes with Lead-oyl qualifying its sharpness with Oyl of Eggs. This Lead-oyl is made two ways the the one out of Ceruse which is green the other out of Litharge which is yellow or reddish Both are prepared with Vinegar Boil Celondine in wine and with this wine you may also cleanse the Ulcer with good effect Mix afterwards a drachm of Verdigrease with about four ounces of the Juyce of Ground-Ivy use it with wiecks or raggs dipt therein for the foul Ulcer-holes Burn Oyster-shells to powder and use it for old Ulcers that need cleansing which this powder will well perform by reason of the Salt that is in those shells You may sometimes have occasion also of the Mercurius praecipitatus or the Mercurius dulcis Cosmeticus If you can prepare this you have a good Remedy As for hard Knobs and Boyls they commonly owing their rise to the Venereal Disease are not so proper for this place However you may make a plaister against such Knobs of the phlegm of Althaea or Marsh-mallows Gummi Ammoniac Galbanum Turpentine Myrrh Missel-toe of the oak mixing a little Bee-wax therewith and some Oyl of Earth-worms If you will have it stronger mix with it Gumm Elemi Tacamahaca or Carana But this can only be compassed by the rich men the poor must be content with the Melilot-plaister mixt with Saffron and the Oyl of Mullain or Dill. You may also prepare for such Patients a Salve of Fox-oyl Dill-oyl Turpentine Man-grease and the like mixing therewith some Oyl of Earth-worms and the Oyl of Mullain-flowers Camomil and white Lillies CHAP. IX Of the Chirurgical means of staunching blood of Wound-balsoms and plaisters of Wound-drinks and remedies for Burnings THis is the most necessary Chapter of this whole Tract For although in every Camp yea in every Regiment and even in every Company there ought to be one or more Chirurgeons yet because in a battle or the storming of a strong-hold there may be wounded a very great number of men who by reason of the multitude cannot all be dressed by the Chirurgeons every common Souldier that is sound and unhurt is obliged to assist his fellow considering it may soon be his own case In the first place then refresh thy fellow that is wounded with wine cold water vinegar or the like then place him in a right posture For if the wounds be in the head or about the breast you ought to lay him high with his head and shoulders that so the blood may sink down from the places wounded If his legg be hurt put it so that it may not hang downwards and thereby the afflux from the body be prevented which otherwise might cause a tumour If the wounds be in the middle of the body then place him so that if possible he may lye somewhat hollow with his back This done wash the wound very gently so as not to anger it with meer wine or even with pure common water only with a very little salt cast into it or with the Patients own urine and then dry it with lint of long-worn linnen without much stirring in the wound for fear of making the veins bleed again If any one do bleed so copiously that it is not easily stopp'd and the Patient is in danger then receive of his blood in an Iron pan and letting it run about therein hold it over the fire till it be dry and between your fingers friable to powder of which strew some into the bleeding wound and it will stop it But of this case more hereafter The wound being cleansed and the bleeding stayed take fine linnen-raggs burn them as you are wont to do for tinder and quench it in Oyl of Olives and put some of it into the wound If you have no plaister at hand take a slice of unsalted lard and lay it on If that be also wanting dip a pledget of linnen-raggs in warm wine and being wrung out very dry lay it upon the wound and a dry bandage over it that so the moist pledget may long keep warm Though in such wounds as are apt to bleed much warm bandages are often to be avoided and sometimes but with singular care and discretion cold bandages to be used if the hurt be not in the brain breast or bowels Whence old Hippocrates hath this Aphorism Frigido verò in iis locis utendum unde sanguis aut fluit aut fluxurus est Yet this must be done with great caution lest in the place affected there should follow a Gangrene After this take Oyl of Olives and Wine beat them well together and warm the mixture dip it in Linnen pledgets wring them dry and lay them on warm with a dry bandage over it This must de done once every hour or every two hours nor let this care and labour seem irksom to you for it will have a good effect This Dress is almost the only thing which the Knights of Maltha make use of at Sea to heal their wounds for the Oyl allays the pain and the swelling as the Wine cleanseth and these two together cause healing Whence the Samaritan in the Gospel is said to have poured only Oyl and Wine into the wounds of him that was fallen among Thieves You may therefore make out of these two a Wound-salve that may be equivalent to almost every common Wound-balsom preparing it thus Take one part of Oyl-olive and two parts of Wine boil them together till the Wine be boiled in and the Oyl when any is thrown into the fire cracks no more and you have a Wound-oyl according to wish Put of it with fine Linnen shavings into the wound and it will for a plain Remedy do