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
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
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
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
'T is corrected by a large-mouth'd Cupping-glass outwardly applied upon the depressed Cartilage and being there fixt let it remain till breathing is hindred then suddenly remove and the Cartilage oftentimes at the first time returning again into its natural place which if it appears not to do the Chirurgeon must repeat this Operation once or twice then having embrocated the Part with Oyl of Roses and Myrtles apply this Plaister to the Part which must remain there several days Take Bistort-Roots Cypress-Nuts of each a dram Mastick Frankincense of each half a dram Balaustians a scruple Oyl of Nutmegs Exprest one dram and an half Naval-Pitch and Turpentine of each enough to make it into a Plaister CHAP. V. Of Ligaments A Ligament is a Similar Spermatick dry part adhering firmly to the Bones tying the parts of the Body mutually together Difference Some are Broad and Membranous some Round and Nervous 'T is here to be observed that the Names Membranous and Nervous are much used both by Writers and Practitioners and hath deceived many of them for 't is requisite to know that here it hath regard only to their external form not their internal essence for the Ligaments both the Membranous and the Nervous are void of Sense which they would not be if they were composed of their true substance of Nerve or Membrane There is no Ligament hollow if you except the slender Ligaments of the Womb and are all destitute likewise of Sense of Motion as from themselves Use is to connect the parts of the Body especially the Bones and preserveth them from continual Luxation Chirurgical Considerations 1. Ligaments hurt by reason of their want of sense seldom draw other parts into consent and by the use of drying Medicines are easily cured I cannot but again in this place taught by Experience commend the Restaurative Powder of which this is the Description Take Roots of Comfrey the greater Aloes Succotrine Calcis vivae of each two ounces Mastick Mirrhe Mummy of each two drams Precipitate two ounces Make it into a Powder Here diligently at the first time is the weak heat of the Ligaments to be considered seeing it may give occasion to a copious collection of Humors and other grievous Symptoms 2. The Ligaments also are not seldom Relaxt Yea although the Ignorant do contradict sometimes they are so much extended that they may give way to a Luxation which the Sciatick pain hath more than once given us example of in such a case external Bleeding and Purging profit much outwardly the Application of corroborating and discussing Topicks The following Plaister is excellent Take Stiptick Plaister of Crollius an ounce Oyl of Earth of Tiles of each a dram Make it into a Plaister to be spread upon Leather CHAP. VI. Of Membranes A Membrane is a Similar Spermatick Part broad soft dilatable white investing the Parts and carrying sense to them Difference Some are very thin others thick some fleshy but for the most part not The Parts which invest are properly call'd Membranes those which contain the Humors Tunicles and those which cover the Brain Meninges It is endued with sense from itself for all Membranes are sensible yea the Nerves themselves owe their sense to the Membranous substance of them Membranes therefore only are the true Organs of feeling they serving the Animal Spirits to this purpose Use is 1. To invest the Parts of the Body 2. To defend it from Injuries 3. To keep them united 4. To strengthen them 5. To give them sense 6. To close the Mouth of the Vessels that the Nutritious Blood be not carried too suddenly into the Part or out of it into the Vein it self 7. To separate the Parts Chirurgical Considerations The Membranes being so very sensible they cannot bear sharp Medicines they are not endowed with great quantity of Blood whence when they suffer a solution of continuity they are not easily united again But I have observed oft entimes that by the Muscles and the assistance of the Quittour they are joyned together as in the Bladder it self whose Wounds and Ulcers otherwise are esteemed incurable CHAP. VII Of Fibres A Fibre is a Similar Spermatick Part dispersed through the Skin Flesh and Membranes to make them the stronger and being naturally distended to contract again into the same manner Differences are right oblique and transverse and some round the right attract the oblique thrust forth transverse retain round constrain but this they do not so by their own singular virtue as by the common virtue of the Member which they serve and from whom they have their sense and nourishment for of themselves they are senseless Use is to strengthen the Membranes Skin and Muscles and when dilated to reduce them into their natural state Whether the Blood it self hath Fibres as many have delivered and as it seems very probable to us shall be explained in another place Chirurgical Consideration These offer nothing worthy consideration except that when they are wounded the consolidation of the Flesh and Skin is the longer and there is a greater stiffness of the Muscles about the place and makes them difficulter to contract and extend The Ductus of the Fibres is diligently to be observed by them which are to make any curious Incision CHAP. VIII Of Veins A Vein is a Similar Spermatick Membranous long hollow Part every where joined by Anastomoses to the Arteries receiving the Blood wanting further Concoction from them and carrying it to the Heart and Liver Difference Veins of a four-fold condition are found in the Body 1. Vena Cava 2. Vena Porta 3. Vena Pulmonalis 4. Vena Lacteae Of the last of which a more convenient occasion will be offered to treat of in the following The Venae Cava and Porta take their beginning from the Liver There are those which would have them come from the heart from a weak Argument taken from unborn Embrio's But where I find many Branches inserted in the Liver few or none in the Heart yea I have observed that it hath not entred into the Heart it self but only to be joined to its right Auricle I rather embrace the old Opinion willingly granting those honours to the Liver that I think belongs to it That the Roots of the Vena Cava and Porta were united by mutual Inosculations the old Anatomists perswaded themselves but the curious Inquisition of the Moderns hath both found out and clearly demonstrated that they mutually touch one another but not so united that the Blood can pass out of one into the other for the extremities of the foresaid Vessels by means of the Parenchyma of the Liver do so mutually consent that Milk or any liquid thing cast into the Vena Porta with a Syringe finds an easie passage into the Vena Cava without either an injury of the Veins or the Parenchyma Concerning which read Glisson Anatom of the Liver pag. 272. Veins have only one Tunicle with many Valves within especially in the external Joints They are nourished
it remains for some time in the same condition 3. When it relaxeth so that it is restored into its former seat and quiet by its Antagonist The Glandulous flesh is white thick and spungy formed of seed from whence it cannot properly be call'd flesh to this purpose ordained 1. To prop up the Vessels 2. To receive the superfluous Humidities whence they are called the Emuâ—ctories of the noble Parts Some Anatomists make strange diversities of them but it will appear to any one that diligently enquires into all the Glandules that they differ not so much in substance as in their Use and Humor The Viscerous flesh or the Parenchemick is red hard convenient to prop the Vessels and to serve for many particular and various operations this is the flesh of the Lungs Heart Liver Spleen which shall be treated of in their places Chirurgical Considerations The Muscles are subject to many Diseases very many of which are of so little consequence that they shall not be numbred here some we have declared in another place the following require consideration oftentimes wonderfully exercising the patience and diligence of the Chirurgeon 1. An Atrophy of the whole Body oftentimes comes from an Internal Cause But if of the Finger Hand Arm Foot for the most part from an External Cause Thus a Fracture Luxation Contusion Tumor too hard Ligature and the like so vehemently compressing the Veins and Arteries that it hinders the free passage of the Blood to the Parts upon which happens an Emacitation for where the Vessels are wholly divided or stopt so that the least quantity of Blood cannot be carried to the Parts there follows not a Wasting of the Part but a Mortification in this Case the External Causes must be removed And care is to be taken that the Blood may again be carried to the Part Here chafing the Part and the use of Nettles as many will is good the Chymists commend much Alumen Plumosum all hot Oyls likewise are here good and this Oyntment is of excellent vertue Take fresh tops of Savin Juniper Lovage of each two handfuls Camomile Flowers Juniper-berries of each two handfuls Oyl of Bayes White-Lillies of each twelve ounces Hogs-grease three ounces Dogs-grease an ounce and half Aqua vitae two ounces Boil them to the consumption of the moisture then add to the express'd Liquor Oyl of Spike three drams Juniper a dram Mustard-seed in Powder half a an ounce Roots of Pellitory of Spain Long-Pepper powdred of each two draws Yellow wax as much as is sufficient to make it into an Ointment Or Take Pulvis Amianti three drams Roots of Pellitory of Spain a dram and half Castor Euphorbium Oyl of Earth of each two drams Gum Ammoniacum an ounce and half Laudanum and Wax as much as sufficeth to make it into a Plaister 2. The true reason of the generation of Wens in my opinion is this the mouths of the Arteries appointed to carry nourishment to the Muscles sometimes are more opened than they ought to be whether it be by Fall or Blow or from an internal Cause especially in Plethorick People and in Parts disorderly moved the native heat converts the extravasated Blood into Flesh But seeing the Member requires not so great a quantity of nourishment it increaseth into a preternatural Swelling and if this Blood be impure Choler produceth Pain Phlegm Viscousness Melancholy a Cartilaginous hardness and 't is to be attributed to these Humors that this preternatural flesh is more yellow white or livid 'T is seldom included in a proper Tunicle except where Phlegm is its greatest Cause and then those Tumors are generally in the Neck The Veins grow big according to the increase of the Tumor so that under the Skin they appear as thick as ones Thumb 'T is not in it self malignant yet by ill applications may be easily made so Air is very hurtful if the Tumor be exposed to it For the most part the best Remedies are here used to little purpose on the contrary the Tumor more and more increasing You cannot promise any Cure except you take it away by a Thred Knife or both In the beginning the Medicines that are to be applied ought to be very astringent and repelling the Part is gently to be rouled having applied to it either a Plate of Lead or a Diachalcitheos Plaister or of Frogs with Mercury or the following Take Pomegranate-rinds Bistort-roots of each one dram Scales of Iron Quick-silver Burnt-Lead of each two drams Bole-armenick Lapis Haematitis of each a dram and half Turpentine Wax as much as is sufficient to make it into a Plaister according to Art In the mean time Purging Bleeding Scarification and the Application of Leeches are not to be neglected Sweating also Watchings and Abstinence profit very much But if the Tumor yields not to these Remedies but daily increaseth Suppuratives are to be applied but if these within few days effect nothing and the Tumor continuing in the same state an actual Cautery may be used which let not the contrary Opinions either of Chirurgeons or standers-by hinder for by its use the increase of the Tumor will be stayed for a long time yea sometimes the Disease will be wholly eradicated But if the Flesh begins to repullulate again beyond expectation the Surgeon ought not to defer to endeavour either by a Thred or Knife its extirpation the Thred being small and strong must be twice wound about the neck of the Tumor and tied with a double knot which must be straightned the same day and so every day until the Tumor be deprived of its colour sense and life which is within seven or eight days then 't is to be taken off with a crooked Knife which is very easie to perform seeing neither any great pain or flux of Blood is to be feared If the Thred be wet in Mercurial or Arsenick-water it hastens the mortification of this Tumor But in this Operation a Phlegmatick Body is required for in other Bodies pain and inflamation do so much afflict the Patient that 't is seldom that the Thred in a short time should take them off yet the Chirurgeon may to lessen the Symptoms and to cool anoint with a Feather the part which the Thred toucheth with white camphorated Ointment of Roses or the like continually putting the Patients in mind how that others bear it more quietly But if you design to use a Knife only the whole Tumor must be endeavoured to be taken away except you will consume the remaining by Medicines which is very rarely effected besides the Chirurgeon must have a Care that he divides not the greater Vessels lest there follows a Flux of Blood not to be stopped 3. The Viscerous Flesh belongs rather to the Physicians care than the Chirurgeons 4. Of the Glandulous Flesh we have treated particularly in several places In general 't is to be noted 1. That the Glandules are of a cold temperament therefore require hot Medicines but very ill suffers cold 2.
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
the Body from the Collar-Bones to the Feet which arise not only out of the Brain from the Parvagum but also from the Spinal Marrow and from the fifth and sixth Vertebra of the Neck Of the other Vessels we have already treated Chirurgical Considerations The Pleura is not only subject to Inflammation upon which follows a Pleurisie an Empiema and Impostumation but also a certain pain which a salt Humor produceth This may be distinguished from a Pleurisie because here is a dry Cough yet no Fever also free breathing enough I have used to remove this by Bleeding and Sweating and if you fear a Pleurisie apply outwardly this Plaister Take Marrow out of an Oxes-bone Ducks-grease of each three ounces the Mussilage of Marshmallows Linseed Fenugreek-seed of an ounce Frankincense Mastick of each half an ounce Oyl of Nucista exprest two drams yellow Wax as much as sufficeth to make it into a Plaister 2. Mediastinum hath not so great a Cavity in Man as in Dogs and other creatures yet it happens sometimes that a purulent matter descends between the two Membranes of it which can by means be evacuated by the Lungs therefore we are forced to perforate the Sternum with a Trepan that so through the made Orifice by the use of Tents Spunges and other Instruments the Matter may be discharged 3. In that kind of Quinsey which we above call Cynanche where the Patient is almost suffocated we remedy by Laringotomia or opening the Wind-pipe the Disease it self is far more dangerous than this Operation therefore it would be well if it was oftener practised nevertheless there is required a diligent consideration that the other parts to wit the Lungs Pleura Gullet c. be not also enflamed or already full of matter which may frustrate your labour afford cause of scandal but every thing being well weighed the Operation is to be performed in this manner Let the Head be a little bent backwards that the Wind-pipe may the more plainly appear and the annulary Cartilages recede the further the one from the other then divide the Skin according to the length of the Larinx unto the hollow and let a stander-by with his Fingers pluck open the Skin of each side that the Chirurgeon may see the two long Muscles Sterno hyoidei which he must remove a little asunder either with a Knife of Wood or Bone then the Larinx appearing he must make his Incision with a Launcet in the middle between the third and fourth annulary Cartilage taking great care that he hurt not the Cartilages themselves upon the Breaths coming forth take out the Knife and put a Silver Pipe into the Wound which must not be so long as to reach the hinder part of the Wind-pipe lest it cause a continual Cough the danger of suffocation being over which for the most part happens to be about the third or fourth day or at least ought then to be the Pipe must be taken forth and the Wound is to be cured in the ordinary manner according to Art from which it differs not 4. 'T is no new thing for Worms to generate in the Pericardium which except kill'd corrode the very Heart it self They may be destroyed with a Decoction of Scordium Wormwood Centaury c. drunk twice or thrice a day Concerning the Wounds of the Lungs Heart and Diaphragm see our Chirurgery A Wound of the Gullet is cured after the same manner as that of the Stomach The End of the third Book of the third Part. The FOURTH BOOK Of the Lower Belly CHAP. I. Of the External Parts of this Belly THE lower Cavity properly call'd the Belly is divided into three parts of which 1. Is the Epigastrium each side of which is call'd Hypochondria 2. The Region of the Navel whose sides are call'd Ilium 3. Hypogastrium the sides of which are the Groins The lower hairy part is call'd Pubes The Abdomen under common Teguments hath ten Muscles of each side five very necessary for the exclusion of the grosser Excrements contained in the Guts they are these 1. Obliquely descending which in the upper part the Navel in the lower in Man the process of the Peritonaeum In Woman the long Ligaments of the Womb perforates 2. The Oblique ascending 3. The Recti or straight 4. The Pyramidal 5. The Trarsverse In the middle of the Abdomen between the two straight Muscles ariseth the Linea Alba or White-Line from the meeting of the broad Tendons of the other thin Muscles which is very sensible Of the Veins Arteries Nerves both of the outward and inward parts of the lower Belly we have already treated of in the first Book as likewise something of the Bones But the more curious Examiner meets withal first five Vertebra's of the Loins which are very full of holes and greater and thicker than all the rest Next to them follows the Os Sacrum which is triangular in old people being only of one Bone but in young consisting of five or six To this is joyned the Os Coccygis bent in Women more outward in Men more inward On the sides of the Os Sacrum is the Os Innominatum or Coxae consisting of three Bones joyned together with a Cartilage Of these 1. Is the Os Ilium much thicker in Women than in Men. 2. Os Pudis more easily separable in the fore-part in Women than in Men. 3. Os Ischion or Coxae furnished with a large Cavity which is call'd Acetabulum or Pixis appointed to receive the head of the Thigh-Bone Chirurgical Consideration The outward Division of the Lower Belly plainly declares what Internal Parts may be affected In the right Hypochondrium the Liver is situated extending it self beyond the Bastard-Ribs two fingers breadth to the Sword-like Cartilage of the Sternum In the middle lies the Stomach extending it self to the softer parts of this Belly so that it reacheth four fingers breadth beyond the Bastard-Ribs Beyond the soft places near the Kidneys lies the Spleen In the middle of the Vmbilical Region and about it lies the Small Gut which being wounded is most dangerous In the right side about the Kidney the Gut Colon takes its rise transversly running between the Stomach and Navel to the left Kidney where winding downwards and becoming narrower is the frequent receptacle of Wind and whence long pain and great tension which is undeservedly attributed to the Spleen on the other side the Intestine rests upon the Mesentery as doth the Stomach upon the Pancreas In the middle of the Hypogastrium are the Bladder and Womb placed and under them the Intestinum rectum On the Side lie the Spermatick Vessels and the Glandules in which both benign and malignant Buboes are produced But all these Parts cannot be wounded except the Peritonaeum and Omentum be first perforated yet in many men the Omentum descends not below the Navel and contrariwise in others it reacheth to the Os Pubis it self CHAP. II. Of the Internal Parts of the Abdomen THe first of
on Horse-tail in Latin Equisetum heals the wounds in the urinary parts the powder of it being taken in broath or Speedwel-water or the Decoction thereof being drank Gummi Ammoniac is a good discutient of hard Tumors and Knobs Tacamahaca appeaseth pain proceeding from cold being laid on the part affected To make the pellets used to be put in wounds that are to be kept open which here in Germany we call Quellmaissel take a Spunge of the finest sort put it in Whites of Eggs well beaten and mixed with Rose-water to make the said Spunge imbibe this moisture Which done bind it close together with thred and let it well dry in the Air and so convey of it into the wound that is to be kept open where it will swell again and so distend the wound If you be troubled with the Gonorrhaea take House-leek growing on old walls call'd by the Latins Semper viâ—…ninus put it into your shoes and go bare-foot upon it anoint your loyns and privy parts with Henbane-oyl and take mornings the quantity of two big hasel-nuts of well washed Turpentine for some days together avoiding all aromatic hard and salt meat An old Experimenter hath noted That whosoever shall wash his head twice a week with a Lixivium made of Juniper-ashes his sight shall never fail him but remain good to his end nor shall that person be troubled with any vermin upon his head nor with any head-ach nor suffer any change of his hair For my part I never tryed it but it being a very plain and safe thing I thought good here to insert it Against the biting of a Mad-dog lay Assa foetida with Garlick upon the bite it will draw out the venom To free your self from the Gravel make a Decoction of Ash-wood in wine and drink of it warm once or twice a day upon an empty stomach using withal good baths Vervin also the leaves and roots beaten together and drank is very good in this case If you have a strong breath proceeding from a foul stomach infuse Wormwood and Carduus benedictus together with some Citron-peels in in wine and let them boil a little therein and then drink a good draught of it mornings Chew also and swallow sometimes a little Myrrh and take now and then three or four Aloes-pills I could add many other things if my leisure would permit These which I have set down you will take in good part and though I have not tryed them all my self yet you may rest assured that such as have not been experimented by my self have been tryed by my honoured Collegues and other honest persons and approv'd FINIS INDEX A AIR what to be observed of it in the Camp 28. Preservatives against the corruption of the Air. 36 c. Animals their blood of what efficacy 51 Antonies fire how to be allayed 112 B BElly the cure of the Aches and Tumors and Gripings thereof 64 65 Beer new Beer causes the Strangury 30 Blood how to cure casting up of Blood 57. And the bleeding of the Nose Ibid. Blood coagulated how to be helped 107 115 Boyls Pestilential and their cure 81 seq Brick well burnt good against a Tenasmus 78 Brimstone a good Medicine in infectious cases 48 Bread Wheaten-bread coming hot out of the Oven and dipt in red Wine very good against Fluxes 70. The same duely prepared good in pestilential Sores 82 Bones broken how to be order'd 10â— Bran good for wrenching of Limbs ib. Burning how to healed 110 C CArbuncles pestilential and their cure 81 Carlina good against faintness 26 Chirurgeons of an Army and their qualities 32 Cold Nights how to provide against 28 Corns of the Feet how to be cured 25 Cough and its cure 57 Crafishes burnt alive good against the Bloody-flux 74 Crafishes after a certain way prepared of great use for drawing out of the body Thorns Small-shot c. 108. The same fried in fresh Butter allays burning 112 Crocus Martis a high Remedy against the Bloody-flux 74 Clysters and their use in the field 75 Chearfulness good in Pestilential times 42 D DAisie and its excellency 31 Diseases in an Army and their cure 34 Diet to be well observed in the Camp 35 Drinks how to provide in the field 27. The excess of it to be avoided 30. The danger of drinking whilst one is hot and the care to be taken in that case 30 31. Drinks in cold weather 39 Drawing out of Thorns Splinters c. how to be effected 115 Dropsie and its cure 69 Drought how to be remedied 77 E EGg-oyl good for Burnings 112 Elder-flowers good in the plague 38 39 Elder-vinegar good to apply to the Heart in the plague 53 Elder-roots the Juyce of them purgeth hydropical persons exceedingly 69. But to be used with great caution ibid. Boiled Elder-buds have the like vertue ibid. Emollients in pestilential Boils 82 Excrement of a Gander is powerful in drawing Iron out of the body 109 F FAintness how to prevent .26 27 Feet sweaty how to remedy 26. Feet frozen how to recover 113 Fevers of all sorts how to be managed and cured in an Army 34 64 Fluxes their several sorts and cures 70. Of the Bloody-flux in particular and its cure 72 Frankincense dryes and clears the Air. 37 Fundament the cure of its falling down 78 G GAngrene how to cure 113 115 Galling how to cure 26 Garlick useful in Fluxes by way of decoction 79 Goat good for men to rub at them when the Air is corrupted 67 36 Groin swelled how to cure 70 Guts the Griping of them how to be cured 69 Granat-wine cures the Bloody flux 75 Gun-powder purifies the Air. 37 Gum Elemi of considerable use in wounds 105 Gonorrhoea how to be order'd 118 Gravel how to be removed 119 H HAwes oure Fluxes 71 Harts-horn good against Fluxes 70 Hearing how to be recovered 65 Heart the cure of this Inflammation 62 haemorrhoid-Haemorrhoid-vein the use of its bleeding 80 Horses how to be made vigorous 27. Ointment for Horses 28 Hunger and Thirst to be prevented by certain herbs 26 I IAundise the cause and cure of it 66 Imperatoria good against faintness 26 Infection its preservatives and cures both for the Poor and Rich. 35.46 The Hungarian Infection and its cure 46. â—â—â— Inflammation its several sorts and cures 58 64 Juniper-wood burnt good in times of the plague 37 Itch how to be cured 11â— L LArd when fresh very good against the Inflammation of the Mouth 62 Lard good against Burnings 112 Lead a considerable cooler 62 Leggs the cure of their swelling 70 Liver the cure of the Obstructions thereof 66 Lillies the Juyce of the Roots of blew Lillies have great virtue of purging hydropical persons but to be used with great discretion 69 Lapis sabulosus good to heal broken Bones 106 Luxations how to be order'd ib. M MArisca's and the cure of them 79 Mastick drys and clears the Air. 38 Mesaraick-veins and the effects of their being obstructed 66 Milk duly prepared good against the Bloody-flux 72 Moss of wild Rose-shrubs an approved Remedy in Bloody-fluxes 73 Mouth how to remedy the falling down of the Palate of the Mouth 56 N NIter excellent to allay Inflammations 61. The way how to prepare it for that use 62 Nose how to remedy the bleeding of it 57 O OBstructions of the Liver and the cure 66 Oyl of Scorpions very good to anonit the Heart with in the Plague 53. A good Succedaneum to it described 54 Oyl of Vitriol good in Fevers 55 Oaken-leaves do cure common Fluxes 70 P PEstilential Diseases and cure 38. seq 81. seq Physicians of an Army and their qualities 32 Pear-trees the Rinds of them cure common Fluxes 71 Preservatives fit for Souldiers 25 26 c. Purgatives fit for Souldiers 25 Putrefaction the cause of grievous Diseases 47 64. Putrefaction of the Mouth how to be cured 115 Q QUinces-wine good against the Bloody-flux 75. The same extinguishes marvellously the burning of any shot 111 R RIngworm how to be cured 116 Rust of Arms how to prevent 26 Rye-biscuit duly prepar'd good against the Bloody-flux 73 S SCarification and its use 82 Souldiers Morals 23 Souldiers care of his Body 24 Souldiers Diseases in the field through the whole Book Sores pestilential and their cure 81. seq Spotted Fevers and their cures 34. seq Squinancy and its cure 57 Strangury and its cure 11 Sufeits and their cures 34 Swellings of the Throat and Almonds how to be cured 56.64 Swelling of the Leggs how to cure 70 Sweat and the ways of procuring it 44. seq See also 51. seq Swallows burnt to powder good to those that have been shot 109 Synovia how to be order'd 110 T TEnasmus and its cure 77 Tench fried good for Burnings 110 Thirst how to quench in case of want of drink 26. Thirst how to quench in Fluxes 77 Throat swoln how to cure 56 Tooth-ach its cure 114 Tongue the cure of the Inflammations of it 58 Turnips after a certain way prepared or rotten cure frozen feet 113 V VErmin how to remove 25 Vein the use of the bleeding of the Hemorrhoid-vein 80 Vesicatories and their use 82 Ulcers and their cure 81 Vinegar good to wash the Temples with in times of the Plague 38 Venae-section not easily to be admitted in pestilential Diseases 43 55 Vulnerary Herbs for several sorts of Wounds 107 W WAter its differences and choice 29 Wheel-grease a good Ointment for Horses 28 Wind in the Guts requires keeping the Body soluble 67 Worms Earth-worms good against the Dropsie together with the way of preparing them 70 Wounds their Inflammation how to be prevented 104. Their swelling how to be helped ib. Wound-drinks of several sorts 107 Wounds mortal how to order 117 Worms in fingers how to be cured 115 Wounds how to be cured see chap. 10. FINIS