Belly-ach that the membranes of the Pudenda were so far stretcht out that the unskilful have taken it for the Matrix it self and do so still For though many Authors have dared to write that the Womb may be cut out without danger of life seems altogether impossible to a skilful Anatomist To cure this Disease lay the Patient on her back with her Knees on high and Legs asunder then take a Wax-Candle of a competent thickness mix therewith some Castoreum or Assa Foetida and with it gently press the Womb inward and having sastened the Candle with a Bandage apply outwardly to the Belly the Emplastrum Barbarum or the following Take the Roots of Cyprus Bistort of each a dram Galls Acacia of each half a dram Cypress-Nuts Date-stones Myrtle-Berries of each one dram Pitch and Colophony as much as sufficeth to make it into a Plaister Then presently enjoyn the Patient to lie still with the Legs cross and to beware of speaking aloud of scolding and of whatever may occasion coughing or sneezing Here great care is to be had that your Wax-Candle be not too thick to the end that by its continual friction it may not cause Fluorem Album whereby the strength of the Body would certainly come to decay Yet because ev'n by the greatest care and circumspection this inconvenience will hardly be altogether or always prevented therefore those do very well and discreetly that long-ways perforat the Candle and thereby give a convenient passage for the humors flowing that way CHAP. IX Of the falling down of the Fundament IF the Gut be sunk down anoint it with Oyl of Rose and Myrtle mixing a little Powder of Galls amongst it and with your Fingers and a small Linnen-Rag put it in If an Inflamation hinder the reducing it then bathe the Anus with these Medicines Take Flowers of Elder Camomile and St. John's-wort of each a handful Red Roses rwo Pugils the tops of Wormwood and Melilot of each half a handful Boil therein Milk and Red Wine and bathe the part Here especially care is to be had that no external cold may come to the fallen-out Anus for then you may sooner than you are aware of be surprized with a Gangreen Wherefore do your utmost to put it in again with speed and in the mean time endeavor with the above prescrib'd Bathing and warm Linnen Rags to preserve its natural heat There is yet another though in appearance ridiculous yet in reality a good way of reducing the Gut With a strong hand strike five or six times the Patient's Buttocks and thereby the Muscles called Ani levatores will presently draw the Anus into its right place again But before the Patient be thus chastized take care that the Gut may first be anointed with Oyl of Roses or of Myrtle CHAP X. Of the second Operation called Diaeresis or the seperation of what was united together HItherto we have joined together again what had been disjoined now it follows that we separate what is united and treat of the second Manual Operation called Diaeresis which teacheth us the manner of Cutting and Burning and that both in the hard and soft parts of the Body In the soft the Cutting is called Incision In the hard it is performed four manner of ways By Terebration or Perforation by Rasion or Scraping by Limation or Filing by Serration or Sawing Burning is done either by an Iron which is the Actual Cautery or by Medicaments called the Potential Cautery as shall be declared particularly hereafter CHAP. XI Of opening a Vein BLeeding one of the greatest Remedies in the Art of Physick is sometimes highly necessary but sometimes so dangerous that it ought not to be used without very urgent Causes Here therefore I think it will be better somewhat to digress for fuller information than to leave the unskilful in their error The Blood is the darling of Nature by whose assistance she performeth all her Operations and which can hardly be drawn from her without dammage yet does Art require that those who meddle with it being neither venturous nor timorous but discreet and couragious and making out of necessity a virtue do sometimes proceed to the opening a Vein yet for no other than these four following causes 1. In a Plethora or super-abundance of blood that by this means Nature may be eased of her too heavy burden and the innate heat preserved from suffocation 2. For Revulsion-sake when the blood and the therein mingled humors by flowing too plentifully to this or that part hinder the Cure Here you are always to chuse a Vein of the opposite side and that sometimes the farthest distant sometimes the nearest 3. For the Derivation or conveyance of the Blood which is already got into the part but is not yet altogether setled there nor extravasated into another place in which case a Vein is to be opened the nearest to the Part. 4. For Refrigeration when the heat of the Blood is so excessive that it cannot be allayed by cooling Medicines or not time enough These limits are too narrow for some who will needs take into those a fifth cause which they make the Corruption of the Blood held by them to be as great an inducement for bleeding as any of the four by us recited to the end say they that Nature being rid of part of what is corrupt may be the better able to correct what remains But I much wish 1. That they could make this discharge without the loss of that strength which is so highly necessary 2. That they would be present when their Patient is to bleed and precisely tell to what degree of corruption his blood is come that so the Chirurgeon may know how much of it he is to take and how often forasmuch as they will not allow that Bleeding is good in all sorts of the Blood 's corruption but in that only which is not gone considerably far 3. That they would declare why they will have cur'd the greater corruption by Purging and the lesser by Bleeding since that they give to the one as well as to the other and that duly the name of Cacho-Chimia Let them shew that things differing only secundum Majus Minus do differ in specie and so require specifically different Remedies Others proceed yet further and shed innocent Blood in all sorts of Fevers without any consideration of spots of the Plague or of Poison it self thus freeing themselves from a great deal of labor and trouble otherwise caus'd to the Physitian from the variety of Fevers But because the nature of all Poyson and Malignant Humors is continually to assault the Heart and suddenly to prostrate the strength of the strongest Persons and since Bleeding doth likewise both not only diminishing strength but also drawing the malignity toward the Heart and driving in again for the oppression of Nature what she had thrown out for her relief I do intreat and warn all the Practisers of our Art That as they love the
and if it be where there is a double Bone as in the Leg and below the Elbow the Flesh and Ligaments between them is to be divided which being performed let the Bone be separated with a very sharp Saw If the Flux of Blood be not great to apply only those Medicines that stop Blood will be sufficient but if great an actual Cautery is to be used which is only to be applied upon the great Vessels then let the Ligature be taken off and the Part be fitly bound up If either the Patient or Chirurgeon be averse to the use of a Cautery then as soon as the Member is taken off let the Skin together with the Flesh in four distinct places opposite one to the other be taken up with a Needle and waxed Thread and the Ligature being loosened above or drawn down that if possible they may meet So by this way is the Hemorage staid the Bone preserved from all danger and the Wound sooner cured But this way is painful and troublesom therefore ought it the seldomer to be used Aquapendens his way When the principal design of Art in this Operation is to put a stop to Putrefaction to cause as little pain as may be and to stay the Flux of Blood all which the above-quoted Author thinks may be done if the Member be amputated in the dead Part but near to the sound then the Bone being divided with burning-hot Irons let the remainder of the dead Part be cauterized till the Patient perceive the heat of the Fire So he writes that by this course a Flux of Blood is not to be feared less pain is caused and within the space of two or three days will appear a separation of the Mortified Part from the Sound but in my opinion we ought to consider well of the Cause For in a Spacelus sprung from an Internal Cause in a Body otherwise sound this way is the best but in a Spacelus caused from a defect of innate Heat the former is more profitable CHAP. XXV Of the Fleshy Rupture SArcocele which is a Fleshy Rupture is a Tumor besides Nature produced from impure Blood flowing in too great quantity itno the Testicles and there degenerated into Flesh In this Definition received by the best Physitians and Chirurgeons I note two things 1. The cause of this Tumor not to be impure Blood seeing the best may produce it not simply abounding in quantity because it also happens in wasted Bodies though 't is not so soon generated nor arrives to such a greatness in these as in those Bodies but the true cause is the Erosion Rupture or Dilatation of the Membranes which close the Mouths of the Capillary Vessels that the nutritious Blood may not flow too suddenly into the Part from whence more Blood flows into the Part than what is required for its nourishment and Nature changeth that Blood which otherwise would purifie into a fleshy Substance 2. This flesh sometimes grows to the second of the common Tunicles of the Scrotum and not to the Testicles in which case it may be taken aways without either hurting or cutting of them out Signs are the hardness and slow encrease of the Tumor which is rather more troublesome than painful except accompanied with sharp Humors no appearance of any Tumor in the Groin Prognosticks A Sarcocele is hardly cured by the help of Medicines and seldom by manual Operation without taking off the Testicle if it extends it self into the Groins for the most part incurable Cure In the beginning when the Membranes of the Vessels being eroded broke or dilated do give leave for too much leave to issue forth Bleeding and the use of Repelling and Restringent Medicines profit much but when it hath begun to augment then we may use these following means Let there be made a little Orifice into the Scrotum rather in its Superior then Inferior Part through which by the help of Plegets let Suppurating Medicines be applied so that if possible to waste the Flesh every dressing diligently wiping away the Matter but not at all that the remaining Flesh may be the better consumed If these things succeed not draw forth the Testicle and by Incision take off as much Flesh as may be done without injury to it then restore it again into its place and the remainder of the Flesh endeavor to consume by Suppuration But if there be no hope of curing this Rupture by the recited means draw forth the Hernious Testicle as far as you may then pass once or twice a Silken Thred above the Tumor by the Process of the Peritonaeum then pass both ends of the Silk through the Orifice it self so that which was on the right side may be on the left and that of the left on the right and having ordered that the process of the Peritonaeum may be tied with a knot then cut off the Testicle letting both the ends of the Silk hang out of the Scrotum and so cure it as another Wound I cannot here but friendly advise 1. The Chirurgeon ought to consider well of the Cause before he comes to the Operation it self for sometimes the Parastates are so swell'd especially the Testicles being Scirrhous that they may easily deceive a very curious Examiner 2. The Ligature ought to be made as near to the Tumor as possible for by how much the higher part of the Process of the Peritonaeum be perforated it is observed to be so much the thicker which thing will retard the Suppuration and the falling of the Thread in the mean time Convulsions coming on denounce death 3. The Spermatick Vessels detain'd in the Scrotum oftentimes by Natures variety exceed the Testicles themselves in greatness which causes no other inconvenience but only Fear which I have observed to be true in more than one CHAP. XXVI The Extraction of the Stone out of the Bladder THe Stone is a hard Body concreted from Slimy Salt or Earthy Matter by a peculiar Lapidifying quality causing Pain Obstruction and other Symptoms in the place where it is detained The Cause is a Pituitous Salt or Earthy Matter which neither by heat nor cold by a peculiar lapidifying quality is changed into a Stone Signs The Urine is white slimy crude and troubled suddenly adhering to the Urinal sometimes it is bloody sometimes sandy or gravelly sometimes full of little Threads and not seldom supprest a great thirst a frequent making of Urine but with pain and by drops The Patients place themselves with their Thighs across always holding their Privy-Parts in their hands pressing the bottom of their Belly the Privy-Part is always erected very painful to go or walk in the Region of the Belly a weight perceived the Patient seldom making Water without going to Stool the Intestine commonly falls out especially in young People Although all these Signs seem plain yet they may sometimes deceive a Phisician it was formerly the Custom with a Catheter passed through the Ureter into the Bladder then
quantity of Water over the Fire for 24 hours then boil them to three quarts and to the strained Liquor add Syrup of Roses Sol. with Senna four ounces Mix them Dose six or eight ounces Some make this Decoction with stale Beer or Wine but in these things the Surgeon ought to consider the past manner of living of his Patient his Temperature and Age If you desire that it purge you more you may add a dram or two of Trochise Alhandal and if not strong enough then you may mix it with five or six grains of white Precipitate provided strength gives leave CHAP. XII Of the Carbuncle A Carbuncle is a Tumor besides Nature from adust Blood corrupting the Part where it is collected Difference 'T is called by the Greeks Anthrax by the Latines Ignis Persicus by the Germans Een Kool Some endeavour a Difference between an Anthrax and Carbuncle but lose their Labour There is is no other Difference but sometimes it is bigger sometimes lesser sometimes more Malignant other times less Cause is adust Blood assuming the Nature of black Choler and so apt to putrifie Signs are sometimes but one great Pustule sometimes many litttle ones which being opened appear black and all about enflamed The Crust being removed instead of Matter you find spungy Flesh the Part affected is very painful a Fever present and Watchings Prognosticks Very dangerous when black especially in Plague time when near to to a principal part if great and suddenly vanishing Cure Strong Purging Medicines I much mistrust Clisters or loosening Medicines will suffice viz. Cassia Fistula Manna Tamarinds Cream of Tartar c. But more suspicious to me is Bleeding to fainting as Galen writes and in its room Leeches or Cups with Scarification will be sufficient But I rely most upon Sudorifick and Refrigerating Medicines using outwardly the same Medicines as in the Plague This Plaister is much commended to make a separation of the Eskar Take old Thereacle Mithridate of each half an ounce Leaven Turpentine of each two ounces Honey of Roses an ounce and a half Fresh Butter two ounces White Vitriol an ounce Soot two ounces and half Black-sope three ounces Saffron three drams Yelks of Eggs N o iij. Mix them and make a Plaister according to Art The External Medicines ought often to be changed Here is no need of Suppuratives for the Humors are easily corrupted of themselves in the place of which the Eskar being separated may be used Ung. Fuscum of Felix Wurtz Aegyptiacum and Honey of Roses c. CHAP. XIII Of a Cancer A Cancer is a Tumor besides Nature sprung from Black Choler round hard livid painful full of turgid Veins resembling the feet of a Crab. Difference Where not exulcerated by the Greeks it is named Carcinoma when ulcerated Plagedaena by the Greeks and by the Germans De Wolf Signs In the beginning difficultly known scarce equalling a Pea in bigness then sometimes increasing suddenly sometimes slowly it makes it self by its grievous Symptoms easily enough to be known The Tumor is hard painful hot livid or black round with some inequality full of swell'd Veins Prognosticks A Cancer is seldom Cured by Medicines often by Chirurgery but not without danger sharp Medicines exulcerate it It is imprudence to attempt an occult Cancer or that is detained in any Cavity of the Body except it be very little and may easily be taken away by Incision Cure Diet the same as in Schirrhus frequent Purging convenient be cautious in Bleeding as also in Scarification The Moneths flowing in Women and in Men the Hemorrhoids are very beneficial Externally Suppuratives and strong Discutients are hurtful the following good Medicines in a Cancer Roots of Arum Dropwort Gentian Figwort Mullein Leaves of Maidenhair Housleek the greater Agrimony Tobacco Plantain Nightshade Hounds-tongue the Spawn of Frogs of Whales Burnt-Crabs Burnt-Lead Mans-Dung Plaisters of Diapompholigos of Lead Diafulpharis of Frogs with Mercury Sugar of Satùrn Camphire For a Cancer not ulcerated Take the Juice of Plantain Endive Housleek the greater Night-shade Rose-Vinegar Oyl of Myrtle of each an ounce Venice-Turpentine two drams Stir them together in a Leaden Mortar with a Leaden Pestle adding of the Rinds of Pomegranates and Citrons of each a dram Bole-armonick Burnt-lead Camphire of each half a dram Make it into a Liniment For an Ulcerated Cancer Take Galls Pomegranate-Rinds of each half an ounce Burnt Talk an ounce Bole-armenick half an ounce Burnt-Lead two drams Ashes of Crab-shells a dram Turpentine and Honey as much as is sufficient Make an Ointment By the use of these or the like Medicines Cancers that are not ulcerated have been often cured and ulcerated Cancers have been for many years kept in the same condition but for the most part the business is committed to Chirurgery The Part affected being held by a pair of Forceps is to be cut off by the help of a convenient Knife but so that nothing of the Cancer be left behind left it bud afresh others holding it only with their left hands or passing a string quite cross take it off by Incision Many with great Praises extol prepared Arsenick or Mercury sublimate but its Deeds answer not their Words Its Preparation John Faber in his Myrotheico Spargirico teaches The Quintessence of Arsenick Take Cristalline Arsenick with the like weight of Salt-Petre and reduce all into the finest Alchool and put them into a very strong Glass-Retort to which joyn a Recipient big and large enough being well luted together distil them with Embers observing the degrees of the Fire at first gentle at the end very strong and violent until all the Spirits of the Arsenick and Salt Petre are gone forth They being come forth and the Vessels cold disjoyn the Recipient from the neck of the Retort having great care of the Spirits that are within which are venomous suddenly stopping the mouth of the Receiver with a strong Lute afterwards breaking the Retort and that which is in the bottom must be powdered and put into a new Retort and upon the Powder that is put into the Retort the Spirits of Arsenick which were in the Receiver is to be powred and distill'd again being luted well as at first This is to be done three or four times till the Arsenick be well calcin'd with the Salt-Petre then lay the Arsenick upon a strong Tile and for a whole day make a strong fire about it so that which could not be Calcined by Distillation may be Calcined and burnt by an open Fire This Calx of Arsenick is to be dissolv'd in distilled Rain-water and the Solution so cleansed and depurated from its Terrestrial Excrements and by filtring made clear and limphid is to be evaporated and dried and calcined again with a very strong Fire until it remits no Faeces in the Solution but the whole Calx is dissolved and the Water remains most clear and limphid then the Water being evaporated it is to be dried Then lastly it s above reserved Spirit
when we spoke concerning a Phlegmon Erysipelas Oedema Schirrhus Then Care is to be had of the Blood seeing it affords assistance to the matter and serves to unite the Wound Where it is vitiated it requires purging But if it flow in too great quantity Intercipients Repellents Revellents and Derivation must be us'd If it flow in too small quantity Aliments that nourish are convenient as also Medicines that strengthen and that move Sweat Outwardly gentle Frictions and Embrocations moderately hot Then the Cure is to be perfected by External Medicines which shall be declared in the following Chapter when we speak of the removal of the Symptoms and the Cure of Wounds themselves CHAP. IV. Of the Symptoms of Wounds THe chief Symptoms of Wounds are 1. A Fever whose Cure we commend to the Physitian ' 2. A Flegmon or Inflamation 3. An Erysipelas Of the Cure of both which look in the second and third Chapter of the first Book 4. Hemorage which not only impedes the Cure but also deprives of strength and life it self therefore great Care is to be taken that it be stopped as soon as possible which in the greater Vessels especially the Arteries is very hard to do therefore those Wounds are for the most part Mortal For Medicines that stop Blood are too weak and hard Ligatures occasion a Gangrene the surest way therefore in my opinion is an actual Cautery the lesser Vessels may and will close Some close the Wound of the Vessels with their Fingers and so hold them there while the Blood is coagulated and the Flux stopt but this Operation seldom succeeds besides the long holding of the Finger in the Wound is hurtful Therefore let the Wound together with the Vessels be forthwith clos'd by the Fingers but if you cannot come to do this outwardly make a compress upon the Vessel which done wipe away the Blood with a Spunge then sprinkle some restringent Powder but not over the whole Wound which is used to be done by the ignorant but only upon the Vessels then bind up the Wound continuing the use of the Medicines stopping Bleeding while there appears no longer any Blood not neglecting in the mean time Generals viz. Scarification and Bleeding c. Medicines that stop a Flux of Blood Roots of Bistort Cinquefoil Tormentil Comfrey the greater Red Saunders Lignum Leutisci Pomegranate-rinds Mastick Talk Acacia Dragons-Blood Amber Sarcocols Frankincense the hairs of a Hare Os sepiae burnt-Crabs Whites of Eggs Mummy Cobwebs red Coral Chalk Bloodstone Bole-Armenick Aloes succotrine Frogs dried and powdered crude Vitriol burnt Vitriol Take fine Meal three ounces Dragons-Blood Frankincense of each an ounce and half Bole Sealed Earth of each two drams Talk six drams dried Frogs an ounce Hares hair cut very small a dram and a half Whites of Eggs dried in the Sun and powdered half an ounce New Spunges torrified an ounce white Vitriol a dram Mix them and make them into a fine Powder 5. Pain which must of necessity be eased because it creates watchings and dejects the Spirits and is cause of the Flux of Humors to the Party affected and of Inflamation Fever and Gangrene but the Causes are diligently to be considered For if either Medicines that are sharp or too hot occasion it they are presently to be altered 'T is better to confess the Error than pertinaciously to persevere in it If any foreign Body remains in the Wound it must be drawn forth If pain comes from the choaking in of the Matter you must allow it a free passage If an Inflamation be the cause of it its Remedies are set down in the second Chapter of the first Book You must apply to the Wound those things which ease pain and are anodine as Oyl of Roses Linseed Camomile Worms sweet Almonds Poppies c. Take Oyl of Roses of Poppy-seeds of Camomile of each an ounce the White of an Egg Saffron a scruple Mix them But if the pain cease not with these or the like Medicines it is a sign that some Nerve is wounded or affected by consent The Cure shall be set down in the following 6. Convulsion or Spasm this shews the Malignity of the Humor or the ill constitution of the Nerves neither of them promising any good Here must be used both Internal and External Medicines appropriated to the Disease the Internal by reason of the diversity of causes we commend to the Physitian External Medicines for a Convulsion Balsam of Peru the fat of Geese Castor Foxes Rams Mans Horse-dung Oyls of Juniper Lavender Ol. Philosophorum Amber Turpentine Rue Marjoram Worms Castor Orise Bays Petraeleum Ointments of Agrippa Martiatum Ung. Nervorum Spirit of Wine Take Oyl of Snails Worms Sesamin of each an ounce of the Grease of Rams and Foxes of each half an ounce fresh Butter six drams Spirit of Wine three ounces Let them boil till the Spirit be consumed then add Oyl of Spike distilled Rosemary Amber of each two drams Mix it into an Ointment Against a Convulsion there cannot a better Remedy be invented than distill'd Oyl of Lavender some few drops being given in some convenient Liquor and anointing well the convulsed part 7. Hypersarcosis or too great increase of flesh which if it happens from abundance of Blood the flesh is solid and otherwise well conditioned but if from the too weak quality of drying Medicines it is spungy of the same nature as when the Bone underneath is rotten In the former Case Bleeding is convenient and sometimes fasting and the use of strong drying Medicines In the latter the Medicines must be very strongly drying that are applied Detersive and Corroding Remedies are here good Medicines against too great increase of Flesh Burnt-Spunges Burnt-Allom Galls Aloes the Bark of Frankincense Tutty Verdigrease burnt Vitriol Praecipitate Arsenick A Green Corrosive Water Take crude Allom Verdigrease of each two drams boil them in eighteen ounces of white-Wine to a wasting of the fourth part strain them and add Camphire a dram Mix them A Powder very drying and somewhat corroding Take Galls Balaustions burnt-Allom Frankincense Myrrhe of each a dram dragons-Dragons-Blood Ceruse Verdigrease of each half a dram Make it into a Powder 8. A Gangrene and Sphacelus concerning which look in the fourteenth Chapter of the first Book of the second Part of Chirurgery CHAP. V. Of the drawing forth Extraneous Bodies out of the Wound NO Wound ought to be joined together as long as any Extraneous Body remains in it for otherwise after some little time it will break out into an Ulcer The Blood by which Nature unites the divided Parts if it flow in great quantity to the wounded Part and there coagulates 't is to be removed by Expression sucking it out or by any other way for so there will be less Matter generated and the Symptoms fewer but where an Haemorage is feared all the Blood is not to be cleansed away Where Hairs are about the Wound they are to be removed If Sand or any such like thing remain
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
quiet of their Mind and the good of their Patients they would beware of bleeding in Pestilential and other Malignant Fevers as also in all cases that may befal People by Poyson either inward or outward The French Italians Spaniards and Portugueses great Blood-letters will I expect tell me That Nature when by bleeding she hath vent and is somewhat discharg'd shall be better able to throw out the remaining Evil. And this seems to be true for the blood indeed receives Air that the Spirits may the better flie away and is robb'd of that strength which it so necessarily wants whereupon Nature exchangeth the Life of the Patient for death and extorts tears from the By-standers Without alledging other Reasons they ground themselves upon Experience And it were to be wished they had that ground indeed for we find such Patients of theirs who in the morning were in no danger even after but the taking away of five or six ounces of Blood to be cold and stiff at night Whence it may easily be collected what it is they call Experience viz. If the Patient by chance escape death then Bleeding must have the honor of it but if he die as for the most part then the malignity of the Disease was the cause of it Wherefore I alledge Experience against Experience and praise God Almighty that he hath vouchsafed to furnish all those who without envy passion or slavish dependance upon others will duly consider Diseases with surer means The more moderate sort of them would have Bleeding only administred in the beginning of the Disease and before the Malignity appears outwardly This I shall willingly allow them 1. In very hot Countreys 2. In a Plethorick Body 3. If the humors flying to the head cause any grievous symptoms there in which case bleeding in the Hand or Foot may be I think very beneficial Otherwise those that use it in all bodies and without distinction in these cold and moist parts will find the ill effects of it and be puzled withal to give a reason for their Practice allowable by Art the rather because by their own confession they dare not use this their Darling of Bleeding at certain times but find themselves best in the use of Sudorificks and cooling Drinks But enough of this Now how many Ounces of Blood ought to be taken at once the degree of the Disease and the Patients more or less strength will indicate And 't is better too little than too much I have never taken more from the strongest and most plethoric Person under my Cure than twelve ounces at once chusing rather in case of need to let out twenty ounces at two times than fifteen at once of which method I have found good success As to the season of the year and the hour of the day little regard needs to be had in those Diseases wherein bleeding cannot be deferred without danger as in Plurisies Squinancies c. Otherwise the Spring and Autumn and the Morning are best The veins that are wont commonly to be opened are these In the Forehead the Vena frontis in the Temples the Vena Temporalis in the Mouth the Vena sublingualis or Ranularis in the Neck the Jugularis externa in the Arm the Basilica under which lieth an Artery the Mediana under which lieth a Nerve and under both of them a Tendon and the Cephalica which hath under or near it neither Artery Nerve nor Tendon and therefore may safely be opened This last hath but one small Branch that runs outward to the head whence it hath got the name of the Head Vein Without this consideration it little matters which of these three be opened in regard that about the Arm-pits they all acknowledge no more but one Branch In the Hand between the little finger and its neighbour the Salvatella in the Foot the Saphena and Ischiatica The manner of Bleeding is so well known that I think it needless here to describe it only I could wish that some of those that let blood would take care somewhat better to guess of the number of Ounces of Blood they take from their Patients that so we might not find 12 16 18 yea 22 ounces drawn away instead of 6 or 8 that were prescribed To prevent so intolerable a mistake I would advise that small Porringers of Tin or Copper were made in which the number of ounces were mark'd though expert Masters do not at all need them as knowing that Blood is really weightier than it outwardly seems CHAP. XII Of the opening of Abscesses or Imposthumes THe Humors here and there gathered do often cause a Swelling which nature is not always able to dissipate unless Art do succor her by fit means which if fruitless you must use Suppuration and then stay till she of her self make an opening except there be a necessity to hasten one or even not to stay for a perfect Suppuration As 1. When the matter being very sharp or malign upon which happens a Corrosion of the neighboring parts and a corruption of the Bones Tendons or Nerves 2. When it may affect a nobler part 3. When it lieth in the Joynts 4. When it is cast out by a Crisis Before you proceed to the opening you are to consider whether the matter be contain'd in its own proper Tunicle or whether it be without any Tunicle If without any then make your apertion with a right Line observing the Fibres of the Muscles For Example In the head according to the position of the Hair long-ways in the Eye-lids transverse in the Temples the Nose Neck Breast Back Arms Feet Joynts long-ways in the midst of the Abdomen let it be long-ways in the sides of it somewhat oblique in the Groins transverse but not very deep by season of the subjacent seminary Vessels Always beware of touching any great Vein Artery or Nerve though the Fibres be cut a-cross lest from a lesser evil there should arise a greater The properest place for the opening is the most raised and softest part of the Abscess if possible in the depending that the purulent matter may the more conveniently be discharged To which end also you are with a Tent so long to keep open the wound until the part being altogether cleansed of its preternatural Humors may return to its former Functions In the opening thrust not in the Launcet too deep nor further into the Cavity than to the matter and as soon as you perceive that draw it a little back and turn the point upward making your opening through the Skin so big as may afford the contained matter a free vent If the Abscess be included in a Tunicle if small make the Incision long ways if big then make a double incision that is cross-ways and beware of touching the Vesicle otherwise you must expect a foetide and almost incurable Ulceration This being well done press out with your Fingers the Vesicle which seldom or never sticks to the Skin and easily follows cut off the little Artery
Fissure and foul Bone in the Teeth also when they are crusted over with a Tartarous black substance the Bones are to be scraped till you come to the sound part which is white and solid and a little blood cast forth and to the Bone thus scraped some drying Powder is to be applied the Pericranium and Periostium must first be seperated from the Bone before you go about this Operation for by no means are they to be touched with the Instrumenr neither likewise the lips of the Wound Filing is used in the Teeth for when they unnaturally stand forth and either in Eating or Speaking are any hinderance to a man then that which thus sticks forth is with a File to be taken off which must be done carefully without any injury to the neighouring parts and by degrees neither with two great a Violence lest it loosen the Tooth The use of the Saw is in a mortified part when the Bone is to be cut a sunder concerning which Operation I shall suddenly speak Perforating or Trepanning is of great use when the Bones are extreamly soul but 't is of greatest use in those effects which the Fissure or a Fracture of the Skull or a Contusion may produce Seeing therefore this Operation is so full of danger 't is diligently to be enquired in what Cases 't is necessary and in what 't is not for a Fissure as a Fissure as likewise a Fracture as a Fracture requires not the Trepan as an operation without which they cannot be cured In like manner a slight Contusion doth not always occasion such dangerous symptoms that the Trepan may not cause worse for oftentimes a small quantity of extravasated Blood in Robust People is often discussed by the work of Nature her self except the innate heat be weakened by external Cold which in the use of the Trepan let what care possibly be had cannot be totally avoided besides this the Blood is more often extravasated between the two Membranes the Dura-Mater and the Pia Mater there the Trepan can seem to promise but little good but in this case I would not much matter to divide the Dura Mater Experience having taught us that by the help of Art and Nature hath an Incision nay Gangrene of the Part it self been cured Therefore for the most part but in three cases is the Trepan required 1. Where the loose pieces of the Bones prick and wound the Meninges which is to be known by the continual pricking pain presently from the very hurting perceived granted the Patient be sensible but if not he is always feeling the Part affected wirh his hands There happens likewise Contusions of the Eyes and Convulsions of the Limbs Besides the quality of the Instrument which the Fracture hath made will more plainly demonstrate it 2. Where the first Table is only depressed but the second broke there being no way to give passage to the pieces how well soever by Art or Nature separated The Signs of this are a Dimness a Giddiness a Fever Vomiting and sometimes an Apoplexy a feeble small Pulse and especially about the Temples the depressed Bone in some manner obstructing the Circulation of the Blood in the Brain 3. Extravasation of Blood upon which follows Putrefaction and if not remedied Death it self The Signs which declare this Putrefaction is a continued Fever a great Heat in the Head unquiet Sleep Watchings Inflammation of the Eyes and light Delirium and moreover the Temperaments of Bodies are diligently to be consider'd for in Plethorick People to those above-named Symptoms are joyned a Laughing Talking idly and Redness of â—he whole Face In the Cholerick appears a yellowness of the Face and Eyes great Heat and Madness In the Phlegmatick all the Symptoms are less but sometimes it is accompanied with a Palsie sometimes with an Apoplexy In Melancholy men a dread impertinent Talk and Laughing is usual Where the Trepan is necessary apply it as soon as possible lest the putrifying Blood causeth greater evils that is on the third fourth or fifth day The manner of Trepanning is thus The Hair being shav'd Let the Skin be divided with a double Incision inform of a Cross to the Pericranium avoiding with the greatest diligence always the temperal Muscles and the Sutures of the Head this done bind up the Wound except the Hemorage be small which very often is so violent that it hinders the Chirurgeon for some days from any further Operation if it will then give leave to divide likewise the Pericranium from the Skull After some few hours the Skull already bar'd of its Pericranium the Patient well plac'd his Head must by some Person be firmly held his Ears being stopt with Cotton then set on the Trepan with a Pin which must neither be upon the Fracture nor upon the Sutures although there are some that venture to apply it upon the very Sutures themselves the Surgeon holding in his left hand the Instrument and with his right let him gently turn about the Trepan until it hath taken good hold round then take out the Pin and set the Trepan on again without it moving it still about and if you see any small Filings of the Skull take off the Trepan and wipe them away and the Trepan it self is sometimes to be dipt in the Oyl that it may the easier be turned about and sometimes in Water that it grows not hot If any Blood appears you may be certain that the Trepan had past the first Table then are you to have a greater care lest the Trepan should unawares slip in and wound the Meninges from whence oftentimes follows sudden Death For the Dura Mater invests the inside of the Scull in the same manner as the Pericranium doth the out-side but yet not so strongly joined to it but that by a fall or blow it may be easily separated from the Skull When the piece of Bone separated by the Trepan begins to be loose you must with a little Instrument put in between the Skull and the Trepan'd part and free it from the whole and so gently take it out with a pair of Forceps If there remain any inequality from Trepanning in the inside of the inward Table that may cause injury to the Meninx 't is to be taken away with an Instrument called Lenticula And that there may be a discharge given to the coagulated Blood and Matter the Dura Mater is to be compressed with an Instrument called a Decussorium To effect the same 't is commended that the Patient if sensible his Mouth and Nose being shut hold his Breath so that the Brain being raised upward the concreted and corrupted Matter may be thrown forth but very seldom is the Matter discharg'd by this only remedy for the Chirurgion hath need enough of the Decussorium Spunges Lint and the like Instruments the description and delineation of the which you may find in Joh. Andr. Ã Cruce Paraeus and others Read the 4 th Chapter of this Chirurgery where Fractures of the
pint and half Dissolve the Gums in Vinegar and let the rest be powdered mingle them according to Art and boil them into the form of a Plaister Epulotick or drying Medicines Roots of Comfry Tormentil Herbs St. Johns-wort Plantain Sanicle Fluellin Betony Flowers of Balaustians Red Roses Saunders Aloes Myrrhe Mastick Sarcocols Lapis Calaminaris Red Lead Lead Litharge Tutty Ointments of Diapompholigos Album Camphoratum Plaisters Gryseum de plumbo Opâ—deldoch de Minio Barbarum Take Oyl of Roses of unripe Olives of each three ounces of Myrtles Ointment of Poplars of each an ounce and half Leaves of Plantain and Night-shade of each an handful let them steep together eight days afterwards add to the strain'd Liquor Wax two ounces mingle them over the fire adding Litharge of Gold three ounces Ceruse an ounce Tutty a dram Burnt Lead three drams Burnt Brass a dram and an half Camphire a dram let them be rubb'd in a Leaden Mortar into the form of an Ointment Take Roots of Tormentil Bistort round Birth-wort burnt Egg-shels Frankincense Dragons-blood of each half an ounce Lapis Calaminaris a dram Litharge two drams Make it into a Powder Take Ung. Pompholigos Diapalmae Grisei of each an ounce Gum Elemny two drams Saccharum Saturni half a dram Wax as much as sufficeth to make it into a Plaister I never knew any better Medicine if applied in a fitting time to bring to a Cicatrice than an Amalgama of Mercury of which this is the description Take two ounces of Lead melt it then add to it two ounces of Quick silver pour it upon Paper dried and powdered it may be mixt with the Plaister of Lead or Diapompholigos To these External Remedies we join also Internal Medicines which have been observed to profit much at all times in the Cure of Wounds Vulneraries Wintergreen Sanicle Ladies-Mantle Comfry Mugwort Saxifrage Tormentil Agrimony Milfoil Horse-tail Hounds-tongue Betony Periwincle Mouse Ear Golden rod Birthwort Bistort Dictany Centory the less Gentain A Wound Dring Take Roots of Comfrey the greater half an ounce of Wintergreen two handfuls of Sanicle two pugils Straw-berries Ladies-Mantle Sage of each an handful boil them in red Wine and to a pint and half of the strained Liquor add of the whitest Sugar as much as is sufficient Dose three ounces Another very effectual even when the Bone is hurt Take Roots of round Birthwort an ounce and half Sowbread an ounce Self-heal Crane-bill of each an handful Savin three drams Mummy two drams Crabs-eyes half an ounce Galangal two drams powdered and cut boil them in red-Wine and to three pints of the strained Liquor add of the Syrup of Comfry of Fernelius four ounces mingle them Dose two ounces If any desires an Ointment that many boast is able to cure the wound though the Patient be absent this is its best description A Sympathetick Ointment Take Moss two ounces Mummy half an ounce Mans fat two ounces mans-Mans-blood half an ounce Oyl of Linseed two drams Oyl of Roses Bole of each an ounce Mix it and make an Ointment Some use only Vitriol calcin'd in the Sun but whosoever shall use them without Superstition shall find many things attributed to Medicines that are due to Nature therefore 't is safest to proceed in the beaten way CHAP. VIII Of Wounds of the Nerves IN Treating of the Wounds of the Nerves we also comprehend those of the Tendons because there is scarce any difference in the Cure it self 'T is to be distinguished here where the Nerve or Tendon be divided or only prick'd This Wound is known 1. By considering the wounded place and by Anatomy which teacheth in what Members the Nerves are inserted but the Tendons seeing they terminate near the Joynts the Hands and Feet having many if a Wound should be inflicted in these parts who would not fear them to be so hurt especially if it be with a transverse wound 2. From the great Pain which causes Pulsation Inflamation Convulsion and Delirium c. except the Nerves be wholly transversly divided and then the Symptoms are altogether not so grievous Prognosticks All the wounds of the Nerves are dangerous a Puncture more dangerous than an Incision Wounds of Tendons are less dangerous than Nerves Convulsion is an ill sign Nerves and Tendons wounded do easily putrifie Cure In all Wounds of Nerves or Tendons seeing pain greatly molests occasioning many Symptoms care is to be taken that it be alleviated as soon as possible Outward cold things do here hugely injure not only the Air but Medicines themselves For Experience hath taught us that cold moist and astringent Medicines do nought but hurt therefore 't is best to use Medicines moderately hot and drying but void of any sharpness The Wound also is to be kept open till the Cure be absolutely performed that the Matter may flow freely forth which if kept in may increase the pain and cause the putrefaction of the Nerve which if it should happen the corrupt Part is to be cut off or removed by an actual Cautery Moreover it is to be observed whether the Nerve or Tendon lies bare or not if bare warm Medicines are convenient but if covered hotter Medicines are required in the mean time Purging and Bleeding are not to be neglected External Medicines in Wounds of the Nerves and Tendons Old Oyl of Olives of Earth-worms of Dill Rue Rosemary Costmary white-Lillies St. John's wort Castore of Turpentine Wax Lavender Balsom of Peru Gums Elemi Tacamahac Caranna Opobalsamum Capayvae Spirit of Wine Take Venice-Turpentine Tears of the Fir-tree of each an ounce Gum Tacamahac half an ounce of Caranna two drams Balsom of Peru three drams Propoleos six drams Oyl of St. John's wort an ounce Make it into an Ointment Oyl of Wax Lime water and the brown Ointment of Faelix Wurtz are here excellent if rightly used CHAP. IX Of Wounds by Gun-shot ALthough daily practice teaches us that Bullets may be poison'd yet they are not so of their own nature for the pain in part and the other Symptoms arise from the solution of the continuity and the contusion Here first the Bullet and any thing else that accompanies it is to be drawn forth lest pain and inflamation coming upon it may hinder and care is to be had that neither of them increase and the contused Part by the following Medicines be brought to suppuration Take Oyl of white Lillies of Violets of each two pints two Puppies newly whelp'd boil them till their Bones be almost dissolv'd then add Oyl of Earth-worms a pint and boil them again strain them and add of Venice-Turpentine three ounces Spirit of Wine an ounce Make it into a Liniment A Wound-Ointment Take Venice-Turpentine an ounce Galbanum two drams Calfs-marrow half an ounce Powder of Scorzonera and Scordium Roots of each two scruples Oyl of St. John's-wort half an ounce the Yolk of an Egg Threacle a dram Make it into an Ointment Another more effectual Take Roots of Birthwort powdred a scruple and an half Mummy
of others if thou dilligently require of what parts the Fabrick of thy Body consists to this end first we will shew the simple parts and their use then after the division of the whole Body the compounded Parts The Chirurgical use Seeing 't is very necessary even at first sight that thou shouldst know the nature and temperaments of Men because they give the Rules of what is to be done in the curing of each Disease we have thought it convenient in the very beginning of this Treatise to describe their Signs The Sanguine abound with Hair but lank and yellowish in process of time declining into blackish handsom red cheek'd freshy strong When young addicted to Venery not enduring â—â—â—ours easily sweating phthisical affable in their Conversation and Discourse not suspicious equally prone to laughter and tears they sleep soundly their dreams are pleasant Pulse is great and strong Urine yellowish and in great quantity soluble They hate Women and except in their company seldom think of them They bear Bleeding provided it be at a fitting time and in a convenient quantity otherwise they easily fall into a Dropsie Strong Purges to wit Euphorbium Scammony Colloquintida and those that are compounded of them they cannot bear though gentle Medicines easily as Cream of Tartar Manna Tamarinds Pruines Syrup of Roses with Senna Syrup of Succory with Rhubarb Pulp of Cassia Electuaries of Diacatholicum Lenitive c. As they easily fall into a Disease so they quickly again recover The Cholerick have black Hair and for the most part curled lean but very strong Coition profitable they are judicious and swift in action avoiding idleness they trust neither the words or gestures of Men soon subject to Laughter if the thing require it otherwise grave When irritated addicted to strike more inclined to Drink and Watching than to Eating and Sleep their dreams are of Fire Thunder Quarrels Battels Pulse strong quick and great Urine high-coloured as also their Excrements Choler requires not Bleeding yet permits it if there be a quantity of Blood joined with it but it must neither be excessive nor oftner repeated than just necessity requires lest the Choler shews its Malignity gentle Purges relieve it but strong irritate it it produceth vehement and dangerous Diseases and for the most part short Phlegmatick have long Flaxen Hair which easily falls off and as easily grows again Pale-fac'd cold and weak Body long ere they desire Marriage and soon debilitated by it sloathful unfit for Conversation not sollicitous about publick Affairs difficulty brought to Laughter or Anger which then lasts not long They eat and drink little prone to sleep Dreams are of Fish of the Water and Rain Pulse small and slow Urine pale and sometimes thin but generally thick and darkish the Belly soluble they bear not Bleeding except upon necessity they endure strong Purging their Diseases are long but not dangerous The Melancholick are almost destitute of Hair which is lank and black of a grim Countenance the whole skin livid lean slow and addicted to Venery prudent morose in conversation readier to give counsel to others than to themselves not subject to Laughter or Anger but long before appeased they eat and sleep much Urine copious Excrements little grievous Dreams Pulse small slow and hard Bleeding is hurtful Purging profitable the Diseases which it begets are stubborn and tedious and oftentimes more dangerous in the end than in the beginning Let these general Signs suffice in this place But 't is to be observed that the Temperaments are mixt and then the Signs are also Yea many Mutations Vices and Dissimulations as also Virtues and Ingenuity may be attributed to them which is your part judiciously to distinguish but we assent not to Galen who held that the dispositions of the Mind relie upon the Temperaments CHAP. II. Of the Parts in general· A Part properly so call'd is a firm limited Body which is nourished by other living Parts but doth not nourish having a peculiar use and operation for the advantage of the whole It is distinguished 1. Into the Principal Parts or or those not so Principal are those that perform some Noble Operation common to the whole Body as the Heart Liver Brain Testicles Those not so are those that serve the Principal and whence they are call'd their Servants as the Eye Ear Hands c. This distinction pleased some Anatomists many years since whom I much esteem yet not me For if the Liver and Heart are numbred amongst the Principal Parts because they elaborate the Blood for the advantage of the whole Body why is not the Tongue accounted a Principal Part also which is not only an Instrument of Speech by which we are distinguished from Beasts but also of Tastes by whose assistance we chuse those Aliments which are best which if wanting how the Heart and Liver could supply the Body with good Nutriment I see not The Brain governs all but how I beseech you If the Intestines did not perform their Orifice aright what would it effect How should we be esteem'd if like an Oister we should want Eyes and Ears How despised are the Feet and Hands yet in how many conditions do they serve For those not stirring both Chilification would be impaired and the Blood and the Spirits rendred thicker and the Brain made unfit for all actions In how short a time would the Limpha of our Body be corrupted if besides its own motion it was not also moved with the whole Body All things in our Body are joyned together as in a Clock one cannot be without the other neither is the most despicable Wheel less necessary than the Hand of the Clock itself without which it cannot be accounted a Clock 2. Into similar Parts and dissimilar A similar which divided into many parts yet whose single parts be of the same Nature with the whole Dissimilar are made up of more or less similars as the Hand Fingers Feet There are ten Similars found in the Body a Bone Cartilage Ligament Membrane Fibre Nerve Vein Artery Flesh Skin the eight former are made of Seed Flesh of Blood alone the Skin of both This Division is subject to greater difficulties than the former but seeing it is not convenient to reject it without the greatest confusion in the practice of Physick let us consider the thing it self committing the Disputes concerning the Name to the Schools Chirurgical Considerations 1. A Principal Part being affected or wounded renders the whole Cure dangerous therefore Prognosticks are not to be given here but with limitation lest the sudden alteration be rather ascribed to thee than to the Disease 2. Wounds of the similar Parts are less dangerous than of the dissimilar yea oftentimes they are sooner cured by simple Medicines than by compound the consent of the Parts by reason of the Vital and Animal Spirits is so great that scarce a Joint of the Finger being hurt can be cured without regard had to the whole Body In deed by the
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
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
of some Humor which renders the Cure very difficult For this I commend the often praised Restorative Powder 3. A great Tendon is inserted in the Calcaneus or Bone of the Heel which being wounded or much contused brings Convulsions and death it self About this place comes Kibes whose cause is intense cold or heat with driness Here first are observed Fissures in the Skin then follows an Ulceration All fat things and Plaisters profit here especially the following Take Powder of Galls of round Birthwort of each half a dram red Lead a dram Mercury sublimate six grains Litharge Mirrhe of each a dram and half Camphire a scruple Franckincense two drams green Wax as much as sufficeth to make it into a Plaister In the room of green Wax you may take the Fat of Deer or of Rams 4. The Fingers or Toes being frozen must be rubb'd with Snow or with a bruised frozen Turnep then this following Plaister is much commended Take Hogs-grease fresh Oyl of Olives of each an ounce white Wax two ounces boil them a little and make a Plaister 5. Issues are often made in the Joynts we have formerly declared the place In the Arms between the Muscle Deltois and Biceps in the Thigh two fingers breadth above the Knee in the inside in the Leg the uppermost two fingers breadth below the Knee the lowermost two fingers or three above the Ankle That you may make these Issues without pain instead of a Conclusion take this Caustick which works without pain which is also very much to be commended in sordid and cancerous Ulcers and in Excrescencies Take Crude Brimstone white Arsnick Crude Antimony of each two ounces the Brimstone being melted by a gentle fire and stirred about with a Spatula add the Arsnick and Antimony powdred and mix them whilst they are incorporated with the Brimstone and look red Afterwards Take of this Mixture an ounce Caput mortuum of Vitriol half an ounce Mix them and make a Powder let it be washt six times in Spirit of wine and dried for your use A TREATISE OF THE PLAGUE THE Plague is a Disease whose nature is not to be comprehended by us the Cause thereof seems to proceed from a Spirituous and Infectious Vapour which is powerful enough to make a sudden dissolution of the consistence of the Blood by which means the Heart is deprived both of strength and life I do assert that the Nature of it is not to be comprehended by us as well because it is a Punishment inflicted on us by the immediate hand of Almighty God who vouchsafes not that his Incomprehensible Wisdom and Essence which is sometimes faintly described to us should be narrowly pryed into by his creatures as also that it is in it self so mutable that if we should seriously recollect our selves and recount the several Pestilences wherewith all former Ages have been visited we shall not thereby be able to instance in two of that whole number which have agreed with each other in all circumstances From whence we may easily infer that in the Cure of this Disease an Experienced Physician may much more safely follow the Dictates of his own Reason than adhire strictly to the Method Prescriptions of others For although it doth sometimes by the more remarkable symptoms sufficiently evidence it self yet we cannot likely discover its Nature and Essence although we should the most industriously attempt it But that we may cautiously enquire into it we must know that it is sometimes not accompanied by any Fever And it is necessary that what Physician soever is ignorant of this should either by perusing good Authors or his own Experience acquaint himself throughly with it I have been sent for to several Patients my self who although they appeared otherwise in good health not refusing their meat nor disturb'd in their sleep have nevertheless had Buboes arising in their Groin on their Neck under their Arm-pits or behind their Ears which have apparently discovered a greater Malignity than could be discerned in those Buboes which in other persons have been attended by a violent Fever And many hereupon who have been incredulous and lightly regarded the cautions which I have given them upon this account have with great danger to themselves experimented that as soon as those Buboes have sunk down the Pestilential Symptoms which have appear'd have been very dreadful and much more dangerous than in those that have carefully used the means prescribed to them who have been also much more easily and speedily cured than the other Sometimes the Plague is accompanied with a Fever and again there are some Pestilent Fevers without the Plague To distinguish this Fever from the Plague I used to observe that they that are seized with it complain of pain in their Head and Stomach which sometimes is dispersed over the whole Body sometimes it confines it self to the Arm-pits the Neck the Parts behind the Ears or to the Groin To outward appearance there is not the least swelling If the Patient by such means as is requisite be provoked to sweat at the beginning of the Disease the pain utterly ceaseth and in a few dayes he will be perfectly restored to his health the Disease not having at all discovered it self by any outward Symptoms Why such a Fever should be accounted a Species of the Plague I see no reason But there is no one but will confess it to have seized on that Body on which Buboes Carbuncles and Spots do outwardly appear The cause of the Plague is either Internal or External but unto which soever we impute it it is necessary to conclude that there is in it a power of dissolving the natural Consistence of the Blood and depriving the whole Body of its strength As to the Inward Cause which is Meat and Drink it is evident to all that it cannot produce in any Body whatsoever so great sudden a change but it is most certain that by a long continued course of bad Diet the Blood may by degrees be after such a manner dissolved weakned and corrupted that some part of it assuming to it self a malignant quality a man may be surprized by a sudden Disease sometimes be deprived of life it self which hath been observed in sick persons at several times when there hath been no contagion in the place nor any suspected who have been troubled with perfect Buboes and other Symptoms of the Plague much more intolerable than others have been at any time when the Air hath been infected As to the outward Causes every one confesseth that there are such but their Nature is known but to few The Chymists who are able by the force of Fire distinctly to separate the Parts of simple Drugs endeavour to find the Original of the Contagion in a Volatile Salt which suddenly dissolves the fixed Salt of the Blood which hath indeed some appearance of truth though it will not be relished by all men If you enquire into the Cause hereof from others their
as also of Hereditary Maladies together with their Remedies 'T Is known seldom to fail that in an army there reigneth some Disease or other according to the nature and constitution of the Country Air and Diet. The reasons are First that amongst so great a number of Men raised from so many different places there are to be found Men of very different tempers and constitutions sound and unsound and amongst the latter some that are scabby others scorbutical others labouring under venereal Diseases many inclined to dangerous and infectious Fevers c. all which a Physitian must have a watchful eye upon and endeavour to prevent their spreading Secondly that Souldiers in an Army want conveniences wherewith to take due care of their health but are often constrain'd to expose themselves and sleep in the open Air on moist ground the vapours whereof penetrate into their bodies and they are careless or want oppertunities of expelling them out again by sweat Whence is caused an inward putrefaction in the blood and humours which sometimes proceeds so far as to assume a venemous nature and to break out into spots tumors bubo's carbuncles c. Thirdly that Souldiers commonly keep an irregular diet Sometimes they have plenty and do supperabound at other times they have nothing and then being very hungry when they come again to a place of plenty they over-feed and surfeit whence are bred crudities in the Stomach and corruption which causeth malignant Fevers in abundance Besides they often feed upon Meat that is unwholsom as stinking Venison rotten Cheese musty Bread c. which cannot but occasion many Diseases And when they come to places where Fruit abounds as Apples Pears Plums Melons Cherries Grapes c. they over-eat themselves and thereby cause Gripings in the Guts Diarrhaea's c. Lastly sometimes the Air is corrupted especially after a great Battel and slaughter of Men that remain unburied whereby the Air being tainted infects the living that take it in Which is often made worse by the exhalations of low and moorish ground and by thick Fogs These are the general Causes of the common Distempers reigning in Armies against which thou art to arm thy self accordingly First then be careful in thy Diet eat not greedily and indiscreetly every thing that comes to hand and though it be good yet eat and drink not too plentifully of it but restrain thy appetite considering how destructive every excess may be to thy health If thou canst and hast no aversion from it drink every Morning of thy own Vrine which prevents corruption in the Stomach opens obstructions in the Liver Spleen Mesaraic Veins which if not removed there will follow Fevers the Yellow Jaundice Swellings and difficulty of breathing If thou art averse from doing so eat some Bread and Butter with Rue on it or if it be not hot weather take in the morning the quantity of a Hasel-nut of Mithridate or Treacle or infuse in Brandy or rather in Spirit of Juniper-berries some Zedoary Angelica and a little Citron-peels and drink a spoonful of it in the Morning When the Air is corrupted and there be at hand a Goat rub thy self at him and let not the strong smell keep thee from it Also put Quicksilver in an empty Hasel-nut closed up with Spanish Wax and hang it about thy neck or the Zenechton prepared of Arsenic after the manner by and by to be described sowed up in thin Leather for if it should touch the bare skin it would cause Blisters and do harm This Zenechton is a Plaister out of which are cut pieces of the bigness of a Dollar which are carried about the Neck and hang down near the Heart keeping good a whole year And when the infection is past this Zenechton being reduced to Powder will yet serve to kill Rats and Mice with It is to be thus prepar'd Take of Yellow and White Arsenic of each an ounce or ¾ of an ounce of gummi Tragacanth ½ an ounce put this gummi in Rose-water or in common water over night and it will yield a slimy Water Then beat thy Arsenic in a Mortar and put so much of this gummed Water to it as is necessary to reduce it to a Paste having the consistence of Dough work it well and round it and then cut off a slice of the bigness of a Dollar somewhat thicker let this slice dry in the Air and sow it in a piece of thin Leather well-dressed Dogs-skin is the best for this purpose carry this about thy Neck so as to let it hang down upon and to touch the place of thy Heart Some mix with it a proportion of the Powder of dried Toads which I have done my self it being esteem'd more powerful Some carry about their Necks dried Spiders Theophrastus commends Celondine Leaves and Root carried about the Neck Remember also to burn frequently Juniper-wood before thy Tent though all ordinary fires cleanse the Air Upon which account Hippocrates advised great fires to be made in Greece at the time of a great Plague which was thought to have been remov'd by that means Some burn only a few Chips of Juniper-roots or some of the Berries of that shrub which is as effectual If these means cannot be had burn some Gunpowder ordering it like a Train this purifieth the Air likewise And the volleys of shot made mornings and evenings in a Camp conduce very much to the dispelling of Mist and qualifying raw weather Frankincense also Mastick and such other Perfumes as dry and clear the Air may be very usefully burnt and even a Scholars Perfume made of waste Paper is not to be despised If thou canst get Rue smell often to it And remember me for this general hint to take good notice of all Herbs that are green Winter and Summer and which are not eaten by Horses or Cattel for they are endow'd with excellent virtues for the good of Man and therefore made to grow at all seasons of the year When the Air is pestilential or breeding any Epidemical Disease then wash thy face with Vinegar every morning If thou canst get Acetum of Rue Elder-flowers Lavender Roses Marigold-flowers 't is the better Or if you have the conveniency prepare the following Acetum Take Rue Elder-flowers Burnet-roots white Dittany Carlina of each equal quantity a few Orange or Citron-peels of which the latter are the better of the two and a little Camphire and some Walnut-kernels the fresher the better leaving the bitter skins upon them put all these into common Vinegar and with this infusion moisten every morning thy Temples Mouth and Nostrils and the beating Arteries of both thy Wrists taking down a good spoonful of it and thou hast a good preservative If it be cold weather take Angelica-roots Zedoaria white Dittany some dried Citron-peels and a little Camphir infuse them all in Brandy especially in such as is made out of Wormwood or Juniper-berries Of this Liquor drink in the morning a spoonful But if thou be of a