with Blood from the little Arteries not that contained within themselves They are endowed with feeling both from themselves and sometimes from the Nerves Use is to receive the Blood not sufficiently elaborated from the Arteries and return it to the Heart and Liver there to be more perfectly concocted For the better Methods sake in the following we must be forced to describe all Veins here particularly and divide them into their Branches Vena Cava taking its beginning in the Liver as is before said is separated into the ascending Trunk and descending The Ascending which is the greater perforates the Diaphragm and is divided into four Branches of these 1. Phrenica which disperseth it self through the Diaphragma and Pericardium 2. Coronaria appropriated to the Basis of the Heart proceeds from the Trunk it self after it hath penetrated the Pericardium and inwardly united it self by a large fleshy Orifice to the right Auricle of the Heart 3. Azygos or sine pari coming from the right side of the same Trunk when ascending it hath passed the upper part of the Pericardium affording chief Branches to the eight lower Ribs then about the fleshy appendices of the Diaphragm it enters the Cavity of the lower Belly where on the left side 't is inserted into the Emulgent Vein on the right into the Trunk of the Cava 4. Subclavia from whom comes forth several Branches which go both upward and downward The Superiors are 1. Muscula Superior 2. Jugularis externa interna that on both sides sometimes single sometimes double goes to the Neck Head and Face this to the thick Meninx of the Brain to whose third Sinus its greater Branch is united The Inferiors are 1. Intercostalis serving the four upper Ribs and their Intercostal Muscles 2. Mammaria which is carried to the Breasts 3. Mediastina which goes to the Mediastine and Thyme 4. Cervicalis which goes to the Neck 5. Muscula inferior which goes to the Muscles of the Neck 6 7. Thoracica inferior and superior which goes to the Muscles of the Breast The Subclavials being come out of the Breast are called Axillares then go to the Arms where they are divided into 3 great branches which are 1. Cephalica in the hand between the little Finger and its next 't is named Salvatella Its Branches are variously mixt with the Branches of the Median 2. Basilica or Liver-Vein 3. Mediana which proceeds with other branches from the Basilica The descending Trunk which is the lesser and is undivided till it comes to the fourth Vertebra of the Loins then it communicates 1. Adipsosa to the Membranes of the Kidneys 2. Emulgens to the Kidneys themselves 3. Spermatica to the Testicles 4. Lumbares two three or four to the Loins and to their Vertebra's Nearer to the Os Sacrum it is separated into two Branches called Illiaci Before they go to the Feet the Trunk it self presents 1. Muscula Superior which goes to the Muscles of the Loins and Peritonaeum 2. Sacra sometimes single sometimes double to the Os sacrum 3. Muscula Media to the Buttocks 4. Hypogastria to the Bladder and its Neck to the Sphincter Ani to the Penis and to the neck of the Womb. 5. Epigastrica to the Muscles of the Abdomen and to the Peritonaeum 6. Pudenda to the privy Parts 7. Muscula Inferior to the joint of the Hips The Iliack Branches as soon as they have left the Cavity of the Belly are called Crurales From these proceed 1. Ischiatica minor which goes to the Skin and Muscles of the Hip. 2. Ischiatica major to the Hip then to all the Toes 3. Proplitea to the Ham. 4. Suralis to the Muscles of the Calf of the Leg. 5. Saphena To the Knee Ankle and to the upper part of the Foot and to the great Toe The Vena Cava where it comes out of the Heart receives three Valves called Tricuspidales looking internally for this purpose that the Blood may freely enter into the Heart but to hinder its return The Use of the Vena Cava is to receive the cruder Blood from the Arteries and remit it to the Heart Vena Porta much lesser and looser than the Vena Cava ariseth from the Umbilical Vein and with many Roots is inserted into the Liver without the Liver it is divided into Trunk and Branches all which are distributed into several Parts contain'd in the lower Belly From the Trunk proceeds 1. Gastroepiplois which goes to the Caul and Stomach 2. Intestinalis to the intestine Duodenum 3. Cysticae Gemellae to the Gall. 4. Gastrica minor to the left side of the Stomach Then this Trunk is divided into two great branches the Splenick and Mesenterick Ramus Splenicus sometimes joyning to the Sweet-bread sometimes passing through it divides into four little Branches as soon as it hath left it which are these 1. Vena Gastrica major which goes to the Spleen communicating from thence three or four small Veins to the Stomach These being blown up in living and dead Bodies manifestly declare nothing at all can enter into the Cavity of the Stomach so by consequence no Humor coming from the Spleen as long since Learned Men have imagined taught and writ seeing they terminate in the Coats of the Stomach and open not into the Cavity it self 2. Epiploica dextra 3. Coronaria stomachi 4. Epiploica sinistra Mesenterious ramus is also divided into four others of these the 1. Retains its old name and is distributed with fourteen or more Branches through the Mesentery 2. Vena Haemorrhoidalis and goes to the Spleen the Womb and the right Intestine 3. Vena Coecalis to the blind Intestine 4. Ramus Mesocolicus and goes to the Intestine call'd Colon. The Use of the Vena Porta is to take the Blood not sufficiently elaborated from the Arteries and carry it to the Liver for the perfecter concoction and for the separation of the Choler Venis pulmonalis which the Ancients corruptly call'd Arteria venosa seeing that it hath but only one Tunicle beats not of it self nor returns the Blood coming out of the left Ventricle of the Heart with a wide Orifice goes to the Lungs to receive the more imperfect Blood from the Pulmoniack Artery and carries it to the Heart About its egress from the Heart it hath two Miter-like Valves hindring the regress of the Blood to the Lungs It s Use is to carry the Blood received from the Pulmoniack Artery into the left Ventricle of the Heart Chirurgical Considerations 1. We have in another place treated of the Wounds of Veins we shall only add that if the Bandage by which you stay the bleednig be bound too hard it will easily induce a Gangrene 2. We have admitted only four general Indications of Bleeding to wit for the Refrigeration Imminution Revulsion and Derivation of the Blood but special Diseases requiring one Vein to be chosen before the other which are these following in a Delirium and great pain of the Head the Vein of the Forehead or
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
Amber Mastick of each a dram Turpentine half an ounce Euphorbium a dram Ung. Aegyptiacum half an ounce yolks of one Egg Oyl of Elders as much as is sufficient Saffron a scruple Make it into an Ointment Another more excellent than the former and which likewise resists Putrefaction Take Tar Turpentine Galbanum of each two ounces Mastick Frankincense Nitre Sal Armoniack of each an ounce Allom half a dram Verdigrease white Vitriol Camphire Powder of Worms of each a dram Oyl of Lin seed Roses of each two ounces Oyl of Worms and Turpentine of each a dram Molax them with a gentle Fire and make them into an Ointment If the Nerve hinder not in a great putrefaction there may be added some Precipitated Mercury An Anodine Plaister Take Bean-meal Crums of brown-Bread of each two drams let them be put in Milk adding to them Oyl of Roses Violets of each an ounce Yolks of Eggs No. iij. Powder of Red Roses Scordium of each an ounce and half Wax as much as sufficeth Make it into a Plaister An Anodine Cataplasm Take Roots of Marshmallows Comfrey the greater of each an ounce Flowers of Camomil Melilot St. John's wort of each half a handful Tops of Wormwood two pugils boil them in Milk adding to them of the Meal of Marshmallow-roots and Beans of each an ounce and an half Make it into a Poultice If the Wound be quite through a Tent must be put into both Orifices for a Flamula is inconvenient and hurtful At first dressing it once a day is sufficient for in Wounds made by Gun-shot there seldom appears any Matter before the third or fourth day after this the quantity or acrimony of the Matter will guide you best whether it is to be drest once twice or thrice a day CHAP. X. Of Poysoned Wounds POysoned Wounds are made sometimes by Bullets Arrows Swords and other Instruments sometimes by mad Beasts as Dogs Wolves which hurt more by their venomous quality than by wounding Signs are vehement pain a livid Colour suddenly becoming black Symptoms more grievous than for the quality of the Wound a Heat over the whole Body Trembling Delirium Fainting c. Prognosticks A poysoned Wound though little may bring death especially if near to the Heart or any other Noble Part or the Chirurgeon not call'd soon enough Cure consists chiefly in this that the Venom be drawn forth by Cupping glasses attractive Medicines Scarifications or which is safest by an actual Cautery but then it must not be in a Nervous Part the Escar to be forthwith removed and the Wound to be cured by degrees Inwardly Sudorificks and Cordials profit Bleeding and Purging hurt A Plaister that draws forth the Poyson out of the Wound and corroborates the Part. Take boiled Onions three ounces Treacle half an ounce Goats dung an ounce Angelica-Roots in Powder a dram and half Oyl of Scorpions an ounce and half Honey and Wax as much as is sufficient to make it into a Plaister That corroborates the Part extracts the Venom produceth Matter and incarns the Wound Take Gums Galbanum Sagapenum Opoponax Assa Foetida Mirtle Pepper Brimstone of each six drams Pigeons and Ducks-dung of each an ounce Mummy half an ounce the great Comfrey-Roots powdered three drams Oyl of St. John's-wort as much as sufficeth to make it into a Plaister CHAP. XI Of particular Wounds IN Wounds of the Head where the Pericranium is hurt a stitch either by Needle or Plaister is not convenient fat things hurt but comforting and drying profit much Take Mastick Myrrhe Aloes Sarcocols of each half a dram Dragons-blood two scruples Bole a scruple Venice-Turpentine two ounces Honey of Roses a little Make it into a Plaister Wounds of the Brain are accompanied with pain of the Meninges and a great Flux of Blood to which succeeds other Symptoms and for the most part Death it self Oyl of Roses applied warm greatly easeth pain and fresh Pigeons-blood effects the same In an Haemorage Take Myrrhe Aloes Mastick Dragons-blood Rhubarb Red Coral prepared Hares hair cut small of each a dram Make it into a very a fine Powder Wounds of the Face are not to be stitcht but always care is to be taken that the Scars may not render it deformed In Wounds of the Eyes you must abstain from all Unctious things The sound Eye is to be bound as well as the whole The Head must be placed upright if there be a Flux of Blood the following things are convenient The Blood of Turtles Pigeons Hens Mucilage of the seeds of Fleawort of Quinces Tragacanth Bloodstone Ceruse Tutty Frankincense Aloes the white of an Egg Water of Roses and Plantain Decoction of Balaustians Red Roses Galls c. Take white Troches of Rasis prepared Tutty Aloes Powdered of each half a scruple Red-wine an ounce Red Rose water and Plantain of each two ounces Mucilage of the seeds of Fleawort Tragacanth of each a dram Make a Collyrium In pain Womans-milk fresh is good or the above described Collyrium adding to it half a scruple of Opium and applying over it this Cataplasm Take of rotten Apples two ounces Flowers of Linseed half an ounce Mucilage Seeds of Flea wort two drams crude Opium half a dram Yolks of Eggs as much as is sufficient to make it into a Cataplasm A part of the Nose quite cut off never unites again although the Wound be but just made but if it adheres still to the Body 't is to be stitched to it with a Needle Wounds of the Ears and Lips find greater benefit from the Needle than from Ligature Wounds of the Lungs require comforting and drying Medicines sharp being here very hurtful though used in other Wounds Externally Take Roots of great Comfrey Tormentil Cloves of each half an ounce Flowers of Red Roses half a handful Mastick Myrrhe Aloes of each a dram boil them in Barley-water and to half a pint of the strained Liquor add Syrup of Mirtles common and strained Honey of Roses of each two ounces Make it into a Liniment Internally Take Leaves of Fluellin Strawberries Sanicle of each half a handful Lung-wort a handful Roots of Angelica two drams Liquoras a dram Jujubies No. xv Raisons half an ounce boil them in Barley-water and add to a pint and half of the strained Liquor Syrup of Diacodion three ounces Mix them let them take four ounces of it three or four times a day Half a dram of Sperma Ceti taken every day is excellent but it weakens the Brain Wounds of the Heart are always mortal and those that penetrate into the left Ventricle kill suddenly they seldom live so wounded above six twelve or twenty hours although there are examples produced for it If wounded into the right Ventricle it permits the Patient to live longer but that which terminates in the substance of the Heart grants yet longer time Wounds of the Stomach for the most part are left to be cured by Nature which here doth miracles yet in a Flux of Blood Bleeding is requisite In
Belly-ach that the membranes of the Pudenda were so far stretcht out that the unskilful have taken it for the Matrix it self and do so still For though many Authors have dared to write that the Womb may be cut out without danger of life seems altogether impossible to a skilful Anatomist To cure this Disease lay the Patient on her back with her Knees on high and Legs asunder then take a Wax-Candle of a competent thickness mix therewith some Castoreum or Assa Foetida and with it gently press the Womb inward and having sastened the Candle with a Bandage apply outwardly to the Belly the Emplastrum Barbarum or the following Take the Roots of Cyprus Bistort of each a dram Galls Acacia of each half a dram Cypress-Nuts Date-stones Myrtle-Berries of each one dram Pitch and Colophony as much as sufficeth to make it into a Plaister Then presently enjoyn the Patient to lie still with the Legs cross and to beware of speaking aloud of scolding and of whatever may occasion coughing or sneezing Here great care is to be had that your Wax-Candle be not too thick to the end that by its continual friction it may not cause Fluorem Album whereby the strength of the Body would certainly come to decay Yet because ev'n by the greatest care and circumspection this inconvenience will hardly be altogether or always prevented therefore those do very well and discreetly that long-ways perforat the Candle and thereby give a convenient passage for the humors flowing that way CHAP. IX Of the falling down of the Fundament IF the Gut be sunk down anoint it with Oyl of Rose and Myrtle mixing a little Powder of Galls amongst it and with your Fingers and a small Linnen-Rag put it in If an Inflamation hinder the reducing it then bathe the Anus with these Medicines Take Flowers of Elder Camomile and St. John's-wort of each a handful Red Roses rwo Pugils the tops of Wormwood and Melilot of each half a handful Boil therein Milk and Red Wine and bathe the part Here especially care is to be had that no external cold may come to the fallen-out Anus for then you may sooner than you are aware of be surprized with a Gangreen Wherefore do your utmost to put it in again with speed and in the mean time endeavor with the above prescrib'd Bathing and warm Linnen Rags to preserve its natural heat There is yet another though in appearance ridiculous yet in reality a good way of reducing the Gut With a strong hand strike five or six times the Patient's Buttocks and thereby the Muscles called Ani levatores will presently draw the Anus into its right place again But before the Patient be thus chastized take care that the Gut may first be anointed with Oyl of Roses or of Myrtle CHAP X. Of the second Operation called Diaeresis or the seperation of what was united together HItherto we have joined together again what had been disjoined now it follows that we separate what is united and treat of the second Manual Operation called Diaeresis which teacheth us the manner of Cutting and Burning and that both in the hard and soft parts of the Body In the soft the Cutting is called Incision In the hard it is performed four manner of ways By Terebration or Perforation by Rasion or Scraping by Limation or Filing by Serration or Sawing Burning is done either by an Iron which is the Actual Cautery or by Medicaments called the Potential Cautery as shall be declared particularly hereafter CHAP. XI Of opening a Vein BLeeding one of the greatest Remedies in the Art of Physick is sometimes highly necessary but sometimes so dangerous that it ought not to be used without very urgent Causes Here therefore I think it will be better somewhat to digress for fuller information than to leave the unskilful in their error The Blood is the darling of Nature by whose assistance she performeth all her Operations and which can hardly be drawn from her without dammage yet does Art require that those who meddle with it being neither venturous nor timorous but discreet and couragious and making out of necessity a virtue do sometimes proceed to the opening a Vein yet for no other than these four following causes 1. In a Plethora or super-abundance of blood that by this means Nature may be eased of her too heavy burden and the innate heat preserved from suffocation 2. For Revulsion-sake when the blood and the therein mingled humors by flowing too plentifully to this or that part hinder the Cure Here you are always to chuse a Vein of the opposite side and that sometimes the farthest distant sometimes the nearest 3. For the Derivation or conveyance of the Blood which is already got into the part but is not yet altogether setled there nor extravasated into another place in which case a Vein is to be opened the nearest to the Part. 4. For Refrigeration when the heat of the Blood is so excessive that it cannot be allayed by cooling Medicines or not time enough These limits are too narrow for some who will needs take into those a fifth cause which they make the Corruption of the Blood held by them to be as great an inducement for bleeding as any of the four by us recited to the end say they that Nature being rid of part of what is corrupt may be the better able to correct what remains But I much wish 1. That they could make this discharge without the loss of that strength which is so highly necessary 2. That they would be present when their Patient is to bleed and precisely tell to what degree of corruption his blood is come that so the Chirurgeon may know how much of it he is to take and how often forasmuch as they will not allow that Bleeding is good in all sorts of the Blood 's corruption but in that only which is not gone considerably far 3. That they would declare why they will have cur'd the greater corruption by Purging and the lesser by Bleeding since that they give to the one as well as to the other and that duly the name of Cacho-Chimia Let them shew that things differing only secundum Majus Minus do differ in specie and so require specifically different Remedies Others proceed yet further and shed innocent Blood in all sorts of Fevers without any consideration of spots of the Plague or of Poison it self thus freeing themselves from a great deal of labor and trouble otherwise caus'd to the Physitian from the variety of Fevers But because the nature of all Poyson and Malignant Humors is continually to assault the Heart and suddenly to prostrate the strength of the strongest Persons and since Bleeding doth likewise both not only diminishing strength but also drawing the malignity toward the Heart and driving in again for the oppression of Nature what she had thrown out for her relief I do intreat and warn all the Practisers of our Art That as they love the
is to be powred upon it and mixt with it but first it ought to he seven times rectified You must make this Conjunction in a Matrace a Glass-Vessel so called by reason of its roundness in the bottom and long neck and in a warm Balneum till the Calx hath imbibed its Spirit then in a Glass-Alembick you shall separate by Balneum whatsoever of waterish Humidity can be separated and there will remain in the bottom the Buttery Calx of Arsenick of great virtue which must be kept in a Glass-Vessel well stopt Take some of this Powder mix it with Basilicon or a Digestive and thus mixt apply to the ulcerated Cancer CHAP. XIV Of a Gangrene and Sphacelus A Gangrene is a beginning Mortification of the the soft Parts of the Body most commonly following a great Inflammation or ill cured Sphacelus Necrosis Syderatio is a perfect Mortification not only of the soft but of the hard parts also Differences In a Sphacelus the parts are altogether dead but in a Gangrene they begin but to die and the sense is not perfectly abolished there the Skin is first pallid suddenly livid then black here in a manner red greater stink in that than in this The Causes of both are six 1. The External Cold of the Air or Repelling Medicines 2. External Heat from burning or use of Corrosive Medicines 3. A Defect of Nutriment as in an Atrophia either by the compression or obstruction of the Vessels by reason of which straightness the Blood cannot pass to the Part. 4. The stopping of the Pores or Perspiration hindred from whence comes a Suffocation of the Natural Heat 5. Malign Humor either begotten in the Body or contractee from venomous Beasts or Medicines 6. The Scurvy which by a peculiar property causeth the Parts sometimes to mortifie Signs A Sphacelus is easily to be known the Part looks black Spungy Flesh Sense Heat and Pulsation abolish'd But the Signs of a Gangrene vary according to the variety of the Causes If contracted from Cold a great pricking Pain is felt in the affected Part First 't is red then pale at length black The Natural heat by degrees is extinguished and there happens a shaking not unlike that in a Quartane Ague If caused from an External Heat or stopping of the Pores the Redness is changed into White then into Black Pulsation and Pain cease the Senses lessened and at last there appear some Pustules from whence issue a gleety Humor If from defect of Aliment there is neither Pain Inflammation or Tumor the Body waxeth cold and for the most part seizeth upon the Joynts If from a venomous Creature or Humor great Pain and Fever always accompany it frequent Faintings and oftentimes Deliriums Here ariseth a Pustule under which appears a black Spot which spreads it self over the whole part If from the Scurvy it for the most part begins at the Toes it shews it self outwardly with blackish spots and lines which degenerates into a dry Crust upon which follows a Numness of the Part and at length a Mortification it self without any Stink Sometimes without pain other times very great especially in them that are given to Passion or Sadness Prognosticks Except a Gangrene be suddenly stopt it degenerates into a Sphacelus easilier cured in young than old People The Humors continually flowing to the part affected bring danger with them and that very great if they are Malignant In the Cavities of the Body to wit in the Mouth Privy Parts and Fundament c. a Gangrene is always difficult of Cure as also that which happens among the Nerves and Tendons in Hydropicks always mortal That which happens from the Scurvy may be spun out from many Months but seldom cured A Sphacelus is not cured but by the Knife and Fire Cure Diet must be good the Air Meat and Drink generally cooling and drying But seeing the Causes are various we leave it to the Physitian to prescribe what is convenient who also must well distinguish concerning Bleeding and Purging when to be used with advantage or disadvantage Sudorisicks and Cordials are of great use here and because that in this and other Diseases they are often used I thought it convenient to set them down in this Place Diaphoreticks or Sudorisicks Roots of Angelica Scorzonera Lovage Contrayerva Herbs Holy-Thistle Fumitory Scordium Harts Horn Unicorns-Horn Bezoar the Stone of an Indian Hog called Pedro Porco Waters of Threacle Alexipharmick Diascordium Threacle Mithridate Species Liberantis Antimony Diaphoretick Salts of Wormwood Prunella Holy-Thistle Rob. Sambuct Take Diascordium Farcastorii one dram Alexipharmick-Water two drams Holy-Thistle water as much as is sufficient Syrup of Limons half an ounce Make a Potion Cordials Waters of Roses Borage Bugloss Conserves of Rosemary-flowers of Roses Violets Borage Bezoar Harts horn Unicorns horn Confections of Alchermes Hiacynthus Rob. of Red Currans of Barberries of Scorzonera Roots Candied Citron and Orange-peels Candied Saccharum Perlatum Salt of Coral Take Water of Borage Bugloss of each two ounces and an half Alexipharmick-water three Drams Cinnamon-water two Drams Saccharum Perlatum half an ounce Confection of Hiacinth half a Dram prepared Crabs eyes two Scruples Spirit of Salt four Drops Mix them Let the Patient now and then take one or two Spoonfuls Externally Cupping glasses and Leeches but chiefly Scarification must be used although there are some of our Chirurgeons which altogether reject Scarification nevertheless happily curing their Patients by the following Medicines which resist Putrefaction External Medicaments against a Gangrene Roots of Angelica round Birthwort Herbs of Wormwood Holy-Thistle Tobacco Rue Colewort Germander Flowers of Elder St. John's Wort Mellilot Camomil Lye Brine Ink Urine Spirit of Wine Treacle Ung. Aegyptiacum Fuscum of Felix Wortz Horse-dung Some mix Hemlock in Plaisters or Poultices and use it with success Or Take the Tops of Wormwood Camomil and Elder flowers of each half a handful Leaves of Germander a handful and half Rue half a handful Crums of brown Bread seven ounces Horse-dung three ounces Boyl them in Brine in the end adding to them Ink two ounces Spirit of Wine three ounces Make it into a Cataplasm The sound part ought also to be preserved partly by keeping the Humors from flowing and partly by keeping the Gangrene from spreading For this purpose the Red defensive Plaister or the Cerot of Virgo is good as also this following Cataplasm Take Bolearmonick half an ounce Powder of Galls Cypress-nuts Pomegranate-rinds of each three Drams Barley-meal six Ounces Oxymel simplex as much as is sufficient to make it into a Cataplasm Or Take Seal'd Earth Bolearmenick of each half an ounce prepared Harts-horn a dram Camphire a Scruple Rose-vinegar an Ounce Oyl of Mirtles three ounces white of an Egg Make it into a Linament Cure of a Gangrene caused from Cold. The part gangren'd if not grown black but as yet appears very red with pain the Patient is to be placed at the Fire but not too near but at a distance
Respiration Difference 'T is divided into three species the first is called Cynanthe when the Muscles of the Larinx are inflamed the Symptoms here are very dangerous although neither internally nor externally appear any Tumor the Patient puts forth his Tongue like a tired Dog to fetch his breath Second is Synanche when the Tumor shews it self within the Jaws the Symptoms are likewise here great but much less than in Cynanthe Third is Parasynanche when the Tumor appears more Externally than Internally and in this the Symptomes are least of all Cause is Blood for the most part mixt with Serum or Choler seldom with Phlegm or Melancholy Signs of an approaching Quinsie are a stiffness of the Neck swallowing and breathing somewhat hindred an unusual heat and pain in the Jaws especially when Quinsies are Epidemick Signs of a present are a suffocating Asthma swallowing hindred which often increaseth to so great a heighth that Drink taken in at the Mouth comes forth again through the Nostrils Pain Redness Tumor for the most part also a continual Fever the Tongue likewise swell'd and the Voice altered Prognostick A perfect Quinsie never wants danger but sometimes suffocates the Patient the first day generally before the fourth If the Matter be not suddenly concocted and thrown forth it is desperate if the Vertebraes be laxated death is near at hand foaming at mouth is a sign of present death if the Patient be taken with a pain of the Head a Delirium raving and death it self suddenly follows Cure Bleeding in this case effects much both by taking away of the Inflammation and by hindering its increase which is to be performed at first sight therefore let the Median or Cephalick Vein of the side most affected be opened though in Women with Child then the Vein under the Tongue Cupping Glasses with Scarification may also be applied to the Neck about the second Verrebra Shoulders and Breast Leeches Cauteries and Blisters do much good especially in them that are Subject to Quinsie In the mean time if the Patient can swallow let some purging Medicines be given him if not let a Clister be cast in with Bleeding which must be often reiterated as occasion requires Gargarisms then and other External Medicines are to be used which in the beginning are to be more Repelling afterwards more Discussing for Experience and best Authors have taught 1. Repellents never are to be used alone except in the beginning and in a light Quinsie 2. That Repellents ought always to be mixt with Resolvents for Repellents destroy the heat of the Part Resolvents cause Fluxion Medicines in a Quinsie Roots of Marsh-mallows Liquoras Herbs Comfrey Myrtle Prunella Dandelion Scabious Plantain Housleek the greater Sage Alehoof Violets Flowers of Balaustians Red Roses Saffron the four cold Seeds Poppy the Rinds and Juice of Pomegranates Figs Album Graecum Burnt-Swallows Burnt-Allom Swallows Nests Syrups of Maidenhair Violets Purslane Jujubies Scabious Lungwort Honey of Roses Rob. Diamori A Repellent Gargarism Take Flowers of Red-Roses Balaustians of each two pugils Pomegranate-Rinds half an ounce Oak-leaves a handful Burnt-Allom half a dram Boil them in Smith's Water and add to a pint of the Liquor two ounces of Rob. Diamori Mix them Another very convenient in the beginning of the Disease Take leaves of Dandelion two handfuls Alehoof Violets of each half an handful boil them in Barley-water and to a point of the strained Liquor add of common Honey of Roses and strained of each an ounce and half Spirit of Vitriol 15 drops Mix them A Repellent and somewhat Discussive Gargarism Take Liquoras Pomegranate-Rinds of each two drams Balaustia Flowers a pugil Jujubies No. xij Figs No. iij. Raisins six drams boil them in Barley-water To a pint of the Decoction add of common and strained Honey of Roses Syrup of Maiden-hair of each an ounce Mix them A Gargarism greatly Repelling but strongly Discussing Take the Roots of Dwarf Elder Orrise of each two drams Flowers of Camomil a pugil Red-Roses Hysop of each two pugils Dates No. iij. Figs No. vj. Fenugreek-seeds two drams Album Graecum one dram Boil them in Turnep-Broth Add to it Syrup of Maiden-hair and Jujubies of each an ounce Mix them If the pain be very great boil them in new Milk chiefly in Goats External Medecines for a Quinsie Oyl of Nuts White-Lillies Almonds Camomile Dill Capons-grease Hoggs-grease Ointment of Marsh-mallows Plaister of Musilages Dogs and Pigeons-Dung Swallows-Nests Take Roots of Marsh-Mallows White-Lillies of each an ounce one Swallows Nest Figs Dates of each No. iij. Album Graecum half an ounce Boil'd Onions half an ounce Boil them in Barley-water and to a point of the strained Liquor add of Wheat-meal and the Powder of Lin-seed of each an ounce Fenugreek and Marsh-mallows powdered of each two ounces and a half Yolks of two Eggs Eastern Saffron two drams Oyl of Camomile two ounces and a half Make it into a Cataplasm Take Juice of Onions two ounces Oyl of white-Lillies Orise of each an ounce and half boil them a little adding to them of Swallows-Nest a dram Pitch and Wax as much as sufficeth to make it into a Plaister But if the Tumor tends to Suppuration 't is to be forwarded and then to be opened either by Medicines or Launcet A Suppurating Cataplasm Take Roots of Briony white-Lillies Orrise of each three drams Leaves of Pellitory of the Wall a handful Camomile-Flowers half a handful Onions an ounce Figs No. xij Boil them and bruise them adding of the Powder of Fenugreek-seed and Lin-seed of each two ounces Hens grease an ounce Oyl of Camomile two ounces Mix them A Suppurating Gargarism Take Roots of white-Lillies and Liquoras of each three drams Onions half an ounce Raisins stoned an ounce Figs No. vj. Lin-seed and Fenugreek of each two drams Leaves of Mallows and Coleworts of each half a handful boil them in Barley-water and to a pint of the strained Liquor add of Syrup of Maiden-hair two ounces Mix them And to make the Abscess break add to this Gargarism Take Mustard-seed two drams Roots of Pollitory of Spain powdered one dram Saffron a scruple Oximel simple an ounce Mix them But if it doth not forthwith break by these Medicines 't is to be opened by a Launcet or some other Instrument afterwards using Emollient Gargarismes and somewhat abstersive The end of the first Book of the second Part. BARBETTY'S CHIRURGERY The Second Book of the Second Part Of CHIRURGERY Of Wounds CHAP. I. Of the Nature Differences Causes and Signs of Wounds A Wound is a Solution of continuity in the soft parts of the Body from a hard Instrument causing an Abolition or Immination of Action Differences are taken 1. From the Form some are long others oblique some are little others great some are deep others superficial 2. From the wounded Part as the Head Lungs Heart Stomach Liver Spleen Guts Nerve Tendon Vein or Muscle sometimes the Skin is only penetrated then 't is a simple Wound sometimes a Part
of the Flesh is taken away and then 't is call'd a compound or hollow Wound 3. From the Causes which shall presently be set down sometimes a wound happens to be poisoned and to have many Symptoms joined with it Causes are five-fold viz. 1. All things that cut as a Knife Sword Glass 2. Al things that prick as Needles Arrows Teeth 3. Which perforate as hot Iron Bullets 4. Which break as a Fall Stroke or the carrying or lifting of any great Burdens 5. All things which contuse as a Stone Stick c. Signs External Wounds are of themselves manifest enough but those of the Internal parts are not always so easily judged of these therefore are to be known by Anatomy 1. What is the situation of each part 2. What the use 3. The Symptoms are to be considered 4. The Quality of those things are to be noted that Nature ejected through the Wound The other Signs you shall have in their proper places Prognosticks To know the Events of Wounds especially to predict which are Mortal which not is a thing absolutely necessary for a Surgeon For from this judgment oft-times depends the Life of unfortunate Man A mortal Wound is that which in the space of few hours or days of necessity causes Death and cannot by any Art be cured For those that in themselves are curable yet by reason of ill Symptoms or through the neglect either of the Patient or Chirurgeon do occasion Death ought not to be accounted mortal Wounds Incurable Wounds themselves are not to be call'd Mortal if they are not the cause of Death suddenly to the Patient but that he not only lives many weeks but oftentimes many years after 1. Among the Wounds that are Mortal are to be accounted the Wounds of the Brain but not all of them for Experience hath taught us that part of the Brain hath been taken forth and the Life preserved though the Understanding lost Therefore those Wounds of the Brain that be absolutely mortal are 1. When besides the Brains a Nerve is also wounded 2. When Blood or some other Humor obstructs the beginning of the Nerves 3. When after a few days the concrete and putrified Blood produceth a Fever Delirium and Death it self By concreted Blood I understand not that which lies between the Dura-Mater and the Skull for that is to be taken forth by the Trepan and the Patient this way may be preserved but that which is included between the Dura and Pia-Mater or between the Pia and the Brain Although sometimes that which is detained between both Membranes by the dividing of the Dura may be taken forth and so the Patient preserved 2. The Wounds of the Spinal Marrow are also mortal which happens in the Neck or nearer to the Head but those which happen lower as about the Os Sacrum are of lesser danger 3. The Wounds of the Lungs are mortal if great and deep where the great Vessels or the Branches of the Aspera Arteria are hurt Where the Vessels are divided there follows a great effusion of Blood where the Branches of the Aspera Arteria the Breath comes forth more through the Wound than the Mouth 4. Wounds of the heart are always mortal for though one or two wounded in the heart have lived two three or four days it was never found yet that ever any escaped 5. The Wound of the Wind-pipe may be cured if the Membranes only behind to which the Cartilaginous Rings are join'd be hurt but if the Rings themselves are wounded there 's no cure to be expected yet sometimes those wounds being a lingering Death so that I have seen on so wounded live Eighteen weeks before he died 6. Wounds of the Diaphragma those that are inflicted in the fleshy Part of it are curable but those that are in the Nervous Part though these always occasion not sudden Death yet 't is impossible ever to cure them 7. Wounds of the Stomach are sometimes cured those chiefly being mortal that happen in the upper Orifice or in Nerves that are distributed over the Stomach 8. The Wounds of the Small Guts are seldom cured but the Wounds of the Great Guts much oftner especially if they are not great 9. Wounds of the Liver and Spleen are mortal where the Vessels themselves are wounded where not they may be cured 10. Wounds of the Kidneys are not mortal if the Wound penetrate into the Cavity it self for the most part an Ulcer follows which consumes the whole Kidney yet the Patient may continue many years If the Parachyma only be wounded sometimes through difficulty it may be cured 11. Wounds of the Bladder are seldom so perfectly cured but that for the most part there remains a Fistula but those that are made at the neck of the bladder are daily cured 12. Wounds of the great Veins and Arteries are often mortal but every Surgeon understands not rightly to bind up such Wounds therefore the cause of death is not always to be cast upon the guilty 13. Wounds of the great Nerves are for the most part incurable and sometimes mortal 14. Wounds from poisoned Instruments or Creatures generally are mortal Wounds of Nerves Veins Tendons and Membranes are more difficultly and longer of Cure than those of the fleshy parts A Wound from a pricking Instrument is of less danger than from a bruising A Nerve Vein or Artery if wholly divided are less dangerous than if they were but in part A great Inflamation coming upon a great Wound is of no great danger except it continue too long but a great Inflamation falling upon a little Wound is an ill sign The Inflamation for the most part vanisheth by the fifth day therefore if the Wound then appear white livid or black 't is not void of danger A Fever Vomiting and Convulsion are dangerous but a Fever and Vomiting of less danger than a Convulsion CHAP. II. Of the Cure of Wounds in general HEre are required four Intentions 1. To preserve the strength and native heat of the wounded Part. 2. To remove the Symptoms 3. To endeavour that nothing remains or be left behind in the Wound 4. That the gaping Lips of the Wound be joined together and being so joined be kept CHAP. III. Of the preservation of the strength and Native heat in the wounded Part. CHirurgery removes the impediments of Cure but Nature her self cures the Disease which it will scarce effect where the Native heat is weak or the Blood vitiated or where it flows in too great or too little quantity to the Wound in flowing in too great quantity it produceth an Inflammation Pain Putrefaction and many other Symptoms where in too little quantity the Wound is robbed of its Natural Balsam necessary to consolidate it The natural strength and native heat is preserved by a convenient Diet fitted to the temperament of Mans body in general and in particular to the Part affected Of the Diet of the Sanguine Cholerick Phlegmatick and Melancholick we have treated of before
be purified and in some manner concocted in which its operation that the Blood may be rendred more perfect 't is carried to the Heart especially when by reason of its continual and necessary Pulsation the Blood cannot remain long in the Heart and for this reason I judge the whole Blood must needs be moved about with a circular motion The Blood made in the Liver as is declared but now in the eighth Chapter enters the Vena Cava and from thence into the Heart And thus the Royal Liver at the same time when Kings are taken away may yet use a limited power and may remain with honour in its own Kingdom But what shall we do with the Melancholick Spleen which makes many laugh It hath many accusers and not fewer excusers 1. It was never accounted by Hippocrates the Learned Greek a receptacle of the Excrements or is it any where to be found in him that he call'd the Spleen another Liver 2. The great number of Veins and Arteries and so by consequence the abundance of Vital Spirits do not permit the Excrements to be collected here 3. It hath not any convenient Cavity wherein the Melancholy Faeculent Juice can be received 4. And if you imagine that there is no necessity here of a Cavity its Parenchyma is too thick and not porous enough therefore unfit for the reception of so thick a Humor which also is never naturally found in it 5. It is too great a Bowel to perform so vile an Office 6. In dead men where Melancholiness hath been the cause of their death upon the examination of the Internal parts there none of them less recede from its natural state than the Spleen the Heart only excepted whom the Vital Spirits do so greatly defend that it is less affected than other parts which seldom happen to the Intestines Kidneys Gall and Bladder What is therefore its Use It elaborates the Acid Humor which is very necessary but not Excrementitious and mingles it as a Ferment with the Blood by which it becomes more perfect and fitter for Circulation In my judgment the Salt of the Blood affords matter to this Humor which it greatly requires that it may not be corrupted but this Salt which proceeds from the Meat and drink is never so pure but that it hath need to be brought to a more perfect state in our Body But this is my Opinion The Supremest of the Kings is the Heart to this are two others subject the Liver and Spleen I beseech you give me leave to make use of this Similitude in favour of the Ancients the Heart makes the Blood the Liver repeats the Concoction and separates the Choler the Spleen from its own Salt by an innate vigor produceth an Acid Humor which as a Ferment by the Venal Splenic Branch it mixeth with the Blood to render it the perfecter and the more fit for Circulation if any Excrementitious part should be there separated it is all by the Caeliack Artery and the Haemorrhodal Vessels sent to the Guts If it appears to any one to be a contradictory that by Salt a Humor should be made Acid we advise that person to taste some Spirit of Salt About sixteen years since the great Anatomist Franciscus Sylvius put forth some particular things concerning the use of the Spleen he was of opinion that the Blood was not made in the Ventricles of the Heart neither that it was carried from the Heart by the Arteries to all the parts of the Body for nourishment-sake alone but that it likewise underwent some other Mutation in the rest of the Viscera's particularly that the Spleen further concocts the Arterial Blood and brings it to a higher degree yea that it more then perfects it so that the Blood in a manner in this place assumes the nature of Ferment by whose means in a short time a great quantity of Mass may become acid in the same manner he affirms that the Blood more and more concocted in the Spleen there receives strength by which it restores the returned and weakned Blood and preparing together with it the Chile that it may the sooner be turned into Blood The Reasons which he produceth for it are these 1. The Spleen receives a much greater quantity of Blood from the Heart than is necessary for its nourishment 2. That it can be returned back again to the Heart by no other way than by the Branches of the Vena Cava and Porta for what hath hitherto been delivered of the short Vessel are to be accounted but ridiculous Fictions as may most evidently be made appear in dissected Bodies 3. Seeing this Blood is continually mix'd with the returned Blood and Chile in its passage to the Heart it ought not to be an Excrement for so the Noble Parts and the whole Body would not be purged but the more injured 4. Chymistry hath long since taught us that such mutations happen daily in Nature The Remaining Part of the Blood unuseful to the Body therefore Excrementious is thrown out through the Guts Ureters and Parts of the Skin c. concerning which it is not necessary to add more here but now we are forced to describe those new watry passages which the studious in Anatomy have long and diligently inquired into The watery passages the Lymphatick Vessels have their rise both from the Liver and from the Joints and receive the liquid Juice from the Arteries with which they correspond Those which come from the Liver embrace the Vena Porta and so pass to the Misaraick Glandules of the Chile as do those also that ascend from the Feet thence they discharge their Water into the great Lacteal Vein which as we have already declared carries the Chile to the Heart Those which proceed from the Arm both lie above and under the Veins until they come to the Subclavial Vein which they enter about the same place where the great Lacteal Vein doth being furnished with a particular Valve just at their entrance and so altogether they carry the Water to the Heart This Water is Sweet not being as Urine is Salt These Vessels consist of a very thin Tunicle whence they are soon broke Use of them in my opinion is to take the superfluous Water from the Arteries and carry it to the Glandules of the Chile and Lacteal Vein by which the Chile being made more Liquid may the more conveniently be conveyed through the narrower passages thence to return the same to the Arterial Blood making it fitting to serve to the nutrition of the moist parts and to the cooling and moistening of the hot But that it may the more clearly appear in what manner I conceive how what hath already been said is perform'd in our Body observe that the Meat is converted in the Stomach into Chile to which part of the Drink is mingled this mixture is carried through the Glandules of the Chile and the great Lacteal Vein into the Heart where it is changed into Blood which is by means of
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
in one days space with compound Ointment of Marshmallows the watry matter being suckt out by a Woman or Whelp but this discharge being neglected or delayed every day the Breast grows harder and harder nay becomes enflamed then Bleeding Purging Sweating is requisite Outwardly this Cataplasm may be applied Take meal of Marshmallows of Fenugreek of each an ounce Flowers of Elders Camomile of each an handful red Roses two pugils Crums of course Bread an ounce and half Boil them in Ale adding to them of Rose-Vinegar an ounce Make a Cataplasm The Flux of Humors and Pain being ceased the remaining may be discussed by the following Cataplasm Take Meal of Beans of Linseed and Fenugreek-seed of each an ounce Cummin-seed three drams boil them in Wine adding to it compound Ointment of Marshmallows Oyl of Camomile of each half an ounce Make it into a Cataplasm When it begins to apostumate Maturatives are to be used Take Leaves of Mallows Marshmallows of each a handful Powder of Linseed an ounce of Fenugreek-seed an ounce and half Leaven half an ounce boil them in Milk adding to them Vnguentum Basilicon an ounce Saffron a scruple Make it into a Cataplasm The Tumor being suppurated must be opened with a Caustick or what is better with a Launcet and put a Tent into it dipt in common Balsom of Brimstone until the end of the Cure laying upon the Breast Emplastrum Diasulphuris Bulandi 3. A Gibbosity ariseth from the spine of the Back when the Vertebra's are removed outwardly or of one side from their natural place which is occasioned sometimes by an External Cause some by an Internal especially when some pituitous Humor is collected about them this Humor must be taken away by discussive Oyl and Plaisters before what is started out can by a Steel-compress fitted to the Body of the Patient be reduced This reduction is not so much performed by the Compress as it is by the Emollient quality of the Iron For this reason it is necessary that the Patient though cured for a year or more after use another Bandage that the soft Bones may not again start out It is here likewise to be observed that in the middle of the Back about the seventh Vertebra with great success may an Issue be made to intercept Rheums flowing to the Hip Kidneys Feet c. CHAP. II. Of the Internal Parts of the Thorax THe Breast now comes to be opened that we may view the Fountain of Life which the Celestial Truth affirms to consist in the Blood for what reason is it therefore that the Sovereign Sanguification is not attributed to the Heart where every where and by all it is call'd the Original of Life Within the Breast is invested by the Pleura which is afterward doubled and at length quadrupled extending it self from the Vertebra's to the Sternum and then it is called Mediastinum dividing the Lungs and Thorax Near to the Throat there adheres to the Mediastinum a Glandulous Body call'd Thymus The Lungs drawing in the Air so cooling the Heart is furnished to this purpose with a Trachea Aspera Arteria or Wind-pipe this lies upon the Gullet and consists of Cartilaginous Rings and a double Membrane The outermost of these Membranes which is the thinner ariseth from the Pleura the innermost which is the thicker from the Dura Mater The annulary Cartilages are joyned together with Ligaments and make not a perfect Circle as being destitute of a fourth part that lies upon the Gullet The Wind-pipe distributes Branches through the whole Lungs which are strong enough but not at all Cartaliginous The Lungs themselves covered with a thin porous Tunicle consist of a soft red spongy substance In the fore-part they adhere to the Sternum in the back-part to the Vertebra's filling the greatest part of the Breast It hath seven lesser Vessels of which we shall speak in their places The Heart the Work-house of the Blood the Fountain and Origin of Life as the Sacred Writ it self also witnesseth is included in a certain Case call'd by Anatomists Pericardium It consists of two Membranes the outermost comes from the Mediastinum the innermost from the Vessels of the Heart it contains a clear watry Liquor void of all Acrimony which we no longer doubt of to be brought from the Ductus's of the Limpha The Heart it self consists of a fleshy serene and hard substance which is invested with a proper Tunicle furnished with Fibres of all sorts and like a Muscle is continually moved It is placed in the middle of the Breast but the point of it inclines sometimes to the left side In Figure it is like to a Pine-Apple having in its upper part two Auricles or little Ears which alwayes beat before the Heart it self In old people the right Auricle is bigger than the left which in Infants is the contrary in the throwing forth of the Blood the Auricles as well as the Heart it self are purst together and dilated as often as they take in the Blood and this Constriction and Dilation makes the Pulse For the concoction reception and throwing forth of the Blood it hath two Cavities and four Vessels The Cavities are distinguished by a fleshy Division in which I could not yet find any way appointed for the motion of the Blood out of the right Ventricle into the left although many Anatomists do certainly affirm it These Cavities are divided into the right and left the right which is the greater receives the Vena Cava and Arteria pulmonalis or Vena Arteriosa the left which is the least receives the Arteria aorta or great Artery and Vena pulmonalis or Arteria venosa Of these Vessels as also of the Nerves and Chylous passages or the Thoracick lacteal Veins we have treated of in the first Book Under the Wind-pipe in the Cavity of the Breast lies the Oesophagus or Gullet resting upon the Vertebra's About the fifth Vertebra of the Back it inclines a little to the right side that it may give way to the Arteria aorta unto the eleventh Vertebra thence with a straight Ductus it passeth the Diaphragm into the lower Belly It consists of a double Membrane the outermost is fleshy having streight and round Fibres the innermost transverse and oblique Many add to these a third from the Peritonaeum and rightly in my opinion The Diaphragm in nature of a Fan serving to respiration divides the Thorax from the Abdomen and adheres to all the Bastard-Ribs to the Cartilage of the Breast-bone about the Vertebra's sending two fleshy Processes to the lower parts Its edges round about are fleshy variously movable like a Muscle but its Center Membranous and very sensible It hath three perforations 1. In the middle of it through which the Vena Cava passeth 2. In the left side through which the Gullet with the adjacent Nerves 3. About the Vertebra's for the passage of the Arteria aorta with the Vena azygos It receives more Nerves than any other part of
answer will be various but most of them very idle and impertinent It hath by some been thought probable that a Plague might proceed from the Heavens they affirming that the Stars do actuate the Subluminary Bodies both by the influence of their Light and by several other qualities inherent in and peculiar unto them But the Conjectors raised from hence are very uncertain and the foundation of them unsecure We are not ignorant of the Fopperies of Astrology and of the vanity of those Predictions which have no other Foundation than the several Courses the Conjunction and Opposition of the Stars which are all so frivolous that we cannot think it worth our labour to refute them We acknowledge that the Air may be several ways corrupted from whence the Vapors which have been received from the Earth are sent down again amongst us which like Fire may inkindle our Blood Corrupt waters Carcasses either not at all buried or else shallowly interred the South-wind which may be supposed to promote the Putrefaction Men already infected successively imparting the Contagion to the sound by that means spreading the Venom through the Bodies of Men the Air itself This Pestilential Infection may likewise for a long time lie couched and concealed in Straw or Stubble amongst Garments Hangings and the Furniture of Beds which we have sometimes observed strangely to impart their Malignity to those that have handled them or approached unto them But all these things only inform us of the means by which this Pestilential Poyson is conveyed unto us but no one hath as yet declared what it is and wherein its Nature doth properly consist The Symptoms of it are these The sick persons are seized with a shivering all over their Body which is presently followed with an inward heat which is oft-times very intense yet without any great thirst somtimes the thirst is excessive the Fever moderate But whether the heat of the Fever be great or small it is most commonly accompanied with a dryness of the Tongue an Urine of the same constitution which you might expect from a man in perfect health They are taken sometimes with a great drowsiness sometimes with a Dilirium or with an excessive pain in the Head in this case the white of the Eyes appeareth of a Saffron-colour they are more wakeful than is consistent with their ease quiet great pain at the Heart the Pulse seems small if not at first when you touch it lightly for then it oftentimes appears to beat high yet at least when you press it closely with your Fingers The strength fails in the beginning of the Disease decreaseth much more visibly than in the most burning Fever which hath no Malignity attending it Some are taken with a Diarrhaea which can by no means be stopt Others bleed much at the Nose the Eyes the Ears or Mouth some at the Yard or Womb. Some are troubled with a continual Vomiting others with a Nauseousness On some Bodies there appear red or purple spots on others Buboes behind their Ears on their Neck under their Chin in the Groin and under the Arm-pits In some there break forth red Wheals or Pushes in others white Bladders or Carbuncles And wheresoever these Bladders Buboes Carbuncles c. do appear they are a most certain sign of the Plague although the bigness of them may be inconsiderable especially if they either accompany or are Consequents of a Fever As to the Prognosticks we must consider that the Plague is a very treacherous Disease and whilst it flatters us most it intends us the greatest mischief A Bubo is less dangerous than a Carbuncle and a Carbuncle than the Spots which very seldom portend less than present death wheresoever they are display'd A Bubo behind the Ears on the Neck or under the Arm-pits is more dangerous than that in the Groin Carbuncles on the Hands and Feet may by some be thought less pernicious because they are more remote from the Heart but since they happen amongst many Nerves and Tendons they are more to be feared than those which appear in other parts of the Body which are better covered with flesh A Carbuncle arising after a Bubo is a sign of Death If a Bubo or Carbuncle appear before the Fever there is less danger than if they follow it at a distance and arise slowly A blew Circle encompassing the Bubo the second day after its appearance is a sign of Death If a Bubo suddenly disappears the state of the Patient is dangerous unless Nature dispatcheth the Malignant Humour to some other Part. Thus we have often observed that upon the retreat of that Morbifick Matter which hath caused a Bubo in the Groin there hath appeared a Gangrene in the Foot and on the same side which was before affected and many have by that means escaped If a Cupping-glass applied to the Patient raiseth no Blister we may reasonably conclude his condition to be desperate It is an infallible sign of Death if after Cauterization or the application of a Cupping-glass the Carbuncle abates not in 12 or 24 hours as likewise if there is no moisture proceeding from it but if a Bladder appears or any separation of the matter be made which is so much the better by how much it is the greater with a sufficient purulency the Patient is then past danger A Carbuncle which seems to have a little tail or push at the end of it is very dangerous as are likewise those which look white which unless the Fever doth very much abate are certain forerunners of Death If the Patient that hath a Bubo in his Neck or behind his Ears be troubled with a pain in his Throat and a difficulty in swallowing and no considerable Inflammation appear we have always found it a certain Rule that in this case he outlives not 12 or 15 hours Sleep more sound than ordinary Diliriums waking often in the night inflammation of the Eyes pain at the Heart a trembling and convulsion of the Joynts are all very dangerous Symptoms but do not always portend Death A great Fever without a pain at the Heart is not so dangerous as a lesser which is accompanied with that Symptom The greatness of the danger may sometimes be judged from the great dryness of the Tongue If by the administration of Sudorificks Sweat is not provoked the Patient usually miscarrieth A Flux of Blood was heretofore held dangerous in all Plagues but in our Age all that can either bleed at the Nose or have their Menstrua's come off safe We have no president of any that have pissed Blood but a Dissentery is the sign of an approaching Death It is very certain although it but seldom happens that incurable Carbuncles do break out about the Eyes Nose Stomach even amidst the Entrails themselves If they seize on the Bladder they become mortal to the Patient and put him to excessive pain I can instance only in one who after he had for
it be not given cold lest Gripings Flux and a pain at the Heart such like Maladies should be caused thereby To such who have weak stomachs a pain at their heart I do use to give the liberty when their Fever abates to drink Mosel or Rhenish-wine with Sugar the juice of Limons provided that they take it in a moderate quantity But I believe they do err very much who prescribe to their Patients whilst the Fever continues still very high some sort of French Wine either alone by it self or mixt with their Sudorificks That Oriental Stone call'd Lapis Porcinus or Pedro Porco is of very great use if it be steeped for a while in your ordinary Drink for it strongly provokes Sweat and very much refresheth the Heart This Stone if I mistake not is generated in the Gall of an Hog for it is exceeding bitter and though it be very hard yet every time it is infused it abates somewhat of its quantity which is discoverable by the Tincture which it imparts to the Liquor Nor is the Gall of a man sometimes void of such Stones which are like unto those taken out of an Hog in savour hardness and colour and we might find them too perhaps in their efficacy likewise if we thought fit to make trial of them This Fever is often accompanied with drowsiness which forbids the use of the principal Sudorificks such as Treacle Mithridate Diascordium c. because there is Opium in their composition which makes them not so effectual for the preventing of sleep It is more requisite to use this following which is agreeable for dispelling the Vapours which infect the Head and the heat about the Heart Take Salt of Rue of Scordium Prunella of each half a scruple Vitriolated Tartar 8 grains our Prophylactick Water an ounce Balm-water as much as sufficeth Syrup of Betony an ounce Mix them for a draught Let Sweat be thereby provoked and let it be the care of the Attendants that after the first or second day the Patient may be kept from sleep if it be found that he hath strength to bear it There is sometimes joyn'd with the Fever continual Watchings and a great pain of the Head I do not use to be much concerned for the watchings although it should continue for the first three days without intermission for it often falls out that by the use of Sudorificks only the pain is the first day abated on the 2d becomes tolerable and on the third is quite taken away Opium hath in it the virtue of causing Sweat and is a great Ingredient in Treacle Diascordium and Mithridate which without it would not in my judgment have that Sudorifick quality for which they are now noted It is also reckoned by several Authors amongst those Medicines which are famous for dispelling of Poison whose use is very requisite in all malignant Fevers nor do I believe that there can any other Medicine be named which gives so present relief to the Patient as Opium concerning the operation whereof they are able to give a better account who have been frequent and curious in the use of it I have sometimes in this case though contrary to Custom given it sparingly when I have found the sick person not to sleep in the first second or third days But when he hath waked for six or seven days together and found a great decay of strength this following Prescription taken every quarter of an hour by a spoonful till sleep hath seized on him hath afforded great relief and the sleep produced thereby hath been undisturbed and of long continuance Take our Prophylactick-water an ounce half Borage-water an ounce Cinamon-water three drams Confection of Hyacinth a dram Lozenges of Sugar pearl'd three drams Laudanum Opiat two grains Mix them You may safely make use of Opium after the manner before mentioned but in Gachectick infirm Bodies whosoever gives it too boldly or is fearful of prescribing it at all discovers that he understands not its Virtue and Efficacy Before I come to the use of Opiat Laudanum I endeavour to ease the pain of the Head by these following viz. by applying Ground-Ivy bruised to the nape of the Neck and to the soles of the Feet and palms of the Hands this or some such like Composition Take Leaves of Rue a handful and half sowre Leaven two ounces Pigeons dung an ounce common Salt half an ounce Elder-Vinegar as much as sufficeth to make it into a Poultice to be applied to the soles of the Feet and palms of the Hands Or Take Bolearmenick seal'd Earth common white Chalk of each half an ounce Vinegar of Marigolds as much as sufficeth Apply it as before To the Forehead I have often applied the Powder of Cloves moistened with the Spirit of Wine for I take Vinegar to be hurtful as are also all Emulsions Vomiting and the Hiccough is another symptom of the Plague It hath been observed by several who have been so curious as to open Bodies which have died of the Plague that Carbuncles have often appear'd in the Stomach and amongst the Entrails whose testimony is not to be rejected since it is so agreeable both to Reason and Experience These If they are not the Cause of the Vomiting and Hiccough may be easily removed by a spoonful of this following Preparation taken cold every quarter of an hour Take Mint-water our Prophylactick-water of each an ounce and half Cinamon-water half an ounce Confection of Hyacinth a dram Salt of Coral a scruple Syrup of Myrtles half an ounce Rose-Julep half an ounce Mix them By the use hereof the Vomiting is usually stay'd especially if the Stomach be sometimes anointed with this following Oyl Take Oyl of Nutmegs by Expression a dram and half Oyl of distill'd Mace half a dram Oyl of Wormwood a dram Mix them In the mean while let the sick person forbear to drink too plentifully and as soon as the Vomit is stayed let him make use of some good Sudorifick Another Symptom of the Plague is a great Flux which is usually a sign that Death approacheth but when the sick person hath not voided meer blood nor any thing of a bloody substance I have sometimes found these following Prescriptions to be successful Let him abstain from all things that are either acid or salt which except in this case are of great use in the Plague and likewise from drinking much But if his thirst be so exceeding great that he cannot bear it let him take one two or three spoonfuls of this following Mixture Take Tormentil-Roots an ounce Red Roses a handful Shaving of Harts-horn a dram Seeds of Sorrel and Mirtle of each a dram Boil them in Smiths water and to nine ounces of the Liquor add of the Confection of Hyacinth a dram Syrup of Mirtles an ounce Mix them Many have also from Treacle alone received great benefit by swallowing a little of it every four hours till they have taken the quantity of a dram as likewise
even to her Head-cloaths and drank Whey in which Tamarinds had been boiled from whence proceeded her sudden change for the worse and upon that her Death and these are the effects of self-conceitedness VIII Helena van Wyngaerden a Servant of mine on the first day had some slight Symptoms of the Disease the next she was taken with Vomiting a pain in the Head and at her Heart especially when she endeavoured to rise from her Bed her Eyes look'd red but her Tongue was well enough and her Fever was but small a few dayes before without my knowledge she had been at an house that was visited I gave her presently a Sudorifick whereupon the third day after a Bubo appeared in the left Groin I continued the use of Sudorificks and the Chirurgeon took care of the Bubo by which means within a fortnight she perfectly recovered and went again about her business IX The Daughter of N. Domer on the second of September complained of a great pain in her head and at her Heart and her Tongue grew black and dry The first and second day we put her into a Sweat and on the third she told us that she was perfectly well her Tongue became moist her Pain her Fever Anxiety left her nevertheless I perswaded her to continue the Sudorificks but she arose and ate and drank went abroad and after that slept well all night but in the morning the former Symptoms returned and in the evening of the same day there appeared Spots and the next morning she died X. N. N. had lain very ill for six dayes at what time I was sent for to him on the twentieth of August he began to be light-headed his Tongue became black and dry and he had a great anxiety at his Heart his Eyes were fixed his Hands trembled and a great Carbuncle discovered it self on his Cheek whose Tail reached to his very Chin which was also hard and much swelled It seem'd to threaten a much greater increase for it was very dry much inflamed and not circumscribed within any bounds To this was added a pain in the Throat which Symptom I conjectured to be mortal and a very intense Fever This desperate case put us in mind of desperate Remedies wherefore being guided by my ow Reason and Experience and perswaded by the Authority of the most Eminent Physitians both Ancient and Modern I boldly recommended to him an actual Cautery which was presently applied by the Chirurgeon without any great pain to the Patient This Operation was perform'd in the Morning at ten of the Clock and between 4 and 5 in the Afternoon it appearâ—d purulent and the Crust began to be separated nor did the Core of it creep any further all which effects I know not from what means they could have been expected besides this In the mean while he sweat plentifully and all things gave his Friends to hope that he would again recover but I was of another mind as knowing well the nature of this treacherous Disease The same Evening he took another Sudorifick and slept quietly enough all night On the 21 day the Cheek that was affected discovered on it some moisture the Fever continued as it was Between his forefinger and his middle one there brake forth a very painful Carbuncle which affected the whole Arm. To this there was applied another actual Cautery without any great alteration discerned in the Patient then we prescribed him a Julep which might cause Sweat some food that was nourishing but no Sweat appear'd the affected places being drier than the rest fore-boded an ill event At 9 in the Morning another Chirurgeon was sent for who approved of whatsoever we had done in this case at midnight he fell into an high Delirium so that he could not be held in his Bed by those which attended about morning he betook himself to rest in one hour after departed Some of his Friends accused me of being negligent which ingratitude I can the better bear since I am conscious to my self and give thanks to God for it that I omitted nothing which the Rules of Art required to be done XI The Wife of Cornelius Janson being fifty years old was after she had been sick two dayes troubled with a Bubo in her Groin and a great anxiety of Heart but the Fever was but small Her Eyes which I do much observe in all sick persons look'd very well as soon as she sweat she began to confess her self better her anxiety was presently removed and her Fever also after few days The Bubo a Blister being first drawn was dressed by a Chirurgeon with the Magnetical Arsenick Plaister She fell sick on the eighteenth of September and her Son on the 23d who was taken with a pain in his Head and refusing all Medicines died within three dayes but she recovered XII Everard Tessalear a Vintner was taken on the 28th of September with a chilness all over him and then with a very great heat his anxiety was great and his breathing difficult accompanied with nauseating a pain in the Head a trembling of the Hands a burning of the Eyes and an intolerable pain on the right side of the Groin yet without an apparent swelling I gave in my Opinion that he was taken with a Pestilential Fever and prescribed some Remedies for that purpose after the first Sudorifick the pain in the Head and Groin abated and the Vomiting was stopped after the second the pain became tolerable and by the fourth it was wholly taken away and the Feaver cured Being so suddenly restored he believed not that there was any Malignity in it and went abroad forthwith which I did very much disallow accusing him of unthankfulness to God and foretelling that he was to suffer somewhat more severe because I could easily perceive his Health and Strength not to be confirmed and that there was need of a further course of Physick to settle it He still refused to hearken to me till on the day following he was attaqued by the same Enemy and his Wife also he first complained of a pain in his Groin and then of a Bubo which Symptoms confirmed the truth of what I had foretold and caused him to repent when it was too late The fear of Death made him now desirous of repeating the Sudorificks by means whereof through the Divine assistance they were both cured in nine dayes though the Bubo continued on the Woman for a Month after XIII Albert N. on the second of October was taken with a great pain at the Heart his Pulse was not to be discerned by a gentle touch his Countenance was like one in an Agony he was extream prone to Vomit and to Sleep but he was pretty well in his Senses his Eyes were not inflamed his Tongue moist the Fever but small and the Thirst not great The Vomiting was presently relieved by the use of those things which we have mentioned in their proper place but the Sweat came but slowly whereupon
least thou shouldst swallow Frog or Snake-spawn For I have known and had in my cure a Countrey-man who voided though not at once but at different times two hundred fifty and five Frogs and of them many in my own house in the presence of divers Ecclesiastical and Secular Persons and some of the biggest of them being dried are still to be seen in the Repositoy of Mantua as also in that of Mr. Philip Hainhofer at Auspurg And there is a Cook in the Hospital of Wessenburg or Landsberg who as appeared by the event had drunk the Spawn of Serpents out of which were bred divers Serpents in his Body some of which he voided by vertue of the Medicine he took amongst which there was one of the length of a Bavarian Ell. The Man hath been since in good health and continues in his service to this day Wherefore it will behove you to spread your handkerchief over the Ditch-water and so drink through it or if you take any of it up unstrain'd quench first a red-hot Stone or Iron in it whereby the noxious quality will be destroyed Or if you lye still and can get any Oyl of Vitriol let some drops of that fall into it and you need not then fear any corruption or poyson in such water Otherwise if time will permit let it boil up and cool again and put a crust of bread into it and you may drink of it safely Those Waters that run out of stony hills and from under rocks are the best to which may be reckon'd those Springs that flow from high places and purge themselves in clear sand and pebles If thou meet with Beer or Wine take heed of excess and forbear drinking New beer that hath not yet done working or is not some days old because new beer causeth the Strangury And in case this should trouble thee take a handful of Hay-blossoms boyl them in water and Urine over it drawing into thy body the warm steam thereof and anointing thy Navel several times with warm suet If thou art hot and canst not forbear drinking make water first then wash thy mouth and cool the arteries on both thy temples and those of both thy wrists and then drinking will hurt thee less If you chance to drink whilst you are hot which is so dangerous a thing that some have dyed within 24 hours after it others have fallen into consumptive Coughs others been troubled with Pains in their sides and with Impostumes c. then take of the leaves of Bellis or Daisy which grows in all meadows and pasture-grounds and is green both winter and summer and wash them clean and dress them like a Salad with Oyl Vinegar and a little Salt and forthwith eat thereof and it helps immediately as I know by much Experience But this must be used presently the sooner the better I can say with truth that in all my Practice of Physick for above 20 years I have not met with any Experiment of so quick an Operation from any herb as from this But here I must note that I have always used the Red Daisy and have not tryed the other sorts though I am apt to believe the others may have the like effect You must not eat the Flowers but only the Leaves This Experiment should be put up on all posts every where for the good of Courriers Mowers and other labouring Men that are wont to drink plentifully when they are hot and thereby spoil themselves in great numbers But to proceed as thou art to beware of excess of drinking at all times so thou art especially to forbear when thou art to stand Sentinel lest thou should fall a sleep whereby thou mayst lose thy life at least thy place and thy preferment for ever Neither be fond of Gaming at dice tables c. whence are occasioned quarrels mistrusts deceit swearing and what not Avoid also the company of base women lest thou shouldst be constrained to undergo the Mercurial Salivation and with it a very lean Diet of thin broth water-gruel barley-broth prunes roasted apples and such like without any flesh-meat at all CHAP. III. Concerning the Physicians and Chirurgeons in an Army EVery Army ought to be well provided with one or more able Physicians such as are not only expert in the cure of inward Diseases but also understanding in outward Cases as Wounds Burnings Luxations Dislocations Erysipelas's or St. Antony's Fires c. These Physicians ought to be no Youngsters that are lately come from Schools and Univerversities knowing only in Controversies and Disputations but such as are expert in the Cure of Diseases especially such as are most frequent in Armies They are also to be Men of good nature great honesty and condescension willing to take pains with the poor as well as the rich Physicians thus qualified may so gain the hearts of the Souldiers that these will love and honour them as if they were their Parents Likewise the Chirurgeons ought to be learn'd discreet and affable such as have been long vers'd and experienc'd in all the operations of Chirurgery that can distinguish well of Diseases and with prudence make their judgments thereon They ought also to be diligent and careful of those committed to their charge and very knowing in all manner of outward applications as Unguents Plaisters Pulments Lenitives Stiptiques Attractives Digestives Causticks Escharotiques as also their Mollifying Dissipating Repelling Suppurating and Mundifying c. Medicines They ought to be skilful in discerning them and withal in knowing well the cases and times where and when to use them They are to be very careful in observing the beginning middle and end of Ulcers Wounds c. since it often may be impertinent and even hurtful too to use that in the beginning that may be pertinent and beneficial in the midst of the cure and the like An able and dextrous Chirurgeon is a great Treasure in an Army and cannot be enough valued especially if he consult in all dangerous cases with an understanding Physitian These two Physitians and Chirurgeons are to be intimate friends together assisting one another without envy and pride for the better relief and the greater safety of their Patients 'T is very necessary both these should go abroad and travel before they undertake to practise thereby to acquire experience and to learn also to converse with the more discretion and gentleness with all sorts of humors And when they come to practise the Chirurgeons ought to advise with Physitians who are but lame Doctors if they be not skilled in Chirurgery since this is the third part of Physick from which it can and ought not to be separated being an integral part thereof It is recorded in history that above 2000 years since Podalyrius and Machaon Sons to Esculapius went both with Agamemnon in the Expedition for Troja and there purchased great honour by their practise not so much of Physick as Chirurgery CHAP. IV. Of Fevers Hungarian Distempers Spotted Fevers and other Pestilential Diseases
the Plague reign not open first a Vein For a violent Cough boil white Turnips well cleansed in common water throw away this first water pour on other water and in it let the Turnips boil till they grow soft Strain this water sweeten it with Sugar or infuse in it Liquorice cut small and drink of it mornings and evenings warm Or make a Decoction of St. Johns bread and drink it abstaining from all four and salt things The bleeding at the Nose is also incident to persons infected which is no good sign though in sound persons it often frees from the Head-ach and cools the Liver If this bleeding be too violent clap Ice-cold water about the Patients Neck or let him put his Pudenda in cold Vinegar CHAP. V. Of the Inflammation of the Tongue its rise and concomitants together with the Remedies WHen the Tongue is inflamed the whole Oesophagus or Weasand is inflamed also and this from beneath upward because the inward fire sends up its smoak all along as it were that chimney which like soot sticks to it drying and blackning the same But there is another Inflammation much more dangerous which taking its rise about the Heart and therefore is call'd the Inflammation of the Heart which proceeds from the great inflammation of the orifice of the Stomach situate near the heart in which is inserted the sixth pair of Nerves which maketh the said orifice very sensible of any pain This part being seized by so great an inflammation which is venomous withal it must in a manner harden and shrink and this heat is of that extent that the inner Membrane of the Stomach that of the Tongue being one and the same what befalls the Stomach the Tongue must needs be sensible of it Whence it comes to pass that if the Gall overflows and passeth into the Stomach the Tongue presently finds the bitterness of it or if the Stomach be full of slime or foul or the like the Tongue is soon affected therewith There is another kind of Inflammation by the Latins called Prunella alba This is of the same kind with the rest but not of the same degree for 't is not of so dry a nature as the others are but commonly is moist yet overlays all the Gums the Throat and the Weasand with such a tough white slime like a kind of Leather and so covers the Almonds with the same that sometimes it can hardly be removed even with Instruments The Tongue is as if it were crusted over with dough the Gums like an Oven that by the heat of fire is burnt white the Almonds cover'd as 't were with white leather and the Palate of the Mouth likewise And in this case if the Patient will speak he lalls and stutters his Tongue being burthen'd with a load of slime or if he make his Tongue wagg the slime spins out like a thred and so invades the Teeth as if they were laid over with varnish And when this varnish on the Teeth grows black as I have often observ'd it to do and drieth on them 't is a mortal sign of which Hyppocrates saith Quibus in febribus livores circumdentes nascuntur his fortes fiunt febres 4. Aph. 53. These are the three sorts of Inflammation for which let us now seek out the Remedies beginning from the last the White This is not to be master'd by gargarisins alone but the hand must be employed also Take therefore Cotton-wooll or Flax and wind it about a stick or rod and dip this in Vinegar and rake his Throat and Gums therewith yet taking care not to make it raw let him gargarise between and wash well his Mouth with Water and Vinegar or Mul-berry-juyce Privet that grows in the hedges or the middle rind of Haw-thorn boiled in Water and a little Vinegar then strained with a little Sal-armoniack put into it is in this case an excellent gargarism but if there be blisters upon the Tongue or elsewhere then take instead of Sal-armoniack a little unburnt Allom and mix it therewith If you can have the Juyce of Turnips or the Juyce of fresh House-leek dissolve therein also a little Sal-armoniack and use it to wet the stick wherewith thou cleansest the Throat of the Patient dipping it often therein and carrying it about the Vvula or Palate of the Mouth and you will see lumps come away as big as Pease The skin is under this Prunella alba fair and red but tender Whilst thou art cleansing the Patients Mouth let him often gargarise with the Waters above-specified and he will clear his Mouth of the loosen'd lumps If thou canst get Mul-berry-juyce mixt with Honey of Roses the Mouth will heal the better for upon this sort of Inflammation there usually follows a Putrefaction of the Mouth and in case thou perceivest any such thing take Wood-sorrel and the above said rind of Haw-thorn make a Decoction of it and put in it a little Allom and often gargarise with it Clean thy Teeth from the slime with Water well sharpned with Vitriol The common Inflammation of the Mouth may be cured with frequent washing of the Mouth taking a gargarism made of House-leek Lettice Night-shade or Self-heal Water mixing a little Honey of Roses and Mul-berry-juyce with it Of this gargarism the Patient is also to swallow a little thereby to moisten the Throat Some take House-leek and beat it and put to a pound of it half an ounce of Sal-armoniack mixing it well together And so they put it for some days in an earthen pot glased under ground then they distill of it a Water in Balneo or in Sand Which is excellent both to drink and to gargarise though the Sal-armoniack make it a little unpleasant But there is nothing better to allay this Inflammation than Niter which is so well known amongst Souldiers that they are wont to give one another Gunpowder to drink which Powder performs this effect not upon the account of the Coals or Brimstone but the Saltpeter For this cause Experienced Physitians and Chirurgeons endeavour to purifie Niter for this use that it may have the greater effect and this they do in manner following They take of the purest Niter they can get as much as they think fit they beat it to a fine powder and melt it in a large Crucible whilst it boils up and foameth they pour into it a little powdered Sulphur and so let it boil together till the blew Sulphur-flame ceaseth then they cast in more fresh Sulphur Which they repeat often and then pour out the Niter into an earthen vessel glased making Lozenges of it of which they put one pulverised into a quart of limpid water and so give the Patient to drink of it as much as he needs to quench his thirst Or they give of this purified Niter to their Patients labouring under this Inflammation the quantity of a ducat or half a ducat weight in Broath or in Ptisan till they find the Tongue cleared of its