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A59191 The Art of chirurgery explained in six parts part I. Of tumors, in forty six chapters, part II. Of ulcers, in nineteen chapters, part III. Of the skin, hair and nails, in two sections and nineteen chapters, part IV. Of wounds, in twenty four chapters, part V, Of fractures, in twenty two chapters, Part VI. Of luxations, in thirteen chapters : being the whole Fifth book of practical physick / by Daniel Sennertus ... R.W., Nicholas Culpepper ... Abdiah Cole ... Sennert, Daniel, 1572-1637. 1663 (1663) Wing S2531; ESTC R31190 817,116 474

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or no being Cured and his Wound healed he be likely to undergoe and suffer the hurt Action of some one or other of his Members For so oftentimes it happeneth that some Tendon being cut asunder the motion of some part is wholly lost and that the Brain being wounded the Memory or Rational faculty is thereby hurt and Moreover whether the wound be likely to be Cured in a short or whether it wil take up a longer time But on the other side if the wound be altogether incurable whether it be Mortal and such as is likely to hasten Death or else whether it be not more probable that it will degenerate into some long continuing Ulcer And Lastly it must be foretold likewise whether the Changes and Alterations of the Wound will be for the better or for the worse and when these Changes wil be Now in the first place it must be diligently explained What Wounds are Deadly and what Wounds are not so For indeed this Question is of very great Moment and therefore most diligently and exactly to be weighed and known by the Physitian For whereas oftentimes the lives of some men are much hazarded and endangered when they are brought before the Magistrates in the publike Courts of Justice by Reason of Wounds they gave unto others and that oftentimes the Judges desire the Physitians Opinion touching the same great Care and a diligent Endeavour ought to be used that the Physitian give so true a Relation and so distinctly deliver his Opinion touching the quality of the said Wounds that the innocent may not be condemned nor the Guilty acquited But in the first place we are to know that not every Wound which hath Death following it is to be called a Mortal wound but that alone which in its own Nature bringeth Death Now such like wounds are twofold For Mortal or Deadly as Galen in the 5. B. of the Aphor. Aphor. 2. and Aph. 18. teacheth us is somtimes taken and understood of those wounds that are of necessity deadly and somtimes again of such Wounds as are so for the most part as Hippocrates speaketh and such as by Reason of which as the same Hippocrat maketh the limitation in the 18. Aphorism 6. Sect in Coacis or his tract of Playsters those that are wounded almost or for the most part die like as Galen in his 5. B. Aphor. 2. writeth that Deadly is to be taken for that that is dangerous and is oftentimes terminated in Death But the Question is here especially of the former kind for that wound that hath been at any time Cured in others cannot be taken for a wound simply Mortal and Deadly But we shall afterward tel you when it is to be taken and accounted for Mortal or not Mortal And therefore Secondly Wounds cannot be accounted simply Mortal whereupon the supervening of most grievous Symptoms which said Symptoms notwithstanding do not alwaies and necessarily follow upon the reception of these like wounds the wounded person dieth as when in the Wounds of the Joynts and the Nervous parts an inflammation Deliry and other Symptoms happen or that by Reason of a Cacochymy lying secretly in the Body a feaver is kindled upon occasion of the Wound And it is altogether most true that many things often fal out that render Wounds incurable which in their own nature were curable Like as neither are those to be accounted for Wounds simply Mortal the Curing of which is long protracted by Reason of which it at length happeneth that the Wounded person perisheth by a slow and lingring Death the same that happeneth when the Lungs being Wounded an Ulcer and the Consumption follow thereupon or the Thorax or Stomack being wounded which oftentimes after a long space of time become the Causes of Death unto the wounded person For whenas it hath been observed and known that these like Wounds have been healed in others they cannot then be accounted for Wounds simply Mortal But those Wounds are only to be reputed simply Mortal which in the space of a few hours or daies do necessarily bring Death unto the sick person and cannot be cured by any Art And therefore we are to distinguish between Wounds Mortal and Wounds incurable For all Mortal Wounds are incurable but all Wounds that are incurable cannot be said to be Mortal For Wounds incurable as we have told you are al those that though they cannot indeed be cured yet notwithstanding they are not suddenly the Cause of Death unto the wounded person since that although they cannot be healed yet nevertheless the sick person may after this live not only many Weeks but even yeers also And such a like Wound was that which Mathias Cornax in his Epistle Responsory unto Dr. Aegidius Hertogh and Julius Alexandrinus in his Annotations upon the sixth Book of Galen his Meth. of Physick Chap. 4. have described unto us For when as a certain Bohemian Boor as he was hunting received a Wound in his Stomack with a broad hunting spear it could not possibly be consolidated but yet in tract of time the lips of the wound became hardn'd by a certain Callousness growing over them so that the wounded person survived for many yeers after and by applying of an instrument he could at his pleasure evacuate his stomack And now in the next place let us see what Wounds they are that we may account to be simply Mortal or Deadly And now whereas Death happeneth upon the defect extinction of the Native heat and that the Native heat may in a twofold manner be extinguished either sensibly and by degrees as it is in a Natural Death and long continued Diseases as the Consumption and the like or else suddenly and violently the latter way it is that Wounds are said simply and necessarily to bring Death unto the wounded person to wit a violent one Now the innate heat is extinguished either because the vital spirits are dissipated or because they are suffocated And therefore all Wounds that are Mortal and of necessity cause a sudden and violent Death either they suddenly suffocate the vital spirits or else they dissipate and corrupt them But in regard that the Heart is the Store-house of the vital spirits and the Native heat first of all therefore the Wounds of the Heart of all others do especially and most speedily bring upon the Wounded Person a violent Death And the very truth is as Galen writeth in his 5. B. of the places affected and 3. Chapter if the Wound penetrateth unto the ventricle of the Heart especially the left the wounded person of necessity dieth suddenly but if the Wound penetrate not so far as unto the ventricle of the Heart but that it consist in the substance thereof the man may then indeed live for a while but yet nevertheless he must necessarily die this violent Death Secondly It is of necessity that the man die if some Vessel be wounded in that part of the Lungs that are next unto the Heart and
that out of it store of Blood be poured forth unto the Heart overwhelming it and suffocating the heat thereof Thirdly Al the internal wounds of the greater Vessels that cannot by any art be closed upon regard they cause the Blood being plentifully poured forth either out of the Veins or the Arteries that the spirits be suddenly dissipated therefore of necessity they speedily suffocate the wounded person Fourthly All those Wounds are said to be Mortal that suddenly take away the Respiration and hinder the ventilation of the Heart so that the Native heat of the Heart is suffocated and so cause that the Man die even almost in the very same manner as Apoplectical persons are wont to die And such like wounds are especially the Wounds of the Brain but yet not all of them since that there are many Wounds of the Brain that are not Mortal as afterwards we shall shew you and as we have already told you in the first B. of our Practice first part and 23. Chapter But those great Wounds and such as are the Cause that the Animal spirits be suddenly dissipated or that the blood being poured forth of the Vessels the Orifice of the Nerves be quite stopped and so by this means the influx of the Animal Spirits be hindered or that from the same an inflammation of the Brain or a feaver be excited And this is not only done by the Wounds of the very Brain it self but likewise by the strokes and vehement Confusions of the Head by which the Vessels of the Brain and those neer about it are broken and the Blood poured forth of them unto the beginning of the Nerves and there subsisting hinder the influx of the Animal Spirits And this may also happen if the Sinus or hollow places of the Brain chance to be hurt so that out of them blood be poured forth unto the Basis of the Brain and so it is likewise in the Wounds of the Eyes if they penetrate so deep that they open either the Vessels of the Brain or those that are in the Basis thereof or those that are neer about the said Basis of the Brain and so that the Blood poured forth unto the Basis of the Brain hinder the influx of the Animal spirits by compressing the beginning of the Neryes For although that the Blood if it be poured forth above upon the Brain may possibly be emptied forth by perforating and opening of the Cranium or Skul yet nevertheless if it be poured forth unto the Basis of the Brain it is impossible that it should ever be evacuated There seemeth yet nevertheless to be another way whereby the Blood poured forth into the Brain or about the Brain bringeth Death within a v●ry few daies if it cannot be evacuated For when as it is without the Vessels it beginneth to putrefie usually about the fifth day from whence feavers deliries and Convulsions are excited so that the man dieth in the same manner almost as one in a Phrensie That which is done by the Wounds of the brain the very same happeneth likewise from the spinal Marrow if it be indeed wholly cut assunder in the superior part thereof for then the motion of all the inferior parts and so of the Thorax likewise is abolished and the wounded persons are suffocated And unto one of these four waies I conceive that al kinds of Mortal Wounds may be referred And therefore if a Wound penetrate into any interior part of the Body so that thereupon the wounded person die within a short space of time we are then to Judg that that Wound was Mortal and if diligent inquiry be made I am of Opinion that it may be referred unto some one kind or other of these Mortal Wounds whether that Wound hurt the vital faculty it self immediatly or else hurt it by the intervening of some other Disease or Symptom For as Nicolaus Boetius writeth out of Felinus in his 323. Decision Numb 10. it is all one whether a Wounded man die of his Wound or of some infirmity caused by the same Which yet nevertheless is so to be understood if the Wound necessarily attract that Disease or that Symptom which is the Cause of Death But as for all the other Wounds whatsoever that cannot be referred unto some one of these manners I conceive that they cannot simply nor necessarily be accounted Mortal The which that it may be made the more plainly to appear we have it now in our purpose in special to weigh and discover unto you the Wounds of all parts that are to be accounted Mortal Now Hippocrates Judgeth the wounds of seven parts to be Mortal What Wounds accounted Mortal by Hippocrates whilest in his sixth Sect. Aphor. 18. he thus writeth Whosoever hath his Bladder out through or his Brain or his Heart or his Midriff or any of his smal Guts or his Stomack or his Liver that Wound is Mortal Which Aphorism notwithstanding in his Coaca or his Tract of Playsters Aphor. 509. he both Limiteth and Amplifieth when he thus saith From a Wound even Death it self may almost happen if any one be wounded in his Brain or in his spinal Marow or in his Liver or in his Midriff or in his Heart or in his Bladder or in any one of the greater Veins Death likewise soon followeth if any extraordinary great Blows be inflicted upon an Artery and upon the Lungs so that the Lungs being wounded the Breath that passeth out at the Mouth is less then that which issueth forth at the Wound But they suddenly perish whosoever they are that have received a Wound in the interior Nerves whether smal or g eat if the Blow or Wound be both Transverse and great but if the Wound be but smal and straight there are some that escape the danger But there is neither Death nor any great dang●r impending from those Wounds that are inflicted on those parts of the Body in the which there are none of these or which are as far distant at may be from these Indeed he limits the Aphorism whilest that he doth not simply write that such like wounds are altogether Mortal but almost and for the most part He amplifyeth it whilest that he addeth the spinal Marrow the greater and thicker Veins the rough Artery and the Lungs and the interior Nerves And therfore we wil in order consider the wounds of these parts For it is without doubt that the Wounds of the rest of the Parts are not at all of the●selves Mor●al and this Hippocrates himself teacheth us in the above mentioned Aphorism 509. in Coacis Celsus in his 5. B. and 26. Chap. thus rendereth the foresaid Opinion of Hippocrates He cannot possibly be preserved that hath the Basis of his Brain his Heart his Stomack the parts of his Liver the Marrow in his Back-bone wounded or that person that hath either the middle of his Lungs or the Jejunum i. e. the hungry Gout or any of the smaller Guts or the Stomack or the Reins be
of the wounded part be by all manner of means preserved 6. That all the symptoms and whatsoever may possibly hinder the uniting and Coalition of the part may be taken away and removed And thus although that a wound only considered as a wound is one simple Affect and seemeth to indicate and require one only uniting yet nevertheless the very truth is that there are herein couched very many indications as before we told you Chap. 5. Of things extraneous and from without that are to be taken forth of the VVound IN the first place therefore we must use our endeavour that there may be nothing extraneous in the wound that may hinder the union and glutination thereof And therefore first of all the blood is not instantly to be suppressed and we must permit whatsoever we find sticking in the lesser veines cut assunder freely to flow forth For so by this means there will both a less quantity of Pus be generated and all the danger of putrefaction and inflammation be prevented Which is likewise very well known by him who out of simple wounds is wont either to extract the blood by sucking it forth with his mouth or to squeez it out by the compression of the wounded part with his finger Moreover when there are any hayres neer about the wound they are to be shaven away lest that they fall within the lips of the wound Thirdly if sand or earth or any such like thing stick within the lips of the wound it is to be cleansed away with wine Fourthly if there shal be any Clods of blood in the wound seeing that they may hinder the uniting excite pain and putrefying may cause a fever they are therefore to be wiped away with a piece of a soft Linen Cloth or a lock of wool or if need require they may likewise and must be taken forth with an iron instrument In which action notwithstanding we must use no manner of violence at the first setting upon the cure neither is all the Clotted blood at once to be taken forth and especially if a Hemorrhage be feared since that the clods of blood may stop the orifices of the veins and the vessells may grow together under them but this is to be deferred until the second or third dressing when we have afterward nature her self which beginneth to expel whatsoever is extraneous helping and assisting Fifthly the little broken bones likewise if any such be in the Wound are to be taken forth In the first dressing nevertheless only those things are to be taken forth that are altogether free and loose so that they may be taken out of the Wound without offering any violence thereunto but as for such smal pieces as yet stick fast unto other bones in these Natures endeavour is to be expected and so it wil soon be seen whether she intend to unite these fragments that are broken with the rest of the bone or else whether she purpose to make a separation Sixthly if Glass be broken in the wound it is to be taken forth and this is also to be done if any other kind of Weapon or Arms wherewith the wound is inflicted stick in the Wound But before we assay the extraction of the said weapons we are to look and consider whether or no the wounded person be likely to live after the drawing forth of those things aforesaid For if there be no hopes of life remaining there is no such taking forth of any thing to be attempted no not of the weapon it self lest that the Chirurgeon should be thought to have hastened on the parties death and lest the wounded person dye under the very hands of the Chirurgeon which happeneth sometimes in the wounds of the Heart of the Brain the basis thereof especially the Vena Cava or great hollow vein or the great Artery For it hath been observed that such wounded persons though the weapon hath been left in the wound have yet lived for the space of a whole day but that upon the drawing forth of the weapon by reason of the Hemorrhage following thereupon they have instantly died But where there is any hope that the sick person may be recovered of his wound we ought then to labour that first of al the weapon be drawn forth For the weapons as likewise leaden bullets although they may somtimes stick very long in the body yet notwithstanding it is a very rare thing that a wound should be perfectly cured the weapon stil secretly abiding in the body But now to draw forth the weapons aright is a thing of much difficulty The drawing forth of the Weapons and this difficulty ariseth especially from the place into which these weapons being thrust into the body have penetrated And therefore for him that wil attempt rightly to draw out the weapons forth of the body there are two things mainly necessary First wel to consider and mind the substance and nature the figure situation and connexion of each several part of the body and then Secondly to know the diversity of the weapons from their matter magnitude and figure and it is likewise altogether necessary in the drawing out of the Weapons to be cautious that the veins Arteries Nerves and tendons be not torn or violated For as Ambrose Parry saith truly it would be a thing very shameful and much unbecoming an Artist that the hand of the Chirurgeon should do more hurt then the iron weapon But that the weapons may the more fitly and expeditely be drawn forth let the wounded person be set in such a posture and figure as he was in when he received his wound Which if it cannot altogether be done yet lying along let him so be placed that he may come as neer as is possible unto that figure Now the Weapons are taken forth in a twofold manner How many ways the Weapons may be drawn forth either by extraction or impulsion that is to say either the same way that the weapon went in or else that way that it tendeth It is extracted the same way that it was thrust in either without making any section or else by a section made in the part For if the weapon hath not pierced very deep if it hath not passed thorow the great vessells and Nervous places and if that either right opposite unto it or the way that it tendeth it hath bones veins arteries or nerves and lastly if there be no great fear of any danger to follow upon a wide opening of the part then in this case it may be drawn back the same way by which it pierced into the body and that without any section at all But if there be any danger and cause to fear lest that the body may be torn if the weapon be drawn back the same way by the which it entered in the wound is then to be dilated either by section or else even without it to wit with that instrument which Celsus in his fifth Book and Chap. 7. calleth Ypsiloeides or
that such Persons have no refreshment from the breathings in the ambient Air which finding the passages obstructed proceeds not so far as the Praecordia or Entrails to moderate and qualifie their excessive heat and they are in continual fear lest that their Blood should again be driven forth unto the streightned place Whereupon haply they wil give way that a Vein be suddenly opened which may prove very pernicious unto them And truly in this kind of disposition there happeneth unto them an extream dangerous constriction or streightning of their breathing a beating of the Heart Hereupon they are evermore exposed to a sudden death and especially those of them that are fatned in their younger daies for these have alwaies their Veins very smal and much streightned And they are likewise exposed unto the Apoplexy and Palsie and throbbing of the Heart and the Flux Diarrhaea by reason of their humidity they are also subject to fainting and swooning fits and the worst sorts of Feavers neither can they away with fatsting or thirst by reason of the constriction of the passages of breath the vehemency of the cold of their complexion their smal store of Blood and the abundance of their Phlegm And to this moreover may be added that they are whether they be Men or Women issueless and barren the Male being not able to Generate nor the Female to produce the Embryo in the Womb. As also their Seed is little or none at all to wit because it is concocted through the imbecility of the heat although there may be store of Seed in regard of their humidity or moisture yet notwithstanding such as is waterish and in Galens judgment thin and unmeet for Generation or if it be generative it is of Females only And the like may be said of Women that those of them which are fat do not conceive or if they do now and then conceive they forthwith miscarry and lastly their appetite to wit that which is natural is exceeding weak Thus far Avicen 2. The truth is that the Cure of this affect may be hoped for but it is wont to proceed but very slowly neither is it to be compleated in a short time and it is mainly requisite hereunto that the Patient be as we say morigerous and in all points ready and willing to submit The Cure The Cure of this Tumor consists in the removal of the Cause which is an over-great store of Flesh and Fat Now this abundant flesh and fat is taken away by wasting and annihilating what is already generated and then by taking a course that it may not again be multiplied and this may be done if we take care that too great an abundance of Blood be not bred or that which is already in the Body that it be by degrees wasted and lessened Both these intentions are accomplished by those things that heat and exsiccate or dry much For whereas the Liver if it hath a gentle remiss and temperate heat generates great plenty of sweet and Oyly blood and so continually foments matter for the breeding of much fat and store of flesh if now this temperate constitution of the Liver shal be altered and the Liver rendered more hot dry than formerly then instead of good and laudable I mean fat and oyly blood it generates that which is hot and cholerick or that which is serous wheyish waterish And thus it is that Medicaments hot and dry do both retard the propagation of an abundant and oleaginous blood and also they waste and by degrees consume the fat that is there already bred throughout the body But then for the wasting or lessening of the flesh already bred those Medicaments are the most prevalent in which siccity or driness is predominant and the heat in a mediocrity By what hath been said you cannot but understand how that in curing this affect we ought heedfully to observe whether it be the flesh or whether or no it be the fat that offends in the excess and so accordingly fit and proper Medicaments are to be made choyce of and as for such as are undoubtedly exceeding ful of flesh and such generally are al those that have the constitutions and habits of Wrastlers we are not to prescribe unto them such Medicaments as either cause or encrease heat but only such as meerly dry and attenuate and such are Venesection i. e. Blood-letting Purgation abstinence from food and frictions or rubbings In fat persons we may notwithstanding properly enough make use of Remedies that are of a heating Nature but yet so as that in the administring of them we be very circumspect lest that by the overmuch heating we procure some other Disease And therefore when as the blood administers matter for the raising of an abundant store of flesh and fat it is to be forthwith evacuated and diminished And for such as are ful of flesh we may safely enough exact a more liberal and copious evacuation of the blood yet alwaies provided that the evacuation be not proscecu●ed unto the extream as Hippocrates cautions us in the first Book of his Aphorisms Aphor. 3. But in those that abound with fat this letting out of the blood ought to be more sparing since that fat persons are more propense unto cold distempers Cupping-glasses also either with or without scarification are very useful and proper for both the one and the other Frequent rough and hard frictions of the whol body are likewise chiefly convenient Pliny in B. 11. Chap. 37. writes That the Son of L. Apronius who had been Consul was contented to have his fatness drawn away from him Fat drawn out of the body of one extreamly fat thereby to alleviate and lighten his body til then immovable of some part of his burden But no man wil easily admit of so desperate and barbarous a Remedy and therefore I forbear to speak any thing more concerning it Exsiccating or drying Baths whether taken by drinking or made use of for the bathing of the body are in this case of singular benefit Frequent purgations with Aloes unto which may be added Mirrh and Nitre are here likewise very convenient and consequently the Pills de Tribus must needs be a proper Remedy Such are also al bitter and hot Medicaments administred as namely Wormwood Myrrh Frankincense Rue Oxymel simplex and Oxymel compositum Oxymel of Squils the Syrup de duabus and de quinque radicibus and generally al things that provoke and expel Urine Wherefore the roots of Asparagus and Fennel and of Parsley and such like ought very frequently to be used This Pouder likewise is much approved of and commended viz. Take Salt of Nitre one dram Allum two scruples Myrrh Frankincense the Rind of the Wood Guajacum the Root of Sarsaparilla of each of these two drams and so make a Pouder Of the which let half a dram be administred in the morning for two months together Also the Salt of Vipers is very effectual for the purpose
wounded or he that hath the greater Veins or Arteries about his Jaws cut assunder And they also very hardly recover their former soundness that have any part of their Lungs or the thick part of their Liver or the Membrane that conteineth the Brain or the Spleen or the Matrice or the Bladder or any Intestine or the Midriff wounded These likewise are in extream great danger in whom the Swords point hath pierced even unto the greater Veins that lie hid and concealed within in the Arm-pits or in the Hams And those Wounds are also dangerous wheresoever there are any of the greater Veins in regard that they soon spend a man by the extraordinary effusion of Blood And this happeneth not only in the Arm-pits and in the Hams but likewise in those Veins that reach even unto the A●se and the Stones And besides these that Wo end is also evil and dangerous that is in the Groins or in the Thighs or in the void places or in the Joynts or between the Fingers As also whatsoever wound it be that hath hurt any Muscle or Nerve or Artery or Membrane or Bone or Cartilage But now because that Hippocrates what he had said in the sixth B. of his Aphorism Aphor. 18. to be Mortal and Deadly that in his Coaca Aphor. 509 he explaineth by saying that they almost die let us therefore see what ●ounds of these parts are simply Mortal and what not And first of all Hippocrates in the Sixth Book of his Aphorism Aphor. 18. reckoneth up the Wounds of the Brain among the Mortal Wounds The Wounds of the Brain and yet nevertheless in his Coaca he limits it and writes that for the most part this is so For all the Wounds of the Brain are not Mortal For Galen himself saw when such Wounds were Cured in the 8. B. of the Vse of the parts and 10. Chap. and in the sixth of the Aphor. Aph. 18. And we have instances thereof in Valleriola in his 4. B. of Observat and 10. chap. and in his 5. B. of Observ chap. 9. and in his sixth B. of Obser ch 4. in Gulielm Fabricius his 4. Cent. Observ 1 2 and 3. and he there giveth us a long Catalogue of the Physitians who had seen some Wounds of the Brain Cured In Johannes Andreas a Cruce in his first B. of Wounds Tract 2. chap. 14. of a hurt and wounded Brain Yea Moreover it hath been observed that after the loss and perishing of some smal part of the Brain yet nevertheless the wounded person hath perfectly rec●vered for the confirmation of which we have many Histories given us by Divers Physitians Anton. Musa Brasavolus in his Comment upon the 18. Aphor. of the sixth Sect. of Hippocrates Nicolaus Missa in his first B. Epist 11. Fallopius in his Tract of the Curing of Wounds chap. 45. Franciscus Arcaeus in his first B. of the Curing of Wounds and 6. chap. Johannes Andreas a Cruce in his first B. of Wounds Tract 2. chap. 14. Ambrosius Paraeus in his 9. B. and 22 chap. and others all which or at least the greatest part of them have been collected by Schenckius in his first B. Oserva 40. and 42. And well worth Observation also are the Histories of the most dangerous Wounds of the Brain that are extant in Cabrolius his Obse vat 16 22 and 34. in Henricus Petraeus his 2. Tome of Harmonic Disputat Disput 36. Quest 10. in Gulielm Fabricius every where very frequently in wounding of the Heart did long survive For although it hath indeed been observed that Tumors and Ulcers have been found in the Heart yet those seeing that they arise and grow by degrees life may somtimes for a while persist together with them although that in the conclusion even these also bring Death unto the Party But wounds in regard that they suddenly disturb the very frame and Oeconomy of the Heart the life cannot therefore long persist with these And albeit Galen in his 2. B. of the Decrees of Plato and Hippocrates and 4. Chap. relateth that sacrifices at the Altar after the heart hath been cut forth have been heard to cry yet notwithstanding this lasteth so long only as the vital spirits are remayning in the Arteries which being exhausted soon after the Beast fals down and dieth For as Aristotle writes in his third B. of the parts of Animals and 4. Chapter the Heart alone of the Bowels and of all the parts of the Body will not admit of or bear any great injury and this for very good Reason For when the very principium or principal part of all is corrupted and injured it cannot then possibly afford any aid and assistance unto those other parts that depend thereupon And more especially as hath been said the left ventricle of the Heart which is the storehouse and treasury of the Blood and the vital Spirit being wounded the wounded person immediatly perisheth But if the right ventricle of the Heart be wounded that the wounded person may in this case lengthen out his life for some short time is confirmed unto us by a strange but yet true History that we may finde written in a Table hanging up against a Wall in the Library of the University of Groning and as it is described by Gothofredus Hegenitius in Itinerario Frisic Hollandico Page 16. in these very Words Nicholaus Mulerius health to the Reader It hath hitherto been beleeved that the heart being wounded no man could possibly lengthen out his life no not for the short time of one hour Which opinion both Reason and Experience confirm For seeing that our life dependeth upon the safety of the spirits whose Store-house and Fabrick is Scituated in the very Heart the Heart being wounded the said treasury and fabrick that it Scituated in the same must of necessity be wounded likewise But I thought good here to relate unto you a very Memorable History a History I say of a certain Soldier who being wounded at the Heart yet lived above fifteen daies after the like whereunto we meet not with in any of the observations of either Ancient or Modern Physitians Andreas Haesevanger being a Soldier enrolled in the City Garison under the most Illustrious Count William of Nassau Chief Governour of Frisia Groning Omland c. received a wound in his breast from a fellow Soldier of his in the year 1607. the two and twenty day of August in the evening and he died the eighth day of September following an hour after Sun-rising it being the sixteenth day from that whereon the wound was given him The Body of this dead Soldier by the command of the Governour of the City Garison for the discovery of the Nature of this his wound was opened and examined by my self and two Chirurgeons Gaspar and Luke Hulten there being present and looking on that valiant and most Noble Bernhard Hoornkeus there looking on likewise some others both of the meaner and better sort of Soldiers We had no sooner opened the
miraculous unto many men as well Courtiers as Citizens And thus this Boor in the space of a few weeks by the use of fit and convenient remedies administred unto him by that most expert Chirurgeon without any further sickness and trouble alwaies eating wel and drinking and sleeping as somtimes he told me himself by the blessing of God and the liberal Charity of many people toward him in his low and poor condition contrary unto the determinate assertion of Physical Aphorisms fully recovered his wonted perfect health and soundness and not long after he married a Wife But those wounds of the Stomack are especially mortal that are inflicted upon the superiour orifice thereof in regard that it hath those considerable Nerves that arise from the sixth Conjugation of the Brain and thereby obteineth a very neer consent with the Brain and Heart so that it being wounded most grievous Symptoms may very easily be excited And Benivenius in his tenth B. of the hidden Causes of Diseases that are curable Chap. 110. reporteth that a certain Fuller with one blow of his fist upon the Stomack of a young Man smote him so violently that he immediatly died thereof Eightly The wounds of the smal Guts The Wounds of the smaller Guts are by Hippocrates accounted and reckoned up among those that are Mortal And more especially the wounds of the Jejunum or hungry Gut among al the wounds of the Intestines are especially Mortal by Reason of the greatness of the Vessels and the almost Nervous substance of the Tunicle of that Gut from whence for the most part there follow great torments and pains of the Intestines Sobbings and Faintings as is to be seen in the Histories related by Valleriola in his 2 B. Observat 8. and 9. And indeed the wounds of the smaller Guts are then most especially incurable when the said Guts are wholly cut assunder in a transverse manner since that the Lips thereof standing wide one from the other cannot possibly by any means be Joyned and made to grow together But now the wounds of the thicker Guts are less dangerous and especially if they be not great and that oftentimes such like wounds have been Cured appeareth from the many extant Observations of Physitians which Schenckius in his Observations hath Collected Ninthly VVounds of the Liver Hippocrates likewise accounteth the wounds of the Liver in the number of such as are Mortal which yet nevertheless wanteth a limitation For Aegineta hath truly told us in his 6. B. and 28. Chap. that the Liver having been wounded and a part thereof cut away yet that the wounded person may be preserved And Gemma relateth in the first B. of his Cosmocrit and 6. Chap. that a Spanish youth a great part of whose Liver brake forth by the wound of the right Gut was yet notwithstanding Cured And Bertinus also in his 13. B. and 7. Chap. writeth that a Noble person after a wound inflicted neer about the Region of his Liver and a smal part of the substance thereof drawn forth and cut off yet escaped and became sound again And the same hath likewise been observed by others Guilhelmus Fabricius in his 2. Cent. Observ 34. relateth that a certain Helvetian thirty years old in a Duel was with an Helvetian Sword hurt in that part that is opposite unto the Liver and that he received a very great wound one span long and that hereupon there was taken from him a good big piece of his Liver And yet nevertheless this Man notwithstanding the superveising of most grievous and violent Symptoms by the blessing of God was perfe●●ly recovered And Matthias Glandorpius in his Speculum Chirurgic Observ 34. Page 160 hath a History of a youth dangerously wounded in his Liver who yet nevertheless recovered perfect soundness And yet notwithstanding we say that they only recover who have the superficies alone or the substance of their Liver only wounded without any hurt at all of the great Vessels For if there be wounded any one of the greater Vessels the wounded person cannot possibly escape and by reason of the large effusion of the Blood the Man before that the wound can be Sodered and Agglutinated dieth And of these some indeed for a very short time have their life protracted but others of them die in an instant or at least in a very short space For as Hippocrates in his 5. Epidem telleth the story a certain person having had a dart thrust into his Liver immediatly the colour of a dead Carcass was dispersed all his Body over his Eyes sunk in his Head a difficulty of breathing together with an aestuation or sudden vehement passions followed after this and the same day he died Another Boy being strucken upon his Liver by a Mule died the fourth day after and before his Death he was troubled with a short and thick breathing neither understood he any thing but all the while until he died lay under a feaver Wounds of the spleen Tenthly The Wounds of the Spleen are almost of the same Nature and alike dangerous as those of the Liver For if only the Parenchyma of the Spleen be wounded without any hurt of the Vessels the wounded person may possibly escape But if the Vessels of the Spleen be wounded such like wounds are not only dangerous but also deadly and Mortal For seeing that the Spleen hath st●re of Veins and especially of Arteries these being wounded by Reason of the great effusion of Blood and Dissipation of the Spirits the wounded person must of necessity perish VVounds of the Bladder Eleventhly The Wounds of the Bladder are likewise found in Hippocrates his Catalogue of Mortal Wounds But yet nevertheless here also a distinction is requisite For a smal wound is soon sodered together by the intervening of flesh as Galen in the 6. of the Aphorism Aph. 18. and Experience teach us But if the whole Bladder chance to be cut quite through which wound Hippocrates calleth Diacope the Wound is then yet more dangerous And indeed that is most especially perillous which is inflicted at the very bottom of the Bladder and the Nervous pa● thereof for by Reason of the sharpness and extremity of the pain the inflammation following thereupon and the continual feaver the party dyeth soon after But as for these Wounds that are inflicted at the Neck of the Bladder which is fleshly they are Curable as we are taught even by the Cutting of the Stone And yet nevertheless it hath been observed that the Bladder wounded even in the very bottom thereof hath likewise been Cured the truth of which we have confirmed unto us by those examples we meet with in the Observations of Schenckius For the whole Bladder is not altogether Nervous but the Exterior Membrance thereof is more fleshy whereupon Hieronymus Fabricius ab Aquapendente and Spigelius account the said Membrane for the Muscle that shutteth the Bladder But it is very rare that such a like wound of the Bladder is
not to wake use of Medicaments that are over sharp lest so while we seek to avoid one danger we fall into another as great in exciting both a pain and a Convulsion And therefore in such parts the safest way wil be to apply those Medicaments only that draw forth the poyson by the property of their substance Neither likewise ought the use of sharp Medicaments alone to be long continued but after they have been continued for a day or two then after others more mild are to be imposed The Compositions are very many and various Treacle is of singular life if mingled with other Medicaments which that some should therefore have in suspition in regard that by reason of the coldness of the Opium it may possibly drive the poyson inwardly this is indeed a most ridiculous conceit in a time of so much light from the truth Or else drop in Matthiolus his oyl which he describeth in his Comment upon the preface of the sixth Book of Dioscorides or that of the great Duke of Hetruria or the Juice of Vipers Grass Guido in poysoned Wounds commendeth this Emplaster Take Galbanum Sagapenum Opopanax Asafaetida Myrrh Pepper Sulphur of each one ounce and half Doves dung and Ducks dung of each two ounces Calamint and wild Mint of each one ounce Let the Gums be dissolved in Wine and mingling them all with honey and old oyl make an Emplaster or Take Turpentine the Water or Juice of Swallow-wort washed two ounces the propolis of Beehives two ounces Matthiolus his Oyl half an ounce Oyl of Turpentine two drams Precipitate a dram and half Water Germander and the Root of Vipers grass of each four scruples mingle them and make an unguent or Take Ammoniacum Galbam●m Bdellium of each half an ounce Styrax Liquid three drams Myrrh and Sulphur that hath not felt the fire of each two drams Euphorbium and Precipitate of each one ounce Matthiolus his oyl and oyl of Turpentine of each two drams let the Gums be dissolved in scillitick vinegar and then mingled with the rest and then with as much Propolis and Ship pitch as will suffice make a Cerote or Take Root of Dragon wort and Round Aristolochy of each one ounce Tabaco and Water Germander of each one handful Frankincense Myrrh Brimstone that hath not been neer the fire of each half an ounce Dittany of Crete Angelica Root and white Dittany of each three ounces Oyl of Turpentine two ounces Wax and Ship pitch of each as much as will serve the turn Mingle them and make an Emplaster or Take Tops of St. Johns wort two handfuls Carduus Benedictus Water Germander Tobaco Swallow wort of each one handful Rue one pugil Root of Dragon wort two ounces Sour or Sharp dock an ounce and half let them be well bruised together and then applyed in the form of an Emplaster or Take Oyl of Olives and Honey of each two ounces Quick lime two drams Roots of round Aristolochy one dram make a Cataplasm or Take Onyons Garlick Leeks of each three ounces boyl and bruise them and then add the root of Dragon wort and Asphodill of each two drams Treacle half an ounce Oyl of Scorpions one ounce and mingle them Or Take Ashes of the herb Trinity or Hearts ease and Quick lime of each two ounces Wormwood Round Aristolochy Rue Garlick and Oynons of each one ounce Figgs twenty Number Goats dung Oyl of Euphorbium and Oyl of Scorpions of each three ounces Honey one pound and half Wine Vinegar one pint Mingle them and make an Eplaster More of these you shal have in the following sixth Book touching the bitings of venemous Creatures And withall even instantly upon the receiving of the wound there ought to be administred Alexipharmaca or counterpoysons as we properly call them that may Guard and fortify the heart from the poyson and may expel it unto the outward parts And indeed if the kind of poyson be known we are then to opposse and counter work it by its own proper and peculiar Alexipharmaea touching which more in the following Book But if the species or kind of the poyson be hid and unknown to us then these universal or general Alexipharmaca to wit the Bezodi stone Treacle Mithridate Treacle Waters and others of this kind every where commonly known are to be administred And with the very same the Heart is likewise outwardly to be fenced and guarded and therefore not Treacle and Mithridate alone but chiefly the Oyl of Matthiolus is to be anoynted upon the Region of the Heart and the Arteries as also the Oyl of the Great Duke of Hetruria The poyson being drawn forth we are then to hasten unto the Curing of the wound for which purpose this Unguent is very usefull Take Wax black pitch Rosin the soft fat of a Ram and old oyl of each three ounces Galbanum six ounces Make an Vnguent And afterwards the Cure is to be performed as in all other Wounds But if we come to understand from the dangerous symptoms as cold sweats faintings swoundings and the Syncope that the poyson hath now already penetrated unto the more inward parts of the body and especially the Heart then the wounded part is not much to be troubled and tampered withall but in this case we ought rather to take care for the preservation of the whole body but more especially the Heart Chap. 22. Of Particular Wounds ANd hitherto we have been treating touching Wounds in General as also touching the general Cure of them But now in regard that the Cure of wounds is very different and various according to the variety of the parts that are wounded we should now therefore come to speak of them more particularly and in speciall to wit of the wounds of each single part But since that we have already handled them in our former Books therefore here again to treat of them wil be a thing altogether needless and superfluous For in Book 1. Part. 1. Chapt. 21. 22. 23. 24. and 25. We treated of the Wounds of the Head and Brain Ibid. P. 3. Sect. 2. Chapt. 9. Of the Wounds of the Eyelids Chap. 10. Of the Wounds of the Eyes Ibid. Sect. 3. Chapt. 5. Of the Wounds of the Nosethrills Ibid. Sect. 5. Chapt. 3. Of the Wounds of the Tongue Lib. 2. Part. 1. Chapt. 4. Of the Wounds of the Lipps Ibid. Part. 2. Chap. 4. Of the opening of the vessels of the Lungs Ibid. Chap. 11. Of the Wounds of the Lungs Ibid Chap. 15. Of the Wounds of the Diaphragm Ibid. Chapt. 17. Of the Wounds of the Chest Ibid. Chap. 22. Of the Wounds of the spinal Marrow Ibid. P. 4. Chap. 3. Of the Wounds of the Heart Book 3. P. 1. Sect. 1. Of the Wounds of the Oesophagus Ibid. Chapt. 16. Of the wounds of the Stomack Ibid P. 2. Sect. 1. Chapt. 8. Of the Wounds of the Intestines Ibid. P. 4. Chapt. 7. Of the Wounds of the Spleen Ibid. P. 6. Sect. 1. Chapt. 7. Of the Wounds of
the Liver Ibid. P. 7. Sect. 1. Chapt. 11. Of the Wounds of the Reins Ibid. P. 8. Sect. 1. Chapt. 5. Of the Wounds of the Bladder Ibid. P. 9. Sect. 1. Chapt. 5. Of the Wounds of the Testicles Ibid. Chap. 11. Of the Wounds of the Yard Ibid. P. 10. Chap. 15. Of the Wounds of the Abdomen Book 4. P. 1. Sect. 2. Chapt. 1. We treated of the Wounds of the Womb. Chap. 23. Of the Diseases and Symptoms that happen unto Wounds And now since that it often happeneth that other Diseases as likewise divers symptoms do happen unto Wounds and follow upon them al which yield forth peculiar Indications and so draw the cure to themselves deject and weaken the strength of the Patient and render the Wounds very difficult to be cured and dangerous we ought therefore to treat of those also and to shew you how and by what means they are to be removed and taken way until which be done no Cure of the wound is to be expected Of Feavers And indeed in the first place it happeneth very often that Fevers follow upon Wounds And therefore although I have already treated of Feavers in a peculiar Tract by its self yet nevertheless in regard that it much concerneth us to know and rightly to understand the differences of Feavers that follow upon Wounds that so we may the better remove them we wil therefore herein this place speak somthing of them inspeciall and particularly And therefore first of al we are diligently to inquire what the nature of this Feaver is that followeth upon the Wound and what the Cause of it For these kind of Feavers are very various some of them being every day Feavers having their Original from the great disturbance of the spirits and the boyling heat of the blood by reason of anger Fear and upon all occasions of the humors being disturbed by the motion of the body or the commotion of the Mind And moreover also Secondly these feavers happen while the Pus and especially if there be great store of it is in breeding according to that of the 47. Aphor. of the second Sect. Thirdly from an Inflammation Fourthly and somtimes these putrid Feavers are likewise generated from the putridness that is in the wounded part And fifthly from the store of the vitious humors The first kind of Feavers invadeth the Patient at the first in the very beginning The first kind of seaver from the disturbance of the humors and as I told you before it proceedeth from the passion of the mind and the motion of the body and the disturbance of the blood and spirits following thereupon And hitherto also belongeth most vehement pain which by dsturbing the humors and causing restlesness may both set on fire those humors and the spirits and likewise excite a Feaver Their Signs Now these Feavers are known by this that they invade the wounded person instantly upon the inflicting of the Wound and together with it But yet notwithstanding because that the putrid Feavers may likewise somtimes invade the person immediatly and even from the very first beginning therefore by what Signs these Ephemerae or every day Feavers may be discerned from the putrid we have told you before and the difference will sufficiently appear from what we have written hereof in our first Book of Feavers and sixth Chapter Prognosticks And the truth is these Feavers of themselves bring with them no danger at all unto the sick person and yet Nevertheless neither can they at all promise any safety unto him seeing that then the time of the fluxion and Inflammation that are wont to follow upon the Wound is not as yet overpassed and gone The Cure But now this Feaver requireth not any peculiar Cure but if the Patient will but only submit himself unto the strict Rules of Dyet soon vanisheth of its own accord But yet nevertheless all the Causes thereof if they be yet present or that there be any fear of their returning are to be removed for otherwise they may easily draw upon the person some kinde of danger And in regard that otherwise about the fourth day Inflammations and fluxions are wont to happen these Feavers if they continue so long as until the said fourth day may possibly attract and augment those Evils And then again while the Pus is in breeding A Feaver from the generating of Pus and especially if there be a great abundance thereof generated Feavers are caused as Hippocrates telleth us in the 2 Aphorism Sect. 27. For then whatsoever over aboundeth in the wounded part and cannot be changed into the substance of the part beginneth to putrefie and there is caused as it were a certain kinde of boyling forth of putrefied mattier And yet notwithstanding Nature doth what lieth in her power and what she is not able to turn into the substance of the part she doth what she can so to work and frame it that it may not be altogether corrupted but most of it turned into Pus And therefore from this Ebullition or boyling there is indeed a heat of the blood in the Veins and Arteries communicated unto the Heart which when it is thither come it kindleth a Feaver that is like unto an Ephemera of many daies rather then to putrid Feavers properly so called Signs And therefore the Signs of Putridness are absent and appear not and so likewise for the Signs of an Inflammation and these Feavers invade the wounded person at that time wherein the Pus is wont to be generated and especially about the fourth day The heat is much but withall sweet the pulse great swift and frequent The Urine differeth and recedeth but little from its Natural state and there is no ill and dangerous Symptom Joyned together with it to accompany it Prognostick This Feaver of it self hath no danger at all in it but soon after ceaseth Cure And this that it may so much the sooner be done there is a passage forth to be made for the Pus and this so much the more speedily if the Pus be conteined in a more noble part or in a part that hath consent with some one of the more principal and noble parts and withal we are to endeavour that al the afflux of the Humors may be hindered and prevented And Thirdly Feavers from an Inflammation Feavers are somtimes kindled from the Inflammation that followeth and happeneth unto the wounded part somtimes Quotidians or every day Feavers and somtimes putrid Feavers even according as the Spirits Wax hot and this heat is communicated unto the Heart and also according as the putrid Vapours transfused into the Veins and Arteries do penetate unto the Heart and heat it Signs Now these like Feavers are known from the Signs of an Inflammation touching which we have spoken in the first Part and 5. Chapter But whether the Feaver be a Quotidian or a right putrid Feaver this may be known by the Signs of them both of which we have likewise