Ventricles of the Heart where kept in by the density thereof they turn into yellowish moisture as we see it happens in an Alembeck The Consistence Nature would have the Pericardium of a dense and hard consistence that by the force thereof the Heart might be kept in better state for if the Pericardium had been bony it would have made the Heart like iron by the continual attrition on the contrary if it had been soft and fungous it would have made it spongy and soft like the Lungs CHAP. XI Of the Heart What the Heart is and of what substance THe Heart is the chief mansion of the Soul the organ of the vital faculty the beginning of life the fountain of the vital spirits and so consequently the continual nourisherer of the vital heat the first living and last dying which because it must have a natural motion of it self was made of a dense solid and more compact substance than any other part of the body The three sorts of fibers of the Heart The flesh thereof is woven with three sorts of fibers for it hath the right in the inner part descending from the basis into the point that they might dilate it and so draw the blood from the Hollow-vein into the receptacles thereof and the breath or air from the Lungs by the Arteria venosa it hath the transverse without which pass through the right at right angles to contract the Heart and so drive the vital spirits into the great Artery Aorta and the cholerick blood to the Lungs by the Vena arteriosa for their nourishment It hath the oblique in the midst to contain the air and blood drawn thither by the forementioned vessels until they be sufficiently elaborate by the Heart All these fibers do their parts by contracting themselves towards the original as the right from the point of the Heart towards the basis whereby it comes to pass that by this contraction of the fibers the Heart dilated becomes shorter but broader no otherwise than it is made more long and narrow by the contraction of the tranverse but by the drawing of the oblique it is lessened in that part which looks towards the Vertebra's which chiefly appears in the point thereof The Magnitude It is of an indifferent bigness but yet in some bigger in some less according to the diverse temper of cold or hot men as we noted in the Liver Figure The figure thereof is pyramidal that is it is broader in the basis and narrower at his round point Composition It is composed of the most dense flesh of all the body by the affusion of blood at the divisions and foldings of the vessels and there concrete as it happens also to the other entrails For the blood being there a little more dryed than that which is concrete for the making of the Liver turns into a fleshy substance more dense than the common flesh even as in hollow ulcers when they come to cicatrize The proper Vessels It hath the Coronal veins and arteries which it receives either on the right side from the Hollow vein or on the left from the basis at the entrance of the artery Aorta You cannot by your eye discern that the Heart hath any other nerves than those which come to it with the Pleura The Nerves Yet I have plainly enough observed others in certain Beasts which have great hearts as Swine they appeared seated under the fat which covers the vessels and basis of the Heart lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the heart Whereby you may perceive that the heat of the Heart is different from the Elementary heat as that which suffers fat to grow about this entrail where otherwise it doth not concrete unless by cold or a remiss heat which thing is chiefly worth admiration The Heart is one alone situate most commonly upon the fourth vertebra of the Chest Number and site which is in the midst of the Chest Yet some think that it inclines somewhat to the left side because we there feel the motion or beating thereof but that happens by reason of its left ventricle which being it is filled with many spirits and the beginning of the Arteries it beats far more vehemently than the right It required that seat by the decree of Nature because that region is the most safe and armed besides it is here on every side covered as it were with the hands of the Lungs It hath connexion with the fore-mentioned Vertebra's but by the parts composing it Connexion with those parts from whence it hath them with the Lungs by the Vena arteriosa and the Arteria venosa and lastly with all the parts of the body by the Arteries which it sends to them all It is of a hot and moist temper as every fleshy part is The action thereof is Temper and action first to prepare the blood in its right ventricle for the fit nourishment of the Lungs for from hence it is that Galen saith This right ventricle was made for the necessity of the Lungs Secondly to generate the vital spirits in its left ventricle for the use of the whole body What the vital spirit is But this spirit is nothing else than a certain middle substance between air and blood fit to preserve and carry the native heat wherefore it is named the Vital as being the author and preserver of life In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them such are the Valvulae or Valves the Vessels and their mouths their distribution into the Lungs the wall or partition and the two productions or Ears of the Heart which because they are doubtful whether they may be reckoned amongst the external or internal parts of the heart I will here handle in the first place Therefore these Auriculae or Ears are of a soft and nervous substance The Auriculae Cordis or ears of the heart compact of three sorts of fibers that so by their softness they might the more easily follow the motions of the Heart and so break the violence of the matter entering the Heart with great force when it is dilated For otherwise by their violent and abundant entrance they might hurt the Heart and as it were overwhelm and suffocate it but they have that capacity which we see given by nature that so they might as it were keep in store the blood and air and then by little and little draw it forth for the use of the necessity of the Heart But if any enquire if such matters may be drawn into the Heart by the only force of the Diastole ad fugam vacui for avoiding of emptiness I will answer That that drawing in or attraction is caused by the heat of the Heart which continually draws these matters to it no otherwise than
a fire draws the adjacent air and the flame of a Candle the Tallow which is about the wiek for nourishments sake Whilst the Heart is dilated it draws the air whilst it is drawn together or contracted it expels it This motion of the Heart is absolutely natural as the motion of the Longs is animal Some add a third cause of the attraction of the Heart to wit the similitude of the whole substance But in my judgment this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the Heart than in that which is performed for attraction of matters for the benefit of the whole Body These Ears differ in quantity for the right is far more capacious than the left Their magnitude and Number because it was made to receive a greater abundance of matter They are two in number on each side one situate at the basis of the Heart The greater at the entrance of the hollow vein into the Heart the less at the entrance of the veinous and of the great Artery with which parts they both have connexion We have formerly declared what use they have that is Their use to break the violence of the matters and besides to be stays or props to the Arteria venosa and great Artery which could not sustain so rapid and violent a motion as that of the Heart by reason of their tenderness of substance Of the Ventricles of the Heart THe Ventricles are in number two on each side one The partition between the ventricles of the heart distinguished with a fleshy partition strong enough having many holes in the superficies yet no where piercing through The right of these Ventricles is the bigger and encompassed with the softer and rarer flesh the left is the lesser but is engirt with a threefold more dense and compact flesh for the right Ventricle was made for a place to receive the blood brought by the hollow-vein and for distributing of it partly by the Vena arteriosa into the lungs for their nourishment partly into the left ventricle by sweating through the wall or partition to yield matter for the generation of the vital spirits Therefore because it was needful there should be so great a quantity of this blood Why the right ventricle is more capacious and less compact it was likewise fit that there should be a place proportionable to receive that matter And because the blood which was to be received in the right ventricle was more thick it was not so needful that the flesh to contain it should be so compact but on the contrary the arterious blood and vital spirit have need of a more dense receptacle for fear of wasting and lest they should vanish into air and also less room that so the heat being united might become the stronger and more powerfully set upon the elaboration of the blood and spirits Therefore the right Ventricle of the Heart is made for preparation of the blood appointed for the nourishment of the Lungs and the generation of the vital spirits The action of the right ventricle as the Lungs are made for the mitification or qualifying of the Air. Which works were necessary if the Physical Axiome be true That like is nourished by like as the rare and spongious Lungs with more subtil blood the substance of the Heart gross and dense with the veinous blood as it flows from the Liver that is gross The action of the left ventricle And it hath its Coronal veins from the Hollow-vein that it might thence draw as much as should be sufficient But the left Ventricle is for the perfecting of the vital spirit and the preservation of the native heat Of the Orifices and Valves of the Heart The uses of the four orifices of the Heart THere be four Orifices of the Heart two in the right and as many in the left Ventricle the greater of the two former gives passage to the vein or the blood carryed by the Hollow-vein to the Heart the lesser opens a passage to the Vena arteriosa or the cholerick blood carried in it for the nourishment of the Lungs The larger of the two other makes a way for the distribution of the Artery Aorta and the vital spirit through all the body but the lesser gives egress and regress to the Ateria venosa or to the air and fuliginous vapors And because it was convenient that the matters should be admitted into their proper Ventricles by these orifices by the Diastole to wit into the right ventricle by the greater orifice and into the left by the lesser and because on the contrary it was fit that the matters should be expelled by the Systole from their ventricles by the fore-mentioned orifices The Valves Therefore nature to all these orifices hath put eleaven valves that is to say six in the right ventricle that there might be three to each orifice five in the left that the greater orifice might have three and the lesser two for the reason we will presently give How they differ These Valves differ many ways First in action for some of them carry in matter to the Heart others hinder that which is gone out that it come not back again Secondly they differ in site Action Site Figure for those which bring in have membranes without looking in those which carry out have them within looking out Thirdly in figure for those which carry in have a Pyramidal figure but those which hinder the coming back again are made in the shape of the Roman letter C. Fourthly Substance in substance for the former for the most part are fleshy or woven with fleshy fibers into certain fleshy knots ending towards the point of the heart The latter are wholly membranous Number Fiftly they differ in number for there be only five which bring in three in the right ventricle at the greater orifice and two in the left at the lesser orifice those which prohibit the coming back Motion are six in each ventricle three at each orifice Lastly they differ in motion for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit and contrariwise are shut in the Systole that they may contain all or the greater part of that they brought in The membranous on the contrary are opened in the Systole to give passage forth to the blood and spirits over all the body but shut in the Diastole that that which is excluded might not flow back into the Heart But you shall observe that Nature hath placed only two Valves at the orifice of the Arteria venosa Why there be only two Valves at the Orifice of the Arteria venosa because it was needful that this Orifice should be always open either wholly or certainly a third part thereof that the air might continually be drawn into the Heart by this Orifice in Inspiration and sent forth by
in the parts thereunder an unvoluntary excretion of the Urine and other excrements Signs that the Spine is wounded or a totall suppression of them seises upon the Patient When the hollow vein and great Artery are wounded the Patient will dye in a short time by reason of the sodain and aboundant effusion of the blood and spirits which intercepts the motion of the Lungs and heart whence the party dies suffocated CHAP. XXX Of the cure of the Wounds of the Chest WE have read in John de Vigo that it is disputed amongst Chirurgeons concerning the consolidation of wounds of the Chest For some think that such wounds must be closed up Vigo tract de vuln thoraâ— cap. 10. and cicatrized with all possible speed lest the cold air come to the heart and the vitall spirits fly away and be dissipated Others on the contrary think that such wounds ought to be long kept open and also if they be not sufficiently large of themselves that then they must be inlarged by Chirurgery that so the blood poured forth into the capacity of the Chest may have passage forth which otherwise by delay would putrefie whence would ensue an increase of the feaver a fistulous ulcer and other pernicious accidents The first opinion is grounded upon reason and truth if so be that there is little or no blood poured forth into the capacity of the Chest But the latter takes place where there is much more blood contained in the empty spaces of the Chest Which lest I may seem rashly to determin I think it not amiss to ratifie each opinion with a history thereto agreeable Whilst I was at Turin Chirurgeon to the Marshall of Montejan the King of France his General A History I had in cure a Souldier of Paris whose name was Levesque he served under captain Renovart He had three wounds but one more grievous than the rest went under the right brest somewhat deep into the capacity of the Chest whence much blood was poured forth upon the midriff which caused such difficulty of breathing that it even took away the liberty of his speech besides through this occasion he had a vehement feaver coughed up blood and a sharp pain on the wounded side The Chirurgeon which first drest him had so bound up the wound with a strait and thick suture that nothing could flow out thereat But I being called the day after and weighing the present symptoms which threatned speedy death judged that the sowing of the wound must straight be loosed which being done there instantly appeared a clot of blood at the orifice thereof which made me to cause the Patient to lye half out of his bed with his head downwards and to stay his hands on a Settle which was lower than the bed and keeping himself in this posture to shut his mouth and nose that so his Lungs should swell the midriffe be stretched forth and the intercostal muscles and those of the Abdomen should be compressed that the blood poured into the Chest might be evacuated by the wound but also that this excretion might succeed more happily I thrust my finger somewhat deep into the wound that so I might open the orifice thereof being stopped up with the congealed blood and certainly I drew out some seven or eight ounces of putrefied and stinking blood by this means When he was laid in his bed I caused frequent injections to be made into the wound of a decoction of Barly with Honey of Roses and red Sugar which being injected I wisht him to turn first on the one and then on the other side and then again to lye out of his bed as before for thus he evacuated small but very many clots of blood together with the liquor lately injected which being done the symptomes were mitigated and left him by little and little The next day I made another more detergent injection adding thereto wormwood Why bitter things must not be cast into the Chest centaury and Aloes but such a bitterness did rise up to his mouth together with a desire to cast that he could no longer indure it Then it came into my mind that formerly I had observed the like effect of the like remedy in the Hospital of Paris in one who had a fistulous ulcer in his Chest Therefore when I had considered with my self that such bitter things may easily pass into the Lungs and so may from thence rise into the Weazon and mouth I determined that thenceforwards I would never use such bitter things to my Patients for the use of them is much more troublesome than any way good and advantagious But at the length this Patient by this and the like means recovered his health beyond my expectation Read the History of Maryllus in Galen lib. 7. de Anaâ—om administra But on the contrary I was called on a time to a certain Germain gentleman who was run with a sword into the capacity of his Chest the neighbouring Chirurgeon had put a great tent into the wound at the first dressing which I made to be taken forth for that I certainly understood there was no blood powred forth into the capacity of the Chest because the Patient had no feaver no weight upon the Diâ—phrâ—gma nor spitted forth any blood Wherefore I cured him in few dayes by only dropping in some of my balsome and laying a plaister of Diacalcitheos upon the wound What harm ensues the too long use of Tents The like cure I have happily performed in many others To conclude this I dare boldly affirm that wounds of the Chest by the too long use of tents degenerate into Fistula's Wherefore if you at any time shall undertake the cure of wounds which penetrate into the capacity of the Chest you shall not presently shut them up at the first dressing No liniments must be used in wounds of the Chest but keep them open for two or three dayes but when you shall find that the Patient is troubled with none or very little pain and that the midriffe is pressed down with no weight and that he breathes freely then let the tent be taken forth and the wound healed up as speedily as you can by covering it only with lint dipped in some balsome which hath a glutinative faculty and laid somewhat broader than the wound never apply liniments to wounds of this kind lest the Patient by breathing draw them into the capacity of the Chest Wherefore also you must have a care that the tent put into those kinds of wounds may be fastned to the pledgets and also have somewhat a large head lest they should be drawn as we said into the capacity of the Chest for if they fall in they will cause putrefaction and death Let Emplast Diacalcitheos or some such like be applyed to the wound But if on the contrary you know by proper and certain signs that there is much blood fallen into the spaces of the Chest then let the orifice of
concavity of the body Signs that a wound hath pierced in the concavity of the chest if the air come forth at the wound making a certain whizzing noise if the patient breathe with great difficulty if he feel a great heaviness or weight on or about the midriff whereby it may be gathered that a great quantity of blood lieth upon the place or midriff and so causeth him to feel a weight or heaviness which by little and little will be cast up by vomiting But a little after a fever commeth and the breath is unsavory and stinking by reason that the putrifying blood is turned into sanies the patient cannot lye but on his back and he hath an often desire to vomit but if he escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting Signs that the Lungs are wounded That the Heart is wounded he is vexed with a grievous shortness of breath and with pain in his sides We may perceive the heart to be wounded by the abundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse paleness of the face cold sweat with often swooning coldness of the extreme parts and sudden death When the midriff which the Latins call Diaphragma is wounded The Midriff the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortness of winde a cough and fit of grievous pain and drawing of the intrals upwards Wherefore when all these accidents appear we may certainly pronounce that death is at hand Death appeareth suddenly by a wound of the hollow Vein or the great Artery The Vena Cava and great Artery by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindered The marrow of the back bone being pierced The spinal marrow the patient is assaulted with a palsie or convulsion very suddenly and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood cometh out at the wound The Liver and pricking-pain disperseth it self even unto the sword-like gristle which hath its situation at the lower end of the breast-bone called Sternon the blood that followeth from thence down into the intestines doth oft-times infer most malign accidents yea and sometimes death When the stomach is wounded the meat and drink come out at the wound The Stomach there followeth a vomiting of pure choler then commeth swearing and coldness of the extreme parts and therefore we ought to prognosticate death to follow such a wound When the Milt or Splene is wounded black and gross blood cometh out at the wound The spleen the patient will be very thirsty with pain on the left side and the blood breaks forth into the belly and there purrifying causeth most malign and grievous accidents and often-times death to follow When the guts are wounded the whole body is griped and pained The Guts the excrements come out at the wound whereat also oft-times the guts break forth with great violence When the reins of Kidnies are wounded the patient will have great pain in making his urine The Kidnies and the blood commeth out together therewith the pain commeth down even unto the groin and yard and testicles When the Bladder and Ureters are wounded the pain goeth even unto the entrails The Bladder the parts all about and belonging to the groin are d stended the urine is bloody that is made and the same also commeth oftentimes out of the wound When the womb is wounded the blood commeth out at the privities The womb and all other accidents appear like as when the bladder is wounded The nerves When the sinews are pricked or cut half asunder there is great pain in the affected place and there followeth a sudden inflammation flux abscess fever convulsion and oftentimes a gangrene or mortification of the part whereof commeth death unless it be speedily prevented Having declared the signs and tokens of wounded parts it now remaineth that we set down other signs of certain kindes of death that are not common or natural whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgment of the descreet Physician or Surgeon Signs that an infant is smothered or over-laid Therefore if it chance that a nurse either through drunkenness or negligence lies upon the infant lying in bed with her and so stifles or smothers it to death If your judgment be required whether the infant died through the default or negligence of the nurse or through some violent or sudden disease that lay hidden and lurking in the body thereof you shall finde out the truth of the matter by these signs following For if the infant were in good health before if he were not froward or crying if his mouth and nostrils now being dead be moistened or bedewed with a certain foam if his face be not pale but of a Violet or Purple colour if when the body is opened the Lungs be found swoln and puffed up as it were with a certain vaporous foam and all other intrails sound it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corps of a man be found lying in a field or house alone and you be called by a Magistrate to deliver your opinion whether the man were slain by lightning or some other violent death you may by the following signs finde out the certainty hereof Signs of such as are slain by lightning For every body that is blasted or stricken with lightning doth cast forth or breathe out an unwholsome stinking or sulphureous smell so that the birds and sowls of the air or dogs will not once touch it much less prey or feed upon it the part that was stricken oftentimes sound and without a wound but if you search it well you shall finde the bones under the skin to be bruised broken or shivered in pieces Lib. 2. cap. 54. But if the lightning hath pierced into the body with making a wound therein according to the judgment of Pliny the wounded part is far colder then all the rest of the body For lightning driveth the most thin and fiery air before it and striketh it into the body with great violence by the force whereof the heat that was in the part is soon dispersed wasted and consumed Lightning doth alwaies leave some impression or sign of some fire either by ustion or blackness for no Lightning is without fire Moreover whereas all other living creatures when they are
Savoy with six other Surgeons following the Army to see the hurt of the said Lord of Martigues and to know of me how I had dressed him and with what medicines The Emperors Physician bid me declare the essence of the wound and how I had drest it Now all the assistants had a very attentive ear to know if the wound were mortal or not I began to make a discourse that Monsieur de Martigues looking over the wall to perceive them that did undermine it received a shot from an Arquebus quite through the body presently I was called to dress him I saw he cast out blood out of his mouth and his wounds Moreover he had a great difficulty of breathing and cast out winde by the said wounds with a whistling in so much that it would blow out a candle and he said he had a most sharp pricking pain at the entrance of the bullet I do beleive and think it might be some little pieces of bones which prickt the Lungs When they made their Systole and Diastole I put my finger into him where I found the entrance of the bullet to have broken the fourth Rib in the middle and scales of bones which the said bullet had thrust in and the out-going of it had likewise broken the fifth Rib with pieces of bones which had been driven from within outward I drew out some but not all because they were very deep and adherent I put in each wound a Tent having the head very large tied with a thred lest by the inspiration it might be drawn into the capacity of the Thorax which hath been known by experience to the detriment of the poor wounded for being faln in it cannot be taken out which is the cause that engenders putrefaction a thing contrary to nature The said Tents were annointed with a medicine composed of yelks of eggs Venice-turpentine with a little oyl of Roses My intention for putting the Tents was to stay the flux of blood and to hinder that the outward air did not enter into the brest which might have cooled the Lungs and by consequent the heart The said Tents were also put to the end that issue might be given for the blood that was spilt within the Thorax I put upon the wound great Emplasters of Di acolcitheos in which I had relented oyl of Roses and Vineger to the avoiding of the inflammation then I put great stupes of Oxycrate and bound him up but not too hard to the end he might have easie respiration that done I drew from him five porrengers of blood from the Basilisk vein of the right arm to the end to make revulsion of the blood which runs from the wounds into the Thorax having first taken indication from the wounded part and chiefly his forces considering his youth and sanguine temper He presently after went to stool and by his urine and sieg cast great quantity of blood And as for the pâ—â—n which he said he felt at the entrance of the bullet which was as if he had been pricked with a bodkinâ— that was because the Lungs by their motion beat against the splinters of the Broken Rib. Now the Lungs are covered with a coat comming from the membrane called Pleura interweâ—ved with nerves of the sixt Conjugation from the brain which was cause of the extreme pain â—e self likewise he had great difficulty of breathing which proceededd from the blood which was spilt in the capacity of the Thorax and upon the Diaphragm the principal instrument of respiration and from the dilaceration of the muscles which are between each Rib which help also to make the expiration and the inspiration and likewise because the Lungs were torn and wounded by the bâ—llet which hath caused him ever since to spit black and putrid blood in coughing The fever seised him soon after he was hurt with faintings and swoonings It seemed to me that the said fever proceeded from the putredinous vapors arising from the blood which is out of his proper vessels which hath falln down and will yet flow down The wound of the Lungs is grown great and will grow more great because it is in perpetual motion both sleeping and waking and is dilated and comprest to let the air to the heart and cast fuliginous vapors out by the unnatural heat is made inflammation then the expulsive vertue is constrained to cast out by cough whatsoever is obnoxious unto it for the Lungs cannot be purged but by coughing and by coughing the wound is dilated and grows greater from whence the blood issues out with great abundance which blood is drawn from the heart by the vein arterial to give them nourishment and to the heart by the vena cava his meat was barly broath stued prunes somtimes Panado his drink was Ptisan He could not lye but upon his baâ—k which shewed he had a great quantity of blood spilt within the capacity of the Thorax and being spread or spilled along the spondyls doth not so much press the Lungs as it doth being lain on the sides or â—itting What shall I say more but that the said Lord Martigues since the time he was hurt hath not reposed one hour only and hath alwaies cast out bloody urines and stools These things then Messieres considered one can make no other prognostick but that he will dye in a few dayes which is to my great grief Having ended my discourse I â—rest him as I was wont having discovered his wounds the Physicians and other assistants presently knew the truth of what I had said The said Physiciâ—ns having felt his pulse and known his forces to be almost spent and abolished they concluded with me that in a few dayes he would dye and at the same instant went all toward the Lord of Savoy where they all said that the said Lord Martigues would dye in a short time he answered it were possible if he were well drest he might escape Then they all with with one voice said he had been very well drest and sollicited with all things necessary for the curing of his wounds and could not be better and that it was impossible to cure him and that his wound was mortal of necessity The Monsieur de Savoy shewed himself to be very much discontented and wept and asked them again if for certain they all held him deplored and remediless they answered yes Then a certain Spanish impostor offered himself who promised on his life that he would cure him and if he failed to cure him they should cut him in an hundred pieces but he would not have any Physicians Surgeons or Apoâ—hecaries with him And at the same instant the said Lord of Savoy told the Physicians and Surgeons they should not in any wise go any more to see the said Lord of Martigues And he sent a Genâ—leman to me to forbiâ— me upon pain of life not to touch any more the said Lord of Martigues which I promised not to do wherefore I was very glad seeing he
the skins the fleshy Pannicle the fat the brests The division of the Chest into 〈◊〉 parts the common coat of the Muscles the Muscles of that place the fore-mentioned Bones the coat investing the ribs the Diaphragma or Midriff The parts contained are the Mediastinum the Pericardium or purse of the heart the heart the lungs and their vessels Of the containing parts some are common to all the body or the most part thereof as both the skins the fleshy pannicle and fat Of which being we have spoken in our first Book there is no need now further to insist upon Others are proper to the Chest as its Muscles of which we will speak in their place the Brests the fore-mentioned Bones the membrane investing the ribs and the Diaphragma or Midriff We will treat of all these in order after we have first shewed you the way how you may separate the skin from the rest of the Chest Putting your knife down even to the perfect division of the skin you must draw a straight line from the upper part of the lower Belly even to the Chin then draw another straight-line overthwart at the Coller-bones even to the Shoulder-blades and in the places beneath the Coller-bones if you desire to shun prolixity you may at once separate both the skins the fleshy Pannicle the fat and common coat of the Muscles because these parts were shewed and spoken of in the dissection of the lower Belly Yet you must reserve the Brests in dissecting of the Bodies of Women wherefore from the upper parts of the Brests as artificially as you can separate only the skin from the parts lying under it that so you may shew the Pannicle which there becometh fleshy and musculous and is so spred over the neck and parts of the face even to the roots of the hairs CHAP. III. Of the Brests or Dugs THe Brests as we said when we spoke of the nature of Glandules Their substance are of a glandulous substance white rare or spongious in Maids and Women that do not give suck they are more solid and not so large Wherefore the bigness of the Dugs is different although of a sufficient magnitude in all Magnitude Figure Composure Their figure is round somewhat long and in some sort Pyramidal Their composure is of the skin the fleshy Pannicle Glandules Fat Nerves Veins and Arteries descending to them from the Axillaris under the Sternon betwixt the fourth and fifth and sometimes the sixth of the true ribs And there they are divided into infinite rivulets by the interposition of the glandules and fat by which fit matter may be brought to be changed into the Milk by the faculty of the Dugs We will speak no more of the nature of the Glandules or Kernels as having treated of them before Which Glandules have nerves and which have none only we will add this that some of the Glandules have Nerves as those of the Brests which they receive from the parts lying under them that is from the intercostal by which it comes to pass that they have most exquisite sense Others want a nerve as those which serve only for division of the vessels and which have no action but only use They be two in number on each side one seated at the sides of the Sternon upon the fourth fifth and sixth true ribs Their connexion Wherefore they have connexion with the mentioned parts with their body but by their vessels with all other parts but especially with the womb by the reliques of the mamillary veins and arteries which descend down at the sides of the Brest-blade in which place these veins insinuating themselves through the substance of the Muscles How the brests and womb communicate each with other are a little above the Navel conjoyned with the Epigastricks whose original is in some sort opposite to the Hypogastricks which send forth branches to the womb By the meeting of these it is more likely that this commerce should arise than from other and those almost capillary branches which are sometimes seen to descend to the Womb from the Epigastrick Their temper They are of a cold and moist temper wherefore they say that the blood by being converted into milk * Recrudescere becomes raw flegmatick and white by the force of the proper flesh of the Dugs Their action is to prepare nourishment for the new-born Babe to warm the heart from whence they have received heat Their action and use and to adorn the Brest By this you may know that some Glandules have action others use and some both At the top of the Dugs there are certain hillocks The Nipples or eminencies called Teats or Nipples by sucking of which the Child is nourished through certain small and crooked passages which though they appear manifest to the sight whilst you press out the milk by pressing the Dug yet when the Milk is pressed out they do not appear nor so much as admit the point of a Needle by reason of the crooked ways made by nature in those passages for this use that the Milk being perfectly made should not flow out of its own accord against the Nurse's will For so the seed is retained and kept for a certain time in the Prostats CHAP. IV. Of the Clavicles or Coller-bones and Ribs IF we should handle these parts after the common order we should now treat of the Muscles of the Chest which move the Arm and serve for respiration and which first offer themselves to our sight But for that they cannot be fitly shewed unless we hurt the Muscles of the Shoulder-blade and Neck therefore I think it better to defer the explanation of these Muscles until such time as I have shewed the rest of the contained and containing parts not only of the Chest but also of the Head that having finished these we may come to a full demonstration of all the rest of the Muscles beginning with those of the Head which we first meet with and so prosecuting the rest even to the Muscles of the Feet as they shall seem to offer themselves more fitly to dissection that so as much as lyes in us we may shun confusion Wherefore to return to our proposed task after the foresaid Muscles come the Coller-bones the Sternon and Ribs But that these parts may be the more easily understood we must first know what a Bone is and whence the differences thereof are drawn What a Bone is Therefore a Bone is a part of our body most terrestrial cold dry hard wanting all manifest sense if the teeth be excepted A double sense I said manifest sense that you may understand that the parts have a double sense of Touching the one manifest such as resides in the flesh skin membranes nerves teeth and certain other parts the other obscure yet which may suffice to discern the helping and hurting tactile qualities such sense the Bowels and Bones have for very small
divided into four lobes disjoyned with a manifest and visible division on each side two whereby they may be the more easily opened and contracted and the air may the better enter Besides also in large bodies who have a very great Chest there is found a fifth lobe arising from the second lobe of the right side as a cushion or bolster to bear up the Hollow-vein ascending from the Midriff to the Heart In little men who have a shorter Chest because the Heart is so near as to touch the Diaphragma this lobe is not seen yet it is alwayes found in Dogs The Lungs represent the figure or shape of an Oxes foot or hoof Figure for like it they are thicker in their basis but slenderer in their circumference as you may see in blowing them up by the Weazon with your mouth or a pair of bellows Composition They are compounded of a coat coming from the Pleura which on each side receives sufficient number of nerves from the sixth conjugation and also of the Vena arteriosa coming from the right ventricle of the Heart and the Arteria venosa from the left as shall be shewed in the Anatomy of the Heart besides the Aspera arteria or Weazon coming from the Throat and lastly it s own flesh which is nothing else than the concretion of cholerick bloud poured out like foam about the divisions of the foresaid vessels as we have said of other parts The body of the Lungs is one in number unless you will divide it into two by reason of the variety of its site because the Lobe of the Lungs stretched forth into the right and left side do almost involve all the Heart that so they may defend it against the hardness of the Bones which are about it they are tyed to the Heart chiefly at its basis but to the roots of the ribs and their vertebra's by the coat it hath from thence but by the vessels to these parts from whence they proceed The sticking of the Lungs to the ribs But oft-times presently from the first and natural conformation they are bound to the circumference of the ribs by certain thin membranous productions which descend from thence to the Lungs otherways they are tyed to the ribs by the Pleura The nourishment of the Lungs is unlike to the nourishment of other parts of the body Their nourishment for you cannot find a part equally rare light and full of air which may be nourished with blood equally thin and vaporous In temper they incline more to heat than to cold whether you have regard to their composure of cholerick blood or their use which is to prepare and alter the air that it hurt not the Heart by its coldness The Lungs is the instrument of voice and breathing by the Weazon or Wind-pipe For the Lobes are the instruments of voyce and the ligaments of respiration But the Larinx or Throttle is the chief instrument of the voyce for the Weazon first prepares the voice for the Throttle in which it being in some measure formed is perfected in the Palate of the Mouth as in the upper part of a Lute or such like Instrument by the help of the Gargareon or Uvula as a certain quil to play withall But as long as one holds his breath he cannot speak for then the muscles of the Larinx ribs the Diaphragmn and the Epigastrick muscles are pressed down whence proceeds a suppression of the vocal matter which must be sent forth in making or uttering a voice Nature would have the Lungs light for many reasons the first is Why the lungs are light That seeing they are of themselves immoveable they might be more obsequious and ready to follow the motion of the Chest for when it it straitned the Lungs are straitned and subside with it and when it is dilated they also are dilated and swell so big that they almost fill up all the upper capacity thereof Another cause is That by this their rarity they might more easily admit the entring air at such times as they have much or sodain necessity as in running a race And lastly That in Plurisies and other purulent abscesses of the Chest the Pus or matter poured forth into the capacity of the Chest may be suckt in by the rare substance of the Lungs and by that means the sooner sent forth and expectorated The use of respiration is to cool and temper the raging heat of the Heart The use of respiration or breathing For it is cooled in drawing in the breath by the cool air and in sending out thereof by avoiding the hot fuliginous vapor Therefore the Chest performs two contrary motions for whilst it is dilated it draws in the encompassing air and when it is depressed it expels the fuliginous vapor of the Heart which any one may easily perceive by the example of a pair of Smiths-bellows CHAP. X. Of the Pericardium or Purse of the Heart Whence it hath its matter THe Pericardium is as it were the House of the Heart which arising at the basis thereof either the ligaments of the Vertebra's situate there or else the vessels of the Heart yielding it matter is of a nervous thick and dense substance without any fibers It retains the figure of the Heart and leaves an empty space for the Heart to perform its proper motion Wherefore the bigness of the Pericardium exceeds that of the Heart It consists of a double coat one proper of which we have spoken another common coming from the Pleura and also of the veins arteries and nerves the vessels partly coming from the Mamillary partly from the Diaphragma chiefly there where it touches it the nerves come on each side from the sixt Conjugation Number and Connexion It is only one placed about the Heart and annexed to it at the basis thereof by its membranes to the original of the Lungs and the Vertebra's lying under them and by the vessels to the parts from whence it received them It is of a cold and dry temper as every Membrane is Use The use thereof is to cover the Heart and preserve it in its native humidity by certain natural moisture contained in it unless you had rather say that the moisture we see contained in the Pericardium is generated in it after death by the condensation and concretion of the spirits Although this seems not very likely because it grows and is heaped up in so great quantity in living bodies that it hinders the motion of the Heart and causes such palpitation or violent beating thereof that it often suffocates a man From whence the matter of the watery humor contained in the Pericardium For this Palpitation happens also to hearty and stout men whose Hearts are hot but blood thin and waterish by reason of some infirmity of the Stomach or Liver and this humor may be generated of vapors which on every side exhale into the Pericardium from the blood boyling in the
Exspiration in the contraction of the Heart Whereby we may gather this that there is but one third part of that air we draw into the Heart in breathing sent forth again in the form of vapor in exspiration because Nature would have but one third part of the Orifice to lye open for its passage out Therefore the exspiration or breathing out and the Systole of the Heart and Arteries is shorter than the inspiration so that we may truly say that the inspiration or drawing the breath in is equally so long as the exspiration is together with the rest which is in the midst between the two motions CHAP. XII Of the distribution of the Vena arteriosa and the Arteria venosa HAving hitherto shewed the original of the vessels of the Heart we must now speak of their distribution The Vena arteriosa or the Arterious vein and the Arteria venosa or the Veinous Artery each proceeding out of his proper ventricle that is the right and left are divided into two large branches one of which goes to the right and the other to the left hand the one lying cross-ways over the other the Vein always riding over the Artery as you may understand better by the sight of your eys The Artery always lies under the vein than by reading of Books These branches at their entrance of the Lungs are divided into two other large branches and each of them go to his peculiar Lobe of the Lungs and these again run almost into infinite other branches dispersed in three places over the Lungs These Vessels have acquired their names by reason of that transmutation of consistence whereby the composure of a vein degnerates into an Artery A twofold reason why the Vein was made arterious or like an artery and that of an Artery into a Vein for the commodity of life For this is a miracle of prudent Nature to change the Coats of the vessels of the Lungs producing a Vein which in its Body should imitate an Artery and an Artery which should represent a Vein for if the Vena arteriosa should have retained its proper consistence the arterious blood which is carryed by it from the Heart to nourish the Lungs might by reason of its subtilty penetrate through and flow away by reason of the rarity of the veinous texture and so nature should never have attained her conceived end that is to nourish the Lungs by reason of the continual motion of their contraction and dilatation For nourishment cannot be assimilated to the part unless it be put and cleave to it Wherefore it was fit that nature should make the Body of this vein solid that it might be immoveable unshaken and stubborn in respect of a vein which by its softness would have been too obsequious and yielding to the agitation of the Lungs that so it might have nourishment which might be diffused into all parts thereof and which might neither be drawn by its Diastole Why the Artery was made like a Vein nor driven back into the heart by its Systole But the artery hath the consistence of a vein that by that veinous softness according to the necessity of Nature it might be the more readily contracted and dilated to bring the air in and carry the vapours forth of the heart Here we meet with a difficulty which is By what way the Blood is carried out of the right and left ventricle of the heart Galen thinks that there be certain holes in the partition made for that purpose By what way blood may pass out of the right into the left ventricle and verily there are such but they are not perforated Wherefore Columbus hath found out a new way which is that the Blood is carried to the lungs by the Vena Arteriosa and there attenuated and carried from thence together with the air by the Arteria venosa to the left ventricle of the heart this he writes truly very probably Botallus in his Treatise de Catarrho hath found out a third way to wit a vein which he cals Arteriarum nutrix that is The nurse of the arteries The vein called the Nurse of the arteries Fallop initio obser Arteriarum Gal. lib. 15. de usu partium cap. 6. which creeps a little above the Coronal to the right ear of the Heart and then goes into the left ear thereof But yet I am very much afraid that this vein observed by Botallus is that vessel observed by Fallopius whereby the Vena Arterialis is joyned to the Aorta and by which the all vital Blood is carried for the forming and nourishment of the Lungs whilst the infant is yet in the womb Of which also Galen makes mention but it had lain hid from his time to this day but that Fallopius raised up the memory of it again CHAP. XIII The Distribution of the ascendent Hollow-Vein THe Hollow Vein rising out of the gibbous part of the Liver Gal. lib. de form foetus The greater descendent branch of the hollow vein and resembling according to Galen the Body of a Tree is divided into two notable Branches but not of a like bigness For the greater by the hind-part of the Liver upon the Back-bone and by the way receives certain other Branches from the substance of the Liver which enter not into the great trunck with the rest You may often see this descendent Branch even to the Back-bone upon which it lies in this its descent covered with the substance of the Liver so that it may seem that branch proceeds not from that common trunk together with the ascendent The upper branch of the hollow vein is the less although indeed it always doth But the lesser Branch ascends to the upper parts and is distributed after this manner following For first arising into the Midriff it bestows two small veins upon it on each side one which from that part are called Phrenicae But from thence when it arrives at the right Ear of the Heart it makes the Coronales the Coronal or Crown-veins Venae phrenica Coronales which compass the basis of the heart in manner of a Crown Thirdly entring somewhat more deeply into its right Ear in its greater part it produces the vena arteriosa Fourthly lifted up above the heart Vena Arteriosa on the right side it produces the vein Azygos or sine pari that is without a fellow which descending to the fourth rib reckoning from above downwards nourisheth the intercostal muscles and also the membranes of the eight lower ribs on both sides sending a Branch into each of the muscles at the lower part of the rib which may be sufficient for their nourishment Besides also oftentimes Vena Azygos or sine pari especially in little men this vein Azygos nourishes all the spaces between all the ribs by the like Branches which it sends in the same manner to the four upper ribs Moreover also this Azygos sometimes The Azygos sometimes two How the matter
open Aneurismaes unless they be smal in an ignoble part not indued with large vessels but rather let him perform the cure after this manner Cut the skin which lies over it until the Artery appear and then separate it with your knife from the particles about it then thrust a blunt and crooked needle with a thred in it under it bind it then cut it off and so expect the falling off of the thread of it self whiles Nature covers the orifices of the cut Artery with the new flesh then the residue of the cure may be performed after the manner of simple wounds Those of the inward parts incurable The Aneurismaes which happen in the internal parts are incurable Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease because being so attenuated and heated therewith that it cannot be contained in the receptacles of the Artery it distends it to that largeness as to hold a man's Fist Which I have observed in the dead body of a certain Taylor who by an Aneurisma of the Arterious vein suddenly whilst he was playing at Tennis fell down dead A History and vessel being broken his body being opened I found a great quantity of bloud poured forth into the capacity of the Chest but the body of the Artery was dilated to that largness I formerly mentioned and the inner coat thereof was boney For which cause within a while after I shewed it to the great admiration of the beholders in the Physitians School whilest I publiquely dissected a body there whilst he lived he said he felt a beating and a great heat over all his body the force of the pulsation of all the Arteries by the occasion whereof he often swounded Doctor Sylvius the Kings Professor of Physick at that time forbad him the use of Wine and wished him to use boyled water for his drink and Curds and new Cheeses for his meat and to apply them in form of Cataplasms upon the grieved and swoln part At night he used a Ptisan of Barly meal and Poppy-seeds and was purged now and then with a Clyster of refrigerating and emollient things or with Cassia alone by which medicines he said he found himself much better The cause of such a bony constitution of the Arteries by Aneurismaes is for that the hot and fervid bloud first dilates the Coats of an Artery then breaks them which when it happens it then borrows from the neighbouring bodies a fit matter to restore the loosed continuity thereof This matter whilest by little and little it is dryed and hardened it degenerates into a gristly or else a bony substance just by the force of the same material and efficient causes by which stones are generated in the reins and bladder For the more terrestrial portion of the bloud is dryed and condensed by the power of the unnatural heat contained in the part affected with an Aneurisma whereby it comes to pass that the substance added to the dilated and broken Artery is turned into a body of a bony consistence In which the singular providence of Nature the Hand-maid of God is shewed as that which as it were by making and opposing a new wall or bank would hinder and break the violence of the raging bloud swelling wich the abundance of the vital spirits unless any had rather to refer the cause of that hardness to the continual application of refrigerating and astringent medicines Which have power to condensate and harden Lib 4. cap. ult de praesaex pulsu A Caution in the knowing Aneurismaes as may not obscurely be gathered by the writings of Galen But beware you be not deceived by the fore-mentioned signs for sometimes in large Aneurismaes you can perceive no pulsation neither can you force the bloud into the Artery by the pressure of your fingers either because the quantity of such bloud is greater than which can be contained in the Ancient receptacles of the Artery or because it is condensate and concrete into clods whereupon wanting the benefit of ventilation from the heart it presently putrefies Thence ensue great pain a Gangrene and mortification of the part and lastly the death of the Creature The End of the Seventh Book The Eighth BOOK Of Particular TVMORS against NATVRE The Preface BEcause the Cure of Diseases must be varyed according to the variety of the temper not only of the body in general but also of each part thereof the strength figure form site and sense thereof being taken into consideration I think it worth my pains having already spoken of Tumors in general if I shall treat of them in particular which affect each part of the body beginning with those which assail the head Therefore the Tumor either affects the whole head or else only some particle thereof as the Eyes Ears Nose Gums and the like Let the Hydrocephalos and Physocephalos be examples of those tumors which possess the whole head CHAP. I. Of an Hydrocephalos or watry tumor which commonly affects the heads of Infants THe Greeks call this Disease Hydrocephalos as it were a Dropsie of the Head What it is The causes by a waterish humor being a disease almost peculiar to Infants newly born It hath for an external cause the violent compression of the head by the hand of the Midwife or otherwise at the birth or by a fall contusion and the like For hence comes a breaking of a vein or artery an effusion of the bloud under the skin Which by corruption becoming whayish lastly degenerateth into a certain waterish humor It hath also an inward cause which is the abundance of serous and acrid bloud which by its tenuity and heat sweats through the pores of the vessels sometimes between the Musculous skin of the head and the Pericranium sometimes between the Pericranium and the skull and sometimes between the skull and membrane called Dura mater Differences by reason of place and otherwhiles in the ventricles of the Brain The signs of it contained in the space between the Musculous skin and the Pericranium Signs are a manifest tumor without pain soft and much yielding to the pressure of the fingers The Signs when it remaineth between the Pericranium and the skull are for the most part like the fore-named unless it be that the Tumor is a little harder and not so yielding to the finger by reason of the parts between it and the finger And also there is somewhat more sense of pain But when it is in the space between the skull and Dura-mater or in the ventricles of the Brain or of the whole substance thereof there is a dulness of the senses as of the sight and hearing the tumor doth not yield to the touch unless you use strong impression for then it sinketh somewhat down especially in Infants newly born who have their skuls almost as soft as wax and the junctures of their Sutures lax both by nature as also
which was cut quite asunder and put the lips of the wound as close together as I could I could not get hold of the Gullet because it was fallen down into the Stomach then I bound up the wound with medicines pledgets and fit ligatures After he was thus drest he begun to speak and tell the name of the villain the author of this fact so that he was taken and fastened to the wheel and having his limbs broken lost his wretched life for the life of the innocent wounded man who dyed the fourth day after he was hurt Another History The like hurt befel a certain German who lay at the house of one Perots in the street of Nuts he being frantick in the night cut his throat with a sword I being called in the morning by his friends who went to see him drest him just after the same manner as I dressed the Englishman Wherefore he presently recovered his speech which before could not utter one syllable freed from suspition of the crime and prison the servant who lying in the same chamber with him was upon suspition committed to Prison and confessing the thing as it was done lived four days after the wound being nourished with Broths put into his Fundament like Clysters and with the grateful vapour of comfortable things as Bread newly drawn out of the Oven and soaked in strong Wine I having thus by Art of Chirurgery made the dumb speak for the space of four days CHAP. XXX Of the Wounds of the Chest The differences of wounds of the Chest SOme wounds of the Chest are on the fore-side some behind some penetrate more deep others enter not into the capacity thereof othersome pierce even to the parts contained therein as the Mediastinum Lungs Heart Midriffe hollow Vein and ascendent Artery Othersome pass quite through the body whereby it happens that some are deadly some not The signs You shall thus know that the wound penetrates into the capacity of the Chest if that when the Patients mouth and nose be shut the breath or wind break through the wound with a noise so that it may dissipate or blow out a lighted candle being held near it If the Patient can scarse either draw or put forth his breath this also is a sign that there is some bloud fallen down upon the Diaphragma Signs that the heart is wounded By these signs you may know that the heart is wounded If a great quantity of bloud gush out if a trembling possess all the members of the body if the pulse be little and faint if the colour become pale if a cold sweat and frequent swooning assail him and the extream parts become cold then death 's at hand A History Yet when I was at Turin I saw a certain Gentleman who fighting a duel with another received a wound under his left brest which pierced into the substance of his heart yet for all that he struck some blows afterwards and followed his flying enemy some two hundred paces until he fell down dead upon the ground having opened his body I found a wound in the substance of the heart so large as would contain ones finger there was only much bloud poured forth upon the midriffe Signs that the Lungs are wounded These are the signs that the Lungs are wounded if the bloud comes foamy or froathy out of the wounds the Patient is troubled with a cough he is also troubled with a great difficulty of breathing and a pain in his side which he formerly had not he lies most at ease when he lies upon the wound and sometimes it comes so to pass that lying so he speaks more freely and easily but turned on the contrary side he presently cannot speak Signs that the midriffe is wounded When the Diaphragma or Midriffe is wounded the party affected is troubled with a weight or heaviness in that place he is taken with a Delirium or Raving by reason of the sympathy of the Nerves of the sixth conjugation which are spread over the midriffe difficulty of breathing a cough and sharp pain troubles the Patient the Guts are drawn upwards so that it sometimes happens by the vehemency of breathing that the Stomach and Guts are drawn through the wound into the capacity of the Chest which thing I observed in two The one of these was a Mason who was thrust through the midst of the Midriffe where it is nervous and dyed the third day following I opening his lower belly and not finding his stomach A History thought it a monstrous thing but at length searching diligently I found it was drawn into the Chest through the wound which was scarse an inch broad But the stomach was full of wind but little humidity in it The other was called captain Francis d' Alon a Native of Xantoigne Another History who before Rochell was shot with a Musket Bullet entring by the breast-bone near to the sword-like Gristle and passing through the fleshy part of the midriffe went out at the space between the fifth and sixth bastard ribs The wound was healed up on the outside yet for all that there remained a weakness of the stomach whereupon a pain of the guts like to the colick took him especially in the Evening and on the night for which cause he durst not sup but very sparingly But on the eighth month after the pain raging more violently in his belly then it was accustomed he dyed though for the mitigating of the vehemency thereof Simon Malmâ—dy and Anthony du Val both learned Physitians omitted no kind of Remedy The body of the diseased was opened by the skilful Chirurgeon James Guillemeau who found a great portion of the Colick-gut swelled with much wind gotten into the Chest through the wound of the Diaphragma for all it was so small that you could scarse put your little finger in thereat But now let us return from whence we digressed We understand that there is blood poured forth into the capacity of the Chest by the difficulty of breathing the vehemency of the increasing feaver the stinking of the breath Signs that there is blood pouted into the capacity of the Chest the casting up of blood at the mouth and other symptoms which usually happen to those who have putrefied and clotted blood poured out of the vessels into the belly infecting with the filthy vapour of the corrupt substance the parts to which it shall come But also unless the Patient cannot lye upon his back he is troubled with a desire to vomit and covets now and then to rise whence he often falls into a swound the vitall faculty which sustains the body being broken and debilitated both by reason of the wound and concreat or clotted blood for so putting on the quality of poyson it greatly dissipates and dissolves the strength of the heart It is a sign the spinal marrow is hurt when a Convulsion or Palsie that is a sodain loss of sense and motion
emplasters and so applied it asswageth pain by stupefaction hindering the acrimony of pustles and cholerick inflammations But by its humidity it softneth scirrhous tumors dissolveth and dissipateth knots and tophous knobs besides it causeth the breath of such as are annointed therewith to stink by no other reason then that it putrefies the obvious humor by its great humidity Avicens experiment confirms this opinion who affirmeth that the blood of an Ape that drunk Quick-silver was found concrete about the heart the carcass being opened In l. 6 Dios c. 28 Matthiolus moved by these reasons writes that Quick-silver killeth men by the excessive cold and humid quality if taken in a large quantity because it congeals the blood and vital spirits and at length the very substance of the heart as may be understood by the history of a certain Apothecary An history set down by Conciliator who for to quench his severish heat in stead of water drunk of a glass of Quick-silver for that came first to his hands he died within a few hours after but first he evacuated a good quantity of the Quick-silver by stool the residue was found in his stomach being opened and that to the weight of one pound besides the blood was found concrete about his heart Others use another argument to prove it cold and that is drawn from the composition thereof because it consists of Lead and other cold metals But this argument is very weak For unquencht Lime is made of flints and stony matter which is cold yet nevertheless it exceeds in heat Lib. 4. de nat rerum Paracelsus affirmeth that Quick-silver is hot in the interior substance but cold in the exterior that is cold as it comes forth of the Mine But that coldness to be lost as it is prepared by art and heat only to appear and be left therein so that it may serve instead of a tincture in the trans-mutation of metals And verily it is taken for a Rule amongst Chymists that all metals are outwardly cold by reason of the watery substance that is predominant in them but that inwardly they are very hot which then appears when as the coldness together with the moisture is segregated for by calcination they become caustick Moreover many account quick-silver poison Tract de casu offen yet experience denies it For Marianus Sanctus Boralitanus tells that he saw a woman who for certain causes and effects would at several times drink one pound and a half of quicksilver which came from her again by stool without any harm Moreover he affirmeth that he hath known sundry who in a desperate Colick which they commonly call miserere mei have been freed from imminent death by drinking three pounds of quick-silver with water only For by the weight it opens and unfolds the twined or bound up gut nnd thrusts forth the hard and stopping excrements he addeth that others have found this medicine effectual against the colick drunk in the quantity of three ounces Antonius Musa writes that he usually giueth Quick-silver to children ready to die of the worms Avicen confirmeth this averring that many have drunk Quick-silver without any harm wherefore he mixeth it in his ointments against scales and scabs in little children whence came that common medicine amongst country people to kill lice by annointing the head with Quick-silver mixed with butter or axungia Quick-silver good for women in travel Matthiolus affirmeth that many think it the last and chiefest remedy to give to women in travel that cannot be delivered I protest to satisfie my self concerning this matter I gave to a whelp a pound of Quick-silver which being drunk down it voided without any harm by the belly Whereby you may understand that it is wholly without any venomous quality Verily it is the only and true Antidote of the Lues Venerea and also a very fit medicine for all malign ulcers as that which more powerfully impugns their malignity then any other medicines that work only by their first qualities For the disease called Malum sancti manis Besides against that contumacious scab which is vulgarly called Malum sancti manis there is not any more speedy or certain remedy Moreover Guido writes that if a plate of lead be besmeared or rubbed there with and then for some space laid upon an ulcer and conveniently fastned that it will soften the callous hardness of the lips thereof and bring it to cicatrization which thing I my self have often times found true by experience Lib. de comp med socurd loc Against malign ulcers Certainly before Guido Galen much commended Quick-silver against malign ulcers and cancers Neither doth Galen affirm that lead is poisonous which many affirm poisonous becaus it consists of much Quick-silver but he only saith thus much that water too long kept in leaden pipes cisterns by reason of the drossiness that it useth to gather in lead causeth bloody fluxes which also is familiar to brass and copper Otherwise many could not without danger bear in their bodies leaden bullets during the space of so many years as usually they do It is reported It is declared by Theodoret Herey in the following histories how powerful Quick-silver is to resolve and asswage pain and inflamations Not long since Against the Parotides saith he a certain Doctor of Physick his boy was troubled with parotides with great swelling heat pain and beating to him by the common consent of the Physicians there present I applied an Anodine medicine whose force was so great that the tumor manifestly subsided at the first dressing and the pain was much asswaged At the second dressing all the symptoms were more mitigated At the third dressing I wondring at the so great effect of an Anodine Cataplasm observed that there was Quick-silver mixed therewith and this happened through the negligence of the Apothecary who mixed the simple Anodine medicine prescribed by us in a mortar wherein but a while before he had mixed an ointment whereinto Quick-silver entred whose reliques and some part thereof yet remained therein This which once by chance succeeded well I afterwards wittingly and willingly used to a certain Gentlewoman troubled with the like disease possessing all the region behind the ears much of the throat and a great part of the cheek when as nature helped by common remedies could not evacuate neither by resolution nor suppuration the contained matter greatly vexing her with pain and pulsation I to the medicine formerly used by the consent of the Physicians put some Quick-silver so within a few daies the tumor was digested and resolved But some will say it resolves the strength of the nerves and limbs as you may see by such as have been anointed therewith for the Lues Venerea who tremble in all their limbs during the rest of their lives This is true if any use it too intemperately without measure and a disease that may require so great a remedy for thus we see the Gilders
miseries of mans life as it were by the enticements of that pleasure also the great store of hot blood that is about the heart wherewith men abound maketh greatly to this purpose which by impulsion of imagination which ruleth the humors being driven by the proper passages down from the heart and entrails into the genital parts doth stir up in them a new lust The males of brute beasts being provoked or moved by the stimulations of lust rage and are almost burst with a Tentigo or extension of the genital parts and sometimes wax mad but after that they have satisfied their lust with the female of their kinde they presently become gentle and leave off such fierceness CHAP. IV. What things are to be observed as necessary unto generation in the time of copulation How women may be moved to Venery conception WHen the husband commeth into his wives chamber he must entertain her with all kinde of dalliance wanton behaviour and allurements to Venery but if he perceive her to be slow and more cold he must cherish embrace and tickle her and shall not abruptly the nerves being suddenly distended break into the field of nature but rather shall creep in by little and and little intermixing more wanton kisses with wanton words and speeches handling her secret parts and dugs that she may take fire and be enflamed to Venery for so at length the womb will strive and wax servent with a desire of casting forth it own seed and receive the mans seed to be mixed together therewith But if all these things will not suffice to enflame the woman for women for the most part are more slow and slack unto the expulsion or yeelding forth of their seed it shall be necessary first to foment her secret parts with the decoction of hot herbs made with Muscadine or boiled in any other good wine and to put a little Musk or Civet into the neck or mouth of the womb and when she shall perceive the efflux of her seed to approach by reason of the tickling pleasure she must advertise her husband thereof that at the very instant time or moment The meeting of the seeds most necessary for generation he may also yeeld forth his seed that by the concourse or meeting of the seeds conception may be made and so at length a child formed and born And that it may have the better success the husband must not presently separate himself from his wives embraces lest the air strike into the open womb and so corrupt the seeds before they are perfectly mixed together When the man departs let the woman lye still in quiet laying her legs or her thighs across one upon another and raising them up a little lest that by motion or downward situation the seed should be shed or spilt which is the cause why she ought at that time not to talk especially chiding nor to cough nor snees but give her self to rest and quietness if it be possible CHAP. V. By what signs it may be known whether the woman have conceived or not IF the seed in the time of copulation or presently after be not spilt if in the meeting of the seeds the whole body do somewhat shake that is to say the womb drawing it self together for the compression and entertainment thereof if a little feeling of pain doth run up and down the lower belly and about the navel if she be sleepy if she loath the embracings of a man and if her face be pale it is a token that she hath conceived In some after conception spots or freckles arise in their face Spots or specks in the faces of those that are with child their eies are depressed and sunk in the white of their eyes waxeth pale they wax giddy in the head by reason that the vapors are raised up from the menstrual blood that is stopped sadness and heaviness grieve their minds with loathing and waywardness by reason that the spirits are covered with the smoaky darkness of the vapors pains in teeth and gums and swounding often-times commeth the appetite is depraved or overthrown with aptness to vomit and longing whereby it happeneth that they loath meats of good juice and long for and desire illaudable meats Why many women being great with childe refuse laudable meats and desire those that are illaudable and contrary to nature The suppressed terms divided into three parts and those that are contrary to nature as coles dirt ashes stinking salt-fish sowr austere and tart fruits pepper vinegar and such like acrid things and other altogether contrary to nature and use by reason of the condition of the suppressed humor abounding and falling into the orifice of the stomach This appetite so depraved or over-thrown endureth in some untill the time of child-birth in others it cometh in the third month after their conception when hairs do grow on the child and lastly it leaveth them a little before the fourth month because that the child being now greater and stronger consumes a great part of the excremental and superfluous humor The suppressed or stopped terms in women that are great with childe are divided into three parts the more pure portion maketh the nutriment for the child the second ascendeth by little and little into the dugs and the impurest of all remaineth in the womb about the infant and maketh the secondine or after-birth wherein the infant lieth as in a soft bed Those women are great with child whose urine is more sharp fervent and somewhat bloody the bladder not only waxing warm by the compression of the womb fervent by reason of the blood contained in it but also the thinner portion of the same blood being expressed and sweating out into the bladder Hip. 1. de morb mul. A swelling and hardness of the dugs and veins that are under the dugs in the breasts and about them and milk comming out when they are pressed with a certain stirring motion in the belly are certain infallible signs of greatness with child Neither in this greatness of child-bearing the veins of the dugs only but of all the whole body appear full and swelled up especially the veins of the thighs and legs so that by their manifold folding and knitting together they do appear varicous Aph. 41. sect 5. whereof commeth sluggishness of the whole body heaviness and impotency or difficulty of going especially when the time of deliverance is at hand Lastly if you would know whether the woman have conceived or not give unto her when she goeth to sleep some mead or honied water to drink and if she have a griping in her guts or belly she hath conceived if not she hath not conceived CHAP. VI. That the womb so soon as it hath received the seed is presently contracted or drawn together AFter that the seeds of the male and female have both met and are mixed together in the capacity of the womb then the orifice thereof doth draw it self close together lest
concoct the same as may be seen in the ejaculatory spermatick vessels for which use also the length of the navel is half an ell so that in many infants that are somewhat grown it is found three or four times doubled about their neck or thigh As long as the child is in his mothers womb he taketh his nutriment only by the navel The childe in the womb taketh his nutriment by his navel not by his mouth and not by his mouth neither doth he enjoy the use of eyes ears nostrils or fundament neither needeth he the functions of the heart For spirituous blood goeth unto it by the artertes of the navel and into the Iliack arteries and from the Iliack arteries unto all the other arteries of the whole body for by the motion of these only the infant doth breath Therefore it is not to be supposed that the air is carried or drawn in by the lungs unto the heart in the body of the child How the childe breatheth but contrariwise from the heart to the lungs For neither the heart doth perform the generation or working of blood or of the vital spirits For the issue or infant is contented with them as they are made and wrought by his mother Which untill it hath obtained a full perfect and whole description of his parts and members cannot be called a child but rather an embryon or an imperfect substance CHAP. IX Of the ebullition or swelling of the seed in the womb and of the concretion of the bubbles or bladders or the three principal entrails IN the six first dayes of conception the new vessels are thought to be made and brought forth of the eminences or cotyledons of the mothers vessels and dispersed into all the whole seed as they were fibres or hairy strings Those as they pierce the womb so do they equally and in like manner penetrate the tunicle Chorion And it is carried this way being a passage not only necessary for the nutriment and conformation of the parts but also into the veins diversly woven and dispersed into the skin Chorion For thereby it cometh to pass that the seed it self boileth and as it were fermenteth or swelleth not only through occasion of the place but also of the blood and vital spirits that flow unto it and then it riseth into three bubbles or bladders like unto the bubbles which are occasioned by the rain falling into a river or channel full of water These three bubbles or bladders are certain rude or new forms The three bladders or concretions of the three principal entrails that is to say of the liver heart and brain All this former time it is called seed and by no other name but when those bubbles arise it is called an embryon or the rude form of a body untill the perfect conformation of all the members When the seed is called an embryon on the fourth day after that the vein of the navel is formed it sucketh grosser blood that is of a more full nutriment out of the Cotyledons And this blood because it is more gross easily congeals and curdles in that place where it ought to prepare the liver fully and absolutely made For then it is of a notable great bigness above all the other parts and therefore it is called Parenchyma Why the liver is called Parenchyma because it is but only a certain congealing or concretion of blood brought together thither or in that place From the gibbous part thereof springeth the greater part or trunk of the hollow vein called commonly vena cava which doth disperse his small branches which are like unto hairs into all the substance thereof and then it is divided into two branches whereof the one groweth upwards the other downwards unto all the particular parts of the body In the mean season the arteries of the navel suck spirituous blood out of the eminences or Cotyledons of the mothers arteries whereof that is to say of the more fervent and spirituous blood the heart is formed in the second bladder or bubble being endued with a more fleshie sound and thick substance as it behooveth that vessel to be which is the fountain from whence the heat floweth and hath a continual motion In this the virtue formative hath made two hollow places one on the right side another on the left In the right the root of the hollow vein is infixed or ingraffed carrying thither necessary nutriment for the heart in the left is formed the stamp or root of an artery which presently doth divide it self into two branches the greater whereof goeth upwards to the upper parts and the wider unto the lower parts carrying unto all the parts of the body life and vital heat CHAP. X. Of the third Bubble or Bladder wherein the head and the brain is formed THe far greater portion of the seed goeth into this third bubble that is to say Why the greater portion of seed goeth into generation of the head and brain yeelding matter for the conformation of the brain and all the head For a greater quantity of seed ought to go unto the conformation of the head and brain because these parts are not sanguine or bloody as the heart and liver but in a manner without blood bony marrow cartilaginous nervous and membranous whose parts as the veins arteries nerves ligaments panicles and skin are called spermatick parts because they obtain their first conformation almost of seed only although that afterwards they are nourished with blood as the other fleshie and musculous parts are But yet the blood when it come unto those parts degenerateth and turneth into a thing somewhat spermatick by virtue of the assimulative faculty of those parts All the other parts of the head form and fashion themselves unto the form of the brain when it is formed and those parts which are situated and placed about it for defence especially are hardened into bones Why the head is placed on the top of the body The head as the seat of the senses and mansion of the minde and reason is situated in the highest place that from thence as it were from a lofty tower or turret it might rule and govern all the other members and their functions and actions that are under it for there the soul or life which is the rectress or governess is situated and from thence it floweth and is dispersed into all the whole body Nature hath framed these three principal entrals as props and sustentations for the weight of all the rest of the body for which matter also she hath framed the bones The first bones that appear to be formed or are supposed to be conformed are the bones called ossa Ilium conneâ—ed or united by spondyls that are between them then all the other members are framed and proportioned by their concavites and hollownesses which generally are seven that is to say two of the ears two of the nose one of the mouth and in the parts beneath the
with vaporous spirits wherewith as long as the humor distills it is replenished and looks white A Fornace or Reverberation furnished with his Retort and Receiver A. Shews the Fornace B. The Retort C. The Receiver D. The vessel filled with cold water Now for the Receiver there are two things to be observed The first is that it be great and very capacious that it may not be distended and broken by the abundant flowing of vaporous spirits as it doth oft-times happen another thing is that you set it in a vessel filled with cold water lest it should be broken by being over hot you may easily perceive all this by the ensuing figure CHAP. XVII A Table or Catalogue of Medicines and Instruments serving for the cure of Diseases MEdicines and Medicinal meats fit for the cure of Diseases are taken from living Creatures Plants and Minerals From living creatures are taken Horns Heoves Hairs Feathers Sheâ—s Sculls Scales Sweats Skins Fat 's Flesh Blood Entraile Vrine Bones Extreme parts Hearts Liver Lungs Brain Womb Secundine Testic es Pizzle Bleader Sperm Tail Ceats of the Ventricle Exspirations Bristles Silk Webs Tears Spittle Heny Wax Egge Milk Butter Cheese Marrow Rennet Sâ—nells whether they be stinking oâ— sweet as also Poysons whole creatures themselves as Foxes Whelps Heagâ—hâ—gs Frogs Worms Crabs Cray fishes Scorpions Hoâ—sleeches Swallows Dungs From. Pâ—nts that is Trees Shrubs and Herbs are taken Roots Moss Pith Siens Buds Stalks Leaves Flowers Cups Fibers or hairy threads Ears Seeds Bark Wood Meal fuyces Tears Orts Gâ—ws R sins R tterness Mass oâ— spissament Mâ—nna which falling amâ— like dew upon plants presently concretes Wh l. plants as Mallows Omâ—â—ns c. Metals o Minerals are taken either from the Water oâ— Earth and are either kindes of Earth Stones o Metals c. The kinâ—es oâ— Earth are Bole-Armenick Terâ—a sigillata Fullere-earth Chalk Okar Plaster Lime Now the kindes of Stones are Flints Lapis Jâ—daicus Lapis Lynâ— is The Pumice Lâ—p Haematites Amiantus Galactites Spunge stones Diamonds Saphire Chryâ—â—lite Tâ—pace Lâ—ad-stone The Pytites or fire-stone Alablaster Marble Chrystaâ— and many â—ther precious stâ—nâ—s The kinâ—es of Salts as well Natural as Artificial are Common Salt Salt nitrum Sal Aâ—kali Sal Ammomacum Salt of Vrine Salt of tartar and generally all salts that may be made of any kinde of Plants Those that are commonly called Minerals are Marchasite Antimony Muscevy Glâ—ss Tutty Arsnick Orpiment Lazure or blue Rose agar Brimstone Quick-silver White-Coperas Chalâ—itis â—â—ry Roman Vitrâ—l Colcother vitrio or Green-coperas Alumen sciffile Common Alum Alumen rotinâ—um R und Alum Alumen liquidem Alumen â—tmosum Borax er Burrace Bitumen Naptha Cinnabâ— is er Vermillion Lytharge of Gela. Lytharge of Silver Chrysocolla Scandaracha Red-lead White-lead and divers other Now the Metals themselves are Gold Silver Iron Lead Tin Brass Copper Steel Lattin and such as arise from these as the scales verdigrease rust c. Now from the Waters as the Sea Rivers Lakes und Fountains and the mud of these waters are taken divers medicines as white and red Corral Pearls and infinite other things which Nature the hand-maid of the great Architect of this world hath produced for the cure of Diseases so that into what part soever you turn your eyes whether to the surface of the earth or the bowels thereof a great multitude of Remedies present themselves to your view The choyce of all which is taken from their substance or quantity quality action place season smell taste sight figure and weight other circumstances as Siltyus hath abundantly shewed in his Book written upon t his Subject Of these Simples are made divers Compositions as Collyriâ— Caputpurgia Eclegmate Dentifrices Dentiscalpia Apophlegmatismi Gargarisms Pilis Boles Petions Emplasters Vnguents Cerats Liniments Embrecations Fomentations Epithemes Attractives Reâ—overs Suppuratives Emollients Mundificatives Incarnatives Cicatrizers Putrifâ—rs Corrosives Aglutinatives Anâ—dynes Apozemes Julips Syrups Powders Tablets Opiats Conserves Preserves Consect â—ns R wls Vâ—nits Sternutatories Suderyficks Glysters Pessaries S â— ppâ—â—tories Fumigations Tr câ—iks F nerals Caâ—s Stomachers Bags Baths Half baths Virgins-mâ—k Feâ—i Picatiâ—ns Depilatâ—ries Viâ—â—catâ— ies Pâ—â—ential cauteries Nâ—se-gayâ—s â—ans Campies or extenaed clâ—aths to make winde Artifiâ—al â—â—uâ—tains tâ—â—alâ—â— or ar p dâ—wâ— liquorâ— Now these tâ—aâ—â—â—e â—â—ought to be noâ—rishing medicines are Restarratives Cullises Exor ssi ns Gellies Pâ—i ans Barâ—y creams Panad'es Almâ—nd milks Marck-pains Wafers Hâ—â— of â—cher H d â—â—el and such other drink Muâ—cilages Oxymeâ— Oxye are R â—-Vineger Hyd aelium Mâ—thâ—glâ—n Câ—der Drink of Servisses Alt. Beer Vinegar Verjuyce Oil. Steâ—led water Water brewed with cread-crums Hippocratâ— Perry and such like Waters and distilled oyls and divers other Chymical extractions As the waters and oyls of hot dry and aromatick things dâ—wn in a copper-Alembick with a cooler with ten times as much water in weight as of herbs now the herbs must be cry that the cistillation may the better succeed Waters are extracted out of flowers put into a Retort by the heat of the Sun or of Dung or of an heap of p esled our Grapes or by Balneo if there be Receiver put and closely â—luted thereto All kindes oâ— salt of things calcined dissolved in water and twice or thrice filtred that so they may become more pure and fit to yield oyl Other distillâ—tions are made either in Cellars by the coldness or moist are of the place the things being laid either upâ—n a marble or else hanged up in a bag and thus is made oyl oâ—â—â—rtar and of S lts and other things of an Aluminous nature Bones must be distilled by descent or by the joyning together of vessels All woods roots-barks shells of fishes and seed or grains as of corn broom beans and other things whose juice cannot be got out by expression must be distilled by descent or by the joyning together of vessels in a Reverberatory Fornace Metals calcined and having acquired the nature of salt ought to be dissolved and filtred and then evaporated till they be drie then let them be dissolved in distilled vinegar and then evaporated and dryed again for so they will easily distill in a Cellar upon a Marble or in a bag Or else by putting them into a glassy Retort and setting it in sand and so giving fire thereto by degrees until all the watery humidity be distilled then change the receiver and lute another close to the Retort then increase the fire above and below and thus there will flow forth an oil very red colored Thus are all metalline things distilled as Alums salts c. Gums axungiae and generally all rosins are distilled by Retort set in an earthen vessel filled with Ashes upon a Fornace now the fire must be encreased by little and little according to the different condition of the distilled matters The Vessels and Instruments serving for Distillations are commonly these Bottoms of Alembicks The heads of them from whence the liquors drop Refrigeratories Vessels tor subblimation For Reverberation For distilling by
Christ and love toward his neighbors with hope of life everlasting left that he being carried away by favor or corrupted with money or rewards should affirm or testifie those wounds to be small that are great and those great that are small for the report of the wound is received of the Surgeon according to the Civil Law Wounds termes great for three respects It is recorded in the works of antient Physicians that wounds may be called great for three respect The first is by reason of the greatness of the dissolved Unity or resolution of Continuity and such are these wounds which made by a violent stroke with a back-sword have cut off the arm or leg or overthwart the breast The second is by reason of the dignity or worthiness of the paâ—t now this dignity dependeth on the excellency of the action therefore thus any little wound made with a bodkin knife in any part whose substance is noble as in the brai Heart Liver or any other part whose action and function is necessary to preserve life as in the Weasant Lungs or Bladder is iudged great The third is by reason of the greatness and ill habit or the abundance of ill humors or debility of all the wounded body so those wounds that are made in the nervous parts and old decayed people are said to be great But in seaching of wounds let the surgeon take heed that he be not deceived by his probe For many times it cannot go into the bottom of the wound but stoppeth and sticketh in the way either because he hath not placed the patient in the same posture wherein he was when he received his hurt or else for that the stroke being made down right slipt aside to the right or left hand or else from below upwards or from above downwards and then he may expect that the wound is but little and will be cured in a short time How long a Surgeon must suspend his judgment in some cases when it is like to be long in curing or else mortal Therefore from the first day it behooveth him to suspend his judgment of the wound until the ninth for in time the accidents will shew themselves manifestly whether they he small or great according to the condition of the wound or wounded bodies and the state of the air according to his prinitive qualities or venemous corruption General signs whereby we judg of diseases But generally the signs whereby we may judg of diseases whether they be great or small of long or short continuance mortal or not mortal are four For they are drawn either from the nature and essence of the disease or from the cause or effects thereof or else from the similitude proportion and comparison of those diseases with the season or present constitution of the times Therefore if we are called to the cure of a green wound whose nature and danger is no other but a simple solution of Continuity in the musculous flesh we may presently pronounce that wound to be of no danger and that it will soon be cured But if it have an Ulcer annexed unto it that is if it be fanious then we may say it will be more difficult and long in curing and so we may pronounce of all diseases taking a sign of their essence and nature But of the signs that are taken of the causes let this be an example A wound that is made with a sharp-pointed and heavy weapon as with an halberd being stricken with great violence must be accounted great yea and also mortal if the accidents be correspondent But if the patient fall to the ground through the violence of the stroke if a cholerick vomiting following thereon if his sight fail him together with a giddiness if blood come forth at his eyes and nostrils if distraction follow with loss of memory and sense of feeling we may say that all the hope of life remaineth in one small sign which is to be deduced from the affects of the wound But by comparing it unto the season that then is and diseases that then assault mans body Wounds deadly by the fault of the air we may say that all those that are wounded with Gun-shot are in danger of death as it happened in the skirmishes at the siege of Rean and at the battle of Saint Denis For at that time whether it were by reason of the sault of the heavens or air through the evil humors of mans body and the disturbance of them all wounds that were made by Gun-shot were for the most part mortal So likewise at certain seasons of the year we see the small-pocks and meazles break forth in children as it were by a certain pestilent contagion to the destruction of children only inferring a most cruel vomit and lask and in such a season the judgment of those diseases is not difficult Signs of a fractured scull But you by the following signs may know what parts are wounded If the patient fall down with the stroke if he lye â—ensless as it were asleep if he avoid his excrements unwittingly if he be taken with giddiness if blood come out at his ears mouth and nose and if he vomit choler you may understand that the scull is fractured or pierced through by the defect in his understanding and discourse You also may know when the scull is fractured by the judgment of your external senses as if by feeling it with your finger you finde it elevated or depressed beyond the natural limits if by striking it with the end of a probe when the Perictanium or nervous film that investeth the scull is cut cross-wise and so divided there from it it yield a base and unperfect sound like unto a pot-sheard that is broken or rather like to an earthen-pitcher that hath a cleft or rent therein But we may say that death is at hand if his reason and understanding fail him Signs of death by a wound on the head if he be speechless if his sight forsake him if he would tumble head-long out of his bed being not at all able to remove the other parts of his body if he have a continual fever if his tongue be black with driness if the edges of the wound be black or drye and cast forth no sanions matter if they resemble the colour of salted-flesh if he have an apoplexy phrensie convulsion or palsie with an involuntary excretion or absolute suppression of the urine and excrements Signs that the throat is cut You may know that a man hath his throat that is his weason and winde-pipe cut First by the sight of his wound and next by the abolishment of the function or office thereof both wayes for the patient can neither speak nor swallow any meat or drink and the parts that are cut asunder divide themselves by retraction upwards or downwards one from another whereof cometh sudden or present death You may know that a wound hath pierced into the brest or
in the lowest Belly by the Gate-vein But although it be not parted into any branches until it come to the Jugulum Propagations of the Ascendent Trunk Phrenica yet before that it spreads some propagations at its sides and of those three notable ones The first ee is that which is called Phrenica or the vein of the Midriff on either side one and is distributed throughout the whole Midriff which is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 with a numerous issue sending little branches to the neighbouring Pericardium or purse of the Heart and the mediastinum or partition of the Chest which when it has now got above and entred the Chest it inclines a little to the left hand and enters the Pericardium and being hidden very close over against the eight Rack-bone of the Chest is very strongly infixt into the right ventricle C of the heart that Aristotle did not without cause guess that it sprung from hence But before it be so infixed it sends out another propagation bb which is a notable one and extends it self by the hinder part of the Heart and the left side of it towards the forepart compassing the basis of the Heart like a Crown Coronâ—ria from whence it is called Coronaria or the Crown-vein of the Heart This scatters many branches through all the outer surface of the Heart but especially through the left side as that which needed a more copious aliment then the right side because of the continual and greater motion there But because the flesh of the Heart is hard and solid it ought therefore to be nourisht with a thicker blood from whence it is that this branch grows out of the vein before it enters the Heart to wit when the blood is somewhat thicker and not yet attenuated in the cavities of the Heatt Near to the original of this there is a little valve or flood-gate which hinders the blood from flowing back to the Hollow-vein as it might easily do by reason of the continual motion of the Heart When the Hollow vein has now gotten above the Heart it becomes lesser and perforates again the Pericardium and for sakes the Rack-bones of the Back and being got above the Gullet the rough Artery and the Aorta or great Artery which lean so upon one another that the Gullet takes hold of the bodies of the Rack-bones the rough Artery lies upon that and the aorta again upon this it climbs upwards through the midst of the division of the Lungs where the right part is separated from the left But because by this means it could not get to the back and the little branches if it should have sent forth any such had been very liable to danger of breaking being so hanged up therefore it sends forth a third propagation cc as soon as it is got out of the Pericardium or purse of the Heart 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 The Greeks call this vein 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 the Latins sine pari or carens conjuge without a companion or wanting a mate because in a man there is but one and it has no companion or mate on the left side as other veins have though in creatures that chew the cud it is double and plainly to be perceived of both sides But it issues forth about the fifth Rack-bone of the Chest out of the hinder part of the Hollow-vein and the right side and goes downwards not directly but inclining a little toward the right hand is as it were reflected backwards to the Back-bone but as soon as it reaches the eight or ninth rib it is cleft above the Spine of the Back into two branches which running downwards pass through the division of the midriff which is betwixt its two productions and so are spread abroad into the lowest Belly Of these the left which is sometimes the greater hiding it self about the transverse Processes of the Rack-bones and under the left production of the midriff and the original of the first bending Muscle of the thigh is inserted into the left Emulgent either near to its beginning or as it oft happens into the middle of it But the right running on likewise under the membranes about the transverse processes of the right side and the right production of the Septum or Midriff and the beginning of the same first bender of the thigh which keeps the right side is implanted sometimes into the very Trunk of the Hollow-vein sometimes into the first vein of the Loins And we are indebted for this observation to the learned Fallopius who would have the matter that is gathered together in the Chest whether it be watery or purulent and corrupt or sanguinous to be evacuated by the benefit of the left branch of this vein of which notwithstanding we will say something briefly in the following Book But this vein in its journey downwards shoots forth twigs of both sides as well right as left of which the right are more notable and larger of which there are numbred almost alwayes ten which run out to as many distances of the lower ribs and make the inferior Intercostal veins But I say they are almost alwayes ten because it happens very seldome that all the distances of the ribs receive branches from this vein the two uppermost to wit the first and second distance getting their surcles or twigs from the fourth branch that is presently to be mentioned But these twigs run straight forwards near to to the lower side of the ribs where there are cavities cut out for them as we have taught in the second Book And truly this place is diligently to be taken notice of by Students in Chirurgery because of the opening of the Chest in the disease called Empyema that they may know that incision is to be made in the uppermost place of the rib because in the lower the vessels would be harmed to the great indangering of life But these veins do not run through the whole length of the true ribs but are terminated together with the bony part But the propagations of the Mammary vein nourish the six distances between the gristles of the seven true ribs as we shall tell you by and by Yet in the bastard ribs they run even beyond the Gristles towards the Abdomen or Paunch into whose Muscles they insinuate themselves But there are certain other little branches propagated from the same vein by which nourishment is derived to the marrow of the Rack-bones and the Muscles to wit those about which they are carried some also are implanted into the Mediastinum near to the back This vein sine pari without a companion being thus constituted the Hollow-vein ascends to the Jugulum or Hollow of the Neck D being supported by the Mediastinum and a certain soft and glandulous body which the Greeks call 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 and is placed in the highest part of the Chest to defend the divarications of the veins there hanging up from all danger of breaking And here
joyned by Anastomosis or ineculation 10. 10. The second called Pudenda 11. spent upon the privy parts 11. The third Coxalis 12 upon the Muscles of the Hip. 12. Here the outer Iliacal vein having past through the Peritoneum or rim of the Belly enters the Crus and begins to be called the Crural Trunk Γ Γ. that is undivided as far as to the two lower heads of the Thigh But it reaches forth four propagations before its division The first 13 13. is called Saphena which creeps through the inside of the Leg under the skin as far as to the ends of the Toes 14. Another 14 called Ichia is spread out into the skin upon the Hip-bone The third 15 named Muscula is sent to the Muscles 15. which extend the Leg. 16. The fourth 16 named Poplitea is distributed into the Calf of the Leg. 13. The vein Saphena also scatters from it self four surcles 17 the first 17 into the upper part of the skin of the inside of the Thigh 18. the second 18 about the middle of the Thigh 19. the third 19 into the Knee the fourth 20 is carried forward and backward to the middle of the Leg. 20. Δ. The division of the Crural Trunk near to the two lower heads of the Thigh into an inner branch Θ Θ. and an outer one Λ. Λ. Θ. The inner distributes little branches to the Muscles of the Calf 21 12. and then runs down under the inner ankle to the great Toe 22. 22. Λ. The outer presently is cleft into two branches an inner one Ξ Ξ. and an outer Π. That is spent wholly upon the Muscles of the Calf Π. this passes on near to the Fibula or lesser bone of the Leg through the outer and back-side of the Leg. The second Treatise Concerning The ARTERIES CHAP. I. Shews the upper or ascendent Trunk of the great Artery with its propagations that are distributed through the Head THere is no controversie among writers of Anatomy concerning the number and original of the Arteries The Original of the great Artery but an unanimous consent that all the propagations which are scattered throughout the body take their rise from one which they call Aorta and that this is derived out of the Heart But the Heart consisting of two sinus or cavities a right and a left one this great Artery grows out of the left sinus or ventricle A where it is largest and more hard and griestly then elswhere But as soon as it is grown out and before it fall out of the Pericardium or purse of the Heart Arteriae Coronariae the Crown-Arteries it presently propagates two small sprigs a a one of each side which they call Arteriae Coronariae the Crown-Arteries because together with the vena Coronalis or Crown-vein they compass the basis of the Heart in manner of a Crown and from these many propagations are scattered downward all along the Heart But they are more and greater about the left then the right ventricle as we have also formerly said concerning the vein because the Heart needs a greater plenty of blood on that side as which beats with a perpetual and more violent motion wherein more blood is digested then the right sinus or ventricle does yet that propagation is bigger and longer which arises on t of the right side of the Artery sometimes also there is only one at whose orifice a little valve is found Those propagations being thus disseminated the Artery ascends somewhat under the Trunk of the vena Arteriosa The divisions of the great Artery into two Trunks or Arterial vein and pierces through the Pericardium and having got above it is cleft B into two branches which because of their natural greatness we will call Trunks and because one ascends C and the other runs downward Q that shall be the Ascendent Trunk this the Descendent Yet the Descendent and lower one is bigger by much then the upper What parts both the Trunks nourish The order of that which is to be said because that serves more parts then this For the Ascendent one goes only to some parts of the Chest to the Head and Arms but the lower to very many parts of the Chest to all the lowest belly and the Legs That therefore we may treat of the great Artery with more perspicuity we will first shew the Ascendent Trunk and its progress through the Chest and Head and after that its branches distributed through the Arms. Then we will fall upon the Descendent one add explain the manner of its distribution through the Chest and lowest belly and lastly through the Legs The Ascendent therefore or upper Trunk of the Aorta C being fastened to the Oe sophagus or Gullet climbs upward betwixt the rough Artery and Hollow-vein and the mediastinum or partition of the Chest Which situation of it they ought diligently to observe who desire to know the reason of that Aphorism which is the four and twentieth of the fifth Section in Hippocrates For sayes he cold things as snow and ice are enemies to the Breast provoke coughs and cause eruptions of blood and distillations Truly they are enemies to the Breast because whilest they are swallowed down through the Gullet they cool the rough Artery that lyes next to it together with the Gullet which part being of it self cold does easily take harm from so violent a cold hence the cough and other diseases of the Brest follow one another in a long row But issues of blood happen in like manner the great Artery being cooled whereby the vital Spirits and the blood are driven back to the Heart and from thence are sent up forcibly to the Head which being stuft eruptions of blood are caused by its dropping forth at the Nostrils as also catarrhs and distillations it being driven down undigested to the inferiour parts And hence also a reason may be rendered why some upon drinking of cold water after vehement motions and exercise of body have presently been suffocated the passion of the heart and grievous swoundings following thereupon For the Artery being vehemently coold the blood is congealed as well that which was in the Aorta or Great artery as that which abides in the heart from whence happen at first fearful symptoms and then suddain death But we have seen in these men that a vein being opened the blood hath come out thick and cold and with very great difficulty whence also we have not found a more present remedy for them then such things as by reason of the thinness of their parts have a power of dissolving the clots of blood Hence also a reason may be given why in burning fevers the tongue becomes black the diseased can hardly swallow For although it be true which is the cause commonly assign'd that many vapors are sent up from the whole body to the head yet we may ascribe a main
we must look upon it as the mark and labour to preserve it by the use of convenient things as much as lies in our power Wherefore because it is very necessary to know the distinction of Temperaments I have thought good in this place briefly to handle the Temperaments of the parts of the Body Ages Seasons of the year Humors and Medicines Therefore the temperaments of the parts of our body are of this nature not only by the judgment of the touch of a mans hand which is justly tempered who is often deceived by flowing heat which What the temperaments of mans body are spread from the heart into all the body imparts a certain kind of heat to all the parts but also by the rule of their reason composure and substance as A Bone is the most dry and cold A Grisle less than it A Ligament less then a Grisle A Tendon is so much dryer and colder than the membrane by how much it in the same temper exceeds a Vein and Artery Then follow the harder Veins for the softer are in a middle temper of dryness and moisture like as the Skin although all both soft and hard are of a cold temper Wherefore all these parts of their own nature are cold and without blood although the Veins and Arteries wax hot by reason of the heat of the blood they contain which notwithstanding also borroweth that heat from the heart as a part most hot and softer than the skin the Liver next followeth the heart in the order of the hotter parts which is farre softer than the skin it self for if according to Galens opinion Ad finem lib. de Temper the heart is somewhat less hard then the skin and that is far harder than the liver as appears by touching them it must necessarily follow that the liver much exceeds the skin in softness I understand the skin simple and separated from the flesh lying under it to which it firmly cleaves The flesh is more moist and hot than the skin by reason of the blood dispersed in it The spinal marrow is colder and moister than the skin but the brain so much exceeds it in moisture as it is exceeded by the fat The lungs are not so moist as the fat and the spleen and kidneys are of the like nature and nevertheless they are all moisture than the skin According to the diversities of ages the temperaments both of the whole body The temperaments of ages and all its parts undergo great mutations for the bones are far harder in old men than in children because our life is as it were a certain progress to dryness which when it comes to the height consequently causeth death What an age is Wherefore in this place we must speak of the Temperaments of Ages when first we shall have defined what an Age is Therefore an Age is defined A space of life in which the constitution of the body of its self and own accord undergoeth manifest changes The whole course of life hath four such Ages The first is Childhood which extends from the birth to the eighteenth year of age and hath a hot and moist temper because it is next to the hot and moist beginnings of life seed and blood Youth followeth this which is prolonged from the eighteenth to the twenty fifth year and is temperate and in the midst of all excesses Mans estate succeedeth Youth which they deny to extend beyond the thirty fifth year of age in its proper temper it is hot and dry whereby it commeth to pass that then the heat is felt more acide and biting which in childhood seemed milde because the progress of the life to dryness Old-age divided into two parts hath much wasted the native humidity Then succeeds Old-age ever divided into two parts the first whereof extends from the thirty fifth to the forty ninth year those of this age are called Old-men but we commonly call them middâ—e ag'd men The latter is as it were divided by Galen into three * Three degrees of the second part of Old-age degrees the first whereof are those who having their strength sound and firm undergo civill affairs and businesses which things those which are in the second degree of Old-age cannot do because of the debility of their now decaying strength but those which are in the last degree are afflicted with most extream weakness and misery and are as much deprived of their senses and understanding as of the strength of their bodies whereof arose this Proverb Old men twice Children Those Old men of the first rank are pleasant and curteous and those we say are beginning to grow Old or in their green Old-age those of the second sort delight in nothing but the boord and bed but old decrepit men of the last order think of nothing else than their graves and monuments Old men have their solid parts dry Their firm and solid parts are of a cold and dry temperature by reason of the decay of the radical moisture which the inbred heat causeth in the continuance of so many years Which thing may happen in a short space by the vehement flame of the same natural heat turned by fevers into a fiery heat But if any to prove Old men moist will object That they cough oft and spit much I will answer him as an old Doctor once said That a pitcher filled with water may pour forth much moisture yet no man will deny but that such a vessel of its own terrene nature and matter is most dry so old men may plainly be affirmed to be moist by reason of their defect of heat and abundance of excrements But this description of ages is not to be taken so strictly as alwayes to be measured by the spaces and distances of years for there are many which by their own misdemeanour seem elder at forty than others do at fifty A comparison of the four ages to the four seasons of the year Lastly the famous Philosopher Pythagoras divided mans life into four ages and by a certain proportion compared the whole course thereof to the four seasons of the year as Childhood to the Spring in which all things grow and sprout out by reason of plenty and abundance of moisture And Youth to the Summer because of the vigor and strength which men enjoy at that age And mans estate or constant age to Autumn for that then after all the dangers of the fore-passed life the gifts of discretion and wit acquire a seasonableness or ripeness like as the fruits of the earth enjoy at that season And lastly he compares Old-age to the sterile and fruitless Winter which can ease and consolate its tediousness by no other means than the use of fruits gathered and stored up before which then are of a cold and troublesome condition But for extreme Old-age which extends to eighty or a hundred years it is so cold and dry that those which arrive at that decrepit age are
Connexion when we search whether every thing be in its proper place and whether they be decently fitted and well joined together We have handled the varieties of the four seasons of the Year when we treated of Temperaments But the consideration of Region because it hath the same judgment that the Air shall be referred to that disquisition or enquiry which we intend to make of the Air amongst the things Not-natural Diet. The manner of life and order of Diet are to be diligently observed by us because they have great power either to alter or preserve the Temperament But because they are of almost infinite variety therefore they scarce seem possible to fall into Art which may prosecute all the differences of Diet and Vocations of life Wherefore if the Calling of Life be laborious as that of Husbandmen Mariners and other such trades it strengthens and dries the parts of the body Although those which labour much about Waters are most commonly troubled with cold and moist diseases although they almost kill themselves with labour Again those which deal with Metals as all sorts of Smiths and those which cast and work brass are more troubled with hot diseases as Feavers But if their Calling be such as they sit much and work all the day long sitting at home as shoomakers it makes the body tender the flesh effeminate and causeth great quantity of excrements A life as well idle and negligent in body as quiet in mind in all riotousness and excesses of Diet doth the same For from hence the body is made subject to the Stone Gravel and Gout That calling of life which is performed with moderate labour clothing and diet The commodities of an indifferent Diet. seems very fit and convenient to preserve the natural temper of the body The ingenious Chirurgion may frame more of himself that may more particularly conduce to the examination of these things Therefore the things natural and those which are near or neighbouring to them being thus briefly declared the Order seems to require that we make enquiry of things Not-natural CHAP. XII Of things Not-natural THe things which we must now treat of Why they are called things Not-natural have by the later Physitians been termed Not-natural because they are not of the number of those which enter into the constitution or composure of mans body as the Elements Humors and all such things which we formerly comprehended under the name of Natural although they be such as are necessary to preserve and defend the body already made and composed Wherefore they were called by Galen Preservers because by the due use of them the body is preserved in health Also they may be called Doubtful and Neuters for that rightly and fitly used they keep the body healthful but inconsideratly they cause diseases Whereby it comes to pass that they may be thought to pertain to that part of Physick which is of preserving health not because some of these things should be absolutely and of their own nature wholsom and others unwholsom but only by this that they are or prove so by their convenient or preposterous use Therefore we consider the use of such like things from four conditions Quantity Quality Occasion and Manner of using If thou shalt observe these thou shalt attain and effect this Galen 1. ad Glauconem That those things which of themselves are as it were doubtful shall bring certain and undoubted health For these four Circumstances do so far extend that in them as in the perfection of Art the Rules which may be prescribed to preserve health are contained But Galen in another place hath in four words comprehended these things Not-natural as things Taken Applyed Expelled and to be Done Things Taken are those which are put into the body either by the mouth or any other way Lib. de Sanitat tuenda as the air meat and drink Things applyed are those which must touch the body as the Air now mentioned affecting the body with a diverse touch of its qualities of heat cold moisture or driness Expelled are what things soever being unprofitable are generated in the body and require to be expelled To be Done are labour rest sleep watching and the like We may more distinctly and by expression of proper Names revoke all these things to six Which are Air. Meat and Drink Labour and Rest Sleep and Watching Repletion and Inanition or things to be expelled or retained and kept Perturbations of the Mind CHAP. XIII Of the Air. AIR is so necessary to life that we cannot live a moment without it if so be that breathing How necessary for Life the Air is and much more transpiration be not to be separated from life Wherefore it much conduceth to know what Air is wholsom what unwholsom and which by contrariety of qualities fights for the Patient against the disease or on the contrary by a similitude of qualities shall nourish the disease that if it may seem to burden the Patient by increasing or adding to the disease we may correct it by Art So in curing the wounds of the head especially in winter we labour by all the means we may to make the air warm For cold is hurtful to the Brain Bones and the wounds of these parts and heat is comfortable and friendly But also the Air being drawn into the body by breathing when it is hotter than ordinary doth with a new warmth over-heat the heart lungs and spirits and weaken the strength by the dissipation of the Spirits too much attenuated so being too cold in like manner the strength of the faculties faints and grows dull either by suppression of the vapors or by the inspissation or thickning of the Spirits Therefore to conclude That Air is to be esteemed healthful which is clear subtil and pure What Air is hurtful free and open on every side and which is far remote from all carion-like smels of dead carkases or the stench of any putrefying thing whatsoever the which is far distant from standing pools and fens and caves sending forth strong and ill vapors neither too cloudy nor moist by the nearness of some river Such an Air I say if it have a vernal temper is good against all diseases That Air which is contrary to this is altogether unhealthful as that which is putrid shut up and prest by the straitness of neighbouring Mountains infected with some noisom vapor And because I cannot prosecute all the conditions of Airs fit for the expelling of all diseases as which are almost infinite it shall suffice here to have set down what we must understand by this word Air. Three things are understood by the name of the Air. Physitians commonly use to understand three things by the name of Air The present state of the Air the Region in which we live and the season of the Year We spoke of this last when we treated of Temperaments Wherefore we will now speak of the two former
defluxion or falling down of humors into the part Or these evacuations are performed by much matter evacuated from an opened Bile or running Ulcer a Fistula or such like sores Or by sweats which are very good and healthful especially in sharp diseases if they proceed from the whole body and happen on the critical days By vomit The force of vomits which often violently draws these humors from the whole body even from the utmost joynts which purging medicines could not evacuate as we may see in the Palsie and Sciatica or Hip-gout By spitting as in all who are suppurated either in the sides or lungs By Salivation Salivation or a Phlegmatick flux by the mouth as in those who are troubled with the French-pox By sneezing and blowing the nose for by these the brain opprest with moisture disburdeneth its self whether it be done without or with the help of sternutatories and errhines wherefore children and such as have somewhat moist brains purge themselves often this way By hicket and belching The whole body is also purged by urine for by these the windiness contained in the stomach is often expelled By urine for by this not only Feavers but which is more to be admired the French-pox hath often been terminated and cured For there have been some troubled with the Pox in whom a flux of the vicious and venenate humor could not by Unctions of quicksilver be procured either from the mouth or belly yet have been wounderfully freed bv abundance of Urine both from danger of death and their disease By bleeding for nature hath often found a way for grievous diseases especially in young bodies by bleeding at the nose and by their courses in women By a flux or lask purgation sweats insensible evacuation and transpiration for so tumors the matter being brought to suppuration do sometimes vanish away and are dissolved both of their own accord as also by dissolving or discussing medicines We do the same by exercise diet hot-houses long sleep waking and shedding of tears By sucking as with Cupping-glasses and Hors-leeches in wounds made by venemous bitings We must observe three things in every evacuation In all such kinds of evacuations we must consider three things the quantity quality and manner of evacuation As for an example When an Empyema is opened the matter which runs out ought to be answerable in proportion to the purulent matter which was contained in the capacity of the breasts otherwise unless all the matter be emptyed there may happen a relapse the matter should be white soft equal and nothing stinking Lastly you must let it forth not all together and at one time but by little and little and at several times otherwise not a little quantity of the Spirits and heat doth flow out together with the unprofitable matter and so consequently a dissolution of all the powers CHAP. XVIII Of the Perturbations or Passions of the Mind Why the Passions of the mind are called Accidents Their force THe Perturbations are commonly called the Accidents of the Mind because as bodily accidents from the body so may these be present and absent from the Mind without the corruption of the subject The knowledg of these must not be lightly passed over by the Chirurgeon for they stir up great troubles in the bodies and yield occasion of many and great diseases of which things joy hope and love may give an apparent testimony For by these motions the heat and spirits are sometimes gently sometimes violently diffused over all the body for the enjoying of the present or hoped for good For then the heart is dilated as to embrace the thing beloved and the face is dyed with a rosie and lively colour For it is likely that the faculty it self is stirred by the object by whose power the Heart it self is moved From whence they have their force For it is first necessary before we be moved by any Passions that the senses in their proper seats in which they are seldom deceived apprehend the objects and straight as messengers carry them to the common sense which sends their conceived forms to all the faculties And then that each faculty as a Judge may afresh examin the whole matter how it is and conceive in the presented objects some shew of good or ill to be desired or shunned For What man that was well in his wits did ever fall into laughter unless he formerly knew or saw somewhat said or done The reason of Joy which might yield occasion of laughter Therefore Joy proceeds from the heart for the thing causing mirth or joy being conceived the faculty moves the heart which shaken and moved by the faculty which hath dominion over it is dilated and opened as ready to embrace the exhilarating object But in the mean time by the force of that dilatation it sends forth much heat and spirits together with the bloud into all the body A great part of which comming to the face dilates it the fore-head is smooth and plain the eyes look bright the cheeks become red as died with Vermilion the lips and mouth are drawn together and made plain and smooth some have their cheeks dented with two little pits which from the effects are called laughing cheeks because of the contraction or curling which the muscle suffer by reason of their fulness of bloud and spirits The effects of Joy all which to be brief is nothing but to laugh Joy recreates and quickens all the faculties stirs up the spirits helps concoction makes the body to be better liking and fattens it the heat bloud and spirits flowing thither and the nourishing dew or moisture watering and refreshing all the members from whence it is that of all the passions of the mind this only is profitable so that it exceed not measure for immoderate and unaccustomed joy carries so violently the bloud and spirits from the heart into the habit of the body that sodain and unlookt for death ensues by a speedy decay of the strength the lasting fountain of the vital humor being exhausted Which thing principally happens to those who are less hearty as women and old men Anger Anger causeth the same effusion of heat in us but far speedier than joy therefore the spirits and humors are so enflamed by it that it often causes putrid Feavers especially if the body abound with any ill humour Sorrow Sorrow or grief dries the body by a way quite contrary to that of Anger because by this the heart is so straitned the heat being almost extinct that the accustomed generation of spirits cannot be performed and if any be generated they cannot freely pass into the members with the bloud wherefore the vital faculty is weakned the lively colour of the face withers and decays and the body wastes away with a lingring Consumption Fear Fear in like sort draws in and calls back the spirits and not by little and little as in sorrow but sodainly and violently
hereupon the face grows sodainly pale the extreme parts cold all the body trembles or shakes the belly in some is loosed the voyce as it were stays in the jaws the heart beats with a violent pulsation because it is almost opprest by the heat strangled by the plenty of blood and spirits aboundantly rushing thither The hair also stands upright because the heat and bloud are retired to the inner parts Hiâ—pach lib. 4. 〈◊〉 Miâ— and the utmost parts are more cold and drie than a stone by reason whereof the utmost skin and the pores in which the roots of the hairs are fastned are drawn together Shame is a certain affection mixed as it were of Anger and Fear therefore Shame if in that conflict of as it were contending passions Fear prevail over Anger the face waxeth pale the blood flying back to the heart and these or these Symptoms rise according to the vehemency of the contracted and abated heat But if on the contrary Anger get the dominion over Fear the blood runs violently to the face the eyes look red and sometimes they even fome at the mouth There is another kind of shame which the Latins call Verecundia we Shamefastness Shamefastness in which there is a certain flux and reflux of the heat and blood first recoiling to the heart then presently rebounding from thence again But that motion is so gentle that the heart thereby suffers no oppression nor defect of spirits wherefore no accidents worthy to be spoken of arise from hence this affect is familiar to young maids and boys who if they blush for a fault committed unawares or through carelesness it is thought an argument of a vertuous and good disposition But an agony which is a mixt passion of a strong fear and vehement anger An agony involves the heart in the danger of both motions wherefore by this passion the vital faculty is brought into very great danger To these six Passions of the mind all other may be revoked as Hatred and Discord to Anger Mirth and Boasting to Joy Terrors Frights and Swoundings to Fear Envy Despair and Mourning to Sorrow By these it is evident how much the Passions of the mind can prevail to alter and overthrow the state of the body and that by no other means than that by the compression and dilatation of the heart they diffuse and contract the spirits blood and heat from whence happens the dissipation or oppression of the spirits The signs of these Symptoms quickly shew themselves in the face the heart Why the first signs of passions of the mind appear in the face by reason of the thinness of the skin in that part as it were painting forth the notes of its affections And certainly the face is a part so fit to disclose all the affections of the inward parts that by it you may manifestly know an old man from a young a woman from a man a temperate person from an untemperate an Ethiopian from an Indian a Frenchman from a Spaniard a sad man from a merry a sound from a sick a living from a dead Wherefore many affirm that the manners and those things which we keep secret and hid in our hearts may be understood by the face and countenance Now we have declared what commodity and discommodity may redound to the man from these fore-mentioned passions and have shewed that anger is profitable to none The use of passions of the mind unless by chance to some dull by reason of idleness or opprest with some cold clammy and phlegmatick humor and Fear convenient for none unless peradventure for such as are brought into manifest and extream danger of their life by some extraordinary sweat immoderate bleeding or the like unbrideled evacuatâ—on Wherefore it behoves a wise Chirurgeon to have a care lest he inconsiderately put any Patient committed to his charge into any of these passions unless there be some necessity thereof by reason of any of the fore-mentioned occasions CHAP. XIX Of things against Nature and first of the Cause of a Disease HAving intreated of things natural and not-natural What things against nature are What and how many the causes of diseases be The Primitive cause Internal antecedent now it remains we speak of things which are called against nature because they are such as are apt to weaken and corrupt the state of our body And they be three in number The Cause of a Disease a Disease and a Symptome The cause of a disease is an affect against nature which causes the disease Which is divided into Internal and External The External Original or Primitive comes from some other place and outwardly into the body such be meats of ill nourishment and such weapons as hostilely wound the body The Internal have their essence and seat in the body and are subdivided into antecedent and conjunct That is called an antecedent cause which as yet doth not actually make a disease but goes near to cause one so humors copiously flowing or ready to flow into any part are the antecedent cause of diseases The conjunct is that which actually causes the disease Internal conjunct and is so immediately joyned in affinity to the disease that the disease being present it is present and being absent it is absent Again of all such causes some are born together with us as the over-great quantity and malign quality of both the seeds and the menstruous blood from diseased Parents are causes of many diseases and specially of those which are called Hereditary Other happen to us after we be born by our diet and manner of life a stroke fall or such other like Those which be bred with us cannot be wholly avoided or amended but some of the other may be avoided as a stroke and fall some not as those which necessarily enter into our body as Air Meat Drink and the like But if any will reckon up amongst the internal inherent and inevitable causes the dayly The congenit or inevitable cause of death nay hourly dissipation of radical moisture which the natural heat continually preys upon I do not gainsay it no more than that division of Causes celebrated and received of Philosophers divided into Material Formal Efficient and Final for such a curious contemplation belongs not to a Chirurgeon whom I only intend plainly to instruct Wherefore that we have written may suffice him CHAP. XX. Of a Disease What a disease is and how various A Distemperature A Disease is an affect against Nature principally and by it self hurting and depraving the action of the part in which it resides The division of a Disease is threefold Distemperature ill Conformation and the Solution of Continuity Distemperature is a Disease of the similar parts dissenting and changed from their proper and native temper That digression from the native temper happens two ways either by a simple distemperature from the excess of one quality and this is fourfold Hot Cold Moist
the meanest of the common people is not ignorant that the solution of continuity is to be cured by repairing that which is lost But in what parts we may hope for restitution of the lost substance and in which not is the part of a skilful Chirurgeon to know and pronounce Wherefore he will not vainly bestow his labour to cure the nervous part of the Diaphragma or Midriffe being wounded or the Heart or small Guts Lungs Liver Stomach Brain or Bladder and that I may speak in a word Empericks are not much more skilful than the common people although they do so much extol themselves above others by the name of Experience For although experience be another instrument to find out things with reason Experience without reason is like a blind man without a guide yet without reason it will never teach what the substance of the part in which the disease lies may be or what the action use site connexion from whence special and proper Indications are drawn With which the Chirurgeon being provided and instructed shall not only know by what means to find out a remedy but also lest he may seem to mock any with vain promises he shall discern what diseases are uncurable and therefore not to be medled withal Indications in implicit diseases But implicit or intricate diseases require each to be cured in their several order except some one of them be desperate or so urge and press that the Physitian think it necessary after a preposterous order to begin with it although often he be forced to make some one of these diseases incurable or give occasion of causing some new one into which straits we are necessarily compelled to fall when for example we determine to pull or take away some extraneous body for the performance whereof we are compelled to inlarge the wound So we are forced by necessary to open the neck of the bladder that so we may draw forth the stone therein contained with a wound which oâ—ten degenerates into an uncurable Fistula For that disease which threatens danger of present death is of such moment that to shun that it may be counted a small matter and commodious for the sick to bring in other diseases though uncurable For if a convulsion happen by pricking a Nerve which we cannot heal by any remedies then by cutting the Nerve asunder we end the convulsion but deprive the part into which that Nerve did go of the use of some voluntary motion So if in any great joynt there happen a Luxation with a wound because there is danger of convulsion by trying to restore and set right the luxated part we are forc'd for shunning thereof to attend the wound only and in the mean time to let alone the Luxation Otherwise in implicit diseases if there be nothing which may urge or call us from the ordinary cure we must observe this order that beginning with that affect which hinders the cure of the principal disease we prosecute the rest in the same their proper order until all the diseases being overcome we shall restore the part affected to its integrity An example of Indications in implicit diseases Therefore let us take for an example an ulcer in the Leg a Varix or big-swollen vein and a Phlegmonous tumor round about it and lastly a body wholly plethorick and filled with ill humors order and reason require this that using the advice of some learned Physitian we prescribe a convenient dyet and by what means we may bring him to an equality by purging and blood-letting and then we will scarifie in divers places the part where it is most swollen then presently apply Leeches that so we may free it from the burden of the conjunct matter then use Cauteries to help the corruption of the bone and in the mean time change the circular figure of the ulcer into an oval or triangular then at the length we will undertake the cutting of the Varix and cure the ulcer which remains according to Art and so at the length cicatrize it In all this whole time the Patient shall neither walk nor stand nor sit What we must do when the temper of the part is different from the temper of the whole body but ly quietly having his Leg orderly and decently rowled up But if as it often happens the temper of the hurt part be different from the temper of the whole body the manner of curing must be so tempered that we increase the doâ—â—s of hot or cold medicines according to the ratable proportion of the indications requiring this or that therefore imagine the part ulcerated to be such as that it is two degrees dryer than the just temper but the whole body to exceed the same temper in one degree of humidity Reason and Art will require that the medicine applyed to the ulcer be dryer by one degree than that which the part would otherwise require if it were temperate But on the contrary let us suppose thus the whole body to be one degree more moist then the temper requires and the ulcerated part to be one degree dryer An artificial conjecture is of much force in Indications truly in this case the medicine that is applyed to the ulcer by reason of the part it self shall not be increased in dryness but wholly composed and tempered to the Indication of the ulcer because the force of the moisture exceeding in the like degree doth counterpoise the superfluous degree of dryness But it is more easie by an artificial conjecture to determine of all such things than by any rules or precepts To these so many and various Indications I think good to add two other the one from similitude the other of a certain crafty devise and as the latter Physitians term it a certain subtile stratagem We draw Indication from similitude in diseases which newly spring up and arise Indications from similitude as which cannot be cured by Indications drawn from their contraries as long as their Essence is unknown and hid wherefore they think it necessary to cure them by a way and Art like those diseases with which they seem to have an agreeing similitude of Symptomes and Accidents Our Ancestors did the same in curing the French-Pocks at the first beginning thereof as long as they assimilated the cure to that of the Leprosie by reason of that affinity which both the diseases seem to have But we follow crafty devices and subtile counsels Indication of a subtile device when the Essence of the disease we meet with is wholly secret and hid either because it is altogether of a hidden and secret nature and which cannot be unfolded by manifest qualities or else resides in a subject which is not sufficiently known to us nor of a physical contemplation as the Mind For then we being destitute of Indications taken from the nature of the thing are compelled to turn our cogitations to impostures and crafty counsels and they say this
or magnitude figure composition number connexion by which name we also understand the original and insertion temperature action and use that by the consideration of these things every one may exercise the art of Physick in preserving health curing diseases or foreseeing their events and ends But also we must note that of the organical parts there be three Why the three principal parts are so called by whose power the body is governed which for that cause they call regent and principal because they govern all the rest they are the liver heart and brain But they are called principal not only because they are necessary for life for the stomach wind-pipe lungs reins bladder and such like parts perhaps are equally as necessary for life but because from each of these three some force power and faculty or also matter necessary for the whole body flow over all the body when no such thing proceeds from the rest of the parts For from the Liver a matter fit for nourishment is distributed by the veins through all the body from the heart the vital force diffused by the arteries imparts life to the whole body from the brain by the nerves a power or faculty is carried through all the parts of the body which gives them sense and motion Galen would have the Testicles to be of this kind not for the necessity of the individual Lib. de arte medica or peculiar body but for the preservation of the Species or kind And moreover in his Book de Semine comparing the Testicles with the Heart he makes them the more noble by this reason that by how much it is better to live well and happily than simply and absolutely to live by so much the Testicles are more excellent than the heart because with them we may live well and pleasantly but with this simply live as we see by the Example of Eunuchs and such as are gelt by which the Testicles seem rightly to be accounted amongst the principal parts for nature seeing it desired that this its work should be immortal for the attaining of that immortality which it intends frames those parts like as prudent founders of a City who do not only procure to furnish their City with many Inhabitants so long as they are in building it but also that it may remain in the same state and condition for ever or at least for many ages The use and function of the parts serving for generation And yet notwithstanding of so many Cities built in the first memory of man there remains none whose fame and state together with the Builder's name is not decayed and perished But this humane work of nature stands yet secure for this many thousand of years and shall endure hereafter because it hath found a way by which every one may substitute another in his place before he depart Hence it is that all creatures have members fit for generation and pleasures inserted in those members by which they might be enticed to mutual embraces and copulations But the mind which hath dominion over those members hath an incredible desire of propagating the issue by which also brute Beasts incited desire to propagate their kinds for ever For seeing that nature understands all these her works considered particularly by themselves are frail and mortal it hath done what it could to recompence that fatal necessity of dying by a perpetual succession of Individuals Hitherto we may seem to have abundantly shewed what necessity of knowledge in Anatomy belongs to all Artizans in Physick and also what order is to be observed in the same and lastly how it is defined and the reason of the parts of the definition Wherefore it remains that we prosecute what we have taken in hand which is that we shew and declare how to know all and every the parts of man's body how many and what they be and to understand wherefore they be For although the true knowledge of Anatomy may be perfected by the sight of the eye and touching and handling each part with the hand yet nevertheless the labour of describing Anatomy is not unprofitable For by reading such as have often exercised themselves in the dissecting of mens bodies may refresh and help their memories and such as have not may make plain and easie the way to the understanding of Dissections CHAP. I. The Division or partition of Man's Body BY reason the partition of Man's body can hardly be understood if the distinction of the proper faculties of the soul be not understood for whose cause the body enjoys that form which we see and division into divers Instruments Therefore I thought good in few words to touch that distinction of the faculties of the soul for the better understanding of the partition of the body What the Soul is and with how many faculties it is endued which we intend Wherefore the soul the perfection of the body and beginning of all its functions is commonly distinguished and that in the first and general division into three faculties which are the Animal Vital and Natural But the Animal is divided into the principal sensitive and motive Again the Principal is distinguished into the imaginative reasonable and memorative And the Sensitive into seeing hearing smelling tasting and touching But the Motive into progressive and apprehensive And the Vital is divided into the dilative and contractive faculty of the heart and arteries which we know or understand by the pulsifick faculty But the Natural is parted into the nutritive auctive and generative faculties which three perform their parts by the help and ministry of five other faculties which are the attractive retentive concoctive assimilative and expulsive All the parts of mans body are distinguished into three After the self-same manner the organ or instrument of the soul to wit Man's body at the first division is distinguished into three parts which from their office they call Animal Vital and Natural These again according to the subdivision of the subalternal faculties are divided particularly into other parts so that any one may know the organ of each faculty by the property of the function For while other Anatomists divide Man's body into four universal and chief parts they distinguish from the three first those which they call the Extremities neither do they teach to what rank of the three prime parts each Extremity should be reduced From whence many difficulties happen in reading the writing of Anatomists for shunning whereof we will prosecute as we have said that distinction of man's body which we have touched before What parts are here called Animal Wherefore as we said before man's body is divided into three principal and general parts Animal Vital and Natural By the Animal parts we understand not only the parts pertaining to the head which are bounded with the crown of the head the coller-bones and the first Vertelra of the breast but also the extremities because they are organs and instruments of the
motive-faculty Lib. 6. Epidem Hippocrates seems to have confirmed the same where he writes Those who have a thick and great head have also great bones nerves and limbs And in another place he saith those who have great heads and when they stoop shew a long neck such have all their parts large but chiefly the Animal Not for that Hippocrates would therefore have the head the beginning and cause of the magnitude and greatness of the bones and the rest of the members but that he might shew the equality and private care or government of Nature being most just and exact in the fabrick of man's body as if she hath well framed the head it should not be unlike that she idly or carelesly neglected the other parts which are less seen I thought good to dilate this passage lest any might abuse that authority of Hippocrates and gather from thence that not only the bones membranes ligaments grisles and all the other animal parts but also the veins and arteries depend on the head as the original But if any observe this our distinction of the parts of the body he will understand we have a far other meaning What parts are called Vital By the Vital parts we understand only the heart arteries lungs wind-pipe and other particles annexed to these But by the Natural we would have all those parts understood which are contained in the whole compass of the Peritonaeum or Rim of the body and the processes of the Erythroides the second coat of the Testicles For as much as belongs to all the other parts which we call Containing they must be reckoned in the number of the Animal which notwithstanding we must thus divide into principal sensitive and motive and again each of these in the manner following The division of the animal parts For first the principal is divided into the Imaginative which is the first and upper part of the brain with its two ventricles and other annexed particles into the Reasoning which is a part of the brain lying under the former and as it were the top thereof with its third ventricle into the Memorative which is the cerebellum or after-brain with a ventricle hollowed in its substance Secondly the Sensitive is parted into the visive which is in the eyes the auditive in the ears the smelling in the nose the tasting in the tongue and palat the tactive or touching which is in the body but most exquisite in the skin which invests the palms of the hands Thirdly the motive is divided into the progressive which intimates the legs and the comprehensive which intimates the hands Lastly into simply-motive which are three parts called bellies The division of the vital parts for the greatest part terminating and containing for the vital the instrument of the faculty of the heart and dilatation of the arteries are the direct or streight fibers but of the constrictive the transverse but the three kinds of fibers together of the pulsifick or if you please you may divide them into parts serving for respiration as are the lungs and weazon and parts serving for vital motion as are the heart and arteries furnished with these fibers which we formerly mentioned The division of the natural parts The division of the natural parts remains which is into the nourishing auctive and generative which again are distributed into attractive universal and particular retentive concoctive distributive assimilative and expulsive The attractive as the gullet and upper orifice of the ventricle the retentive as the Pylorus or lower passage of the stomach the concoctive as the body of the ventricle or its inner coat the distributive as the three small guts the expulsive as the three great guts we may say the same of the liver for that draws by the mesaraick and gate-veins retains by the narrow orifices of the veins dispersed through the substance thereof it concocts by its proper flesh distributes by the hollow vein expels by the spleen bladder of the gall and kidnies We also see the parts in the Testicles divided into as many functions for they draw by the preparing vessels retain by the various crooked passages in the same vessels they concoct the seed by the power of their proper substance and faculty they distribute by the ejaculatory at the glandules called Prostatae and the horns of the womb supplying the place of prostates Lastly they expel or cast forth by the prostates horns and adjoyning parts For as much as belongs to the particular attraction retention concoction distribution assimilation of each part that depends of the particular temper and as they term it occult property of each similar and simple part Neither do these particular actions differ from the universal but that the general are performed by the assistance of the three sorts of fibers but the special by the several occult property of their flesh arising from their temperature which we may call a specifick property Now in the composition of mans body nature principally aims at three things The first is to create parts necessary for life as are the heart brain and liver The second to bring forth other for the better and more commodious living as the eyes nose ears arms and hands The third is for the propagation and renewing the species or kind as the privy parts testicles and womb And this is my opinion of the true distinction of mans body furnished with so many parts for the performance of so many faculties which you if you please may approve of and follow If not you may follow the common and vulgar which is into three bellies or capacities the upper middle lower that is the head breast The vulgar division of mans body and lower belly and the limbs or joints In which by the head we do not understand all the Animal parts but only those which are from the crown of the head to the first vertebra of the neck or to the first of the back if according to the opinion of Galen Lib. de ossibus where he makes mention of Enarthrosis and Arthrodia we reckon the neck amongst the parts of the head By the breast whatsoever is contained from the coller bones to the ends of the true and bastard or short ribs and the midriff By the lower belly the rest of the trunk of the body from the ends of the ribs to the share-bones by the limbs we understand the arms and legs We will follow this division in this our Anatomical Discourse because we cannot follow the former in dissecting the parts of mans body by reason the Animal parts are mutually mixed with the vital and natural and first of the lower belly Nature would not have this lower belly bony Why the belly is not bony because the ventricle might be more easily dilated by meat and drink children might grow the better and the body be more flexible It is convenient we begin our Anatomical Administration from this because it is more subject to
that the head of a Muscle is one while above another while below otherwhiles in the midst as in the Midriff as you may know by the insertion of the Nerve because it enters the muscle by its head From their Belly From their belly also there be some differences of muscles taken for some have their belly immediately at their beginning as the muscles of the buttocks others at their insertion as the Midriff others just at their head as those which put forth the Calf of the leg in others it is somewhat further off as in those which draw back the arm and which bend the leg in others the belly extends even from the head unto the tail as in the intercostal muscles and those of the wrist in others it is produced even to their insertion as in those of the palms of the hands and soles of the feet some have a double belly distinguished by a nervous substance as those which open the mouth and those which arise from the root of the lower process of the shoulder-blade From their Tendons Moreover the differences of muscles are drawn also from the Tendons for some have none at least which are manifest as the muscles of the lips and the sphincter-muscles the intercostal and those of the wrist others have them in part and want them in part as the Midriff for the Midriff wants a Tendon at the ends of the shorter ribs but hath two at the first Vertelra of the Loins in which it is terminated Others have a Tendon indeed But some of these move with the bone some not as the muscle of the eyes and besides some of these have broad and membranous tendons as the muscles of the eyes and Epigastrium except the right muscles In others they are thick and round as in the benders of the fingers in others they are less round but more broad than thick such is the Tendon arising from the twin muscles and Soleus of the leg others have short Tendons as the muscles which turn down the hand othersome long as those of the palms of the hands and soles of the feet besides others produce Tendons from the end of their belly which Tendons are manifest others from the midst as the Temporal Muscles Besides also others diffuse many Tendons from their belly as in the hands the benders of the fingers and extenders of the feet Othersome put forth but one which sometimes is divided into many as those which bend the third articulation of the foot otherwhile many muscles by their meeting together make one Tendon as the three muscles of the Calf of the leg and those which bend the cubit and leg All Tendons have their original when the nerves and ligaments dispersed through the fleshy substance of a muscle are by little and little drawn and meet together until at last carried to the joint they are there fastned for the fit bending and extension thereof From the contrariety of their Actions for some parts have contrary muscles benders and extenders From their action From their function other parts have none for the Cods and Fundament have only lifters up From their function for some are made for direct motions as those which extend the fingers and toes others for oblique as the Supinators of the hand and the Pronators others perform both as the pectoral muscle which moves the Arm obliquely upward and downward as the upper and lowers fibers are contracted and also outright if all the fibers be contracted together which also happens to the Deltoides and Trapezius I have thought it good to handle particularly these differences of muscles because that by understanding them the prognostick will be more certain and also the application of remedies to each part and if any occasion be either to make incision or future we may be more certain whether the part affected be more or less nervous CHAP. IX Of the parts of a Muscle HAving declared the nature and differences of a Muscle we must note that some of the parts thereof are compound and universal others simple or particular The compound and simple parts of a Muscle The compound are the head belly and tail The simple are ligaments a nerve flesh a vein artery and coat For the compound parts by the head we understand the beginning and original of a muscle which is one while ligamentous and nervous otherwhiles also fleshy By the belly that portion which is absolutely fleshy But by the tail we understand a Tendon consisting partly of a nerve partly of a ligament promiscuously coming forth from the belly of the Muscle For as much as belongs to the simple which are six in number three are called proper and three common The proper are a Ligament from a bone a nerve proceeding from the Brain or spinal marrow and flesh compact by the concretion of blood The common are a vein from the Liver or trunk arising from thence an artery proceeding from the Heart What use each simple particle hath in a muscle a Coat produced by the nervous and ligamentous fibers spreading over the superficies of the muscle But for the simple use of all such parts the nerve is as it were the principal part of a Muscle which gives it sense and motion the ligament gives strength the flesh contains the nervous and ligamentous fibers of the Muscle and strengthens it filling up all the void spaces and also it preserves the native humidity of these parts and cherisheth the heat implanted in them and to conclude defends it from all external injuries for like a fan it opposeth it self against the heat of the Sun and is a garment against the cold and is as a cushion in all falls and bruises and as a buckler of defence against wounding-weapons The vein nourishes the muscle the artery gives it life the coat preserves the harmony of all the parts thereof lest they should be any ways disjoined or corrupted by purulent abscesses breaking into the empty or void spaces of the Muscles as we see it hapneth in a Gangrene where the corruption hath invaded this membrane by the breathing out of the more acid matter or filth CHAP. X. A more particular inquisition into each part of a Muscle HAving gone thus far it remains that we more particularly inquire into each part of a Muscle that if it be possible nothing may be wanting to this discourse The nature of a Ligament Wherefore a Ligament properly so called is a simple part of mans body next of a bone and grislle the most terrestrial dry hard cold white taking its original immediatly or by the interposition of some Medium from the Bones or Grisles from whence also the Muscles have their beginning whereby it comes to pass that a ligament is void of sense unless it receive a nerve from some other place for so the ligaments which compose and strengthen the tongue and yard are partakers of sense and it inserts it self into the bone and grisle that
so it may bind them together and strengthen and beautifie the whole joint or connexion for these three be the principal uses of a ligament then diffusing it self into the membranes and muscles to strengthen those parts The treefold use of a Ligament What a Nerve is A Nâ—rve to speak properly is also a simple part of our body bred and nourished by a gross and pâ—legmatick humour such as the brain the original of all the nerves and also the Spinal marrow endued with the faculty of feeling and oftentimes also of moving For there be divers parts of the body which have nerves yet are destitute of all voluntary motion having the sense only of â—eeling as the membranes veins arteries guts and all the entrails A nerve is covered with a double cover from the two membranes of the brain and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebra's or else from the Pericranium What we mean by the nervous and ligamentous fibers We understand no other things by the fibers of a Nerve or of a Ligament than long and slender threds white solid cold strong more or less according to the quantity of the substance which is partly nervous and sensible partly ligamentous and insensible You must imagine the same of the fleshy fibers in their kind but of these threds some are streight for attraction others oblique for retention of that which is convenient for the creature and lastly some transverse for expulsion of that which is unprofitable But when these transverse threds are extended in length they are lessened in bredth but when they are directly contracted they are shortned in length But when they are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it self as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animal parts to perform voluntary motions others upon the vital to perform the agitation of the heart and arteries others upon the natural for attraction By what power the similar parts principally draw or attract What and of how many sorts the flesh is retention and expulsion Yet we must observe that the attraction of no similar part is performed by the help of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of emptiness or the familiarity of the substance The flesh also is a simple and soft part composed of the pure portion of the blood insinuating it self into the spaces between the fibers so to invest them for the uses formerly mentioned This is as it were a certain wall and bulwark against the injuries of heat and cold against all falls and bruises as it were a certain soft pillow or cushion yielding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kind is more pallid even in perfect creatures having blood such is the flesh of the heart stomach weason guts bladder womb The third is belonging to the entrails or the proper substance of each entrail as that which remains of the Liver the veins arteries and coat being taken away of the bladder of the gall brains kidnies milt Some add a fourth sort of flesh which is spongy that they say is proper to the tongue alone What a vein is A Vein is the vessel pipe or channel of the blood or bloody matter it hath a spermatick substance consists of one coat composed of three sorts of fibers What an Artery is An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermatick substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thick and dense than the utmost interwoven with transverse fibers and it doth not only contain blood and spirit but also a serous humour which we may believe because there be two emulgent Arteries as well as Veins Why an artery is more thick and dense than a vein But the inner coat of an Artery is therefore more thick because it may contain blood which is more hot subtil and spirituous for the spirit seeing it is naturully more thin and light and in perpetual motion would quickly fly away unless it were held in a stronger hold There is other reason for a Vein as that which contains blood gross ponderous and slow of motion Wherefore if it had acquired a dense and gross coat it could scarce be distributed to the neighbouring parts The mutual Anastomasis of the veins and arteries Where it is manifest God the maker of the Universe foreseeing this made the coats of the vessels contrary to the consistence of the bodies contained in them The Anastomasis of the Veins and Arteries that is to say the application of the mouths of the one to the other is very remarkable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that Anastomasis is apparent in the Vein and Artery that meet together at the joint and bending of the arm which I have sometimes shewed in the Physick schools at such time as I there dissected Anatomies From whence a muscle hath its beginning or head But the action or function of a Muscle is either to move or confirm the part according to our will into which it is implanted which it doth when it draws it self toward its original that is to say its head But we define the head by the insertion of the nerve which we understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower Belly NOw seeing that we have taught what a Muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remains that we come to the particular explication of each Muscle beginning with those of the lower belly as those which we first meet withal in dissection Eight muscles of the Epigastrium These are eight in number four oblique two on each side two right or direct one on the right another on the left side and in like manner two transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may add to this number the two little Supplying or Assisting muscles which are of a Pyramidal form The oblique
dispersed through the Liver betwixt the roots of the hollow and Gate-veins R. the root of the Gate-vein in the Liver S. the root of the hollow-vein in the Liver a. The concourse or meeting of the passages of choler into one branch b. The neck of the bladder into which the passage is inserted c. The passage of the Gall into the Duodenum d. the Duodenum opened to manifest the insertion of the porus biliaris i. e. an artery going to the hollow part of the Liver and the bladder of the Gall. f. a small nerve belonging to the liver and the bladder of gall from the rib branch of the sixth pair gg the cistick twins from the gate-veins CHAP. XIX Of the Spleen or Milt BUt because we cannot well shew the distribution of the gate-vein unless the Spleen be first taken away and removed from its seat therefore before we go any futher The Substance I have thought good to treat of the Spleen Therefore the Spleen is of a soft rare and spongious substance whereby it might more easily receive and drink up the dregs of the blood from the liver and of a flesh more black than the liver For it resembles the colour of its muddy blood Magnitude Figure from which it is generated It is of an indifferent greatness but bigger in some than in othersome according to the diverse temper and complexion of men It hath as it were Composition a triangular figure gibbous on that part it sticks to the ribs and midriffe but hollow on that part next the stomach It is composed of a coat the proper flesh a vein artery and nerve The membrane comes from the Peritonaeum the proper flesh from the faeces or dregs of bloud or rather of the natural melancholy humor with which it is nourished The fourth branch of the vena porta or gate-vein lends it a vein the first branch of the great descendent artery presently after the first entrance without the Midriff lends it an artery But it receives a nerve from the left costal from the sixt conjugation on the inner part by the roots of the ribs and we may manifestly see this Nerve Number and Site not only dispersing it self through the coat of the liver but also penetrating with its Vessels the proper flesh thereof after the self same manner as we see it is in the heart and lungs It is one in number situate on the left side between the stomach and the bastard-ribs or rather the midriffe which descends to their roots For it oft-times cleaves to the midriff on its gibbous part by a coat from the Peritonaeum as also on the hollow part to the stomach both by certain veins which sends it into the ventricle as also by the kall It hath connexion either primarily or secundarily Connexion with all the parts of the body by these its vessels It is of a cold and dry temper the action and use of it is to separate the Melancholick humor Temper and use which being feculent and drossie may be attenuated by the force of many arteries dispersed through its substance For by their continual motion and native heat which they carry in full force with them from the heart that gross blood puts off its grosness which the Spleen sends away by passages fit for that purpose retaining the subtler portion for its nourishment The passages by which it purges it self from the grosness of the melancholy bloud are a vein ascending from it into the stomach to stir up the appetite by its sourness and strengthen the substance thereof by its astriction also another vein which sometimes from the Spleen-branch sometimes from the gate-vein plainly under its orifice descends to the fundament there to make the Haemorrhoidal veins CHAP. XX. Of the Vena Porta and Gate-vein and the distribution thereof THe Gate-vein as also all the other veins is of a spermatick substance The substance and figure of a manifest largeness of a round and hollow figure like to a pipe or quill It is composed of its proper coat and one common from the Peritonaeum It is only one Composition Number and Site and that situate in the simous or hollow part of the Liver from whence it breaks forth or rather out of the umbilical vein into the midst of all the guts with which it hath connexion as also with the stomach spleen sphincter of the fundament and Peritonaeum by the coat which it receives from thence Temper and Action It is of a cold and dry temper The Action of it is to suck the Chylus out of the ventricle and guts and so to take and carry it to the Liver until it may carry back the same turned into bloud for the nutriment of the stomach spleen and guts This gate-vein coming out of the simous part of the Liver is divided into six branches that is four simple and two compound again divided into many other branches Division thereof into 6 branches of which 4 simple 1. Clysticae gemellae 2. Gastrica 3. Gastrepiplois 4. Intestinalis The first of the simple ascends from the fore-part of the trunk of the bladder of the Gall by the passage of the Choler and are marked with g g with a like artery for life and nourishment and this distribution is known by the name of Cysticae gemellae or Cystick twins The second called the Gastrica or stomach vein arising in like manner from the forepart of the trunk is carryed to the Pylorus and the simous or back-part of the stomach next to it The third is called Gastrepiplois the Stomach and kall-vein which coming from the right side of the gate-vein goes to the gibbous part of the stomach next to the Pylorus the right side of the kal. The fourth going forth from behind and on the right hand of the gate-vein ascends above the root of the Meseraick branch even to the beginning of the gut Jejunum along the gut Duodenum from whence it is called Intestinalis or the Gut-vein And these are the four simple branches Now we will speak of the compound The first is splenick which is divided after the following manner Two compound I. Ramus Splenicus sending forth For in its first beginning and upper part it sends forth the Coronalis or Crown-vein of the stomach which by the back-part of the stomach ascends into the upper and hollow part thereof to which place assoon as it arrives 1. Coronalis it is divided again into two branches the one whereof climbs up even to its higher orifice the other descends down to the lower sending forth by the way other branches to the fore and back parts of the stomach These engird and on every side incompass the body or the ventricle for which cause they are named the crown-veins I have sometimes observed this coming forth of the trunk a little above the orifice of the splenick branch 2. Haemorrhoidalis Interna But
turnings might be perfectly concocted and elaborate and attain to a greater fitness to perform the Animal functions The site and number This wonderful Net situate at the sides of the Apophyses clinoides or productions of the wedg-bone is two-fold that is divided by the pituitary Glandule which is situate between the said Apophyses Clinoides having the wedg-bone lying under them next to the Crassa Meninx being perforated on the right and left side next to which lye bones as rare as a sponge even to the Palat by which the Phlegm is purged by the mouth and nose and there-hence I think that spattle flows which such as have a moist Brain continually spit out of their mouth The Eighth Figure of the Brain A The brain B the Cerebellum or after-brain C a process of the Brain but not that is called Mamillaris DD the marrow of the back as it is yet within the skull E the Mamillary process or instrument of smelling F the optick nerve G the coat of the Eye into which the optick nerve is spread H the nerve that moveth the Eye or the second pair I the third conjugation or the harder and lesser branch of the nerves of the third conjugation brought forward K the fourth conjugation or the greater and thicker nerve of the third pair bending downward L a branch of the nerve marked with I which goeth to the fore-head M another branch of the nerve I reaching to the upper jaw NN a nerve proceeding from the branch I intexed or woven with the coat of the nose O the nerve of the temporal muscle issuing from the branch I. P a nerve contorted of the nerves K and b. Q a nerve proceeding from the branch K to the sockets of the upper teeth R a nerve creeping from the nerve K to the lower Jaw S a surcle of the branch R offered to the lower lip TT other surcles from the branch R attaining to the lower teeth VV a branch of the nerve K diffused into the coat of the tongue XX the fourth pair of sinews which go into the coat of the palat Y the fifth pair of sinews which are the nerves of hearing a the membrane of the ear unto which that fifth nerve goeth bc two small branches of the fifth conjugation uniting themselves with the nerve P. d the eighth conjugation or a nerve of the fifth pair attaining unto the face ee the sixt pair of nerves f a branch from the nerve e reaching to the muscles of the neck g small branches derived unto the throttle or Larinx h the bifurcation of the nerve into two branches iii an inner branch hanging to the rack-bones and strengthening the intercostal nerves and is therefore called intercostalis kk surcles of the utter branch going to the heads of the muscles to the breast-bone and to the coller-bones lm branches of the right nerve l making the right recurrent nerve mn the insertion of the recurrent sinews into the muscles of the larinx op branches of the left-nerve making the left recurrent sinew p. qq branches from the sixth conjugation going to the coat of the lungs r small nerves of the heart and of the purse thereof called the Pericardium as also some approaching to the coats of the lungs s nerves on either side sent to the stomach t the right stomach-nerve going to the left orifice of the stomach uu the left stomach-nerve going to the right orifice of the stomach x a nerve from the branch u passing into the hollowness of the liver y the nerve belonging to the right side of the kell z the nerve belonging to the colick-gut α a nerve creeping to the gut called duodenum and the beginning of the jejunum or empty gut β a nerve implanted in the right side of the bottom of the stomach γ a nerve belonging to the liver and bladder of gall δ a nerve reaching to the right kidney ε a branch reaching the Mesenterium and the guts ζ a branch sprinkled to the right part of the bladder η a branch going through the left part of the kel θ surcles derived to the colick-gut and the kel κ small branches inserted into the Spleen λλ a nerve approaching to the left side of the bottom of the stomach μ a branch belonging to the left side of the Mesentery and the guts ν a branch which attaineth to the left kidney ξ small nerves creeping through the left side of the bladder ο the seven pair of sinews Ï€ a branch derived from the sixt conjugation to the muscles which arise from the process called Styloides Ï a branch of the seventh conjugation which goeth to the muscles of the tongue of the bone hyois and of the throttle or larynx Ï‚ a conjunction or coition of the 6. and 7. pair into one nerve What the Apophyses Clinoides are These Apophyses clinoides are certain productions of the Os basilare or Wedg-bone called the Saddle thereof between which as I said the pituitary glandule lies with part of the Wonderful Net There is a great controversie amongst Anatomists concerning this part for Vesalius denies that it is in man Whether the Rete mirabile differs from the Plexus Choroides Columbus admits it yet he seems to confound it with the Plexus Choroides Truly I have observed it always after the manner as Sylvius alledges against Vesalius It remains that we recite the perforations of the skull because the knowledg of these much conduces to the understanding of the insertions of the veins arteries and nerves CHAP. X. Of the holes of the inner Basis of the Skull IN the first place are reckoned the holes of the bone Ethmoides then those of the Optick-nerves Thirdly of the nerves moving the Eyes Fourthly of that portion of the nerves of the fourth conjugation which go to the temporal muscles Fiftly are reckoned those holes scarce visible situate under the pituitary glandule by which the spittle is evacuated Sixthly that hole which is in the wedg-bone made for the entrance into the internal sleepy Arteries composing the Wonderful Net and then passing into the brain by a great Slit. That perforation which we reckon in the seventh place is commonly double made for the entrance of one of the branches of the internal Jugular-vein The eighth hole is somewhat long of an Oval figure by which part of the third conjugation and all the fourth conjugation passes forth The ninth are the auditory passages The tenth are very small holes and give way to the vein and artery going to the auditory passage above the foramen caecum In the eleventh place are reckoned the perforations which yield passage forth to the sixth pair of nerves to part of the sleepy Arteries and of the internal Jugular In the twelfth those which yield a way out to the seventh conjugation The great hole of the Nowl-bone through which the spinal marrow passes is reckoned the thirteenth The fourteenth is that which most commonly is behind that great Hole by which the
second ascends obliquely from the inner part of the Sternon according to the length of the weazon whence it is called Bronchius to the bottom and sides of the same shield-like gristle that it may open and dilate it with it's wings This muscle is seen from the first original thereof even a great part of the way straitly to cohere with the third muscle of the bone Hyoides therefore under each of the muscles there is a glandulous body spred about the fore upper part of the weazon on that place where it applyes it self to the throttle this body although it resemble a fleshy substance A notable History yet it is a glandule which being pluckt away by a certain Emperick taking upon him to cure the Kingsevil caused a defect of voyce on one side because he pulled away the recurrent nerve lying upon the glandule as it goes to the throttle as Galen reports Lib. de locis affectis The third last arises from the parts of the Vertebra's of the neck lying transversly upon the sides of the gullet ends at the wings and sides at the shield like gristle that it may tye it more straitly to the second gristle But these three are called common muscles because they take their original from some other place than the throttle that so they may be inserted into some part thereof for they are called the proper muscles which arise from the throttle it self which we have said to be six on each side the first of which arising from the forepart of the second gristle makes a circle under the basis of the shield-like gristle whilst ascending obliquely to the basis thereof it is afterwards inserted in a part of it so to strengthen dilate it The second in like manner arising from the second gristle from that place where it adheres to the first it runs obliquely crossing the first to the inner forepart of the gristle Thyroides neer to the basis thereof that it may joyn it to the second The third from the hind-basis of the second gristle ascends directly to the basis of the third gristle Arytenoides that with the second muscle it may open and shut it The fourth ascends from the sides of the second gristle neer the original of the second muscle to the sides of the Arytenoides that with the second muscle it may open and shut it The fift arises from the inner middle of the shield-gristle and ends in the fore-part of the Arytenoides at the insertion of the fourth muscle that so it may press down the said Gristle The sixt and last ascends by the hind-basis of the Arytenoides to the fore-basis of the same Whence the muscles of the Throttle have their nerves to press it down But you must note that all such muscles as arise from below upwards receive branches from the recurrent but especially those who open and shut the gristle Arytenoides But the site temper connexion and use of the throttle may easily be known by that we have said before Although it be a thing very full of difficulty to search out and demonstrate all the conditions of the organical parts by reason of the diversity of their composition Wherefore henceforward concerning the substance temper and other circumstances of such parts as we shall omit you may have recourse to those things which we have written in the Demonstration of the simple and similar parts of which these organical are composed as if any should ask of what temper the Larinx is you shall answer Of a cold dry hot and moist because it consists both of a gristly and fleshy substance He which reckons up all the parts of the mouth The Epiglottis or After-tongue must not omit that gristly and membranous body which arises from the roots of the tongue which that it might be more quick for motion that is whereby it might be more easily erected and depressed for those things which are more soft do continually slide away but those which are too hard cannot be bended it was convenient it should be neither too hard nor too soft that it might be erected whilest we breathe but depressed when we swallow It is a principal instrument of the voyce for it cannot be well articulated unless the way were strait Therefore it straitens that way and the passage of the gristles of the throttle but specially the Arytenoides it is alwayes moist by a certain native and inbred humidity wherefore if it happen to be dryed by a feaver or any other like accident the speech is taken away It is bound on both sides by the common membrane of the mouth to the sides of the Arytenoides even to the back-part thereof that so like a cover it may open and shut the orifice of the throttle that none of the meat and drink in swallowing may fall into the Weazon in such abundance as may hinder the egress and regress of the air Of potable things somewhat alwayes falls upon the Lungs For we must not think that this body doth so closely shut the orifice of the throttle but that some small quantity of moisture alwayes runs down by the inner sides as the walls thereof to moisten the Lungs otherwise Eclegma's should be of no use in the diseases of the Chest And because that this little body is partaker of voluntary motion therefore according to the opinion of some there are four muscles bestowed upon it two which may open it and two that shut it on each side one The opening muscles descend from the root of the bone Hyoides The muscles of the Epiglottis and in their insertion growing into one they are terminated in the root of this body that is the Epiglottis in the back-part thereof The shutting muscles in those creatures where they are found arise on the inside between the coat and gristle thereof Truly I could never observe and find these four muscles in a man though I have diligently and earnestly sought for them but I have alwayes observed them in beasts Therefore some have boldly affirmed that this little body in swallowing lies not upon the orifice of the Throttle unless when it is pressed down by the heaviness of such things as are to be swallowed but that at all other times by reason of the continual breathing it stands upright the Throttle being open There remain as yet to be considered The use of the cavities or fissures of the Throttle two small bosomes or cavities or rather fissures which Nature hath hollowed in the very Throttle under the Epiglottis on each side one that if by chance any of the meat or drink should fall or slip aside in the Larinx it might be there stayed and retained Beside that the Air too violently entring should be in some sort broken by these clifts or chinks no otherwise then the bloud and spirit entring into the heart through the Auriculae or Ears thereof CHAP. XVI Of the Neck and the parts thereof FIrst we will
with sense and life but this Dracunculus when he is drawn too violently especially if he be broken thereby will cause extream pain We do answer that the conclusion doth not follow and is of no consequence for these pains happen not unless when the unprovident Surgion draws or puls in stead of the Dracunculus some nervous or membranous body swoln and repleat with an adust humor whence there cannot but be great pain that part being pull'd which is the author of sense But it is childish to say that the Dracunculus feels for that it causeth sharp pains to the living body in which it is Therefore that at last we may determin something of the nature essence and generation of these Dracunculi I dare boldly affirm It is nothing else but a tumor and abcess bred from the heat of the blood in a venerate kind Such blood driven by the expulsive faculty through the veins to the External parts especially the limits that is the Arms and Legs causeth a tumor round and long often stretched from the joynt of the shoulder even to the wrist or from the groin even to one of the Ankles with tension heat renitency pricking pain and a feaver But this tumor is some while stretched forth streight otherwhiles into oblique and crooked tumors which hath been the cause that many taken with this kind of disease and having their limbs so infolded as with the twinings of a Serpent would say they had a Serpent I have thus much to say of the Dracunculi especially of those of our own country For the cure it is not unlike to the cure of a Phlegmon arising from a Defluxion The Cure for here also in like manner the remedies must be varied according to the four times of the disease and the same rule of diet phlebotomy and purging must be observed which is before prescribed in the cure of a Phlegmon The mention of the Dracunculi cals to my memory another kind of Abscesse altogether as rare So the Malum pilate in Aristotle cap. 11. lib. 7. hist animal This our French men name Cridones I think á Crinibus i. from hayrs it chiefly troubles children and pricks their backs like thorns They toss up and down being not able to take any rest This disease ariseth from small hairs which are scarce of a pins length but those thick and strong It is cured with a fomentation of water more than warm after which you must presently apply an oyntment made of hony and wheaten flower for so these hairs lying under the skin are allured and drawn forth and being thus drawn they must be plucked out with small mullets I imagine this kind of disease was not known to the ancient Physitians The End of the Eighth Book The Ninth BOOK Of WOVNDS in General CHAP. I. What a wound is what the kinds and differences thereof are and from whence they may be drawn or derived A Wound is a solution of Continuity caused by a stroak fall or bite newly done What a wound properly is bloody and with putrefaction and filth They also call it a new simple Ulcer for the solution of continuity happens to all parts of the body but according to the diversity of parts it hath divers names amongst the Greeks For in the flesh it is called Helcos in the bone Catagma in the nerve Spasma in the ligament Thalasma in the vessels Apospasma in the Muscles Regma and that solution of continuity Divers appellations of wounds according to the varieties of the parts which happens in the vessels their mouths being open is termed Anastomosis that which happens by erosion Aneurosis that which is generated by sweating out and transcolation Diapedesis That these may be the more easily understood I have thought good to describe them in the following table A Table of the Differences of Wounds The differences of Wounds are drawn or taken From the nature of the parts in which they are made or happen But these parts are Either similar and these Either soft as the Glandules Flesh Fat Marrow Or hard as A Bone A Gristle Or of a midle consistence as the Membranes Ligaments Fibers Vessels Nerves Veins Arteries Or Organical and these either Principal as the Brain Heart Liver to which some add the Womb and Testicles Or serving the principal as The Weason Lungs Gullet Stomach Guts Bladder Or neither as The Ears Nose Feet Hands and other of the same kind From their proper essence from whence they are called Simple wounds When there is no complication of any other disease or symptom besides Or compound When there is a complication of some one or more diseases which unless they be taken away we must not hope for to cure the wound From their quantity according to which they are called Great Indifferent Little Long broad Deep Short Narrow Superficiary From their figure according to which they are named Streight Oblique Cornered CHAP. II. Of the Causes of Wounds Divers denominations from their causes ALl things which may outwardly assail the body with force and violence may be counted the causes of wounds which are called green and properly bloudy These things are either animate or inanimate The animate as the bitings and prickings of Beasts The Inanimate as the stroak of an Arrow Sword Club Gun Stone a Dagger and all such like things From the variety of such like causes they have divers names for those which are made by sharp and pricking things are called punctures those caused by cutting things are called wounds or gashes and those which are made by heavy and obtuse things are named Contusions or wounds with contusions CHAP. III. Of the Signs of Wounds WOunds are first known by sight and by the signs drawn from thence A caution for making reports of Wounds The Chirurgeon ought first and chiefly to consider what Wounds are curable and what not what wounds will scarse admit of cure and what may be easily cured for it is not the part of a prudent Chirurgeon to promise cure in a deadly or dangerous and difficult wound lest he may seem to have killed him whom not the unsufficiency of the Art but the greatness of the wound hath slain But when the wound is dangerous but yet without despair of recovery it belongs to him to admonish the Patient's friends which are by of the present danger and doubtful state of the wound that if Art shall be overcome by the greatness thereof he shall not be thought ignorant of the Art neither to have deceived them But as this is the part and duty of a good and prudent Chirurgeon A Jugling cheating Chirurgeon so it is the trick of a cheating and jugling Knave to enlarge small wounds that so he may seem to have done a great cure when it is nothing so But it is agreeable to reason that the Chirurgeon professing the disease easie to be cured will think himself in credit bound by such promises and his duty and therefore seek
all means for the quick recovery of the Patient lest that which was of its own nature small may by his negligence become great Therefore it is expedient he should know what wounds are to be accounted great This as Galen saith is three ways to be known The first is by the magnitude and principality of the part affected for thus the wounds of the Brain Heart and of the greater vessels Lib. 4. Meth. cap. 6.1 though small of themselves yet are thought great Wounds are called Great out of three respects Then from the greatness of the solution of continuity for which cause wounds may be judged great in which much of the substance of the part is lost in every dimension though the part be one of these which are accounted servile Then from the malignity through which occasion the wounds of the joynts are accounted great because for the most part they are ill conditioned CHAP. IV. Of Prognosticks to be made in Wounds THose Wounds are thought dangerous wherein any large Nerve vein or Artery are hurt What wounds are dangerous From the first there is fear of Convulsion but from the other large effusion of the veinous or arterious bloud whence the powers are debilitated also these are judged evil which are upon the Arm-pits groins leggs joynts and between the fingers and likewise those which hurt the head or tail of a Muscle They are lest dangerous of all other which wound only the fleshy substance But they are deadly which are inflicted upon the Bladder Brain Heart Liver Lungs Stomach and small guts But if any Bone Gristle Nerve or portion of the cheek What least dangerous What deadly Hip. aphor 19. Lib. 6. or prepuce shall be cut away they cannot be restored Contused wounds are more difficult to cure than those which are from a simple solution of continuity for before you must think to heal them up you must suppurate and cleanse them which cannot be done in a short time Wounds which are round and circular are so much the worse for there can be no unity unless by an angle that is a meeting together of two lines which can have no place in round wounds because a circular figure consists of one oblique line Besides wounds are by so much thought the greater by how much their extreams and lips are the further disjoyned which happens to round wounds Why round Wounds are difficult to heal Contrary to these are cornered wounds or such as are made alongst the fibers as such as may be healed Wounds may be more easily healed in young men than in old because in them Nature is more vigorous and there is a greater plenty of fruitful or good bloud by which the loss of the flesh may be the better and more readily restored which is slowlier done in old bodies by reason their bloud is smaller in quantity and more dry and the strength of nature more languid Wounds received in the Spring Hip. lib. de ulcer Hip. aph 66. lib. 5. are not altogether so difficult to heal as those taken in Winter or Summer For all excess of heat and cold is hurtful to them it is ill for a Convulsion to happen upon a Wound for it is a sign that some Nervous body is hurt the Brain suffering together therewith as that which is the original of the Nerves A Tumor coming upon great wounds is good for it shews the force of nature is able to expel that which is harmful and to ease the wounded part The organical parts wholly cut off cannot again be united because a vital part once severed and plucked from the trunk of the body cannot any more receive influence from the heart as from a root without which there can be no life The loosed continuity of the Nerves Veins Arteries and also the Bones is sometimes restor'd not truly and as they say according to the first intention but by the second that is by reposition of the like but not of the same substance The first intention takes place in the fleshy parts by converting the Alimentary bloud into the proper substance of the wounded part But the second in the spermatique in which the lost substance may be repaired by interposition of some heterogeneous body which nature diligent for its own preservation substitutes in place of that which is lost for thus the body which restores and agglutinates What a Callus is and whence it proceeds is no Bone but a Callus whose original matter is from an humor somewhat grosser than that from whence the Bones have their original and beginning This humor when it shall come to the place of the fracture agglutinateth the ends of the Bones together which otherwise could never be so knit by reason of their hardness The Bones of Children are more easily and speedily united by reason of the pliantness of their soft and tender substance Small and contemptible Wounds often prove mortal Aphor. 1. sect 1. Lastly we must here admonish the Chirurgeon that small Wounds and such as no Artisan will judg deadly do divers times kill by reason of a certain occult and ill disposition of the wounded and incompassing Bodies for which cause we read it observed by Hippocrates that it is not sufficient for the Physitian to perform his duty but also external things must be rightly prepared and fitted CHAP. V. Of the Cure of Wounds in general The general Indication of Wounds THe Chirurgeon ought for the right cure of wounds to propose unto himself the common and general indication that is the uniting of the divided parts which indication in such a case is thought upon and known even by the vulgar for that which is dis-joyned desires to be united because union is contrary to division But by what means such union may be procured is only known to the skilful Artisan Therefore we attain unto this chief and principal Indication by the benefit of Nature as it were the chief Agent and the work of the Chirurgeon as the servant of Nature And unless Nature shall be strong the Chirurgeon shall never attain to his conceived and wished for end therefore that he may attain hereto he must perform five things Five things necessary for uniting wounds the first is that if there be any strange Bodies as pieces of Wood Iron Bones bruised Flesh congealed Bloud or the like whether they have come from without or from within the Body and shall be by accident fastened or stuck in the wound he must take them away for otherwise there is no union to be expected Another is that he joyn together the lips of the Wound for they cannot otherwise be agglutinated and united The third is that he keep close together the joyned lips The fourth that he preserve the temper of the wounded part for the distemper remaining it is impossible to restore it to its unity The fifth is that he correct the accidents if any shall happen because these urging
blows as with Stones Clubs Staves the report of a peece of Ordnance or crack of Thunder and also a blow with ones hand Lib. 5. Epidem Thus as Hippocrates tells that beautiful Damosel the daughter of Nerius when she was twenty yeers old was smitten by a woman a friend of hers playing with her with her flat hand upon the fore-part of the head and then she was taken with a giddiness and lay without breathing and when she came home she fell presently into a great Feaver her head aked and her face grew red The seventh day after there came forth some two or three ounces of stinking and bloudy matter about her right Ear and she seemed somewhat better and to be at somewhat more ease The Feaver encreased again and she fell into a heavy sleepiness and lost her speech and the right side of her face was drawn up and she breathed with difficulty she had also a convulsion and trembling both her tongue failed her and her eyes grew dull on the ninth day she dyed But you must note that though the head be armed with a helmet yet by the violence of a blow the Veins and Arteries may be broken not only these which pass through the Sutures The vessels of the brain broken by the commotion thereof but also those which are dispersed between the two Tables in the Diploe both that they might bind the Crassa meninx to the Skull that so the Brain might move more freely as also that they might carry the alimentary juyce to the Brain wanting Marrow that is bloud to nourish it as we have formerly shewed in our Anatomy But from hence proceeds the efflux of bloud running between the Skull and Membranes Signs or else between the Membranes and Brain the bloud congealing there causeth vehement pain and the Eyes become blind Vomitting is caused Celsus the mouth of the Stomach suffering together with the Brain by reason of the Nerves of the sixt conjugation which run from the Brain thither and from thence are spread over all the capacity of the ventricle whence becoming a partaker of the offence it contracts it self and is presently as it were overturned whence first The cause of vomitting when the head is wounded those things that are contained therein are expelled and then such as may flow or come thither from the neighbouring and common parts as the Liver and Gall from all which Choler by reason of its natural levity and velocity is first expelled and that in greatest plenty and this is the true reason of that vomitting which is caused and usually follows upon fractures of the Skull and concussions of the Brain Within a short while after inflammation seizes upon the Membranes and Brain it self which is caused by corrupt and putrid bloud proceeding from the vessels broken by the violence of the blow and so spread over the substance of the Brain Such inflammation communicated to the Heart and whole body by the continuation of the parts causes a Feaver But a Feaver by altering the Brain causes Doting to which if stupidity succeed the Patient is in very ill case according to that of Hippocrates Stupidity and doting are ill in a wound or blow upon the Head Aph. 14. sect 7. But if to these evils a Sphacel and corruption of the Brain ensue together with a great difficulty of breathing by reason of the disturbance of the Animal faculty which from the Brain imparts the power of moving to the Muscles of the Chest the Instruments of Respiration then death must necessarily follow A great part of these accidents appeared in King Henry of happy memory A History a little before he dyed He having set in order the affairs of France and entred into amity with the neighbouring Princes desirous to honour the marriages of his daughter and sister with the famous and noble exercise of Tilting and he himself running in the Tilt-yard with a blunt-lance received so great a stroak upon his Brest that with the violence of the blow the vizour of his helmet flew up and the trunchion of the broken Lance hit him above the left Eyebrow and the musculous â—kin of the Fore-head was torn even to the lesser corner of the left Eye many splinters of the same Trunchion being struck into the substance of the fore-mentioned Eye the Bones being not touched or broken but the Brain was so moved and shaken that he dyed the eleventh day after the hurt What was the necessary cause of the death of King Henry the second of France His Skull being opened after his death there was a great deal of bloud found between the Dura and Pia Mater poured forth in the part opposite to the blow at the middle of the Suture of the hind-part of the Head and there appeared signs by the native colour turned yellow that the substance of the Brain was corrupted as much as one might cover with ones Thumb Which things caused the death of the most Christian King and not only the wounding of the Eye as many have falsly thought For we have seen many others who have not dyed of farr more grievous wounds in the Eye The History of the Lord Saint-Johns is of late memory he in the Tilt-yard A History made for that time before the Duke of Guises house was wounded with a splinter of a broken Lance of a fingers length and thickness through the visour of his Helmet it entring into the Orb under the Eye and piercing some three fingers bredth deep into the head by my help and Gods favour he recovered Valeranus and Duretus the Kings Physitians and James the Kings Chirurgeon assisting me What shall I say of that great and very memorable wound of Francis of Lorain the Duke of Guise He in the fight of the City of Bologne had his head so thrust through with a Lance A History that the point entring under his right Eye by his Nose came out at his Neck between his Ear and the Vertebrae the head or Iron being broken and left in by the violence of the stroak which stuck there so firmly that it could not be drawn or plucked forth without a pair of Smith's pincers But although the strength and violence of the blow was so great that it could not be without a fracture of the Bones a tearing and breaking of the Nerves Veins and Arteries and other parts yet the generous Prince by the favour of God recovered By which you may learn that many dye of small wounds and other recover of great yea Why some die of small wounds and others recover of great very large and desperate ones The cause of which events is chiefly and primarily to be attributed to God the Author and Preserver of Mankind but secondarily to the variety and condition of Temperaments And thus much of the commotion or concussion of the Brain whereby it happens that although all the Bone remains perfectly whole yet some veins broken
young men and more slowly in old And thus much may serve for Prognosticks Now will we treat as briefly and perspicuously as we can of the cure both in general and particular wherefore beginning with the general we will first prescribe a convenient Diet by the moderate use of the six things not natural CHAP. XIV Of the general cure of a broken Skull and of the Symptoms usually happening thereupon THe first cure must be to keep the Patient in a temperate air and if so be How the air ought to be that it be not such of it self and its own proper nature it must be corrected by Art As in winter he must have a clear fire made in his chamber lest the smoak cause sneesing and other accidents and the windows and doors must be kept shut to hinder the approach of the cold air and wind All the time the wound is kept open to be drest some body standing by shall hold a chafendish full of coals or a heated Iron bar over the wound at such a distance that a moderate heat may pass thence to the wound and the frigidity of the encompassing air may be corrected by the breathing of the diffused heat For cold according to the opinion of Hippocrates is an Enemy to the Brain Bones Aphor. 18. sect 5. Nerves and spinal marrow it is also hurtful to ulcers by suppressing their excrements which supprest do not only hinder suppuration but also by corrosion makes them sinuous Therefore Galen rightly admonisheth us to keep cold from the Brain not only in the time of trepaning but also afterwards For there can be no greater nor more certain harm befal the fractured skull than by admitting the air by such as are unskilful For if the air should be hotter than the Brain Lib. 2. de usâ— part cap. 2. then it could not thence be refrigerated but if the brain should be laid open to the air in the midst of Summer when it is at the hottest yet would it be refrigerated The Air though in Summeâ— is colder than the brain and unless it were relieved with hot things take harm this is the opinion of Galen whereby you may understand that many who have the r Skulls broken dye more through default of skill in the curing than by the greatness of the fracture But when the wound is bound up with the pledgets cloths and rowlers as is fit if the air chance to be more hot than the Patient can well endure let it be amended by sprinkling and strawing the chamber with cold water oxycrate the branches of Willows and Vine Neither is it sufficient to shun the too cold air unless also you take heed of the over light chiefly until such time as the most feared and malign symptoms are past For a too great light dissipates the spirits increases pain strengthens the feaver and symptoms The discommodities of too much Light Hippocrates wholly forbids wine therefore the Patient instead thereof must drink Barly water fair water boyled and tempered with Julep of roses syrup of Violets vinegar the like water wherein bread crums have been steeped Water and Sugar with a little juyce of Limmons What his drink must be or Pomecitron added thereto and such like as the ability and taste of the Patient shall require Let him continue such drinks until he be free from malign symptoms which usually happen within fourteen days His meat shall be pap Ptisan shunning Almond-milks for Almonds are said to fill the Head with vapours and cause pain stued Damask Prunes Raisons and Currants seasoned with Sugar Almonds increase the pain of the head and a little Cinamon which hath a wonderful power to comfort the stomach and revive and exhilarate the Spirits Chickens Pidgeons Veal Kid Leverets Birds of the fields Pheasons Black-birds Turtles Partridges Thrushes Larks and such like meats of good digestion boyled with Lettuce Purslain Sorrel Borage Bugloss Succory Endive and the like are thought very convenient in this case If he desire at any time to feed on meats rosted he may only dipping them in Verjuyce in the acid juyces of Oranges Citrons Limons or Pomegranates sometimes in one and sometimes in another What fish he may eat according to his tast and ability If any have a desire to eat fish he must make choyce of Trouts Gudgeons Pikes and the like which live in running and clear waters and not in muddy he shall eschew all cold Sallets and Pulse because they fly up and trouble the head it will be convenient after meat to use common dridg powder or Aniseed Fennel-seed or Coriander-comfits also Conserve of Roses or Marmilate of Quinces to shut up the orifice of the Ventricle lest the head should be offended with vapours arising from thence Aphor. 13. 14. sect 1. Children must eat often but sparingly for children cannot fast so long as those which are elder because their natural heat is more strong wherefore they stand in need of more nourishment so also in winter all sorts of people require more plentiful nourishment for that then their stomachs are more hot than in Summer Aphor. 15. sect 2. When the fourteenth day is past if neither a Feaver nor any thing else forbids he may drink wine moderately and by little and little encrease his diet but that respectively to each one's nature strength and custom He shall shun as much as in him lies sleep on the day time unless it happen that a Phlegmon seise upon the brain or the Meninges Why sleep upon the day time is good for the brain being inflamed Lib. 2. Epidem For in this case it will be expedient to sleep on the day time especially from morning till noon for in this season of the day as also in the Spring bloud is predominant in the body according to the opinion of Hippocrates For it is so vulgarly known that it need not be spoken that the bloud when we are awake is carryed into the habit and surface of the body but on the contrary by sleep it is called into the noble parts the Heart and Liver Wherefore if that the bloud by the force of the Sun casting his beams upon the Earth at his rising is carryed into the habit of the body it should again be more and more diffused by the strength and motion of watching the inflammation in the Brain and Meninges would be much encreased Wherefore it will be better especially then to stay by sleep the violence of the bloud running into the habit of the body when it shall seem to rage and more violently to affect that way The discommodities ensuing immoderate Watching Gal. Meth. 18. Watching must in like manner be moderate for too much depraves the temper of the Brain and of the habit of the whole body it causes crudities pains and heaviness of the head and makes the wounds dry and malign But if the Patient cannot sleep by reason of the vehemency of the
the wound be kept open with larger tents untill all the Sanies or bloody matter wherein the blood hath degenerated shall be exhausted But if it happen at any time as assuredly it sometimes doth that notwithstanding the Art and care of the Physitian the wound degenerates into a Fistula then the former evil is become much worse For Fistula's of the Chest are scarse cured at any time and that for divers causes The first is for that the muscles of the Chest are in perpetual motion Wounds of the Chest easily degenerate into a Fistula Another is because they on the contrary inside are covered only with the membrane investing the ribs which is without blood The third is for that the wound hath no stay by means whereof it may be compressed sowed and bound whereby the lips being joined together the wound may at length be replenished with flesh and cicatrized Why there flows such plenty of matter out of wounds of the Chest But the reason why wounds of the Chest do every day heap up and pour forth so great a quantity of matter seems to be their vicinity to the heart which being the fountain of blood there is a perpetual efflux thereof from thence to the part affected For this is Natures care in preserving the affected parts that continually and aboundantly without measure or mean it sends all its supplyes that is blood and spirits to their aid Add hereto that the affected parts by pain heat and continual motion of the Lungs and midriffe draw and allure much blood to themselves Such like blood defiled by the malignity and filth of the wound is speedily corrupted whence it is that from the perpetual afflux of blood there is a continual efflux of matter or filth which at the last brings a man to a consumption because the ulcerated part like a ravenous wolf consumes more blood by the pain heat and motion than can be ministred thereto by the heart Yet if there be any hope to cure and heal the Fistula it shall be performed after the use of diet and phlebotomy according to the prescript of the Physitian by a vulnerary potion which you shall find described when we treat of the Caries or rottenness of the bones The cure of a Fistula in the Chest When Aegyptiacum must be put into the injections Wherefore you shall make frequent injections therewith into the Fistula adding and mixing with it syrup de rosis siccis and mel rosarum Neither do I if the putrefaction be great fear to mix therewith Aegyptiacum But you must have a care to remember observe the quantity of the injected liquor that you may know whether it all come forth again after it hath performed its detergent office For if any thereof remain behind in the corners and crooked passages it hurts the part as corrupted with the contagion thereof The form of a Syringe fit to make injection when a great quantity of liquor is to be injected into any part After the injected liquor is come forth a pipe of gold silver or lead shall be put into the fistulous ulcer and it must have many holes in it that so the filth may pass forth at them it must be fast tyed with strings that it may not fall into the capacity of the Chest A great Spunge steeped in Aqua-vitae and wrung forth again shall be laid hot to the end or orifice thereof both to hinder the entrance of the air into the Fistulous ulcer as also to draw forth the filth there by its gentle heat the which thing the Patient shall much further if often times both day and night he hold his breath stopping his mouth and nose and lying upon the diseased side that so the Sanies may be the more forcibly evacuated neither must we leave the putting in the pipe before that this fistulous ulcer shall be almost dry that is whole as when it yields little or no matter at all then it must be cicatrized But if the orifice of this fistulous ulcer being in the upper part hinder the healing thereof then by a chirurgical Section a passage shall be made in the bottom as we said before in an Empyema The delineation of the Pipes with their Strings and Spunges The Reader must note that the Pipes which are fit for this use need not have so many holes as these here exprest but only two or three in their ends for the flesh growing and getting into the rest makes them that they cannot be plucked forth without much pain A wound made in the Lungs admits cure What wounds of the Lungs are curable unless it be very large if it it be without inflammation if it be on the skirts of the Lungs and not on their upper parts if the Patient contain himself from coughing much and contentious speaking and great breathing for the wound is inlarged by coughing and thence also arises inflammation the Pus and Sanies whereof The harm that insues upon coughing in wounds of the Lungs whilst the lungs again endeavour to expel by coughing by which means they are only able to expel that which is hurtful and troublesome to them the ulcer is dilated the inflammation augmented the Patient wastes away and the disease becomes incurable There have been many Eclegma's described by Physitians for to clense the ulcer How Eclegma's must be swallowed which when the Patient useth he shall lye on his back to keep them long in his mouth so to relax the muscles of the Larinx for thus the medicin will fall by little and little alongst the coats of the Weazon for if it should fall down in great quantity it would be in danger to cause coughing Cows Asses or Goats-milk with a little Hony lest they should corrupt in the Stomach are very fit remedies for this purpose but Womans milk exceeds the rest But Sugar of Roses is to be preferred before all other medicins in the opinion of Avicen The utility of Sugar of Roses in ulcerated or wounded Lungs for that it hath a detergent and also an astrictive and strengthening faculty than which nothing is more to be desired in curing of ulcers When you shall think it time to agglutinate the clensed ulcer you must command the Patient to use emplastick austere and astringent medicins such as are Terra sigillata bolus armenus hypocystis Plantain Knot-grass Sumach Acacia and the like which the Patient shall use in his Broaths and Eclegma's mixing therewith Hony of Roses which serving for a vehicle to the rest may carry away the impacted filth which hinders agglutination But seeing an hective Feaver easily follows upon these kinds of wounds and also upon the affects of the Chest and Lungs it will not be amiss to set down somewhat concerning the cure thereof that so the Chirurgeon may know to administer some help to his Patient whilst a Physitian is sent for to overcome this disease with more powerful and certain remedies CHAP. XXXII
of Vines Rosemary and Orris roots For the same purpose you may sprinkle the floor with sweet water A sweet water if the Patient be able to undergo such cost As â„ž majoranae menthae radic cyperi calami aromat salviae lavendulae faenicul thymi stoechad fâ—â—r chamaem melilot satureiae baccarum lauri juniperi an M. iij. pulv caryophyl nucis Moschat an â„¥ j. aqua rosar vitae an lib. ij vini albi boni odorifici lb. x. Perfumes to burn bulliant omnia in balneo Mariae ad usum dictum You may also make perfumes to burn in his chamber as thus â„ž carbonis salicis â„¥ viij ladani puri â„¥ ij thuris masculi ligni baccarum Juniperi an â„¥ j. xylâ—aloes benjoini styracis calamit an â„¥ ss Nuâ—is moschatae santal citriu an Ê’ iij. caryophyll styracis liquidae an Ê’ ij zedoariae calami ar mat an Ê’ j. gummi tragracanth aqua rosar soluti quod sit satis Make hereof perfumes in what fashion you please For the rottenness and corruption of bones we wil treat thereof hereafter in due place CHAP. XII Certain memorable Histories HEre I think good for the benefit of young practitioners to illustrate by examples the formerly prescribed Method of curing Wounds made by Gunshot The famous and most valiant Count of Mansfelt Governour of the Dutchy of Luxembourg Knight of the Order of Burgundy coming to the aid of the French King was at the Battel of Moncontour The malign symptoms which usually happen upon wounds made by Gunshot where in the conflict he received so great a wound at the joint of the left arm with a Pistol-bullet that the bones were shivered and broken in so many pieces as if they had been laid upon an Anvil and struck with an hammer hence proceeded many malign symptoms as cruel and tormenting pain inflammation a feaver an oedematous and flatulent tumor of the whole arm even to the fingers end and a certain inclination to a Gangraene which to resist Nicolas Lambert and Richard Habert the King's Chirurgeons had made many and deep scarifications But when I came to visit and dress him by the Kings appointment and had observed the great stench and putrefaction I wished that they would use lotions of Aegyptiacum made somewhat stronger then ordinary and dissolved in Vinegar and Aqua vitae and do other things more largely spoken of in the Chapter of a Gangraene For the Patient had also a Diarrhoea or Flux whereby he evacuated the purulent and stinking filth which flowed from his Wound Which how it might come to pass we will show at large when we come to treat of the suppression of the Urine Matter may flow from the wounded limbs into the belly For this seemed very absurd to many because that if this purulent humor flowed out of the arm into the belly it must needs flow back into the veins be mixed with the bloud and by its pernicious and contagious passage through the heart and liver cause exceeding ill symptoms and lastly death Indeed he often swounded by the ascent of the filthy vapours raised from the ulcer to the noble parts which to resist I wished him to take a spoonful of Aqua vitae with some Treacle dissolved therein I endeavoured to repress the oedematous and flatulent Tumor possessing all the arm with stoups dipped in Oxycrate A brief recital of the manner of the cure to which was put a little Salt and Aqua vitae these stoups I stayed and held to the part with double cloaths sowed as strait as I could Such a compression held the broken bones in their places pressed their Sanies from the ulcers and forced back the humors flowing to the part into the center of the body If at any time I omitted this compression the tumor was so encreased that I was in a great deal of fear lest the native heat of the part should be suffocated Neither could I otherwise bind up the arm by reason of the excessive pain which molested the Patient upon the least stirring of the arm There were also many Abcesses about his elbow and over all his arm besides For the letting forth of whose matter I was forced to make new Incisions which he endured very stoutly At length I cured him with using a vulnerary potion and by cleansing the ulcers and correcting the putrefaction with Aegyptiacum dissolved in wine and honey of Roses and so poured into the ulcers and repressing the growth of proud flesh with the powder of burnt Alum drying it after the detersion with liniments Now this I can truly affirm and profess that during the time of the cure I took out above threescore splinters of bones and those necessarily amongst which there was one of the length of ones finger yet by Gods assistance at length he became sound in all things but that he could not put forth or draw in his arm Not long after by the Kings command I went to see Charles Philip of Croy Lord of Auret the Duke of Asches brother not far from Mounts a City of Henalt He kept his bed seaven months by reason of a wound made by a Bullet the space of three fingers above his knee Horrid symptom occasioned by a wound made by Gun-shot When I came to him he was afflicted with these symptoms intolerable pain a continual feaver cold sweats watchings excoriation of the hippes by reason of his long lying upon them his appetite dejected with much thirst He oft sunk down as if he had the Falling-sickness had a desire to vomit and a continual trembling or shaking so that he could not put one hand to his mouth without the assistance of the other he swounded frequently by reason of the vapours ascending to the noble parts For the thigh-bone was broken long-ways and side-wayes with many splinters of bones whereof some were plucked out others remained sticking fast in He besides also had an ulcer in his groin which reached to the midst of his thigh many other sinuous ulcers about his knee All the muscles of his thigh and leg were swoln with a flegmatick cold and flatulent humor so that almost all the native heat of those parts seemed extinct All which things being considered I had scarse any hope to recover him so that I repented my coming thither Yet at length putting some confidence in his strength and prime of youth I began to have better hopes Therefore with his good liking first of all I made two Incisions so to let forth the matter which lying about the bone did humect the substance of the muscles Incisions wherefore made This had happy success and drew out a great quantity of matter then I with a Syringe injected much Aegyptiacum dissolved in Wine and a little Aqua vitae into these Incisions so to restrain and amend the putrefaction repress the spongie loose and soft flesh resolve the oedematous and flatulent tumor asswage the pain and stir
heat is oppressed and suffocated But this I would admonish the young Chirurgeon that when by the fore-mentioned signs he shall find the Gangrene present that he do not defer the amputation for that he finds some sense or small motion yet residing in the part For oft-times the affected parts are in this case moved not by the motion of the whole muscle but only by means that the head of the muscle is not yet taken with the Gangrene which moving its self by its own strength also moves its proper and continued tendon and tail though dead already wherefore it is ill to make any delay in such cases CHAP. XIV Of the Prognosticks in Gangrenes HAving given you the signs and causes to know a Gengrene it is fit we also give you the prognosticks The fierceness and the malignity thereof is so great that unless it be most speedily withstood the part it self will dye and also take hold of the neighbouring parts by the contagion of its mortification which hath been the cause that a Gangrene by many hath been termed an Esthiomenos For such corruption creeps out like poyson Why a Gangrene is called Esthiomenos and like fire eats gnaws and destroys all the neighbouring parts until it hath spread over the whole body For as Hippocrates writes Lib. de vulner capitis Mortui viventis nulla est proportio i. there is no proportion between the dead and living Wherefore it is fit presently to separate the dead from the living for unless that be done the living will dye by the contagion of the dead In such as are at the point of death The quick impatient of the dead a cold sweat flows over all their bodies they are troubled with ravings and watchings belchings and hicketing molest them and often swoundings invade them by reason of the vapours abundantly and continually raised from the corruption of the humors and flesh and so carryed to the Bowels and principal parts by the Veins Nerves and Arteries Wherefore when you have foretold these things to the friends of the Patient then make haste to fall to your work CHAP. XV. Of the General cure of a Gangrene Various Indications of curing a Gangrene THe Indications of curing Gangrenes are to be drawn from their differences for then cure must be diversly instituted according to the essence and magnitude For some Gangrenes possess the whole member others only some portion thereof some are deep othersome superficial only Also you must have regard to the temper of the body For soft and delicate bodies as of Children Women Eunuchs and idle persons require much milder medicins than those who by nature and custom or vocation of life are more strong and hardy such as Husbandmen Labourers Mariners Huntsmen Porters and men of the like nature who live sparingly and hardly What parts soonest taken â—old by a Gangrene Neither must you have respect to the body in general but also to the parts affected for the fleshy and musculous parts are different from the solid as the nerves and joynts or more solid as the Vertebrae Now the hot and moist parts as the privities mouth womb and fundament are easilyer and sooner taken hold of by putrefaction wherefore we must use more speedy means to help them Wherefore if the Gangrene be chiefly occasioned from an internal cause he must have a dyet prescribed for the decent and fitting use of the six things not natural If the body be plethorick or full of ill humors you must purge or let bloud by the advice of a Physitian Against the ascending up of vapours to the noble parts the heart must chiefly be strengthened with Treacle dissolved in Sorrel or Carduus-water with a bole of Mithridate the Conserve of Roses and Bugloss and with Opiâ—tes made for the present purpose according to Art this following Apozeme shall be outwardly applyed to the region of the heart A cordial Epithema â„ž Aquae rosar nenuphar an â„¥ iiij aceti scillitici â„¥ j. câ—rallorum santalorum alborum rulrorum rosar rub in pulver redactarum spodii an â„¥ j. mithrid theriacae an Ê’ ij ss trochiscorum de CaphuraÊ’ ij flor cardial in pollin redactarum p. ij creciÊ’ j. Ex omnibus in pollinem redactis fiat epithema Which may be applyed upon the region of the heart with a Scarlet-cloth or spunge These are usually such as happen in the cure of every Gangrene CHAP. XVI Of the particular cure of a Gangrene THe cure of a Gangrene caused by the too plentiful and violent defluxion of humors suffocating the native heat by reason of great Phlegmons is performed by evacuating and drying up the humors The cure of a Gangrene made by inflammation which putrefie by delay and collection in the part For this purpose scarifications and incisions great in differeâ—s small deep and superficiary according to the condition of the Gangrene are much commenâ—â—d that so the burdened part may injoy the benefit of perspiration and the contained humorâ— of difflation or evacuation of their sooty excrements Let Incisions be made when the â—ffeâ—◠〈◊〉 deep in and neer to mortification But scarifications may be used when the part first 〈◊〉 to putrefie for the greatness of the remedy must answer in proportion to that of the disâ—â—â—â— Wherefore if it penetrate to the bones it will be fit to cut the skin and flesh with mâ—â—â—â—â—d deep Incisions with an Incision-knife made for that purpose yet take heed of cutting the larger nerves and vessels unless they be wholly putrefied for if they be not yet putrefied you shall make your Incisions in the spaces between them if the Gangrene be less we must rest satisfied with only scarifying it When the Scarifications and Incisions are made we must suffer 〈◊〉 bloud to flow forth that so the conjunct matter may be evacuated Then must we apply and put upon it such medicins as may by heating drying resolving clensing and opening amend and correct the putrefaction and by piercing to the bottom may have power to overcome the virulency already impact in the part For this purpose Lotions made of the Lye of the Ashes of Fig-tree or Oak wherein Lupins have been throughly boyled are good Or you may with less trouble make a medicine with Salt-water wherein you may dissolve Aloes and Aegyptiacum adding in the conclusion a little Aqua vitae The description of an Aegyptiacum for Aqua vitae and calcined Vitriol are singular medicins for a Gangrene Or â„ž acet optmi lb j. mel ros â„¥ iiij syrup acetosi â„¥ iij. salis com â„¥ v. lulliant simul adde aqua vitae lb. s Let the part be frequently washed with this medicine for it hath much force to repress Gangrenes After your Lotion lay Aegyptiacum for a Liniment and put it into the Incisions for there is no medicine more powerful against putrefaction for by causing an Eschar it separates the putrid flesh from the sound But we must not in
Cathaereticks which is excellent in these kinds of Wounds whether by it self or mixed with others You shall use these and such like even unto the perfect agglutination and cicatrization of the wound and you may of your self devise other things such as these as occasion shall offer its self CHAP. XXIV What just occasion moved the Author to devise this new form of remedy to stanch the blood after the amputation of a member and to forsake the common way used almost by all Chirurgeons which is by application of actual Cauteries VErily I confess I formerly have used to stanch the bleeding of members after amputation Hot Irons not to be used after another manner than that I have a little before mentioned Whereof I am ashamed and agrieved But what should I do I have observed my masters whose method I intended to follow alwayes to doe the like who thought themselves singularly well appointed to stanch a flux of blood when they were furnished with various store of hot Irons and caustick medicins which they would use to the dismembred part now one then another as they themselves thoâ—ght meet Which thing cannot be spoken or but thought upon without great horror much less acted For this kind of remedy could not but bring great and tormenting pain to the Patient seeing such fresh wounds made in the quick and sound flesh are endured with exquisite sense Neither can any caustick be applyed to nervous bodies but that this horrid impression of the fire will be presently communicated to the inward parts whence horrid symptoms ensue and oft-times death it self And verily of such as were burnt the third part scarce ever recovered and that with much adoe for that combust wounds difficultly come to cicatrization for by this burning are caused cruel pains whence a Feaver Convulsion and oft-times other accidents worse than these Add hereunto that when the eschar fell away oft-times a new haemorrhage ensued for stanching whereof they were forced to use other caustick and burning Instruments Neither did these good men know any other course so by this repetition there was great loss and waste made of the fleshy and nervous substance of the part Through which occasion the bones were laid bare whence many were out of hope of cicatrization being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembred which also took away the opportunity of fitting or putting to of an artificial leg or arm instead of that which was taken off Wherefore I must earnestly entreat all Chirurgeons that leaving this old and too too cruel way of healing they would embrace this new which I think was taught me by the special favour of the sacred Deity for I learnt it not of my masters nor of any other neither have I at any time found it used by any Only I have read in Galen Lib. 5. Meth. that there was no speedier remedy for stanching of blood than to binde the Vessels through which it flowed towards their roots to wit the Liver and Heart This precept of Galen of binding and sowing the Veins and Arteries in the new wounds when as I thought it might be drawn to these which are made by the amputation of members I attempted it in many yet so that at first in my budding practice thereof I alwayes had my Cauteries and hot Irons in a readiness that if any thing hapned otherwise then I expected in this my new work I might fetch succour from the ancient practice untill at length confirmed by the happy experience of almost an infinite number of particulars I bid eternally adieu to all hot Irons and Cauteries which were commonly used in this work And I think it fit that Chirurgeons do the like For antiquity and custom in such things as are performed by Art ought not to have any sway authority or place contrary to reason as they oft-times have in civil affairs wherefore let no man say unto us that the Ancients have alwayes done thus CHAP. XXV The practice of the former precepts is declared together with a memorable history of a certain Souldier whose Arm was taken off at the Elbow I Think it fit to confirm by an example the prescribed method of curing a Gangrene and Mortification A History Whilest I was Chirurgeon to the Marshall of Montejan at Turin a certain common souldier received a wound on his wrist with a musket-bullet by which the bones and tendons being much broken and the nervous bodies cruelly torn there followed a Gangrene and at length a mortification even to the Elbow besides also an inflammation seised upon the middle part of his Chest and there was as it were a certain disposition to a Gangrene whereby it followed that he was painfully and dangerously troubled with belchings hicketings watchings unquietnesse and frequent swoundings which occasioned many Chirurgeons to leave him as desperate But it so fell out that I orecome by his friends intreaty undertook the cure of this wretched person destitute of all humane help Wherefore knowing the mortification by its signs I cut off the arm by the Elbow as speedily as I could making first the ligature whereof I made mention I say I took it off not with a saw Dismembring at a joynt but only with an incision-knife cutting in sunder the ligaments which held the bones together because the sphacell was not passed the joynt of the Elbow Neither ought this section to be counted strange which is made in a joint for Hippocrates much commends it Sect. 4. Lib. de Art and saith that it is easily healed and that there is nothing to be feared therein besides swounding by reason of the pain caused by cutting the common tendons and ligaments But such incision being made the former ligature could not hinder but much blood must flow from thence by reason of the large vessels that run that way Wherefore I let the blood to flow plentifully so to disburden the part and so afterwards to free it from the danger and fear of inflammation and a Gangrene then presently I stanched the blood with an hot Iron for as yet I knew no other course Then gently loosing the ligature I scarified that part of the brawn of the Arm which was gangrenated with many and deep incisions shunning and not touching the inner part by reason of the multitude of the large vessels and Nerves which run that way then I presently applyed a cautery to some of the incisions both to stanch the bleeding and draw forth the virulent sanies which remained in the part And then I assailed and overcame the spreading putrefaction by putting and applying the formerly prescribed medicins I used all sorts of restrictive medicins to stay the inflammation of the Chest I also applyed Epithemaes to the region of the heart and gave him cordiall potions and boles neither did I desist from using them untill such time as his belching hicketting and swoundings had left him
power to kill it no otherwise then meat well drest is apt to nourish it For Conciliator writes that the properties of poyson are contrary to nourishments in their whole substance for as nourishment is turned into blood in each part of the body whereto it is applied to nourish by perfect assimilation substituted in the place of that portion which flows away each moment Thus on the contrary poyson turns our bodies into a nature like it self and venenate for as every agent imprints the force and qualities thereof in the subject patient thus poyson by the immoderation of faculties in their whole nature conttary to us changeth our substance into its nature no otherwise then fire turneth chaff in a moment into its own nature and so consumes it Therefore it is truly delivered by the Antients who have diligently pried into the faculties of natural things that it is poyson that may kill men by destroying and corrupting their temper and the composure and conformation of the body Now all poysons are said to proceed either from the corrupt air or from living creatures plants and minerals or by any artificial malignity in distilling The differences of poyson subliming and diversly mixing of poysonous and fuming things Hence arise sundry differences of poysons neither do they all work after the same manner for some corrupt onr nature by the unmeasureableness of the manifest and elementary qualities whereof they consist All poysons have not a peculiar antipathy with the heaâ—r others from a specifick and occult property Hence it is that some kill sooner then other some neither is it true that all of them presently assail the heart but others are naturally at deadly strife with other parts of the body as Cantharides with the bladder the sea-Hare with the lungs the Torpedo with the hands which it stupefieth though the fishers rod be betwixt them Thus of medicines there are some which are apt presently to comfort and strengthen the heart others the brain as stoechas others the stomach as cinnamon Also there are some poysons which work both wayes that is by manifest and occult qualities as Euphorbium for that both by the excessive heat and the whole substance or the discotd of the whole substance with ours corrupts our nature An argument hereof is that Treacle which by its quality is manifestly hot infringeth the force thereof as also of all others of an occult propetry Poysons which work by an occult and specifick property do not therefore do it because they are too immoderately hot cold dry moist but for that they are absolutely such and have that essence from the starrs and celestial influence which is apt to dissolve and destroy the strength of mans body because being taken but even in a small quantity yet are they of so pernicious a qualityâ— that they kill almost in a moment Now poysons do not only kill being taken into the body but some being put or applied outwardly neither do venomous creatures onely harm by their stinging and biting but also by their excrements as spittle blood the touch and breath CHAP. II How poysons being small in quantity may by their only touch cause so great alterations IT seemeth strange to many how it may come to pass that poyson taken or admitted in small quantity may almost in a moment produce so pernicious effects over all the body and all the parts faculties and actions so that being admitted but in a little quantity it swells up the body into a great bigness Neither ought it to seem less strange how Antidotes and Counter-poysons which are opposed to poyson can so suddenly break and weaken the great and pernicious effects thereof being it is not so likely that so small a particle of poyson or Antidote can divide it self into so many Cap. 5. lib. 6. de loc affect and so far severed particles of our body There are some saith Galen who think that some things by touth onely by the power of their quality may alter those things which are next to them and that this appears plainly in the fish Torpedo as that which hath so powerful a quality that it can send it alongst the fishers rod to the hand and so make it become torped or numb But on the contrary Philosophers teach that accidents such as qualities are cannot without their subjects remove and diffuse themselves into other subjects The true reason of the wondrous effects of poysons Therefore Galens other answer is more agreeable to reason that so many and great affects of poysons and remedies arise either from a eertain spirit or subtil humidity not truly for that this spirit and subtil humidity may be dispersed over the whole body and all the parts thereof which it affects but that little which is entred the body as cast in by the stroak of a Spider or the sting of a Scorpion infects and corrupts all the next parts by contagion with the like quality these other that are next to them until from an exceeding small portion of the blood if the stroke shall light into the veins it shall spread over the whole mass of blood or of phlegm if the poyson shall chance to come to the stomach and so the force thereof shall be propagated and diffused over all the humors and bowels The doubt of Antidotes is less for these being taken in greater quantity when they shall come into the stomach warmed by the heat of the place they become hot and send forth vapors which suddenly diffused over the body by the subtility of their substance do by their contrary forces dull and weaken the malignity of the poyson Wherefore you may often see when as Antidotes are given in less quantity then is fit that they are less prevalent neither do they answer to our expectation in overcoming the malignity of the poyson so that ir must necessarily follow thar these must not onely in qualities but also in quantity be superior to poysons CHAP. III. Whether there be any such poysons as will kill at a set time No poysons kill in a set time TO the propounded question whether there may be poysons which within a certain and definite time put case a mouth or year may kill men Theophrastus thus answers of poysons some more speedily perform their parts others more slowly yet may you find no such as will kill in set limits of time according to the will and desire of men For that some kill sooner or later then others they do not this of their own or proper nature as Physicians rightly judg but because the subject upon which they light doth more or less resist or yield to their efficacy H w poysons come to kill sooner or later Experience sheweth the truth hereof for the same sort of poyson in the same weight and measure given to sundry men of different tempers and complexions will kill one in an hour another in six hours or in a day and on the contrary will not
out by putting in of warm water made it credible that the plant was poysoned by their spittle and urine whereby you may understand how unwisely they do who devour herbs and fruits newly gathered without washing Also we must take heed lest falling asleep in the fields we lie not near the holes which toads or other venomous beasts of the same nature have made their habitation For thence a venomous or deadly air may be drawn into the lungs May frogs For the same cause we must abstain from eating of frogs in the month of May because then they engender with toads Oxen in feeding somtimes lick up smalltoads together with the grass which presently will breed their great harm for thereupon the Oxen swell so big that they often burst withall Neither is the venom of toads deadly only being taken inwardly but even sprinkled upon the skin unless they forthwith wipe the place and wash it with urine water and salt Such as are poysoned by a toad turn yellow swell over all their bodies are taken with an Asthmatick difficulty of breathing a Vertigo convulsion swounding and lastly by death it self These so horrid symptoms are judged inherent in the poyson of toads not only by reason of the elementary qualities thereof coldness and moisture which are chiefly predominant therein but much rather by the occult property which is apt to putrefie the humors of that body whereto it shall happen The cure Therefore it will be convenient to procure vomit especially if the poyson be taken by the mouth to give glysters and to weaken the strength of the poyson by hot and attenuating Antidotes as treacle and mithridate dissolved in good wine but in conclusion to digest it by baths stoves and much and great exercise Rondeletius in his book de piscibus affirms the same things of the cursed venom of toads as we have formerly delivered yet that they seldom bite but that they cast forth either their urine the which they gather in a great quantity in a large bladder or else their venomous spittle or breath against such as they meet withall or assail besides the herbs which are tainted by their poysonous breath but much more such as are sprinkled with their spittle or urine are sufficient to kill such as eat them Antidotes against the poyson of Toads The Antidotes are juice of betony plantane mug-wort as also the blood of Tortoises made with flower into pils and forthwith dissolved in wine and drunken Plinye writes that the hearts and spleens of Toads resist poyson The vulgar opinion is false who think that the Toad-stone is found in their heads which is good against poyson CHAP. XXV Of the Stinging of a Scorpion The description of a Scorpion His tail A Scorpion is a small creature with a round body in form of an egg with many feet and a long tail consisting of many joynts the last whereof is thicker and a little longer then the rest at the very end thereof is a sting it casts in some two hollow and replete with cold poyson the which by the sting it casts into the obvious body it hath five legs on each side forked with strong claws not unlike to a Crab or Lobster but the two foremost are bigger then the rest they are of a blackish or sooy colour they go aside aside and oft-times fasten themselves with their mouths and feet so fast to them Winged Scorpions that they can scarce be plucked there-hence There be some who have wings like the wings of Locusts wasting the corn and all green things with their biting and burning Such are unknown in France These flie in divers countries like winged Ants. This is likely to be true by that which Matthiolus writes that the husband-men in Castile in Spain in digging the earth oft-times finde a swarm of Scorpions which betake themselves thither against winter Plinie writes that Scorpions laid waste a certain part of Ethiopia by chasing away the inhabitants The Antients made divers kinds of Scorpions according to their variety or difference of colours some being yellow others brown reddish ash-coloured green whitish black dusky some have wings and some are without They are more or lesse deadly according to the countries they inhabit In Tuscany and Scithia they are absolutely deadly but at Trent and in the Iland Pharos their stinging is harmless Symptoms The place stung by a Scorpion presently begins to be inflamed it waxeth red grows hard and swells and the patient is again pained he is one while hot another while cold labour presently wearies him and his pain is some-whiles more and som-whiles less he sweats and shakes as if he had an Ague his hair stands upright paleness dis-colours his members and he feels a pain as if he were pricked with needles over all his skin winde flieth out backwards he strives to vomit and go to stool but doth nothing he is molested with a continual fever and swounding which at length proves deadly unless it be remedied Dioscorides writes Lib. 2. cap. 44. lib 6. ca. 10. that a Scorpion beaten and laid to the place where he is stung is a remedy thereto as also eaten rosted to the same purpose It is an usual but certain remedy to annoint the stung place with the oil of Scorpions There be some who drop into the wound the milky juice of figs others apply calamint beaten other-some use barly-meal mixed with a decoction of Rue Snails beaten together with their shells and laid thereon presently asswage pain Sulphur vivum mixed with Turpentine and applied plaster-wise is good as also the leaves of Rue beaten and laid thereto In like sort also the herb Scorpioides which thence took its name is convenient as also a briony-root boiled and mixed with a little sulphur and old oil Lib. 3. cap. 1. Dioscorides affirms Agarick in powder or taken in wine to be an Antidote against poysons verily it is exceeding good against the stingings or bitings of Serpents Yet the continual use of a bath stands in stead of all these as also sweat and drinking wine some-what allaid Now Scorpions may be chased away by a fumigation of Sulphur and Galbanum also oil of Scorpions dropped into their holes hinders then coming forth Juice of raddish doth the same For they will never touch one that is besmeared with the juice of radish or garlick yea verily they will not dare to come near him CHAP. XXVI Of the stinging of Bees Wasps c. BEes Wasps Hornets and such like cause great pain in the skin wounded by their stinging by reason of the curstness of the venom which they send into the body by the wound yet are they seldom deadly but yet if they set upon a man by multitudes they may come to kill him For thus they have sometimes been the death of horses Wherefore because such as are stung by these by reason of the cruelty of pain may think they are wounded by a more
Lewis Vartoman who denies that Unicorns are wild or fierce for he saith that he saw two which were sent out of Ethiopia to the Sultan who kept them shut up in Penne in Mecha a city of Arabia Felix renowned by the Sepulcher of Mahomet Thevet travelling thither tells that he diligently inquired of the inhabitants what their opinion was of such a beast yet could he never hear any tidings thereof Whence it is easie to discern that such beasts have neither been in our not in Vartomans times The so great variety of dissenting opinions easily induceth me to believe that this word Vnicorn is not the proper name of any beast in the world and that it is a thing only feigned by Painters and Writers of natural things to delight the readers and beholders For as there is but one right way but many by waies and windings so the speech of truth is but one and that alwaies simple and like it self but that of a lie is diverse and which may easily refel it self by the repugnancy and incongruity of opinions if one should say nothing What the ordinary unicorns horns are What therefore will some say of what creatures are these horns which we see wholly different from others if they be not of Unicorns Thevet thinks them nothing else then Elephants bones turned and made into the fashion that we see them for thus in the Eastern Countries some crafty merchants and cunning companions turn hollow and being softned draw to what length these please the teeth of the fish Rohard which lives in the Red and Ethiopian Sea and being so handled they sell them for Unicorns horn Verily that which is termed Unicorns horn being burnt sends forth a smell like to Ivory Now Cardanus affirms that the teeth and bones of Elephants made soft by art may be drawn forth and brought into what form you please like as Ox-bones are For what is there in the world which the thirsting desire of gold will not make men to adulterate and counterfeit The Unicorns born is not effectual against poyson But it is time that we come to the third scope Grant there be Unicorns must it therefore follow that their horns must be of such efficacy against poysons If we judg by events and the experience of things I can protest thus much that I have often made trial thereof yet could I never find any good success in the use thereof against poysons in such as I have had in cure If the matter must be tried by witnesses and authorities a great part of the Physicians of better note have long since bid it adieu and have detracted from the divine and admirable vertues for which it formerly was so much desired And this they have done moved thereto by many just but two especial reasons Lib. de ponder cap. 19. Horns and bones not effectual unless to dâ—ie The first is of Rondoletius who in this case affirms that horns are endued with no taste nor smell and therefore have no effect in physick unless it be to dry Neither saith he am I ignorant that such as have them much predicate their worth so to make the greater benefit and gain by them as of the shavings or scrapings of Unicorns horn which they sell for the weight in gold as that which is singular good against poysons worms which things I think Harts-horn and Ivory do no less effectually perform which is the cause why for the same disease and with the like success I prescribe Ivory to such as are poor and Unicorns horn to the rich as that they so much desire This is the opinion of Rondoletius who without any difference was wont for Unicorns horn to prescribe not only Harts horn or Ivory but also the bones of Horses and Dogs and the stones of Myrabalanes Another reason is that whatsoever resists poyson is cordial that is fit to strengthen the heat which is chiefly assailed by poysons but nothing is convenient to strengthen the heart unless it be by laudable blood or spirit which two are only familiar to the heart as being the work-house of the arterious blood and vital spirits For all things are preserved by their like as they are destroied by their contraries for all things that generate generate things like themselvs But Unicorns horn as it contains no smell so neither hath it any aery parts but is wholly earthy and dry neither can it be converted into blood by the digestive faculty for as it is without juice so is it without flesh For as it cannot be turned into Chylus so neither is it fit to become Chymus that is juice or blood Therefore it is joyned to the heart by no similitude nor familiarity Furthermore there is not a word in Hippocrates and Galen corcerning the Unicorns horn who notwithstanding have in so many places commended Harts-horn Therefore D. Chapelain the chief Physician of King Charls the ninth often used to say that he would very willingly take away that custom of dipping a piece of Unicorns horn in the Kings cup but that he knew that opinion to be so deeply ingraffed in the minds of men that he feared that it would scarce be impugned by reason Besides he said if such a superstitious medicine do no good so certainly it doth no harm unless it be to their estates that buy it with gold or else by accident because Princes whilst they relie more then is fitting upon the magnified virtues of this horn neglect to arm themselves against poysons by other more convenient means so that death oft-times takes them at unawares When as upon a time I inquired of Lewis Duret the Kings Physician and Professor by reason of the great opinion that all learned men justly had of his learning and judgment what he thought of this horn He answered that he attributed no faculties thereto for the confirmation whereof he rendred the second reason I have formerly given but more largely and elegantly neither feared he to affirm it aloud and in plain words to his auditory of learned men coming from all parts to hear him In what cases good But if at any time ore'come by the fault of the times and place he prescribed this horn that he did it for no other intent then to help faintings or swoundings that happen by the abundance of serous humors floating in the orifice of the ventricle which makes men ill disposed because this mixed with other things endued with the like faculty hath power to drink up the waterish humidity by its earthy driness But some will reply that neither the Lemnian nor Armenian earth have any juice in them neither any smell nor aiery spirit It is granted neither truly are such things truly and properly called cordial but only by event and accident for that by the excellent and astrictive faculty they have and stopping the passages of the vessels they hinder the poison from entring into the heart This is my opinion of Unicorns horn which if any
hinder natures diligence and care of concoction For as in the Dog-Dayes the lees of wine subsiding to the bottom are by the strength and efficacie of heat drawn up to the top and mixed with the whole substance of the wine as it were by a certain ebullition or working so melancholick humors being the dregs or lees of the blood stirred by the passions of the minde defile or taint all the blood with their seculent impurity We found that some years agon by experience at the battle of S. Dennis For all wounds by what weapon soever they were made degenerated into great and filthy putrefactions and corruptions with severs of the like nature and were commonly determined by death what medicines and how diligently soever they were applied which caused many to have a false suspicion that the weapons on both sides were poysoned But there were manifest signs of corruption and putrefaction in the blood let the same day that any were hurt and in the principal parts disected afterwards that it was from no other cause then an evil constitution of the air and the mindes of the Souldiers perverted by hate anger and fear CHAP. V. What signs in the Air and Earth prognosticate a Plague WEe may know a plague to be at hand and hang over us if at any time the air and seasons of the year swerve from their natural constitution after those waies I have mentioned before if frequent and long continuing Meteors or sulphureous Thunders infect the air Why abortions are frequent in a pestilent season if fruits seeds and pulie be worm-eaten If birds forsake their nests eggs or young without any manifest cause if we perceive women commonly to abort by continual breathing in the vaporous air being corrupted and hurtful both to the Embryon and original of life and by which it being suffocated is presently cast forth and expelled Yet notwithstanding those airy impressions do not solely courrupt the air but there may be also others raised by the Sun from the filthy exhalations and poysonous vapors of the earth and waters or of dead carkasses which by their unnatural mixture easily corrupt the air subject to alteration as that which is thin and moist from whence divers Epidemial diseases and such as are every-where seize upon the common sort according to the several kinds of corruptions A Catarrh with difficulty of breathing killing many such as that famous Catarrh with difficulty of breathing which in the year 1510 went almost all over the world and raged over all the Cities and Towns of France with great heaviness of the head whereupon the French named it Cuculla with a straitness of the heart and lungs and a cough a continual fever and sometimes raving This although it seized upon many more then it killed yet because they commonly died who were either let blood or purged it shewed it self pestilent by that violent and peculiar and unheard of kinde of malignity The English Sweating-sickness Such also was the English Sweating-sickness or Sweating-fever which unusual with a great deal of terror invaded all the lower parts of Germany and the Low-Countries from the year 1525 unto the year 1530 and that chiefly in Autumn As soon as this pestilent disease entred into any City suddenly two or three hundred fell sick on one day then it departed thence to some other place The people strucken with it languishing fel down in a swound and lying in their beds sweat continually having a fever a frequent quick and unequal pulse neither did they leave sweating till the disease left them which was in one or two daies at the most yet freed of it they languished long after they all had a beating or palpitation of the heart which held some two or three years and others all their life after At the first beginning it killed many before the force of it was known but afterwards very few when it was found out by practice and use that those who furthered and continued their sweats and strengthened themselves with cordials were all restored But at certain times many other popular diseases sprung up as putrid fevers fluxes bloody-fluxes catarrhs coughs phrenzies squinances plurisies inflamations of the lungs inflamations of the eies apoplexies lithargies The Plague is not the definite name of one disease small pox and meazles scabs carbuncles and malign pustles Wherefore the Plague is not alwaies nor every-where of one and the same kinde but of divers which is the cause that divers names are imposed upon it according to the variety of the effects it brings and symptoms which accompany it and kinds of putrefaction and hidden qualities of the air What signs in the earth foreteâ—l a plague They affirm when the Plague is at hand that Mushroms grow in greater abundance out of the Earth and upon the surface thereof many kinds of poysonous insecta creep in great numbers as Spiders Catterpillers Butter-flies Grass-hoppers Beetles Hornets Wasps Flies Scorpions Snails Locusts Toads Worms and such things as are the off-spring of putrefaction And also wilde beasts tired with the voporous malignity of their dens and caves in the Earth forsake them and Moles Toads Vipers Snakes Lizards Asps and Crocodiles are seen to flie away and remove their habitations in great troops For these as also some other creatures have a manifest power by the gift of God and the instinct of Nature to presage changes of weather as rains showrs and fair weather and seasons of the year as the Spring Summer Autumn Winter which they testifie by their singing chirping crying flying playing and bearing with their wings and such like signs so also they have a perception of a Plague at hand And moreover the carkasses of some of them which took less heed of themselves suffocated by the pestiferous poyson of the ill air contained in the earth may be every-where found not onely in their dens but also in the plain fields These vapors corrupted not by a simple putrefaction but an occult malignity How pestilent vapors may kill plants and trees are drawn out of the bowels of the earth into the air by the force of the Sun and Stars and thence condensed into clouds which by their falling upon corn trees and grass infect and corrupt all things which the earth produceth and also kills those creatures which feed upon them yet brute beasts sooner then men as which stoop and hold their heads down towards the ground the maintainer and breeder of this poyson that they may get their food from thence Therefore at such times skilful husbandmen taught by long experience never drive their Cattle or Sheep to pasture before that the Sun by the force of his beams hath wasted and dissipated into air this pestiferous dew hanging and abiding upon the boughs and leaves of trees herbs corn and fruits But on the contrary that pestilence which proceeds from some malign quality from above by reason of evil and certain conjunction of the Stars is
speedily putrefie Men that are of an ill juyce are also most apt to this kind of Pestilence for in the naughty quality of the juyce there is a great preparation of the humors unto putrefaction You may know it by this that when the Pestilence reigneth there are no other diseases among the common people which have their original of any ill juyce but they all degenerate into the Plague Therefore when they begin to appear and wander up and down it is a token that the Pestilence will shortly cease or is almost at an end But here also I would have you to understand those to be of an ill juyce which have no pores in their skin by which as it were by rivers the evil juyce which is contrary to nature may be evacuated and purged Who least subject to take the Plague And I have noted and observed that those are less in danger of the Pestilence which have Cancerous Ulcers and stinking sores in their Noses and such as are infected with the French-Pox and have by reason thereof tumors and rotten Ulcers or have the Kings-evil running upon them the Leprosie or the Scab and to conclude all those that have Fistulaes and running in their bodies I think those that have quartane Fevers are the better priviledged for the same because that by the fit causing sweat that cometh every fourth day they avoid much of the evill juyce that was engendred This is more like to be true then to think that the poyson that cometh from without may be driven away by that which lurketh within Contrariwise women that are great with childe as I have noted Who subject thereto because they have much ill juyce being prohibited from their accustomed evacuations are very apt to take this disease and so seldom recover after they are infected Black or blew Impostumes and spots and pustles of the same colour dispersed over the skin Signs the disease is incurable A good sign argue that the disease is altogether incurable and mortal When the swelling or sore goeth or cometh before the Fever it is a good sign for it declareth that the malignity is very weak and feeble and that nature hath overcome it which of it self is able to drive so great portion thereof from the inner parts A deadly sign But if the sore or tumor come after the Fever it is a mortal and deadly sign for it is certain that it cometh of the venomous matter not translated but dispersed not by the victory of nature but through the multitude of the matter with the weight whereof nature is overcome When the Moon decreaseth those that are infected with the Pestilence are in great doubt and danger of death because then the humors that were collected and gathered together before the Full of the Moon through delay and abundance do swell the more and the faculties by which the body is governed become more weak and feeble because of the imbecillity of the native heat which before was nourished and augmented by the light and so consequently by the heat of the Full Moon For as it is noted by Aristotle the Wainings of the Moon are more cold and weak and thence it is that women have their menstrual fluxes chiefly or commonly at that time In a gross and cloudy air the pestilent infection is less vehement and contagious In what air most contagious then in a thin and subtil air whether that thinness of the air proceed from the heat of the Sun or from the North winde and cold Therefore at Paris where naturally and also through the abundance of filth that is about the City the air is dark and gross the pestilent infection is less fierce and contagious then it is in Province for the subtilty of the air stimulates or helps forward the Plague But this disease is mortal and pernicious wheresoever it be because it suddenly assaulteth the heart which is the Mansion or as it were the fortress or castle of life but commonly not before the signs and tokens of it appear on the body and yet you shall scarce find any man that thinketh of calling the Physician to help to preserve him from so great a danger before the signs thereof be evident to be seen and felt but then the heart is assaulted And when the heart is so assaulted what hope of life is there or health to be looked for What effects fear and confidence produce in the Plague Therefore because medicines come oft-times too late and this malady is as it were a sudden and winged messenger of our death it cometh to pass that so many die thereof And moreover because of the first suspicion of this so dire and cruel a disease the imagination and mind whose force in the diversly much stirring up of the humors is great and almost incredible is so troubled with fear of imminent death and despair of health that together with the preturbed humors all the strength and power of nature falleth and sinketh down This you may perceive and know by reason that the keepers of such as are sick and the bearers which are not fearful but very confident although they do all the basest offices which may be for the sick are commonly not infected and seldom die thereof if infected CHAP. XVIII How a pestilent Fever comes to be bred in us THe Plague oft-times findeth fuel in our bodies and oft-times allurements to wit the putrefaction of humors or aptness to putrefie but it never thence hath its first original for that comes alwayes from the defiled air therefore a pestilent Fever is thus bred in us The pestilent air drawn by inspiration into the lungs The original of the Plague alwayes from the air and transpiration into the utmost mouths of the veins and arteries spread over the skin the bloud or else the humors already putrefying or apt to putrefie therein are infected and turned into a certain kind of malignity resembling the nature of the agent These humors like unquench't lime when it is first sprinkled with water send forth a putrid vapor which carryed to the principal parts and heart especially infecteth the spirituous bloud boyling in the ventricles thereof and therewith also the vital spirits and hence proceeds a certain feverish heat This heat diffused over the body by the arteries together with a malign quality taints all even the solid parts of the bones with the pestiferous venom and besides causeth divers symptoms according to the nature thereof and the condition of the body and the hâ—mors wherein it is Then is the conflict of the malignity assailing and nature defending manifest in which if nature prevail it using the help of the expulsive faculty will send and drive it far from the noble parts either by sweats vomits bleeding evacuation by stool or urine buboes carbuncles pustles spots and other such kinds of breakings out over the skin Signs that nature is oâ—â—come But on the contrary if the malignity prevail
aceti rosar an lb. ss sant rub ros rub anÊ’iii flor nenuph. violar camphur an Ê’ss methridat theriac an Ê’ii terantur misceantur simul omnia When you intend to use them take some portion of them in a vessel by its self wherewith let the affected bowel be fomented warm CHAP. XXIV Whether purging and blood-letting be necessary in the beginning of pestilent diseases SO soon as the heart is strengthened and corroborated with cordials and antidotes Reasons for and against blood-letting in the Plague we must come to phlebotomy and purging As concerning blood-letting in this case there is a great controversie among Physicians Those that wish it to be used say or affirm that the pestilent Fever doth infix it self in the blood and therein also the pestilent malignity taketh its seat and therefore it will soon infect the other humors unless that the blood be evacuated and the infection that remaineth in the blood be thereby taken away Contrariwise those that do not allow phlebotomy in this case alledg that it often cometh to pass that the blood is void of malignity when the other humors are infected with the venomous contagion If any man require my judgment in this doubtful question I say that the pestilence sometimes doth depend on the default of the Air this default being drawn through the passages of the body doth at length pierce unto the intrails as we may understand by the abscesses which break out The composing of this controversie one while behind the ears sometimes in the arm-holes and sometimes in the groins as the brain heart or liver are infected And hereof also come Carbuncles and other collections of matter and eruptions which are seen in all parts of the body by reason that nature using the strength of the expulsive faculty doth drive forth whatsoever is noisom or hurtful Therefore if the Physician will follow this motion of nature he must neither purge nor let blood lest that by a contrary motion that is by drawing in from without the motion of nature which proceeds outwardly from within should be troubled So we often see in those who are purged or let blood for such Buboes as come through unlawful copulation that the matter is thereby made contumacious and by drawing it inwardly it speedily causeth the French Pox. Wherefore When Bubes Carbuncles and other pestilent eruptions appear which come through the default of the air we ought to abstain from purging and phlebotomy but it is sufficient to fore-arm the heart inwardly and outwardly with Antidotes that are endued with a proper virtue of resisting the poison For it is not to be doubted but that when nature is debilitated with both kinds of evacuation and when the spirits together with the blood are exhausted the venomous air will soon pierce and be received into the empty body where it exerciseth its tyranny to the utter destruction thereof An history In the year of our Lord God 1566. in which year there was great mortality throughout all France by reason of the pestilence and pestilent diseases I earnestly and diligently inquired of all the Physicians and Chyrurgions of all the Cities through which King Charls the Ninth passed in his progress unto Bayon what success their patients had after they were let blood and purged whereunto they all answered alike that they had diligently observed that all that were infected with the Pestilence and were let bleed some quantity of blood or had their bodies somewhat strongly purged thence forwards waxed weaker and weaker and so at length died but others which were not let blood nor purged but took cordial Antidotes inwardly and applied them outwardly for the most part escaped and recovered their health for that kind of Pestilence took its original of the primitive and solitary default of the Air and not of the corruption of the humors When purging and bleeding may be used The like event was noted in the hoarsness that we spake of before that is to say that the patients waxed worse and worse by purging and phlebotomy but yet I do not disallow either of those remedies if there be great fulness in the body especially in the beginning and if the matter have a cruel violence whereof may be feared the breaking in unto some noble part For we know that it is confirmed by Hippocrates Aph. 22 sect 2. Aph. 10 sect 4. that what disease soever is caused by repletion must be cured by evacuation and that in diseases that are very sharp if the matter do swell it ought to be remedied the same day for delay in such diseases is dangerous but such diseases are not caused or inflicted upon mans body by reason or occasion of the pestilence but of the diseased bodies and diseases themselves commixed together with the pestilence therefore then peradventure it is lawful to purge strongly and to let a good quantity of blood least that the pestilent venom should take hold of the matter that is prepared and so infect it with a contagion whereby the pestilence taketh new and far greater strength especially as Celsus admonisheth us Cap. 7. lib. 3. where he saith that by how much the sooner those sudden invasions do happen by so much the sooner remedies must be used yea or rather rashly applyed therefore if the veins swell the face wax fiery red if the arteries of the temples beat strongly if the patient can very hardly breath by reason of a weight in his stomach if his spittle be bloody then ought he to be let blood without delay for the causes before mentioned It seems best to open the Liver-vein on the left arm whereby the heart and spleen may be better discharged of their abundant matter Why blood must be let on the left arm in the Plague yet blood-letting is not good at all times for it is not expedient when the body beginneth to wax stiff by reason of the coming of a Fever for then by drawing back the heat and spirits inwardly the outward parts being destitute of blood wax stiff and cold therefore blood cannot be let then without great loss of the strength and perturbation of the humors And it is to be noted that when those phlethorick causes are present there is one Indication of blood-letting in a simple pestilent Fever and another in that which hath a Bubo id est a Botch or a Carbuncle joined therewith For in one or both of these being joined with a vehement and strong burning Fever blood must be letten by opening the vein that is nearest unto the tumor or swelling against nature keeping the straitness of the fibres that this being open the blood might be drawn more directly from the part affected for all and every retraction of putrefied blood unto the noble parts is to be avoided because it is noisom and hurtful to nature and to the patient Therefore for example sake admit the patient be plethorick by repletion which is called Ad Vasa id
away the flesh that was under them that the rough artery or winde-pipe might be seen bare when the Eschar was fallen away I had once a Carbuncle which was in the midst of my belly so that when the Eschar was fallen away I might very plainly see the Peritoneum or Rim and the cicatrice that remaineth is as broad as my hand but they do not spread themselves so far without the great danger or death of the patient There are also some Carbuncles which beginning at the parts under the chin disperse themselves by little and little unto the battle-bones and so strangle the patient So in many the Buboes in the groin arâ—se above a great part of the muscles of the Epigastrium Truly of those abscesses that are so large great in quantity Huge pestilent Abscesses commonly deadly and so terrible to be seen there is great danger of death to the patient or at least to the grieved part For after the consolidation the part remaineth as if it were leprous which abolisheth the action of the part as I have seen in many Oftentimes also the corruption of the matter is so great that the flesh leaveth the bones bare but Carbuncles often leave the joints and ligaments quite resolved through the occasion of the moisture that is soaked and sunk into them for they often cast out putrefied â—nd virulent sanious matter whereby eating and creeping ulcers are bred many blisters and pustles arising up in the parts round about it which shortly breaking into one make a great ulcer These come very seldom and slowly unâ—o suppuration or at least to cast out laudable matter especially if they have their origional of choler because the matter is sooner burned with heat then suppurated Therefore then if they can be brought to suppuration by no medicines if the tumor still remain black Deadly Carbuncles if when they are opened nothing at all or else a very little sharp moisture doth come forth they aâ—e altogether mortal and there is scarce one of a thousand who hath these accidents that recovereth health Dispersed small blisters coming of vapors stirred up by the matter that is under the skin and are there staied and kept from passage forth do not necessarily fore-shew death â—n Carbuncles But if the part be swoln or puffed â—p if it be of a green or black colour and if it feel neither pricking not burning it is a sign of a mortal Gangrene Buboes or Carbuncles seldom or never come without a Fever but the Fever is more vehement when they are in the emunctaries or nervous parts then when they are in the fleshly parts yet it is less and all Symptoms are less and more tolerable in a man that is strong and of a good temperature Carbuncles not only affect the outward but also the inward parts and oftentimes both together Jf the heart be vexed in such sort with a Carbuncle that nothing thereof appeareth forth on the superficial parts all hope of life is past and those die suddenly eating drinking or walking and not thinking any thing of death If the Carbuncle be in the midriff or lungs they are soon suffocated If it be in the brain the patient becometh frantick and so dieth If it be in the parts appointed for the passage of the urine they die of the suppression of their water as it happened in the Queen-mothers waiting maid at the Castle of Rossilion of whom I spak before If it be in the stomach it interreth the accidents that are shewed in this history following While I was Surgeon in the Hospital of Paris a young and strong Monk of the order of St. Victor being overseer of the woman that kept the sick people of that place An history fell into a continual Fever very suddenly with his tongue black dry rough by reason of the putrefied and corrupted humors and the vapors rising from the whole body unto that place and hanging out â—â—â—e unto an hounds with unquenchable thirst often swounding and desire to vomit He hath convulsions over all his body through the vehemency and malignity of the disease and so he died the third day Wherefore those that kept the sick people in the Hospital thought that he had been poisoned for the certain knowledg whereof the Governors of the Hospital commanded his body to be opened I therefore calling to me a Physician and Surgeon we found in the bottom of his stomach a print or impression as if it had been with an hot iron or potential Cautery with an Eschar or â—ruâ—â— as broad as ones nail all the rest of his stomach was greatly contracted and shrunk up together and as it were horny which we considering and especially the Eschar which was deep in the substance of the stomach we all said with one voice that he was poysoned with Sublimate or Arsenick But behold while I was sowing up his belly I perceived many black spots dispersed diversly throughout the skin then I asked my company what they thought of those spots truly said I it seemeth unto me that they are like unto the purple spots or marks that are in the pestilence The Physician and the Surgeon denied it and said that they were the bitings of fleas But I perswaded them to consider the number of them over all the whole body and also of their great depth and depression into the flesh for when we had thrust needles deep into the flesh in the middest of them and so cut away the flesh about the needle How to distinguish purple spots from flea bitings we found the flesh about the needle to be black moreover his nostrils nails and ears were livid and all the constitution of his body was contrary and far unlike to the bodies of those that died of other sicknesses or diseases Also it was credibly reported unto us by those that kept him that his face was so altered a little before he died that his familiar friends could hardly know him We perswaded by these proofs revoked our former opinion and sentence and made a Certificate to be sent unto the Governors and Masters of the Hospital setting our hands and seals unto it to certifie them that he died of a pestilent Carbuncle CHAP. XXXIV Of the Cure of a pestilent Carbuncle BY the fore named signs of a pestilent Carbuncle and especially by the bitterness of the pain malignity of the venomous matter Why emplastick very hot and great drawers are not good for a Carbuncle and by the burning fever that is therewithall annexed I think it manifest that very hot emplastick and drawing medicines should not be applied to this kind of tumor because they prohibit or hinder the exhalation or wasting forth of the venenate malignity because that by stopping the pores of the skin they increase and cause a greater heat in the part then there was before Therefore it is better to use resolving medicines which may asswage heat and resolve the pores of the skin Therefore first
womb There are women that bear the childe in their womb ten or eleven whole moneths and such children have their conformation of much quantity of seed wherefore they will be more big great and strong and therefore they require more time to come to their perfection and maturity for those fruits that are great will not be so soon ripe as those that are small But children that are small and little of body do often come to their perfection and maturity in seven or nine moneths if all other things are correspondent in greatness and bigness of body it happeneth for the most part that the woman with childe is not delivered before the ninth moneth be done A male will be born soonner then a female or at the leastwise in the same moneth But a male childe will be commonly born at the beginnâ—ng or a little before the begining of the same moneth by reason of his engrafted heat which causeth maturity and ripeness Furthermore the infant is sooner come to maturity and perfection in a hot woman then in a cold for it is the property of heat to ripen CHAP. XXXI How to preserve the infant in the womb when the mother is dead IF all the signes of death appear in the woman that lieth in travel and cannot be delivered there must then be a Surgeon ready and at hand which may open her body so soon as she is dead whereby the infant may be preserved in safety neither can it be supposed sufficient if the mothers mouth and privie parts be held open for the infant being inclosed in his mothers womb Why it is not sufficient to preserve life in the childe to hold open the mouth and privie parts of the mother so soon as she is dead and the childe alive in her body and compassed with the membranes cannot take his breath but by contractions and dilatations of the artery of the navel But when the mother is dead the lungs do not execute their office function therefore they cannot gather in the air that compasseth the body by the mouth or aspera arteria into their own substance or into the arteries that are dispersed throughout the body thereof by reason whereof it cannot send it unto the heart by the veiny artery which is called arteria venalis for if the heart want air there cannot be any in the great artery which is called arteria aorta whose function it is to draw it from the heart as also by reason thereof it is wanting in the arteries of the womb which are as it were the little conduits of the great artery whereinto the air that is brought from the heart is derived and floweth in unto these little ones of all the body and likewise of the womb Wherefore it must of necessity follow that the air is wanting to the cotyledons of the secundines to the artery of the infants navel the iliack arteries also and therefore unto his heart and so unto his body for the air being drawn by the mothers lungs is accustomed to come to the infant by this continuation of passages How the bellie of the woman that dieth in travel must be cut open to save the childe Therefore because death maketh all the motions of the mothers body to cease it is far better to open her body so soon as she is dead beginning the incision at the cartilage Xiphoides or blade and making it in a form semicircular cutting the skin muscles and peritonaeum not touching the guts then the womb being lifted up must first be cut lest that otherwise he infant might perchance be touched or hurt with the knife You shall oftentimes finde the childe unmoveable as though he were dead but not because he is dead indeed but by reason that he being destitute of the accesse of the spirits by the death of the mother hath contracted a great weakness yet you may know whether he be dead indeed or not by handling the artery of the navel for it will beat and pant if he be alive otherwise not but if there be any life yet remaining in him How it may be known whether the infant be aâ—ive or not shortly after he hath taken in the air and is recreated with the access thereof he will move all his members and also all his whole body In so great a weakness or debility of the strength of the childe by cutting the navel string it must rather be laid close to the region of the belly thereof that thereby the heat if there be any jot remaining may be stirred up again But I cannot sufficiently marvel at the insolency of those that affirm that they have seen women whose bellies and womb have been more then once cut and the infant taken out when it could no otherwise be gotten forth and yet notwithstanding alive which thing there is no man can perswade me can be done without the death of the mother by reason of the necessary greatness of the wound that must be made in the muscles of the belly and substance of the womb for the womb of a woman that is great with childe by reason that it swelleth and is distended with much blood must needs yield a gread flux of blood which of necessity must be mortal And to conclude when that the wound or incision of the womb is cicatrized it will not peâ—mit or suffer the womb to be dilated or extended to receive or bear a new birth For these and such like other causes this kinde of cure as desperate and dangerous is not in mine opinion to be used CHAP. XXXII Of superfetation SUperfetation is when a woman doth bear two or more children at one time in her womb What superfetation is and they be enclosed each in his several secundine but those that are included in the same secundine are supposed to be conceived at one and the same time of copulation by reason of the great and copious abundance of seed and these have no number of daies between their conception and birth but all at once For as presently after meat the stomach which is naturally of a good temper is contracted or drawn together about the meat to comprehend it on every side though small in quantity as it were by both hands so that it cannot rowl neither unto this or that side so the womb is drawn together into the conception about the seeds assoon as they are brought into the capacity thereof and is so drawn in unto it on every side that it may come together into one body not permitting any portion thereof to go into any other region or side so that by one time of copulation the seed that is mixed together cannot engender more children then one which are divided by their secundines A womans womb is not distinguished into diverse cells And moreover because there are no such cells in the wombs of women as are supposed or rather known to be in the wombs of beasts which therefore bâ—ing forth many
suffocation of the womb live only by transpiration without breathing will stain or make the glass duskie Also a fine downish feather taken from under the wing of any bird or else a fine flock being held before the mouth will by the trembling or shaking motion thereof shew that there is some breath and therefore life remaining in the body But you may prove most certainly whether there be any spark of life remaining in the body by blowing some sneesing powders of pellitory of Spain and Elebore into the nostrils But though there no breath appear yet must you not judge the woman for dead for the small vital heat by which being drawn into the heart she yet liveth is contented with transpiration only and requires not much attraction which is performed by the contraction and dilatation of the breast and lungs unto the preservation of it self For so flies gnats pismires and such like How flies gnats and pismires do live all the winter without breathing because they are of a cold temperament live unmoveably inclosed in the caves of the earth no token of breathing appearing in them because there is a little heat left in them which may be conserved by the office of the arteries and heart that is to say by perspiration without the motion of the breast because the greatest use of respiration is that the inward heat may be preserved by refrigeration and ventilation Those that do not mark this fall into that error which almost cost the life of him who in our time first gave life to Anatomical administration that was almost decayed and neglected For he being called in Spain to open the body of a noble woman which was supposed dead through strangulation of the womb behold at the second impression of the incision-knife A history she began suddenly to come to her self and by the moving of her members and body which was supposed to be altogether dead and with crying to shew manifest signs that there was some life remaining in her Which thing struck such an admiration and horror into the hearts of all her friends that were present that they accounted the Physicâ—an being before of a good fame and report as infamous odious and detestable so that it wanted but little but that they would have scratched out his eyes presently wherefore he thought there was no better way for him if he would live safe then to forsake the Country But neither could he so also avoid the horrible prick and inward wound of his conscience from whose judgment no offendor can be absolved for his inconsiderate dealing but within few dayes after being consumed with sorrow he died to the great loss of the Common-wealth and the art of Physick CHAP. XLVII How to know whether the strangulation of the wombe comes of the suppression of the Flowers or the corruption of the seed The signs of suffocation of the womb comming of corrupt seed THere are two chief causes especially as most frequently happening of the strangulation of the womb but when it proceedeth from the corruption of the seed all the accidents are more grievous and violent difficulty of breathing goes before and shortly after comes deprivation thereof the whole habit of the body seemeth more cold then a stone the woman is a widow or else hath great store or abundance of seed and hath been used to the company of a man by the absence whereof she was before wont to be pained with heaviness of the head to loath her meat and to be troubled with sadness and fear but chiefly with melancholy Moreover The signs when it comes of the suppression of the flowers when she hath satisfied and every way fulfilled her lust and then presently on a sudden begins to contain her self It is very likely that she is suffocated by the suppression of the flowers which formerly had them well and sufficiently which formerly had been fed with hot moist and many meats therefore engendring much blood which sitteth much which is grieved with some weight and swelling in the region of the belly with pain in the stomach and a desire to vomit and with such other accidents as come by the suppression of the flowers The signs of one recovering of or from the suffocation of the womb Those who are freed from the fit of the suffocation of the womb either by nature or by art in a short time their colour cometh into their faces by little and little and the whole body beginneth to wax strong and the teeth that were set and closed fast together begin the jaws being loosed to open and unclose again and lastly some moisture floweth from the secret parts with a certain tickling pleasure but in some women as in those especially in whom the neck of the womb is tickled with the Midwives finger instead of that moisture comes thick and gross seed which moisture or seed when it is fallen the womb being before as it were raging is restored unto its own proper nature and place Why the suppression of the seed is not perilous or deadly to men and by little and little all symptoms vanish away Men by the suppression of their seed have not the like symptoms as women have because mans seed is not so cold and moist but far more perfect and better digested and therefore more meet to resist putrefaction and whiles it is brought or drawn together by little and little it is dissipated by great and violent exercise CHAP. XLVIII Of the cure of the Strangulation of the Womb. The pulling of the hairs of the lower parts are profitable both for this malady and for the cause of the same SEeing that the strangulation of the womb is a sudden and sharp disease it therefore requireth a present and speedy remedy for if it be neglected it many times causeth present death Therefore when this malady cometh the sick woman must presently be placed on her back having her breast and stomach loose and all her cloaths and garments slack and loose about her whereby she may take breath the more easily and she must be called on by her own name with a loud voice in her ears and pulled hard by the hairs of the temples and neck but yet especially by the hairs of the secret parts that by provoking or causing pain in the lower parts the patient may not only be brought to her self again but also that the sharp and malign vapour ascending upwards may be drawn downwards the legs and arms must be bound and tied with painfull ligatures all the body must be rubbed over with rough linnen clothes besprinkled with salt and vineger untill it be very sore and red and let this pessary following be put into the womb A Pessary â„ž succi mercurial artemis an â„¥ ii in quibus dissolve pul bened Ê’ iii. pul radic enula camp galang minor an Ê’ i. make thereof a pessary Then let the soals of her feet be anointed with oil of bayes
What an Embrocation iâ— when as from an high we as it were showâ— down some moisture upon any part This kinde of remedy is chiefly used in the parts of the head and it is used to the coronal future for that the skul is more thin in that part so that by the spiracula or breathing places of this future more open then chose of the other futures the force of the medicine may more easily penetrate unto the Meninges or membranes of the brain The matter of Embrocations is roots leaves flowers seeds fruits and other things according to the intention and will of the Physician They are boiled in water and wine to the half or third part Embrocations may also be made of Lye or Bâ—ine against the cold and humid affects of the brain Sometimes of oyl and vineger otherwhiles of oyl only â„ž fol. plantag solan an m. i. sem portul cucurb an Ê’ ii myrtil Ê’ i. flor nymph ros an p. ss fiat decoct ad lb i. cum aceti â„¥ ii si alte subeundem sit ex qua irrigetur pars inflammata In affects of the brain when we would repercuss we often and with good success use oyl of Roses with a fourth part of vineger We use Embrocations Their use that together with the air drawn into the body by the Diastole of the arteries the subtler part of the humor may penetrate and so cool the inflamed part for the chief use of Embrocations is in hot affects Also we use Embrocations when as for fear of an haemorrhagy or the slying asunder of a broken or dislocated member we dare not loose the bondages wherein the member is bound For then we drop down some decoction or oyl from high upon the bondages that by these the force of the medicine may enter into the affected member CHAP. XXXI Of Epithemes EPithema or an Epitheme is a composition used in the diseases of the parts of the lower middle belly like to a fomentation not much unlike an embrocation What an Epitheme is They are made of waters juices and powders by means whereof they are used to the heart chest liver and other parts Wine is added to them for the more or less penetration as the condition of the hot or cold affect shall seem to require for if you desire to heat more wine must be added as in swooning by the clotting of blood by the corruption of the seed by drinking some cold poison the contrary is to be done in a fainting by dissipation of the spirits by feverish heats also vineger may be added The matter of the medicines proper to the entrails is formerly described yet we commonly use the species of electuaries as the species elect triasantali the liver being affected In the sixth Chapter and Diamargariton in affects of the heart The proportion of the juices or liquors to the powders uses to be this to every pinte of them â„¥ i. or â„¥ iss of these of wine or else of vineger â„¥ i. You may gather this by the following example A cordial Epitheme â„ž aqu ros bugl borag an â„¥ iii. succi scabios â„¥ ii pul elect diamarg. frigid Ê’ii cort citri sicciÊ’i coral ros ebor an Ê’ ss sem citri card ben an Ê’ii ss croci moschi an gra 5. addendo vini albi â„¥ ii fiat Epithema pro corde Their use Epithemes are profitably applied in hectick and burning fevers to the liver heart and chest if so be that they be rather applied to the region of the lungs then of the heart for the heat of the lungs being by this means tempered the drawn in air becomes less hot in the pestilent and drying fevers They are prepared of humecting refrigerating and cordial things so to temper the heat and recreate the vital faculty Sometimes also we use Epithemes to strengthen the heart and drive there-hence venenate exhalations lifted or raised up from any part which is gangrenate or sphacelate Some cotton or the like steeped or moistened with such liquors and powders warmed is now and then to be applied to the affected entrail this kinde or remedy as also all other topick particular medicines ought not to be used unless you have first premised general things CHAP. XXXII Of Potential Cauteries The use of potential cauteries THat kinde of Pyrotick which is termed a Potential Cautery burns and causeth an eschar The use of these kindes of cauteries is to make evacuation derivation revulsion or attraction of the humors by those parts whereto they are applied Wherefore they are often and with good success used in the punctures and bites of venemous beasts in a venemous as also in a pestilent Bubo and Carbuncle unless the inflammation be gâ—eat for the fire doth not only open the part but also retunds the force of the poison calls forth and plentifully evacuates the conjunct matter Also they are good in phlegmatick and contumacions tumors for by their heat they take away the force and endeavours of our weak heat Also they are profitably applied to stanch bleeding or eat or waste the superfluous flesh of ulcers and wens to bring down the callous lips of ulcers and other things too long here to insist upon The ma ter of them The materials of these Cauteries are Oke-ashes Pot-ashes the ashes of Tartar of Tithymals or spurges the Fig-tree the stalks of Coleworts and beans cuttings of Vines as also sal ammoniacum alkali axungia vitri sal nitrum Roman Vitrol and the like for of these things there is made a salt which by its heat is caustick and escharotiâ—â— like to an hot iron and burning coal Therefore it violently looses the continuity by eating into the skin together with the flesh there-under I have thought good here to give you divers forms of them The forms of them Take of unquenâ—ht Lime extinguished in a bowl of Barbers Lye three pounds When the Lye is settled let it be strained and into the straining put of Axungia vitri or Sandiver calcined Argol of each two pounds of Sal nitrum ammoniacum of each four ounces these things must be beaten into a gross powder then must they be boiled over the fire and after the boiling let them remain in the Lye for four and twenty hours space being often stirred about and then strained through a thick and double linnen-cloth lest any of the earthly dross get thorow together with the liquor This strained liquor which is as clear as water they call Capiteum and they put it in a brasen Basin such as barbers use and so set it upon the fire and assoon as it boils they keep it with continual stirring lest the salt should adhere to the basin the Capitellum being half boiled away they put in two ounces of powdred vitriol so to hasten the falling of the eschar and so they keep the basin over the fire until all the liquor be almost wasted away Then they cut
violently on the last spondil of the back and first of the loyns both with the hand and knee for unto this place the orifice of the stomach is turned that by the power of the vomitory medicine and concussion of the stomach they might be constrained to vomit Neither did our purpose fail us for presently they voided clammy yellow and spumous phlegm and blood But we not being contented with all this blowed up into their nostrils out of a Goose-quil the powder of Euphorbium that the expulsive faculty of the brain might be stirred up to the expulsion of that which oppressed it therefore presently the brain being shaken or moved with sneesing and instimulated thereunto by rubbing the chymical oyl of Mints on the palate and on the cheeks they expelled much viscous and clammy matter at their nostrils Then we used frictions to their arms legs and back-bones and ministred sharp glysters by whose efficacy the belly being abundantly loosened they began presently to speak and to take things that were ministred unto them of their own accord and so came to themselves again In the do ng of all these things James Guillemeau Surgeon unto the King of Paris and John of Saint Germanes the Apothecary did much help and further us In the afternoon that the matter being well begun might have good success John Hauty and Lâ—â—is Thibaut both most learned Physicians were sent for unto us with whom we might consâ—lt on other things that were to be done They highly commended all things that we had done already thought it very convenient that cordials should be ministred unto them which by ingendring of laudable humors might not only generate new spirits but also attenuate and putrifie those that were cloudy in their bodies The rest of our consultation was spent in the inquity of the cause of so diâ—e a mischance For they said it was no new or strange thing that men may be smothered with the fume and cloudy vapor of burning coals For we read in the works of Fulgosius Volaterenus and Egnatius Lib. 9. cap. 12. lib. 23. An history that as the Emperor Jovinian travelled in winter-time towards Rome he being weary in his journey rested at a village called Didastances which divideth bithynia from Galatia where he lay in a chamber that was newly made and plaisted with lime wherein they burnd many coals for to dry the work or plaistering that was but as yet green on the walls or roofs of the chamber Now he dyed the very same night being smothered or strangled with the deadly and poysonous vapor of the burned charcoal in the midst of the night this happened to him in the eighth moneth of his reign the thirtieth year of his age and on the twentieth day of August But what need we to amplifie this matter by the antient histories seeing that not many years since three servants died in the house of John Bigine goldsmith who dwelt at the turning of the bridge of the Change by reason of a fire made with coals in a close chamber without any chimney where they lay And as concerning the causes these were alledged Many were of opinion that it happened by the default of the vapor proceeding from the burned coals which being in a place void of all air or winde infers such like accidents as the the vapor or must of new wine doth that is to say pain and giddiness of the head For both these kindes of vapor besides that they are crude like unto those things whereof they come can also very suddenly obstruct the original of the Nerves and so cause a convulsion by reason of the grossness of their substance Sect. 5. Aph. 5. For so Hippocrates writing of those accidents that happen by the vapor of new wine speaketh If any man being drunken do suddenly become speechless and hath a convulsion he dieth unless he have a fever therewithall or if he recover not speech again when his drunkenness is over Even on the same manner the vapor of the coals assaulting the brain caused them to be speechless unmoveable and void of all sense and had died shortly unless by ministring and applying warm medicines into the mouth and to the nostrils the grossness of the vapor had been attenuated and the expulsive facultie moved or provoked to expel all those things that were noisome and also although at the first sight the Lungs appeared to be greived more then all the other parts by reason that they drew the malign vapor into the body yet when you consider them well it will manifestly appear that they are not grieved unless it be by the sympathy or affinity that they have with the brain when it is very grievously afflicted The proof hereof is because presently after there followeth an interception or defect of the voice sense and motion which accidents could not be unless the beginning or original of the nerves were intercepted or letted from performing its function being burthened by some matter contrary to nature The occasion of the death of such as have the apoplexy And even as those that have an apoplexy do not dye but for want of respiration yet without any offence of the Lungs even so these two young mens deaths were at hand by reason that their respiration or breathing was in a manner altogether intercepted not through any default of the Lungs but of the brain and nerves distributing sense and motion to the whole body and especially to the instruments of respiration Others contrariwise contended and said that there was no default in the brain but conjectured the interception of the vital spirits letted or hindred from going up into the brain from the heart by reason that the passages of the Lungs were stopped to be the occasion that sufficient matter could not be afforded for to preserve and feed the animal spirit Which was the cause that those young men were in danger of death for want of respiration without which there can be no life For the heart being in such a case cannot deliver it self from the fuliginous vapors that encompass it by reason that the Lungs are obstructed by the grossness of the vapor of the coals whereby inspiration cannot well be made for it is made by the compassing air drawn into our bodies but the air that compasseth us doth that which nature endeavoureth to do by inspiration for it moderateth the heat of the heart and therefore it ought to be endued with four qualities The first is that the quantity that is drawn into the body be sufficient The second is that it be cold or temperate in quality The third is that it be of a thin and mean consistence The fourth is that it be of a gentle benign substance But these four conditions were wanting in the air which those two young men drew into their bodies being in a close chamber Conditions of the air good to breath in For first it was little in quantity by reason that small quantity that
memory I may work more certainly and surely when as I have any more curious operation to be performed the left side remain whole and the Lungs Heart Diaphragma stomach splene kidnies beard hairs yea and the nails which being pated I have often observed to grow again to their form and bigness And let this be the bound of this our immense labor and by Gods favor our rest to whom Almighty all-powerful immortal and invisible be ascribed all honor and glory for ever and ever Amen Labor improbus omnia vincit The end of the Treatise of reports and embalming the dead The NINE and TWENTIETH BOOK The Apology and Treatise containing the voyages made into divers places By Ambrose Pare of Laval in Maine Counsellor and chief Chirurgion to the King Of what the Adversary accuseth the Author TRuly I had not put my hand to the pen to write on such a thing were it not that some have impudently injured taxed and more through particular hatred disgraced me then for zeal or love they bear to the publick good which was concerning my manner of tying the Veins and Arteries writing thus as followeth The words of the Adversary Male igitur nimium arroganter inconsultus temerarius quidam vasorum ustionem post emortui membri rejectionem à veteribus omnibus plurimum commendatam semper probatam damnare ausus est novum quendam deligandi vasa modum contra veteres omnes medicos sine ratione experientà judicio docere cupiens nec animadverit majora multo pericula ex ipsa vasorum deligatione quam acu partem sanam profunde transfigendo adminâ—strari vult imminere quam ex ipsa ustione Nam fi acu nervosam aliquam partem vel nervum ipsum pupugerit dum it à novo inusitato modo venam absurde conatur constringere nova inflammatio necessario consequetur à qua Convulsio a convulsione cita mors Querum symptomatum metu Galenus non ante transversa vulnera suere audebat quod tamen minus erat periculosum quam musculorum aponeuroses denudasset Adde quod forcipes quibus post sectionem iterum carnem dilacerat cum retracta versus originem vasa se posse extrahere somniat non minorem adferant dolorem quam ignita ferramenta admota Quod si quis laniatum expertus incolumis evaserit is Deo optimo maximo cujus Beneficentia crudelitate ista carnificina liberatus est maximas gratias habere semperagere debet which is thus Ill then and too arrogantly a certain indiscreet and rash person would blame and condemn the cauterizing of vessels after the amputation of a rotten and corrupted member much praised and commended and alwayes approved by the Antienâ—s desiring to shew and teach us without reason judgment and experience a new way to tie the vessels against the opinion of the Antient Physicians taking no heed nor being well advised that there happens far greater perils and accidents through this new way of tying the vessels which he will have to be made with a needle piercing deeply the sound part then by the burning and ustion of the said vessels for if the needle shall prick any nervous part yea the nerve it self when he shall by this new and unaccustomed way absurdly constrain the vein by binding it there must necessarily follow a new inflammation from the inflammation a convulsion from a convulsion death for fear of which accidents Galen never durst stitch transversal wounds which notwithstanding were less dangerous before he had discovered the Aponeuroses of the muscles Moreover the pincers with which after the section the flesh is again dilacerated while he thinks to draw the vessels out which are drawn in toward their original bring no less pain then the cautering irons do And if any one having experimented this new manner of cruelty have escaped danger he ought to render thanks to Almighty God for ever through whose goodness he hath been freed from such tyranny feeling rathet his executioner then his methodical Chirurgion The Authors answer O what sweet words are here for one who is said to be a wise and learned Doctor he remembers not that his white beard admonisheth him not to speak any thing unworthy of his age and that he ought to put off and drive out of him all envy and rancor conceived against his neighbor So now I will prove by authority reason and experience that the said Veins and Arteries ought to be tyed Authorityes AS for Authorityes I will come to that of that worthy man Hippocrates who wils and commands the cure of Fistulaâ— in the fundament by ligature as well to consume the callosity as to avoid hemoâ—â—hagy In the book of Fistulas of the fundament chap. 3. book 5 leaâ— 4. Galen Treâ—ise 2 chap. 17. in his method speaking of a flux of blood made by an outward cause of whom see here the words It is saith he most sure to tye the root of the vessel which I understand to be that which is most near to the Liver or the heart Avicen Treatise 3. Doct. 1. chap. 3. commands to tye the vein and the Artery after it is discovered towards his original Guido of Canliac speaking of the wounds of the Veins and Arteries injoyneth the Chirurgion to make the ligature in the vessel Master Hollier in the 3. book chap. 4. of the matter of Chirutgery speaking of a flux of blood commands expresly to tye the vessels Calmethâ—us in 12. chap. of the wounds in the Veins and Arteries tels a most sure way to stay a flux of blood by ligature of the vessel Celsus chap. 26. book 5. from whom the said Physiâ—ian hath snatched the most part of his book chargeth expresly to tye the vessels in a flux of blood happening to wounds as a remedy most easie and most sure Vesalius in his Chirurgery chap. 4. book 3. willeth that the vessel be tied in a flux of blood John de Vigo book 1. treatise 1. treating of hemoâ—â—hagy in bleedâ—ng wounds commands to tye the Vein and the Artery Tegaultius chap 12. book 2. treating of the means to stay the flux of blood commands to pinch the Vein or Artery with a Crow or Parrats-bill â—â—en to â—yâ— it with a very strong thred Peter of Argillata of Bullonge tâ—eatise 4. chap. 11 book 1. discoursing of a flux of blood and the means to stop it giveth a fourth way expresly which is made by ligature of the vessels John Andreas a Cruce â— Venetian book 1. sect 3. chap. 16. page 5 upon the 8â— chap of the book of Paul makes mention of a method to stay a flux of blood by the ligature of the vessels D. Alechamp commands to tye the Veinâ— and Arteries See then my little good man the â—â—thorities which command you to tye the vessels As for the â—eaâ—ons I will debate of them The hemoâ—hagy say you iâ— not so much to be feared in the section of the Call as that of
if the humor go back to the Breast or Lungs it breaks through or eats out their vessels and hence follows a spitting first of blood then of corrupt matter and from thence at last a Consumption as Hippocrates teaches in his Aphorism But in this place it is first of all to be observed that there are two sorts of propagations of veins which make the Emroids for there are some propagations of the Gate-vein of which we have already treated but there are others of the Hollow-vein which arise from the Iliacal branches of which we are to speak hereafter Now if the forementioned humors whether melancholick or cholerick or phlegmatick and salt flow through the propagations of the Gate-vein the internal Emroids are caused which being cured the matters flow back into the branches of the Gate-vein that are scattered through the lower Belly into which the veins being loaden with these humors unburden themselves make a species of the Dropsie called Ascites But if they flow through the branches of the Hollow-vein they cause the external Emroids and these being cured against the Precept of Hippocrates there is danger of a Consumption to ensue because from hence there is an easie passage of the peccant matter through the Hollow-vein to the Lungs nigh to the Heart And this is that which we have of a good while observed that many who have been long troubled with Fistula's of the Fundament and afterwards cured through the ignorance of Physitians have faln into a spitting of blood and then into a Consumption Nay we remember that a Maid was once cured by us in Germany which had a Fistula in the middle of her Hip and for three years had sought help from many in vain but being cured she fell at length after three or four month into a spitting of much blood Although she was scarce ten years old I let her blood presently in the foot of that side on which she had been troubled with the Fistula and purging her body and laying on a cautery near the place in which the Fistula had been I easily freed her in this manner from imminent danger of a Consumption This spitting of blood happened from no other cause but that sharp and cholerick matter which when it could no longer finde a way out by the Fistula got up afterwards to the Lungs through the branches of the Hollow-vein But Hippocrates sayes expresly that there is danger of a Dropsie or Consumption to follow because it sometimes falls out that neither of these happen but rather some other disease insues as it happened to Alcippus who fell in to a madness and from that into an acute Feaver sometimes also the bloody flux follows and other mischiefs Sometimes also it happens that they who are so cured are preserved still in health by abundance of urine sweatings remedies and a good rule of diet CHAP. II. Treats of the superior or ascendent Trunk of the Vena Cava or Hollow-vein and the branches which it scatters through the Head WEE are now to consider the other vein which as we told you is called Cava the Hollow one a which spreads it self much wider then the Gate-vein The use of the Hollow-vein as being distributed throughout the whole body For its office is to nourish all those pars of our body which conduce not to the concoction of the food those parts being spread far and wide it is necessary that the Hollow-vein also be very large and extended to a great length and because they ought to be nourisht with a thinner and more elaborate blood and not so thick and faeculent as that wherewith the Stomach Spleen and Gall are nourisht therefore the blood which the Hollow-vein makes and carries is also more pure thin and sincere In delivering the History of this vein although we are not of their opinion The method to be observed in the History of this Vein who derive its beginning either from the liver or heart yet because we must begin our Treatise of it somewhere we thought fit to follow the received custome of Anatomists and so for perspicuities sake we shall alwayes speak of it as if it took its birth from the Liver It may be added that it spreads certain roots as it were in the Liver just like the Gate-vein in the History of which when for that reason we took our rise from those roots we may not without cause begin thence also with the Hollow one But this vein although it run directly through the whole Trunk of the body and make one very notable stock D that is drawn out through the middle and lowest belly like one straight line continued or rather in manner of a channel or conduit pipe is notwithstanding wont to be divided into two by reason of the Liver and so one to be called the Ascendent Trunk the other the Descendent For indeed that is not true to which many perswade themselves that the Hollow-vein in its going forth from the Liver like the great Artery when it comes out of the heart is cleft into two trunks but if hereafter they be called Trunks by me you must beleive that I do it only for orders sake in teaching The Ascendent thetefore of upper Trunk A.D. is that which stands about the Liver and is terminated about the Jugulum or Hollow of the Neck but that is called the Descendent one T.V. which is beneath the Liver and reaches down as far as the Legs For both of them are afterwards divided into two branches of which they of the Ascendent m and q â—re carried upwards to the head as the Jugular or Neck-branches or to the Arms as the Brachiales G and I or Arm-veins these of the Descendent Trunk to the Legs and are called the Crural b anches T We will speak therefore of all these in order so that we first deliver the History of the Ascendent Trunk then of its branches that grows up partly to the Head partly to the Arms after that we will come to the Descendent Trunk and its branches that are digested into the Legs The Ascendent Trunk As therefore we have said that many little Veins like roots grow out of the Hollow side of the Liver which alwayes by degrees inserted into the greater veins and all of them at length meeting together about the middle of it did make a Trunk so in the same manner out of the circuit of the Convex side of the Liver a numerous propagation of veins issues forth which afterwards meet together in one Trunk This Trunk makes its way through the nervous part of the midriff on its right side and passing through it goes undivided to the Jugulum or Hollow of the Neck and because it climbs upwards it is commonly called the Ascendent Trunk by them who conceive that the Hollow-vein rises out of the Liver It is much lesser then the Descendent because the upper parts are nourished by it alone but almost all the inferior parts that are contained
midriff the Coeliacal one then the upper Mesenterick the two emulgents as many spermatical ones at last the lower Mesenterick and the Lumbares or arteries of the loins Of these the Intercostals are scattered whilst the trunk is yet in the chest the rest whilst it passes on through the lowest belly But some of them accompany the branches of the gate-vein as the Coelicacal and both the Mesenterical arteries others those of the hollow vein as the rest Now we will treat of these in order beginning from the Intercostals or arteries between the ribs which are placed uppermost Presently therefore after the Descendent trunk Q is issued forth from its back-side it sends over little branches on both sides to the distances of the eight lower ribs which they call Intercostales inferiores Intercostales inferiores the arteries between the lower ribs the lower arteries between the ribs uuu in respect of the upper Intercostal of which we have spoken above These associating themselves with the veins and nerves of the same name go straight on by the lower side of the ribs where peculiar sinus or channels are cut out for them But as the Intercostal veins reach in the true ribs only to the gristles but in the bastard ones somewhat farther to wit to the sides of the abdomen so also the arteries end in them together with the bony parts of the ribs but in these run out a little farther And these arteries send over some propagations through the holes of the nerves to the spinal marrow and to the muscles that lye upon the rack-bones of the back just as we have said the Intercostal veins were propagated Their use But the use of them is to diffuse the vital spirit and the blood to the muscles betwixt the ribs besides which they have also another notable office to wit of carrying down the water and purulent matter that is gathered together in the chest into the great artery and from thence by the Emulgent branches to the bladder Although I am not ignorant that the most learned Fallopius and others who have read before me in this most famous University of Padua have shewn another way to their Auditors by which either purulent matter or water might be conveyed forth by help of the kidneys to wit the vein sine pari or without a companion a little branch whereof in the left side goes into the Emulgent of the left kidney But this way which we shew through the Intercostal arteries is by much the shorter that I pass by this that any matter heaped together may be more easily dispatcht away through the arteries then the veins Nor needs any one here to be afraid lest the vital spirits should be infected from these excrementitious and ill humurs whereby the heart may incurre fearful symptoms when we willingly grant which experience also hath often taught us that whilst the corrupt matter is emptied out by the urine the sick parties have often faln into fits of swounding and other diseases sometimes also have died suddenly when the peccant humor has been of too great a quantity or too bad a quality and has offered so much violence to nature that the heat and spirits have been over come therewith The explanation of a place in Hippocrates But here a certain place in Hippocrates calls upon me to explain it which has long and often troubled my minde The place is in Coacis praenotionibus where he says They who together with the heart have their whole lungs inflamed so that it falls to the side are deprived of motion all over and the parties so diseased lye cold senseless and dye the second or third day But if this happen to the lungs without the heart they live not so long Yet some also are preserved I have often thought with my self what should be that sympathy of the heart lungs with the brain and nerves that from the inflammation of those parts the patient should be so deprived of sense and motion all over when the same Hippocrates teacheth in the same place that the diseased suffer such deprivation in that part livid spots appear on the outside about the rib where-about the Aortae so he seems to call the lobes or division of the lungs being inflamed fall to the sides But if they be not much inflamed so that they fall not down to the side he sayes that there is a pain indeed all over but no deprivation of sense or motion nor any spots appear Having deliberated often with my self at length I came to be of this opinion that there was no other cause but the sympathy betwixt these Intercostal arteries and the marrow in the back-bone This sympathy arises from those propagations which we told you past through the holes of the rack-bones of the chest into the back-bone Wherefore if the lungs and heart be so mightily inflamed that great plenty of blood rush into the great artery whereupon it swels as also these vessels betwixt the ribs and consequently those surcles which go to the marrow of the back-bone truly it cannot be but that both the marrow and the nerves which issue out of it be comprest from whence what else can follow but the resolution of those parts into which those nerves are implanted to which they impart the faculty of motion This opinion seems to me to be wonderfully confirmed by a certain pretty observation which the learned Cornelius Gemma has in his book de hemititraeo pestilenti A certain studious young man sayes he through the whole course of his disease had his left eye less then the other He was paind in the left side especially all the time the fit raged but about the crisis or judication thereof the artery of his left leg being swoln up was moved according to its length that being to be seen by us it seemed to be turned upward and downward like a rope pull'd back Who will not here willingly confess that this matter was in the arteries when the crisis was made by them But from this that hath been said a reason may be also given of another observation of Galen which is l. 4 de locis affect c. 4. where he sayes thus In a certain man who was troubled with a vehement inflammation of the lungs as wel the outer as the inner parts of his arm from the cubit to the very ends of his fingers labour'd with difficulty of sense and their motion also was somewhat empair'd In the same man also the nerves which are in the first and second distances betwixt the ribs sustained harm And a little after This man was quickly restored to his health to wit a medicine being applyed to the place from whence the nerves issue forth near to the first and second spaces betwixt the ribs By reason of the same branches betwixt the ribs John Valeriola the son of that Physitian whose observations we have being yet a boy suffered Convulsion-fits in a grievous Pleurisie The arteries
description and use 713 Viper See Adder Virginity the signs thereof 747 Vital parts which 56 their division ibid. Vitreus humor 130 Viver or as some term it the Weaver a fish his poysonous prick and the cure 515 Ulcers conjoyned with tumors how cured 188. in what bodies not easily cured 294. their nature causes c. 327. signs 328. prognosticks 329. their general cure 330. signs of a distempered one and the cure ibid. a painful one and the cure 321. with proud flesh in them ibid. putrid and breeding worms 332. a sordid one ibid. a malign virulent and eating one 333. advertisements concerning the time of dressing ulcers ibid. how to binde them up 334. such as run are good in time of the plague 328. Ulcers in particular and first of the eyes 334. of the nose 335. of the mouth ibid. of the ears 336. of the windepipe weazon stomach and guts 337. of the kidnies and bladder ibid. of the womb 338. that happen upon the fracture of the leg rump and heel 365. how to prevent them ibid. they must be seldome drest when the Callus is breeding 366 Umbilical vessels how many and what 594 Unction to be used in the Lues Venerea 467. their use 468. cautions in their use ibid. and the inconveniences following the immoderate use 469 Ungula or the web on the eye the causes prognosticks and cure 406 Unguentum adstringens 706. nutritum ibid. reum ibld. basilicum sive tetrapharmacum ibid diapompholigos 707. desiccativum rub ib. enulatum ib. Album Rhasis ib. Altheae ib. populeon ib. apostolorum ib. comitissae ib pro stomacho ib. ad morsus rabiosos ibid. Unicorn if any such beast what the name imports 523. what the ordinary horns are 524. not effectual against poyson ibid. effectual onely to dry ibid. in what cases good 525. Voices whence so various 136 Vomits their force 25. their description 197 Vomiting why it happens in the Colick 73. the fittest time therefore 450. to make it easie ibid. Voyages and other employments wherein the Author was present of Thurin 756. of Morolle and Low Britain 757. of Perpignan 758. of Landresie 759. of Bologn ibid. of Germany ibid. of Danvillers 760. of Castle of Compt 761. Of Mets ibid. of Hedin 765. Battel of St. Quintin 771. Voyage of Amiens of Harbor of Grace 772 to Roven ibid. battel of Dreux 773. of Moncontour ibid. Voyaâ—e of Flanders 774. of Burges 777 battel of St. Dennis ibid. voyage of Baion ibid. Urachus 93 Ureters their substance c. 85 Urine stopt by dislocation of the thigh-bone 391. suppression thereof how deadly 421. how it happens by internal causes 434. by external 435. prognosticks ibid. things unprofitable in the whole body purged thereby ibid. bloody the differences and causes thereof 436. the cure 437. scalding thereof how helped 474. a receptacle for such as cannot keep it 568. Urines of such as have the Plague sometimes like those that are in health 536 Utelif a strange fish 45. Vvea tunica 142 Vulnerary potions their use 482. the names of the simples whereof they are composed ibid. their form and when chiefly to be used 483 Uvula the site and use thereof 136 the inflammation and relaxation thereof 209. the cure ibid. W. WAlnut tree and the malignity thereof 519 Warts of the neck of the womb 638. their cure ibid. Washes to beautifie the skin 721 Wasps their stinging how helped 513 Watching and the discommodities thereof 24 Water its qualities 3. best in time of plague 530 Waters how to be distilled 729 Watrsh tumors their signs and cure 191 192 Weapons of the Antients compared with those of the moderm times 287 Weazon the substance c. thereof 109. how to be opened in extreme diseases 208. the wounds thereof 273. the ulcers thereof 337 Weakness two causes thereof 178 Web on the eye which curable and which not 406. the cure ibid. Wedge-bone 121 Weights and measures with their notes 702 Wen their causes and cure 193. c. how to distinguish them in the brest from a Cancer 194 Whale why reckoned among monsters 676. they bring forth young and suckle them 677. how caught ibid. Whalebone ibid. Whirl-bone the fracture and the cure 362. dislocation thereof 394 White lime 69 Whites the reason of the name differences c. 636. causes 637. their cure ibid. Whitlows 223 Wine which not good in the gout 452 Windes their tempers and qualities 13 20 Winter and the temper thereof 6. how it increaseth the native heat ibid. Wisdom the daughter of memory and experience 598 Witches hurt by the Divels assistance 661 Wolves their deceits and ambushes 44 Womb the substance magnitude c. thereof 89. the coats thereof 92 signs of the wounds thereof 280. ulcers thereof and their cure 338. when it hath received the seed it is shut up 593. the falling down thereof how caused 604. it is not distinguished into cells 617. a scirrhus thereof 622. signs of the distemper thereof 623. which meet for conception ibid. of the falling down preversion or turning thereof 624. the cure thereof 625. it must be cut away when it is putrified 626. the strangulation or suffocation thereof 628. See Strangulation Women their nature 18. how to know whether they have conceived 593. their travel in childebirth and the cause thereof 599. what must be done to them presently after their deliverance 602. bearing many children at a birth 648 Wonderful net 120 Wondrous original of some creatures 669. nature of some marine things ibid. Worms in the teeth their causes and how killed 415. bred in the head 488. cast forth by urine 489. how generated and their differences 490. of monstrous length ibid. signs 491. the cure 492 Wounds may be cured only with lint and water 35 Wounds termed great in three respects 229 742 Wounds poysoned how cured 500 Wounds of the head at Paris and of the legs at Avignon why hard to be cured 301 Wounds what the divers appellation and division of them 227. their causes 228. and signs 229. prognosticks ibid. small ones sometimes mortal 230. their cure in general ibid. to stay their bleeding 232. to help pain 223. why some die of small ones and others recover of great 249. whether better to cure in children or in old people 250. wounds of the head See fractures Of the musculous skin thereof 255. their cure 256. of the face 267. of the eye-brows ibid. of the eyes 268. of the cheek 170. of the nose 272. of the tongue ibid. of the ears 273. of the neck and throat ibid. of the weazon and gullet ibid. of the chest 274. of the heart lungs and midriff ibid. of the spine 275. what wounds of the lungs curable 277. of the Epigastrium or lower belly 280. their cure 281. of the Kall ibid. of the fat ibid. of the groins yard and testicles ibid. of the thighs and legs 282. of the nerves and nervous parts ibid. of the joints 284. of the ligaments 286 Wounds contused must be brought to suppuration 294 Wounds made by gun-shot are not burnt neither must they be cauterized 288. they may be dressed with suppuratives 289 why hard to cure ibid. why they look black 291. they have no Eschar ibid. why so deadly 292. in what bodies not easily cured 294. their division ibid. signs 295. how to be drest at the first ibid. how the second time 299. they all are contused 305 Wounds made by arrows how different from those made by gunshot 308 Wrist and the bones thereof 155. the dislocation thereof and the cure 388 Y. YArd and the parts thereof 87. the wounds thereof 281. to help the cord thereof 419. the malign ulcers thereof 471. to supply the defect thereof for making water 569 Yew-tree its malignity 519 Z. Zirbus the Kall the substance c. thereof 69 70 FINIS