with Blood from the little Arteries not that contained within themselves They are endowed with feeling both from themselves and sometimes from the Nerves Use is to receive the Blood not sufficiently elaborated from the Arteries and return it to the Heart and Liver there to be more perfectly concocted For the better Methods sake in the following we must be forced to describe all Veins here particularly and divide them into their Branches Vena Cava taking its beginning in the Liver as is before said is separated into the ascending Trunk and descending The Ascending which is the greater perforates the Diaphragm and is divided into four Branches of these 1. Phrenica which disperseth it self through the Diaphragma and Pericardium 2. Coronaria appropriated to the Basis of the Heart proceeds from the Trunk it self after it hath penetrated the Pericardium and inwardly united it self by a large fleshy Orifice to the right Auricle of the Heart 3. Azygos or sine pari coming from the right side of the same Trunk when ascending it hath passed the upper part of the Pericardium affording chief Branches to the eight lower Ribs then about the fleshy appendices of the Diaphragm it enters the Cavity of the lower Belly where on the left side 't is inserted into the Emulgent Vein on the right into the Trunk of the Cava 4. Subclavia from whom comes forth several Branches which go both upward and downward The Superiors are 1. Muscula Superior 2. Jugularis externa interna that on both sides sometimes single sometimes double goes to the Neck Head and Face this to the thick Meninx of the Brain to whose third Sinus its greater Branch is united The Inferiors are 1. Intercostalis serving the four upper Ribs and their Intercostal Muscles 2. Mammaria which is carried to the Breasts 3. Mediastina which goes to the Mediastine and Thyme 4. Cervicalis which goes to the Neck 5. Muscula inferior which goes to the Muscles of the Neck 6 7. Thoracica inferior and superior which goes to the Muscles of the Breast The Subclavials being come out of the Breast are called Axillares then go to the Arms where they are divided into 3 great branches which are 1. Cephalica in the hand between the little Finger and its next 't is named Salvatella Its Branches are variously mixt with the Branches of the Median 2. Basilica or Liver-Vein 3. Mediana which proceeds with other branches from the Basilica The descending Trunk which is the lesser and is undivided till it comes to the fourth Vertebra of the Loins then it communicates 1. Adipsosa to the Membranes of the Kidneys 2. Emulgens to the Kidneys themselves 3. Spermatica to the Testicles 4. Lumbares two three or four to the Loins and to their Vertebra's Nearer to the Os Sacrum it is separated into two Branches called Illiaci Before they go to the Feet the Trunk it self presents 1. Muscula Superior which goes to the Muscles of the Loins and Peritonaeum 2. Sacra sometimes single sometimes double to the Os sacrum 3. Muscula Media to the Buttocks 4. Hypogastria to the Bladder and its Neck to the Sphincter Ani to the Penis and to the neck of the Womb. 5. Epigastrica to the Muscles of the Abdomen and to the Peritonaeum 6. Pudenda to the privy Parts 7. Muscula Inferior to the joint of the Hips The Iliack Branches as soon as they have left the Cavity of the Belly are called Crurales From these proceed 1. Ischiatica minor which goes to the Skin and Muscles of the Hip. 2. Ischiatica major to the Hip then to all the Toes 3. Proplitea to the Ham. 4. Suralis to the Muscles of the Calf of the Leg. 5. Saphena To the Knee Ankle and to the upper part of the Foot and to the great Toe The Vena Cava where it comes out of the Heart receives three Valves called Tricuspidales looking internally for this purpose that the Blood may freely enter into the Heart but to hinder its return The Use of the Vena Cava is to receive the cruder Blood from the Arteries and remit it to the Heart Vena Porta much lesser and looser than the Vena Cava ariseth from the Umbilical Vein and with many Roots is inserted into the Liver without the Liver it is divided into Trunk and Branches all which are distributed into several Parts contain'd in the lower Belly From the Trunk proceeds 1. Gastroepiplois which goes to the Caul and Stomach 2. Intestinalis to the intestine Duodenum 3. Cysticae Gemellae to the Gall. 4. Gastrica minor to the left side of the Stomach Then this Trunk is divided into two great branches the Splenick and Mesenterick Ramus Splenicus sometimes joyning to the Sweet-bread sometimes passing through it divides into four little Branches as soon as it hath left it which are these 1. Vena Gastrica major which goes to the Spleen communicating from thence three or four small Veins to the Stomach These being blown up in living and dead Bodies manifestly declare nothing at all can enter into the Cavity of the Stomach so by consequence no Humor coming from the Spleen as long since Learned Men have imagined taught and writ seeing they terminate in the Coats of the Stomach and open not into the Cavity it self 2. Epiploica dextra 3. Coronaria stomachi 4. Epiploica sinistra Mesenterious ramus is also divided into four others of these the 1. Retains its old name and is distributed with fourteen or more Branches through the Mesentery 2. Vena Haemorrhoidalis and goes to the Spleen the Womb and the right Intestine 3. Vena Coecalis to the blind Intestine 4. Ramus Mesocolicus and goes to the Intestine call'd Colon. The Use of the Vena Porta is to take the Blood not sufficiently elaborated from the Arteries and carry it to the Liver for the perfecter concoction and for the separation of the Choler Venis pulmonalis which the Ancients corruptly call'd Arteria venosa seeing that it hath but only one Tunicle beats not of it self nor returns the Blood coming out of the left Ventricle of the Heart with a wide Orifice goes to the Lungs to receive the more imperfect Blood from the Pulmoniack Artery and carries it to the Heart About its egress from the Heart it hath two Miter-like Valves hindring the regress of the Blood to the Lungs It s Use is to carry the Blood received from the Pulmoniack Artery into the left Ventricle of the Heart Chirurgical Considerations 1. We have in another place treated of the Wounds of Veins we shall only add that if the Bandage by which you stay the bleednig be bound too hard it will easily induce a Gangrene 2. We have admitted only four general Indications of Bleeding to wit for the Refrigeration Imminution Revulsion and Derivation of the Blood but special Diseases requiring one Vein to be chosen before the other which are these following in a Delirium and great pain of the Head the Vein of the Forehead or
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
Amber Mastick of each a dram Turpentine half an ounce Euphorbium a dram Ung. Aegyptiacum half an ounce yolks of one Egg Oyl of Elders as much as is sufficient Saffron a scruple Make it into an Ointment Another more excellent than the former and which likewise resists Putrefaction Take Tar Turpentine Galbanum of each two ounces Mastick Frankincense Nitre Sal Armoniack of each an ounce Allom half a dram Verdigrease white Vitriol Camphire Powder of Worms of each a dram Oyl of Lin seed Roses of each two ounces Oyl of Worms and Turpentine of each a dram Molax them with a gentle Fire and make them into an Ointment If the Nerve hinder not in a great putrefaction there may be added some Precipitated Mercury An Anodine Plaister Take Bean-meal Crums of brown-Bread of each two drams let them be put in Milk adding to them Oyl of Roses Violets of each an ounce Yolks of Eggs No. iij. Powder of Red Roses Scordium of each an ounce and half Wax as much as sufficeth Make it into a Plaister An Anodine Cataplasm Take Roots of Marshmallows Comfrey the greater of each an ounce Flowers of Camomil Melilot St. John's wort of each half a handful Tops of Wormwood two pugils boil them in Milk adding to them of the Meal of Marshmallow-roots and Beans of each an ounce and an half Make it into a Poultice If the Wound be quite through a Tent must be put into both Orifices for a Flamula is inconvenient and hurtful At first dressing it once a day is sufficient for in Wounds made by Gun-shot there seldom appears any Matter before the third or fourth day after this the quantity or acrimony of the Matter will guide you best whether it is to be drest once twice or thrice a day CHAP. X. Of Poysoned Wounds POysoned Wounds are made sometimes by Bullets Arrows Swords and other Instruments sometimes by mad Beasts as Dogs Wolves which hurt more by their venomous quality than by wounding Signs are vehement pain a livid Colour suddenly becoming black Symptoms more grievous than for the quality of the Wound a Heat over the whole Body Trembling Delirium Fainting c. Prognosticks A poysoned Wound though little may bring death especially if near to the Heart or any other Noble Part or the Chirurgeon not call'd soon enough Cure consists chiefly in this that the Venom be drawn forth by Cupping glasses attractive Medicines Scarifications or which is safest by an actual Cautery but then it must not be in a Nervous Part the Escar to be forthwith removed and the Wound to be cured by degrees Inwardly Sudorificks and Cordials profit Bleeding and Purging hurt A Plaister that draws forth the Poyson out of the Wound and corroborates the Part. Take boiled Onions three ounces Treacle half an ounce Goats dung an ounce Angelica-Roots in Powder a dram and half Oyl of Scorpions an ounce and half Honey and Wax as much as is sufficient to make it into a Plaister That corroborates the Part extracts the Venom produceth Matter and incarns the Wound Take Gums Galbanum Sagapenum Opoponax Assa Foetida Mirtle Pepper Brimstone of each six drams Pigeons and Ducks-dung of each an ounce Mummy half an ounce the great Comfrey-Roots powdered three drams Oyl of St. John's-wort as much as sufficeth to make it into a Plaister CHAP. XI Of particular Wounds IN Wounds of the Head where the Pericranium is hurt a stitch either by Needle or Plaister is not convenient fat things hurt but comforting and drying profit much Take Mastick Myrrhe Aloes Sarcocols of each half a dram Dragons-blood two scruples Bole a scruple Venice-Turpentine two ounces Honey of Roses a little Make it into a Plaister Wounds of the Brain are accompanied with pain of the Meninges and a great Flux of Blood to which succeeds other Symptoms and for the most part Death it self Oyl of Roses applied warm greatly easeth pain and fresh Pigeons-blood effects the same In an Haemorage Take Myrrhe Aloes Mastick Dragons-blood Rhubarb Red Coral prepared Hares hair cut small of each a dram Make it into a very a fine Powder Wounds of the Face are not to be stitcht but always care is to be taken that the Scars may not render it deformed In Wounds of the Eyes you must abstain from all Unctious things The sound Eye is to be bound as well as the whole The Head must be placed upright if there be a Flux of Blood the following things are convenient The Blood of Turtles Pigeons Hens Mucilage of the seeds of Fleawort of Quinces Tragacanth Bloodstone Ceruse Tutty Frankincense Aloes the white of an Egg Water of Roses and Plantain Decoction of Balaustians Red Roses Galls c. Take white Troches of Rasis prepared Tutty Aloes Powdered of each half a scruple Red-wine an ounce Red Rose water and Plantain of each two ounces Mucilage of the seeds of Fleawort Tragacanth of each a dram Make a Collyrium In pain Womans-milk fresh is good or the above described Collyrium adding to it half a scruple of Opium and applying over it this Cataplasm Take of rotten Apples two ounces Flowers of Linseed half an ounce Mucilage Seeds of Flea wort two drams crude Opium half a dram Yolks of Eggs as much as is sufficient to make it into a Cataplasm A part of the Nose quite cut off never unites again although the Wound be but just made but if it adheres still to the Body 't is to be stitched to it with a Needle Wounds of the Ears and Lips find greater benefit from the Needle than from Ligature Wounds of the Lungs require comforting and drying Medicines sharp being here very hurtful though used in other Wounds Externally Take Roots of great Comfrey Tormentil Cloves of each half an ounce Flowers of Red Roses half a handful Mastick Myrrhe Aloes of each a dram boil them in Barley-water and to half a pint of the strained Liquor add Syrup of Mirtles common and strained Honey of Roses of each two ounces Make it into a Liniment Internally Take Leaves of Fluellin Strawberries Sanicle of each half a handful Lung-wort a handful Roots of Angelica two drams Liquoras a dram Jujubies No. xv Raisons half an ounce boil them in Barley-water and add to a pint and half of the strained Liquor Syrup of Diacodion three ounces Mix them let them take four ounces of it three or four times a day Half a dram of Sperma Ceti taken every day is excellent but it weakens the Brain Wounds of the Heart are always mortal and those that penetrate into the left Ventricle kill suddenly they seldom live so wounded above six twelve or twenty hours although there are examples produced for it If wounded into the right Ventricle it permits the Patient to live longer but that which terminates in the substance of the Heart grants yet longer time Wounds of the Stomach for the most part are left to be cured by Nature which here doth miracles yet in a Flux of Blood Bleeding is requisite In
'T is corrected by a large-mouth'd Cupping-glass outwardly applied upon the depressed Cartilage and being there fixt let it remain till breathing is hindred then suddenly remove and the Cartilage oftentimes at the first time returning again into its natural place which if it appears not to do the Chirurgeon must repeat this Operation once or twice then having embrocated the Part with Oyl of Roses and Myrtles apply this Plaister to the Part which must remain there several days Take Bistort-Roots Cypress-Nuts of each a dram Mastick Frankincense of each half a dram Balaustians a scruple Oyl of Nutmegs Exprest one dram and an half Naval-Pitch and Turpentine of each enough to make it into a Plaister CHAP. V. Of Ligaments A Ligament is a Similar Spermatick dry part adhering firmly to the Bones tying the parts of the Body mutually together Difference Some are Broad and Membranous some Round and Nervous 'T is here to be observed that the Names Membranous and Nervous are much used both by Writers and Practitioners and hath deceived many of them for 't is requisite to know that here it hath regard only to their external form not their internal essence for the Ligaments both the Membranous and the Nervous are void of Sense which they would not be if they were composed of their true substance of Nerve or Membrane There is no Ligament hollow if you except the slender Ligaments of the Womb and are all destitute likewise of Sense of Motion as from themselves Use is to connect the parts of the Body especially the Bones and preserveth them from continual Luxation Chirurgical Considerations 1. Ligaments hurt by reason of their want of sense seldom draw other parts into consent and by the use of drying Medicines are easily cured I cannot but again in this place taught by Experience commend the Restaurative Powder of which this is the Description Take Roots of Comfrey the greater Aloes Succotrine Calcis vivae of each two ounces Mastick Mirrhe Mummy of each two drams Precipitate two ounces Make it into a Powder Here diligently at the first time is the weak heat of the Ligaments to be considered seeing it may give occasion to a copious collection of Humors and other grievous Symptoms 2. The Ligaments also are not seldom Relaxt Yea although the Ignorant do contradict sometimes they are so much extended that they may give way to a Luxation which the Sciatick pain hath more than once given us example of in such a case external Bleeding and Purging profit much outwardly the Application of corroborating and discussing Topicks The following Plaister is excellent Take Stiptick Plaister of Crollius an ounce Oyl of Earth of Tiles of each a dram Make it into a Plaister to be spread upon Leather CHAP. VI. Of Membranes A Membrane is a Similar Spermatick Part broad soft dilatable white investing the Parts and carrying sense to them Difference Some are very thin others thick some fleshy but for the most part not The Parts which invest are properly call'd Membranes those which contain the Humors Tunicles and those which cover the Brain Meninges It is endued with sense from itself for all Membranes are sensible yea the Nerves themselves owe their sense to the Membranous substance of them Membranes therefore only are the true Organs of feeling they serving the Animal Spirits to this purpose Use is 1. To invest the Parts of the Body 2. To defend it from Injuries 3. To keep them united 4. To strengthen them 5. To give them sense 6. To close the Mouth of the Vessels that the Nutritious Blood be not carried too suddenly into the Part or out of it into the Vein it self 7. To separate the Parts Chirurgical Considerations The Membranes being so very sensible they cannot bear sharp Medicines they are not endowed with great quantity of Blood whence when they suffer a solution of continuity they are not easily united again But I have observed oft entimes that by the Muscles and the assistance of the Quittour they are joyned together as in the Bladder it self whose Wounds and Ulcers otherwise are esteemed incurable CHAP. VII Of Fibres A Fibre is a Similar Spermatick Part dispersed through the Skin Flesh and Membranes to make them the stronger and being naturally distended to contract again into the same manner Differences are right oblique and transverse and some round the right attract the oblique thrust forth transverse retain round constrain but this they do not so by their own singular virtue as by the common virtue of the Member which they serve and from whom they have their sense and nourishment for of themselves they are senseless Use is to strengthen the Membranes Skin and Muscles and when dilated to reduce them into their natural state Whether the Blood it self hath Fibres as many have delivered and as it seems very probable to us shall be explained in another place Chirurgical Consideration These offer nothing worthy consideration except that when they are wounded the consolidation of the Flesh and Skin is the longer and there is a greater stiffness of the Muscles about the place and makes them difficulter to contract and extend The Ductus of the Fibres is diligently to be observed by them which are to make any curious Incision CHAP. VIII Of Veins A Vein is a Similar Spermatick Membranous long hollow Part every where joined by Anastomoses to the Arteries receiving the Blood wanting further Concoction from them and carrying it to the Heart and Liver Difference Veins of a four-fold condition are found in the Body 1. Vena Cava 2. Vena Porta 3. Vena Pulmonalis 4. Vena Lacteae Of the last of which a more convenient occasion will be offered to treat of in the following The Venae Cava and Porta take their beginning from the Liver There are those which would have them come from the heart from a weak Argument taken from unborn Embrio's But where I find many Branches inserted in the Liver few or none in the Heart yea I have observed that it hath not entred into the Heart it self but only to be joined to its right Auricle I rather embrace the old Opinion willingly granting those honours to the Liver that I think belongs to it That the Roots of the Vena Cava and Porta were united by mutual Inosculations the old Anatomists perswaded themselves but the curious Inquisition of the Moderns hath both found out and clearly demonstrated that they mutually touch one another but not so united that the Blood can pass out of one into the other for the extremities of the foresaid Vessels by means of the Parenchyma of the Liver do so mutually consent that Milk or any liquid thing cast into the Vena Porta with a Syringe finds an easie passage into the Vena Cava without either an injury of the Veins or the Parenchyma Concerning which read Glisson Anatom of the Liver pag. 272. Veins have only one Tunicle with many Valves within especially in the external Joints They are nourished
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
Thumb and fore-finger is opened in palpitations of the Heart either that or the Saphena is to be opened Other Arteries are not to be opened except a Bone lies under them for fear of an Aneurism CHAP. X. Of Nerves A Nerve is a Similar Spermatick Membranous round white hollow part serving for the carriage of the Animal Spirits to the Parts for Sense and Motion The Nerves take their Original from the Brain and are divided within the Skull into eight Parts without the Skull to wit those that come out of the Spinal Marrow into thirty Pares seven of which proceed from the Vertebra's of the Back five from the Vertebra's of the Loins six from the Os Sacrum The eight Pare within the Skull proceeding from the Brain are 1. Smelling pare which adheres to the Mammillary Processes 2. Optick pare which is the greatest and united in the middle 3. The pare that moves the Eyes 4. The Tasting pare 5. The second tasting pare 6. The hearing Pare 7. Par vagum which is vested with strong Membranes it descends through the Orifices of the Bone of the hinder part of the Head to the Throat afterwards sending Branches to the Neck of the Larinx to the Muscles of the Tongue and Os Hyodis then is divided of each side into the external and internal Branch The right External Branch having sent some Branches to the Muscles of the Breast makes the right recurrent Nerve this contributes to the Voice as also to the feeling in the Pleura the Coat of the Lungs the Pericardium and to the upper Orifice of the Stomach seeing all those Parts obtain Branches from it The left external Branch constitutes the left recurrent Nerve which goes to the same Parts as we have declared the right doth being brought to the said Orifice of the Stomach it is joined to the right recurrent and so goes to the lower Orifice of the Stomach and to the lower part of the Liver The right internal Branch sends Branches to each intercostal Muscle then having perforated the Diaphragm furnisheth all the parts of the lower Belly with a Nerve ending about the Os Sacrum Of the left Internal Branch is the same Distribution 8. The Part moving the Tongue The Nerves have a Cavity but so little not to be distinguished by the sight except in the Optick Nerves and those of the Pudendum Use is to carry the Animal Spirits for sense and motion of the whole body Chirurgical Considerations The Cure of wounded Nerves and Tendons is so like as it hath been more than once the occasion of Confusion among the best Authors therefore for the better distinction sake 1. The frequent contusion of the Nerves by a Fall or Blow the Skin having suffered a solution of continuity there happens an Ulcer and many other Symptoms from the afflux of Humors It requires the same Cure we have proposed in another place of Wounds of the Nerves But if the contused Nerve be not bare which may be discerned from the greater and more connual pain than is usual in a simple contusion of the Flesh the greatest care is that the coagulated Blood be as soon as possible resolved for if it should suppurate the Nerve easily would putrifie therefore let there be applied a Cloth dipt in one or other of the following Oyls warm to the affected Part. Oyl of Castor Worms Dill Rue Camomile Rosemary Or let this Fomentation be applied very hot with Spunges Take our Orise Roots two ounces Leaves of Rosemary Marjoram Horse-Mint of each half a handful Boil them in white Wine for a Fomentation Or let the following Plaister be laid on Take Sow-bread Roots in Powder two drams Species Diambrae one dram Oyl of Castor three drams Turpentine a dram Plaister of Betony on ounce Virgins-Honey as much as to make it according to Art into a Plaister Oyl of Lavender is excellent in this Case if taken to the quantity of two drops especially where Convulsions happen 2. The Nerves are not seldom obstructed with a pituitous and tough Humor from whence a stuppor of the Part and sometimes also a stiffness these Symptoms I used to remove after the following manner the whole Body if occasion being first purged Take Gum Caranna half an ounce Galbanum an ounce Oyl of Euphorbium a dram and an half Make it into a Plaister Or Take Mans-fat Goose-Fat of each an ounce Oyl of Earth three drams Make it into a Liniment Let the Part affected be anointed with it Morning and Evening then lay on the Stiptick Plaister of Crollius or of Ladanum or Diachilon with Gums You will hasten the Cure if you use Internal Corroboratives which do wonderfully alter the Nerves although these things properly belong to the Physician yet I think it convenient to prescribe this Decoction of great efficacy of which let the Patient take three or four ounces twice a day Take Roots of Piony Sea-holly of each half an ounce Orrise three drams Leaves of Marjoram Rosemary of each an handful Flowers of the Lime tree Lavender and Lilly of the Valley of each a pugil the lesser Cardomomes three drams Nutmegs a dram Infuse them six hours in a sufficient quantity of White-Wine afterwards boil them and to a quart of the strained Liquor add three ounces of Syrup of Stoechas Mix them There often happens through a Chronick Disease or from a Luxation or Fracture a Contraction of the Member which is not to be ascribed to the Nerves but Tendons This is easily remedied by the use of Oyls and Ointments that have the property of mollifying the indurated Tendons especially if there is to be used a daily extention either by the Hands Weights or Instruments Take Oyl of Camomile Olives Foxes of each half an ounce compounded Ointment of Marsh-mallows an ounce Capons-grease an ounce and an half Make it into a Liniment CHAP. XI Of the Flesh THE Flesh is a similar Bloody Soft Thick part together with the Bones to yield a strengthening to the Body and to cover the spermatick Parts Difference Flesh is three fold 1. Musculous 2. Glandulous 3. Viscerous Musculous is soft red and is properly call'd flesh and for these many ages hath come under the name of Muscles But yet a Muscle is not a Similar Part but compounded of many others to wit Fibres Tendons Nerves a Membrane Veins Arteries that it might be a fitter instrument of voluntary motion to which the Fibres Tendons and Nerves do chiefly contribute It hath a Tendon in its begining and end sometimes round sometimes broad sometimes but one sometimes double It s end is in that place where the Tendons are greater and more It s Head or beginning where the Nerve is inserted the middle where the flesh swells out Use is to promote voluntary motion which is performed after a three-fold manner 1. When the Contraction of the Muscle is so that the end comes to the beginning and then its Antagonist is quiet 2. When the Motion is Tonick so that being contracted