that out of it store of Blood be poured forth unto the Heart overwhelming it and suffocating the heat thereof Thirdly Al the internal wounds of the greater Vessels that cannot by any art be closed upon regard they cause the Blood being plentifully poured forth either out of the Veins or the Arteries that the spirits be suddenly dissipated therefore of necessity they speedily suffocate the wounded person Fourthly All those Wounds are said to be Mortal that suddenly take away the Respiration and hinder the ventilation of the Heart so that the Native heat of the Heart is suffocated and so cause that the Man die even almost in the very same manner as Apoplectical persons are wont to die And such like wounds are especially the Wounds of the Brain but yet not all of them since that there are many Wounds of the Brain that are not Mortal as afterwards we shall shew you and as we have already told you in the first B. of our Practice first part and 23. Chapter But those great Wounds and such as are the Cause that the Animal spirits be suddenly dissipated or that the blood being poured forth of the Vessels the Orifice of the Nerves be quite stopped and so by this means the influx of the Animal Spirits be hindered or that from the same an inflammation of the Brain or a feaver be excited And this is not only done by the Wounds of the very Brain it self but likewise by the strokes and vehement Confusions of the Head by which the Vessels of the Brain and those neer about it are broken and the Blood poured forth of them unto the beginning of the Nerves and there subsisting hinder the influx of the Animal Spirits And this may also happen if the Sinus or hollow places of the Brain chance to be hurt so that out of them blood be poured forth unto the Basis of the Brain and so it is likewise in the Wounds of the Eyes if they penetrate so deep that they open either the Vessels of the Brain or those that are in the Basis thereof or those that are neer about the said Basis of the Brain and so that the Blood poured forth unto the Basis of the Brain hinder the influx of the Animal spirits by compressing the beginning of the Neryes For although that the Blood if it be poured forth above upon the Brain may possibly be emptied forth by perforating and opening of the Cranium or Skul yet nevertheless if it be poured forth unto the Basis of the Brain it is impossible that it should ever be evacuated There seemeth yet nevertheless to be another way whereby the Blood poured forth into the Brain or about the Brain bringeth Death within a vâ—ry few daies if it cannot be evacuated For when as it is without the Vessels it beginneth to putrefie usually about the fifth day from whence feavers deliries and Convulsions are excited so that the man dieth in the same manner almost as one in a Phrensie That which is done by the Wounds of the brain the very same happeneth likewise from the spinal Marrow if it be indeed wholly cut assunder in the superior part thereof for then the motion of all the inferior parts and so of the Thorax likewise is abolished and the wounded persons are suffocated And unto one of these four waies I conceive that al kinds of Mortal Wounds may be referred And therefore if a Wound penetrate into any interior part of the Body so that thereupon the wounded person die within a short space of time we are then to Judg that that Wound was Mortal and if diligent inquiry be made I am of Opinion that it may be referred unto some one kind or other of these Mortal Wounds whether that Wound hurt the vital faculty it self immediatly or else hurt it by the intervening of some other Disease or Symptom For as Nicolaus Boetius writeth out of Felinus in his 323. Decision Numb 10. it is all one whether a Wounded man die of his Wound or of some infirmity caused by the same Which yet nevertheless is so to be understood if the Wound necessarily attract that Disease or that Symptom which is the Cause of Death But as for all the other Wounds whatsoever that cannot be referred unto some one of these manners I conceive that they cannot simply nor necessarily be accounted Mortal The which that it may be made the more plainly to appear we have it now in our purpose in special to weigh and discover unto you the Wounds of all parts that are to be accounted Mortal Now Hippocrates Judgeth the wounds of seven parts to be Mortal What Wounds accounted Mortal by Hippocrates whilest in his sixth Sect. Aphor. 18. he thus writeth Whosoever hath his Bladder out through or his Brain or his Heart or his Midriff or any of his smal Guts or his Stomack or his Liver that Wound is Mortal Which Aphorism notwithstanding in his Coaca or his Tract of Playsters Aphor. 509. he both Limiteth and Amplifieth when he thus saith From a Wound even Death it self may almost happen if any one be wounded in his Brain or in his spinal Marow or in his Liver or in his Midriff or in his Heart or in his Bladder or in any one of the greater Veins Death likewise soon followeth if any extraordinary great Blows be inflicted upon an Artery and upon the Lungs so that the Lungs being wounded the Breath that passeth out at the Mouth is less then that which issueth forth at the Wound But they suddenly perish whosoever they are that have received a Wound in the interior Nerves whether smal or g eat if the Blow or Wound be both Transverse and great but if the Wound be but smal and straight there are some that escape the danger But there is neither Death nor any great dangâ—r impending from those Wounds that are inflicted on those parts of the Body in the which there are none of these or which are as far distant at may be from these Indeed he limits the Aphorism whilest that he doth not simply write that such like wounds are altogether Mortal but almost and for the most part He amplifyeth it whilest that he addeth the spinal Marrow the greater and thicker Veins the rough Artery and the Lungs and the interior Nerves And therfore we wil in order consider the wounds of these parts For it is without doubt that the Wounds of the rest of the Parts are not at all of theâ—selves Morâ—al and this Hippocrates himself teacheth us in the above mentioned Aphorism 509. in Coacis Celsus in his 5. B. and 26. Chap. thus rendereth the foresaid Opinion of Hippocrates He cannot possibly be preserved that hath the Basis of his Brain his Heart his Stomack the parts of his Liver the Marrow in his Back-bone wounded or that person that hath either the middle of his Lungs or the Jejunum i. e. the hungry Gout or any of the smaller Guts or the Stomack or the Reins be
ceased and his strength by degrees returned there being no purulent spittle at all that offered to come forth his Cough likewise and difficult breathing were not very urgent and troublesom neither for the first Week did any heat and thirst very much affect the sick person in the interim the wounds being handled after the Vsual manner there daily flowed forth an indifferent Quantity of well concocted pus or purulent matter These means being continued unto the second month and the External wounds being purified and consolidated the sick person was suddenly taken with a most dangerous suffocation so that he was in great peril of being strangled by an Asthma as it were and he was likewise very much afflicted with a cough Atrophy and Hectick Feaver until at length the imposthume of the Lungs brake and with the Cough five or six pints of purulent matter were cast up at his mouth after which the exulceration of the Lungs being cured by fit and proper Remedies the consumption Fever Hectick and all the rest of the symptoms remitted and the Patient was restored unto his perfect health To wit those Wounds of the Lungs are not mortal in which only the substance of the Lungs is hurt and not the great vessels and such as are not so great that they abolish respiration or suddenly destroy the vital faculty either by their dislipating the sprits through some notable Hemorrhage or else suffocating the heart by pouring out the blood upon the Lungs and upon the heart On the contrary if the wound of the Lungs be great and that not only the substance of the Lungs but likewise the great vessels that are therein to wit those notable and observable branches of the Arterial vein and the veiny Artery be wounded those wounds are mortal being such as in which the blood and vital spirit is poured forth and dissipated or else through the overgreat abundance of the blood the Lungs and heart are oppressed and the Patient suffocated Hippocrates in the place alleadged in Coacis addeth yet another cause of death which yet nevertheless doth not bring so sudden a destruction unto any person as those in the former case even now mentioned where the wound being great it is not the vessels containing the blood that are indeed hurt but the great and rough Artery so that by reason of the largness of the wound there is more breath that goeth forth by the wound then by the mouth for then by reason of the sympathy the heart is affected the vital spirits dissipated the Lungs and heart by the ambient Air altered and offended And indeed those wounds of the Lungs bring death likewise in which either the substance of the Lungs beginneth to be exulcerated and that a Consumption is excited or in which the blood is poured forth into the Cavity of the Thorax where it beginneth to putrefy and where it causeth either a feaver or an Empyema But in regard that this doth not alwaies happen and not at al in some wounds of the Lungs and that likewise when it doth happen there is no necessity that the Patient die for this cause therefore those wounds of the Lungs are not to be accounted necessarily Mortal For Felix Platerus in his 3. B. of Obsrv Page 690. relateth that a certain person that he knew falling into a Consumption from a Wound of the Lungs was yet nevertheless Cured and perfectly recovered A certain Coffermaker sayth he one of our Citizens having from a servant of his received a wound very deep in the lowest part of the Thorax by a prick from the point of a knife by the wound he voided forth a most stinking and loathsom pus or matter by the ill savor whereof the whol neighborhood was infected and offended and likewise some certain smal parcells of his Lungs in which the cartilaginous branches of the rough Artery did manifestly appear which persevering a long time albeit that he was in a manner wholly wasted away yet nevertheless at the length the flowing forth of the purulent matter remitting the wound was closed and he restored unto perfect soundness living after this many years as a foot-post in carrying of letters and thus he prolonged his life for forty years safe and found as we say although as it is very probable he wanted great part of his Lungs in one side The wounds of the rough Artery Fifthly That the wounds of the great rough Artery commonly called Aspera Arteria are not mortal but that they may be cured even the Laryngotomy or Cutting of the Laryinx of which we have spoken before in the Second Book of our Pract Part. 1. Chap. 24. doth evidently demonstrate To wit those of them are cured that are not great and in which the membranes only by which the rings of the rough Artery are fastened and linked together are wounded examples of which Schenkius in the Second Book Of his Observat hath collected And I my self also have twice seen such like wounds cured But if those very cartilaginous rings be wounded by reason of their hardness the part cannot again be made to grow together as formerly as Hippocrates teacheth us in the sixth of his Aphorisms Aph. 19. And in the seventh of his Aphorisms Aph. 28. and Galen in Book 5. of his method of Physick Chapt. 7. And yet notwithstanding such like Wounds do not cause a sudden death but a flow and lingering one while that the Lungs are either altered and weakned by that Air that violently breaketh in upon the Lungs thorow the wound or else that a certain smal gobbet of flesh grow unto the wound which by intercepting the breath at the length choaketh the Person But those wounds alone of the rough Artery throttle the Party in which the jugular veins and Arteries being hurt the blood violently and al at once rusheth into the Lungs intercepteth the breathing and so suffocateth the wounded person which yet nevertheless happeneth not by reason of the wound of the said rough Artery but by reason of the wound of the Jugular vein or the soporal i. e. more plainly the sleep-conveying Artery that is very neer unto it Wounds of the Diaphragm Sixthly Hippocrates reckoneth up the Wounds of the Diaphragm among those wounds that are mortal But Galen in his Book 5. of the Method of Physick Chapt. 9. distinguisheth between those wounds of the diaphragm that are inflicted upon the nervous part therof those that are made in its fleshy part and those he wil have to be mortal but these latter Curable And yet nevertheless in the Sixth of the Aphorism Aph. 18. he writeth that the wounds of the nervous part of the Diaphragm are not alwaies mortal but that the great wounds therein are only so For then it is indeed that those grievous symptoms plainly appear viz. a deliry or stupid dotage difficult breathing Feavers Convulsions and as Aristotle hath likewise observed in his third Book of the parts of living Creatures and tenth Chapt. the
an Erysipelas in his left Hand and by the advice of a Barber-Chirurgeon for some daies anoynting his Hand and Arm with Oyl of Roses a Pain an Inflammation and other symptoms were from day to day more and more augmented insomuch that at length the whol Hand was corrupted and altogether rendred incurable by a Gangrene Chap. 8. Of a Bubo A Bubo likewise appertains unto Inflammations For a Bubo as Galen defines it in his Book of the Difference of Feavers Chap. 5. and in his second to Glauco Chap. 1. is an Inflammation of the Glandules in the Groyns For the Glandules being by Nature ordained and appointed that unto them the superfluous Humors should be expelled from the principal parts if they and together with them the blood shal chance to be thrust forth altogether and as it were by heaps unto the Glandulous parts then an Inflammation is excited and this happens most an end and especially in the Groins and somtimes also under the Arm-pits and behind the Ears which latter Inflammations behind the Ears are commonly termed Parotides But now The Humors that stir up and provoke Nature unto the aforesaid expulsion being very various hence it is that the differences arising from Bubo are likewise exceeding various and different For one while the Humors are said to be simply vitious or vitiated so that they have no malignity conjoyned with them and from these originally proceed those Bubo's that are not malignant but then again otherwhiles the matter is malignant and thence the malignant Bubo is produced and this again according to the variety of the malignant matter is either pestilent or else that which we call venereal But in regard that we have already treated of the Pestilent Bubo in our Book of Feavers and that the other which we call Venereal belongs unto the Tract touching the French Pox therefore we wil discourse of the Bubo at large only and handle it as it is in the general The Causes Now every Bubo whatsoever hath its original from a preternatural effusion of the blood into the Glandules in the Groyns or the Arm-holes the which notwithstanding hath evermore conjoyned with it some certain vitious and corrupt humor of what sort soever it be that excites and stirs up Nature into the aforesaid excretion or as we usually term it expulsion From whence also the antecedent yea and the external causes likewise which make for the generation of that humor are very various Notwithstanding the strength of the principall parts is for the most part evermore conjoyned therewith which expel forth whatsoever is offensive and burdensom unto themselves unto these ignoble parts and to the Emunctories Hieronymus Fabricius ab Aquapendente determines that some kind of Bubo's have their beginning and original only from the store of Blood and that certain of them by the way of expulsion are bred from the vitious blood and that the other Diseases follow and are excited at the time and Instant of the Crisis But in very truth I cannot think that a Bubo may be excited from the abundance of blood only but that it hath evermore conjoyned vitious humors which provoke Nature to the expulsion This notwithstanding is most true and certain that one while a Bubo doth follow upon another Disease and is excited by the Crisis whether perfect or imperfect and as soon again without any other Disease preceding it For although only those Tumors which follow upon other Diseases may properly be said to be caused by the Crisis yet notwithstanding even those likewise thâ— arise without any other Diseases are excited by Nature in her expulsion of the depraved and buâ—densome humors The Signs Diagnostick The Bubo is known by this to wit that in the Groyns or under the Arm-holes there appears a Swelling or Tumor with a certain kind of renitency or resistance with a redness of color and likewise with pain and for the most part also a gentle Feaver accompanieth it And this is most certain and sure if the Bubo happen to be by the Crisis that then a Feaver or some o her Disease went before which upon the appearing and breaking forth of the Bubo is lessened and abated and then the signs of a good and hopefull Crisis preceded the which if so be they are absent then the Bubo is to be accounted for symptomatical And then truly if there appear no signs at all of the Pestilence or of the French Disease then it is a single and simple Bubo and not malignant and contagious But if there be conjoyned the signs of the Plague the Bubo is then to be accounted for malignant and contagious and evermore Bubo's are to be suspected where the Pestilence invades the Patient In like manner if the sick Person be infected with the French Pox commonly termed likewise the Neopolitane Disease the Bubo is then also to be held for and esteemed Venereal Malignant and Contagious Prognosticks 1. Bubos that are not malignant and those likewise that are not contagious are not in the least dangerous since that they are resident in the external parts and are caused by Nature in her expelling forth the vitious and corrupt blood unto the weak and ignoble parts and especially if they be forthwith suppurated and then opened 2. But if they belong delaied and that their maturation be not speeded there may be great danger in regard that they very easily pass and degenerate into dangerous Fistula's 3. Those Bubo's that are bred or excited under the Arm-holes are sooner maturated since that they arise from a hotter kind of blood such as is that which the greater Vessels neer neighboring unto the Heart do extrude and thrust forth for as much as that part by reason of the Hearts vicinity hath more than ordinary heat which is altogether necessary and requisite for maturation 4. But Bubo's that have their original in the Groyns are longer ere they come to a supputation in regard that they are excited by a blood that is lets hot and thick and likewise because they are scituatâ— in a place more remote from the heart and which is but meanly hot 5. The slowest of them all in their maturation are those Bubo's that are behind the Ears upon this account namely that they proceed from a colder kind of matter and have their residence in a colder place 6. What we are to think and judge of Pestilential and Venereal Bubo's hath been already shewn in its own proper place The Cure When a Bubo that neither is Pestilent nor Venereal is excited Nature unburdening her self of that whatever it be that is offensive and troublesome unto her and expelling it unto the external ignoble parts Natures operation and endeavor is by no means to be hindred nor the matter to be driven back again unto the internal parts And first of al we must duly weigh whether or no Nature hath excited the Bubo by the Crisis and that a perfect one and that thereupon the sick Person be discharged of the
an extream troublesome palpitation and beating of his Heart For the removal of this great Distemper there were many Remedies prescribed and administred not only by my self but likewise by the most expert Physitians of our Vniversity there All which when they could not in the least prevail over this contumacious and head-strong Disease by reason of the Patients continuing and persevering in his accustomed ill course of Diet he grew the worse thereby and after some few months were passed in the which by the advice of the Physitians he took no Physick at all for they were willing to commit unto Nature a part of the Cure of this Chronical Affect he began to complain of that part that lieth under his left Shoulder-blade The place of his grief being lookt upon and throughly considered there appeared unto me a notable Tumor soft unto the touch and attended with a beating and when pressed down with the Fingers it was then seemingly wholly hid and non-apparent but these were no sooner taken off but forthwith it returneth as before In short the Disease having gotten deep rooting being now become incurable our Patient within a very short time after departed this life But now that we might get the truth and certainty both of the nature and constitution of this Disease as also of the Cause thereof we dissected that part that was affected with the Tumor out of which there issued forth great store of Blood unsavory and stinking as it was all which Blood being wholly evacuated and throughly cleansed there appeared the prime and principle Artery under the Heart having its original from the great Vein in its ascending up into the Head exceedingly dilated and extreamly torn This Vein descending downward creepeth along through the Region of the Intercostal Muscles the Blood that flowed forth of it being heaped up in the spaces of the Muscles and in tract of time putrefying and corrupting had so vitiated and marred the Vertebra and Rib of that place that it seemed unto us altogether rotten and putrefied And therefore say we some other way and means of the generating of this Tumor is to be sought and found out The Author of the Book of the Medicin Definitions defineth Aneurysma by the relaxation of an Artery And so likewise Fernelius in the seventh Book of his Patholog and Chap. 3. asserteth that Aneurysma is a dilatation of an Artery ful of spiritful blood but all this while they do not express the manner how this is done Neither is it ever a whit credible that Aneurisma is caused by the dilating of both the Tunicles of the Artery but only by the widening of one of them For the Atteries have indeed a double Membrane one external which is slender thin and soft having of straight Fibres very many but of oblique ones very few and of transverse ones none at all the other internal which is close thick and hard having transverse Fibres but wanting straight and oblique ones And therefore if the Internal Tunicle be either broken by extension as easily it may be in regard of its hardness or else if it be opened by Section it doth not easily Cement and close together again because it is hard but now the external Tunicle in regard of its softness doth easily and soon grow together again and because it is so soft and wanteth both oblique and transverse Fibres it is thereupon extended by the Blood and the vital Spirit seeking their passage forth in an imperious and violent manner and so this kind of Tumor cometh to be excited in the which the force and the impetuous violence of the blood and the vital spirit may be discovered by the very touch Neither is that which Platerus objecteth of any weight or moment to wiâ— when he tels us that upon the alone bare Section that he saw made in the skin that covered over the Tumor the blood forthwith at first hid it self but then instantly sprang forth amain and this oftentimes saith he is in so great abundance that it cannot by any one use he what means he wil be any more stanched but that it issueth forth in greater abundance insomuch that the whol stock of Blood being almost spent it hath oftentimes brought a sudden Death upon the sick Person But indeed if we should determine that the Aneurisma proceedeth from the dilatation of these Tunicles of the Artery this Objection would then carry some weight along with it But in regard that according to the truth of the matter we have already asserted and determined that an Aneurysma ariseth from the dilatation of the exterior Tunicle alone of the Artery the internal being opened either by Section or by Rupture we cannot therefore by any means grant that the Arterial blood lieth hid under the whole Skin but because the external Tunicle is extraordinarily extended it cohereth and sticketh so close unto the Skin that it is extended together with it and is in a manner so become one therewith that it is almost impossible to cut the Skin without cutting the external Tunicle of the Artery And so then the result of al that hath been said wil be this to wit The nighest cause of Aneurisma That the proxime and nighest cause of Aneurysma is the opening of the interior Tunicle of the Artery and the dilatation of the external Now it is very frequently opened by Section when unexpert Chirurgeons instead of a Vein open an Artery or when at least together with the Vein they cut through the Artery that lieth under it Now if this at any time happen the external Tunicle in regard of its softness and neer alliance with the Tunicles of the Veins very easily and soon closeth together again but the interior by reason of its hardness remaineth open from whence through the patent and open place the Blood and vital Spirit endeavoreth to break forth and by this means distendeth the external Tunicle and causeth this kind of Tumor The same may likewise happen if the internal Tunicle of the Artery be broken either by the violent and impetuous motion of the Arterial blood or by any violent external cause and the overgreat distension of the Artery the external Tunicle that is more apt for extension being al this while safe and sound But now Whether or no that pulsation of the Arteries of which Platerus maketh mention in his Tract touching the palpitation of the Heart and touching which out of Fernelius and Ludovicus Mercatus we have already treated in the fourth Book of our Practice Part 2. Sect. 3. Chap. 9. may or ought properly to be referred unto Aneurysma I very much doubt For whenas the Membrane of either Artery is then whol and entire it seemeth rather to be an Affect in the Veins of kin to the swoln and distorted Veins that we cal Varices than this Tumor Aneurysma of which we are now treating Signs Diagnostick The Aneurysma is easily known and discerned from Ecchymosis because that in Aneurysma the color
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â— In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
flame it self penetrateth unto the Pouder or else that the Bullet striking against Iron or some Stone is kindled by the sparks of Fire just as we see it to be in the striking together of the Steel and the Flint-stone Fourthly if instead of the Leaden bullet either Papper pellets or pellets of Hurds be ram'd into the Gun and then shot forth there will not appear any the least tokens of any burning in them caused either by the Gun-pouder or else from the vehemency of motion but only that somtimes they are sullied by the Gun-pouder and made a little black and they are oftentimes drawn forth of the very Wounds as whole and entire as they went in Fifthly Those who are thus wounded do not feel any heat or burning from these bullets but only a pain from the bruising and tearing of the flesh Sixthly That those bullets are not made hot either by the flame of the Gun-pouder or else by the swiftness of their motion we are sufficiently assured of it even by this that a bullet made of Wax and shot forth of a Gun doth not at all melt but that it even pierceth through a two inch board or any piece of Wood two Fingers thick And from this alone it may appear very manifest-that those bullets whatsoever it be that they do it is not by the power and virtue of any Fire that they have in them but what they effect is meerly by their force and violence But now that I may a little open unto you my thoughts The Decision of al the opinions and give my Judgment touching this Controversie I conceive the third Opinion well weighing the Reasons that are brought for it to be the most agreeable to truth But those Arguments that are brought for the two former Opinions may easily be answered For the first of the three who defend that those Wounds are poysonous they do not prove it by this that first of all grievous and dangerous Symptoms do infest those that are wounded in this manner For all those Symptoms may possibly proceed from a Contusion if it be not rightly Cured or if it be overgreat and that there be from hence a putridness excited For when that bullet doth with the greatest violence that may be penetrate through those parts against which it hitteth it dashet together all whatsoever lieth in its way briuseth and teareth it by which said violence not only the Capillary Veins and the Arteries and Nerves that be every where up and down dispersed throughout the flesh are rent and torn but the greater Vessels likewise are battered and broken insomuch that the Natural flux of the Blood and the Spirits is hereby hindered whereupon the bruised parts being deprived of their Natural and Vital heat are easily corrupted and soon putrifie Neither can it truly be said that the trembling of the Heart and the like Symptoms do happen unto all that are thus wounded But as for what they say in the second place that Alexipharmaca or Counter-poysons have been somtimes found very good and commodious for the person thus wounded we answer that this is not true of all Wounds made by Gun-shot but of those only when by the Contusion and the great putridness following thereupon and the neer approaching of a Gangrene the Heart is hurt by the putrid Vapors ascending from the Wound through the Arteries and thereupon it is by Alexipharmick and Cordial Medicaments to be defended from them and withal strengthened But that those Wounds are a long time to be kept open this is not therefore to be done that so the poyson may be evacuated but that the Pus that is continually generated from the bruised parts may be emptied forth which is done too slowly in regard that in such Wounds as these there is very much of that that is bruised And Lastly for what they alleadg that in many battles the most of those that have been wounded either they have Died or else they have been preserved with very great pains and much difficulty this did not therefore happen because that the Wounds inflicted by Gun-shot were poysonous since that in very many other battles no such thing hath been observed but it happened from hence to wit either by reason of the bad and unhealthful Constitution of the Air or else from the vitious and unsound Constitution of the Body and the great store of depraved Humors in these wounded persons such as is most commonly wont to be in those that follow the Camp But now in special and particularly the poysonousness of those Wounds cannot be proved to arise either from the Gun-pouder or from the bullet For as we also told you before neither is the Sulphur nor the Nitre nor yet the Coals all or any one of them poysonous and therefore surely of these there can nothing be compounded that is poysonous And that Sulphur and Nitre may be safely administred appeareth out of Dioscorides his 5. B. and 83. Ch. and out of Hippocrates in his B. of the Nature of Women and others both Ancient and Modern Now the kindling and inflaming of these and the Fire following thereupon would rather dissipate this poyson if any such were present then any waies produce it Neither do those that make this pouder stop their Mouths and Nosethrils by reason of any poysonous quality that it hath but to keep out the pouder that is otherwise very troublesom when it gets into the Mouth of Nosethrils neither yet do all that make pouder stop the aforesaid places although some do for the reason I have given you And moreover much less can this poysonousness be produced from the Lead For although it being long deteined in the Body and there resolved like unto other Metals if it contract any rustiness it may possibly do hurt but yet nevertheless that in this its moment any passage through the Body there should be any poyson imprinted by it upon the Body this can no way be And as we told you above these bullets have somtimes been known to lie in the Body for many yeers together without any inconvenience or hurt yea and moreover from lead there are many very useful Medicaments to be made for External Ulcers But this we easily and of our own accord yield unâ—o and readily grant them that those Bullets as also all other Weapons may be infected with poyson For although the Lead be thick enough yet nevertheless since that Iron that is yet far more solid may be infected with Poyson why may not Lead also be poysoned Now that Iron may be infected with poyson there is no doubt at all to be made the truth whereof is sufficiently testifyed by the Histories both Ancient and Modern of those Nations that as yet use Arrows And this we are assured of by Dioscorides in his sixth Book and 21. Chapt. and by Paulus Aegineta in his sixth B. and 88. Chap. and by Virgil in the tenth B. of his Aeneids and elsewhere as also by Ovid in his
it as being such as is produced by the most corrupt blood The next unto this is the wan and yellowish Those that are less malignant and consequently the less to be feared are such as have in them a reddish color to wit such in which the blood hath not as yet altogether lost and changed its Nature but that it hath as yet retained somwhat of its native heat and color 2. Those Carbuncles likewise that are smal are less pernicious than those that are great and from a very little Pustule they suddenly acquire and get an extraordinary greatness 3. And so are likewise those that are alone than such as have other Carbuncles conjoyned with them 4. Of al other those are most destructive and deadly which after they have once begun to wax red do immediatly vanish again For the matter being transferred unto the more inward parts often if not evermore proveth destructive and deadly 5. There are some also who conceive that this is likewise throughly to be considered to wit Whether the Pestilent Carbuncle arise before the Feaver or else whether or no the Pestilent Feaver going before it at length break forth For they conceive that the Carbuncle that breaketh forth before a Pastilent Feaver is more safe provided that no Symptoms follow thereupon in regard it is an evidence that Nature is strong and able to expel the Pestilent Poyson before the Feaver ere ever it can seize and surprize the heart And on the other side that to be more dangerous which at length breaketh forth after a Pestilent Feaver forasmuch as the Heart being seized upon it hath its original from the poyson and the corrupt humors now diffusing themselves into al parts of the body 6. The place also manifesteth when the danger is more or less to be feared For those are evermore accounted evil and pernicious that stick fast in the Emunctories and neer unto the Noble and Principal Members But here most especially the strength and natural powers are to be regarded and we are wel to consider whether they be strong or else but weak For that strength that is but weak and languishing may be soon over-powered and vanquished even by a smal Disease Whereas on the contrary that that is more vigorous oftentimes overcometh and mastereth even that disease that in it self is strong and powerful The Indications The Indications in a Pestilent Carbuncle are different from those in a Carbuncle not pestilent In a Pestilent Carbo or Carbuncle the fervent heat of the blood is wholly al the body over to be restrained and withal the Heart at the same time is to be fortified against that malignity which as we have said is here very seldom absent The rest of the Cure is to be directed unto the Carbuncle it self But now in a Pestilent Carbuncle there is a more poysonous and pestilent quality appearing than in the fervent heat of the blood yet neither is this to be sleighted or neglected The Cure And therefore as to what belongeth unto the Cure of a Carbuncle there are two things that we are especially to regard and have an eye unto the Antecedent Cause or the fervent and corrupt blood that is in the whol body and the Conjunct Cause or that same Humor that now exciteth the Carbuncle A convenient Diet therefore being ordained and a moderation observed in those things we cal not natural the extream fervent heat of the blood is by opening a Vein to be taken away And yet this Venesection is not rashly to be made use of in al manner of Carbuncles but if it hath any place at al it is most chiefly in that that is not pestilent touching which likewise that assertion of Galen in his fourteenth Book of the Method of Physick and of other Authors who conceive that the blood is to be drawn forth even until the sick person faint and swoon is to be understood But in a pestilent Carbuncle nothing is rashly to be attempted that may weaken and deject the Natural powers of which there ought to be the most special regard had in the plague and in pestilent Feavers amongst the which Venesection unto fainting and swounding is not the last but rather the first which together with the Spirits evacuateth that humor that is most agreeable and friendly to Nature and even that most excellent and precious Treasury of the life Nay indeed moreover even somtimes when the pestilent Carbuncle is just then breaking forth we cannot safely enough institute and ordain Phlebotomy For whereas the Carbuncle somtimes breaketh forth not instantly upon the very first invasion of the Plague and pestilential Feavers but often afterward on the fourth daies or haply on some other daies the Natural powers wil not then bear the said Venesection in regard that they are now dejected by the disease and have therefore entered the Lists are now conflicting with the said disease But now what Veins are to be opened sufficiently appeareth from that which we have spoken above touching the evacuation of the blood touching Revulsion and Derivation in the Cure of an Inflammation This only is here to be observed that we must beware lest that whilst we evacuate the blood we do not lead and draw the same either unto any noble Member or else through any noble Member lest that the said Member should be affected with its malignity And therefore we say that that Vein is to be opened by means whereof the blood may rather be drawn toward the part affected than drawn back from it Wherefore if the Carbuncle shal be about the Head or the Arm-holes or in the Breast the neerest Vein in the Arm of the same side is then to be opened But if it be below the Liver then the Ankle Vein or the Ham Vein of the same side And this Phlebotomy ought to be put in practice instantly and in the very beginning before the Feaver get strength and the Natural vigor be too much dejected But now in regard that by this blood-letting the naughty corrupt humors can scarcely be evacuated therefore some conceive that there is need of purgation by which the said depraved humors may be evacuated lest otherwise the Native heat should be suffocated and extinguished by them and that Nature may afterward the more rightly moderate the expulsion and that so the part affected may not be corrupted by the great abundance of the Humor flowing thereto But then we ought to be extraordinary careful lest that by the purging Medicament the Humor that Nature endeavoreth to thrust forth unto the external parts be drawn unto the internal and this is most of al to be feared in a pestilent Carbuncle We conceive indeed that it may more safely be ordained and appointed in a Carbuncle that is not malignant But when a Feaver is therewith joyned and that an acute one the crudity of the matter then for the most part forbids it and to speak truth there is hardly a Carbuncle to be found in which
the Evacuation of the blood and the preparation and purgation of the vitious humors ought to be enjoyned according to the Nature of the peccant humors This in the general is to be pre-cautioned that regard be had unto the Heart that it be wel and safe guarded against al the malignant vapors that exhale from the putrifying part And therefore we must here administer for the comforting and strengthening of the Heart Medicaments of Borrage Bugloss Carduus Benedictus the smallest Sorrel Bole-armenick Terra sigillata Bezoar stone Citrons Treacle Mithridate Species of Diamargarit frigid Electuarium de Gemmis Confection of Hyacinth Alkermes and the like Or Take the Water of Scabious Sorrel Borrage Roses and Carduus Benedictus of eâ—â—h one ounce and half Syrup of Sorrel Citrons and Pomegranates of each one ounce the species of Diamargarit frigid Bole armenick and Terra sigillata of each one scruple Mingle them and make a Potion Or Take Conserve of Roses two ounces of Sorrel of Borrage and of Gilliflower of each one ounce Citron rind candied Rob de Ribes of each half an ounce prepared Margarites Bole-armenick Terra sigillata the temperate Cordial Species of each one scruple Syrup of Sorrel and of Citrons as much as wil suffice and mingle them Let the Heart be likewise guarded externally with Topicks As Take the Water of Roses two ounces of Borrage and Sorrel one ounce and half of Carduus Benedictus one ounce Vinegar of Water-Germander six drams Spirit of Roses one scruple Mace Lign-aloes Rinds of the Citron of each half a dram Saffron half a scruple Camphire six grains Mingle them and make an Epithem which must be applied unto the Region of the Heart for its defence and preservation In a Gangrene likewise for the most part the sound part ought to be fenced and guarded and we must be alwaies doing our endeavor that the said part receive none of the putridness And for this end the above mentioned Defensives of Bole-armenick and Terra sigillata must be administred unto which by reason of the malignity Water Germander may be added and mingled therewith As Take Bole-armenick one ounce Terra sigillata half an ounce Harts-horn burnt and prepared one dram Camphire half a dram Wax six drams Oyl of Roses four ounces Rose Vinegar one ounce the juyce of Water Germander half an ounce the white of one Egg mingle them and make an Vnguent As Take Bole-armenick and Terra sigillata or sealed Earth of Lemnos of each half an ounce Mingle them with Vinegar of Water Germander Gulielmus Fabricius frequently made use of this that followeth Take Barley meal four ounces Bolearmenick two drams Galls Cypress Nuts Pomegranate rinds of each one dram and half with a sufficient quantity of Oxymel simplex make a Cataplasm A Gangrene from overmuch cooling But now that we may come unto the more special Cure we will in the first place declare unto you in what manner the Gangrene that hath its originall from an overgreat cooling ought to he Cured But now that it may be wel known how and in what manner al those are to be dealt withal that have been over cooled whether it be so that the Gangrene be already present and in being or that it be only neer at hand we wil from the very begiâ—â—ing briefly pursue and declare the truth of the thing The Cure of such as are over-cooled If therefore there be any one over cooled yet notwithstanding that as yet there is no Gangrene present neither is the part as yet become wan pale and cold but that there is rather a redness in the part together with a vehement and burning pain then in this case the man is not instantly to be moved neer unto the Fire but he is rather to be placed somewhat more remote from it that so by degrees the heat may recover and recollect it self But if it be so that the part be not altogether stiff and stifled with cold so that there be no longer any blood left therein then it is forthwith to be welchafed and rubbed with Snow or the overcooled members are likewise to be throughly washed with cold water upon which they wil begin by little and little to wax warm and to recover their former heat Which the Inhabitants of the Northern Climates have much in use who are wont when any Travellers are overcold stiff and almost dead therewith first of all to plunge them deep into cold water and before ever they give them any entertainment to wash and rub their Hands Feet Noses and other Members with Snow And that from the inward parts the heat may the more strongly diffuse it self unto the external parts and that all the cold may be expelled it wil be requisite to administer suppings made of Wine and to drink Wine and Treacle mingled together The aforesaid People of the Seprentrional Regions use to give their Guests when they are almost dead with cold Hydromel with the Pouder of Cinamom Cloves and Ginger and the like Spices after which they put them to bed and cause them there to Sweat For which purpose there be some that outwardly apply likewise unto the body Flagons or Stone Pots ful of hot water Afterward when the pain and the coldness are something mitigated gentle rubbings with the hands anoynted with the Oyl of Camomile sweet Almonds and Dil are to be administred and the parts are to be fomented with sweet Milk in the which there may also be boyled the Leaves and Berries of the Lawrel Rosemary Camomile Sage Organy French Lavender and the like The Decoction of Rape roots is likewise singularly useful and commonly unto those members that are pained with overcoldness they use to apply the Decoction of Rape roots that have been first frozen with cold After this we must betake our selves unto those things that are hotter such as the Oyl of Lilies of Turpentine of Wax Nettle seed Cresses But if there be not only a fear of a Gangrene but that there also be one already present and that the Member already begin to die we must then use our utmost endeavor that the heat may be preserved in the part and that from other parts it may be again called back unto it and therefore here is little or no benefit to be expected from Defensives but Scarifications are rather to be administred and the parts to be fomented with those hot Medicaments that were but even now mentioned unto which we may add Scabious water Germander the Root of Asclepias or Swallow-wort and the like Unto the parts there may be administred Treacle Mithridate Trochisques of the Viper the Ley in which Water Germander hath been boyled and Treacle Waters Secondly A Gangrene from the afflux of Malignant humors If the Gangrene hath its original from the afflux of Malignant humors or a malignant quality then by appointing a Cooling and drying Diet and by administring of Meats sauced and seasoned with Citrons Lemmons and Pomegranates and
or no being Cured and his Wound healed he be likely to undergoe and suffer the hurt Action of some one or other of his Members For so oftentimes it happeneth that some Tendon being cut asunder the motion of some part is wholly lost and that the Brain being wounded the Memory or Rational faculty is thereby hurt and Moreover whether the wound be likely to be Cured in a short or whether it wil take up a longer time But on the other side if the wound be altogether incurable whether it be Mortal and such as is likely to hasten Death or else whether it be not more probable that it will degenerate into some long continuing Ulcer And Lastly it must be foretold likewise whether the Changes and Alterations of the Wound will be for the better or for the worse and when these Changes wil be Now in the first place it must be diligently explained What Wounds are Deadly and what Wounds are not so For indeed this Question is of very great Moment and therefore most diligently and exactly to be weighed and known by the Physitian For whereas oftentimes the lives of some men are much hazarded and endangered when they are brought before the Magistrates in the publike Courts of Justice by Reason of Wounds they gave unto others and that oftentimes the Judges desire the Physitians Opinion touching the same great Care and a diligent Endeavour ought to be used that the Physitian give so true a Relation and so distinctly deliver his Opinion touching the quality of the said Wounds that the innocent may not be condemned nor the Guilty acquited But in the first place we are to know that not every Wound which hath Death following it is to be called a Mortal wound but that alone which in its own Nature bringeth Death Now such like wounds are twofold For Mortal or Deadly as Galen in the 5. B. of the Aphor. Aphor. 2. and Aph. 18. teacheth us is somtimes taken and understood of those wounds that are of necessity deadly and somtimes again of such Wounds as are so for the most part as Hippocrates speaketh and such as by Reason of which as the same Hippocrat maketh the limitation in the 18. Aphorism 6. Sect in Coacis or his tract of Playsters those that are wounded almost or for the most part die like as Galen in his 5. B. Aphor. 2. writeth that Deadly is to be taken for that that is dangerous and is oftentimes terminated in Death But the Question is here especially of the former kind for that wound that hath been at any time Cured in others cannot be taken for a wound simply Mortal and Deadly But we shall afterward tel you when it is to be taken and accounted for Mortal or not Mortal And therefore Secondly Wounds cannot be accounted simply Mortal whereupon the supervening of most grievous Symptoms which said Symptoms notwithstanding do not alwaies and necessarily follow upon the reception of these like wounds the wounded person dieth as when in the Wounds of the Joynts and the Nervous parts an inflammation Deliry and other Symptoms happen or that by Reason of a Cacochymy lying secretly in the Body a feaver is kindled upon occasion of the Wound And it is altogether most true that many things often fal out that render Wounds incurable which in their own nature were curable Like as neither are those to be accounted for Wounds simply Mortal the Curing of which is long protracted by Reason of which it at length happeneth that the Wounded person perisheth by a slow and lingring Death the same that happeneth when the Lungs being Wounded an Ulcer and the Consumption follow thereupon or the Thorax or Stomack being wounded which oftentimes after a long space of time become the Causes of Death unto the wounded person For whenas it hath been observed and known that these like Wounds have been healed in others they cannot then be accounted for Wounds simply Mortal But those Wounds are only to be reputed simply Mortal which in the space of a few hours or daies do necessarily bring Death unto the sick person and cannot be cured by any Art And therefore we are to distinguish between Wounds Mortal and Wounds incurable For all Mortal Wounds are incurable but all Wounds that are incurable cannot be said to be Mortal For Wounds incurable as we have told you are al those that though they cannot indeed be cured yet notwithstanding they are not suddenly the Cause of Death unto the wounded person since that although they cannot be healed yet nevertheless the sick person may after this live not only many Weeks but even yeers also And such a like Wound was that which Mathias Cornax in his Epistle Responsory unto Dr. Aegidius Hertogh and Julius Alexandrinus in his Annotations upon the sixth Book of Galen his Meth. of Physick Chap. 4. have described unto us For when as a certain Bohemian Boor as he was hunting received a Wound in his Stomack with a broad hunting spear it could not possibly be consolidated but yet in tract of time the lips of the wound became hardn'd by a certain Callousness growing over them so that the wounded person survived for many yeers after and by applying of an instrument he could at his pleasure evacuate his stomack And now in the next place let us see what Wounds they are that we may account to be simply Mortal or Deadly And now whereas Death happeneth upon the defect extinction of the Native heat and that the Native heat may in a twofold manner be extinguished either sensibly and by degrees as it is in a Natural Death and long continued Diseases as the Consumption and the like or else suddenly and violently the latter way it is that Wounds are said simply and necessarily to bring Death unto the wounded person to wit a violent one Now the innate heat is extinguished either because the vital spirits are dissipated or because they are suffocated And therefore all Wounds that are Mortal and of necessity cause a sudden and violent Death either they suddenly suffocate the vital spirits or else they dissipate and corrupt them But in regard that the Heart is the Store-house of the vital spirits and the Native heat first of all therefore the Wounds of the Heart of all others do especially and most speedily bring upon the Wounded Person a violent Death And the very truth is as Galen writeth in his 5. B. of the places affected and 3. Chapter if the Wound penetrateth unto the ventricle of the Heart especially the left the wounded person of necessity dieth suddenly but if the Wound penetrate not so far as unto the ventricle of the Heart but that it consist in the substance thereof the man may then indeed live for a while but yet nevertheless he must necessarily die this violent Death Secondly It is of necessity that the man die if some Vessel be wounded in that part of the Lungs that are next unto the Heart and
wounded or he that hath the greater Veins or Arteries about his Jaws cut assunder And they also very hardly recover their former soundness that have any part of their Lungs or the thick part of their Liver or the Membrane that conteineth the Brain or the Spleen or the Matrice or the Bladder or any Intestine or the Midriff wounded These likewise are in extream great danger in whom the Swords point hath pierced even unto the greater Veins that lie hid and concealed within in the Arm-pits or in the Hams And those Wounds are also dangerous wheresoever there are any of the greater Veins in regard that they soon spend a man by the extraordinary effusion of Blood And this happeneth not only in the Arm-pits and in the Hams but likewise in those Veins that reach even unto the Aâ—se and the Stones And besides these that Wo end is also evil and dangerous that is in the Groins or in the Thighs or in the void places or in the Joynts or between the Fingers As also whatsoever wound it be that hath hurt any Muscle or Nerve or Artery or Membrane or Bone or Cartilage But now because that Hippocrates what he had said in the sixth B. of his Aphorism Aphor. 18. to be Mortal and Deadly that in his Coaca Aphor. 509 he explaineth by saying that they almost die let us therefore see what â—ounds of these parts are simply Mortal and what not And first of all Hippocrates in the Sixth Book of his Aphorism Aphor. 18. reckoneth up the Wounds of the Brain among the Mortal Wounds The Wounds of the Brain and yet nevertheless in his Coaca he limits it and writes that for the most part this is so For all the Wounds of the Brain are not Mortal For Galen himself saw when such Wounds were Cured in the 8. B. of the Vse of the parts and 10. Chap. and in the sixth of the Aphor. Aph. 18. And we have instances thereof in Valleriola in his 4. B. of Observat and 10. chap. and in his 5. B. of Observ chap. 9. and in his sixth B. of Obser ch 4. in Gulielm Fabricius his 4. Cent. Observ 1 2 and 3. and he there giveth us a long Catalogue of the Physitians who had seen some Wounds of the Brain Cured In Johannes Andreas a Cruce in his first B. of Wounds Tract 2. chap. 14. of a hurt and wounded Brain Yea Moreover it hath been observed that after the loss and perishing of some smal part of the Brain yet nevertheless the wounded person hath perfectly recâ—vered for the confirmation of which we have many Histories given us by Divers Physitians Anton. Musa Brasavolus in his Comment upon the 18. Aphor. of the sixth Sect. of Hippocrates Nicolaus Missa in his first B. Epist 11. Fallopius in his Tract of the Curing of Wounds chap. 45. Franciscus Arcaeus in his first B. of the Curing of Wounds and 6. chap. Johannes Andreas a Cruce in his first B. of Wounds Tract 2. chap. 14. Ambrosius Paraeus in his 9. B. and 22 chap. and others all which or at least the greatest part of them have been collected by Schenckius in his first B. Oserva 40. and 42. And well worth Observation also are the Histories of the most dangerous Wounds of the Brain that are extant in Cabrolius his Obse vat 16 22 and 34. in Henricus Petraeus his 2. Tome of Harmonic Disputat Disput 36. Quest 10. in Gulielm Fabricius every where very frequently in wounding of the Heart did long survive For although it hath indeed been observed that Tumors and Ulcers have been found in the Heart yet those seeing that they arise and grow by degrees life may somtimes for a while persist together with them although that in the conclusion even these also bring Death unto the Party But wounds in regard that they suddenly disturb the very frame and Oeconomy of the Heart the life cannot therefore long persist with these And albeit Galen in his 2. B. of the Decrees of Plato and Hippocrates and 4. Chap. relateth that sacrifices at the Altar after the heart hath been cut forth have been heard to cry yet notwithstanding this lasteth so long only as the vital spirits are remayning in the Arteries which being exhausted soon after the Beast fals down and dieth For as Aristotle writes in his third B. of the parts of Animals and 4. Chapter the Heart alone of the Bowels and of all the parts of the Body will not admit of or bear any great injury and this for very good Reason For when the very principium or principal part of all is corrupted and injured it cannot then possibly afford any aid and assistance unto those other parts that depend thereupon And more especially as hath been said the left ventricle of the Heart which is the storehouse and treasury of the Blood and the vital Spirit being wounded the wounded person immediatly perisheth But if the right ventricle of the Heart be wounded that the wounded person may in this case lengthen out his life for some short time is confirmed unto us by a strange but yet true History that we may finde written in a Table hanging up against a Wall in the Library of the University of Groning and as it is described by Gothofredus Hegenitius in Itinerario Frisic Hollandico Page 16. in these very Words Nicholaus Mulerius health to the Reader It hath hitherto been beleeved that the heart being wounded no man could possibly lengthen out his life no not for the short time of one hour Which opinion both Reason and Experience confirm For seeing that our life dependeth upon the safety of the spirits whose Store-house and Fabrick is Scituated in the very Heart the Heart being wounded the said treasury and fabrick that it Scituated in the same must of necessity be wounded likewise But I thought good here to relate unto you a very Memorable History a History I say of a certain Soldier who being wounded at the Heart yet lived above fifteen daies after the like whereunto we meet not with in any of the observations of either Ancient or Modern Physitians Andreas Haesevanger being a Soldier enrolled in the City Garison under the most Illustrious Count William of Nassau Chief Governour of Frisia Groning Omland c. received a wound in his breast from a fellow Soldier of his in the year 1607. the two and twenty day of August in the evening and he died the eighth day of September following an hour after Sun-rising it being the sixteenth day from that whereon the wound was given him The Body of this dead Soldier by the command of the Governour of the City Garison for the discovery of the Nature of this his wound was opened and examined by my self and two Chirurgeons Gaspar and Luke Hulten there being present and looking on that valiant and most Noble Bernhard Hoornkeus there looking on likewise some others both of the meaner and better sort of Soldiers We had no sooner opened the
Cavity of his Breast and emptied forth no smal store of purulent matter that stank not much but behoâ—d we found to our great admiration that the Wound had penetrated even into the right ventricle of the Heart and that the aforesaid part of the Heart was almost all of it withered and wasted away the left part stil abiding safe and entire in which is conteined the Primary Store-house and treasury of the vital Spirits And therefore by the benefit of this alone the life of this Soldier was preserved even unto the sixteenth day in the morning And lest haply that this relation should not be Credited by some the most Noble and Illustrious persons before mentioned Bernhard Hoornkeus Governour of the City Garrison and Petrus Pappus the Military Praetor have confirmed the same by their Testimony and the subscription of their Hands And the latter of them hath likewise made an exact narration of this History in his learned Commentaries upon the Military discipline Done at Groninga the 22 day of June in the year 1627. I Bernhard Hoornkeus do attest what is above written this 22 of June 1627. I Petrus Pappus von Tratzberk do attest that this History is true and that I my self very well know it to be so And therefore what is related by Matthias Glandorpius in his Speculum Chirurgicum Chap. 23. touching Sanctorius a Professor at Padua that struck a Coney through the Heart with a sharp instrument the Coney still remaining alive for many Months after this without doubt being to be understood of the right ventricle of the Heart it happening withal likewise that the instrument out of all question was not broad but narrow and sharp-pointed VVounds of the Lungs Fourthly The Wounds of the Lungs Hippocrates indeed reckoneth them up in the number of those Wounds that are Mortal in the place before alleadged in Coacis and yet nevertheless he doth not absolutely and simply pronounce all the wounds of the Lungs to be Mortal but he himself addeth a Limitation to wit this if the wound shall be so great that the Lungs being Wounded there passeth forth less of the breath by the Mouth then there issueth forth of the Wound And that all the Wounds of the Lungs are not Mortal we are oftentimes taught by experience which evidently confirmeth it unto us that many who have been wounded through the whole Thorax and the Lungs have yet notwithstanding escaped with their lives and recovered their former health and soundness And I my self saw an example of this in a certain Student who in the year 1633. in the Month of July in the night received a wound by a narrow sharp pointed Sword run through his Breast on the right side thereof about the Third short Rib neer unto the Arm-pit and coming forth opposite unto it neer unto Spina so that he sent forth by the wound much Breath with a great noise and yet notwithstanding this man recovered and was well again within the space of a month and even now also in this year 1634. wherein I am writing these things he is in good health and strength Yea Guliâ—lmus Fabricius in his 2 Cent. Observat 32. our of a History imparted unto him by one Abel Roscius which is as followeth telleth us of the Cure of a wound in the Lungs that was far more dangerous then the former The story is this There was saith he among the Delphinates in the town of Calmuntium a certain person grievously wounded in his Brâ—â—st the wound being made by the prick of a Sword betwixt the fifth sixth ribs of the breast not far from the Sternum or Breast bone in whom when the Sword by its broad point had lightly pierced through even the very Lungs in the drawing of it forth I know not by what ill chance it being turned round it brought forth along with it through the wound a smal portion of the Lungs whereupon immediatly all the standers by adjudged the Wounded person to be at the very point of Death In the mean time the Physitian together with a Chirurgeon being sent for so soon as he was come instantly commanded that the part of the Lobe of the Lungs that hung forth being first well washed in Wine should again be thrust back into the Breast But in the handling thereof perceiving that it began to look blackish and wan he caused it to be cut off with a red hot Iron Instrument But as for the Rest of it the Chirurgeon gently thrust it back again into the Breast the Ribbs being first dilated with a Wooden wedg that was instantly provided for that very purpose And then after this by the Art and Medicaments prescribed by the Physitian he was Cured then being withal external means administred and some certain pectoral Decoctions of Vulnerary Herbs for a few daies inwardly drunk and so the wounded person perfectly recovered and after this lengthened out his life for many years his Lungs and Breast all the while continuing still very sound and altogether free from all manner of hurt and detriment And therefore we may conclude that the Wounds of the Lungs are not alwaies of themselves Mortal or incurable unless haply a deep Wound therein be affected with an Inflammation or else when the Wound hath hurt the great Vessels or the Lappets thereof or that the wound reacheth neer unto the Heart And many other such like Histories Schenckius in the 2. B. of his Observat relateth out of Franciscus Valleriola his fourth B. Observat 10. Nicolaus Massa Franciscus Arcaeus Fallopius and Foresius and the like are to be seen also in Guliemus Fabricius his 3. Cent. Observat 36. and Cent. 1. Epist 52. and others all which here to recount would be too tedious And the like History is related also by that excellent and expert Physitian Doctor George Horstius in his 3. B. Observat 11. in these Words A certain Noble youth saith he Abraham a Schleinitz a Knight of Misna living with us at Giessa as a student in the year 161â— goeth to the House of a certain Citisen upon his Birth day which the Citisen as it seemeth was wont to observe in a festival manner other in the saiâ— House by Quarrels and Threats having given an occasion of a Tumult thither being come through a Chink of the Door he was run through his Body with a very sharp Sword the entrance of the Wound being not far from the Sternum about the Third or Fourth superiour Rib and the Sword going forth again under the Shoulder blade not far off from the Spina I being called about the first hour of the Night found that his Pulse was very weak and that there was present a difficulty of Breathing whereupon I had but smal hopes of him as conceiving very great danger to be at hand by Reason of the grievous hurt of hit Lungs and the great Vessels But see what happened A vomiting taking him suddenly without any means used to procure it all the grievous Symptoms
above propounded and set down in the first part Chap. 5. among the defensives in an inflammation The Medicament being layd on the part is to be bound up with a swath that may bind close the vein toward the root thereof and the ligature is not to be loosned before the third or fourth day or indeed it is not to be untyed until the blood be throughly stanched Avicen in his Quart Quarti tr 2. Chapt. 18. tells us of this following medicament that hath in it not only a power of burning but likewise an astringent faculty and a virtue also to generate and breed flesh As Take Chalcanthum Parget made into a very fine powder and sifted thorow a hayr steve of each twenty drams Frankincense powdered six drams Aloes dry Glue of each eight drams Arsenick four drams I had rather here take Mâ—rcury sublimate in regard that many who are ignorant of things Chymical and Metallick of ten times when sublimate in general is mentioned and Mercury sublimate is evermore to be understood there instead thereof these do substitute and appoint Arsenick let them be al beaten into a very fine and smal powder made up in a liniment and imposed upon the orifice of the vessel Some there are that unto this Medicament do add Dragons blood and the excrescence Hypocistis But those internal medicaments that stanch blood are either such as cool and thicken the blood or else they are those we cal Narcoticks The coolers and thickners are prepared of Myrtle Roses Purslane Lettice Berberries Ribes Succory Quinces Pomgranates Tormentil Corals Bolearmenick Sealed Earth Out of which may be made Powders Waters Syrups and from these potions and Electuaries There are likewise some certain things that are sayd to stay the blood by an occult and secret property and thus Strawberry Water is much Commended in al haemorrhages And the Root of Corn-rose or Cockle held under the tongue stoppeth the hemorrhage And some there be that for this purpose commend unto us the roots of that Cichory that hath a white flower And some there are that order the Patient to hold in his hand the Jasper Stone or the Blood Stone Stupefactives are not over commonly to be administred neither indeed at all unless the strength remain firm and entire for fear lest that the powers being already much weakned and fayling by reason of the over great loss of blood should by these stupefactives be farther dejected but if the Patients strength wil admit of it then we may administer one grain or two at the most of Opiat Laudanum But now that the blood when it is stanched may so remain for this the situation of the wounded part maketh very much which ought to be such that the Member may look upward and be free from all pain For pain doth very easily attract the blood and cause it to break forth again and the blood doth more easily flow unto a declining and downward place If yet the blood by this means be not stanched they tell us that we are then to cast upon the vessel pouring forth the blood somthing to tye it withal and especially toward the root thereof by which the branch looks toward the Liver or the Heart and that the veins or Arteryes are to be made naked and bare to be layd hold on with a hook and then presently with a thread of silk especially to be tyed and the thread to be drawn very hard and close upon them and then they appoint that the wound be filled up with flesh before the bond be quite taken off For if the flesh shal not first of al have filled up the place that is about the vessel and have shut the very orifice of the vessel it self the bond falling off the haemorrhage wil again easily follow But the truth is that these things are more easily required and commanded then they are put in practice performed If a vein or an Artery wounded pouring forth blood be wholly cut assunder the blood is then the more easily stanched for the vessel is drawn back and on both sides contracted within it self and so its orifice is covered and shut up by the bodies that lie round about it But the best safest and most easie way if it be rightly ordered of stanching the blood is that which is wrought by Medicaments that stop and stay the Blood and shut up the orifice thereof as they were before propounded by us When the Blood shal be stopt the Wound is scarcely to be opened before the third day And if the Wound be unbound yet notwithstanding if there be yet any further fear of the Bloods breaking forth again the Medicament is not wholly to be taken away if it be not as yet moystened and vitiated by the purulent and sanious matter But if by these it be made so moist that it is ready of it self to drop off another is in this case to be laid on if there be yet any further flux of blood feared And yet notwithstanding we are herein to deal very Cautiously and with all manner of Circumspection and with the one hand that part of the Vessel toward the Root thereof is to be pressed down close together that so the flux of blood may be restrained and with the other hand the Medicament is to betaken off the moist Wound to be clean and dried and a new Medicament laid on But now if the internal Vessels shall be so wounded that they can neither be tied together by any ligature neither yet obstruâ—â—ed and shut up by any Medicaments laid thereon then Medicaments out of those things that have in them a virtue to cool and thicken the Blood and which were but even now mentioned by us are to be provided and a Dyet that is like and answerable thereunto as we have said is to be prescribed Now when the blood shal be fully stanched and shall become clotted then we must use the best of our endeavour to prevent the putrefying of it but that it be rather dissolved which in what manner it is to be performed we have declared before in the 2. Book Part 2. Chap. 6. and above in the first Part and 16. Chap. where what we have written may be seen at large for in this Chapter it is our purpose only to treat of the stanching of the Haemorrhages of Wounds The Dyet The Dyet is likewise so to be ordained that it may stop and stanch the Blood and to this end Meats are to be provided of Rice of Amylum or the fine flour of Wheat Barley Pears Ribes Quinces Services Medlars Lettice Endive The Patient ought to abstain from Wine He must likewise keep himself from Rage and Anger all Commotion of the Minde and over vehement motion and Exercise of the Body and therefore his Adversary that gave him the Wound is not to be admitted into the Room where the Patient is Chap. 15. Of the Wounds of the Nerves and Tendons in general and of the pricking of the
the Liver Ibid. P. 7. Sect. 1. Chapt. 11. Of the Wounds of the Reins Ibid. P. 8. Sect. 1. Chapt. 5. Of the Wounds of the Bladder Ibid. P. 9. Sect. 1. Chapt. 5. Of the Wounds of the Testicles Ibid. Chap. 11. Of the Wounds of the Yard Ibid. P. 10. Chap. 15. Of the Wounds of the Abdomen Book 4. P. 1. Sect. 2. Chapt. 1. We treated of the Wounds of the Womb. Chap. 23. Of the Diseases and Symptoms that happen unto Wounds And now since that it often happeneth that other Diseases as likewise divers symptoms do happen unto Wounds and follow upon them al which yield forth peculiar Indications and so draw the cure to themselves deject and weaken the strength of the Patient and render the Wounds very difficult to be cured and dangerous we ought therefore to treat of those also and to shew you how and by what means they are to be removed and taken way until which be done no Cure of the wound is to be expected Of Feavers And indeed in the first place it happeneth very often that Fevers follow upon Wounds And therefore although I have already treated of Feavers in a peculiar Tract by its self yet nevertheless in regard that it much concerneth us to know and rightly to understand the differences of Feavers that follow upon Wounds that so we may the better remove them we wil therefore herein this place speak somthing of them inspeciall and particularly And therefore first of al we are diligently to inquire what the nature of this Feaver is that followeth upon the Wound and what the Cause of it For these kind of Feavers are very various some of them being every day Feavers having their Original from the great disturbance of the spirits and the boyling heat of the blood by reason of anger Fear and upon all occasions of the humors being disturbed by the motion of the body or the commotion of the Mind And moreover also Secondly these feavers happen while the Pus and especially if there be great store of it is in breeding according to that of the 47. Aphor. of the second Sect. Thirdly from an Inflammation Fourthly and somtimes these putrid Feavers are likewise generated from the putridness that is in the wounded part And fifthly from the store of the vitious humors The first kind of Feavers invadeth the Patient at the first in the very beginning The first kind of seaver from the disturbance of the humors and as I told you before it proceedeth from the passion of the mind and the motion of the body and the disturbance of the blood and spirits following thereupon And hitherto also belongeth most vehement pain which by dsturbing the humors and causing restlesness may both set on fire those humors and the spirits and likewise excite a Feaver Their Signs Now these Feavers are known by this that they invade the wounded person instantly upon the inflicting of the Wound and together with it But yet notwithstanding because that the putrid Feavers may likewise somtimes invade the person immediatly and even from the very first beginning therefore by what Signs these Ephemerae or every day Feavers may be discerned from the putrid we have told you before and the difference will sufficiently appear from what we have written hereof in our first Book of Feavers and sixth Chapter Prognosticks And the truth is these Feavers of themselves bring with them no danger at all unto the sick person and yet Nevertheless neither can they at all promise any safety unto him seeing that then the time of the fluxion and Inflammation that are wont to follow upon the Wound is not as yet overpassed and gone The Cure But now this Feaver requireth not any peculiar Cure but if the Patient will but only submit himself unto the strict Rules of Dyet soon vanisheth of its own accord But yet nevertheless all the Causes thereof if they be yet present or that there be any fear of their returning are to be removed for otherwise they may easily draw upon the person some kinde of danger And in regard that otherwise about the fourth day Inflammations and fluxions are wont to happen these Feavers if they continue so long as until the said fourth day may possibly attract and augment those Evils And then again while the Pus is in breeding A Feaver from the generating of Pus and especially if there be a great abundance thereof generated Feavers are caused as Hippocrates telleth us in the 2 Aphorism Sect. 27. For then whatsoever over aboundeth in the wounded part and cannot be changed into the substance of the part beginneth to putrefie and there is caused as it were a certain kinde of boyling forth of putrefied mattier And yet notwithstanding Nature doth what lieth in her power and what she is not able to turn into the substance of the part she doth what she can so to work and frame it that it may not be altogether corrupted but most of it turned into Pus And therefore from this Ebullition or boyling there is indeed a heat of the blood in the Veins and Arteries communicated unto the Heart which when it is thither come it kindleth a Feaver that is like unto an Ephemera of many daies rather then to putrid Feavers properly so called Signs And therefore the Signs of Putridness are absent and appear not and so likewise for the Signs of an Inflammation and these Feavers invade the wounded person at that time wherein the Pus is wont to be generated and especially about the fourth day The heat is much but withall sweet the pulse great swift and frequent The Urine differeth and recedeth but little from its Natural state and there is no ill and dangerous Symptom Joyned together with it to accompany it Prognostick This Feaver of it self hath no danger at all in it but soon after ceaseth Cure And this that it may so much the sooner be done there is a passage forth to be made for the Pus and this so much the more speedily if the Pus be conteined in a more noble part or in a part that hath consent with some one of the more principal and noble parts and withal we are to endeavour that al the afflux of the Humors may be hindered and prevented And Thirdly Feavers from an Inflammation Feavers are somtimes kindled from the Inflammation that followeth and happeneth unto the wounded part somtimes Quotidians or every day Feavers and somtimes putrid Feavers even according as the Spirits Wax hot and this heat is communicated unto the Heart and also according as the putrid Vapours transfused into the Veins and Arteries do penetate unto the Heart and heat it Signs Now these like Feavers are known from the Signs of an Inflammation touching which we have spoken in the first Part and 5. Chapter But whether the Feaver be a Quotidian or a right putrid Feaver this may be known by the Signs of them both of which we have likewise