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A59999 A short compendium of chirurgery containing its grounds & principles : more particularly treating of imposthumes, wounds, ulcers, fractures & dislocations : also a discourse of the generation and birth of man, very necessary to be understood by all midwives and child-bearing women : with the several methods of curing the French pox, the cure of baldness, inflammation of the eyes, and toothach, and an account of blood-letting, cup-setting, and blooding with leeches / by J.S., M.D. J. S. (John Shirley), M.D.; Shirley, John, 1648-1679. 1678 (1678) Wing S3496; ESTC R38236 39,001 140

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aaren sender Inarings meening Shy hun den til blod forvender Ocs giffuer det igieu naar saften ny yder At samme ferske blod til alle Lemmer flyder Ued aarr gangr krum c. That is Thou Stomack gallant Cook thy meat so well dost dress That of it in a trice thou canst a juic● express Full of craft which is then sent by the middle Vein To th' Liver that it may the dye of blood obtain Whence it is given out when th' other sap is wanting And is seen through our Limbs a free passage attempting By crooked Channel-Veins c. This was the Antients meaning but the Moderns have found that the aliments being well chewed in the Mouth are by the Oesophagus transported into the stomack where by the virtue of some acid liquors proceeding from the reliques of the former Concoction and the Vapours of the Pancreatical juice together with the sub●il descending from the Maxillar Glandules they are fermented agitated and calified almost in the same manner as mettals are dissolved by Aqua fortis In the mean time the aliments helped by the warmth of the neighbouring parts do often contract a spontaneous heat as we see sometimes hay too freshly brought in whereby they are digested which being done the stomack straightning it self and opening its lower orifice called the Pilorus they are thrust down to the Duodenum where by an effervescency arising from the mixture of Choler descending thither by the biliary conduit together with the pancreatical juice and Phlegm sticking to the Bowels they are segregated and their grossest parts precipitated down to be expelled at the seat whilst the subtilest called Chylus are transported by the milky Veins to the common receptacle where being diluted by the Lymphatick humor the Chylus is carried by the Thoracick conduits to the subclavicular branch of the Vena cava where it is mixt with the Blood descending from the Head and other superiour parts of whose Nature and Colour it begins then to partake without coming to the Liver which therefore can neither be the seat nor organ of Sanguification The Chylus thus mixt with the descending Blood being come into the trunck of the Vena cava is mingled with the Blood which ascends by the same Vein from the inferiour parts and is transmitted into the right Ventricle of the Heart where it suffers an effervescency arising from the mixture of the Lymphatick spirit and the lixivious salt of Choler communicated to the Blood out of the Gall by the Hepatick conduit whereby the fiery parts of each being freed of their hindrance do insinuate themselves in the oily parts of the blood which they rarify whereby the Valvules of the Vena cava are shut up and the Blood thus rarified craving a larger room than before the Heart is compell'd to its expulsion which it effects by the collected fibres as another muscle and the Valvules of the Arterial Vein being opened it is transported into the Lungs cooled by Respiration whereby the Heart and the said Vein is unswell'd and the Blood is conveigh'd by the usual Artery whose Valvules are then open into the left Ventricle of the Heart where it is again heated and rarified and being carried by the Aortal Artery whose Valvules then give passage into the greatest Arteries and from thence into the smaller the Heart and the said Arteries leave swelling and the Bl●od is thence received by the Anastomoses in the Veins from whence it proceeds through the vena cava into the right Ventricle of the heart repeating so a continual circulation a perpetuum mobile during our Life Blood is temperate of a mean thickness Red in colour and of a sweet taste it serves instead of fuel to the vital heat which it conveys to the several parts to whose nutrition and increase it alone contributes The Antients did divide it into Venal and Arterial though the place of their flowing be their chief difference Phlegm is of a watry nature liquid whitish and unsavoury it serveth to the ●●fervescency in the duodenum tempers the Blood and renders the Joynts slippery Choler is of a fiery nature a thin consistence a yellow colour and a bitter taste it causeth an Effervescency in the duodenum and another in the Heart as aforesaid it provokes the expelling faculty and thins all Phlegm sticking to the inward parts The Lymphatick humour is of a pure watry substance without any colour and of a subacid taste Its uses are manifold but the chief are to promote an easier slowing of the Chylus and to convey the blood through the thoracick conduit to the Heart and there contribute to its Effervescency it tempers the Blood and perhaps together with phlegm moistens the articulations of the Joynts According to the Antients Phlegm predominates from Midnight till Sun-rising Blood from that time till Noon thence Choler obtains the superiority till Sun-setting and they gave the remaining time till Midnight to Melancholy which we have said to be nothing but grosse Blood Phlegm is also more copious in Autumn Blood in the Spring Choller in Summer and Melancholy or thick blood in Winter They esteemed also Phlegm to be moved every day Choler every third day and Melancholy every fourth supposing the Quotidian Ague to be caused by Phlegm the Tertian by Choler and the Quartan by Melancholy which De Graff attributes to the various Obstructions of the lateral branches of the Pancreas In his Treatise De succo pancreatico The signs of a Bloody Complexion are a red colour in the Face a moist heat through the whole Body sleshy Muscles great Veins and a chearful Heart Cholericks are of a yellowish colour a light disposition and a lean Body they are witty and liberal but wrathful and revengeful Phlegmaticks are pale of a soft flesh sometimes fat lazy sleepy and dull Melancholick or thick blooded men have a blackish face and a sad look they are sorrowful obstinate fearful and covetous but withall very capable of doctrine The Arabs instituted four secundary Humours whereof they called the first Innominate or Implanted which they supposed to be conteined in the extremities of the little Veins where it begun to take some alteration of the several parts They called the same Daw when as it were it bedewed them Gluten when it stuck fast to them and Cambium when it was wholy converted into their substance but the nutrition and increase of the several parts is better expressed by the Moderns as will be said when we speak of Functions When the Primary humors exceed the bounds of their due qualities they are deemed against nature and they may be corrupted in the Veins or out of them Phlegm corrupted in the Veins is of a sower or salt taste and of no colour but out of the Veins it is distinguished in muscous watry plastry and glazy whereunto the Lymphatick humour the salive and the Pancreatical juice may be conveniently referred when they are vitiated Choler corrupted in the Veins is called vitellin or like the yolk
Saffron make a Cataplasme Note that though this be the general Cure of Impostumes they have nevertheless a more proper and particular one according to their several differences but this is as 't were a Rule whereby to proceed in it CHAP. III. Of Wounds THE General Practice of Impostumes being sufficiently treated of in the former Chapter this shall be adapted to expound such Notions as belong to the Cure of Wounds whereof this is the Definition A Wound is a Solution of Continuity caused by an external Instrument in any part of the Body but the Bones Their Causes are all such things as may violate the outward circumference of the Body and unnaturally enter in it and they are either animated as the biting and stinging of Beasts or inanimated as Swords Darts Bullets c. The difference of Wounds is manifold and as Samoicus saith Tam varia humanae sunt vulnera conditionis Ut nequeant proprias cunctis adscribere curas The Wounds of Men are seen so manifold The proper Cure of each cannot be told Nevertheless I have endeavoured to include the most General in the following Paragraphs The Differences of Wounds are drawn either I. From the nature of the wounded part which is First Similary and that 1. Soft as the Glandules and Flesh. 2. Hard as the Gristles 3. Mean as the Membranes and Ligaments Secondly Diss●milary which is either 1. Principal as 1. The Brains 2. The Heart 3. The Liver 2. Ministring to the principal as 1. Aspera Arteria 2. The Lungs 3. Neither of the foresaid as 1. The Eyes 2. The Hands 3. The Feet II. From their own Essence whereby they are termed First Simple when there is no Complication of other Diseases or Accidents Secondly Composed when there is some other Disease or Accident indicating a peculiar Curation III. From their Quantity by which they are termed First Great that is 1. Long 2. Broad 3. Deep Secondly Mean in all Dimensions Thirdly Little that is 1. Short 2. Narrow 3. Superficious IV. From their Figure whence we call them 1. Strait 2. Round 3. Crooked c. When a Wound doth pierce the Skul ●s known by these following Signs The wounded party doth presently ●all lying without sense as if he were a sleep the Ex●rements are not retain●ed and surely if the blood floweth by the Ears Nostrils or the Mouth and if ●he Vomits Choler c. Whether the Wound penetrates into the Thorax is known if the Air com●eth forth at the Wound with a difficulty of Respiration if there be a gravative ●ain on the Diaphragme which is caused by much Blood lying on that part that must afterward be rejected by coughing A little after cometh a Feaver and stinking breath the Patient can lye but on the Back and hath a perpetual desire of Vomiting it often degenerates in a Fistula When the Lungs are hurt there issueth a Spumous Blood at the Wound with Co●ghing there is a great difficulty of Respiration and pain of the 〈◊〉 We know the Heart to be Wounded by the great quantity of Blood that cometh out at the Wound by a trembling of the whole Body a little Pulse a Paleness of the Face and a cold Sweat and ●requent Swounings a coldness of the Extremities and a hasty Death When the Diaphragme is hurt there is a gravati● pain in that part with Phrensie difficulty of Breath Cough with a sharp pain and a contraction of the flanks upwards These signs appearing one may pronounce Death to be near The Vena Cava or great Artery being hurt Death speedily followeth because of the great loss of Blood and Spirits whence the Function of the Heart and Lungs do cease When the Medulla Spinalis is wounded a Paralysis or Conv●lsion presently hapneth the motion of the lower part is abolished the Excrements of the Belly and Bladder either flow unwittingly or are wholly suppressed The Liver being wounded there cometh a great deal of Blood out at the Wound and a Pungitive pain is felt as far as the Cartilage Xiphoides which Death often followeth When the Stomach is wounded the meat and drink cometh out at the Wound then come Sweats and Cold of the extremities fore-runners of Death If the Spleen be wounded there floweth a blackish blood at the Wound Thirst troubleth the Patient with a pain of the left side and the blood flowing into the Belly causeth many accidents and often Death The Gutts being wounded a great pain torments the Bowels the Excrements issue out at the Wound and sometimes the Gutts out of the Abdomen which afterwards pain and swell When the Kidneys are hurt there is a great pain in making Water the Blood coming out therewith and the pain stretching it self to the Yard and Testicles The Bladder and Ureters being wounded the pain reacheth to the Flanks the parts of the Nombril are extended the Urine cometh out bloody and sometimes out at the wound When the Womb is hurt the Blood cometh out at the Privities the same accidents appearing as when the Bladder is wounded The Nerves being prickt or half cut a sharp pain is felt in the wounded part with a sudden inflammation fluxion tumor feaver and convulsion often with gangrene and death unless it be remedied in time Those Wounds are esteemed dangerous which do affect some principal Sinew Vein or Artery Whereunto are added those that are in●licted in the Privities of Man or Woman or in their parts dedicated to natural excretion as also those that hurt either end of any muscle but such as are in the fleshy parts according to the length of the fibres are esteemed the least considerable If a Bone Sinew Tendrel or a portion of the Face or Prepuce be cut off it cannot be repaired All Wounds in the Bladder Brain Heart Liver Lungs Stomach and smal● Guts are deemed mortal The general indication in the Cure of Wounds is the adjunction of what is separated wherein the Chirurgeon ought to be furnished with five Intentions The first whereof is to extract all strange Bodies as Bullets Darts Arrows Splinters c. if any do hinder the Wounds agglutination The second to bring the divided extremities together The third to keep them so The fourth to preserve the wounded parts temperature The fifth to correct such accidents as may fall out The first of these intentions is performed either with the Fingers or some material Instrument at the first dressing unless the extraction of the foresaid things might occasion an Hemoragy or some other dreadful accident for then the safest is to leave their expulsion to Nature but since it may sometimes not little be advanced by Medicaments take this following description Recipe The Root of Iris of Florence of Panacis and Capers of each three Drachms round Aristaloch Manna and Frankincense of each one Drachm beat them to a powder and incorporate them with Honey of Roses and Turpentine of Venice of each two Ounces Make a Salve thereof The second and third intention in the Cure
of Eggs which the Antients esteemed to be produced by an intense heat but is more truly atributed to the mixture of some acid humour as can be perceived when a little spirit of Vitriol is powred into some Gall it often degenerates in Poraceous rus●y and glasteous according to its degrees of acidity The Melancholy humour or thickest Blood is by some thought to turn by adustion into black choler but according to Regnerus de Graaf this last proceeds from the mixture of Choler with a too acid pancreatical juice whereby it is turned into a greenish black colour as the Antients describe the atrabiliary humour The Excrementitious humours are also 1. Phlegm 2. Choler 3. Melancholly 4. And Serum They are called excrementitious because they can yield no nourishment to the Body and therefore are expelled 1. Phlegm not to the Brains as the Antients conceived but to the Maxillar Glandules and thence through the Mouth and Nostrils out of the Body 2. Choler by the Cystick arteries to the Gall whence the superfluous part is expelled to the Duodenum and thence evacuated at the Seat 3. Melancholly which is not attracted by the Spleen as the Antients supposed but is an Excrement of the grossest Blood which is often evacuated by the Haemorrhoides and is also sent to the Atrabiliary Capsuls to be perhaps voided with the Urine which therefore appears sometimes of a black colour 4. Serum which is either evacuated First In the form of Vapours by transpiration whereby according to Sanct●rius more than the half part of our Aliments are dissipated Secondly Or in the consistence of Urine which being separated from the bloud in the Kidneys and filtred through the Papillar Caruncles into the Pilorus is powred through the Uriters into the Bladder and having received the thinnest and most serous part of the Chylus immediately from the Stomack by the Gastrick Vein is thence evacuated out of the Body To Serum is also referred Sweat and the Tears we shed A Part or Limb is defined A Body adhering to the whole and partaking of the same life with it being created for the exercising of certain Functions They are distinguished in Similaries and Dissimilaries A Similary part is that which cannot be divided in other parts of a different species and it is twofold Spermatick and Carnal 1. The Spermatick are constructed in the first conformation of the body out of the grossest part of the Seed 2. The Carnal out of the MenstrualBlood The Similary parts are Eleven in number 1. Bones 2. Tendrels 3. Ligaments 4. Tendons 5. Membranes 6. Fibres 7. A threefold flesh the Musculous the Parenchyme and the Glandules 8. The Skin 9. The Veines 10. The Arteries 11. And the Nerves or Sinews The Bones are joyned either by I. Diarthrosis or Articulation with some motion either by 1. Enarthosis when there is a considerable quantity of the Bone received in a large Cavity 2. Arthrodia when the receiving cavity is but Supersiciary 3. Ginglime when a Bone receives and is received II. Symphosis or Coalition without Motion 1. Sutures as in the Bones of the Head 2. Harmony as in the Bones of the Nose and upper Jaw 3. Gomphosis as the Teeth And they are bound either by First Syncondrosis or with a Tendrel Secondly Syndeurosis or a Ligament Thirdly Sysarcosis or with some flesh or muscle Note that to the exercising of the Similary parts Functions there needs only their due temper and commoderation A Dissimilary part is that which may be divided in parts of a different Species Many do confound them with the Organical Nevertheless there is this difference that all Dissimilary parts are Organical but not all Organical Dissimilary for the Bones Veins and Arteries are Similary and yet produce Organical actions Four conditions are requisite to the perfect exercising of the Dissimilaries actions namely 1. A due Conformation 2. Magnitude 3. Number 4. And Conjunction Whereof the last comprehends two others to wit Seat and Connexion These parts are distinguished in First Containing and Secondly Contained And then again in 1. Common and 2. Proper Distinguished in 1. Nobles 2. Ignobles First The Noble or principal parts distributing the Spirits and Faculties to the whole Body are absolutely necessary to it They are three Viz. 1. The Brains 2. Heart 3. Liver Which being excepted all the rest are Ignoble as being subservient to them and they are the other parts of 1. the Head 2. Trunk And 3. 〈◊〉 1. The Head is divided in the Soul and Face the common containing parts whereof are the thin and the hairy Skin the fat and the ●leshy Membrane It s proper parts are the Scalp or Pericrane the Perioste the Muscles the Bones and two Meninges The contained parts of it are the Brain the A●ter-brain and the Marrow The second hath in its upper part the sore-head in the lower the mouth and the instruments of the Senses as the Eyes the Eares the Nose c. 2. The Trunk is distinguished in the Breast and lower Belly the proper containing parts of the first besides the Muscles Bones c. Being the Pap the Midriff the Pleure and the Mediastin The contained are either Bowels as the Heart with its purse the Lungs a part of the Weazon and of the throat or Vessels as some branches of the Vena Cava and great Artery sustained by the thymus in the Throat and several Sinews The lower Bellies proper containing parts are the Muscles of the Panch and the Belly-rim The contained are either employed to Nutrition namely to Chylification as the Stomack the Kall the Sweet-bread the Guts and the Mesentery or to Sanguisication as the Mesaraick Veins the post Vein and the Cava the Liver the Gall the Bladder and the Milt 3. The Ioints are divided in the uppermost containing the great Hand namely the Arm that is the Shoulder from the upper shoulder to the Elbow and the Cubit from the Elbow to the Wrist The lesser Hand divided in the Wrist between the Cubit and the Palm and the fist between the Wrist and the beginning of the Fingers whose inward part is called the Palm and the outward the Back of the Hand The undermost contain the great Foot comprehending the Thigh from the Britch to the Knee the Leg from the Knee to the lesser foot which is divided in the Foot Pedium Metapedium and Toes Before we come to Faculties and Functions it will not be amiss to say what the Soul is They define it The substantial Form of a living Body and the inward principle of the actions thereof For The Soul a Substance and a Spirit is Which God himself doth in the Body make Which makes the man for every man from this The Nature of a Man and Name doth take It s connexion with the Body is called Life and its separation Death Neither is this last greatly to be feared of a Christian since it is but a passage to a better Life and that as saith the Italian Poet. Altro
mal non ha morte chél pensar a morire E chi morir pur duce quanto piu tosto more Tanto piu tosto al suo morir sinvola A Faculty is a certain disposition of the Body whereby it can do something though it may be it doth it not so that it is only a power of acting It s division is needless since it is but one power though it produceth several actions according to the Vacuity of its Organs A Function is described the exercise of a Faculty and is only distinguisted in Natural and Animal Pulse being referred by the Moderns to sanguification whereof we have spoken in the Theorem of Blood and Respiring to motion of which will be said hereafter The Natural Function is divided in 1. Nutrition 2. Growth 3. Generation To the first whereof the Antients made four others to be subservient for as Dykes saith of the Soul Here she attracts and there she doth retain Here she decocts and doth the food prepare There she distributes it to every Vein And here expels what she may fitly spare Yet the Moderns do exclude from thence all similary attraction and retention Deglution being performed by Detrusion only the several parts of the Mouth the Tongue the OEsophague c. contributing thereunto Retention being also effected by the Oblique Fibres of the Stomack but Hunger is produced by the sourish Vapors of the acid in the Stomack which do gently Vellicate its upper Orifice and the apparent cause of Thirst is the want of moisture To Concoction three others are subordinate 1. Chylification 2. Sanguification 3. Assimilation The two first whereof together with Expulsion are explained in the describing of Humours so that only Assimilation and Growth are here to be expounded which take thus When the Arteries begin to swell as aforesaid the particles of the Blood which in them are convey'd to the roots of certain filaments issuing from the ends of the smallest Arteries whereby they compose the Bones Flesh Skin c. according to the various manner of their application and contexture or directed by the same Plastick virtue whereby the said parts were formed which they nourish something distending them and intruding themselves in their vacancies where they remain when the Arteries return to their former state And Growth is likewise effected The pores of the matter of Chi●drens Bodies being easily extended whereby some particles of the Blood a little greater than those whose places they fill may enter and subsist therein which cannot be longer done when their Limbs are grown more solid Generation is a Function whereby a man produceth another like to himself whereunto the Antients did subordain two others 1. Alteration 2. Conformation Which the Moderns do rather attribute to the Plastick virtue of the Seed though denyed by Rhegius and other Cartesians who affirm That the particles of the Seed moved by its own heat and that of the Uterus because of their various figures are necessarily turned into the Brood of an animal whereunto they since attribute the whole formation of the Foetus without the Function of any intellectual faculty directing it The Animal function is divided in 1. Principal 2. Moving 3. Sensitive Whereof the first comprehends these three viz. 1. Imagination whereby all Objects Species offered to the external senses are perceived and discerned 2. Reasoning whereby a man discourseth and understands 3. Memory whereby the Species of things perceived conceived and understood are preserved whereof will be further spoken in the period of Sensation Motion is thus performed The most vivid and quickest particles of the Blood such as we may conceive the Vital Spirits do ascend from the left Ventricle of the Heart through the Caroties and Cervical Arteries into the Cavities of the Brain where they are turned into a subtile flame or wind usually called the Animal Spirits which being driven by grosser particles do not enter in the Pineal Glandule Steno having shewed us how unapt it is thereunto but in some yet unknown more convenient place of the Head whence they sally out into the Cavities of the Brain and the pores of its substance to be thence conveyed into the Nerves where they have a power which the learned Willis calleth Elastick to change the figure of the Muscles and so move the whole Body To this manner of moving Respiration is also to be referred for the Muscles of the Thorax drawing it up the Lungs to avoid vacuity are extended whereby their small cavities are opened and receive the inspired Air which is again excluded in expiration when the Lungs following the restriction of the Abdomen their said Cavities are again straightned The Sensitive Function is the exercise of the five external Senses which comparatively to certain Beasts are comprised in these two Verses Nos Aper Auditu praecellit Aranea Tactu Vultur Odoratu Lynx Visu Simia Gustu That is The Bore excels in Hearing and the Spider By sence of Touch is a subtil divider The Vul●ers Smell th' Apes Taste and Lynxes Sight Excells the Man by far that solid Wight Their respective Instruments are 1. The Eyes of Seeing in the Retin● 2. The Ears of Hearing in the Auditory Nerve 3. The Nose of Smelling not through the Os Cribriforme which is not pierced as the Antients conceived but by the Apophysces Mammillares or the extremities of the Nerves 4. The Tongue of ●asting by the Papillary eminencies noted by Bellinus whence Savours are conducted to the Filaments of the 4 and 7 pair of the Nerves that end there 5. The Skin of Touching by the Pyramidal papils observed by Malpigius and esteemed the extremities of the Nerves of the sixth pair ending in it Sensation is performed as followeth When the small Filaments of the Sinews are in the least moved by the Objects of the senses they draw to them the parts of the Brain from whence they take Origin whereby they open some pores of the inward superficy of it through which the animal Spirits being derived into the Nerves and Muscles do excite those motions which we perceive our senses being thus or so affected which is to be understood of all Sensation and if the said spirits having the Impression of some Id●a conceived or also discerned in some fit place of the Brain as Cartesius esteemed the Pin●al Gland●le do often pass through the same pores of the Brains texture they do dilate them so that the Objects being absent they may be represented to the Soul whence Memory doth depend But if opening one or more of them some others are dilated Reminiscency is effected and if the traces of the Ideas are conveyed by the smal Ar●eries to the heart and diffuse their beams throughout the mass of Blood it may thence proceed that the Foster is sometimes noted with certain markes Sleep is a Cessation of Motion and of the External Senses and is produced when the Braines substance is not sufficiently ●istended by the Spirits aforesaid or when it is over●whelmed with
Vapours for in these cases it falls together and oppresseth the Nerves of the several Sen●es that their Objects cannot be transmitted And Dreams which happen during Sleep have their origin partly ●rom the inequality of the Spirits issuing ●rom the Souls Domicil and partly from the occurring impressions of Memory Spirits are defined A thin invisible aethere all and most quick substance arising from the subtilest parts of the Blood t● be the Vehicle of all necessary actions The Antients did divide it in 1. Implanted 2. Adventitious Whereof the first is denyed by some who conceive it impossible that the● same cause acting in the same manner should last so long and produce so many and often contrary Functions They were formerly divided as th● Faculties were in 1. Natural 2. Vital 3. Animal But Sylvius de le Boe admits none bu● the Animal and other Moderns the V●● tal under which they comprehend th● Natural and the Animal taking th● subtilest parts of the Blood arising fro●● the left Ventricle of the Heart for th● first which are turned in the Brains int● the Animal serving First To sundry motions of the Sou● and Body Secondly To the exercising of the internal and external Senses 3. To the alteration of Humours Native Heat is a proper and special quality to all animated creatures whereby they live and exercise their functions uses and necessary operations Thus I think to have briefly explained not only the Natural things but also their Annexes except the manner of living which if it be watry and moist ●s obnoxious to diseases of that temper but if it be hot and dry the contrary must be expected In sum it appears by the Premises that the Body of Man is a Microcosme composed of several parts wonderfully effig●r●ted and adorned with sundry Functions created to be for a certain time the Domicil or dwelling place of the Rational Soul so that not without cause the German Poet exclaimes O Edles wundertheir zur weisheit auserkohren Uoll geist voll luft voll got vom himmel selbst gebohren Du Herr du Eben bild und auszug allerwelt Der unter ies den lauff der hohen sterner stelt Du weise Creatuur c. O thou noble Animal wonder to wisdom chosen Full of Spirit and God from Heaven it self rosen Thou Lord Type and extract of the whole Univers Disposing under thee the course of the high stars Thou creature full of Wit c. Those things are called not natural which do not enter in the Bodies composition but by a right use whereof it may long be maintained healthful and sound They are 1. Air. 2. Eating and Drinking 3. Motion and Quiet 4. Sleeping and Watching 5. Repletion and Evacuation 6. The Passions of the mind In the administration of all which we ought to consider 1. The Quality 2. Quantity 3. Manner of Using A free open serene and thin Air is to be esteemed the best as also the East and North Winds but the South and Western are held unwholsom The simpler our diet is the healthful●er it is to be esteemed for as Hora●e saith the variety of meat is very noxious viz. nam variae res Ut noceant homini credas memor illius escae Que simplex olim tibi sederit at simul assis Miscueris elixa simul conchilia turdis Dulcia se in bilem vertent stomachoque tumultum Lenta feret pituita vides ut pallidus omnis Coenâ desurgit dubiâ That thou mayst know how various things offend Think but what single meat did once defend Thee from approaching hunger but at last Roasted with boyld and Birds with Shels thou hast Together mixt In Choler what is sweet Will turn it self and thy Stomack surfeit With slimy Phlegm Consider then how pale Each riseth from his Seat and doubtful Meal Meats affording a good juice and substance are doubtless the wholsomest and nevertheless in expending them the sicknesses nature the strength age and labour of the Patient are to be perspicuously considered whereunto an inveterate custom is to be added for Country Men and Labourers convert meats of an easy digestion into Choler but extract a laudable substance of a courser● diet and thus Consuetudo valet longos mansura per annos Illaque Naturam vires si sumpserit aequat A constant use a second nature proves And if increast with equal force it moves Neither did the Antients neglect Order in Eating for they esteemed that what was easily decocted should enter first into the Stomach and that Lubrick meat ought to precede those that are Astringent But it is now believed that those niceti●s may be omitted since the Aliments are all converted in one mass whence the Chylus is afterward separated Whereunto I shall only add these two Verses of Drinking Aut nulla ebrietas aut tanta sit ut tibi curas Eripiat si quae est inter utrumque nocet Be never Drunk or so much let it be As to asswage thy Cares else 't will hurt thee Motion comprehends all kind of exercises the same ought to be moderate and we ought to leave it when Sweat begins to break out through the Pores for immoderate Labour weakens the Body and is very pernicious as Ovid saith of himself Me quoque debilitat semis immensa Laborum Ante meum tempus cogit esse senem Otia corpus alunt animus quoque pascitur illis Immodicus contra carpit utrumque labor Continual Toyl weakens my weary Limbs And makes me Old before my time be come Body and Mind by Rest are fed it seems But too much Work precipitates their doom Sleep as we said before Is a cessation from motion and sence whose Office is the restoring of the Bodies former strength It s proper time is Night an hour or two after Supper The first lying not being first on the Right Side as many believe but on the Left where the bottom of the Stomach is and the meat ought to lye and about morning when concoction is ended on the Right neither should it exceed the space of Fight hours wherewith if some are not satisfied certainly the sooner Longa quiescendi tempora fata dabunt The Fates will give sufficient time to sleep Dreams do in some manner indicate what ex●retion will be in the Crisis for if red and fiery they presage a Cholerick one if moist and watry a Phlegmatick Moderate watching quickens the senses and diffuseth heat and blood through the whole Body But if it be immoderate it weakens the same dries up the Spirits and spoiles the brains Temperature Repletion is either of quality or of quantity The first is seen in the Hectick Feaver or Marasmus The second hath a relation to the containing parts and is measured by their distention or to the Bodies strength when the same is fuller of humours than it can well bear The repletion of a single humour is called Cacochimy that of more Pletora Evacuation in the strictest sence Is an effusion of such humours as are superfluous
and hurtful and is either of the whole body chiefly performed by Phlebotomy Sweat and Purgation or of the several parts by their respective Conduits as the Brains by the Eyes Nose and Eares the Lungs by the Wind-pipe c. In all Evacuation three things are to be observ'd and considered The Quantity Quality and manner of Excretion V. g. The Empieme being opened the excluded matter ought to be answerable in quantity to that which is included The most laudable is white even and as little stinking as may be And lastly all must be purged out at one time least the Patient suffer too great an Effusion of Spirits The Passions of the Soul or Perturbations of the Mind are very prevalent to alter the Bodies Constitution for as the Banished Poet saith Unda locusque nocent causa valentior istis Anxietas animi quae mihi semper adest The Sea and place do hurt but yet I find A greater Cause the torment of my mind We wil therefore brie●ly expound their Effects A moderate Ioy dilates the heart and distributes abundance of Spirits to the Face and other parts it helps Concoction and renders our habitude more chearful and pleasant Anger or Wrath performs the like effusion but much more rapid and swift● It kindleth sometimes the Humours so much that it makes them apt to receive a sharp volatile Salt which is thought the cause of putrid Feavers and produceth also other Symptoms yet it may be profitably used to quicken the natural heat and render it more active when it is almost prostrated Sorrow and Fear draw heat and blood suddenly to the Heart whence the forces do presently fall and sometimes death immediately follows the Vital Faculty being over whelmed with Blood and Spirits This I conceive sufficient since all other Passions of the mind may be referred to these three or four Those things are termed against nature which may procure the destroying and ruine of the Body They are the cause of Diseases Disease it self and its Accidents or Symptoms The Cause of a Disease is Whatsoever doth any way contribute to the being or increase of it Which though Physitians give them many distinctions may nevertheless all be referred to the efficient especially divided in 1. External 2. Internal For Alas How many things may extinguish our light The humours within us maintain an equal fight and least it be too long Death hath a Pike a Ball a Sword a Knife a Stone and an Arrow to cut our feeble thred c. The External Cause cometh from without the Internal hath its seat in the Body and is either 1. Antecedent that yeilds aptitude to a sickness Or 2. Conjoyn'd which immediately and of it self perfects it They are also co-ingendred with the Patient or have accesse to him after his Birth A Disease is A disposition against Nature immediately and of it self hurting the actions The same is Simple or Complicated The first is when there is no plurality or composition of Diseases The second When it is followed of many Symptoms or when the Cause is so connexed with it that it may be lookt upon as a particular Sickness Diseases are of a threefold species 1. Intempery 2. Evil Conformation 3. Solution of Continuity The first is an Indisposition of the Similary parts caused by the excess of a single Humour or the Exuberance of more The last whereof is called naked or conjoyned with a Vice of the same Humours and is termed equal as being ●qually spread throughout the whole Body or inequal as affecting only some particular part of it There are four sorts of evil Conformation Namely in 1. Figure 2. Magnitude 3. Number 4. Scituation Solution of Continuity is a common Disease of the Similary and Organical parts which hath several Names according to the places where it is incident For in the Flesh it is called Helcos in the Bones Cathagma in the Nerves Spasma The Symptoms of a Disease are the Effects and Productions of it To wit 1. A hurt action that is 1. Abolished 2. Diminished Or 3. Depraved 2. A Vice in the Bodyes Habitude 3. Vitiated Excretions Of the aforesaid Precepts are collected two Intentions 1. What is to be done 2. And if it may be done But the third belongs to Art viz. How it must be done The Practice whereof is better declared in the Words annexed and the following Chapters that do briefly comprehend what doth belong to a Chirurgeon The Indications are of three first and principal Species viz. 1. The first is drawn from the natural things which do Indicate their conservation by the use of things like to themselves and of this kind are the Indications drawn from 1. The strength and forces of the Patient which to preserve the proper Cure is often to be delayed for without them the Chirurgeon can effect but little 2. His Temper viz. 1. Sanguine 2. Cholerick 3. Phlegmatick 4. Melancholy 3. The Habitude of his Body 1. Soft and delicate 2. Lean or Fat. 3. Tall or Short Least he lose that Symetry which Nahath allotted him 4. The Condition and Nature of the part affected Wherein we consider 1. It s Substance whether if Similary it be 1. Hot. 2. Cold. 3. Moist 4. Dry. If Organical 1. Principal 2. Or Ignoble If it be 1. Of a quick Sense 2. Or Stupid and Dull And lastly it s 1. Form 2. Figure 3. Magnitude 4. Number 5. Connexion 6. Action or Use. 5. The Age for many Diseases cannot be Cured in Old Age. 6. The Sex for Women are easier purged than Men. 7. The Season of the Year for Hot meat is convenient in Winter Cold in Summer Moist in Autumn and Dry in the Spring 8. The time of the Disease for what is convenient in the beginning is not so in the progress state or end II. The second is drawn from the things not Natural Which do indicate their Alteration as if Air does conspire with Nature against the Disease it ought to be kept otherwise it must be altered III. The third is taken from the things against Nature which indicate their Ablation and are 1. The Cause of a Disease 2. The Disease it self 3. The Symptoms Which do often indicate contrary things but then this is the Rule When there is Complication the first Remedies ought to take away 1. The most Dangerous 2. The Cause 3. That without which nothing can be done As 1. Loss of Blood 2. Fluxion 3. Intempery A SHORT Compendium OF The PRACTICAL Part OF CHIRURGERY CHAP. II. Of Impostumes HAving thus far treated of such Theorems and Institutions as are wholly necessary to be known of all Well wishers to Chirurgery let us now say something of the Practical part thereof since it is almost impossible to treat perfectly of the Theorical unless the same do give some urgent occasion of it and in this it resembles the three Parts of Curative Physick that can hardly be separated from one another for as a French Poet doth intricately say Quand
defensive Plaisters whereof the most common is made of Bolarmeni dilayed in wine and ●he White of an Egg applying thereupon Bands Compresses and Atelles dip●ed in Oxycrat or Oxyradinon fitted to ●he figure of the diseased part And the ●atient being in a convenient scituation ●he accidents must be corrected as is de●lared in the former Chapters accord●ng to the Artists best invention and ●olerty If the accidents do not oblige us to it 't wil be enough to loosen the Bands at the end of three or four days that fuliginous Vapours may be exhaled and the part a little anointed with refreshing Ointments taking care to give it sometimes a gentle motion least the Joint be rendred stiff and immovable by the growing of a Callus thereon and thus being sometimes lookt to the Cure is brought to its perfection CHAP. VI. Of the Generation and Production of Man HAving thus far proceeded on our intended scope this Chapter shall briefly express what is requisite to be known in the Generation of Man and the way of helping Nature in the Production of the same as her chiefest work and master-piece In the Generation of Man is exactly to be considered 1. The matter out of which he is engendred and the Instruments of Generation 2. The Place thereof 3. In what Time it is perfected 4. And by what Signs its Con●●●tion difference of Sex and approaching time of being brought forth is know● 1. The Matter of his Generation is the Seed of both Sexes whereunto the Menstrua were added by the Antients proceeding from the purest Blood diluted with a great deal of Serum Barbat pag. 49. which is transmitted by the Instruments of Generation the preparing Artery to the Testicles that are nothing but a Conglomeration of Spermatick Vessels wherein the Serum is separated from the Blood that is wrought and elaborated in the Epidydemos or production of the Spermatick Vein incumbent on the Testicles whence it is carried through the Parastates into the defering Vestel and thence into the Spermatick Vesseles and according to some the ●rostata's ending with them in the Conduit of the Urethra where there is extant a Valvul least the Seed should involuntarily flow through the Yard The Nerves probably serving to render it fertile and vegetative by the eff●sion of Animal Spirits There are almost the same Spermatick parts in Women except their situation and the Womb the Receptacle of the Seed and Domicil of the Foster Yet De Graass proveth that their Testicles are as an Ovarium containing perfect Eggs. Thus new Wonders are daily found in the Microcosm 2. The Place wherein he is engendred is the Womb the Foster being found therein commonly gathered in a round and wrapped in two distinct Membranes the Amnios and Chorion the Allantoides being only found in Brutes wherein the three or four first months it is nourished not of the Maternal Blood as the Antients conceived but probably of the Chyle transported by the Lacteal Vein and the Arteries to the Placenta where it is further elaborated and thence partly carried through the Umbilical Vessels to the Port Vein of the Foster whence it floweth into the Cava and finally to the Heart The other part being transmitted by the Arteries of the Membranes into the Capacity of the Amnios constituting there the pure Colliquamentum mentioned by Harvey which the Foster sucks after the fourth month for its sustentation 3. By the Time which we have said ought to be considered in the generation of Man it is to be understood First That of his Conception when the Seed of both Sexes is mingled in the Womb. Secondly That of his Formation which is thought to begin the 7 th day and to be perfected if it be a Male the 30 th if a Female the 40 th or 42. But it is more probable they are figurated about the same time which cannot be so exactly determined Thirdly No more than that of their First Motion which was conceived if a Male to be in the third Month and if a Female in the fourth Fourthly Neither can that of Child-birth be absolutely stated the usual time being the latter end of the ninth Month or the beginning of the tenth though admit a Latitude from the seventh Month inclusively to the eleventh and above 4. The chiefest Signes of Conception are First A little Quivering presently after Copulation Secondly The Retention of the Seed Thirdly The Suppression of the Monthly Courses Fourthly A Livescency of the Face Fifthly A Pain and Swelling of the Breasts Sixthly A Distaste of Meat Which Signs or most of them appearing one may judge of Conception till a more certain one be discerned namely the Motion of the Foster 5. Whether it be a Boy or a Girle is yet more uncertain though some would conjecture by the following Signs If it be a Boy the Mother hath usually a better Colour of the Face and disposition of the Body the heat and good temperature of the Child adding something to that of the Mother for which Cause also they sometimes power a drop of the Milk upon a Looking-glass or such other even thing and if it be of such thickness as not to flow easily they deem it to be a Manchild otherwise not the time of Motion as is said before indicating nothing in this 6. The Signs of 〈…〉 The flowing of the Excrementitious Humours contained in the Chorion the Flanks and Rump are thrust outwards the Secret parts do swell and pain the Face grows Red a kind of feverish quivering seizeth the whole Body These Signs appearing if the Chirurgeon be called he ought then to prepare all things ready and exactly observe what is to be performed 1. Before the Birth 2. In Bringing forth 3. And after the Birth 1. Before the Birth a special care must be had that the Air of the Room must be duly tempered with a moderate heat and then the Woman must be setled in a convenient and middle positure so that she neither lie flat on her Back nor be yet sitting but have her Shoulder and Back something raised that she may have a free respiration and more powerful endeavour to bring forth her Leggs being as much separated as may easily be and so bowed that her Heels may reflect to her Buttocks which should also be something raised she holding her self to a Staff fitly disposed cross the Bed for that purpose and when she feeleth the most pain she must be admonished to strive as much as she is able stopping sometime her Breath to express her Foster whom the Midwife ought in the mean time to thrust gently from above downwards having though a care not to put her in that labour before the time be come least her Forces might leave her when they should be most needful 2. In the Birth it is to be considered If it be according to Nature which is when the Foster issueth forth instantly after the Waters either the Head foremost or the Feet all other manners rendring the Birth