tamed desirous of sedition and novelty stubborn impatient of servitude as may be perceived by the sole example of the Inhabitants of Narbon a Province of France Those who dwell in poor and barren places are commonly more witty and diligent most patient of labors the truth of which the famous wits of the Athenians Ligurians and Romans and the plain country of the Boeotians in Greece of the Campanians in Italy and of the rest of the Inhabiters adjoyning to the Ligurian Sea approves CHAP. VIII Of the Faculties What a faculty is A Faculty is a certain power and efficient cause proceeding from the temperament of the part and the performer of some actions of the body There are three principal Faculties governing man's body 3. Faculties as long as it enjoys its integrity the Animal Vital and Natural The Animal is seated in the proper temperament of the Brain from whence it is distributed by the Nerves into all parts of the body which have sense and motion This is of three kinds for one is Moving another sensitive the third principal The sensitive consists in five external senses sight hearing taste smell and touch The moving principally remains in the Muscles and Nerves as the fit instruments of voluntary motion The Principal comprehends the Reasoning Faculty the Memory and Fantasie Galen would have the common or inward Sense to be comprehended within the compass of the Fantasie although Aristotle distinguish between them The Vital abides in the heart from whence heat and life is distributed by the Arteries to the whole body this is principally hindred in the diseases of the Breast as the Principal is when any disease assails the Brain The triple use of the Pulse the prime Action of the vital faculty is Pulsation and that continued agitation of the Heart and Arteries which is of threefold use to the body for by the dilatation of the Heart and Arteries the vital Spirit is cherished by the benefit of the Air which is drawn in by the contraction thereof the vapours of it are purged and sent forth and the native heat of the whole body is tempered by them both The natural faculty is threefold The last is the Natural faculty which hath chosen its principal seat in the Liver it spreads or carries the nourishment over the whole body but it is distinguished into three other faculties The Generative which serves for the generation and forming of the Issue in the womb the Growing or Increasing faculty which flourisheth from the time the Issue is formed until the perfect growth of the solid parts into their full dimensions of length heighth and bredth The nourishing faculty which as servant to both the other repairs and repays the continual efflux and waste of the threefold substance What Nutrition is for Nutrition is nothing else but a replenishing or repairing whatsoever is wasted or emptied This nourishing-faculty endures from that time the Infant is formed in the womb until the end of life It is a matter of great consequence in Physick to know the four other faculties Four other faculties attend upon the nourishing faculty which as servants attend upon the nourishing faculty which are the Attractive Retentive Digestive and Expulsive faculty The Attractive draws that juyce which is fit to nourish the body that I say which by application may be assimilated to the part This is that faculty which in such as are hungry draws down the meat scarce chewed and the drink scarce tasted into the gnawing and empty stomach The Retentive faculty is that which retains the nourishment once attracted until it be fully laboured and perfectly concocted And by that means it yields no small assistance to the Digestive faculty The necessity of the retentive faculty For the natural heat cannot perform the office of concoction unless the meat be embraced by the part and make some stay therein For otherwise the meat carried into the stomach never acquires the form of Chylus unless it stay detained in the wrinkles thereof as in a rough passage until the time of Chilification The Digestive faculty assimilates the nourishment being attracted and detained into the substance of that part whose faculty it is by the force of the inbred heat and proper disposition or temper of the part So the stomach plainly changes all things which are eat and drunk into Chylus and the Liver turns the Chylus into blood But the Bones and Nerves convert the red and liquid blood which is brought down unto them by the capillary or small veins into a white and solid substance Such concoction is far more laborious in a Bone and Nerve than in the Musculous flesh For the blood being not much different from its nature by a light change and concretion turns into flesh But this Concoction will never satisfie the desire of Nature and the parts unless the nourishment purged from its excrements put away the filth and dross which must never enter into the substance of the part Two excrements of every concoction Wherefore there do not only two sorts of excrements remain of the first and second Concoction the one thick the other thin as we have said before but also from the third Concoction which is performed in every part The one of which we conceive only by reason being that which vanisheth into Air by insensible transpiration The other is known sometimes by sweats sometimes by a thick fatty substance staining the shirt sometimes by the generation of hairs and nails whose matter is from fuliginous and earthly excrements of the third Concoction The work of the expulsive faculty Wherefore the fourth faculty was necessary which might yield no small help to nourishment it is called the Expulsive appointed to expel those superfluous excrements which by no action of heat can obtain the form of the part Such faculties serving for nutrition are in some parts two-fold as some common the benefit of which redounds to the whole body as in the ventricle liver and veins Others only attending the service of those parts in which they remain and in some parts all these four aswell common as proper are abiding and residing as in those parts we now mentioned some with the four proper have only two common as the Gall Spleen Kidnies and Bladder Others are content only with the proper as the Similar and Musculous parts who if they want any of these four faculties their health is decayed either by want of nourishment and ulcer or otherwise By what degrees the nourishment is assimilated The like unnatural affects happen by the deficiency of just and laudable nourishment But if it happen those faculties do rightly perform their duty the nourishment is changed into the proper part and is truly assimilated as by these degrees First it must flow to the part then be joyned to it then agglutinated and lastly as we have said assimilated Now we must speak of the Actions which arise from the faculties
the Muscles it is of a nervous substance as all other membranes are The quantity and breadth thereof is bounded by the quantity of the Muscles which it involves and fits it self to as that which encompasses the Muscles of the Epigastrium is of equal largeness with the same Muscles The figure of it is round it is composed of veins nerves arteries The composure and its peculiar flesh consisting of three sorts of fibers the beginning of it is from the Periostium in that part where the bones give ligaments to the Muscles or according to the opinion of others of the nervous and ligamentous fibers of the Muscles which rising up and diffused over the fleshy superficies thereof The Original are united for the generation of this coat But this membrane arising from the Periostium as every membrane which is below the head takes its original from the Periostium either primarily by the interposition of no Medium or secondarily is stretched over the Muscles by their Tendons But if any object that this membrane pluck'd from the belly of the Muscle may seem to end in a ligament I will answer that it is the condition of every nervous part so to binde or fasten it self to another part of his own kind as to a stay so that it can scarce be pluck'd from thence The number We see the proof hereof in the Peritonaeum or Rim in the Epigastrium or lower part of the lower belly That which covers the Muscles of the Epigastrium is but one unless you had rather part it into two the right and the left distinguished by the interposition of Linea Alba The site or White-Line It is situate betwixt the Fat and Muscles for it is fastened above and below to these parts with fibers which in smalness fineness exceed the Spider's web But by its vessels it participates with the three principal parts and is of a cold and dry temper The use of it The use is to contain the Muscles in their natural union and to keep them as much as in it lies from putrefaction which may happen to them from pus or matter which is often cast forth of the similar parts into the empty spaces and distances of the Muscles Wherefore going about to separate the Fat of the Epigastrium where you must begin the dissection of mans body you must have a care that you hurt it not with your knife but that before you touch the Muscles see you artificially take it away What the White-line is that you may the more easily separate the Muscles lying under it distinguished by a manifest space at the White-Line which is made by the meeting together of the proper coats of all those Muscles CHAP. VIII What a Muscle is and how many Differences there be thereof A Muscle is the instrument of voluntary motion and simple voluntary motion is performed six manner of ways upwards downwards forwards backwards to the right hand What a Muscle is and to the left but the compound one way which is circularly the which is performed by the continual succession of the motion of the Muscles ingirting the part How the circular motion is performed Such a motion Falconers use when they stretch forth their hand and lure their Hawk We have some parts which have motion without a Muscle but that motion is not voluntary such parts be the heart stomach guts both the bladders that is that of the gall and that of the urine and divers other which have the motions of attraction expulsion and retention by the means of the three sorts of fibers for they draw by the right expell by the transverse and retain by the oblique From whence the difference of Muscles are drawn The differences of Muscles which are many and diverse are taken from their substance original insertion into the part which they move form or figure holes or openings magnitude colour site kind of fibers their conjugation or connexion heads bellies tendons opposition in action and office Some in substance are nervous venous arterious because they have manifest nerves Differences of Muscles from their substance veins and arteries as the Midriff the Intercostal or Epigastrick Muscles and many more and that for their difference from other Muscles into which neither nerve nor vein or arteries are manifestly inserted although secretly they admit them all for sense and motion life and nourishment such are the Muscles of the wrist the wormy Muscles of the hands and feet for if there be any nerves observed in them they are very small Some had rather make the difference of Muscles thus that some of them are fleshy some nervous others membranous Differences of Muscles from their original From their Original some arise from the bones as those which move the hands arms and legs others from grislles as the Muscles of the throat others from membranes which invest the tendons as the wormy Muscles of the hands and feet others from ligaments as the extenders of the fingers others from other Muscles as the two lower Muscles of the Yard which proceed from the Sphincter-Muscle of the fundament Others have no original as the membrane which we call the fleshy Pannicle assumes flesh in certain places and degenerates into a Muscle such are the Cremaster or hanging Muscles of the testicles the large Muscles of the face if you please the Midriff as that which is composed of two coats the one encompassing the ribs and the Peritonaeum hath flesh in the midst between the two membranes And moreover some Muscles have their original from one only bone as those which bend and extend the Cubit others arise of many bones as the oblique descending the Dorsal and many Muscles of the neck which arise together from many spondyls and sides of spondyls There be others according to the opinion of some men both from the bones and grisles of the Pubis at the right or direct Muscles of the Epigastrium yet by their favour I think otherwise Because by the Anatomical and received axiom A muscle is there thought to take his beginning from whence he receives a nerve but these Muscles take a nerve from the intercostal Muscles wherefore their original ought to be referr'd to the sides of the breast-blades Where a Muscle hath its original Differences of Muscles from their insertion as shall be shewed in due place From their insertion arise these differences some are inserted into a bone as those which move the head arms and legs others into a grisle as those of the Throtle eye-lids nose and the oblique ascendent muscles of the Epigastrium some into a bone and grisle both as the right muscles of the Epigastrium and the Midriff some into the skin as the muscles of the lips others into the Coats as the muscles of the eyes others into Ligaments as the muscles of the yard But these differences following may be drawn both from their insertion and original For
so it may bind them together and strengthen and beautifie the whole joint or connexion for these three be the principal uses of a ligament then diffusing it self into the membranes and muscles to strengthen those parts The treefold use of a Ligament What a Nerve is A Nâ—rve to speak properly is also a simple part of our body bred and nourished by a gross and pâ—legmatick humour such as the brain the original of all the nerves and also the Spinal marrow endued with the faculty of feeling and oftentimes also of moving For there be divers parts of the body which have nerves yet are destitute of all voluntary motion having the sense only of â—eeling as the membranes veins arteries guts and all the entrails A nerve is covered with a double cover from the two membranes of the brain and besides also with a third proceeding from the ligaments which fasten the hinder part of the head to the Vertebra's or else from the Pericranium What we mean by the nervous and ligamentous fibers We understand no other things by the fibers of a Nerve or of a Ligament than long and slender threds white solid cold strong more or less according to the quantity of the substance which is partly nervous and sensible partly ligamentous and insensible You must imagine the same of the fleshy fibers in their kind but of these threds some are streight for attraction others oblique for retention of that which is convenient for the creature and lastly some transverse for expulsion of that which is unprofitable But when these transverse threds are extended in length they are lessened in bredth but when they are directly contracted they are shortned in length But when they are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it self as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animal parts to perform voluntary motions others upon the vital to perform the agitation of the heart and arteries others upon the natural for attraction By what power the similar parts principally draw or attract What and of how many sorts the flesh is retention and expulsion Yet we must observe that the attraction of no similar part is performed by the help of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of emptiness or the familiarity of the substance The flesh also is a simple and soft part composed of the pure portion of the blood insinuating it self into the spaces between the fibers so to invest them for the uses formerly mentioned This is as it were a certain wall and bulwark against the injuries of heat and cold against all falls and bruises as it were a certain soft pillow or cushion yielding to any violent impression There be three sorts of flesh one more ruddy as the musculous flesh of perfect creatures and such as have blood for the flesh of all tender and young things having blood as Calves and also of all sorts of fish is whitish by reason of the too much humidity of the blood The second kind is more pallid even in perfect creatures having blood such is the flesh of the heart stomach weason guts bladder womb The third is belonging to the entrails or the proper substance of each entrail as that which remains of the Liver the veins arteries and coat being taken away of the bladder of the gall brains kidnies milt Some add a fourth sort of flesh which is spongy that they say is proper to the tongue alone What a vein is A Vein is the vessel pipe or channel of the blood or bloody matter it hath a spermatick substance consists of one coat composed of three sorts of fibers What an Artery is An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermatick substance But it hath two coats with three sorts of fibers the utmost whereof is most thin consisting of right fibers and some oblique But the inner is five times more thick and dense than the utmost interwoven with transverse fibers and it doth not only contain blood and spirit but also a serous humour which we may believe because there be two emulgent Arteries as well as Veins Why an artery is more thick and dense than a vein But the inner coat of an Artery is therefore more thick because it may contain blood which is more hot subtil and spirituous for the spirit seeing it is naturully more thin and light and in perpetual motion would quickly fly away unless it were held in a stronger hold There is other reason for a Vein as that which contains blood gross ponderous and slow of motion Wherefore if it had acquired a dense and gross coat it could scarce be distributed to the neighbouring parts The mutual Anastomasis of the veins and arteries Where it is manifest God the maker of the Universe foreseeing this made the coats of the vessels contrary to the consistence of the bodies contained in them The Anastomasis of the Veins and Arteries that is to say the application of the mouths of the one to the other is very remarkable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that Anastomasis is apparent in the Vein and Artery that meet together at the joint and bending of the arm which I have sometimes shewed in the Physick schools at such time as I there dissected Anatomies From whence a muscle hath its beginning or head But the action or function of a Muscle is either to move or confirm the part according to our will into which it is implanted which it doth when it draws it self toward its original that is to say its head But we define the head by the insertion of the nerve which we understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower Belly NOw seeing that we have taught what a Muscle is and what the differences thereof are and what simple and compound parts it hath and what the use action and manner of action in each part is it remains that we come to the particular explication of each Muscle beginning with those of the lower belly as those which we first meet withal in dissection Eight muscles of the Epigastrium These are eight in number four oblique two on each side two right or direct one on the right another on the left side and in like manner two transverse All these are alike in force magnitude and action so mutually composed that the oblique descendant of one side is conjoined with the other oblique descendant on the other side and so of the rest We may add to this number the two little Supplying or Assisting muscles which are of a Pyramidal form The oblique
obstructed by the thickness of this humor but they are depressed and flatted by reason of the rest of the face and all the neighboring parts swoln more then their wont add hereto that the partition is consumed by the acrimony of the corroding and ulcerating humor The seventh is the lifting up thickness and swelling of the lips the filthiness stench and corrosion of the gums by acrid vapors riseing to the mouth but the lips of leprous persons are more swoln by the internal heat burning and incrassating the humors as the outward heat of the Sun doth in the Moors The eighth sign is the swelling and blackness of the tongue and as it were varicous veins lying under it because the tongue being by nature spongeous and rare is easily stored with excrementitious humors sent from the inner parts unto the habit of the body which same is the cause why the glandules placed about the tongue above and below are swoln hard and round no otherwise then scrophulous or meazled swine Lastly all their face riseth in red bunches or pushes and is over-spread with a dusky and obscure redness the eies are fiery fierce and fixed by a melancholick chachectick disposition of the whole body manifest signs whereof appear in the face by reason of the fore-mentioned causes yet some leprous persons have their faces tinctured with a yellowish others with a whitish color according to the condition of the humor which serves for a basis to the leprous malignity For hence Physicians affirm that there are three sorts of Leprosies one of a reddish black colour consisting in a melancholick humor another of a yellowish green in a cholerick humor another in a whitish yellow grounded upon adust phlegm The ninth sign is a stinking of the breath as also of all the excrement s proceeding from leprous bodies by reason of the malignity conceived in the humors The tenth is a horsness a shaking harsh and obscure voice as it were comming out of the nose by reason of the lungs recurrent nerves and muscles of the throttle tainted with the grosness of a virulent and adust humor the forementioned constriction and obstruction of the inner passage of the nose and lastly the asperity and inequality of the Weazon by immoderate driness as it happens to such as have drunk plentifully of strong wines without any mixture This immoderate driness of the muscles serving for respiration makes them to be troubled with a difficulty of breathing The eleventh sign is very observable which is a morphew or defedation of all the skin with a dry roughness and grainy inequality such as appears in the skins of plucked geese with many tetters on every side a filthy scab and ulcers not casting off only a bran-like scurf but also scales and crusts The cause of this dry scab is the heat of the burning bowels and humors unequally contracting and wrinkling the skin no otherwise then as leather is wrinkled by the heat of the sun or fire The cause of the filthy scab and serpiginous ulcers is the eating and corroding condition of the melancholick humor and the venenate corruption it also being the author of corruption so that it may be no marvel if the digestive faculty of the liver being spoiled the assimilative of a malign and unfit matter sent into the habit of the body cannot well nor fitly perform that which may be for the bodies good The twelfth is the sense of a certain pricking as it were of Goads or needles over all the skin caused by an acrid vapor hindred from passing forth and intercepted by the thickness of the skin The thirteenth is a consumption and emaciation of the muscles which are between the thumb and fore-finger not only by reason that the nourishing and assimilating faculties want fit matter wherewith they may repair the loss of these parts for that is common to these with the rest of the body but because these muscles naturally rise up unto a certain mountainous tumor therefore their depression is the more manifest And this is the cause that the shoulders of leprous persons stand out like wings to wit the emaciation of the inward part of the muscle Trapozites The fourteenth sign is the diminution of sense or a numness over all the body by reason that the nerves are obstructed by the thickness of the melancholick humor hindring the free passage of the animal spirit that it cannot come to the parts that should receive sense these in the interim remaining free which are sent into the muscles for motions sake and by this note I chiefly make trial of leprous persons thrusting a somewhat long and thick needle some-what deep into the great tendon endued with most exquisite sense which runs to the heel which if they do not well feel I conclude that they are certainly leprous Now for that they thus lose their sense their motion remaining entire the cause hereof is that the nerves which are disseminated to the skin are more affected and those that run into the muscles are not so much and therefore when as you prick them somewhat deep they feel the prick which they do nor in the surface of the skin The fifteenth is the corruption of the extreme parts possessed by putrefaction and a gangrene by reason of the corruption of the humors sent thither by the strength of the bowels infecting with the like tainture the parts wherein they remain add hereto that the animal sensitive faculty is there decaied and as often as any faculty hath forsaken any part the rest presently after a manner neglect it The sixteenth is they are troubled with terrible dreams for they seem in their sleep to see divels serpents dungeons graves dead bodies and the like by reas n of the black vapors of the melancholick humor troubling the phantasie with black and dismal visions by which reason also such as are bitten of a mad dog fear the water The seventeenth is that at the beginning and increase of the disease they are subtill crafty and furious by reason of the heat of the humors and blood but at length in the state and declension by reason of the heat of the humors and blood and entrails decaying by little and little therefore then fearing all things whereof there is no cause and distrusting of their own strength they endeavor by craft maliciously to circumvent those with whom they deal for that they perceive their powers to fail them The eighteenth is a desire of venery above their nature both for that they are inwardly burned with a strange heat as also by the mixture of slatulencies therewith for whose generation the melancholick humor is most fit which are agitated and violently carried through the veins and genital parts by the preternatural heat but at length when this heat is cooled and that they are fallen into an hot and dry distemper they mightily abhor venery which then would be very hurtful to them as it also is at the beginning of the disease because
others to the pericardium or puâ—se of the heart and to the heart it self it descends farther within the duplication of the mediastinum and near to the rack-bones is divided into two branches which make the right nerve of the left orifice of the stomach are carried obliquely and theâ— piercing through the midriff together with the gullet to which for all that they afford â—â—ver a branch are consumed upon the leâ—t orifice of the stomach with many branche◠〈◊〉 a little net and so encompass it together with the left nerve Whence the sympathy is betwixt the stomach heâ— t. Propagations of the inner branch that it seems wholly to 〈◊〉 of nerves Hence there is so great a sympathy of the stomach not only with the bâ—a◠〈◊〉 with the heart also that such diseases as pain the upper orifice seem to be of the â—t and indeed so they are the same heart suffering pain because of this nerve being â—â—ined And this is the true cause to wit the communion of this nerve not the ne◠〈◊〉 of both the entrails as others say The inner branch goes to the inner side of the â—oâ—â— of the first â—ib of the chest and cleaving to the rack-bones under the Pleura runs down through the roots of the rest of the ribs taking to it a little branch from every one of the Intercostal nerves that issue out of the back-bone then passing through the midriff with the Descendent trunk of the great artery it is carried as far as to the Os sacrum or great bone at the region whereof it issues out three propagations which are distributed into the natural inner parts The first goes to the lower membrane of the Kall and descending through it is parted into three little branches of which one is distributed to the right side of the same membrane and to that part of the Colique Gut that is joyned into it another the least of them and a very small one to the guts duodenum and the Jejunum about its beginning the third to the bottom of the stomach on the right side and to the upper membrane of the Kall which is something the larger That which remains of this propagation is spent upon the hollow part of the Liver and the bladder of Gall. The second goes into the right kidney and the membrane thereof The third which is greater then either of the former descending to the first rack-bone of the loins reaches into the right side of the mesentery and into the Guts that are tyed thereto entring the center of the mesentery in company of an artery and a vein The remainder goes into the bladder and in women into the right side of the bottom of the womb But the outer branch of the left nerve The outer branch of the left nerve saving that in its descent it has offered sprigs both to the Pleura or membrane investing the rib and to the coat of the lungs and that outwardly as also to the purse of the heart and heart it self inwardly at that part of the Descendent Trunk of the great artery where it first issues out of the heart and is bowed to the back-bone it sends forth three surcles which returning to the said artery close together into one nerve Its propagations The left recurrent nerve which is called sinister recurrens nervus the left returning nerve and in like manner as the right one takes its progress upward and is propagated into the muscles of the Larinx or throttle After this it issues out a small sprig which is distributed through the basis of the heart and coat of it in manner of hairs Afterward the remainder descends inclining it self obliquely to the right and goes to the upper orifice of the Stomach in the right side whereof it is diffused as the right branch was before into the left side being divided into many little branches in manner of a net From this a surclo is carried down along the upper part of the stomach to the pylorus or lower orifice which when hath as it were interwoven with some sprigs it goes into the hollow of the Liver Propagations of the inner branch of the left nerve The inner branch first of all takes to it propagations from the intercostal nerves and then passing through the midriff is divided into three The first of them goes overthwart to the spleen and in the way shoots out two sprigs one which is likewise sent into the lower membrane of the Kall and part of the colick-gut which is tyed thereto another into the left side of the bottom of the stomach and into the upper membrane of the Kall The second propagation goes into the left side of the Mesentery and the guts of that place sometimes also it issues sprigs which run out with the seminary vessels through the processes of the Peritoneum or rim of the belly to the testicles The third goes to the left Kidney and the fat membrane thereof The remainder of the branch passes to the left side of the bladder and of the bottom of the Womb. The use of this pair is manifest enough Use as being very notorious when the outer branch bestows little boughs upon the middle bowels but the inner upon all those of the lowest belly and the right branch upon those of the right side the left on those of the left Besides this use it conduces by the returning branches also to the framing of the voice by imparting the faculty of motion to the muscles of the throttle The seventh pair arises in the utmost part of the nowl bone The seventh pair It s original where the marrow of the brain is ready to go out of the skull and so is counted the hardest of all the nerves that have their original within the skull But it arises in some roots separated from each other which joyning together on both sides into one it goes out of the skull through the fourth and fifth holes of the nowl-bone which are planted betwixt that greatest one which opens a way for the descent of the spinal-marrow and that at which the sixth pair goes out and presently after its egress is involved in one common membrane with the sixth pair whence some not so diligently observing it have believed that they were mixt one with another and thus they descend together When it comes to the root of the tongue it distributes surcles into all the muscles thereof sending over some also to certain muscles of the bone hyoides and of the throttle as also to those which take their beginning from the appendix called styloides It s use The use of this conjugation is to carry down the faculty of sense and motion from the brain to the muscles of the tongue To these seven pairs which are commonly so numbred The eighth pair we add an Eighth which makes the nerves of smelling by which a faculty is derived from the brain of apprehending the odors of things without These are commonly
affirmed to arise out of the marrowy substance of the brain in the basis thereof near to the first pair It s original but the new dissection of the brain and which is performed by turning it upside down hath taught us that they arise at the utmost sides of the brain in that part which is above the holes of the ears whereby it is manifest that hitherto only one half of them hath been shewn They are very sharp at their original and distant one from the other but going forward by degrees betwixt the uppermost and middle prominence of the brain they grow thicker and draw nearer one to another and so at length they lye down above the sinus or cavities of the spongy bone within the skull These are thrust into the mammillary processes of the brain but Galen and Marinus whom almost all Anatomists have followed would not call them by the name of Nerves although they altogether agree therewith in their colour course and use because they neither have productions like the rest of the nerves nor go out of the cavity of the skull but truly they seem to me to commit no other a sophism then they who have expelled the teeth out of the number of the bones because they are not invested on the outside with a membrane as others are although neither this makes any thing to the essence of the bones nor that to the essence of the nerves CHAP. II. Concerning the Nerves of the Spinal Marrow properly so called and first of those of the Rack-bones of the Neck NAture the wise parent of all things as the hath framed the nerves that they might serve for the carrying of the faculties and spirits that are generated in the brain because the brain it self could not be diffused through the whole body so when the same could not conveniently bestow nerves upon all the parts The spinal marrow by reason of their too great distance she made the spinal marrow which is nothing else but the marrow of the after-brain and brain extended through the long conduit pipe of the rack-bones of the back And therefore we having already viewed those nerves which take their original from the marrow of the brain whilest it is yet contained in the skull it remains now that we take a view of them also which come from the spondyls of the back-bone But it is called marrow not that it hath any affinity by reason of its substance with the marrow of the bones Why it is called marrow but because like marrow it is contained within the rack-bones but the substance thereof is like that of the brain which it self also Plato called marrow and it is named the spinall marrow or of the back to distinguish it from both those that are contained in the back-bone It is wrapt up into two membranes but either in the skull as the brain or in the hollowness of the bones as that which is properly called marrow This substance is covered with two membranes no otherwise then the brain it self is from whence it takes its original the one thick the other thinner which are invested with a certain third strong and membranous covering that Galen thought to be the ligament of the rack-bones But it was made to that end that it might distribute sence and motion to the muscles and membranes to which those pairs of the brain do not reach The conjugations or pairs of the spinal marrow Therefore when there is a good number of nerves arising therefrom yet we shall easily reduce them to some certain classes or companies if we say that they all make up thirty pairs of which seven belong to the marrow whilest it is carried through the rack-bones of the neck twelve whilest it is carried through those of the chest five through those of the loins and lastly six to that which is contained in the holes of the Os sacrum or great bone But these nerves go out through the holes of the rack-bones and either with a double original on the fore and hinder part as it happens in the two first conjugations of the neck and five of the great bone which arise not from the sides that is from the right of left part but issue forth two branches before and behinde or else with a single one through the hole bored in both sides of the rack-bones as happens in all the rest of the pairs in which one nerve issues from the right side the other from the left But the first and second pair have a double beginning lest if they should arise with a single one that being somewhat thicker might have been hurt by the joints of the rack-bones or if the hole should be made larger the rack-bone which was small enough of it self should be liable to breaking Therefore that both these evils might be avoined the wise Opificer made a double beginning one on the forepart another on the hinder But the right branches go everywhere to the right side the left to the left and they are distributed on both sides after the same manner The first pair of the neck The first pair thereof tab 1. η. 1. arises with its first and foremost propagation tab 1. Î’. from the forepart of the spinal marrow and passes out berwixt the nowl-bone and the first rack bone of the neck near to the sides of that round ligament wherewith the tooth-like process of the second rack-bone is tyed to the foreside of the nowl-bone and so it is distributed into the muscles over the neck and under the gullet that bend the neck With the other and hinder propagation tab 2. Fig. 1. C. it likewise falls out through the hole that is common to the nowl-bone and first rack-bone of the neck towards the hinder part but with a double sprig one of which being small is spent upon the lesâ—er strait muscles and the upper oblique ones that extend the head the other reaches out into the beginning of the muscle which lifts up the shoulder-blade The second pair tab 1. 2. with its fore-branch tab 1. D. The second pair which is slenderer then the hinder one though both of them seem small enough arising from the fore-part of the marrow goes forth betwixt the first and second rack-bones at the side of the tooth-like process which branch is distributed into the muscles that lye upon the neck as well a the fore-branch of the first pair which is wvapped together with it and is almost wholly spent upon the skin of the face With its hinder branch tab 2. fig. 1. Ε. it slips out through the sides of the backward process of the second rack-bone but presently is cleft into two branches of unequal bigness of which that which is the thicker tab 2. fig. 1. F. tends from the forepart to the hinder where the muscles seated on both sides of the hinder part of the neck do meet together there being mixt t. 2. f. 1. C with the third
another to the hinder The three uppermost of the fore-branches as that of the first pair also go to the Crus or parts of the body below the buttocks the two lowest go into the muscles of the fundament and bladder and in women to the neck of the womb in men to the yard but in both sexes to the outer privy parts The hinder branches are distributed to the muscles seated on the backside of the bones Ilium and sacrum Of this sort are the first and third extending muscles of the chest or Dorsi longissimus the long muscle of the back and sacrelumbus that which bends the loins called sacer and the broad muscle that leads the arm away from the breast as also the three which extend the thigh being the authors of the buttocks and therefore called glutaei the buttock-muscles And this is the utmost end of the spinal marrow which reaching into the rump-bone called Os coccygis is in this manner terminated And this is the history of the thirty pairs of the nerves which go out of the spinal marrow which is diligently and accurately to be committed to the memory that we may know to what place remedies ought to be applyed if at any time from some external cause as by a fall from a lost or a bruise or some notable compression any part shall have lost either motion or sense or both For the remedies must be applyed alwaies to the beginning of that nerve not to the place in which the sumprom is perceived CHAP. VI. Concerning the Nerves which are distributed through the Armes THose nerves being now enumerated which are dispersed through the muscles of the three bellyes and the parts contained in them it remains that we describe those also which are propagated through the artus or extream parts of the body Here we meet with them first which are distributed through the arms whereof there are six pairs commonly set down by Anatomists arising from the fifth sixth and seventh pair of the nerves that come out of the marrow of the neck and from the first and second of those which issue out of the chest These nerves go out through the common holes of the rack-bones on both sides and presently after their going out are united one among another with their forwarder and greater branches by and by are separated one from another again and joined again and finally separated so that they seem to make out a certain net-like texture which cannot be better likened then to those strings of Cardinals hats This implication of nerves goes forth under the clavicle or collar-bone about that place where the axillary veins and arteries go out of the hollow of the chest and from this all the nerves of the arm take their original But their rise is very uncertain by reason of their being so knit together wherefore we in our relation of them will rather follow the footsteps of other men then our own observations lest we should seem to affect new opinions rashly and without necessity The first nerve then tab 1. e which is carried to the arm is a double propagation The first nerve of the arm namely the third and fourth of the fore-branch of the fifth pair of the neck For the one branch tab 1. Î¥. is carried to the second muscle of the upper part of the arm called Deltoides and to the skin that lies upon it the other tab 1. b goes toward the neck of the shoulder-blade where it is cleft into two branches the former of which tab 1. c goes into the muscle Deltoides where it arises from the collar-bone the latter tab 1. d is inserted into the fourth pair of the Muscles of the bone Hyoides called Coracohyoideum and from thence affords a little branch to the upper superscapular muscle and the Deltoides at what place it arises from the spine of the shoulder-blade This nerve runs out through the hinder side of the arm but the other five are carried through the arm-pit into the arm and in the same are scattered into more branches The second nerve tab 1. ζ is thicker The second It s progress and take its original from that net-like complication of which we spake yet from what nerve cannot be evident enough This is carried down through the middle and fore-part of the arm into which it enters under the first bender of the cubit or the double-headed muscle at that part where its two heads are united one with the other and where the tendons are inserted both of the pectoral muscle that leads the arm forward to the breast and of the Deltoides that lifts it up Being hid then under this muscle it sends forth two propagations tab 1. η one of each side Its propagations which enters into the two heads of the muscle biceps and after that about the middle of the length of the upper part of the arm going under the same double headed-muscle it shoots forth another sprig tab 1. †by means whereof it is joined with the third nerve and from thence descending it distributes in its progress a surcle tab 1. θ from its outside to the head of the longer of the two muscles of the radius or wand that turns the palm of the hand downward When it is come to the bending of the cubit being led to the fleshy membrane near to the outside of the tendon of the said double-headed muscle it is distributed into the skin being divided into two branches of which one is the outer the other the inner that is the slenderer this the thicker The outer then tab 1. ι. Its branches The outer The inner being carried down a good way with a branch of the Cephalick vein through the inside of the cubit is distributed tab 1. λ. to the second bone of the thumb The inner branch tab 1. κ. is subdivided under the common vein of the arm or the middle one called Mediana into two branches the outer whereof tab 1. going on obliquely under the skin leaving the vein goe away toward the radius as far as to the wrist but the inner tab 1. ν being fastened to the inner branch of the Cephalick vein when it goes more obliquely in the region of the cubit is cleft into two special branches of which one tab 1. Ï€ is distributed through the region of the lesser bone of the cubit the other tab 1. ο through the region of the greater bone to the wrist and from thence that being past into the skin of the inside of the hand The hinder nerve of the arm tab 1 Ï or the third which is carried to the arm The third lies next under the second and in like manner with it arises from that net-like texture This nerve whilst it passes through the arm pit before it has yet attained to the arm brings forth a propagation tab 1. σ which is dispersed under the skin betwixt the Pectoral muscle that leads the arm to the breast and the
spongy flesh of the tongue it self which affected with the quality of the Object doth presently so possess the nerve that is implanted in it that the kind and quality thereof by the force of the spirit How touching may be carryed into the common sense All parts endued with a nerve enjoy the sense of touching which is chiefly done when a tractable quality doth penetrate even to the true and nervous skin which lyeth under the Cuticle or scarf-skin we have formerly noted that it is most exquisite in the skin which invests the ends of the fingers The Object is every tractable quality whether it be of the first rank of qualities as Heat Cold Moisture Dryness or of the second as Roughness Smoothness Heaviness Lightness Hardness Softness Rarity Density Friability Unctuosity Grosness Thinness The Medium by whose procurement the instrument is affected is either the skin or the flesh interwoven with many Nerves Of motion The next Action is that Motion which by a peculiar name we call Voluntary this is performed and accomplished by a Muscle being the proper Instrument of voluntary Motion Furthermore every motion of a member possessing a Muscle is made either by bending and contraction or by extention Although generally there be so many differences of voluntary motion as there are kinds of site in place therefore Motion is said to be made upward downward to the right hand to the left forward and backward Hither are referred the many kinds of motions which the infinite variety of Muscles produce in the body How respiration may be a voluntary motion Into this rank of Voluntary Actions comes Respiration or breathing because it is done by the help of the Muscles although it be chiefly to temper the heat of the Heart For we can make it more quick or slow as we please which are the conditions of a voluntary Motion Lastly that we may have somewhat in which we may safely rest and defend our selves against the many questions which are commonly moved concerning this thing we must hold that Respiration is undergone and performed by the Animal faculty but chiefly instituted for the vital The third principal Action The principal Action and prime amongst the Voluntary is absolutely divided in three Imagination Reasoning and Memory Imagination is a certain expressing and apprehension which discerns and distinguisheth between the forms and shapes of things sensible or which are known by the senses Reasoning is a certain judicial estimation of conceived or apprehended forms or figures by a mutual collating or comparing them together Memory is the sure storer of all things and as it were the Treasury which the mind often unfolds and opens the other faculties of the mind being idle and not imployed But because all the fore-mentioned Actions whether they be Natural or Animal and Voluntary are done and performed by the help and assistance of the Spirits therefore now we must speak of the Spirits CHAP. X. Of the Spirits THe Spirit is a subtile and airy substance What a Spirit is raised from the purer blood that it might be a vehicle for the faculties by whose power the whole body is governed to all the parts and the prime instrument for the performance of their office For they being destitute of its sweet approach do presently cease from action and as dead do rest from their accustomed labours From hence it is that making a variety of Spirits according to the number of the faculties they have divided them into three as one Animal another Vital Spirits threefold another Natural The Animal hath taken his seat in the Brain for there it is prepared and made that The Animal Spirit from thence conveyed by the Nerves it may impart the power of sense and motion to all the rest of the members An argument hereof is that in the great cold of Winter whether by the intercepting them in their way or by the concretion or as it were freezing of those spirits the joynts grow stiff the hands numb and all the other parts are dull Why so called destitute of their accustomed agility of motion and quickness of sense It is called Animal not because it is the * Anima Life but the chief and prime instrument thereof wherefore it hath a more subtil and airy substance and enjoys divers names according to the various condition of the Sensories or seats of the senses into which it enters for that which causeth the sight is named the Visive you may see this by night rubbing your eys as sparkling like fire That which is conveyed to the Auditory passage is called the Auditive or Hearing That which is carried to the instruments of Touching is termed the Tactive and so of the rest This Animal spirit is made and laboured in the windings and foldings of the Veins and Arteries of the brain of an exquisit subtil portion of the vital brought thither by the Carotidae Arteriae How it is made or sleepy Arteries and sometimes also of the pure air or sweet vapour drawn in by the Nose in breathing Hence it is that with Ligatures we stop the passage of this spirit from the parts we intend to cut off An Humor which obstructs or stops its passage doth the like in Apoplexies and Palsies whereby it happens that the members situate under that place do languish and seem dead sometimes destitute of motion sometimes wanting both sense and motion The Vital spirit is next to it in dignity and excellency The Vital Spirit which hath its chief mansion in the left ventricle of the Heart from whence through the Channels of the Arteries it flows into the whole body to nourish the heat which resides fixed in the substance of each part which would perish in short time unless it should be refreshed by heat flowing thither together with the spirit And because it is the most subtil next to the Animal Nature lest it should vanish away would have it contained in the Nervous coat of an Artery which is five times more thick than the coat of the Veins as Galen out of Herophilus hath recorded It is furnished with matter from the subtil exhalation of the blood What the matter of it is and that air which we draw in breathing Wherefore as it doth easily and quickly perish by immoderate dissipations of the spirituous substance and great evacuations so it is easily corrupted by the putrefaction of Humors or breathing in of pestilent air and filthy vapours which thing is the cause of the so suddain death of those which are infected with the Plague This Spirit is often hindred from entring into some part by reason of obstruction fulness or great inflammations whereby it follows that in a short space by reason of the decay of the fixed and inbred heat the parts do easily fall into a Gangrene and become mortified The Natural spirit if such there be any hath its station in the Liver and Veins There is some
disease Cause of the disease which two often indicate and require medicines contrary to the disease Symptom which two often indicate and require medicines contrary to the disease CHAP. XXIII Of certain wonderful and extravagant ways of curing Diseases AS Monsters happen sometimes in Nature so also in Diseases Monstrous diseases and in the events and cures of diseases I understand by Monsters certain marvellous successes in diseases or certain ways of curing them which swerve from Art and happen besides reason nature and common use Alexander ab Alexandro and Peter Gilius tell that in Apulia a part of Italy The wonderful force of the bite of a certain Spider they have a certain kind of Spider very frequent the Natives call it Tarantula Petrus Rhodius calls it Phalangium The Inhabitants find these Spiders in the first heat of Summer so venenate and deadly that whomsoever they touch with their virulent biting he presently without he have speedy remedy deprived of all sense and motion falls down or certainly if he escape the danger of death he leads the remnant of his life in madness Musick the remedy thereof Experience hath found a remedy by Musick for this so speedy and deadly a disease Wherefore as soon as they can they fetch Fidlers and Pipers of divers kinds who by playing and piping may make musick at the hearing whereof he which was fallen down by reason of the venemous bite rises cheerfully and dances so long to their measures and tunes until by the painful and continued shaking and agitation of the whole body all the malignity is dissipated by transpiration and sweats Alexander adds that it happened once in his sight that the Musicians their wind and hands failing them ceased playing and then the Dancer presently fell down as if he had been dead but by and by the Musick beginning anew he rose up again and continued his dancing till the perfect dissipation of the venom And that it hath happened besides that one not so perfectly healed certain reliques of the disease yet remaining when a long time after he heard by chance a noise of Musicians he presently fell a leaping and dancing neither could he be made to leave before he was perfectly cured Some affirm according to the opinion of Asclepiades Musick gives ease to pain that such as are frantick are much helped with a sweet and musical harmony Theophrastus and Aulus Gellius say that the pain of the Gout and Sciatica are taken away by Musick And the sacred Scripture testifies that David was wont by the sweet sound of the Harp to refresh and ease King Saul when he was miserably tormented by his evil spirit Herodotus in Clio tels that Croesus the King of Lydia had a Son which of a long time could not speak and when he came to man's estate was accounted dumb but when an enemy with his drawn sword invaded his father overcome in a great fight and the City being taken in which he was not knowing that he was the King A strong perturbation of the mind helps by moving the spirits the young man opened his mouth endeavouring to cry out and with that striving and forcing of the Spirit he broke the bonds and hinderances of his tongue and spoke plainly and articulately crying out to the enemy that he should not kill King Croesus So both the enemy with-held his sword and the King had his life and his son had his speech always after Plutarch in his book Of the benefit to be received from our enemies tels That a Thessalian called Prâ—teus had a certain inveterate and incurable Ulcer in a certain part of his body which could not be healed before he received a wound in a conflict in the same place and by that means the cure being began afresh the wound and ulcer were both healed Quintus Fabius Maximus as Livy writes was long and very sick of a quartain Ague Chance sometime exceeds Art neither could have wished success from medicins administred according to Art until skirmishing with the Aeâ—oâ—râ—ges he shaked off his old feaverish heat by a new heat and ardent desire of fighting It was credibly reported to me of late by a Gentleman of the Lord of Lansack's Chamber that there was a French Gentleman in Polonia who was grievously tormented with a quartain Feaver who on a time walking upon the bank of the river Wexel to take away the irksomness of his fit was thrust in jest into the River by a friend of his that met him by chance by which although he could swim as he also knew that thrust him in he conceived so great fear that the Quartain never troubled him after King Henry the second commanded me to go from the Camp at Amiens to the City Dorlan that I mâ—ght cure those that were hurt in the conflict with the Spaniards the Captain S. Arbin although at that time he had a fit of a Quartain Ague yet would he be present at the fight in which being shot through the side of the neck with a Bullet he was strucken with such a terror of death that the heat of the Feaver was asswaged by the cold fear and he afterwards lived free from his Ague Franciscus Valeriola the famous Physitian of Arles tels Observ lib. 2. That John Berlam his fellow-Citizen troubled with a Palsey of one side of his body for many years his house taking fire and the flame coming near the bed in which he lay he strucken with a great fear suddenly raised himself with all the force he had and presently recovering the strength of his body leaps out at the window from the top of the house and was presently cured of his disease sense and motion being restored to the part so that afterward he went upright without any sense of pain who lay unmovable for many years before He tells the like in the same place of his cousen John Sobiratius he was a long time lame at Avignion by reason that the Nerves of his hams were shrunk and drawn up so that he could not go being moved with a vehement and sudden passion of anger against one of his servants whom he endeavoured to beat he so stirred his body that forthwith the Nerves of his hams being distended and his knees made pliant he began to go and stand upright without any sense of pain when he had been crooked about the space of six years before and all his life-time after he remained sound Cap. ult lib. de cur rat per sanguinis miss Galen tels he was once fetched to stanch the bleeding for one who had an Artery cut neer his Anckle and that by his means he was cured without any danger of an Aâ—urisma i. e. a relaxation of a veinous vessel and besides by that accidental wound he was freed from a most grievous pain of his hip with which he was tormented four years before but although this easing of the pain of the Sciatica happened according to reason by
One part of the brain being hurt the other keeps the creature alive The consistence of the Pia mater the fore and hind and presently to separate the same into the right and left that one part being hurt the other may remain safe and sound performing its duty to the creature as we see in some that have the Palsey Columbus observed that this Meninx was double and verily I have found it true by m own sight The other Meninx or Membrane of the Brain called Pia mater is most slender interchased with divers veins and arteries for its own and the brains nourishment and life This doth not only involve the Brain as the Crassa meninx doth but also more deeply penetrate in the anfractuous passages thereof that it may every where joyn and bind it to it self not easily to be drawn from thence by many small fibers whereby it descends even to the cavities of the ventricles thereof Wherefore you must see it absolutely in the site as we have mentioned and not pluck it away unless with the substance of the Brain The sense of the Meninges These membranes when they are hurt or afflicted cause grievous and most bitter torment and pain wherefore I dare say that these membranes are rather the authors of sense than the Brain it self because in diseases of the Brain as in the Lethargy the part affected is troubled with little or no sense of pain CHAP. VI. Of the Brain NOw followeth the Brain the beginning of the nerves and voluntary motion What the Brain is the instrument of the first and principal faculty of the Soul that is the Animal and Rational Man hath this part in greater plenty then any other Creature The quantity for it almost fils the whole skull But if it should have filled it all the Brain could not be moved that is dilated and contracted in the skull It is of a cold and moist Temperature Temper The laudable Temper of the Brain is known by the integrity and perfection of the internal and external senses the indifferency of sleep and waking the maturity of ripeness of judgment and constancy of opinions from which unless it meet with better and more probable it is not easie to be moved The first figure of the Head as it appears when the Skull is taken away The second figure shewing the Brain the skull and Dura mater being taken off AA BB The Dura meninx or thick membrane CCC the third Sinus of this membrane DD the course of the veins as they run through the membrane or the second vein of the Brain EE the first vein of the brain FFF Certain small veins which perforate the skull nnd reach to the Pericranium or skull-skin GGG Fibers of the Dura meninx passing through the Coronal Suture which fibers make the Pericranium HH fibers passing through the sagittal Suture II others passing through the Lambdal Suture K a knub which useth to grow to the Sinus of the skull L a cavity in the forehead-bone M the skull N the Pericranium or skull-skin Fig. 2. AAA a part of the Crasse meninx dividing the brain BB the third Sinus of the same Crasse membrane opened CC the beginning of the vessels out of the third Sinus into the Pia mater DDD the propagation or branches of these vessels EEE the Pia mater or thin meninx immediately compassing the brain FFF certain vessels running through the convolutions or branches of the brain GGG certain branches of veins running through the sides of the dura meninx HHH the thick membrane reflected downward You shall know the brain is more hot by the quickness of the senses and motions of the body by shortness of sleep the suddain conceiving of opinions and change of them by the slippery and failing memory and lastly by easily receiving hurt from hot things as the Sun and Fire Such as have a cold Brain are slow to learning and to conceive other things but they do not easily put away their once conceived opinions They have slow motion to action and are sleepy Those who have a dry Brain are also slow to learn for you shall not easily imprint any thing in dry bodies but they are most constant retainers of those things they have once learned also the motions of their bodies are quick and nimble Those who have a moist Brain do easily learn but have an ill memory for with like facility as they admit the species of things and imprint them in their minds do they suffer them to slide and slip out of it again So clay doth easily admit what character or impression soever you will but the parts of this clay which easily gave way to this impression going together again mixes obliterates and confounds the same Therefore the senses proceeding from a cold Brain are dull the motions slow the sleep profound The Action The action of the Brain is to elaborate the Animal Spirit and necessary sense serving the whole body and to subject it self as an instrument to the principal faculties as to reason The brain is twofold the fore and hind The hind by reason of its smalness is called the Cerebellum the little or After-brain But the fore by reason of its magnitude hath retained the absolute name of the Brain Number Again this fore-Brain is twofold the right and left parted by that depression which we formerly mentioned of the Meninges into the body of the Brain But this division is not to be here so absolutely taken as though the Brain were exactly divided and separated into so many parts but in the sense as we say the Liver and Lungs are divided a pretty way whereas at their Basis they have one continued body The outward surface of the Brain is soft but the inward hard callous and very smooth when on the contrary the outward appears indented and unequal with many windings and crested as it were with many wormlike foldings CHAP. VII Of the Ventricles and Mamillary Processes of the Brain The substance of the Brain is porous and sweats forth blood FOr the easie demonstration of the Ventricles of the Brain it is convenient you cut away a large portion thereof and in your cutting observe the blood sweating out of the pores of it But besides it is fit you consider the spongy substance by which the excrements of the Brain are heaped up to be presently strained out and sent away by the hollow passage In the substance of the Brain you must observe four Ventricles The four ventricles thereof mutually conjoyned by certain passages by which the spirits endued with the species of things sensible may go from one into another The first and two greater one on each side are placed in the upper Brain The third is under them in the middle part of the Brain The fourth and last at the foreside of the Cerebellum towards the beginning of the spinal marrow The two formost are extended the length way of the Brain
alwayes using advice of a Physitian Having used these general means you must apply refrigerating and humecting things such as are the juyce of Night-shade Housleek Purslane Lettuce Navel-wort Water-Lentil or Ducks-meat Gourds a Liniment made of two handfuls of Sorrel boyled in fair water then beaten or drawn through a searse with Oyntment of Roses or some unguent Populeon added thereto will be very commodious Such and the like remedies must be often and so long renewed until the unnatural heat be extinguished But we must be careful to abstain from all unctuous Oyly things Why Oyly things must not be used in an Erysipelas of the face because they may easily be inflamed and so encrease the disease Next we must come to resolving Medicines but it is good when any thing comes from within to without but on the contrary it is ill when it runs from without inwards as experience and the Authority of Hippocrates testifie If when the bone shall become purulent Aph. 25. sect 6. pustules shall break out on the tongue by the dropping down of the acrid filth or matter by the holes of the palat upon the tongue which lyes under now when this symptom appears few escape Also it is deadly when one becomes dumb and stupid that is Apoplectick by a stroak or wound on the Head for it is a sign that not only the Bone but also the Brain it self is hurt But oft-times the hurt of the Brain proceeds so far Deadly signs in wounds of the head that from corruption it turns to a Sphacel in which case they all have not only pustules on their tongues but some of them dye stupid and mute othersome with a convulsion of the opposite part neither as yet I have observed any which have dyed with either of these symptoms by reason of a wound in the head who have not had the substance of their Brain tainted with a Sphacel as it hath appeared when their Skulls have been opened after their death CHAP. XI Why when the Brain is hurt by a Wound of the Head there may follow a Convulsion of the opposite part MAny have to this day enquired A Convulsion is cauâ—ed by dryness but as yet as far as I know it hath not been sufficiently explained why a Convulsion in wounds of the head seizes on the part opposite to the blow Therefore I have thought good to end that controversie in this place My reason is this A twofold câ—use of Convulsifick dryness that kind of Symptom happens in the sound part by reason of emptiness and dryness but there is a twofold cause and that wholly in the wounded part of this emptiness and dryness of the sound or opposite part to wit pain and the concourse of the spirits and humors thither by the occasion of the wound and by reason of the pains drawing and natures violently sending help to the afflicted part The sound part exhausted by this means both of the spirits humors easily falls into a Convulsion For thus Galen writes God the Creator of Nature hath so knit together Lib. 4. de usâ—e partium the triple spirituous substance of our bodies with that tye and league of concord by the production of the passages to wit of Nerves Veins and Arteries that if one of these forsake any part the rest presently neglect it whereby it languisheth and by little and little dyes through defect of nourishment But if any object that Nature hath made the body double for this purpose that when one part is hurt the other remaining safe and sound might suffice for life and necessity but I say this axiom hath no truth in the vessels and passages of the body For it hath not every where doubled the vessels for there is but one only vein appointed for the nourishment of the Brain and the Membranes thereof which is that they call the Torcular by which when the left part is wounded it may exhaust the nourishment of the right and sound part and through that occasion cause it to have a Convulsion by too much dryness Verily it is true that when in the opposite parts the Muscles of one kind are equal in magnitude strength and number the resolution of one part makes the convulsion of the other by accident but it is not so in the Brain For the two parts of the Brain the right and left each by its self performs that which belongs thereto without the consent conspiration or commerce of the opposite part for otherwise it should follow that the Palsie properly so called that is of half the body which happens by resolution caused either by mollification or obstruction residing in either part of the Brain should inferr together with it a Convulsion of the opposite part Which notwithstanding dayly experience convinceth as false Wherefore we must certainly think that in wounds of the Head wherein the Brain is hurt that Inanition and want of nourishment are the causes that the sound and opposite part suffers a Convulsion Francis Dalechampius in his French Chirurgery renders another reason of this question That Opinion of Dalechampius saith he the truth of this proposition may stand firm and ratified we must suppose that the Convulsion of the opposite part mentioned by Hippocrates doth then only happen when by reason of the greatness of the inflammation in the hurt part of the Brain which hath already inferred corruption and a Gangrene to the Brain and Membranes thereof and within a short time is ready to cause a sphacel in the Skull so that the disease must be terminated by death for in this defined state of the disease and these conditions the sense and motion must necessarily perish in the affected part as we see it happens in other Gangrens through the extinction of the native heat Besides the passages of the animal Spirit must necessarily be so obstructed by the greatness of such an inflammation or phlegmon that it cannot flow from thence to the parts of the same side lying there-under and to the neighbouring parts of the Brain and if it should flow thither it will be unprofitable to carry the strength and faculty of sense and motion as that which is infected and changed by admixture of putrid and Gangrenous vapours Whereby it cometh to pass that the wounded part destitute of sense is not stirred up to expel that which would be troublesome to it if it had sense wherefore neither are the Nerves thence arising seised upon or contracted by a Convulsion It furthermore comes to pass that because these same Nerves are deprived of the presence and comfort of the Animal Spirit and in like manner the parts of the same side drawing from thence their sense and motion are possessed with a Palsie for a Palsie is caused either by the cutting or obstruction of a Nerve or the madefaction or mollification thereof by a thin and watry humor or so affected by some vehement distemper that it cannot receive the
from the whole body or any part to them and their ligaments or else a congestion proceeding from the proper and native weakness of these parts or an attraction arising from pain and heat The external is a fall from high upon some hard body a heavy and bruising blow much and often stooping as in Dressers and Lookers to Vineyards and Paviers decrepit old men and also such as through an incurable dislocation of the thigh bone The danger of a vertebra dislocated inwards are forced in walking to stoop down and hold their hand upon their thigh But a vertebra cannot be forced or thrust inwards unless by a great deal of violence and if it at any time happen it is not but with the breaking of the ties and ligaments for they will break rather then suffer so great extension Such a dislocation is deadly for that the spinal marrow is exceedingly violated by too strait compression whence proceeds dulness and loss of sense in the members lying thereunder Hipp. sent 51. sect 3. de art Gal in com Neither is restitution to be hoped for because we cannot through the belly force it into its place the urine is then supprest as also the excrements of the belly sometimes on the contrary both of them break forth against the Patients minde the knees and legs grow cold their sense and motion being lost Such things happen more frequently when the spine is luxated inwards than when it is dislocated outwards for that the nerves thence arising run and are carried more inwardly into the body Besides the pressed spinal marrow becomes inflamed and that being inflamed the parts of the same kind and such as are joined thereto are also inflamed by consent whence it happeneth that the bladder cannot cast forth the urine Now where the sinews are pressed they can no more receive the irradiation of the animal faculty Hence follows the deprivation of the sense and motion in the parts whereto they are carried therefore the contained excrements do no more provoke to expulsion by their troublesome sense neither are pressed to keep them in thence proceeds their suppression and hence their breaking forth against their wils But the spine outwardly dislocated scarce causes any compression of the marrow or nerves CHAP. XVI How to restore the Spine outwardly dislocated THe vertebrae outwardly dislocated when as they stand bunching forth The Cure then it is fit to lay and stretch forth the Patient upon a table with his face downwards and straitly to binde him about with towels under the arm-pits and about the flanks and thighs Another manner of cure And then to draw and extend as much as we can upwards and downwards yet without violence for unless such extension be made restitution is not to be hoped for by reason of the processes and hollowed cavities of the vertebrae whereby for the faster knitting they mutually receive each other Then must you lie with your hands upon the extuberancies force in the prominent vertebra But if it cannot be thus restored then will it be convenient to wrap two pieces of wood of four fingers long and one thick more or less in linnen clothes and so to apply one on each side of the dislocated vertebrae and so with your hands to press them against the bunching forth vertebrae until you force them back into their seats just after the manner you see it before delineated In the mean while have a care How to keep the restored vertebrae in their places that you touch not the processes which stand up in the ridg of the Spine for they are easily broken You may know that the vertebrae are restored by the equal smoothness of the whole Spine It is fit after you have restored it to bind up the part and lay splints or plates of Lead neatly made for that purpose upon it but so that they may not press the crists or middle processes of the vertebrae which I formerly mentioned but only the sides then the Patient shall be laid upon his back in his bed and the splints long kept on lest the vertebrae should fall out again CHAP. XVIII A more particular inquirie of the dislocation of the Vertebrae proceeding from an internal cause THe vertebrae are in like sort luxated by the antecedent cause as we have formerly said which is caused by the nutural imbecilitie of the parts principally of the nervous ligament by which all the vertebrae are bound each to other this ligament comes not to the spinal marrow but onely bindes together the vertebrae on their outsides For besides the two membranes proceeding from the two Meninges of the Brain wherewith the marrow is covered there is a third strong and nervous coat put upon it lest whilest the spine is diversly bended the bended marrow should be broken This third coat arises from the pericranium as soon as it arrives at the first vertebra of the neck Now that ligament wherewith we said the joints of the vertebrae were mutually knit and fastned is encompassed with a tough and glutinous humour for the freer motion of the vertebrae Sometimes another cold crude gross and viscid humour confused and mixed herewith by great defluxions and catarrhs begets a tumour which doth not onely distend the nerves proceeding forth of the holes of the vertebrae but also distends the ligaments wherewith they are bound together which so distended and as it were drawn aside do draw together with them the vertebrae one while towards the right side another while to the left somewhiles inwards otherwhiles outwards and thus move them out of their seats and dislocate them A dislocated vertebra standing forth and making a bunch is termed in Greek Cyphosis Cyphosis Lordosis Scoliosis Com. ad sent 2. sect 3 lib. de art Seisis Those thus affected we may call Bunch-backt But when it is depressed it is named Lordosis Such we may term Saddle-backt But when the same is luxated to the right or left side it maketh a Scoliosis or Crookedness which wresting the spine draws it into the similitude of this letter S Galen adds a fourth default of the vertebrae which is when their joints are moved by reason of the looseness of their ligaments the vertebrae yet remaining in their places and he calls it a Seisis or shaking They also note another defect peculiar to the spinal marrow which is when as it the vertebrae being not moved whereto it adheres is plucked and severed from them The separation of the spinal marrow from the encompassing vertebrae this disease is occasioned by a fall from on high by a great stroak and by all occasions which may much shake and consequently depress the spinal marrow or by any other means remove or put it forth of its place Scarce any recovers of this disease for many reasons which any exercised in the art may easily think upon But let us return to the internal cause of Luxations Fluid and soft bodies such as Childrens usually are very
affirm that he is in danger of his life by reason of the malign symptoms that usually happen upon such wounds such as are great pain a fever inflammation abscess convulsion grangrene and the like Wherefore he stands in need of provident careful dressing by benefit whereof if he escape death without doubt he will continue lame during the remainder of his life by reason of the impotency of the wounded part And this I affirm under my hand Another in the hurts of divers parts We the Surgeons of Paris by the command of the Senate this twentieth day of March have visited Master Lewis Vertoman whom we found hurt with five wounds The first inflicted on his head in the middle of his fore-head-bone to the bigness of three fingers and it penetrates even to the second table so that we were forced to pluck away three splinters of the same bone The other was athwart his right cheek and reacheth from his ear to the midst of his nose wherefore we stiched it with four stitches The third is on the midst of his belly of the bigness of two fingers but so deep that it ascends into the capacity of the belly so that we were forced to cut away portion of the Kall comâ—ing out thereat to the bigness of a walnut because having lost its natural colour it grew black and putrified The fourth was upon the back of his left hand the bigness almost of four fingers with the cutting of the veins arteries nerves and part of the bones of that part whence it is that he will be lame of that hand howsoever carefully and diligently healed Now because by hurting the spinal marrow men become lame sometimes of a leg it is fit you know that the spinal marrow descends from the brain like a rivulet for the distribution of the nerves which might distribute sence and motion to all the parts under the head wherefore if by hâ—â—ing the spinal marrow the patients arms or hands are resolved or numb or wholly without sense it is a sign these nerves are hurt which come forth of the fifth sixth seventh vertebrae of the neck But if the same accidents happen to the thigh leg or foot with refrigeration so that the excrements flow voluntarily without the patients knowledg or else are totally supprest it is a sign that the sinews which proceed from the vertebrae of the loins and holy-bone are hurt or in fault so that the animal faculty bestowing sence â—nd motion upon the whole body and the benefit of opening and shutting of the sphincter-muscle of the bladder and fundament cannot shew its self in these parts by which means sudden death happens especially if there be difficulty of breathing therewith A caution in making report of a woman with chi de being killed Being tâ— make report of a childe killed with the mother have a care that you make a discreet report whether the childe were perfect in all the parts and members thereof that the Judge may equally punish the author thereof For he meriteth far greater punishment who hath killed a childe perfectly shaped and made in all the members that is he which hath killed a live-childe then he which hath killed an Embryon that is a certain concretion of the spermatick body For Moses punisheth the former with death as that he should give life for life but the other with a pecuniary mulct But I judg it fit to exemplifie this report by a President I. A. P. By the judges command visited Mistris Margaret Vlmargy whom I found sick in bed having a strong fever upon her with a convulsion and efflux of blood out of her womb by reason of a wound in her lower belly below her navel on the right side penetrating into the capacity of her belly and the wound therein whence it hath come to pass that she was delivered before her time of a male childe perfect in all his members but dead being killed by the same wound piercing through his scull into the marrow of the brain Which in a short time will be the death of the mother also In testimony whereof I have put my hand and seal The manner how to Embalm the dead I Had determined to finish this my tedious work with the precedent Treatise of Reports but a better thought came into my head which was to bring Man whose cure I had undertaken from his infancy to his End and even to his Grave so that nothing might be here defective which the Surgeon might by his proâ—ession perform about mans body either alive or dead Verily there hath scarce ever been a Nation so barbarous which hath not only been careful for the Burial but also for the Embalm ng or preserving of their dead bodies For the very Scythians who have seemed to exceed other Nations in barbarousness and inhumanity have done this for according to Heredâ—tus the Scythians bury not the corps of their King The caâ—e of the Sâ—â—â—ians in the Embalming their deâ—d The like care of the Ethiopians before that being emboweled stuffed full of beaten Cypress Frankinsence the seeds of Parsley and Aâ—ise he be also wrapped in sear-cloths The lâ—ke care hath also possessed the mindes of the Ethi pians for having disburdened the corps of their friends of their entrails and flesh they plastered them over and then having thus rough-cast them they painted them over with colors so to express the dead to the life they inclosed them thus adorned in a hollow pillar of glass that thus inclosed they might be seen and yet not annoy the spect tors with their smell Then were they kept for the space of a year in the hands of their next kindred who during this space offered and sacrificed to them The year ended they carried them forth of the city and placed them about the walls each in his proper vault Lib. 3. Oâ— the Egyptians as Herod tus affi ms But this pious care of the dead did far otherwise affect the Egyptians then it did other nations For they were so studious to preserve the memory of their ancestors that they Embalmed their whole body with aromatick ointments and set them in translucent Urns or glass-Cells in the more emâ—nent and honored part of their houses that so they might have them daily in their sight and might be as monuments and inciters to stir up them to imitate their Fathers and Grandsiâ—es virtues Besides also the bodies thus embalmed with aromatick and balsamick ointments were in â—â—eâ—d of a most sure pawn so that iâ— any Egyptian had need of a great sum of mony they might easily procure it of such as knew them and their neighbors by pawning the dead body of some of their dead parents For by this means the creditor was certain that he which pawned it would sooner lose his life then break his promise But if all th ngs so unhappily succeeded with any so that through poverty he could not fetch home his pawn again but
CHAP. IX Of the Actions AN Action or Function is an active motion proceeding from a faculty for What an Action is as the faculty depends on the Temperament so the Action on the faculty and the Act or work depends upon the Action by a certain order of consequence But although that the words Action and Act or work are often confounded yet there is this difference between them as that the Action signifies the Motion used in the performance of any thing but the Act or work An action and an Act are different the thing already done and performed for example Nutrition and the Generating of flesh are natural Actions but the parts nourished and a hollow ulcer filled with flesh are the works of that motion or action Wherefore the Act ariseth from the Action as the Action ariseth from the Faculty the integrity or perfection of the instruments concurring in both For as if the Faculty be either defective or hurt no Action will be well performed so unless the Instruments keep their native and due conformity which is their perfect health the operator of the Action proper to the instrument none of those things which ought to be will be well performed Therefore for the performance of blameless and perfect actions it is fit a due conformity of the instrument concur with the faculty But Actions are two fold for they are either Natural or Voluntary Natural actions They are tearmed Natural because they are performed not by our will but by their own accord and against our will As are that continual motion of the Heart the beating of the Arteries the expulsion of the Excrements and such other like which are done in us by the Law of Nature whether we will or no. These Actions flow either from the Liver and Veins or from the Heart and Arteries Wherefore we may comprehend them under the names of Natural and Vital Actions For we must attribute his Action to each faculty lest we seem to constitute an idle faculty and no way profitable for use The unvoluntary vital actions are the dilatation and contraction of the Heart and Arteries the which we comprehend under the sole name of the Pulse by that they draw in and by this they expel or drive forth The unvoluntary vital actions be Generation Growth and Nutrition which proceed from the Generative Growing and Nourishing faculty Generation is nothing else then a certain producing or acquiring of matter What Generation is and an introducing of a substantial form into that matter this is performed by the assistance of two faculties of the altering which doth diversly prepare and dispose the seed and menstruous blood to put on the form of a Bone Nerve Spleen flesh and such like of the Forming faculty which adorns with figure site and composition the matter ordered by so various a preparation Growth is an inlarging of the solid parts into all the dimensions What Growth is the pristine and ancient form remaing safe and sound in figure and solidity For the perfection of every growth is judged only by the solid parts for if the body swell into a mass of flesh or fat it shall not therefore be said to be grown but then only when the solid parts do in like manner increase especially the bones because the growth of the whole body follows their increase even although at the same time it wax lean and pine away Nutrition is a perfect assimilation of that nourishment which is digested What Nutrition is into the nature of the part which digests It is performed by the assistance of four subsidiary or helping actions Attractive Retentive Digestive and Expulsive Action voluntary The voluntary actions which we willingly perform are so called because we can at our pleasure hinder stir up slow or quicken them They are three in general the sensative moving and principal Action The sensitive * Anìma senâ—tens Soul comprehends all things in five senses in Sight Hearing Smell Taste and Touch. Three things must necessarily concur to the performance of them the Organ the Medium or mean and the Object The principal Organ or Instrument is the Animal spirit diffused by the Nerves into each several part of the body by which such actions are performed Wherefore for the present we will use the parts themselves for their Organs The Mean is a Body which carries the Object to the Instrument The Object is a certain external quality which hath power by a fit Medium or Mean to stir up and alter the Organ This will be more manifest by relating the particular functions of the senses by the necessary concurring of these three How sight is performed Sight is an action of the seeing faculty which is done by the Eye fitly composed of its coats and humors and so consequently the Organical body of this Action The Object is a visible quality brought to the Eye But such an Object is two-fold for either it is absolutely visible of its self and by its own Nature as the Sun the Fire the Moon and Stars or desires as it were the help of another that it may be actually such for so by the coming of the light colours which were visible in power only being brought to the Eye they do seem and appear such as they actually are But such Objects cannot arrive at the Eye but through a clear and illuminate Medium as the Air Water Glass and all sorts of Crystal How hearing The Hearing hath for its Organ the Ear and Auditory passage which goes to the stony-bone furnished with a Membrane investing it an Auditory Nerve and a certain inward spirit there contained The Object is every sound arising from the smitten or broken Air and the Collision of two bodies meeting together The Medium is the encompassing Air which carries the sound to the Ear. How smelling Smelling according to Galen's opinion is performed in the Mamillary processes produced from the proper substance of the brain and seated in the upper part of the nose although others had rather smelling should be made in the very fore-most ventricles of the brain This Action is weak in man in comparison of other Creatures the Object thereof is every smell or fumid exhalation breathing out of bodies The Medium by which the Object is carried to the noses of Men How the taste Beasts and Birds is the Air but to Fishes the Water it self The Action of taste is performed by the tongue being tempered well and according to nature and furnished with a Nerve spred over its upper part from the third and fourth Conjugation of the brain The Object is * Sapâ—r Taste of whose nature and kinds we will treat more at large in our Antidotary The Medium by the which the Object is so carried to the Organ that it may affect it is either external or internal The external is that spattle which doth as it were anoint and supple the tongue the internal is the
humiliated to the sense they may use the proper and common qualities of things for their essential differences and forms How a definition differs from a description As on the contrary Philosophers may refuse all definitions as spurious which consist not of the next Genus and the most proper and essential differences But seeing that through the imbecillity of our understanding such differences are unknown to us in their places we are compelled in defining things to draw into one many common and proper accidents to finish that definition which we intend which for that cause we may more truly call a description because for the matter and essential form of the thing it presents us only the matter adorned with certain accidents This appears by the former definition in which Division and Resolution stand for the Genus because they may be parted into divers others as it were into species That which is added over and besides stands in place of the difference because they separate and make different the thing it self from all other rash and unartificial dissections We must know an artificial division is no other than a separation of one part from another without the hurt of the other observing the proper circumscription of each of them which if they perish or be defaced by the division it cannot be said to be artificial And thus much may suffice for the parts of the definition in general The subject of Physick For as much as belongs to the explication of each word we said of Mans body because as much as lies in us we take care of preserve the health and depel the diseases thereof by which it may appear that mans body is the subject of Physick not as it is mans or consists of matter and form but as it is partaker of health and sickness Gal. lib. 1. de usu part lib. 1. Meth. We understand nothing else by a Part according to Galen than some certain body which is not wholly disjoyned nor wholly united with other bodies of their kinds but so that according to his opinion the whole be composed therewith with which in some sort it is united and in some kind separated from the same by their proper circumscription Furthermore by the parts in general The similar parts are nine I understand the head breast belly and their adjuncts By the particular parts of those I understand the simple parts as the similar which are nine in number as a gristle bone ligament membrane tendon nerve vein arterie musculous flesh some add fibers fat marrow the nails and hairs other omit them as excrements but we must note that such parts are called simple rather in the judgment of the sense than of reason For if any will more diligently consider their nature they shall find none absolutely simple because they are nourished have life and sense either manifest or obscure which happens not without a nerve vein and artery How the bones come to feel But if any shall object that no nerve is communicated to any bone except the teeth I will answer that nevertheless the bones have sense by the nervous fibers which are communicated to them by the Periosteum as by whose mediation the Periosteum is connext to the bones as we see it happens to those membranes which involve the bowels And the bones by this benefit of the animal sense expel the noxious excrementitious humors from themselves into the spaces between them and the Periosteum which as indued with a more quick sense admonisheth us according to its office and duty of that danger which is ready to seise upon the bones unless it be prevented Wherefore we will conclude according to the truth of the thing that there is no part in our body simple but only some are so named and thought according to the sense although also otherwise some may be truly named Simple as according to the peculiar and proper flesh of each of their kinds The compound or organical parts Those parts are called Compound which are made or composed by the mediation or immediately of these simple which they term otherwise organical or instrumental as an arm leg hand foot and others of this kind And here we must observe that the parts are called simple and similar because they cannot be divided into any particles but of the same kind but the compound are called dissimilar from the quite contrary reason They are called instrumental and organical because they can perform such actions of themselves as serve for the preservation of themselves and the whole as the eye of it self without the assistance of any other part seeth and by this faculty defends the whole body as also it self Four particles to be observed in each organical part Wherefore it is called an instrument or organ but not any part of it as the coats which cannot of it self perform that act Whereby we must understand that in each instrumental part we must diligently observe four proper parts One by which the action is properly performed as the Crystalline humor in the eye another without which the action cannot be performed as the nerve and the other humors of the eye The third whereby the action is better and more conveniently done as the tunicles muscles are The fourth by which the action is preserved as the eye-lids and circle of the eye The same may be said of the hand which is the proper instrument of holding for it performs this action First by the muscle as the principal part Secondly by the ligament as a part without which such action cannot be performed Thirdly by the bones and nails because by the benefit of these parts the action is more happily performed Fourthly by the veins arteries and skin for that by their benefit and use the rest and so consequently the action it self is preserved But we must consider that the instrumental parts have a fourfold order Four sorts of instrumental parts They are said to be of the first order which are first and immediately composed of the simple as only the authors of some one action of which kinds are the muscles and vessels They are of a second which consist of these first simple and others besides as the fingers They are counted of the third rank which are composed of parts of the second order and some besides as the hand taken in general The fourth order is the most composed as the whole body the organ and instrument of the soul But you must observe that when we say the muscles and vessels are simple parts we refer you to the sense and sight and to the understanding comparatively to the parts which are more compound but if any consider their essence and constitution he shall understand they are truly compound as we said before Now it remains that we understand that in each part whether simple or compound Nine things to be considered in each part nine things are to be considered as substance quantity
common consent of Physitians it is in the midst of all excels for that seeing it is the medium between the object and faculty if it should be hotter colder moister or dryer it would deceive the faculty by exhibiting all objects not as they are of themselves but as it should be no otherwise than as to such as look through red or green spectacles The use all things appear red or green Wherefore for this reason it was convenient the Cuticle should be void of all sense It hath no action in the body but it hath use for it preserves and beautifies the true skin for it seems to be given by the singular indulgence of nature to be a muniment and ornament to the true skin This Providence of Nature the industry of some Artizans or rather Curtizans doth imitate who for to seem more beautiful do smooth and polish it Why the Cuticle cannot be restored in scars By this you may understand that not all the parts of the body have action yet have they their use because according to Aristotle's opinion Nature hath made nothing in vain Also you must note that this thin skin or Cuticle being lost may every where be re-generated unless in the place which is covered with a scar For here the true skin being deficient both the matter and former faculty of the Cuticle is wanting CHAP. IV. Of the true Skin The substance Magnitude THe true skin called by the Greeks Derma is of a Spermatick substance wherefore being once lost it cannot be restored as formerly it was For in place thereof comes a scar which is nothing else but flesh dryed beyond measure It is of sufficient thickness as appears by the separating from the flesh But for the extent thereof it encompasses the whole body if you except the eyes ears nose privities Figure fundament mouth the ends of the fingers where the nails grow that is all the parts by which any excrements are evacuated The figure of it is like the Cuticle round and long with its productions with which it covers the extremities of the parts Composure It is composed of nerves veins arteries and of a proper flesh and substance of its kind which we have said to be spermatical which ariseth from the process of the secundine which lead the spermatick vessels even to the navel in which place each of them into parts appointed by nature send forth such vessels as are spred abroad diffused from the generation of the skin Which also the similitude of them both that is the skin and membrane Chorion do argue For as the Chorion is double without sense encompassing the whole Infant lightly fastened to the first coat which is called Amnios so the skin is double and of it self insensible for otherwise the nerves were added in vain from the parts lying under it ingirting the whole body lightly cleaving to the fleshy Pannicle But if any object That the Cuticle is no part of the true skin seeing it is wholly different from it and easily to be separated from it and wholly void of sense I will answer These arguments do not prevail For that the true skin is more crass thick sensible vivid and fleshy is not of it self The skin it self is void of sense being rather by the assistance and admixture of the parts which derived from three principal it receives into its proper substance which happens not in the Cuticle Neither if it should happen The number would it be better for it but verily exceeding ill for us because so our life should lye fit and open to receive a thousand external injuries which encompass us on every side as the violent and contrary access of the four first qualities Connexion There is only one skin as that which should cover but one body the which it every-where doth except in those I formerly mentioned It hath connexion with the parts lying under it by nerves veins and arteries with those subjacent parts put forth into the skin investing them that there may be a certain communion of all the parts of the body amongst themselves It is cold and dry in its proper temper in respect of its proper flesh and substance for it is a spermatical part Yet if any consider the sinews veins arteries and fleshy threds which are mixed in its body it will seem temperate and placed as it were in the midst of contrary qualities as which hath grown up from the like portion of hot cold moist and dry bodies Use The use of the skin is to keep safe and sound the continuity of the whole body and all the parts thereof from the violent assault of all external dangers for which cause it is every where indued with sense in some parts more exact in others more dull according to the dignity and necessity of the parts which it ingirts that they might all be admonished of their safety and preservation Lastly it is penetrated with many pores as breathing-places as we may see by the flowing out of sweat that so the arteries in their diastole might draw the encompassing air into the body for the tempering and nourishing of the fixed inbred heat and in the systole expel the fuliginous excrements The reason why the skin is blacker and rougher in Winter which in Winter supprest by the cold air encompassing us makes the skin black and rough We have an argument and example of breathing through these by drawing the air in by transpiration in women troubled with the mother who without respiration live only for some pretty space by transpiration CHAP. V. Of the fleshy Pannicle AFter the true skin follows the Membrane which Anatomists call the fleshy Pannicle What a membrane is Why it is sometimes called a coat sometimes the fleshy and fatty Pannicle whose nature that we may more easily prosecute and declare we must first shew what a Membrane is and how many ways the word is taken Then wherefore it hath the name or the fleshy Pannicle A membrane therefore is a simple part broad and thin yet strong and dense white and nervous and the which may easily without any great danger be extended and contracted Sometimes it is called a coat which is when it covers and defends some part This is called the Pannicle because in some parts it degenerates into flesh and becomes musculous as in a man from the coller-bones to the hair of the head in which part it is therefore called the broad muscle whereas in other places it is a simple Membrane here and there intangled with the fat lying under it from whence it may seem to take or borrow the name of the fatty Pannicle But in Beasts whence it took that name because in those a fleshy substance maketh a great part of this Pannicle it appears manifestly fleshy and musculous over all the body Why beasts have this Pannicle wholly fleshy or musculous as you may see in Horses and Oxen that by that
that the head of a Muscle is one while above another while below otherwhiles in the midst as in the Midriff as you may know by the insertion of the Nerve because it enters the muscle by its head From their Belly From their belly also there be some differences of muscles taken for some have their belly immediately at their beginning as the muscles of the buttocks others at their insertion as the Midriff others just at their head as those which put forth the Calf of the leg in others it is somewhat further off as in those which draw back the arm and which bend the leg in others the belly extends even from the head unto the tail as in the intercostal muscles and those of the wrist in others it is produced even to their insertion as in those of the palms of the hands and soles of the feet some have a double belly distinguished by a nervous substance as those which open the mouth and those which arise from the root of the lower process of the shoulder-blade From their Tendons Moreover the differences of muscles are drawn also from the Tendons for some have none at least which are manifest as the muscles of the lips and the sphincter-muscles the intercostal and those of the wrist others have them in part and want them in part as the Midriff for the Midriff wants a Tendon at the ends of the shorter ribs but hath two at the first Vertelra of the Loins in which it is terminated Others have a Tendon indeed But some of these move with the bone some not as the muscle of the eyes and besides some of these have broad and membranous tendons as the muscles of the eyes and Epigastrium except the right muscles In others they are thick and round as in the benders of the fingers in others they are less round but more broad than thick such is the Tendon arising from the twin muscles and Soleus of the leg others have short Tendons as the muscles which turn down the hand othersome long as those of the palms of the hands and soles of the feet besides others produce Tendons from the end of their belly which Tendons are manifest others from the midst as the Temporal Muscles Besides also others diffuse many Tendons from their belly as in the hands the benders of the fingers and extenders of the feet Othersome put forth but one which sometimes is divided into many as those which bend the third articulation of the foot otherwhile many muscles by their meeting together make one Tendon as the three muscles of the Calf of the leg and those which bend the cubit and leg All Tendons have their original when the nerves and ligaments dispersed through the fleshy substance of a muscle are by little and little drawn and meet together until at last carried to the joint they are there fastned for the fit bending and extension thereof From the contrariety of their Actions for some parts have contrary muscles benders and extenders From their action From their function other parts have none for the Cods and Fundament have only lifters up From their function for some are made for direct motions as those which extend the fingers and toes others for oblique as the Supinators of the hand and the Pronators others perform both as the pectoral muscle which moves the Arm obliquely upward and downward as the upper and lowers fibers are contracted and also outright if all the fibers be contracted together which also happens to the Deltoides and Trapezius I have thought it good to handle particularly these differences of muscles because that by understanding them the prognostick will be more certain and also the application of remedies to each part and if any occasion be either to make incision or future we may be more certain whether the part affected be more or less nervous CHAP. IX Of the parts of a Muscle HAving declared the nature and differences of a Muscle we must note that some of the parts thereof are compound and universal others simple or particular The compound and simple parts of a Muscle The compound are the head belly and tail The simple are ligaments a nerve flesh a vein artery and coat For the compound parts by the head we understand the beginning and original of a muscle which is one while ligamentous and nervous otherwhiles also fleshy By the belly that portion which is absolutely fleshy But by the tail we understand a Tendon consisting partly of a nerve partly of a ligament promiscuously coming forth from the belly of the Muscle For as much as belongs to the simple which are six in number three are called proper and three common The proper are a Ligament from a bone a nerve proceeding from the Brain or spinal marrow and flesh compact by the concretion of blood The common are a vein from the Liver or trunk arising from thence an artery proceeding from the Heart What use each simple particle hath in a muscle a Coat produced by the nervous and ligamentous fibers spreading over the superficies of the muscle But for the simple use of all such parts the nerve is as it were the principal part of a Muscle which gives it sense and motion the ligament gives strength the flesh contains the nervous and ligamentous fibers of the Muscle and strengthens it filling up all the void spaces and also it preserves the native humidity of these parts and cherisheth the heat implanted in them and to conclude defends it from all external injuries for like a fan it opposeth it self against the heat of the Sun and is a garment against the cold and is as a cushion in all falls and bruises and as a buckler of defence against wounding-weapons The vein nourishes the muscle the artery gives it life the coat preserves the harmony of all the parts thereof lest they should be any ways disjoined or corrupted by purulent abscesses breaking into the empty or void spaces of the Muscles as we see it hapneth in a Gangrene where the corruption hath invaded this membrane by the breathing out of the more acid matter or filth CHAP. X. A more particular inquisition into each part of a Muscle HAving gone thus far it remains that we more particularly inquire into each part of a Muscle that if it be possible nothing may be wanting to this discourse The nature of a Ligament Wherefore a Ligament properly so called is a simple part of mans body next of a bone and grislle the most terrestrial dry hard cold white taking its original immediatly or by the interposition of some Medium from the Bones or Grisles from whence also the Muscles have their beginning whereby it comes to pass that a ligament is void of sense unless it receive a nerve from some other place for so the ligaments which compose and strengthen the tongue and yard are partakers of sense and it inserts it self into the bone and grisle that
The magnitude The figure The composure NOw we must speak of the Stomach the receptacle of the food necessary for the whole body the seat of appetite by reason of the Nerves dispersed into its upper orifice and so into its whole substance The substance thereof is rather spermatick than sanguine because that for one fleshy membrane it hath two nervous The quantity or magnitude of the ventricle is divers according to the various magnitudes of bodies and gluttony of men The figure of it is round and somewhat long like a Bagpipe The stomach is composed of two proper coats and one common from the Peritonaeum together with veins sinews and arteries the innermost of its proper coats is membranous woven with right fibers for the attraction of meats it is extended and propagated even to the mouth thereof whereby it comes to pass that the affections of one part may easily be communicated to the other by sympathy or consent The cause of the consent of the mouth and stomach This coat hath its original from the membranes of the brain which accompany the nerves descending from the third and fourth conjugation to the mouth thereof And in like sort from other productions descending by the passages of the head from whence also another reason may be drawn from that which they commonly bring from the nerves of the sixt conjugation why in wounds of the head the stomach doth so soon suffer by consent with the brain The exterior or outer is more fleshy and thick woven with oblique fibers to retain and expel It draws its original from the Pericranium which assoon as it comes to the gullet takes unto it certain fleshy fibers There be nerves sent into the Stomach from the sixt conjugation of the Brain as it shall be shewed in its proper place Veins and Arteries are spread into it from the Gastrica the Gastrepiploides the Coronaria and Splenick from the second third and fourth distribution of the Vena-porta or Gate-vein and the third of the descendent artery to the natural parts assoon as it passes forth of the Midriffe It is one in number The greater part of it is situated on the left side between the Spleen The number the hollowness of the Liver and the Guts that assisted by the heat of such neighbouring parts it may more cheerfully perform the concoction of the meat Neither am I ignorant that Galen hath written that a great part of the Stomach lies on the left side But inspection it self and reason makes me derogate from Galen's authority for because there is more empty space on the left side Lib. de usu partium by reason the Spleen is less than the Liver it was fit it should lie more on the left side The connexion The more proper connexion of it is with the gullet and guts by its two orifices with the brain by its nerves with the liver and spleen by its veins with the heart by its arteries and with all the natural parts by its common membrane The temper of the ventricle in men of good habit is temperate because it is almost composed of the equal commixture of sanguine and spermatick parts or according to Galen's opinion The temper Lib. 9. Meth. it is cold of it self and by the parts composing it and hot by the vicinity of the bowels But in some it is hotter in others colder according to the divers temper and complexion of divers bodies That stomach is to be thought well tempered that powerfully draws down the meat and drink and embraces and retains them so drawn until by concoction and elixation they shall be turned into a juyce like cream which the Greeks call Chylos and lastly which doth strongly send from it and repel the excrements of this first concoction The Stomach is known to be hotter by this that it better concocts and digests coorse and hard meats as Beef hard Egs and the like than soft meats easie of digestion Notes of a hoâ— Stomach which it corrupts and turns into belchings For so a young Chicken is sooner burnt than well roasted at a great fire The stomach which is colder desires much meat but is slow in concocting them especially if they be cold and hard of digestion which for that cause quickly turn sowre The action of a well conditioned stomach is twofold one common another proper The common is to attenuate The action twofold mix and digest the meats taken in at the mouth for the nutrition of it self and the whole body after the liver hath performed its duty which before it be done the ventricle only enjoys the sweet pleasure of the Chylus and comforts it self against the impurity of the adjacent parts whereof it is called the work-house of concoction Its first action is to attract retain and assimilate to it self that which is convenient but to expel whatsoever shall be contrary either in quantity or quality or in the whole substance It hath two orifices one above which they commonly call the stomach and heart The two orifices of the stomach the other lower which is called the Pylorus or lower mouth of the stomach The upper bends to the left side neer the back-bone it is far more large and capacious than the lower that so it may more commodiously receive meats half-chewed hard and gross which Gluttons cast down with great greediness it hath an exquisite sense of feeling because it is the seat of the appetite by reason of the nerves incompassing this orifice with their mutual imbracings whereby it happens that the ventricle in that part is endued with a quick sense that perceiving the want and emptiness of meat it may stir up the creature to seek food For albeit nature hath bestowed four faculties on other parts yet they are not sensible of their wants but are only nourished by the continual sucking of the veins as plants by juyce drawn from the earth This orifice is seated at the fifth Vertebra of the chest upon which they say it almost rests The site Yet I had rather say that it lies upon the twelfth Vertebra of the chest and the first of the loins for in this place the gullet perforates the midriffe and makes this upper orifice The glandulous ring of the Pylorus The lower orifice bends rather to the right side of the body under the cavity of the Liver It is far straiter than the upper lest any thing should pass away before it be well attenuated and concocted and it doth that by the help or assistance of as it were a certain ring like to the sphincter muscle of the fundament which some have thought a glandule made by the transposition of the inner and fleshy membrane of the ventricle into that which is the outer of the guts I know Columbus laughs at this glandulous ring but any one that looks more attentively shall perceive that Pylorus is glandulous The stomach in its lower and inner side hath many folds
appetite for by Galen's opinion In arte parva Coldness increases the appetite by which it comes to pass that they have a greater quantity of Chylus by which plenty the Liver is nourished and grows larger Some Beasts as Dogs and Swine have the Liver divided into five or more Lobes but a man hath but one Lobe or two or three at the most and these not so much distinguished as which cherish the upper hollow region of the ventricle with embracing to help forward the work of concoction Therefore the liver is almost content with one Lobe although it is always rent with a small division that the umbilical vein piercing into the roots and substance of it may have a free passage but also oftentimes there is as it were a certain small Lobe of the Liver laid under that umbilical-vein as a cushion The figure of the Liver is gibbous rising up and smooth towards the Midriff The figure towards the stomach is the simous or hollow-side of it somewhat unequal and rough by reason of the distance of the Lobes the original of the hollow-vein and the site of the bladder of the Gall. The composition of the Liver is of Veins Nerves Arteries The composure the coat and proper substance thereof which we call the gross and concrete blood or Parenchyma The vessels Veins and arteries come to it from the navil but nerves immediately from these which are diffused over the stomach according to Hippocrates yet they penetrate not very deep into its substance for it seems not to stand in need of such exact sense but they are distributed upon the coat and surface thereof because this part made for distribution over the whole body keeps to it self no acrid or malign humor for the perception of which it should need a nerve although the coat investing it sends many nervous fibers into its substance as is apparent by the taking away of the coat from a boiled Liver we must think the same of the other entrails The coat of the Liver is from the Peritonaeum waxing small from the umbilical vein when it divides it self for the generation of the gate and hollow-veins as is observed by Galen Lib. de format Foetus The Liver is only one situate in the greater part on the right side The number and site but with the lesser part on the left quite contrary to the Stomach It s chief connexion is with the stomach and guts The connexion by the veins and membranes of the Peritonaeum by the hollow vein and artery with the heart by the nerve with the brain and by the same ligatures with all the parts of the whole body The temper It is of a hot and moist temper and such as have it more hot have large veins and hot bloud The action but such as have it cold have small veins and a discoloured hew The action of the Liver is the conversion of Chylus into the blood the work of the second concoction For although the Chylus entring into the meseraick veins receive some resemblance of blood yet it acquires not the form and perfection of blood before it be elaborate and fully concoct in the liver It is bound and tyed with three strong ligaments The ligaments two on the sides in the midst of the bastard ribs to bear up it sides and the third more high and strong descending from the blade to sustain its proper part which with its weight would press the lower orifice of the stomach and so cause a falling or drawing down of the sternon and coller-bone And thus much may suffice for its proper ligaments for we before-mentioned its common the veins arteries nerves and coat of the Peritonaeum by which it is knit to the loins and other natural parts But we must note that besides these three proper ligaments the liver is also bound with others to the Bastard-ribs as Sylvius observes in his Anatomical observations and Hollerius in his Practice Cap. de Pluritide CHAP. XVIII Of the Bladder of the Gall. The substance greatness and figure thereof NOw we must come to the bladder of the Gall which is of a nervous substance and of the bigness of a small Pear it is of figure round with the bottom more large but the sides and mouth more narrow and strait It is composed of a double coat one proper consisting of three sorts of fibers The composition the other from the Peritonaeum It hath a vein from the Porta or Gate-vein and an artery from that which is diffused into the Liver and a nerve from the sixt conjugation Number and connexion It is but one and that hid on the right side under the greater lobe of the Liver it is knit with the touching of its own body and of the passages and channels made for the performance of its actions with the Liver and in like manner with the Duodenum and not seldom with the stomach also by another passage and to conclude to all the parts by its veins nerves arteries and common coat Temper Action It is of a cold temper as every nervous part is The action of it is to separate from the Liver the cholerick humor and that excrementitious but yet natural by the help of the right fibers for the purifying of the blood and by the oblique fibers so long to keep it being drawn until it begin to become troublesome in quantity or quality or its whole substance then by the transverse fibers The channels of the Gall. to put it down into the Duodenum to provoke the expulsive faculty of the guts I know Fallopius denies the texture of so many fibers to be the minister of such action to the gall But Vesalius seems sufficiently to have answered him The bladder of the gall hath divers channels for coming with a narrow neck even to the beginning of the Gate-vein it is divided into two passages Lib. 2. de temper the one whereof suffering no division is carryed into the Duodenum unless that in some it send another branch into the bottom of the stomach as is observed by Galen which men have a miserable and wretched life being subject to cholerick vomitings especially when their stomachs are empty with great pains of their stomach and head as is also observed by Galen Cap. 74. Artis Med. The other coming out of the body of the Liver divides it self into two or three passages again entring the substance of the Liver is divided with infinite branches accompanying so many branches of the Gate-vein through the substance of the Liver that so the blood unless it be most elaborate and pure may not rise into the hollow-vein all which things Dissection doth manifestly teach The sixth Figure of the Bladder of the Gall. M. the Pylorus joyned to the Duodenum N. the Duodenum joyned to the Pylorus P. shews the bottom of the bladder of the gall QQ the holes of the bladder of Gall
the skins the fleshy Pannicle the fat the brests The division of the Chest into 〈◊〉 parts the common coat of the Muscles the Muscles of that place the fore-mentioned Bones the coat investing the ribs the Diaphragma or Midriff The parts contained are the Mediastinum the Pericardium or purse of the heart the heart the lungs and their vessels Of the containing parts some are common to all the body or the most part thereof as both the skins the fleshy pannicle and fat Of which being we have spoken in our first Book there is no need now further to insist upon Others are proper to the Chest as its Muscles of which we will speak in their place the Brests the fore-mentioned Bones the membrane investing the ribs and the Diaphragma or Midriff We will treat of all these in order after we have first shewed you the way how you may separate the skin from the rest of the Chest Putting your knife down even to the perfect division of the skin you must draw a straight line from the upper part of the lower Belly even to the Chin then draw another straight-line overthwart at the Coller-bones even to the Shoulder-blades and in the places beneath the Coller-bones if you desire to shun prolixity you may at once separate both the skins the fleshy Pannicle the fat and common coat of the Muscles because these parts were shewed and spoken of in the dissection of the lower Belly Yet you must reserve the Brests in dissecting of the Bodies of Women wherefore from the upper parts of the Brests as artificially as you can separate only the skin from the parts lying under it that so you may shew the Pannicle which there becometh fleshy and musculous and is so spred over the neck and parts of the face even to the roots of the hairs CHAP. III. Of the Brests or Dugs THe Brests as we said when we spoke of the nature of Glandules Their substance are of a glandulous substance white rare or spongious in Maids and Women that do not give suck they are more solid and not so large Wherefore the bigness of the Dugs is different although of a sufficient magnitude in all Magnitude Figure Composure Their figure is round somewhat long and in some sort Pyramidal Their composure is of the skin the fleshy Pannicle Glandules Fat Nerves Veins and Arteries descending to them from the Axillaris under the Sternon betwixt the fourth and fifth and sometimes the sixth of the true ribs And there they are divided into infinite rivulets by the interposition of the glandules and fat by which fit matter may be brought to be changed into the Milk by the faculty of the Dugs We will speak no more of the nature of the Glandules or Kernels as having treated of them before Which Glandules have nerves and which have none only we will add this that some of the Glandules have Nerves as those of the Brests which they receive from the parts lying under them that is from the intercostal by which it comes to pass that they have most exquisite sense Others want a nerve as those which serve only for division of the vessels and which have no action but only use They be two in number on each side one seated at the sides of the Sternon upon the fourth fifth and sixth true ribs Their connexion Wherefore they have connexion with the mentioned parts with their body but by their vessels with all other parts but especially with the womb by the reliques of the mamillary veins and arteries which descend down at the sides of the Brest-blade in which place these veins insinuating themselves through the substance of the Muscles How the brests and womb communicate each with other are a little above the Navel conjoyned with the Epigastricks whose original is in some sort opposite to the Hypogastricks which send forth branches to the womb By the meeting of these it is more likely that this commerce should arise than from other and those almost capillary branches which are sometimes seen to descend to the Womb from the Epigastrick Their temper They are of a cold and moist temper wherefore they say that the blood by being converted into milk * Recrudescere becomes raw flegmatick and white by the force of the proper flesh of the Dugs Their action is to prepare nourishment for the new-born Babe to warm the heart from whence they have received heat Their action and use and to adorn the Brest By this you may know that some Glandules have action others use and some both At the top of the Dugs there are certain hillocks The Nipples or eminencies called Teats or Nipples by sucking of which the Child is nourished through certain small and crooked passages which though they appear manifest to the sight whilst you press out the milk by pressing the Dug yet when the Milk is pressed out they do not appear nor so much as admit the point of a Needle by reason of the crooked ways made by nature in those passages for this use that the Milk being perfectly made should not flow out of its own accord against the Nurse's will For so the seed is retained and kept for a certain time in the Prostats CHAP. IV. Of the Clavicles or Coller-bones and Ribs IF we should handle these parts after the common order we should now treat of the Muscles of the Chest which move the Arm and serve for respiration and which first offer themselves to our sight But for that they cannot be fitly shewed unless we hurt the Muscles of the Shoulder-blade and Neck therefore I think it better to defer the explanation of these Muscles until such time as I have shewed the rest of the contained and containing parts not only of the Chest but also of the Head that having finished these we may come to a full demonstration of all the rest of the Muscles beginning with those of the Head which we first meet with and so prosecuting the rest even to the Muscles of the Feet as they shall seem to offer themselves more fitly to dissection that so as much as lyes in us we may shun confusion Wherefore to return to our proposed task after the foresaid Muscles come the Coller-bones the Sternon and Ribs But that these parts may be the more easily understood we must first know what a Bone is and whence the differences thereof are drawn What a Bone is Therefore a Bone is a part of our body most terrestrial cold dry hard wanting all manifest sense if the teeth be excepted A double sense I said manifest sense that you may understand that the parts have a double sense of Touching the one manifest such as resides in the flesh skin membranes nerves teeth and certain other parts the other obscure yet which may suffice to discern the helping and hurting tactile qualities such sense the Bowels and Bones have for very small
by slender membranes and it is so called because it resembles those thick white worms which are found in rotten wood It doth as it were perform the office of a Porter to the formerly mentioned passage that it may give way and entrance into the Cerebellum to a necessary quantity of spirits when need requires lest that if they should rush with a sodain violence into the Cerebellum they might confound the imprinted notions of things to be remembred The Pelvis or Bason Here the Pelvis or Bason is confounded with the Tunnel is a passage appointed for the carrying away of the gross excrements by the Palate and is so called because it hath the similitude and use of a Bason or Tunnel it descends from the third ventricle into the Glandule which is seated between the processes of the wedg-bone called the saddle thereof as you may perceive by putting in a spathern Now there remains the last of the six parts proposed to our consideration in the third ventricle that is the Channel or Passage running from this third ventricle into the fourth for the use formerly mentioned This Channel descending in its original from the Bason The Channel from the third into the fourth ventricle goes from thence under the Buttocks into the last Ventricle the Meninges being perforated which that you may shew it is fit you put the end of a Spathern through it The benefit of a third Ventricle is that it may be as a Tribunal or Judgment-seat to the Reasoning faculty when the mind will draw conclusions from things seen The fourth and fifth figure of the Brain Figure 5. RRR The lower superficies of the callous body reflected STV the triangular surface of the Fornix or Arch. XX the lower part of the partition of the Ventricles continuated with the Arch. YY the upper part of the partition continued with the callous body Figure 6. AAA the lower surface of the Arch. BC two corners of the Arch by which it is continuated with the Ventricles DE the right and left Ventricles FG Arteries climbing up from the sleepy arteries through the lower side of the Ventricles for the forming of that complication of the Vessels which is called Plexus Choroides H a vessel issuing out of the fourth Sinus under the Arch and passing into the third Ventricle IKL the division of this vessel a part whereof goeth to the right Ventricle at K and another to the left at L. MN the Plexus Choroides made of the Artery FG and the vessel H. OO Small veins passing through the Ventricles of the Brain produced from the Vessels K and L. P other veins arising from the same dispersed without the Ventricles into the Pia mater Q a passage from the third Ventricle unto the Bason or Tunnel RS Canales or Sinus graven or furrowed in the substance of the ventricles in which the phlegm is led along to the orifice of the foresaid passage marked with Q. The Sixth figure of the Brain Figure 10. AA Parts of the spinal marrow cut from the Brain BC the places where this marrow did grow unto the Brain DE the Testicles FG the Buttocks H. the Pine-Glandule From I to K a part of the third Ventricle going to the fourth under the Testicles KLMN a part of the fourth Ventricle which is engraven in the marrow O the top of the fourth Ventricle P the place where the spinal marrow goeth out of the skull Figure 11. AB Parts of the optick nerves CD the sleepy arteries E the Bason or Tunnel hanging down F a hole or perforation of the Dura meninx through which the Tunnel reacheth unto the Glandule GG Parts of the second conjugation of sinews Figure 12. A the Glandule B the Bason or Tunnel called Pelvis or Infundibulum CDEF the four holes through which the phlegmatick excrement issueth The fourth ventricle seated in the place we formerly mentioned it is less than the rest but more solid less as that which was not to receive the spirit before it was purified and clensed from all impurities but more solid that it might contain it the safer The use thereof is to be as a treasury and store-house of the opinion and judgments which reason shall decree that when need requires we may fetch and draw them from thence as laid up in store I know Galen and the Greek Physitians have not so distinguished in places the three fore-mentioned faculties but have written that they all are all over-confused through the whole substance of the Brain which opinion also Fernelius in his Pathologia hath renewed Yet I had rather follow this opinion as commonly received and celebrated by the Arabian Physitians The Mamillary processes are the instruments and passages of Smelling The use of the Mamillary processes being of the same substance with the Brain and like Nerves which run out from the hind-horns of the upper or foremost ventricles of the Brain to the Ethmoides and spongy bones of the Nose that hence they may receive the divers kinds of Smells and carty them into the Brain But although they be like Nerves yet they are not accounted Nerves because they go not out of the Skull CHAP. VIII Of the seven Conjugations of the Nerves of the Brain so called because they alwayes shew the Nerves conjugated and doubled that is on each side one THe Nerves are the ways and instruments of the Animal spirit and faculty What a Nerve or Sinew is as of which those Spirits are vehicles as long as they are contained in the Brain they consist of the only and simple marrowey substance of the Brain or spinal marrow It s substence Whether the Nerve have a third membrane from the Ligaments of the Vertebra's But passing forth of the Brain they have another membranous substance which involves them joyned with them from the two membranes of the Brain and according to the opinion of some Anatomists they have also a third from the ligaments drawn as well from divers others as from these by which they are tyed to the Vertebra ' Yet this opinion seems absurd to me seeing such a membrane as that which is insensible wholly repugnes the condition of a Nerve which is to give sense to the parts to which it is inserted The magnitude of the Nerves is different Their magnitude Their figure according to the divers necessity of sense incident to the parts into which they are are inserted Their figure is round and long like to a Conduit-pipe to carry water in the membranes of the Brain with which the Nerves are covered being dilated and stretched over them after the same manner that the processes of the Peritonaeum involves the spermatick vessels with which they go down to the Testicles and take life and nourishment by the capillary Veins and Arteries which descend to them with the membranes Their use They are made for this use that they may impart sense to the sensitive parts and motion to those that are fit to
be moved All the Nerves descend from the Brain either mediately or immediately Their number their Number is seven and thirty pair or conjugations whereof seven have their original immediately from the Brain the other thirty from the spinal marrow The first Conjugation of the Nerves of the Brain is thicker than all the rest The first conjugation of Nerves and goes to the eyes to carry the visive spirit to them These arising from divers parts of the Brain in the middle way before they go out of the Skull meet together croswise like the Iron of a Mill which is fastened in the upper stone going into one common passage with their cavities not visible to the eye that so the spirits brought by those two Nerves may be communicated and they are mutually joyned and meet together so that being driven back from one eye they may flie back into the other An argument whereof may be drawn from such as aim at any thing who shutting one of their eyes see more accurately because the force of the neighbouring spirits united into one eye is more strong than when it is dispersed into both This conjugation when it comes into the glassie humor is spent in the structure of the Net-like coat which contains this humor on the back-part The second conjugation goes into many parts at its passing forth of the Skull The second conjugation and in the bottom of the circle of the eye it is distributed into the seven muscles moving the eyes The third is twofold in the passage out of the Skull it is likewise divided into many branches The third conjugation of which some are carryed to the temporal muscles into the Masseteres or grinding muscles into the skin of the face forehead and nose Othersome are sent into the upper part of the Cheek and the parts belonging to it as into the teeth gums and the muscles of the upper lip and those which are called the round which incompass the mouth on the inside the last are wasted in the coat of the tongue to bestow upon it the sense of tasting The fourth Conjugation is much smaller The fourth conjugation and is almost wholly wasted upon the coat of the Palat of the mouth to endue it also with the sense of tasting The fifth at its original and having not as yet passed forth of the skull is divided into two The fift conjugation and sends the greater portion thereof to the hole of the ear or passage of hearing that it may support the audory faculty and it sends forth the other lesser portion thereof to the temporal muscles by the passage next to it by which the second Conjugation passes forth The sixt being the greatest next to the first passing entire forth of the skull The sixt conjugation imparts some small branches to certain muscles of the neck and throttle and then descending into the chest it makes the recurrent nerves and dispersed over all the parts of the two lower Bellies it passes even to the bladder and testicles as we shewed in the former book The seventh is inserted and spent upon the muscles of the bone Hyois the tongue The seventh conjugation and some of the throttle to give them motion it passes forth of the skull by the hole of the Nowl-bone at the extuberancies thereof The seventh Figure shewing the eighth Conjugation of the Nerves of the Brain AA 1 2 The Brain BB 1 2 the After-brain CC 1 2 the smelling of the brain which some call the Mamillary processes D 1 the beginning of the spinal marrow out of the basis of the brain F 1 2 a part of the spinal marrow when it is ready to issue out of the skull FF 1 2 the mamillary processes which serve for the sense of smelling GG 1 2 the Optick nerves H 1 the coition or union of the optick nerves II 1 2 the Coat of the eye whereinto the optick nerves are extended KK 1 2 the second pair of the sinews ordained for the motion of the eyes LL 1 2 the third pair of sinews or according to the most Anatomists the lesser root of the third pair MM 1 2 the fourth pair of sinews or the greater root of the third pair N 2 a branch of the third conjugation derived to the musculous skin of the fore-head O 2 a branch of the same to the upper jaw PP 2 another into the coat of the nostrils Q 2 another into the temporal muscles R 2 a branch of the fourth conjugation crumpled like the tendril of a vein S 2 a branch of the same reaching unto the upper teeth and the gums T 2 another of the same to the lower jaw V 2 a surcle of the branch T to the lower lip XX 2 another surcle from the branch T to the roots of the lower teeth YY 2 the assumption of the nerves of the fourth conjugation unto the coat of the tongue Z 1 2 the fourth pair are vulgarly so called which are spent into the coats of the palat a 1 2 the fifth pair of sinews which belong to the hearing φ the Auditory-nerve spred abroad into the cavity of the stony bone * a hard part of the fifth conjugation above the * which may be counted for a distinct nerve b 1 2 a small branch derived from this harder part of the first pair c 1 2 a lower branch from the same original d 1 2 this nerve is commonly ascribed to the fifth pair but indeed is a distinct conjugation which we will call the Eighth because we would not interrupt the order of other mâ—ns accounts e 1 2 the sixt pair of sinews f 2 a branch from them derived to the neck and the muscles couched thereupon g 2 another branch to the muscles of the Larinx or throttle h 1 2 the seventh pair of sinews i 1 the union of the seventh pair with the sixt l 2 a propagation of the seventh pair to those muscles which arise from the Appendix called Stiloides m 2 surcles from the seventh conjugation to the muscles of the tongue the bone Hyois and the Larinx opq 1 three holes through the hole o the phlegm issueth out of the third ventricle of the Brain to the Tunnel and at pq is the passage of the Soporary arteries to the ventricles of the Brain CHAP. IX Of the Rete Mirabile or wonderful Net and of the Wedg-bone The existence of the Animal Spirit What the Rete Mirabile is THe Animal spirit is made of the vital sent from the Heart by the internal sleepy Arteries to the Brain For it was requisite that it should be the more elaborate because the action of the Animal is more excellent than that of the vital Nature hath framed a texture of Arteries in many places running cross one another in the form of a Net divers times doubled whereupon it had the name of the wonderful Net that so the spirit by longer delay in these Labyrinthian or maze-like
passions of hope The Countenance is the bewrayer of the will fear sorrow and delight possess our minds and what state our bodies are in sound sick or neither Wherefore seeing the Face is of so much moment let us return to the Anatomical description thereof which that we may easily and plainly perform we will begin with the Bones thereof whereby as we formerly said the original and insertion of the Muscles may be more certain and manifest to us CHAP. I. Of the Bones of the Face Bones in each orb of the Eye THe Bones of the Face are 16 or 17. in number And first there be reckoned six about the orbs of the Eyes that is three to each orb of which one is the bigger another lesser and the third between both each of these touch the forehead-bone in their upper part Besides the greater is joyned with a Suture to the process of the stony-bone and so makes the Zygoma VVhat the Zygoma is and what use it hath that is the Os Jugale or Yoke-bone framed by Nature for preservation of the temporal muscle The lesser is seated at the greater corner of the Eye in which there is a hole perforated to the Nose and in this is the glandule in which the Aegylops doth breed The middle is in the bottom The Aegylops or inner part of the orb very slender and as it were of a membranous thinness The two bones of the Nose then follow the two bones of the Nose which are joyned to the fore-head-bone by a suture but on the foreside between themselves by harmony But on the back and hind-part with two other bones The two inner bones of the Palat. on each side one which descending from the bone of the fore-head to which also they are joyned by a suture receive all the teeth These two in Galen's opinion are seldom found separated But these are the thickest of all the bones of the face hitherto mentioned knit by a suture with the greatest bone of the Orb on the back-part with the wedg-bone on the inner side with the two little inner bones of the Palat which on the inside make the extremity thereof whereby it comes to pass that we may call these bones the hinder or inner bones of the Palat. They reckon one of these bones the eleventh and the other the twelfth-bone of the head these two little bones on their sides next to the winged productions of the wedg-bone receive on each-side one of the nerves of the fourth conjugation which in the former book we said were spent upon the membrane of the Palat. The two bones of the Jaw And in Galen's opinion there be other two in the lower Jaw joined at the middle of the chin although some think it but one bone because by the judgment of sense there appears no division or separation therein Two productions on each side of the lower Jaw But you may see in Children how true this their supposition is for in men of perfect growth it appears but one bone these two are reckoned for the thirteenth and fourteenth bones Now these two bones making the lower Jaw have in their back-part on each side two productions as they lye to the upper Jaw the one of which represents the point of a sword and is called the Corone the other is obtuse and round which is inserted into the cavity seated at the root of the process of the stony-bone neer to the passage of the Ear. This may be strained to the fore-part by violent gaping by retraction of the muscles arising from the wing-like processes and ending at the lower angles of the broader part of the same Jaw The Luxâ—tion of the lower Jaw The lower Jaw filled with a marrowy humor This Jaw is hollow as also the upper especial in the back-part being filled with a white and glutinous humor conducing to the growth of the teeth This humor hath its matter from the blood brought thither by the vessels veins arteries and nerves from the third Conjugation entring here by a passage large enough Whereby it comes to pass that this part is not only nourished and lives but also the teeth receive sense by the benefit of the nerves entring thither with the vein and artery by small holes to be seen at the lower roots of the teeth How the teeth feel Why the teeth have a beating pain and thence it is that a beating pain may be perceived in the Tooth-ach because the defluxions may be by the Arteries or rather because the humor flowing to the roots of the teeth may press the artery in that place beside also you may see same appearance of a nervous substance in the root of a tooth newly pluckt out But also you must consider The nerves of the lower jaw must be observed that this Jaw from its inner capacity produces at the sides of the chin two nerves of a sufficient magnitude over against the lower Dog-teeth and the first of the smaller grinding teeth as I have noted in the description of nerves of the third conjugation I have thought good to put thee in mind of these that when thou shalt have occasion to make incision in these places thou maist warily and discreetly handle the matter that these parts receive no harm There remains another bone seated above the Palat from which the gristly partition of the Nose arises being omitted of all the Anatomists for as much as I know The bone of the nose above the palate or the partition of the nose Now therefore that you may the better remember the number of the bones of the Face I will here make a repetition of them There are six of the Orbs of the Eyes at each three The seventh and eighth we may call the Nasal or Nose-bones The ninth and tenth the Jaw-bones The eleventh and twelfth are called the inner bones of the Palat. The thirteenth and fowerteenth the bones of the lower Jaw The partition of the Nose may be reckoned the fifteenth Now it remains having spoken of these bones that we treat of the Teeth the Eye-brows the skin the fleshy pannicle the Muscles and lastly the other parts of the Face CHAP. II. Of the Teeth THe Teeth are of the number of the bones and those which have the most The teeth are bones have thirty two that is sixteen above and so many below of which in the forepart of the mouth there are four above and as many beneath which are called Incisorii Cutting or shearing Teeth to cut in sunder the meat and they have but one root The shearing teeth To these are joyned two in each Jaw that is on each side of the other one which are called the Canini Dentes Dog-teeth because they are sharp and strong like Dogs-teeth these also have but one root The Dogteeth but that is far longer then the other have Then follow the Molares or grinders on each side five that is ten
above and as many below The grinding teeth that they may grind chaw and break the meat that so it may be the sooner concocted in the stomach for so they vulgarly think that meat well chawed is half concocted those grinders which are fastned in the upper Jaw have most commonly three roots and oft-times fower Why the upper grinding teeth have more roots But these which are fastned in the lower have only two roots and sometimes three because this lower Jaw is harder then the upper so that it cannot be so easily hollowed or else because these teeth being fixed and firmly seated needed not so many stayes as the upper which as it were hang out of their seats The shearing teeth cut the meat because they are broad and sharp The use of the teeth the Dog-teeth break it because they are sharp pointed and firm but the Grinders being hard broad and sharp chaw and grind it asunder But if the grinders had been smooth they could not fitly have performed their duty for all things are chawed and broken asunder more easily by that which is rough and unequal Wherefore they sharpen their Milstones when they are smoother then they should be The teeth are fastened in the Jaws by Gomphosis The fastening of the teeth into the Jaws is to be observed by picking them with a sharp Iron The Teeth are fastened in the Jaws by Gomphosis that is as a stake or nail so are they fixed into the holes of the Jaws for they adhere so firmly thereto in some that when they are pluckt out part thereof followes together with the tooth which I have often observed to have been also with great effusion of blood This adhesion of the teeth fastned in the Jaws is besides strengthened with a ligament which applyes it self to their roots together with the nerves and vessels The teeth differ from the other bones because they have action whilst they chaw the meat because being lost they may be generated and for that they grow as long as the party lives for otherwise by the continual use of chawing they would be worn and wasted away by one another You may perceive this by any that have lost one of their teeth for that which is opposite to it becomes longer then the rest because it is not worn by its opposite Wherein the teeth differ from the other bones For what use the teeth have sense Beside also they are more hard and solid than the rest of the bones and indued with a quick sense by reason of the nerves of the third conjugation which insert themselves into their roots for if you rub or grind a tooth newly pluckt out you may see the remains of the nerve they have such quick sense that with the tongue they might judg of tastes But how feel the teeth seeing they may be filled without pain Fallopius answers that the teeth feel not in their upper or exterior part but only by a membrane which they have within And the teeth have another use especially the fore-teeth which is They serve for distinct and articulate pronuntiation The fore-teeth help for the articulation of the voyce for those that want them faulter in speaking as also such as have them too short or too long or ill-ranked Besides children speak not distinctly before they have their fore-teeth And you must note that the Infant as yet shut up in its Mothers womb hath solid and bony teeth which you may perceive by dissecting it presently after it is born But even as there are two large cavities in the fore-head bone at the eye-brows filled with a viscous humor serving for the smelling and in like manner the air shut up in the mamillary processes is for hearing so in the Jaws there be two cavities furnished with a viscid humor for the nourishment of the teeth CHAP. III. Of the Broad Muscle NOw we should prosecute the containing parts of the face to wit the skin the fleshy pannicle and fat but because they have been spoken off sufficiently before I will only describe the fleshy pannicle before I come to the dissection of the eye that we may the more easily understand all the motions performed by it whether in the face or fore-head First that you may more easily see it you must curiously separate the skin in some part of the face For unless you take good heed you will pluck away the fleshy pannicle together with the skin as also this broad muscle to which it immediately adheres and in some places so closely and firmly as in the lips eye-lids and the whole forehead that it cannot be separated from it Nature hath given motion or a moving force to this broad muscle that whilst it extends or contracts it self it might serve to shut and open the eye It will be convenient to separate the muscle thus freed from the skin beginning from the fore-part of the clavicles even to the chin ascending in a right line and then turnig back as far as you can for thus you shall shew how it mixes it self with the skin and the muscles of the lips There are no particular Muscles appointed to open and shut the Eye for that is the broad muscle only Divers reasons to that purpose When thou shalt come to the Eyes thou shalt teach how the Eye is shut and opened by this one muscle because it is composed of three sorts of fibers although by the opinion of all who hitherto have written of anatomy those actions are said to be performed by the power of two muscles appointed for that purpose one of which is at the greater corner on the upper part the other resembling a semicircle at the lesser corner from whence extending it self to the middle of the gristle Tarsus it meets with the former ending there but they are in part extended over all the Eye-lid whereby it commeth to pass that it also in some sort becometh moveable But although in publick dissections these two muscles are commonly wont to be solemnly shewed after the manner I have related yet I think that those which shew them know no more of them than I do I have grounded my opinion from this that there appears no other musculous flesh in these places to those which separate the fleshy pannicle or broad muscle than that which is of the pannicle it self whether you draw your Incision-knife from the fore-head downwards or from the cheek upwards Why you must take heed of making a transverse incision upon the Eye-brows Besides when there is occasion to make incision on the Eye-brows we are forbidden to do it transverse lest this broad muscle falling upon the Eye make the upper Eye-lid unmoveable but if such a cut be received accidentally we are commanded presently to stitch it up which is a great argument that the motion of the upper Eye-lid is not performed by its proper muscles but wholly depends and is performed by the broad muscle Now if these same
and pinna are THe Ears are the Organs of the sense of Hearing They are composed of the skin a little flesh a gristle veins arteries and nerves They may be bended or folded in without harm because being gristly they easily yield and give way but they would not do so if they should be bony but would rather break That lap at which they hang Pendants and Jewels is by ancients called Fibra but the upper part Pinna They have been framed by the Providence of Nature into two twining passages like a Snails-shel The figure and the reason thereof which as they come neerer to the foramen caecum or blind-hole are the more straitned that so they might the better gather the air into them and conceive the differences of sounds and voices and by little and little lead them to the membrane This membrane which is indifferently hard hath grown up from the nerves of the fifth conjugation which they call the auditory But they were made thus into crooked windings lest the sounds rushing in too violently should hurt the sense of Hearing Yet for all this we oft find it troubled and hurt by the noise of Thunder Guns and Bels. Otherwise also lest that the air too sodainly entring should by its qualities as cold cause some harm and also that little creeping things and other extraneous Bodies as Fleas and the like should be stayed in these windings and turnings of the wayes the glutinous thickness of the cholerick Excrement or Ear-wax For what use the Ear-wax serves hereunto also conducing which the Brain purges and sends forth into this part that is the auditory passage framed into these intricate Maeanders The Figure of the Ears and Bones of the Auditory passage Tab. 10. Sheweth the Ears and the divers internal parts thereof Fig. 1. Sheweth the whole external Ear with a part of the Temple-bone Fig. 2. Sheweth the left Bone of the Temple divided in the midst by the instrument of Hearing whereabout on either side there are certain passages here particularly described Fig. 3. and 4. Sheweth the three little Bones Fig. 5. Sheweth a portion of the Bone of the Temples which is seen neer the hole of Hearing divided through the midst whereby the Nerves Bones and Membranes may appear as Vesalius of them conceiveth Fig. 6. Sheweth the Vessels Membranes Bones and Holes of the Organ of Hearing as Platerus hath described them Fig. 7. and 8. Sheweth the little Bones of the Hearing of a man and of a Calf both joyned and separated Fig. 9. Sheweth the Muscle found out by Aquapendens For the particular Declaration see Dr. Crooks Anatomy pag. 577. But that we may understand how the Hearing is made For what use the membrane stretched under the auditory passage serves we must know the structure of the Organ or Instrument thereof The Membrane which we formerly mentioned to consist of the Auditory-Nerve is stretched in the inside over the Auditory passage like as the head of a Drum For it is stretched and extended with the air or Auditory Spirit implanted there and shut up in the cavity of the mamillary process and foramen caecum that smitten upon by the touch of the external air entring in it may receive the object that is the sound What sound is which is nothing else than a certain quality arising from the air beaten or moved by the collision and conflict of one or more bodies Such a collision is spred over the air as the water which by the gliding touch of a stone produces many circles and rings one as it were rising from another So in rivulets running in a narrow channel the water strucken and as it were beaten back in its course against broken craggy and steep Rocks wheels about into many turnings this collision of the beaten air flying back divers wayes from arched and hollow-roofed places as Dens Cisterns Wells thick Woods The cause of an echo and the like yields and produces a double sound and this reduplication is called an Echo Wherefore the Hearing is thus made by the air as a medium but this air is twofold that is External and Internal The exteriour is that which encompasses us The 3 bones of the auditory passage but the interiour is that which is shut up in the cavity of the mamillary process and foramen caecum which truly is not pure and sole air but tempered and mixed with the auditory spirit Thence proceeds the noise or beating of the Ears when vapors are there mixed with the air instead of spirits whereby their motion is perturbed and confused But neither do these suffice for hearing for Nature for the more exact distinction of sounds hath also made the little bones of which one is called the Incus or Anvil another the Malleolus or hammer the third the Stapes or Stirrop because the shape thereof resembles a German-stirrop Also it may be called Deltoides because it is made in the shape of the Greek Letter Δ. Their use They are placed behind the membrane wherefore the Anvil and Hammer moved by the force of the entrance of the external air and beating thereof against that membrane they more distinctly express the difference of sounds as strings stretched within under the head of a Drum as for example Whence the difference of sounds these Bones being more gently moved represent a low sound to the common sense and faculty of Hearing but being moved more vehemently and violently they present a quick and great sound to conclude according to their divers agitation they produce divers and different sounds The Glandules should follow the Ears in the order of Anatomy as well those which are called the emunctories of the Brain that is the Parotides which are placed as it were at the lower part of the Ears as these which lye under the lower Jaw the Muscles of the Bone Hyoides and the Tongue in which the Scrâ—phulae and other such cold abscesses breed It shall here suffice to set down the use of all such like Glandules Therefore the Parotides are framed in that place by Nature to receive the virulent and malign matter sent forth by the strength of the Brain by the Veins and Arteries spred over that place The rest serve to strengthen the division of the vessels to moisten the Ligaments and Membranes of the Jaw lest they should be dryed by their continual motion Their other conditions and uses are formerly handled in our first Book of Anatomy CHAP. XI Of the Bone Hyoides and the Muscles thereof The reason of the name THe substance of the Bone Hyoides is the same with that of other Bones The figure thereof imitates the Greek letter Ï… from whence it took the name as also the name 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 And from the letter λ it is in like sort called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by some it is styled os Gutturis and os Linguae The composition that is the Throat-bone and Tongue-bone The composition
Ship The second that it is a way or passage for the marrow The third is because it contains and preserves the same The fourth is that it serves for a wall or bulwark to the entrails which lye and rest upon it on the inside And because we have fallen into mention of Ligaments it will not be amiss to insert in this place that which ought to be known of them First therefore we will declare what a Ligament is then explain the divers acceptions thereof and lastly prosecute their differences VVhat a Ligament is Therefore a Ligament is nothing else than a simple part of mans body next to a bone and Gristle the most terrestrial and which most usually arises from the one or other of them either mediately or immediately and in the like manner ends in one of them or in a muscle or in some other part VVhy it is without sense whereby it comes to pass that a Ligament is without blood dry hard cold and without sense like the parts from whence it arises although it resemble a Nerve in whiteness and consistence but that it is somewhat harder A Ligament is taken either generally or more particularly in general VVhat parts may be called Ligaments in a general signification for every part of the body which tyes one part to another in which sense the skin may be called a Ligament because it contains all the inner parts in one union So the Peritonaeum comprehending all the natural parts and binding them to the Back-bone so the Membrane investing the Ribs that is the Pleura containing all the vital parts thus the membranes of the Brain the Nerves Veins Arteries Muscles Membranes and lastly all such parts of the body which bind together and contain other may be called Ligaments because they bind one part to another as the Nerves annex the whole Body to the Brain the Arteries fasten it to the Heart and the Veins to the Liver But to conclude the name of a Ligament more particularly taken signifies that part of the Body which we have described a little before Table 20. Figure 1. sheweth all the Rack-bones of the back knit together Figure 2. sheweth the fore and upper face of the neck c. See D. Crook p. 398. From A to B the seven vertebra's of the neck From C to D the twelve vertebra's of the chest From E to F the five rack-bones of the Loins From G to H the Os sacrum or Holy-bone consisting commonly of six vertebrae From I to K the bone Coccyx or the Rump-bone according to the late Writers LL the bodies of the vertebrae M the transverse processes of the vertebrae N the descendent processes OO the ascendent processes PP the backward processes QQ the holes that are in the sides of the vertebrae through which the nerves are transmitted RR a gristly ligament betwixt the vertebrae A 2 3 4 the hole whereout the marrow of the back issueth B 2 3 the cavity which admitteth the root of the second rack-bone C 3 4 a cavity or Sinus in the same place crusted over with a gristle D 2 a prominence in the outward region of this Sinus EF 2 3 the Sinus or cavity of the first rack-bone which admitteth the two heads of the Nowl-bone GG 2 3 4 the transverse process of the first Vertebra H 1 the hole of this transverse process I 3 the Sinus which together with the cavity of the nowl-bone marked with E maketh a common passage prepared for the nerves K 3 4 a rough place where the Spine of the first rack is wanting LL 4 two cavities of the first rack receiving the two bunches of the second rack marked with MN MN 5 6 the 2. bunches of the second rack which fall into the cavities of the first O 7 the appendix or tooth of the second rack P 5 a knub of this appendix trusted over with a gristle Q 6 the back-side of the tooth R 6 the Sinus or cavity of the same about which a transverse Ligament is rowled containing the said tooth in the cavity of the first rack ST 6 Certain cavities at the sides of the tooth whence the roots issue of the fore-branch of the second pair of sinews V 5 the point of the tooth X 3 an asperity or roughness where is a hole but not thrilled through Y 6 a cavity of the second rack which together with the cavity marked with Z maketh a hole through which the nerves do issue Z 4 the Sinus of the first rack a 5 6 7 the double spine of the second rack b 5 6 7 the transverse process of the second rack c 7 the hole of the said transverse process d 6 7 the descending process of the second rack whose cavity is marked with d in the 6. figure e 6 7 the place where the body of the second rack descendeth downward f gg 8 the lower side of the body of the third rack at f the two eminent parts of the same at gg hi 8 the ascending processes l m 8 the two descending processes nopq 8 the transverse processes r 8 9 the spine or backward process st 8 the two tops of the spine u 9 the descending process of the third rack x 9 the ascending process y the transverse process of the third rack α 8 9 the hole of this transverse process β 9 the upper hollowed part of the body of the third rack δ 9 the Sinus or cavity which maketh the lower part of a hole through which the conjugations of the nerves are led ε 7 the upper part of the same hole The differences of Ligaments properly so called The differences of Ligaments are many for some are membranous and thin others broad othersome thick and round some hard some soft some great some little some wholly gristly others of a middle consistence between a bone and gristle according to the nature of the motion of the parts which they bind together in quickness vehemency and slowness We will shew the other differences of Ligaments as they shall present themselves in dissection CHAP. XVII Of the Muscles of the Neck Their number THe Muscles of the Neck as well proper as common are in number twenty or else twenty two that is ten or eleven on each side of which seven only move the head or the first vertebra with the head the other three or four the neck it self Of the seven which move the head and with the head the first Vertebra some extend and erect it others bend and decline it others move it obliquely but all of them together in a successive motion move it circularly and the like judgment may be of the Muscles of the Neck The fourth Figure of the Muscles This Figure sheweth the cavities of the middle and lower bellies the bowels being taken out but most part of the Bones and Muscles remaining AB The first muscle bending the neck called Longus CC the second bender of the neck called Scalenus DDDD the
bone and the Os Ilium or Hanch-bone to the Thigh bestows certain sprigs to the hind-muscles thereof proceeding from the protuberation of the Ischium or Huckle-bone and in like sort it gives othersome to the skin of the Buttocks and also to the skin covering the fore-mentioned Muscles A little after it is parted into two branches descending undivided even to the bending of the Knee they both are communicated by divers surcles of the Muscles of the Leg yet so as the lesser produces another branch from the rest of the portion thereof descending on the fore-part of the Leg alongst the Shin-bone unto the top of the Foot where it is divided into ten surcles scarce apparent to the sight two running to each of the Toes The other greater descending in like manner in the remainder of its portion by the hind-part of the Leg into the sole of the Foot casts it self with the Veins and Arteries between the Heel and Leg-bone were first divided into two Branches each of which presently parted into five send two sprigs to the sides of the Toes And these are the most notable and necessary distributions of the Vessels and Nerves we purposely omit others which are infinite and of which the knowledg is impertinent CHAP. XXXIV Of the proper parts of the Thigh HAving explained the common parts of the Leg in general now we must come to the proper beginning at the Thigh The proper parts of the Thigh are Muscles Bones and Ligaments But because the demonstration of the Muscles is somewhat difficult if we be ignorant of the description of the Bones from whence they arise and into which they are inserted therefore we judg it worth our labour first to shew the Bones and the dearticulation of these of the Thigh beginning with those Bones which are knit with the upper part of the Holy-bone And they are two in number on each side one commonly called the Ossa Ilium Of how many Bones the Ossa Ilium consist each of these is composed of three Bones of which one is the upper another the lower and anterior and the third the middle and after a manner the posterior The upper by a particular name is called the Os Ilium the Hanch-bone and it is the largest and biggest What the Os Ilium strictly taken is having a gristly Appendix in the compass thereof even to the connexion it hath with the other neighbouring Bones whose upper part we term the right line thereof but the basis which is adjoyned to it by Symphysis we call the lip or brow thereof because it stands both somewhat out and in after the manner of the brow But that which lies between the basis and straight line we name the Rib What the line lip brow and rib of the Os Ilium are this same upper bone hath two hollow superficies the one internal the other external The connexion thereof by Symphysis is two-fold the one with the upper part of the Holy-bone the other with that Bone we called the middle and after some sort the posterior which taking its beginning from the narrower part of the Os Ilium makes that cavity in which the head of the Thigh is received this cavity the Greeks call Cotyle the Latins Acetabulum The Os Ischium or Huckle-bone and it is ended by the side of the hole common to it and the Share-bone this middle and in some sort posterior-bone is called properly and particularly the Os Ischii or Huckle-bone and contains nothing else but the fore-mentioned cavity but that on the hind and lower part thereof it brings forth a proccess which adjoyns it self to the Share-bone at the lower part of the common hole in which place it appears very rough and unequal and it is called the tuberosity of the Huckle-bone at whose extremity also it brings forth a little head somewhat resembling the process of the lower Jaw called Corone The Os pubis or Share-bone The third bone named Os pubis or the Share-bone stretches it self even to the highest part of the Pecten where meeting with the like Bone of the other side it is united to it by Symphysis after which manner also all these three Bones are united It is reported that this Bone opens in women in their travel yet hitherto I can find no certainty thereof You may perceive a manifest separation of these three Bones in the Sceleton of a Child for in those who are of more years the Gristles which run between these connexions turn into Bones Now follows the Thigh-bone the biggest of all the Bones of the Body it is round The description of the Thigh-bone and so bended that it is gibbous on the exterior and fore-part thereof that so it might be the safer from external injuries but on the hind and inner part it is hollow or simous like to the Back of an Ass whereby the Muscles might have a more commodious original and insertion That simous part a little below the midst thereof is divided into two lines the one whereof goes to the internal tuberosity the other to the external of the lower appendix of the same thigh These are chiefly to be observed because the oblique fibers of the vast Muscles thence take their original Besides this Bone hath two appendices in the ends thereof as easily appears in a childs thigh The two Appendices of the Thigh-bone the upper appendix makes the round head of the Thigh it self which as every other appendix seated upon a long Neck is received in the cavity of the Hanch-bone by Enarthrosis it is stayed and fastned there by two sorts of ligaments of which the one is common proceeding from the Muscles which descend from above about the Neck thereof the other is proper which is twofold that is one membranous and broad proceeding from the whole cavity of the Orb or Cup descending about all the head of the Thigh above the Neck thereof the other thick and round descending from the second cavity of the Cotyle it self which is extended even to the common hole at the top of the head thereof Besides under this head that Bone hath two processes the one great and thick The two processes of the Thigh-bone make the two Trochanters the other little and short The greater seated in the hind-part is called the great Trochanter the lesser situate in the inner part is named the little Trochanter But you must note that the greater Trochanter on the higher and hind-part thereof which looks towards the Head of this Bone makes a certain small sinus or bosom into which the Twin-muscles and others whereof we shall hereafter speak are implanted we must also consider the multitude of holes encompassing this Neck Whence the Marrow becomes partaker of sense between the Head and the two Trochanters which yield a passage to the vessels that is the veins arteries and nerves into the Marrow of the Bone it self whence the marrow it self becomes partaker of sense especially on that
composure is in the Cubit-knee that is in the connexion of the Thigh-bone And thus much of Dearticulation and the three kinds thereof Synarthrosis or Coarticulation another kind of juncture hath also three kinds thereof 3 kinds of Synarthrosis Gal. lib. deâ—ssiâ—us to wit Sutura Gomphosis and Harmonia Suture is a composition of the Bones after the manner of sewing things together What a Suture is What Gomphosis is What Harmonia is example whereof appears in the Bones of the Skull Gomphosis when one bone is fastened in another as a Pin is fastened in a hole after which manner the teeth are fastened in their sockets in both the Jaws Harmony is when the bones are composed by the interposition of a simple line after which manner many Bones of the Nose and Face are joyned together Hitherto we have spoken of the first construction of the Bones by articulation and the kinds thereof now it follows we treat of Symphysis Symphysis or growing together as we formerly said is nothing else What Symphysis is than natural union of the bones such union is made two manner of wayes that is either by interposition of no other thing after which sort in success of time the bones of the lower Jaw grow together which formerly in children were manifestly distinguished or by the mediation of some Medium but that happens three manner of wayes by interposition of three several Media as first of a Gristle which kind of union the Greeks call Synchondrosis after which manner the Share-bones grow together Synchondrosis and also some Appendices in young bodies secondly of a Ligament and it is named by the Grecians Syneurosis the Name of a Nerve being taken in the largest sense Syneurosis The things signified by the word Nerve for sometimes it is used for a tendon otherwhiles for a Ligament otherwhiles for a Nerve properly so called and which is the author of sense and motion But this Symphysis or union hath place by Syneurosis or interposition of a Nerve in certain bones of the Sternon and Haunch Thirdly the Bones grow into one by interposition of flesh Synsarcusis called in Greek Synsarcosis thus the flesh of the Gums fastens the teeth and makes them immoveable But if some be less pleased with this division by reason of the obscurities in which it seems to be involved this following expression comes into my mind which I was first admonished of by German Cortin Doctor of Physick which if you well observe it is both blameless and more easie for your understanding An Epitome or brief recital of all the Muscles of Man's Body As I have formerly reckoned up the Bones so here I have decreed to recite the Muscles of Man's Body Wherefore in the Face we first meet with the broad or skin-muscle arising from the fleshy pannicle and covering the whole Neck and almost all the Face Then follow 4 pertaining to the upper Eye-lids In the Orbs of the Eyes lie 14 that is 7 in each Orb of which 4 are called right two oblique and one pyramidal Then succeed 4 of the Nose two external on each side one and two internal these draw it together and the other open it After these come the ten muscles of the lower Jaw of which two are called the Crotaphitae or Temporal two Massiteres or Grinders two round which seem to me rather to pertain to the lips than to this Jaw two little ones hid in the mouth arising from the winged process of the wedg-bone two openers of the mouth being nervous or tendinous in their midst Then follow the 8 muscles of the lips that is 4 of the upper and as many of the lower shutting and opening the mouth The tongue with his ten Muscles hid as it were in the den of the mouth Wherefore the Muscles of the whole face are 51. In the fore-part of the Neck are found the Muscles of the bone Hyoides and Throttle now 8 Muscles hold the Bone Hyoides as equally ballanced of which there are 2 upper arising from the Chin 2 on the sides from the process Styloides perforated in their midst through which the 2 openers of the mouth in that part nervous do pass 2 arise from the Sternon and lastly 2 from the upper rib of the Shoulder-blade to the Coracoides which also in their midst are nervous in which place the two Mastoidei lye upon them The bones which as pillars sustain the fabrick of the whole body are either United mutually by Symphysis or union by which they are so conjoyned that there is no dissimilar nor heterogeneous body at least which may be discerned interposed between them Such union appears in the two bones of the lower Jaw at the Chin in the bones of the Sternon the Hanch with the Huckle-bones and the Share-bones between themselves of this union there are no more kinds for by this it cometh to pass that the bones which were more and distinct meet together by interposition of one Medium to wit a Gristle which now indeed is no Gristle but is turned into a Bone or Conjoyned by that which they call Arthrodia or Articulation as when they so concurr are bound together that some Heterogeneous substance may be noted betwixt them but the bones thus composed are knit two manner of wayes that is either more loosly as by Diarthrosis that is a kind of Articulation not very strait as by which it might have opportunity to perform diverse motions of this composure or Articulation of bones there are three kinds as Enarthosis when the head of a bone is wholly received in the cavity of another and hid therein as the Thigh-bone is joyned with the Huckle-bone Arthrodia when in a lightly engraven and not much depressed cavity the head of another bone is not wholly hid but only received in part thereof so that unless Nature had otherwise provided a sufficient receptacle for the head of this bone as by the ligaments of the neighbouring Muscles it would otherwise have been in perpetual danger of dislocation Thus the Arm-bone is fastened to the Shoulder-blade Ginglymos when the bones mutually receive each other such like composition hath the Cubit and Arm-bone or more straitly as by Synarthrosis when the bones are more straitly knit so that they can perform no motions in the body Of this Articulation there are also three kinds that is Gomphysis as when one bone so receives another as a Pâ—n is fastned in the hole made by a piercer thus the teeth are fastned in the jaws Sutura like a Saw or teeth of a Combe as the bones of the skull are mutually knit together or as scales or tiles are laid after which manner the stony-bones are fastened to those of the Sinciput Harmonia which is by interposition of a simple-line which parts bones abutting one upon another as the bones of the Nose The 18. muscles of the Larinx The Throttle composed of three gristles hath eighteen or twenty Muscles of which six or
digested and ripened thirdly by induration when it degenerates into a Scirrhus the thinner part of the humor being dissolved the fourth which is the worst of all by a corruption and Gangrene of the part which is when overcome with violence or the abundance or quality of the humor or both it comes to that distemper that it loses its proper action It is best to terminate a tumor by resolution and the worst by corruption suppuration and induration are between both although that is far better than this The signs of a tumor to be terminated by resolution The signs by which the Chirurgeons may presage that an Impostume may be terminated by resolving are the remission or slacking of the swelling pain pulsation tension heat and all other accidents and the unaccustomed liveliness and itching of the part and hot Impostumes are commonly thus terminated because the hot humor is easily resolved by reason of its subtilty Signs of suppuration are the intension or encrease of pain heat swelling pulsation The signs of suppuration and the Feaver for according to Hippocrates Pain and the Feaver are greater when the matter is suppurating than when it is suppurated The Chirurgeon must be very attentive to know and observe when suppuration is made for the purulent matter oft-times lies hid as Hippocrates saith by reason of the thickness of the part lying above or over it The signs of an Impostume degenerating into a Scirrhous hardness The signs and causes of a tumor terminated in a Scirrhus are the diminution of the tumor and hardness remaining in the part The causes of the hardness not going away with the swelling are the weakness of nature the grosness and toughness of the humor and unskilfulness of the Chirurgeon who by too long using resolving things hath occasioned that the more subtil part of the humor being dissolved the rest of the grosser nature like earthy dregs remains concret in the part For so Potters vessels dryed in the Sun grow hard But the unskilful Chirurgeon may occasion a Scirrhous hardness by another means as by condensating the skin and incrassating the humors by too much use of repercussives The signs of a Gangrene at hand But you may perceive an Impostume to degenerate into a Gangrene thus if the accidents of heat redness pulsation and tension shall be more intense than they are wont to be in suppuration if the pain presently cease without any manifest cause if the part wax lived or black and lastly if it stink But we shall treat of this more at large when we come to treat of the Gangrene and Sphacelus Of disappearance of a tumor and the signs thereof A sodain diminution of the tumor and that without manifest cause is a sign of the matter fallen back and turned into the body again which may be occasioned by the immoderate use of refrigerating things And sometimes much flatulency mixed with the matter although there be no fault in those things which were applyed Feavers and many other malign Symptoms as Swoundings and Convulsion by translation of the matter to the noble parts follow this flowing back of the humor into the body CHAP. IV. Of the Prognostique in Impostumes TUmors arising from a melancholy phlegmatick gross tough or viscous humor Cold tumors require a longer cure ask a longer time for their cure than those which are of bloud or choler And they are more difficultly cured which are of humors not natural than those which are of humors yet contained in the bounds of nature For those humors which are rebellious offend rather in quality than in quantity Tumors made of matter not natural are more difficultly cured and undergo the divers forms of things dissenting from Nature which are joyned by no similitude or affinity with things natural as Suet Poultis Hony the dregs of Oil and Wine yea and of solid bodies as Stone Sand Coal Straws and sometimes of living things as Worms Serpents and the like monsters The tumors which possess the inner parts and noble entrails are more dangerous and deadly is also those which are in the joynts or neer to them And these tumors which seise upon great vessels as veins arteries and nerves for fear of great effusion of blood Hippo. Aph. 8. sect 6. wasting of the spirits and convulsion So Impostumes of a monstrous bigness are often deadly by reason of the great resolution of the spirits caused by their opening Those which degenerate into a Scirrhus are of long continuance and hard to cure as also those which are in hydropick leprous scabby and corrupt bodies for they often turn into malign and ill-conditioned Ulcers CHAP. V. Of the General cure of Tumors against Nature THere be three things to be observed in the cure of Impostumes What must be considered in undertaking the cure of tumors The first is the essence thereof the second the quality of the humor causing the Impostume the third the temper of the part affected The first indication drawn from the essence that is from the greatness or smalness of the tumor varies the manner of curing for the medicines must be increased or diminished according to the greatness of the tumor The second taken from the nature of the humor also changes our counsel for a Phlegmon must be otherwise cured than an Erysipelas and an Oedema than a Scirrhus and a simple tumor otherwise than a compound And also you must cure after another manner a tumor coming of an humor not natural than that which is of a natural humor and otherwise that which is made by congestion than that which is made by defluxion What we must understand by the nature of the part The third Indication is taken from the part in which the tumor resides by the nature of the part we understand its temperature conformation site faculty and function The temperature indicates that some medicines are convenient for the fleshy parts as those which are more moist others for the nervous as more drie for you must apply some things to the eye and others to the throat one sort of things to these parts which by reason of their rarity are easily subject to defluxion another to those parts which by their density are not obnoxious to it But we must have good regard to the site of the part as if it have any connexion with the great vessels and if it be fit to pour forth the matter and humor when it is suppurated What we must understand by the faculty of the part Galen by the name of Faculty understands the use and sense of the part This hath a manifold indication in curing for some parts are principal as the Brain Heart and Liver for their vertue is communicated to the whole body by the Nerves Arteries and Veins Others truly are not principal but yet so necessary that none can live without them as the Stomach Some are endued with a most quick sense as the Eye the
by accident by reason of the humor contained therein moistening and relaxing all the adjacent parts the humor contained here lifts up the skull somewhat more high especially at the meetings of the Sutures which you may thus know because the Tumor being pressed the humor flies back into the secret passage of the Brain To conclude the pain is more vehement the whole head more swollen the fore-head stands somewhat further out the eye is fixt and immoveable and also weeps by reason of the serous humor sweating out of the Brain Vesalius writes that he saw a Girl of two years old A History whose head was thicker than any man's head by this kind of Tumor and the skull not bony but membranous as it useth to be in Abortive-births and that there was nine pound of water ran out of it Abucrasis tells that he saw a child whose head grew every day bigger by reason of the watery moisture contained therein till at length the tumor became so great that his neck could not bear it neither standing nor sitting so that he died in a short time I have observed and had in cure four children troubled with this disease one of which being dissected after it died had a Brain no bigger than a Tennis Ball. But of a Tumor and humor contained within under the Cranium or Skull I have seen none recover but they are easily healed of an external Tumor Therefore whether the humor lye under the Pericranium or under the musculous skin of the head it must first be assailed with resolving medicines but if it cannot be thus overcome you must make an Incision taking heed of the Temporal Muscle and thence press out all the humor whether it resemble the washing of flesh newly killed or blackish bloud or congealed or knotted bloud as when the tumor hath been caused by contusion then the wound must be filled with dry lint and covered with double boulsters and lastly bound with a fitting ligature CHAP. II. Of a Polypus being an eating disease in the Nose The reason the name THe Polypus is a Tumor of the Nose against Nature commonly arising from the Os Ethmoides or Spongy-Bone It is so called because it resembles the feet of a Sea Polypus in figure and the flesh thereof in consistence This Tumor stops the Nose intercepting and hindering the liberty of speaking and blowing the Nose Lib. 6. cap. 8. Celsus saith the Polypus is a caruncle of excresence one while white another while reddish which adhere to the Bone of the Nose and sometimes fills the Nostrils hanging towards the lips sometimes it descends back through that hole by which the spirit descends from the Nose to the Throttle it grows so that it may be seen behind the Uvula The differences hereof and often strangles a man by stopping his breath There are five kinds thereof the first is a soft membrane long and thin like the relaxed and depressed Uvula hanging from the middle gristle of the Nose being filled with a phlegmatick and viscid humor This in exspiration hangs out of the Nose but is drawn in and hid by inspiration it makes one snaffle in their speech and snort in their sleep The second hath hard flesh bred of Melancholy bloud without adustion which obstructing the nostrils intercepts the respiration made by that part The third is flesh hanging from the Gristle round and soft being the off-spring of Phlegmatick bloud The fourth is a hard Tumor like flesh which when it is touched yields a sound like a stone it is generated of Melancholy bloud dryed being somewhat of the nature of a Scirrhus confirmed and without pain The fifth is as it were composed of many cancrous ulcers spred over the transverse surface of the gristle Which of them admit no manual operation Of all these sorts of Polypi some are not ulcerated others ulcerated which send forth a stinking and strong smelling filth Such of them as are painful hard resisting and which have a livid or leaden colour must not be touched with the hand because they savour of the Nature of a Cancer as into which they often degenerate yet by reason of the pain which oppresses more violently you may use the Anodyne medicines formerly described in a Cancer such as this following An Anodyne â„ž Olei de vitell ovorum â„¥ ij Lytharg auri Tuthiae praep an â„¥ i succi plat solani an â„¥ i ss Lapid haematit camphorae an â„¥ ss Let them be wrought a long time in a Leaden Mortar and so make a medicine to be put into the nostrils Those which are soft loose and without pain are sometimes curable being plucked away with an Instrument made for that purpose or else wasted by actual cauteries put in through a pipe so that they touch not the sound part or by potential cauteries as Egyptiacum composed of equal parts of all the simples with Vitriol which hath a faculty to waste such like flesh Why it must be taken clear away Aqua fortis and Oyl of Vitriol have the same faculty for these take away a Polypus by the roots for if any part there remain it will breed again But Cauteries and acrid medicines must be put into the Nostrils with this Caution that in the mean time cold repelling and astringent medicines be applyed to the Nose and parts about it to asswage the pain and hinder the inflammation Such as are Unguentum de bolo and Unguentum nutritum whites of Eggs beaten with Rose-leaves and many other things of the like nature CHAP. III. Of the Parotides that is Certain swellings about the Ears What it is THe Parotis is a Tumor against Nature affecting the Glandules and those parts seated behind and about the Ears which are called the Emunctories of the brain for these because they are loose and spongy The differences are fit to receive the excrements thereof Of these some are critical the matter of the disease somewhat digested being sent thither by the force of Nature Others Symptomatical Their Signs and Symptoms the excrements of the Brain increased in quantity or quality rushing thither of their own accord Such abscesses often have great inflammation joyned with them because the biting humor which flows thither is more vitiated in quality than in quantity Besides also they often cause great pain by reason of the distention of the parts indued with the most exquisite sense as also by reason of a Nerve of the fifth Conjugation spread over these parts as also of the neighbouring membranes of the Brain by which means the Patient is troubled with Head-ach and all his face becomes swoln Yet many times this kind of Tumor useth to be raised by a tough viscous and gross humor This Disease doth more grievously afflict young men than old Prognostick it commonly brings a Feaver and watching It is difficult to be cured especially when it is caused by a gross tough and viscid humor sent
so the venenate matter may flow forth more freely for which purpose also medicines which are of a thin and liquid consistence but of a drying and digestive faculty shall be powred in to call forth and dissolve the virulency as Treacle and Mithridate dissolved in Aqua vitae with a little of some mercurial powder for this is a noble antidote A worthy Alexipharmacum oâ— Antidote Also cupping glasses and scarifications will be good Lastly the condition of all dolorifick causes shall be oppugned by the opposition of contrary remedies as if pain by reason of a pricked nerve or tendon shall cause a Convulsion it must presently be resisted by proper remedies as oyl of Turpentine of Euphorbium mixt with Aquae vitae and also with other remedies appropriated to punctures of the nerves If the pain proceed from excess of cold because cold is hurtful to the brain the spinall marrow and nerves the patient shall be placed in a hot air such as that of a hot-house or stoave all the spine of his back and convulsed parts must be anointed with the hot liniments above mentioned for that is much better than suddenly to expose him from the conceived convulsifick cause to a most hot fire or warm Bath In the mean time the Chirurgion must take diligent heed that as soon as the signs of the Covulsion to come or already present You must hinder the locking of the teeth or at hand do shew themselves that he put a stick between the patients teeth lest they be fast locked by the pertinacious contraction of the Jaws for many in such a case have bit off their tongues for which purpose he shall be provided of an instrument called Speculum Oris which may be dilated and contracted according to your mind by the means of a screw as the figures underneath demonstrate the one presenting it open and somewhat twined up and the other as it is shut The Figure of a Speculum Oris to open the teeth when they are locked or held fast together CHAP. XII Of the Palsie What a Palsie is The differences thereof THe Palsie is the resolving or mollification of the nerves with privation of sense and motion not truly of the whole body but of the one part thereof as of the right or left side And such is properly named the Palsie for otherwise and less properly the resolution of some one member is also called the Palsie for when the whoâ—â— body is resolved it is an Apoplexy Therefore the Palsie sometimes takes half the body otherwhiles the upper parts which are between the navel and the head otherwhiles the lower which are from the navell to the feet sometimes the tongue gullet bladder yard eyes and lastly any of the particles of the body How it differs from a Convulsion It differs from a Convulsion in its whole nature For in a convulsion there is a contention and contraction of the part but in this a resolving and relaxation thereof besides it commonly happeneth that the sense is either abolished or very dull which usually remains perfect in a Convulsion There are some which have a pricking and as it were great pain in the part The causes The causes are internal or external the internal are humors obstructing one of the ventricles of the brain or one side of the spinal marrow so that the animal faculty the worker of sense and motion cannot by the nerves come to the part to perform its action The external causes are a fall blow and the like injuries by which oft-times the joints are dislocated the spinal marrow wrested aside and constrictions and compressions of the Vertebrae arise which are causes that the animal spirit cannot come to the Organs in its whole substance But it is easy by skill in Anatomy perfectly to understand by the resolved part the seat of the morbifick cause for when there is a Palsie properly so called that is when the right or left side is wholly seized upon then you may know that the obstruction is in the brain or spinal marrow but if the parts of the head be untoucht either of the sides being wholly resolved the fault remains in the original of the spinal marrow if the armes be taken with this disease we may certainly think that the matter of the disease lies hid in the fifth sixth and seventh Vertebrae of the neck But if the lower members languish we must judge the Paralytick cause to be contained in the Vertebrae of the Loins and Holy bone Which thing the Chirurgeon must diligently observe that he may alwaies have recourse to the original of the disease The Palsie which proceeds from a nerve cut or exceedingly bruised is incurable because the way to the part by that means is shut against the animal spirit Old men scarce or never recover of the Palsie because their native heat is languid and they are oppressed with abundance of excrementitious humors neither doth an inveterate Palsie which hath long possest the part neither that which succeeds an Apoplexy yeeld us any better hope of cure It is good for a feaver to come upon a Palsie for it makes the dissipation of the resolving and relaxing humor It is good for a feaver to happen upon a Palsie to be hoped for When the member affected with the palsie is much wasted and the opposite on the contrary much encreased in quantity heat and colour it is ill for this is a signe of the extream weakness of the afflicted part which suffers it self to be defrauded of its nourishment all the provision flowing to the sound or opposite side CHAP. XIII Of the Cure of the Palsie The decoction of Guaiacum is good for a palsie Things actually hot good for to be applied to paralytickâ— members IN the cure of the Palsie we must not attempt any thing unless we have first used general remedies diet and purging all which care lyeth upon the learned and prudent Physitian The Decoction of Guaiacum is very fit for this purpose for it procures sweat and attenuates digests and drieth up all the humidity which relaxeth the nerves but when sweat doth not flow it shall not be unprofitable to put about the resolved members bricks heated red hot in the fire and quenched in a decoction of Wine Vinegar and resolving herbs or also stone bottles or Ox and Swine bladders half-filled with the same decoction for such heat which is actual resuscitateth and strengthneth the heat of the part which in this disease is commonly very languid Then the patient shall go into a bathing-tub which is vailed or covered over just as we have described in our Treatise of Baths that so he may receive the vapour of the following decoction â„ž fol. Salviae Lavend Lauri major Absinth Thym. Angelicae Rutae ana M. ss Florum Chamaem Melil Anethi Anthos ana P ij Baccar Laur. Juniper Conquassatar ana â„¥ j. Caryophyl â„¥ ij Aquae fontanae Vini albi ana lb iv
Let them be all put in the vessel mentioned in the Treatise lately described for use The patient shall keep himself in that Bathing-tub as long as his strength will give him leave Leo. Faventius his ointment then let him be put into his bed well covered where he shall sweat again be dried and rest Then let him be presently anointed with the following ointment which Leonellus Faventius much commends â„ž Olei Laurini de Terebinth ana â„¥ iij. Olei Nardini petrolei ana â„¥ j. Vini malvatici â„¥ iv Aqua vitae â„¥ ij Pyrethri Piperis Sinap Granor. Junip Gumni hederae anacard Laudani puri an â„¥ jss Terantur misceantur omnia cum Oleis Vino bulliant in vase duplici usque ad Vini consumptionem facta forti expressione adde Galbani Bdellii Euphorbii Myrrhae Castorei adipis Ursi Anaetis Ciconiae an â„¥ ij Make an ointment in form of a liniment adding a little wax if need shall require Or you shall use the following remedy approved by many Physitians â„ž Myrrhae Aloes Spicae nardi Sanguinis draconis thuris opoponacis An approved Ointment for the Palsie Bdellii Carpobalsami amomi sarcocollae croci mastic gummi arabici styrac liquidae ladani castorei ana â„¥ ij Moschi Ê’ i Aqua vitae â„¥ i Terebinthinae venetae ad pondus omnium pulverbauntur pulverisanda gummi eliquabuntur cum aqua vitae aceti tantillo And let them all be put in fit vessels that may be distilled in Balneo Mariae and let the Spine of the Back and paralytick limbs be anointed with the liquor which comes from thence I have often tryed the force of this following Medicine â„ž rad Angel Ireos floren gentian cyperi ana â„¥ i. Calami aromat Cinam Cariophyl nucis Mosch macis A distilled water good to wash them ouâ—wardly and to drink inwardly anaÊ’ ij Salviae major Iuae arthriticae Lavend rorism satureiae puleg. calament mentastri ana M ss florum chamaem melil hyperic anthos stoechad ana P j Concisa omnia contundantur in Aquae vit Vini malvat. an lb ij infundantur And let them be distilled in Balneo Mariae like the former let the affected parts be moistned with the distilled liquor of which also you may give the Patient a spoonful to drink in the morning with some Sugar For thus the Stomach will be heated and much phlegm contained therein as the fuel of this disease will be consumed You must also appoint exercises of the affected parts and frequent and hard frictions Exercises and frictions Chymical Oyl with hot linnen clothes that the native heat may be recalled and the excrements contained in the parts digested you may also use the Chymical Oyls of Rosemary Thyme Lavender Cloves Nutmegs and lastly of all Spices the manner of extracting whereof we shall hereafter declare in a peculiar Treatise CHAP. XIV Of Swooning SWooning is a sodain pertinacious defect of all the powers but especially the vital in this What Swooning is the Patients lie without motion and sense so that the Ancients thought that it differed from Death only in continuance of time The cause of swoon ng Three causes of Swooning which happens to those that are wounded is Bleeding which causeth a dissipation of the Spirits or Fear which causeth a sodain and joynt retirement of the spirits to the Heart Whence follows an intermission of the proper duty as also of the rest of the faculties whilest they being thus troubled are at a stand Also Swooning happens by a putrid and venenate vapour carryed to the heart by the Arteries and to the Brain by the nerves by which you may gather that all swooning happens by three causes The first is by dissipation of the spirits and native heat as in great bleeding And then by the oppression of these spirits by obstruction or compression as in fear or tumult for thus the spirits fly back hastily from the surface and habit of the body unto the heart and center Lastly by corruption as in bodies filled with humors and in poysonous wounds The signs of swooning are paleness a dewy and sodain sweat arising the failing of the pulse a sodain falling of the body upon the ground without sense and motion a coldness possessing the whole body so that the Patient may seem rather dead than alive For many of these who fall into a swoon die unless they have present help Therefore you shall help them if when they are ready to fall you sprinkle much cold water in their face if that the swooning happen by dissipation of the spirits The cure of Swooning caused by d ssipation of spirits or if they shall be set with their faces upwards upon a bed or on the ground as gently as may be and if you give them bread dipt in wine to hold and chew in their mouths But if it be caused by a putrid vapour and poysonous air you shall give them a little Mithridate or Treacle in Aqua vitae with a Spoon as I usually do to those which have the Plague or any part affected with a Gangrene or Spacel The cure of swooning caused by a venâ—na e air But if the Patients cannot be raised out of their swoons by reason of the pertinacious oppression and compression of the spirits about the heart you must give them all such things as have power to diffuse call forth and resuscitate the spirits such as are strong Wines to drink The cure of swooning caused by oppression and obstruction sweet perfumes to smell You must call them by their own name lowd in their ear and you must pluck them somewhat hard by the hairs of the Temples and Neck Also rub the Temples Nostrils Wrists and Palms of the Hands with Aqua vitae wherein Cloves Nutmegs and Ginger have been steeped CHAP. XV. Of Delirium i.e. Raving Talking idly or Doting DOting or Talking idlely here is used for a symptom which commonly happeneth in Feavers caused by a wound and inflammation and it is perturbation of the phantasie What a symptomatical Delirium is The causes thereof and function of the mind not long induring Wherefore such a doting happens upon wounds by reason of vehement pain and a feavour when as the nervous parts as the joynts stomach and midriffe shall be violated For the Ancients did therefore call the Midriffe Phrena because when this is hurt as if the mind it self were hurt a certain phrensie ensues that is a perturbation of the animal faculty Why the Brain suffers with the midâ—iffe which is imployed in ratiocination by reason of the community which the Diaphragma hath with the Brain by the nerves sent from the sixth conjugation which are carryed to the stomach Therefore doting happens by too much bleeding which causeth a dissipation of the spirits whereby it happens that the motions and thoughts of the mind err as we see it happens to those who have bled much
well in a plethorick body or in a body replete with ill humors or indued with exquisite sense Therefore in such a case it will be safer to follow the course here set down For wounds of the nerves do not only differ from other wounds but also among themselves in manner of curing For although all medicines which draw from far and waste sanious humors may be reputed good for the wounds of the nerves yet those which must be applyed to punctures and to those nerves which are not wholly laid open ought to be far more powerful sharp and drying yet so that they be not without biting that so penetrating more deep they may draw forth the matter or else consume and discuss that which either lies about the nerves or moistens their substance On the contrary Medicines fit for wounds of the nerves when the sinews are bared from flesh and adjoyning particles they stand in need but of medicines which may only dry Here you may furnish your selves with sufficient store of medicines good for the nerves howsoever pricked As â„ž Terebinth vin olei veteris an â„¥ j. aquae vitae parum Or â„ž olei Terebinth â„¥ j. aqua vitaeÊ’ j. cuphor Ê’ ss Or â„ž radices Dracontiae Brioniae Valerianae Gentianae exsiccatas in pulverem redactas misce cum decocto centaurii aut oleo aut exungia veteri drop hereof warm into the wound as much as shall suffice Or else put some Hogs Goose Capons or Bears-grease old Oyl Oyl of Lillies or the like to Gall anum pure Rozin opopanax dissolved in Aqua-vitae and strong Vinegar Or â„ž olei hypericonis samâ—uti de cuphorâ—io an â„¥ j. suâ—phuris vivi subtiliter pulverisati â„¥ ss gummi ammoni bdellii an Ê’ ij aceti boni â„¥ ij vermium terrest praeparat â„¥ j. bulliant omnia simul ad consumptionem aceti Let as much hereof as shall suffice be dropped into the wound then apply this following Cerate which draws very powerfully â„ž olei supra-scripti â„¥ j. Terebinth venet â„¥ ss diachylonis albi cum gummi Ê’ x. ammoniac â—dellii in aceto dissoluterum an Ê’ ij resin pini gum clemi picis navalis an Ê’ v. cerae quod sufficit fiat ceratum satis molle We must use some whiles one some whiles another of these medicines in punctures of the Nerves with choice and judgment according to their conditions manner depth and the temperaments and habits of the wounded bodies But if the pain yield not to such remedies but rather increase What wounds of the N rves must be burnt with the inflammation of the affected part a swelling of the lips of the wound and sweating forth of a serous thin and virulent matter or filth then you shall pour into it scalding Oyl and shall touch three or four times not only the surface of the wound but the bottom thereof with a rag dipped therein and tyed to the end of a Spatula For this will take away the sense from the Nerve Tendon or Membrane A certain Anodyne in pain of the teeth like as if they were burnt with a cautery and so the pain will be eased So in the most grievous pains of rotten teeth the thrusting of an hot iron into their roots or stopping them with Cotton dipped in Oyl of Vitriol or Aqua-vitae gives most certain ease for by burning the Nerve which is inserted into their roots the sense and so consequently the pain is taken away So also in malignant Why Escharoticks must be used to spreading ulcers gnawing eating and spreading ulcers which are alwayes associated with much pain the pain ceases by applying an Escharotick the powder of Alum or Mercury or Aegyptiacum made somewhat more strong than usual That the young Chirurgeon may be more ready for this practise and the use of the former medicines I have thought good to insert the following History both for the lateness of the thing and the pleasing memory of the most laudable Prince Charles the ninth the French King being sick of a Feaver A famous History Monsieur Chapellan and Castellan his Physitians thought it fit he should be let bloud for the performance whereof there was called a Chirurgeon wondrous famous for that business but when as he by chance had pricked a nerve in stead of a vein the King cryed out that he felt a mighty pain in that place Then I bid that the ligature should straight-wayes be loosed otherwise the arm would presently be much swelled But he going slowly about it behold the arm began to swell with such contraction that he could not bend it nor put it forth and cruel pain molested not only the pricked particle but all the whole member besides I forthwith laid upon the wound a plaister of Basilicon to hinder the agglutination thereof and then I wrapped all the arm in a double linnen cloth dipped in Oxycrate putting upon it an expulsive ligature which beginning at the wrist and ending at the top of the shoulder might keep the bloud and spirits from fear of defluxion and inflammation This being thus performed we went aside to consult what was necessary to be done both to asswage the pain as also to divert the other symptoms which usually happen upon punctures of the nerves I being desired thus delivered my opinion that in my mind there were nothing better then presently to drop into the wound some Oyl of Turpentine warmed and mixed with a little Aqua-vitae And then all the arm should be covered with a plaister of Diacalcitheos dissolved in Vinegar and Oyl of Roses bound over and besides with the expulsive ligature which we formerly mentioned For the Oyl and Aqua-vitae have a faculty to penetrate into the bottom of the wound and to exhaust and dry up the serous and virulent humor which sweats from the substance of the pricked nerve and also to mitigate the pain by its actual heat Furthermore emplaister Diacalcitheos hath a faculty to dissolve the humor which hath already fallen down into the arm and to hinder the entrance and defluxion of any new matter And the ligature is such as by its moderate astriction would serve to strengthen the muscles and to press out and repel the humors which were fallen down into the upper part and to prohibit that which is ready to fall down Mine advice being approved of the Physitians both in word and deed the pain was mitigated But the humor stayed in the part A discussing and drying cataplasm for the dissolving and drying whereof this following remedy was used â„ž far hordei crobi an Ê’ ij flor chamaem melilot an p. ij butyr recentis siue sale â„¥ i ss lixivii â—arbitonsoris quod sufficit fiat cataplasma ad formam pultis By these remedies the King at last after three months space was perfectly healed so that there remained no sign of the depraved action in the part But if at any time there shall be so great contumacy that it will
will be good in this case if so be that you add hereto so much powder which dryes without acrimony as occasion shall serve I admonished you before to take heed of cold and now again for it is hurtful to all wounds and ulcers but especially to these of the nervous parts hence it is that many dye of small wounds in the winter who might recover of the same wounds though greater in the Summer Aphor. 20. sect 5. For cold according to Hippocrates is nipping to ulcers hardens the skin and hinders them from suppuration extinguisheth natural heat causes blackness cold aguish fits convulsions and distentions What matter usually flows from wounds of the joynts Now divers excrements are cast forth of wounds of the joynts but chiefly albugineous that is resembling the white of an egg and mucous and sometimes a very thin water all which savour of the nature of that humor which nourisheth these parts For to every part there is appropriate for his nourishment and conservation a peculiar balsam which by the wound flows out of the same part as out of the branches of the vine when they are pruned their radical moisture or juyce flows whence also a Callus proceeds in broken bones Now this same mucous and albugineous humor slow and as it were frozen flowing from the wounded joynts shews the cold distemper of the parts which cause pain not to be orecome by medicins only potentially hot Wherefore to correct that Why things actually hot must be applyed to the wounded joynts we must apply things actually hot as beasts and swines bladder half full of a discussing decoction or hot bricks quenched in Wines Such actual heat helps nature to concoct and discuss the superfluous humor impact in the joynts and strengthens them both which are very necessary because the natural heat of the joynts is so infirm that it can scarse actuate the medicin unless it be helped with medicins actually hot Of the site and posture of wounded joynts Neither must the Chirurgeon have the least care of the figure and posture of the part for a vicious posture increases ill symptoms uses to bring to the very part though the wound be cured distortion numness incurable contraction which fault lest he should run into let him observe what I shall now say If the forepart of the shoulder be wounded a great boulster must be under the arm-pit and you must carry your arm in a scarf so that it may bear up the lower part of the arm that so the top of the shoulder may be elevated somewhat higher and that so it may be thereby more speedily and happily agglutinated and consolidated If the lower part be wounded when flesh begins to be generated and the lips of the wound to meet you must bid the Patient to move and stir his armes divers wayes ever and anon for if that be omitted or negligently done when it is cicatrized then it will be more stiffe and less pliable to every motion and yet there is a further danger lest the arm should totally lose its motion If the wound be upon the joynt of the elbow the arm shall be placed and swathed in a middle posture that is which neither too straitly bows it nor holds it too stiffly out for otherwise when it is cicatrized there will be an impediment either in the contraction or extention When the wound is in the wrist or joints of the fingers either externally or internally the hand must be kept half-shut continually moving a ball therein For if the fingers be held straight stretched forth after it is cicatrized they will be unapt to take up or hold any thing which is their proper faculty But if after it is healed it remain half-shut no great inconveniency will follow thereon for so he may use his hand divers wayes to his sword pike bridle and in any thing else If the joints of the Hip be wounded you must so place the Patient that the thigh-bone may be kept in the cavity of the hucklebone and may not part a hairs breadth there-from which shall be done with linnen boulsters and ligatures applyed as is fitting and lying full upon his back When the wound shall begin to cicatrize the Patient shall use to move his thigh every way lest the head of the thigh-bone stick in the cavity of the huckle-bone without motion In a wound of the knee the leg must be placed straight out if the Patient desire not to be lame When the joints of the feet and toes are wounded these parts shall neither be bended in nor out for otherwise he will not be able to go To conclude the site of the foot and leg is quite contrary to that of the arm and hand CHAP. XL. Of the Wounds of the Ligaments Ligaments more dry than Nerves and without sense THe wounds of the Ligaments besides the common manner of curing those of the Nervs have nothing peculiar but that they require more powerful medicins for their agglutination deficcation and consolidating both because the Ligamental parts are harder and dryer and also for that they are void of sense Therefore the foresaid cure of Nerves and Joints may be used for these wounds for the Medicins in both are of the same kind but here they ought to be stronger and more powerfully drying The Theory and cure of all the symptoms which shall happen thereupon have been expressed in the Chapter of curing the Wounds of the nervous parts so that here we shall need to speak nothing of them for there you may find as much as you will Wherefore here let us make an end of wounds and give thanks to God the Author and giver of all good for the happy process of our labours and let us pray that that which remains may be brought to a happy end and secure for the health and safety of good people The End of the Tenth Book The Eleventh BOOK Of Wounds made by GVNSHOT other fiery Engines and all sorts of Weapons THE PREFACE I Have thought good here to premise my opinion of the original encrease and hurt of fiâ—ry Engines for that I hope it will be an ornament and grace to this my whole Treatise as also to intise my Reader as it were with these junckets to our following Banquet so much savouring of Gunpowder For thus it shall be known to all whence Guns had their original and how many habits and shapes they have acquired from poore and obscure beginnings and lastly how hurtful to mankind the use of them is Lib. 2. de invent reâ—um Polydore Virgil writes that a German of obscure birth and condition was the Inventor of this new Engin which we term a Gun being induced thereto by this occasion He kept in a mortar covered with a tyle or slate for some other certain uses a powder which since that time for its chief and new known faculty is nâ—med Gunpowder Now it chanced as he struck fire with a steel and
incompassing air under which also is comprehended that which is taken from the season of the yeer region the state of the air and soil and the particular condition of the present and lately by-past time Hence it is we read in Guido Why wounds of the head at Paris and of the legs at Avignion are hard to be cured that Wounds of the head are cured with far more difficulty at Paris than at Avignion where notwithstanding on the contrary the Wounds of the legs are cured with more trouble than at Paris the cause is the air is cold and moist at Paris which constitution seeing it is hurtfull to the brain and head it cannot but must be offensive to the Wounds of these parts But the heat of the ambient air at Avignion attenuates and dissolves the humors and makes them flow from above downwards But if any object that experience contradicts this opinion of Guido and say that wounds of the head are more frequently deadly in hot countries let him understand that this must not be attributed to the manifest and natural heat of the air but to a certain malign and venenate humor or vapor dispersed through the air and raised out of the Seas as you may easily observe in those places of France and Italy which border upon the Mediterranean Sea An indication may also be drawn from the peculiar temper of the wounded parts for the musculous parts must be dressed after one and the bony parts after another manner The different sense of the parts indicates and requires the like variety of remedies for you shall not apply so acrid medicins to the Nerves and Tendons An indication to be drawn from the quick and dull sense of the wounded part as to the ligaments which are destitute of sense The like reason also for the dignity and function of the parts needfull for the preservation of life for oft-times wounds of the brain or of some other of the naturall and vitall parts for this very reason that they are defixed in these parts divert the whole manner of the cure which is usually and generally performed in wounds Neither that without good cause for oft-times from the condition of the parts we may certainly pronounce the whole success of the disease for wounds which penetrate into the ventricles of the brain into the heart the large vessels the chest the nervous parts of the midriffe the liver ventricles small guts bladder if somewhat large are deadly as also those which light upon a joynt in a body repleat with ill humors as we have formerly noted Neither must you neglect that indication which is drawn from the situation of the part and the commerce it hath with the adjacent parts or from the figure thereof seeing that Galen himself would not have it neglected Gal. lib. 7. Meth 2. ad Glauc But we must consider in taking these forementioned Indications whether there be a composition or complication of the diseases for as there is one and that a simple indication of one and that a simple disease so must the indication be various of a compound and complicate disease But there is observed to be a triple composition or complication of affects besides nature for either a disease is compounded with a disease as a wound or a plegmon with a fracture of a bone or a disease with a cause as an ulcer with a defluxion or a disease with a symptome as a wound with pain or bleeding It sometimes comes to pass that these three the disease cause and symptome concur in one case or affect In artificially handling of which we must follow Galens counsell Gal. lib. 7. Meth. who wishes in complicated and compounded affects that we resist the more urgent then let us withstand the cause of the disease and lastly that affect without which the rest cannot be cured Which counsell must well be observed for in this composure of affects which distracts the Emperick on the contrary the rational Physitian hath a way prescribed in a few and these excellent words which if he follow in his order of cure he can scarse miss to heal the Patient Symptomes truly as they are symptomes yeeld no indication of curing neither change the order of the cure for when the disease is healed the symptome vanishes as that which follows the disease as a shadow follows the body But symptomes do oftentimes so urge and press How and when we must take indication of curing from a symptome that perverting the whole order of the cure we are forced to resist them in the first place as those which would otherwise increase the disease Now all the formerly mentioned indications may be drawn to two heads the first is to restore the parts to its native temper the other is that the blood offend not either in quantity or quality for when those two are present there is nothing which may hinder the repletion or union of wounds nor ulcers CHAP. IX What remains for the Chirurgeon to do in this kind of Wounds THe Chirurgeon must first of all be skilfull and labour to asswage pain hinder defluxions prescribe a diet in those six things we call not-natural forbidding the use of hot and acrid things as also of Wine for such attenuate humors and make them more apt for defluxion Why such as are wounded must keep a slender diet Therefore at the first let his diet be slender that so the course of the humors may be diverted from the affected part for the stomach being empty and not well filled draws from the parts about it whereby it consequently follows that the utmost and remotest parts are at the length evacuated which is the cause that such as are wounded must keep so spare a diet for the next dayes following Venery is very pernicious for that it inflames the spirits and humors far beyond other motions whereby it happens that the humors waxing hot are too plentifully carried to the wounded and over heated part The bleeding must not be stanched presently upon receiving of the wound for by the more plentiful efflux thereof the part is freed from danger of inflammation and fulness Why we must open a vein in such as are wounded by Gunshot Wherefore if the wound bleed not sufficiently at the first you shall the next day open a vein and take blood according to the strength and plenitude of the Patient for there usually flows no great store of blood from wounds of this nature for that by the greatness of the contusion and vehemency of the moved air the spirits are forced in as also I have observed in those who have one of their limbs taken away with a Cannon bullet For in the time when the wound is received there flows no great quantity of blood although there be large veins and arteries torn in sunder thereby But on the 4 5 6. or some more dayes after the blood flows in greater abundance and with more violence the native
enter in Also you must have a care when the eyelids lips sides of the fingers neck the arm-pits hams and bending of the elbow are burnt that you suffer not the parts to touch one the other without the interposition of some thing otherwise in continuance of time they would grow and stick together Therefore you shall provide for this by fit placing the parts and putting soft linnen rags between them But you must note that deep combustions and such as cause a thicker Eschar Why deep combustions are less painful then superficiary are less painful than such as are but only superficiary The truth hereof you may perceive by the example of such as have their limbs cut off and seared and cauterized with an hot Iron for presently after the cauterising is performed they feel little pain For this great combustion takes away the sense the vehemency of the sensory or thing affecting the sense depriving the sensitive parts of their sense As we have formerly noted when we treated of wounds and pains of the Nerves The falling away of such Eschars shall be procured by somewhat a deep scarification which may pierce even to the quick that so the humors which lye under it may enjoy freer perspiration emollient medicins may the freelier enter in so to soak moisten and soften the Eschar that it may at length fall away The rest of the cure shall be performed by detergent and sarcotick medicins adding to the former Ointments metalline powders when the present necessity shall seem so to require But we cannot justly say in what proportion and quantity each of these may be mixed by reason of that variety which is in the temper and consistence of bodies and the stubbornness and gentleness of diseases After a Burn the scar which remaineth is commonly rough unequal and ill-favoured therefore we will tell you in our Treatise of the Plague how it must be smoothed and made even I must not here omit to tell you Marks or spots made in the face 〈◊〉 corns of Gunpowder can 〈◊〉 be taken away that Gunpowder set on fire doth often so penetrate into the flesh not ulcerating nor taking of the skin and so insinuate and throughly fasten it self into the flesh by its tenuity that it cannot be taken or drawn out thence by any remedies no not by Phoenigmes nor vesicatories nor scarification nor ventoses nor horns so that the prints thereof alwayes remain no otherwise than the marks which the Barbarians burn in their slaves which cannot afterwards be taken away or destroyed by any Art CHAP. X. Of a Gangrene and Mortification CErtainly the malign symptoms which happen upon wounds and the solutions of Continuity are many caused either by the ignorance or negligence of the Chirurgeon or by the Patient or such as are about him or by the malignity and violence of the disease but there can happen no greater than a Gangrene as that which may cause mortification and death of the part and oft-times of the whole body wherefore I have thought good in this place to treat of a Gangrene first giving you the definition then shewing you the causes signs prognosticks and lastly the manner of the cure Now a Gangrene is a certain disposition Gal. 2. ad Glanconem and way to the mortification of the part which it seiseth upon dying by little and little For when there is a perfect mortification it is called by the Greeks Sphacelos by the Latins Syderatio our Countreymen term it the fire of Saint Anthony or Saint Marcellus CHAP. XI Of the general and particular causes of a Gangrene The general cause of a Gangrene THe most general cause of a Gangrene is when by the dissolution of the harmony and joint-temper of the four first qualities the part is made unapt to receive the faculties the Natural Vital and Animal spirits by which it is nourished lives feels and moves For a part deprived by any chance of these The particular causes as of the light languishes and presently dyes Now the particular causes are many and these either primitive or antecedent The primitive or external are combustions caused by things either actually or potentially burning actually as by fire scalding Oyl Cold causeth a Gangrene or Water Gunpowder fired and the like But potentially by acrid medicins as Sublimate Vitriol potential Cauteries and other things of the same nature for all these cause a great inflammation in the part But the ambient air may cause great refrigerations and also a Gangrene which caused Hippocrates lib. de Acr. to call great refrigerations of the brain Sphacelisme Therefore the unadvised and unfit application of cold and narcotick things a fracture luxation and great contusion too strait bandages the biting of Beasts especially of such as are venemous a puncture of the Nerves and Tendons the wounds of the nervous parts and joynts especially in bodies which are plethorick and repleat with ill humors great wounds whereby the vessels which carry life are much cut whence an Aneurisma and lastly many other causes which perturb that harmony of the four prime qualities which we formerly mentioned and so infer a Gangrene CHAP. XII Of the Antecedent Causes of a Gangrene How defluxions cause a Gangrene NOw the Antecedent or Internal and Corporeal causes of a Gangrene are plentiful and abundant defluxions of humors hot or cold falling into any part For seeing the faculty of the part is unapt and unable to sustain and govern such plenty of humors it comes to pass that the native heat of the part is suffocated and extinct for want of transpiration For the Arteries are hereby so shut or pent up in a Strait An uncurable Gangrene that they cannot perform their motions of contraction and dilatation by which their native heat is preserved and tempered But then the Gangrene is chiefly uncurable when the influx of humors first takes hold of the Bones and inflammation hath its beginning from them Lib. de tumor praeter natur For in the opinion of Galen all these kinds of affects which may befal the flesh are also incident to the bones Neither only a Phlegmon or Inflammation but also a rottenness and corruption doth oft-times first invade and begin at the bones for thus you may see many who are troubled with the Leprosie and French disease to have their skin and flesh whole and fair to look on whose bones notwithstanding are corrupt and rotten and oft-times are much decayed in their proper substance This mischief is caused by a venemous matter whose occult quality we can scarse express by any other name than poyson inwardly generated Oft-times also there is a certain acrid and stinking filth generated in flesh with a malign and old ulcer with which if the bones chance to be moistned they become foul and at length mortified Aph. 5. sect 6. A Gangrene by efflux of a cold matter of which this saying of Hippocrates is extant Ulcers of a
this kind of affect expect that the putrid flesh may of it self fall from the sound but rather cut off with your Incision-knife or Scissers whatsoever thereof you can and then put to it Aegyptiacum as oft as need shall require The knowledg hereof may be acquired from the colour smell and sensibleness of the flesh it self The description of the Aegyptiacum whose wondrous effects I have often tryed in these causes is this â„ž floris aeris aluminis roch mellis com an â„¥ iij. aceti acerrimi â„¥ v. salis com â„¥ j. vitrioli rom â„¥ ss sublimati pul Ê’ ij bulliant omnia simul ad ignem fiat unguent If the force of the putrefaction in the part be not so great a weaker Aegyptiacum may serve When you have put in the Aegyptiacum then presently lay the following Cataplasm thereupon For it hinders putrefaction resolves clenses and dryes up the virulent sanies and by the dry subtlety of the parts penetrates into the member strengthens it and asswages the pain â„ž farin fabar hordei orobi lent lupin an lb. s sal com Astringents that may be used in cure of a Gangrene mellis rosat an â„¥ iiij succi absinth marrub an â„¥ iiss aloes mastiches myrrhae aqua vit an â„¥ ij oxymelitis simpl quantum sufficit fiat Cataplasma molle secundum artem Somewhat higher than the part affected apply this following astrigent or defensitive to hinder the flowing down of the humors into the part and the rising up of the vapours from the putrid part into the whole body â„ž olci rosati myrtill an â„¥ iiij succi plantag solani sempervivi an â„¥ ij album ovorum 5. boli armeni terrae sigillatae subtiliter pulverisatorum an â„¥ j. oxycrati quantum sufficit misce ad usum dictum But these medicins must be often renewed If the grief be so stubborn that it will not yield to the described remedies we must come to stronger to wit Cauteries after whose application Gal. 2. ad Glauconem Galen bids to put upon it the juyce of a Leek with Salt beaten and dissolved therewith for that this medicin hath a piercing and drying faculty and consequently to hinder putrefaction But if you prevail nothing with Cauteries then must you come to the last remedy and refuge that is the amputation of the part For according to Hippocrates Aphor 6. sect 11. to extream diseases exquisitely extream remedies are best to be applyed Yet first be certain of the mortification of the part for it is no little or small matter to cut off a member without a cause Therefore I have thought it fit to set down the signs whereby you may know a perfect and absolute mortification CHAP. XVII The signs of a perfect Necrosis or Mortification YOu shall certainly know that a Gangrene is turned into a Sphacel or mortification and that the part is wholly and throughly dead if it look of a black colour and be colder than stone to your touch the cause of which coldness is not occasioned by the frigidity of the air if there be a great softness of the part so that if you press it with your finger it rises not again but retains the print of the Impression if the skin come from the flesh lying under it if so great and strong a smell exhale especially in an ulcerated Sphacel that the standers by cannot indure or suffer it if a sanious moisture viscid green or blackish flow from thence if it be quite destitute of sense and motion whether it be pulled beaten crushed pricked burnt or cut off Here I must admonish the young Chirurgeon that he be not deceived concerning the loss or privation of the sense of the part For I know very many deceived as thus A note concerning the unsensibleness of the part the Patients pricked on that part would say they felt much pain there But that feeling is oft deceitful as that which proceeds rather from the strong apprehension of great pain which formerly raigned in the part than from any faculty of feeling as yet remaining A most clear and manifest argument of this false and deceitful sense appears after the amputation of the member for a long while after they will complain of the part which is cut away Verily it is a thing wondrous strange and prodigious and which will scarse be credited A wondrous symptom unless by such as have seen with their eyes and heard with their ears the Patients who have many months after the cutting away of the Leg grievously complained that they yet felt exceeding great pain of that Leg so cut off Wherefore have a special care lest this hinder your intended amputation a thing pitiful yet absolutely necessary for to preserve the life of the Patient and all the rest of his body by cutting away of that member which hath all the signs of a Sphacel and perfect mortification for otherwise the neglected fire will in a moment spread over all the body and take away all hope of remedy for thus Hippocrates wisheth That Sections Ustions Sect. 7. Lib. 6. Epidem and Terebrations must be performed as soon as need requires CHAP. XVIII Where Amputation must be made IT is not sufficient to to know that Amputation is necessary The controversie decided but also you must learn in what place of the dead part it must be done and herein the wisdom and judgment of the Chirurgeon is most apparent Art bids to take hold of the quick and to cut off the member in the sound flesh but the same Art wisheth us to preserve whole that which is sound as much as in us lies I will shew thee by a familiar example how thou maist carry thy self in these difficulties Let us suppose that the foot is mortified even to the anckle here you must attentively mark in what place you must cut it off For unless you take hold of the quick flesh in the amputation or if you leave any putrefaction you profit nothing by amputation for it will creep and spread over the rest of the body It befits Physick ordained for the preservation of mankind to defend from the iron or instrument and all manner of injury that which injoyeth life and health Wherefore you shall cut off as little of that which is sound as you possibly can yet so that you rather cut away that which is quick Lib. 7. cap. 33. than leave behind any thing that is perished according to the advice of Celsus Yet oft-times the commodity of the action of the rest of the part and as it were a certain ornament thereof changes this counsell For if you take these two things into your consideration they will induce you n this propounded case and example to cut off the Leg some five fingers breadth under the knee For so the Patient may more fitly use the rest of his Leg and with less trouble that is he may the better go on a wooden Leg for otherwise if
according to the common rules of Art you cut it off close to that which is perished the Patient will be forced with trouble to use three Legs instead of two An observable Histâ—ry For I so knew Captain Francis Clerk when as his foot was stricken off with an iron bullet shot forth of a man of war and afterwards recovered and healed up he was much troubled and wearied with the heavy and unprofitable burden of the rest or his Leg wherefore though whole and sound he caused the rest thereof to be cut off some five fingers breadth below his knee and verily he used it with much more ease and facility than before in performance of any motion We must do otherwise if any such thing happen in the Arm that is you must cut off as little of the sound part as you can For the actions of the Legs much differ from those of the Arms and chiefly in this that the body rests not neither is carried upon the Arms as it is upon the Feet and Legs CHAP. XIX How the section or amputation must be performed THe first care must be of the Patients strength wherefore let him be nourished with meats of good nutriment easie digestion and such as generate many spirits as with the yolâ—s of Egs and bread tosted and dipped in Sack or Muskadine Then let him be placed as is fit and drawing the muscles upwards towards the sound parts let them be tyed with a strait ligature a little above that place of the member which is to be cut off with a strong and broad fillet like that which women usually bind up their hair withall The Ligature of the part This ligature hath a threefold use the first is that it hold the muscles drawn up together with the skin so that retiring back presently after the performance of the work they may cover the ends of the cut bones and serve them in stead of â—o â—isters or pillows when they are healed up and so suffer with lesse pain the compression in sustaiâ—ing the rest of the body besides also by this means the wounds are the sooner healed and cicatrized for by how much more flesh or skin is left upon the ends of the bones by so much they are the sooner healed and cicatrized The second is for that it prohibits the flux of bloud by pressing and shutting up the veins and arteries The third is for that it dulls the sense of the part by stupefying it the animal spirits by the strait compressing being hindred from passing in by the Nerves Wherefore when you have made your ligature cut the flesh even to the bone with a sharp and well-cutting incision-knife or with a crooked Knife such as is here expressed A crocked knife fit for dismembring or a dismembring knife The Figure of such a Saw A caution to be observed Now you must note that there usually lies beâ—ween the bones a portion of certain muscles which you cannot easily cut with a large incision or dismembring-knife wherefore you must carefully divide it and separate it wholly from the bone with an instrument made neatly like a crooked Incision-knife I thought good to advertise thee hereof for if thou shouldest leave any thing besides the bone to be divided by the Saw you would put the Patient to excessive pain in the performance thereof for soft things as flesh tendons and membranes cannot be easily cut with a Saw Therefore when you shall come to the bared bone all the other parts being wholly cut asunder and divided you shall nimbly divide it with a little Saw about some foot and three inches long and that as near to the sound flesh as you can And then you must smooth the front of the Bone which the Saw hath made rough CHAP. XX. How to stanch the bleeding when the member is taken off WHen you have cut off and taken away the member let it bleed a little according to the strength of the Patient that so the rest of the part may afterwards be lesse obnoxious to inflammation and other symptoms Then let the veins and arteries be bound up as speedily and straitly as you can that so the course of the flowing blood may be stopped and wholly stayed Which may be done by taking hold of the vessels with your Crows-beak whereof the figure follows The Crows-beak fit for to draw the vessels forth of the flesh wherein they lye hid that so they may be tyed or bound fast The ends of the vessels lying hid in the flesh How to draw forth the vessels and bind them must be taken hold of and drawn with this instrument forth of the muscles whereinto they presently after the amputation withdrew themselves as all parts are still used to withdraw themselves towards their originals In performance of this work you need take no great care if you together with the vessels comprehend some portion of the neighbouring parts as of the flesh for hereof will ensue no harm but the vessells will so be consolidated with more ease than if they being bloodlesse parts should grow together by themselves To conclude when you have so drawn them forth bind them with a strong double thred CHAP. XXI How after the blood is stanched you must dresse the wounded member WHen you have tyed the Vessels How the lips of the dismembred part are to be joined together loose your Ligature which you made above the place of amputation then draw together the lips of the wound with four stitches made across having taken good hold of the flesh for thus you shall draw over the bones that part of the skin and cut muscles drawn upwards before the amputation and cover them as close as you can that so the air may the lesse come at them and that so the wound may be the more speedily agglutinated But when we say draw together the lips of the wound with four stitches you must not so understand it as that you must endeavour to draw them so close as to touch each other for that is impossible for the stitches would sooner break out and so the part would lye bare Wherefore it will be sufficient to draw them indifferent close together that so you may suffer the skin and flesh thereunder to enjoy its former liberty which it possest before the drawing up and so in fine by nature's assistance the wound may be the more easily agglutinated CHAP. XXII How you must stop the bleeding if any of the bound-up vessels chance to get loose THe business hitherto being performed as we said if peradventure it happen that any bandage of any of the vessels be unloosed then must you again bind the member with that kind of Ligature which you did before the amputation thereof Or else which is better more easie and less painful let your servant take hold of the member with both his hands pressing his fingers strait stop the passage of the loosed vessell for so he may stanch the bleeding Then
broken or severed from their periosteum shall be smoothed and set in order with your fingers as is fitting Other things shall be done according as art and necessity shall perswade and require CHAP. XVII Of a Fracture of the Shoulder or Arm-bone THe Arm-bone is round hollow full of marrow rising up with an indifferent neck The description of the arm or shoulder-bone and ending on the upper part into somewhat a thick head On the lower part it hath two processes the one before the other behinde between which there is as it were an half-circle or the cavity of a pulley each end whereof leads into its cavity of which one is interior another exterior that by these as it were hollow stops the bending and extension of the arm might be limited lest that the bone of the cubit if the circle should have been perfect sliding equally this way and that way might by its turning have gone quite round as a rope runs in a pulley which thing would much have confused the motion of the cubit For so the extension or bending it back would have been equal to the necessary bending it inwards It is very expedient that a Surgeon know these things that so he may the better know how to restore the fractures and luxations of this part The cure If one of the fragments of this broken bone shall lye much over the other and the Patient have a good strong body then the arm shall be much extended the Patient being so set upon a low seat that he may not rise when the fracture shall be a setting and so hinder the begun work and also that so the Surgeon may the more easily perform his operation upon the Patient seated under him yet Hippocrates regarding another thing would have the Patient to sit higher But you must have a care that the shoulder-bone it self be drawn directly downwards and the cubit so bended as when you put it into a scarf For if any one set this bone lifting the arm upwards or otherwise extending it then must it be kept in that posture for otherwise if the figure be changed the setting will quickly be spoiled when as you come to put the arm in a scarf Wherefore the Surgeon must diligently and carefully observe How the arm must be placed when the bone is set Sect. 3. offic sect 1. de fract that in setting a broken arm he put it in such a posture that resting on the breast it look down towards the girdle You must have a care in laying the splints and rowling your ligatures that they hurt not nor press too hard upon the joints For in the opinion of Hippocrates by the pressure of parts which are nervous fleshless and consequently endued with exquisite sense by the splints there is danger of most grievous pain inflammation denudation both of the bone and nerve but chiefly if such compression hurt the inner part towards which the arm is bended wherefore the splints made for this place must be the shorter Therefore after the arm-bone is set the arm shall be laid upon the breast in a right angle and there bound up in a scarf lest that the Patient when he hath need to stir spoil and undo the setting and figure of the broken bone In what time it will knit But the arm must be kept in quiet untill such time as the fragments shall be confirmed with a Callus which usually is in forty dayes sooner or later according to the different constitutions of bodies CHAP. XVII Of the Fracture of the Cubit or the Ell and Wand The differences IT sometimes happeneth that the cubit and wand are broken together and at once and otherwhiles that but the one of them is fractured Now they are broken either in their midst or ends their ends I say which are either towards the elbow or else towards the wrist That fracture is worst of all wherein both the bones are broken for then the member is made wholly impotent to perform any sort of action and the cure is also more difficult for the member cannot so easily be contained in its state for that bone which remains whole serves for a stay to the arm and hinders the muscles from being drawn back which usually draw back and shrink up themselves whensoever both bones are broken Hence it is that that fracture is judged the worst The cure wherein the cubit or ell-bone is broken But that is easiest of all wherein only the wand is broken for so the fractured part is sustained by the ell-bone when both the bones are broken there must be made a stronger extension for that the muscles are the more contracted Therefore whensoever either of them remains whole it doth more service in sustaining the other then any either ligatures or splints for that it keeps the muscles right in their places Wherefore after the bones shall be set and rowled up with ligatures and splints the arm must be so carryed up in a scarf put about the neck that the hand may not be much higher than the elbow lest the blood and other humours may fall down thereinto But the hand shall be set in that posture which is between prone and supine for so the wand shall lye directly under the ell Sent. 3. sect 1. de fract as we have read it observed by Hippocrates The reason is for that by a supine figure or situation both the bone and muscles are perverted for first for the bone the Apophysis styloides and Olecranum of the cubit ought to be in an equal plain and to be seated each against other which is not so in a supine figure as wherein the Processus styloides of the cubit is set against the inner process of the arm-bone But in muscles for that like as the insertion and site of the head of a muscle is such also is the site of the belly thereof and lastly such the insertion of the tail thereof but by a supine figure the muscles arising from the inner process of the arm-bone and bending the cubit shall have the tail placed in an higher and more exteriour site In the interim you must not omit but that the Patients arm The figure of a fractured Arm with a wound bound up and seated as is fit may with as little pain as possible you can be bended and extended now and then lest by the too long rest of the tyed up part and the intermission of its proper function the bones of the joint may be sowdred together by the interposition and as it were glue of the defluxion which falls abundantly into the joint of the elbow and neighbouring parts whence the stifness unmoveableness thereof as if there were a Callus grown there from whence it may happen that the arm thereafter may neither be bended nor extended which I have observed to have happened to many Com. in lib. de art Whereof also Galen makes mention and calls this kind of vitiated conformation Ancyle
for as much as pertains to the generating of a Callus as light meats are For that makes the Callus too dry these too tender Lib. 6. meth c. 5. Wherefore Galen pronounces these meats onely fit for generating a Callus which are neither fragil nor friable neither serous and thin nor too dry but indifferent gross and also viscid fat and tough These meats digested by the stomach into chylus are sent into the guts and from hence by the mesaraick veins into the gate-vein and the hollow part of the Liver thence into the hollow vein and so into the veins dispersed over all the body and parts thereof There are also some of these veins which carry bloud into the bones but in the large cavities of the bones is marrow contained as in the small a certain marrowy substance proportionable thereto being their proper nourishment The generation of marrow is from the grosser portion of the bloud which flows into the greater cavities of the bones by larger veins and arteries but into the less by lesser which end in their pores and small passages For in large bones you may observe large and apparent passages by which the veins and arteries enter for the forementioned use Why the marrow may seem to have sense of feeling By the same ways the nerves also insinuate themselves from whence proceeds a membrane which involves the marrow of the bones the which by that means is endued with most exquisite sense as experience teacheth which is the cause that makes many believe that the marrow hath sense of feeling because the membranes thereof being hurt cause most bitter pain Therefore out of the marrow and the proper substance of the bone there sweats a certain gross and terrestrial juice whereof by the power of the assimilating faculty which serves in stead of the formative a Callus grows and knits In what space the leg is usually knit Simple fractures of the leg are usually knit in fifty days but through the occasion of the wound and the scales quite broke off and other accidents which befel me it was three whole months before the fragments of the bones were perfectly knit and it was also another month before I could go upon my leg without the help of a crutch Going was painful to me for some few days because the Callus had taken up some place of the muscles for before my former freedom of motion could return again to the broken and knit part it was necessary that the tendons and membranes should separate themselves by little and little from the scar In the performance of all these things I had the diligent and faithful assistance amongst the Surgeons to omit Physitians of Anthony Portal the Kings Surgeon CHAP. XXIX Of those things which may hinder the generation of a Callus and how to correct the faults thereof if it be ill formed HAving already spoken of the signs of a Callus beginning to concrete of its generation and the manner thereof it now remains that we treat of those things which hinder the generation thereof and what on the contrary help forwards the conformation and concretion thereof Now these things which either wholly hinder Discussing and unctuous medicines hinder the generation of a Callus What helps forward the generation thereof or else retard the generation of a Callus have a strong and powerful discussive and attenuating faculty or else they are unctuous oily and moist For by such the juice whereof the Callus ought to be is either melted and consumed or else grows soft and is relaxed But on the contrary those things which help forwards a Callus must be drying incrassating thickening hardning and emplastick moderately hot and astringent But for moist and relaxing medicines they ought to have no place here unless when it happens that the Callus is ill formed that is too thick or crooked or otherwise ill shapen whereby it may be wasted and broken so to be restored again after a better manner Yet notwithstanding such things are not to be attempted unless when the Callus is yet green and so depraved that the fault thereof doth very much pervert the native conformation of the part and exceedingly offend the action Then therefore in such a case the place must be fomented with a decoction of a Sheeps head and guts wherein shall be boiled the roots of Marsh-mallows of Briony the seeds of Line of Faenugreek Pigeons dung Bay-berries and the like You shall also use this following ointment and plaster ℞ Vnguenti de Althaeâ ℥ iv olei liliorum axungiae anseris an ℥ j. aquae vitae parum liquefiant fimul fiat linimentum quo lineatur pars Then apply this following emplaster ℞ Emplast de Vigo cum Mercurio cerati oesypati descriptione Phylagrii an ℥ iij. olei anethini liliorum an ℥ j. liquefiant omnia simul fiat emplastrum let it be spread upon leather for the aforesaid use When by this means the Callus shall seem to be sufficiently mollified it shall be broken and the bones restored to their natural state and the cure of the fracture to be followed as at the beginning What Callus must not be broken though distort or otherwise ill conformed If the Callus be become too hard through age it is better not to break it but to let it alone lest some worse accident befal the Patient For it may so fall out that by your labouring to break it the bone may break in some other part before it break in that which is knit by the Callus Therefore the discreet Patient had rather live lame than for eschewing it to undergo the hazzard of his life If the Callus be too gross it shall be diminished if it be as yet fresh with emollient resolving and powerfully astringent medicines which have force to dissolve dry and exhaust It will also be good strongly to rub the Callus with oyl of Bays wherein Salt-petre or some other kind of Salt hath been dissolved then wrapped about with a rowler to binde it very straitly putting a leaden plate thereon whereby the flowing down of the nourishing humour into the part may be forbidden that thus by little and little the Callus may decay and diminish If on the contrary The causes of too slender a Callus it any ways happen that the Callus be more thin and slender and grows more slowly for that it is too straitly bound or because the idle part is longer kept in quiet than is fit without exercising of its proper function which cause is to be reckoned amongst the chief causes of the leanness even for this reason for that exercise stirs up the native heat of the part the worker of digestion and nutrition or else for that they feed upon such nourishments as offend in quality or quantity or both or for that the ligature used to the part is too often loosed or because the part it self is too hastily and before the time
de art But if the luxated rib fall inwards it can no more be restored or drawn forth by the hand of the Surgeon than a vertebra which is dislocated towards the inside for the reasons formerly delivered CHAP. XXI Of a dislocated shoulder THe shoulder is easily dislocated because the ligaments of its dearticulation are soft and loose as also for that the cavity of the shoulder blade is not very deep and besides it is every where smooth and polite no otherwise than that of the shoulder bone for that it is herein received Add hereunto that there is no internal ligament from bone to bone Why there is no internal ligament from the arm bone to the shoulder blade Differences of a luxated shoulder which may strengthen that dearticulation as is in the leg and knee Wherein notwithstanding we must not think nature defective but rather admire Gods providence in this thing for that this articulation serves not only for extension and bending as that of the elbow but besides for a round or circular motion as that which carries the arm round about now up then down according to each difference of site The shoulder bone which Hippocrates cals the arm bone may be dislocated four manner of ways upwards downwards or into the arm-pit forwards and outwards but never backwards or to the hinder part For seeing that there the cavity of the blade bone which receives the head of the arm bone which Hippocrates calls a joint Sent. 1. sect 1. lib. de art lies and stands against it who is it that can but imagine any such dislocation In like sort it is never dislocated inwardly for on this part it hath the flesh of a strong muscle termed Deltoides lying over it besides also the back and acromion of the blade and lastly the anchor-like or beak-like process all which four hinder this joint from slipping inwards Now Hiprocrates saith that he hath only seen one kind of dislocation of this bone to wit that which is downwards or to the arm-pit and certainly it is the most usual and frequent wherefore we intend to handle it in the first place When the shoulder is dislocated downwards into the arm-pit Signs of the shoulder dislocated downwards a depressed cavity may be perceived in the upper part of the joint the acromion of the blade shews more sharp and standing forth than ordinary for that the head of the shoulder bone is slipt down and hid under the arm-pit causing a swelling forth in that place the elbow also casts it self as it were outwards and stands further off from the ribs and though you force it yet can you not make it to touch them the Patient cannot lift up his hand to his ear on that side neither to his mouth nor shoulder Which sign is not peculiar to the luxated shoulder but common to it affected with a contusion fracture inflamation wound abscess schirrus or any defluxion upon the nerves arising out of the vertebrae of the neck and sent into the arm also this arm is longer than the other Lastly which also is common to each difference of a luxated shoulder the Patient can move his arm by no kind of motion without sense of pain by reason of the extended and pressed muscles some also of their fibres being broken The ways to restore it There are six ways to restore the shoulder luxated downwards into the arm-pit The first is when it is performed with ones fist or a towel the second with a clew of yarn which put under the arm-pit shall be thrust up with ones heel the third with ones shoulder put under the arm-hole which manner together with the first is most fit for new and easily to be restored luxations as in those who have loose flesh and effeminate persons as children eunuchs and women the fourth with a ball put under the arm-pit and then the arm cast over a piece of wood held upon two mens shoulders or two standing posts the fifth with a ladder the sixth with an instrument called an Ambi. We will describe these six ways and present them to your view CHAP. XXII Of the first manner of setting a Shoulder which is with ones Fist FIrst let one of sufficient strength placed on the opposite side firmly hold the Patient upon the joint of the shoulder lest he move up and down with his whole body at the necessary extension working and putting it in then let another taking hold of his arm above the elbow so draw and extend it downwards that the head thereof may be set just against its cavity Gal. com ad sent 23. sect 1. de art hollowed in the blade-bone Then at last let the Surgeon lift and force up with his fist the head of the An expression of the first manner of putting a Shoulder into joint bone into its cavity Here this is chiefly to be observed that in fresh luxations especially in a body soft effeminate moist and not over corpulent that it sometimes comes to pass that by the only means of just extension the head of the bone freed from the muscles and other particles wherewith it was as it were entangled will betake it self into its proper cavity the muscles being by this means restored to their place and figure and drawing the bone with them as they draw themselves towards their heads as it were with a sudden gird or twitch wherefore in many A perfect setting the luxated shoulder by extension only whilest we thought no such thing it sufficed for restitution only to have extended the arm But if the luxation be inveterate and the hand cannot serve then must the Patients shoulder be fastned to a post with the forementioned ligature or else committed to ones charge who may stand at his back and hold him fast Then the arm shall presently be tyed about a little above the elbow with a fillet whereto a cord shall be fastened which being put or fastned to the pulley shall be drawn or stretched forth as much as need shall require Lastly the Surgeon with a towel or such like ligature fastned about his neck and hanging down and so put under the Patients arm-pit near to the luxation shall raising himself upon his feet with the whole strength of his neck lift up the shoulder and also at the same time bringing his arm to the Patients breast shall set the head of the shoulder-bone forced with both his hands into its cavity as you may see by the precedent figure Then must you cover all the adjacent parts with a medicine made ex farinâ volatili bolo armenio myrtillis pice resinâ alumine beaten into powder and mixed with the white of an egg Then must the hollowness under the arm be filled with a clew of woollen or cotten yarn or a linnen cloth spread over with a little oil of Roses or Myrtles a little vinegar and unguentum rosatum or refrigerans Galeni lest it stick to the hairs if there be any
or else eaten away and consumed by acrid and catheretick medicins in performance of which there is need of great moderation of the minde and hand For it is a part endued with most exquisite sence and near the brain wherefore by handling it too roughly there is fear of distension of the nerves and consequently of death Sometimes also the preternatural falling of some strange bodies into this passage maketh a stopping of the ears such as are fragments of stone gold silver iron and the like metals pearls cherry-stones or kernels pease and other such like pulse Now solid and bony bodies still retain the same magnitude but pease seeds and kernels by drawing the moisture there implanted into them swell up and cause vehement pain by the distension of the neighbouring parts wherefore the sooner they are drawn forth the better it is for the patient This shall be done with small pincers and instruments made in the shape of ear-picks But if you profit nothing thus then must you use such gimblets as are made for the drawing forth of bullets shot deep into the bodie Little stones and bodies of the like stonie hardness shall be forced forth by the brain provoked to concussion by sneesing The concussive force of sneesing and by dtopping some oil of almonds first into the passage of the ear that the way may be the more slippery for it will come to pass by this sneesing or violence of the internal air forcibly seeking passage out that at length they may be cast forth the mouth and nostrils being stopped with the hand But if we cannot thus prevail it remains that we cut open the passage with an incision-knife so much as shall be sufficient for the putting in and using of an instrument for to extract them If any creeping things of little creatures as fleas ticks pismires gnats and the like which sometimes happeneth shall get therein you may kill them by dropping in a little oil and vinegar There is a certain little creeping thing which for piercing and getting into the ears the French call Perse-oreille we an ear-wig This if it chance to get into the ear may be killed by the foresaid means you may also catch it or draw it forth by laying half an apple to your ear as a bait for it CHAP. XXIV Of getting of little bones and such like things out of the jaws and throat SOmetimes little bones and such like things in eating greedily use to stick The cure different according to the places where they stick or as it were fasten themselves in the jaws oâ— throat Such bodies if you can come to the sight of them shall be taken out with long slender and crooked mallets made like a Cranes-beak If they do not appear nor there be no means to take them forth they shall be cast forth by causing vomit or with swallowing a crust of bread or a drie fig gently chawed and so swallowed or else they shall be thrust down into the stomack or plucked back with a leek or some other such long and stiff crooked bodie anointed with oil and thrust down the throat If any such like thing shall get into the weazon you must cause coughing by taking sharp things or else sneesing so to cast forth whatsoever is there troublesome CHAP. XXV Of the Tooth-ache OF all pains The Tooth-ach a most cruel pain there is none which more cruelly tormenteth the patients then the Tooth-ache For we see them oft-times after the manner of other bones to suffer inflammation which will quickly suppurate and they become rotten and at length fall away piece-meal for we see them by daily experience to be eaten and hollowed and to breed worms some portion of them putrefying The cause of such pain is either internal or external and primitive The internal is a hot or cold defluxion of humors upon them filling their sockets The cause thereof and thence consequently driving out the teeth which is the reason thar they stand sometimes so far forth that the patient neither dares nor can make use of them to chaw for fear of pain for that they are loose in their sockets by the relaxation of the gums caused by the falling down of the defluxion When as they are rotten and perforated even to the roots if any portion of the liquor in drinking fall into them they are pained as if you thrust in a pin or bodkin the bitterness of the pain is such The signs of a hot defluxion are sharp and pricking pain The signs of this or that defluxion as if needles were thrust into them a great pulsation in the root of the pained tooth and the temples and some ease by the use of cold things Now the signs of a cold defluxion are a great heavinesse of the head much and frequent spitting some mitigation by the use of hot remedies In the bitternesse of pain we must not presently run to Tooth-drawers or cause them presently to go in hand to pluck them out First consult a Physician who may prescribe remedies according to the variety of the causes Now here are three intensions of curing The first is concerning diet the other for the evacuation of the defluxion or antecedent cause Three scopes of curing the third for the application of proper remedies for the asswaging of pain The two former scopes to wit of diet and diâ—eâ—ting the defluxion by purging phlebotomie application of cupping-glasses to the neck and shoulders and scarification do absolutely belong to the Physician Now for proper and to pick medicines they shall be chosen contrary to the cause Wherefore in a hot cause it is good washing the mouth with the juice of pomgranats plantain-water A cold and repercussive lotion for the mouth a little vinegar wherein roses balaustiae and sumach have been boiled But such things as shall be applyed for the mitigating of the pain of the teeth ought to be things of very subtle parts for that the teeth are parts of dense consistence Therefore the ancients have alwaies mixed vinegar in such kind of remedies â„ž rosar rub sumach hordei an m. ss seminis hyoscyami canquassatiÊ’ii santalorum an Ê’i lactucae summitatum rubi solani plantaginis an m. ss bulliant omnia in aquae lb. iiii pauco aceto ad hordei crepaturam Wash the mouth with such a decoction being warm You may also make Trochises for the same purpose after this manner â„ž sem hyosciami Trochises for a hot defluxion sandarachae coriandri opii an Ê’ ss terantur cum aceto incorporentur formenturque trochisci apponendi dentibus dolentibus Or else â„ž seminis portulacae hyoscyami coriandri lentium corticis santali citrini rosar rub pyrethri camphorae an Ê’ ss let them all be beaten together with strong vinegar and made into trochises with which being dissolved in rose-water let the gums and whole mouth be washed when need requireth But if the pain be not asswaged with these you
being fastned so stiffly to the roots thereof that it cannot be turned up nor drawn down or over the Glans The first manner of constriction is termed Phimosis the later Paraphimosis The causes The Phimosis happens either by the fault of the first conformation or else by a scar through which occasion the Prepuce hath grown lesser as by the growing of warts Now Paraphimosis is often occasioned by the inflammation of the yard by impure copulation for hence ulcers breed between the Prepuce and Glans with swelling and so great inflammation that the prepuce cannot be turned back The cure Whence it is that they cannot be handled and cured as you would and a gangrene of the part may follow which may by the contagion bring death to all the body unless it be hindred and prevented by amputation but if a scar be the cause of the constriction of the prepuce the patient being placed in a convenient site let the prepuce be drawn forth and extended and as much as may be stretched and enlarged then let the scar be gently cut in three or four places on the inner side with a crooked knife but so that the gashes come not to the outside and let them be an equal distance each from other But if a fleshly excrescence or a wart shall be the occasion of this straitness and constriction it shall be consumed by the same remedies by which the warts of the womb and yard are consumed or taken off But when as the prepuce doth closely adhere to the Glans on every side the cure is not to be hoped for much less to be attempted CHAP. XXXIII Of those whose Glans is not rightly perforated and of the too short or strait ligament bridle or cord of the Yard SOme at their birth by evil conformation The cause have not their Glans perforated in the middle but have only a small hole underneath toward the bridle and ligament of the yard called the cord Which is the cause that they do not make water in a strait line unless they turn up their yard toward their belly neither by the same reason can they beget children because through this fault of conformation the seed is hindred from being cast directly into the womb The cure is wholly chirurgical and is thus performed The prepuce is taken hold of and extended with the left hand but with the right hand The cure the extremity thereof with the end of the Glans is cut even to that hole which is underneath But such as have the bridle or ligament of the yard too short so that the yard cannot stand straight but crooked and as it were turned downwards in these also the generation of children is hindred because the seed cannot be cast directly and plentifully into the womb Therefore this ligament must be cut with much dexterity and the wound cured after the manner of other wounds having regard to the part Children also are sometimes born into the world with their fundaments unperforated Such as are born without a hole in their fundament are not long-lived for a skin preternaturally covering the part hinders the passage forth of the excrement those must have a passage made by art with an instrument for so at length the excrements will come forth yet I have found by experience that such children are not naturally long-lived neither to live many dayes after such section CHAP. XXXIV Of the causes of the Stone THe Stones which are in the bladder have for the most part had their first original in the reins or kidnies to wit Why children are subject to the stone in the bladder falling down from thence by the ureters into the bladder The cause of these is twofold that is material and efficient Gross tough and viscid humors which crudities produce by the distempers of the bowels and immoderate exercises chiefly and immediately after meat yield matter for the stone whence it is that children are more subject to this disease than those of other ages The cause But the efficient cause is either the immoderate heat of the kidnies by means whereof the subtiler part of the humors is resolved but the grosser and more earthly subsides and is hardned as we see bricks hardned by the sun and fire or the more remiss heat of the bladder sufficient to bake into a stone the faeces or dregs of the urine gathered in great plenty in the capacity of the bladder The straightness of the ureters and urinary passage may be accounted as an assistant cause For by this means the thinner portion of the urine floweth forth but that which is more feculent and muddy being stayed behinde groweth as by scale upon scale by addition and collection of new matter into a stony mass And as a wick oftentimes dipped by the Chandler into melted tallow by the copious adhesion of the tallowy substance presently becomes a large Candle so the more gross and viscid faeces of the urine â—â—ay as it were at the bars of the gathered gravel and by their continual appulse are at length wrought and fashioned into a true stone CHAP. XXXV Of the signs of the Stone in the Kidnies and Bladder Why the thigh is numm in the stone of the reins THe signs of the Stone in the Reins are the subsiding of red or yellow sand in the urine a certain obscure itching at the kidnies and the sense of a weight or heaviness at the loins a sharp and pricking pain in moving or bending the body a numness of the thigh of the same side Signs of the stone in the bladder by reason of the compression caused by the stone of the nerves descending out of the vertebrae of the loins of the thigh But when the stone is in the bladder the fundament and whole perinaeum is pressed as it were with a heavy weight especially if the stone be of any bigness a troublesom and pricking pain runs to the very end of the yard and there is a continual itching of that part with a desire to scratch it hence also by the pain and heat there is a tension of the yard and a frequent and needless desire to make water and sometimes their urine cometh from them drop by drop A most grievous pain torments the patient in making water which he is forced to shew by stamping with his feet Why such as have a stone in the bladder are troubled with the falling of the fundament bending of his whole body and the grating of his teeth He is oft-times so tormented with excess of pain that the Sphincter being relaxed the right gut falleth down accompanied with the swelling heat and pain of the Hemorhoid veins of that place The cause of such torment is the frequent striving of the bladder to expell the stone wholly contrary to the nature thereof whereto by sympathy the expulsive faculty of the guts and all the parts of the belly come as it were for
flatulencies are chiefly generated Signs of flatulencies but much flatulency mixed therewith especially in great joints as in the huckle or hip-bone and the knees they sometimes cause so great distention that they drive the heads of the bones forth of their places You may partly understand it is so if a tensive pain afflict the patient with any sense of heaviness if when you press the tumor with your fingers the place retain no mark or impression thereof as happens in an oedema but on the contrary a flatulent spirit lifts it up as it were by renitency as if one should thrust a pair of bellows which are filled with winde hence the part cannot perform its duty for that the spaces of the joints are possessed with abundance of flatulencies so that the liberty of motion is intercepted and the member is kept as it were bound up Many no very skilful Surgeons putting their fingers to these kinde of tumors How flatulencies may make you believe there is puâ— or matter so that lifting up the one they press down the other when as they perceive the flatulency as iâ— were rising between their fingers supposing it to be the motion of pus or matter already generated and flowing up and down as is usual in impostumes they have opened it by incision but when as nothing flowed forth it appeared how much they were deceived yet in the interim by this their rashness they have caused many dangerous symptoms as increase of pain defluxion of humors by force whereof the bones have been dislocated and brought to the patient an incureable lameness But these flatulent Gouts are seldome without some phlegmatick matter which is neither too crude nor viscid Such like flatulencies are not easily discussed nor at the first endeavor Why hard to cure by reason of a cold distemper which they bring to the part and the densitie of the membranes and ligaments by which the articulation is knit and fastened so that scarce any part of that which is there shut up can breath forth of such straight passages Therefore the cure must be undertaken with resolving discussing and drying fomentations as for example with a decoct on of fennel anis-seeds rue camomil melilote sage rosemary origanum calamints hore-hound and the like boiled in wine with a little lee rose-vineger and common salt This following ointment shall be used after the fomentation â„ž olei chamaem aneth rut lauri an â„¥ ii cum cerâ albâ fiat linimentum 〈◊〉 aq vitae parum After you have anointed it apply thereto this following Cataplasm â„ž fâ—at cham melil aneth ros rub pulv an m.i. fol. malv. absinth an m. ss furfur m. i. bulliant omnia simul cum lixivio vino rubâ—o deinde pistentur cum medulla panis farina fabarum quantum sufficit fiat cataplasma addendo ol â—osar myrtil an â„¥ ii Some highly approve of this following medicine for the wasting of flatulencies â„ž axung fuil â„¥ iv calcis vivae â„¥ i ss terantur diligentur in morâ—â—ris incerporata applicentur Or else â„ž stercor caprar cocti cum vino aceto an lb ss tereb veâ—â— mei com an â„¥ ii aq vitae â„¥ ss pul rad Ireos florent sabin an â„¥ iii. olei rut aneth an â„¥ i. farin fâ—barum quantum sufficit Make a cataplasm to the form of a pultis Also stoups dipped in oxycrate and wrung out shall be applyed in this oxycrate shall be boiled wormwood origanum chamomil melilote rue common salt adding thereto some aqua vitae Then the part shall be bound up as straight as the patient can endure it in conclusion that the native strength may by little and little be restored to the part it shall be fomented with lee made of the ashes of oakwood and the cuttings of vines wherein shall be boiled salt sulphur choice alum and wetting linnen-clothes or stoups therein and applying them it shall be straightly swathed up Yet if great pain shall mote cruelly vex the part then neglecting for a time the proper cure of the disease you shall withstand the symptom by rubbing the part and anointing it with some discussing oil laying thereon some moist wool and other anodine things CHAP. XXII Of the Ischias Hipâ—gout or Sciatica FOr that the hip-gout in the greatness of other causes bitterness of pain Why it hath the most grievous symptomâ— and vehemency of other symtoms easily exceeds the other kinds of Gout therefore I have thought good to treat thereof in perticular The pain of the Sciatica is therefore the most bitter and the symtoms most violent for that the dearticulation of the huckle-bone with the head of the thigh-bone is more deep then the rest because also the phlegmatick humor which causeth it is commonly more plenteous cold gross and viscid that flow's down into this joint and â—â—ly because the Sciatica commonly succeed's some other chronical disease by reason of the translation and falling down thither of the matter The cause of the large spreading of the pain become malign and corrupt by the long continuance of the former disease But the pain not only troubles the hip but entring deep is eâ—tended to the muscles of the buttocks the groins knees and very ends of the toes yea often times it vexeth the patient with a sense of pain in the very vertebra of the loins so that it makes the patients and also oftimes the very Physicians and Surgeons to think it the winde or stone-colick The cause of such wandring and dispersed pain is to be referred to the manifold distribution of the nerves which come to that joint from the loins and holie-bone for they are sent into the muscles of the buttocks and so dispersed over the whole leg to the very ends of the toes as it is â—â—ewed in our Anotomy Therefore the pain is largely extended that is to what part soever a nerve runs which comes from the affected hip Often times there is no swelling no redness nor distemper manifest to the eie by reason that the veins are very few which rise into the surface and skin oâ— this part and the humor lies as it were sunk in which is the cause that â—ivers times the excrementitious humors mixed with flatulency run so violently into the cavity of this joint that relaxing the ligaments as well proper as common the head of the thigh-bone is easily driven out from hence The thighbone often dislocated by the Sciatica so that it may never be restored again if it remain so for any space oâ— time for that in this time the humor falling down into this cavity by delay concretes as it were into a stony bâ—dy and the head of the thigh-bone wears it self another cavity in the neighboring bone but the lips of the true cavity which are gristlie become more straight and deprest and lastly all the ligamentous bodies moistened with this excrementitious humor become more loose and weak whence succeed many
it inflames it Lastly the bones are subject to the same diseases as the flesh that lieth under them is besides also according to Galen the beginning of inflammation oftimes proceeds fâ—om the bones but they heat not because Hip lib de ulc fract Gal. lib de tum cont nat according to the opinion of the ancients pulsation is a dolorifick motion of the Arteries but the bones want sense Which verily I cannot deny but also we must confess that the membrane that encompasseth them and the arteries that enter into their bodie are endued with most exquisite sense Wherefore the arteries compressed and waxing hot by reason of the inflamed bone cause a sense of pain in the periostium so that the patients complain of a dull and deep pain as it were sunk into the substance of the bones The rottenness or corruption is oftimes manifest to the eie Signs of the rottenness as when the bone is laid bare for then it varieth from the natural colour and becomes livid yellowish or black Otherwise you may perceive it by touch as by searching it with a probe as when you meet with any inequality or toughness or when but gently touching it your probe runs into the substance of the bone as into rotten wood for a bone is naturally hard but being rotten becomes soft Hardness is no infallible sign of sound bones Yet hardness is not an infallible sign of a sound bone For I have seen rotten and bared bones to have sometimes grown so hard by the appulse of the air that a Trepan could not without a strong endeavor enter them Also the rotteness of the bone is known by the condition of the filth which flows forth of the ulcer for it is not only more thin and liquid but also more stinking Furthermore such ulcers have a soft loose and watery flesh besides also they are untoward and rebellious to sarcotick and epulotick medicines to which if they chance to yield and be cicatrized yet within a short while after the scar will relent of its own accord for that nature destitute of the firm and sound foundation of the bones cannot build up a laudable and constant flesh Neither is it sufficient that the Surgeon know certainly that the bone is rotten and corrupt it is furthermore fit he know whether this corruption be superficiary or pierce deep into the substance of the bone that he may know how much of the bone must be scaled The cure of a rotten bone For scaling is the only cure of that which is corrupted now it is scaled by that which dries exceedingly and draws forth all the humidity aswell the excrementitious the author of the rottenness as the alimentary For thus it remains without blood and nourishment and consequently life also whence it must of necessity scale or fall off being destitute of the glue or moisture which joined it to the sound parts in vicinity and communion of life like as leavs which fall away from the trees the humidity being exhausted by which as by glue they adhered to the boughs A catagmatick powder For this purpose Catagmatick pâ—wders are prepared to amend the corruption which is only superficiary â„ž pul aloes cretae combustae pempholyges an Ê’ii ireos flor aristoloch rot myrrh cerussae an Ê’i pul osteor combust Ê’ ss terantur subtiliss fiat pulvis let it be applied either alone by it self or else with hony and a little aqua vitae Also the following emplaster being applied stirs up nature to the exclusion of the broken bones and cleanseth the ulcers from the more gross and viscid sanies â„ž cer nov res pini gum ammon elemi an Ê’vi tereb â„¥ iii. pul A desquamatory or scaling plaster Diosc lib. 7 cap. 78. mastich mirrh an â„¥ ss aristol rot ireos flor aloes opopan euphorb an Ê’i olei rosati quantum sufficit fiat emplast secundum artem Euphorbium according to Dioscorides takes off the scales of bones in one day Hereto also conduceth Emp. de botonicâ Or â„ž olei caryophil â„¥ ss camph. Ê’ii misceantur simul in mortario utere But if that part of the bone which is corrupt cannot thus be taken away then must you use the scaling Trepans and Scrapers described formerly in wounds of the head especially if any more great or solid bone be soul Furthermore the here-described Trepan will be good to perforate the rotten bone in many places where it is corrupted untill as it were a certain bloody moisture issue forth at the holes for thus it more freely enjoies the air and also the force of the medicines admitted by these holes work more powerfully A Trepan with two triangular bits and a pin to hold them in the stock as also another Trepan having four-sqare and six square bits convenient to be used in the rottenness of greater bones But it the rottenness be more deep and the bone more hard either by nature or accident as by the occasion of the too long admission of the air then the rotten scales shall be cut off by the instruments described in wounds of the head driving them into the bone with leaden maâ—leâ—s lest the part should be too much offended or shaken with the blow The scales and fragments shall be taken forth with mullets Signs that the rottenness is taken away the signs that all the rottenness is taken away are the solidness of the bone thereunder and the bloudy moisture sweating out thereat CHAP. XXVII Of actual and potential Cauteries BUt if the described remedies cannot take place by reason of the malignity or magnitude of the rottenness then must we come to actual and potential Cauteries But I should rather approve of actual Actual Cauteries to be preferred before Potential because by strengthening the part they consume the excrementitious humours wherewith it is over charged to wit the matter of the Caries which is not so effectually performed by potential Cauteries Yet are we oftimes forced to use these to please the patients which are terrified at and affraid of hot irons Potential Cauteries are Aqua fortu Aqua vitrioli Potential Cauteries scalding oyl melted Sulphur and boyling and the like in pouring on of which I would have the Surgeon to be prudent and industrious lest he should rashly violate the neighbouring sound parts by the burning touch of these things which his temerity would cause vehement pains inflammations and other horrid symptoms For actual Cauteries their variety in figure is so great that it cannot be defined much less set down in writing for they must be varied according to the largeness of the rottenness and the figure and conformation of the souled bones Such as are more usual I have thought good here to delineate unto you content only to admonish you thus much that some of these work by pricking some by cutting some flat-wise and other some with their points made to the form of an Olive-leaf Sundry forms of actual
head one of the fundament and another of the yard or conduit of the bladder and furthermore in women one of the neck of the womb without the which they can never be made mothers or bear children When all these are finished nature that she might polish her excellent work in all sorts hath covered all the body and every member thereof with skin Exod. 20 qu â—2 Into this excellent work or Micrecâ—smâ—s so perfect God the author of nature and all things infuseth or ingrafteth a soul or life which St. Augustine proveth by this sentence of Moses If any man smite a woman with child so that thereby she â—e delivered before her natural time and the childe be dead being first formed in the wâ—mâ— let him die the death but if the child hath not as yet obtained the ful propertion and conformation of his body and members let him recompence it with mâ—ny Therefore it is not to be thought that the life is derived propagated or taken from Adam or our parents as it were an hereditary thing distributed unto all mankinde by their parents but we must beleive it to be immediately created of God even at the very instant time when the childe is absolutely perfected in the lineaments of his body and so given unto it by him The meâ—a in the womb liveth not as the childe So therefore the rude lumps of flesh called molae that engender in womens wombs and monsters of the like breeding and confused bigness although by reason of a certain quaking and shivering motion they seem to have life yet they cannot be supposed to be endued with a life or a reasonable soul but they have their motion nutriment and increase wholly of the natural and infixed faculty of the womb and of the generative or procreative spirit that is ingraffed naturally in the seed But even as the infant in the womb obtaineth not perfect conformation before the thirtieth day so likewise it doth not move before the sixtieth day at which time it is most commonly not perceived by women by reason of the smallness of the motion But now let us speak briefly of the life or soul wherein consisteth the principal original of every function in the body and likewise of generation CHAP. XI Of the life or soul The liâ—e goeth not into the mass of seed that doth engender the childe before the body of the childe and each part thereof hath his perfect proportrien and â—â—rm Why the life or soul doth not presently execute all his offices THe soul entreth into the body so soon as it hath obtained a perfect and absolute distinction and conformation of the members in the womb which in male-children by reason of the more strong and forming heat which is ingraffed in them is about the fourtieth day and in females about the fortie fifth day in some sooner and in some later by reason of the efficacie of the matter working and pliantness or obedience of the matter whereon it worketh Neither doth the life or soul being thus inspired into the body presently execute or performe all his functions because the instruments that are placed about it cannot obtain a firm and hard consistence necessary for the lively but especially for the more divine ministeries of the life or soul but in a long process of age or time Those instruments of the soule are vitiated either in the first conformation as when the form or fashion of the head is shaped upwards or pyramidal as was the head of Thersites that lived in the time of the Trojan war and of Triboulet and Tonin that lived in later years or also by some casualtie as by the violent handling of the midwife who by compression by reason that the seal is tender and soft hath caused the capacitie of the ventricles that be under the brain to be too narrow for them or by a fall stroak disorder in diet as by drunkenness or a fever which inferreth a lethargie excessive sleeepiness or phrensie 1. Coâ—c 12. Presently after the soul is entred into the body God endeth it with divers and sundry gifts hereof it commeth that some are endued with wisdom by the spirit others with knowledg by the same spirit others with the gift of healing by the same spirit others with power dominion and rule others with prophesie others with diversities of tongues and to others other endowments as it hath pleased the divine providence and bounty of God to bestow upon them against which no man ought to contend or speak For it is not meet that the thing formed should say unto him that formed it why hast then made me thus hath not the Potter power to make of the same lamp of clay one vessel to hâ—nor and another to dishonor It is not my purpose neither belongeth it unto me or any other humane creature to search out the reason of those things but only to admire them with all humility But yet I dâ—re affirm this one thing that a noble and excellent soul neglecteth elementary and a transitory things and is ravished and moved with the contemplation of ceâ—eâ—â—â—al which it cannot freely enjoy before it be separated from this earthly inclosure or prison of the body and be restored unto its original Therefore the soul is the inward Entelechia or perfection What the 〈◊〉 or life is or the primitive cause of all motions and functions both natural and animal and the true form of man The Antients have endevoured to express the obscure sence thereof by many descriptions For they have called it a celestiâ—â—l spirit and a superior incorporeal invisible and immortal essence which is to be comprehended of its self alone that is of the mind or understanding The life is in all the whole body and in every portion thereof The life or soul is simple and indâ—â—sible Divers names and the reason of divers â—â—mes thâ—t are given to humane forms Others have not doubted but that we have our souls inspired by the universal divine minde which as they are alive so they do bestow life on the bodies unto whom they are annexed or united And although this life be dispersed into all the whole body and into every portion of the same yet iâ— it void of all corporal weight or mixtion and it is wholly and alone in every several part being simple and invisible without all composition or mixture yet endued with many virtues and faculties which it doth utter in divers parts of the body For it feeleth imagineth judgeth remembreth understandeth and ruleth all our desires pleasures and animal motions it seeth heareth smelleth tasteth toucheth and it hath divers names of these so many and so great functions which it performeth in divers parts of the body It is called the soul or life because it maketh the body live which of it self is dead It is called the spirit or breath because it inspireth our bodies It is called reason because it discerneth 〈◊〉 from falshood as it
were by a cerâ—ain divine rule It is termed the minde because it is mindfull of things past in recalling and remembring them And it is called the vigor or courage beâ—â—◠〈…〉 vigor and courage to the sluggish weight or mass of the body And lastly it is 〈◊〉 the sense and understanding because it comprehendeth things that are sensible and intelliâ—â—â—â— Because it is incorporeal it cannot occupie a place by corporeal extention although notwithstanding it filleth the whole body It is simple because it is but one in essence not increased not diminished for it is no less in a Dwarf then in a Giant and it is like perfect and great in an 〈◊〉 as in a man according to its own nature But there are three kindes of bodies informed by a soul whe eby they live Three kindes of living bodies The superiours soul containeth in it self all the powers of the inferiour the first being the most imperfect is of plants the second of brute beasts and the third of men The plants live by a vegetative beasts by a sensitive and men by an intellective soul And as the sensitive soul of brute beasts is endued with all the virtues of the vegetative so the humane intellective comprehenceth the virtues of all the inferior not separated by any division but by being indivisibly united with reason and understanding into one humane form and soul whereon they depend But because wee have said a little before that divers functions of the life are resident and appear in divers parts of the body here in this place omitting all others we will prosecute those only which are accounted the principal The principal functions of the humane soul according to the opinion of many are four in number proceeding from so many faculties and consequently from one soul they are these What the common sense The function of the common sense is double The Common Sense Imagination Reasoning and Memory And they think that the common or interiour sense doth receive the formes and images of sensible things being carried by the spirit through the passage of the nerves as an instrument of the external senses as it were a messenger to go between them and it serves not only to receive them but also to know perceive and discern them For the eie wherein the external sense of seeing consisteth doth not know white or black Therefore it cannot discern the differences of colours as neither the tongue tastes nor the nose savours nor the ears sound nor lastly the hands their touching quality yea the eye doth not of it selfe perceive that it seeth nor the nose that it smelleth nor the ears that they hear nor the tongue that it tasteth nor the hands that they touch For all these things are the offices and functions of the common sense for this sense knoweth that the eye hath seen some thing either white black red a man horse sheep or some such like material thing yea even when the sight is gone and past and so likewise the nose to have smelled this or that savour the ear to have heard this or that sound the tongue to have tasted this or that taste and the hand to have touched this or that thing be they never so divers For all the external senses and all the functions thereof do end and are referred to the Common sense as it were the lines of a circle from the circumference into the center as it is expressed in this figure For which cause it is called the common or principal sense for that therein the primitive power of feeling or perceiving is situated for it useth the ministery or service of the external senses what cause the internal sense is called the common sense The common sense understandeth or knoweth those things that are simple only to know many and divers things whose differences it doth discern and judge but simple things that are of themselves and without any composition and connexion which may constitute anthing true or false or any argumentation belongeth only to the minde understanding or reason For this was the counsel of nature that the external sences should receive the forms of things superficially lightly and gently only like as a glass not to any other end but that they should presently send them unto the Common sense as it were unto their center and prince which he that is to say the Common sense delivereth to be collected unto the understanding or reasoning faculty of the soul which Avicen and Averrcis have supposed to be situated in the former paâ— of the brain What imagination is Next unto the common sense followeth the phantasie or imagination so called because of it arise the formes and Ideas that are conceived in the minde called of the Greeks Phantaâ—mata This doth never rest but in those that sleep neither alwaies in them for ofttimes in them it causeth dreams and causeth them to suppose they see and perceive such things as were never perceived by the senses not which the nature of things not the order of the world will permit The power of this faculty of the minde is so great in us that it often bringeth the whole body in subjection unto it For it is recorded in history that Alexander the Great sitting at Table and hearing Timotheus the Musician sing a Martial sonnet unto his Cythern that he presently leaped from the Table and called for arms but when again the Musician mollified his tune he returned to the table and sate down as before The power of imagination caused by musical harmony was so great that it subjected to it the courage or the worlds conquerour by whose various motion it would now as it were cause him to run headlong to arms and then pacifie and quiet him and so cause him to return to his chair and banquetting again And there was one whosoever it was who some few years agon seeing the Turk dance on a rope on high with both his feet fastned in a basin turned his eyes from so dangerous a sight or spectacle although came of purpose to see it and stricken with such fear that his body shook and heart quaked for fear lest that by sudden falling down headlong he should break his neck Many looking down fron an high and lofty place are so stricken with fear that suddenly they fall down headlong being so overcome and bound with the imagination of the danger that their own strength is not able to sustain them Therefore it manifestly appeareth that God hath dealt most graciously and lovingly with us who unto this power of imagination hath joyned another that is the faculty or power of reason and understanding which discerning false dangers and perils from true doth sustain and hold up a man that he may not be overthrown by them What Reason is After this appeareth and approacheth to perform his function the faculty of Reason being the Prince of all the principal faculties of the soul which bringeth together composeth joyneth and
or breadth so much is wanting in their length The cause of the divers turnings of the womb into divers parts of the body and therefore it happeneth that the womb being removed out of its seat doth one while fall to the right side towards the liver sometimes to the left towards the milt sometimes upwards unto the midriff and stomach sometimes downwards and so forwards unto the bladder whereof cometh an Ischury and strangury or backwards whereof cometh oppression of the straight gut and suppression of the excrements and the Tenesmus But although we acknowledge the womb to decline to those parts which we named yet it is not by accident only as when it is drawn by the proper and common ligaments and bands when they are contracted or made shorter The womb is not so greatly moved by an accident but by it self being distended with fulness but also of it self as when it is forced or provoked through the grief of something contrary to nature that is contained therein it wandreth sometimes unto one side and sometimes unto another part with a plain and evident natural motion like unto the stomach which embraceth any thing that is gentle and milde but avoideth any thing that is offensive and hurtfull Whereof come such divers accidents of strangulation of the womb yet we deny that so great accidents may be stirred up by the falling of it alone unto this or that side for then it might happen that women that are great with childe whose wombs are so distended by reason that the childe is great that it doth press the midriff might be troubled with a strangulation like unto this but much rather by a venemous humor breathing out a malign and gross vapor not only by the veins and arteries but also by the pores that are invisible which pollutes the faculties of the parts which it toucheth with its venemous malignity and infection and intercepts the functions thereof Neither doth the variety of the parts receiving only but also of the matter received cause variety of accidents For some accidents come by suppression of the terms others come by corruption of the seed but if the matter be cold The cause of sleepiness in the strangulation of the womb it brinketh a drowsiness being lifted up unto the brain whereby the woman sinketh down as if she were astonished and lieth without motion and sense or feeling and the beating of the arteries and the breathing are so small that sometimes it is thought they are not at all but that the woman is altogether dead If it be more gross it inferreth a convulsion if it partipate of the nature of a gross melancholick humor it bringeth such heaviness fear and sorrowfulness that the party that is vexed therewith shall think that she shall die presently and cannot be brought out of her minde by any means or reason The cause of drowsie madness if of a cholerick humor it causeth the madness called furor uterinus and such a pratling that they speak all things that are to be concealed and a giddiness of the head by reason that the animal spirit is suddenly shaken by the admixtion of a putrified vapour and hot spirit but nothing is more admirable then that this disease taketh the patient sometimes with laughing and sometimes with weeping for some at the first will weep and then laugh in the same disease and state thereof But it exceedeth all admiration which Hollerius writeth A history usually happened to two of the daughters of the Provost of Roven For they were held with long laughter for an hour or two before the fit which neither for fear admonition nor for any other means they could hold and their parents chid them and asked them wherefore they did so they answered that they were not able to stay their laughter The ascention of the womb is to be distinguishâ—d from the strangulation The ascention of the womb is diligently to be distinguished from the strangulation thereof for the accidents of the ascention and of the strangulation are not one but the woman is only oppressed with a certain pain of the heart difficulty of breathing or swouning but yet without fear without raving or idle talking or any other greater accident Therefore oftentimes contrary causes inferr the ascention that is overmuch driness of the womb labouring through the defect of moisture whereby it is forced after too violent and immoderate evacuations of the flowers and in childe-bed and such like and laborious and painfull travel in childbed through which occasion it waxeth hot contrary to nature and withereth and turneth it self with a certain violence unto the parts adjoyning that is to say unto the liver stomach and midriff if haply it may draw some moisture there-hence unto it I omit that the womb may be brought unto its place upwards by often smelling to aromatick things yet in the mean while it inferrs not the strangulation that we described before CHAP. XLV The signs of imminent strangulation of the Womb. BEfore that these fore-named accidents come the woman thinks that a certain painfull thing ariseth from her womb unto the orifice of the stomach and heart and she thinketh her self to be oppressed and choaked she complaineth her self to be in great pain and that a certain lump or heavy thing climbs up from the lower parts unto her throat and stoppeth her winde her heart burneth and panteth And in many the womb and vessels of the womb so swell that they cannot stand upright on their legs but are constrained to lie down flat on their bellies that they may be the less grieved with the pain and to press that down strongly with their hands The womb it self doth not so well make the ascention as the vapor thereof that seemeth to arise upwards although that not the womb it self but the vapor ascendeth from the womb as we said before but when the fit is at hand their faces are pale on a sudden their understanding is darkned they become slow and weak in the leggs with unableness to stand Hereof cometh sound sleep foolish talking interception of the senses and breath as if they were dead loss of speech the contraction of their legs and the like CHAP. XLVI How to know whether the woman be dead in the strangulation of the womb or not I Have thought it meet because many women not only in ancient times Women living taken for dead but in our own and our fathers memory have been so taken with this kind of symptom that they have been supposed and laid out for dead although truly they were alive to set down the signs in such a case which do argue life and death Therefore first of all it may be proved whether she be alive or dead by laying or holding a clear and smooth looking-glass before her mouth and nostrils For if she breath although it be never so obscurely the thin vapor that cometh out How women that have the
empl de Vigo without addition and with addition oxycroceum diacalcitheos dissolved in a digesting oyl to the form of a cerot Araeoticks are profitably used in the increase and state of superficial tumors The use of diaphoreticks But Diaphoreticks are not to be used in the increase of tumors unless some astringent be added lest by their more strong digestion they should draw and increase the defluxion but when the tumors decline they are then only to be used in the parts chiefly where the skin is dense and hard and when the tumor is cold and gross and lying hid deep in the body so that the virtue of medicaments can hardly come thereto but consideration is to be had of the parts to which resolutives are to be applied for you may not apply relaxers or diaphoreticks to the liver spleen stomach or bowels unless you add some astringents of which a great part must be aromaticks To the parts where sence is more dull may be applied the stronger diaphoreticks but those parts whiâ—h are endued with a more exquisite sense as the eye and the nerves to them we must apply weaker When the mâ—tter is gross and cold things cutting and attenuating and then emollient are to be used and so by degrees come to diaphoreticks otherwise that only is resolved which is the most subtil of unprofitable matter the grosser becomming concrete and hardned But if the part be afflicted with a continual defluxion so that there may be danger of a gangrene or sphacel it is not lawful then to make use of resolvers but you must in the place where the humor flows divide the skin by scarification as it is most learnedly noted by Hollerius in that profitable book of his left to posterity whose title is De materia Chirurgica CHAP. XII Of suppuratives What a suppurative medicine is A Suppurative medicine is said to be that which shutting the pores and preventing transpiration by his emplastick consistence increaseth the matter and native heat and therefore turneth the matter cast out of the vessels into pus and sanies It is of nature hot and moist and proportionable to the native heat of the part to which it is applied and of an emplastick consistence that so it may hinder the native heat from being exhaled in which respect it differeth from emollients and malacticks of which we shall speak hereafter There be two kindes of suppuratives Differences of Suppuratives for some do it of themselves and by their proper quality others by accident Those things which by their own strength do bring to suppuration are either simples or compounds Simples are radix liliorum caeâ—a allium malvarum omnium folia semina buglossum acanthus senecio violae pariâ—taria crocus caules ficus passulae mundatae with a decoction of these things farina tritici farina volatâ—lis farina hordei excorticati lolii seminis lini foenugraeci galbanum ammoniacum styrax pirguis ladanum viscum aucupatorum thus pix cera resina colla adeps suillus vitulinus vaccinus capâ—inus butyrum vitellus ovi oesipus humida-stercus suillum columbinum caprinum pueri Compounds are oleum liliorum lumbricorum de croco unguent basilicum emplast diachilon commune magnum de mucilaginibus Suppuratives by accident Those things do suppurate by accident which work it only by the means of an emplastick consistence for so oft-times astringents because they are of earthy and thick parts are found to suppurate such are unguentum de bolo rutritum and such like Such also are those which by their coldness keep the heat in and shut the poâ—es Hence it is that the qualities of sorrel are commended to generate pus for whilst it keepeth the heat within it increaseth his effects to the thickning of the suppurable matter and the overcomming other rebellious qualities We use things ripening in great inflammations whose growth we cannot hinder with repellers or increase with resolvers or discussers CHAP. XIII Of Mollifying things Gal. cap. 7. lib. 5. simp How suppuratives emollients differ THat is defined to be a mollifying medicine which by a stronger heat then that which is proper to suppuratives without any manifest quality of drying or moistening again malaxeth or softeneth hardned bodies wherefore this differs from that which suppurates because that they be hot in the firrst or second degree according to the several temper of the body or part to which it is applied working rather by the quantity of heat then the quality contrariwise that which mollifieth being indued with a greater heat rather worketh by the quality of the heat being otherwise in driness and moisture temperate Although as many things agree together in some respects though of a diverse nature so many emollients are such as are hot in the first degree and drie in the second and third that so they may the better disperse and diffuse that which is congealed by taking away a little of the humidity which is contained within the part affected but not by exhausting it wholly by the violence of heat ordriness for hereon would follow a greater hardness Things mollifying are either simple or compound and these again strong or weak The differences of emollients The weak are Radix liliorum alborum cucumeris agrestis althaeae folia malvae bismalvae liliorum anethi summitates viola branca ursina semen malvae bismalvae lini foenugraeci carici pingues passulae mundatae pedum capitum intestinorum vervecinorum decoctum adeps ex junioribus castratis domesticis foeminis animalibus adeps suillus vitulinus hoedinus caprinus bubulus vulpinus gallinaceus anserinus anatinus olorinus efficaces The weaker are things more gentle as Butyrum lana succida cera pinguis vitellus ovi medulla ex â—ssibus cervina ovilla caprina The compound are oyl wherein are boiled mollifying herbs as Oleum liliorum chamaemelinum amygdalarum dulcium Stronger emollients are Acetum adeps taurinus ursinus cervinus leoninus pardalinus apri equi sevum pinea picea abietina terebinthina ammoniacum bdelium styrax galbanum ladanum propolis opopanax ung de althaea emp. diachylon commune magnum de mucilaginibus ceroneum oxycroceum Joannis de Vigo We use emollients in schirrous tumors of the muscles or in the lips of ulcers Their use in any of the limbs belly glandules bowels by reason of a gross cold and viscous matter either phlegmatick or melancholick Yet those tumors which come of melancholy commonly turn to cancers which are exasperated by mollifying things On the contrary such as proceed from a phlegmatick matter are brought to an equality of consistence by the use of emollients Furthermore there are three things observable in the use of emollients the first is duly to consider how much the affected part differs from his proper and natural temper and proportion that so we may apply an equivalent remedy The second is that we distinguish the natures of the parts Things observable in
violently on the last spondil of the back and first of the loyns both with the hand and knee for unto this place the orifice of the stomach is turned that by the power of the vomitory medicine and concussion of the stomach they might be constrained to vomit Neither did our purpose fail us for presently they voided clammy yellow and spumous phlegm and blood But we not being contented with all this blowed up into their nostrils out of a Goose-quil the powder of Euphorbium that the expulsive faculty of the brain might be stirred up to the expulsion of that which oppressed it therefore presently the brain being shaken or moved with sneesing and instimulated thereunto by rubbing the chymical oyl of Mints on the palate and on the cheeks they expelled much viscous and clammy matter at their nostrils Then we used frictions to their arms legs and back-bones and ministred sharp glysters by whose efficacy the belly being abundantly loosened they began presently to speak and to take things that were ministred unto them of their own accord and so came to themselves again In the do ng of all these things James Guillemeau Surgeon unto the King of Paris and John of Saint Germanes the Apothecary did much help and further us In the afternoon that the matter being well begun might have good success John Hauty and Lâ—â—is Thibaut both most learned Physicians were sent for unto us with whom we might consâ—lt on other things that were to be done They highly commended all things that we had done already thought it very convenient that cordials should be ministred unto them which by ingendring of laudable humors might not only generate new spirits but also attenuate and putrifie those that were cloudy in their bodies The rest of our consultation was spent in the inquity of the cause of so diâ—e a mischance For they said it was no new or strange thing that men may be smothered with the fume and cloudy vapor of burning coals For we read in the works of Fulgosius Volaterenus and Egnatius Lib. 9. cap. 12. lib. 23. An history that as the Emperor Jovinian travelled in winter-time towards Rome he being weary in his journey rested at a village called Didastances which divideth bithynia from Galatia where he lay in a chamber that was newly made and plaisted with lime wherein they burnd many coals for to dry the work or plaistering that was but as yet green on the walls or roofs of the chamber Now he dyed the very same night being smothered or strangled with the deadly and poysonous vapor of the burned charcoal in the midst of the night this happened to him in the eighth moneth of his reign the thirtieth year of his age and on the twentieth day of August But what need we to amplifie this matter by the antient histories seeing that not many years since three servants died in the house of John Bigine goldsmith who dwelt at the turning of the bridge of the Change by reason of a fire made with coals in a close chamber without any chimney where they lay And as concerning the causes these were alledged Many were of opinion that it happened by the default of the vapor proceeding from the burned coals which being in a place void of all air or winde infers such like accidents as the the vapor or must of new wine doth that is to say pain and giddiness of the head For both these kindes of vapor besides that they are crude like unto those things whereof they come can also very suddenly obstruct the original of the Nerves and so cause a convulsion by reason of the grossness of their substance Sect. 5. Aph. 5. For so Hippocrates writing of those accidents that happen by the vapor of new wine speaketh If any man being drunken do suddenly become speechless and hath a convulsion he dieth unless he have a fever therewithall or if he recover not speech again when his drunkenness is over Even on the same manner the vapor of the coals assaulting the brain caused them to be speechless unmoveable and void of all sense and had died shortly unless by ministring and applying warm medicines into the mouth and to the nostrils the grossness of the vapor had been attenuated and the expulsive facultie moved or provoked to expel all those things that were noisome and also although at the first sight the Lungs appeared to be greived more then all the other parts by reason that they drew the malign vapor into the body yet when you consider them well it will manifestly appear that they are not grieved unless it be by the sympathy or affinity that they have with the brain when it is very grievously afflicted The proof hereof is because presently after there followeth an interception or defect of the voice sense and motion which accidents could not be unless the beginning or original of the nerves were intercepted or letted from performing its function being burthened by some matter contrary to nature The occasion of the death of such as have the apoplexy And even as those that have an apoplexy do not dye but for want of respiration yet without any offence of the Lungs even so these two young mens deaths were at hand by reason that their respiration or breathing was in a manner altogether intercepted not through any default of the Lungs but of the brain and nerves distributing sense and motion to the whole body and especially to the instruments of respiration Others contrariwise contended and said that there was no default in the brain but conjectured the interception of the vital spirits letted or hindred from going up into the brain from the heart by reason that the passages of the Lungs were stopped to be the occasion that sufficient matter could not be afforded for to preserve and feed the animal spirit Which was the cause that those young men were in danger of death for want of respiration without which there can be no life For the heart being in such a case cannot deliver it self from the fuliginous vapors that encompass it by reason that the Lungs are obstructed by the grossness of the vapor of the coals whereby inspiration cannot well be made for it is made by the compassing air drawn into our bodies but the air that compasseth us doth that which nature endeavoureth to do by inspiration for it moderateth the heat of the heart and therefore it ought to be endued with four qualities The first is that the quantity that is drawn into the body be sufficient The second is that it be cold or temperate in quality The third is that it be of a thin and mean consistence The fourth is that it be of a gentle benign substance But these four conditions were wanting in the air which those two young men drew into their bodies being in a close chamber Conditions of the air good to breath in For first it was little in quantity by reason that small quantity that
the upper end of the table where every one drank carouses to him and mee thinking to make me foxt which they could not do For I drank but according to my old custom A few dayes after we returned back and took leave of Madam the Dutchess of Ascot who took a Diamond-ring from her finger which she gave me acknowledging I had very well drest her brother which Diamond was better worth then fifty Crowns Monsieur Auret grew better and better walked all alone round about his garden with crutches I begd leave of him divers times to come away to Paris declaring that his Physician and Surgeon would well do the rest that remained for the cure of his grief And now to begin a little to estrange my self from him I prayed him to give me leave to go see the City of Antwerp which he willingly accord d to and commanded his Steward to conduct me thither accompanied with two Pages we passed through Malignes Bruxelle where the chief of the City prayed the said Steward that at our return they might hear of it they they had a great desire to feast me as they of Monts had done I thankt them most kindely told them that I was not worthy of such honor I was two dayes a half to see the Citty of Antwerp where some Merchants knowing the Steward prayed him to do them the honour that they might bestow a dinner or supper upon us There was striving who should have us they were all very joyful to hear of the good health of the Marquess of Auret doing me more honor then I expected To conclude we came back to the Marquess making good cheer and within five of six daye I asked my leave of him which he granted with great grief and gave me an honest Present and of great value and made me be conducted by the said master of his house and two Pages even to my house at Paris I have forgot to tell you that the Spaniards have since ruined and demolisht his Castle of Auret sackt pillagd rifled and burnt all the houses Villages belonging unto him because he wouâ—d not be of their side in the slaughters and ruines of the Low Countries The Voyage of Bourges 1562. THe King with his Camp remained not long at Bourges but those within yielded it up and went out with their jewels saved I know nothing worthy of memory but that a boy of the Kings privy kitchin who beeing neer the walls of the Citty before the composition was made cried with a loud voyce Huguenot Huguenot shoot here shoot here having his arms lifted up and his hand stretched out a souldier shot his hand quite thâ—ough with a bullet having received his stroak he came and found me out to dress him My Lord high-Constable seeing the boy to have his hand all bloody and all rent and torn demanded of him who had hurt him Then there was a Gentleman who saw the shot made said it was well bestowed because he cried Huguenot shoot here shoot here Then the Said Constable Lord said this Huguenot was a good musketeer and bare a pittiful minde for it was very likely if he would have shot at his head he might have done it more easily then in the hand I dressd the said Cook who was very sick â—ut at length was cured but with lameness of his hand and ever since his companions call him Huguenot he is living The Battle of St. Dennis 1567. ANd as for the battle of Saint Dennis there were divers slain as well on one side as on the other ours being hurt went back to Paris to be dressed together with the prisoners who were taken whereof I dressed a great part The King commanded me by the request of the Lady high-Constable to go to her house to dress my Lord who had received a Pistol-shot in the middle of the sponâ—yls of his back whereby he presently lost all sence and motion of thighs legs with retention of excrements not being able to cast out his Urine nor any thing by the fundament because that the spinal marrow from whence proceed the sinews to give sence and motion to the inferiour parts was bruised broken torn by the vehemence of the bullet He likewise lost his reason and understanding and in a few dayes he dyed The Surgeons of Paris were a long time troubled to dress the said wounded people I beleive my little Master that you saw some of them I beseech the great God of victories that we may never be employed in such evil encounters and disasters The Voyage of Bayonne 1564. NOw I say moreover what I did in the Voyage with the King to Bayonne where we have been two years and more to compass all this Kingdome where in divers Cities and Villages I have been called into consultations for divers diseases with the deceased Monsieur Chaplain chief Physician to the King and Monsieur Chastellon chief to the Queen-Mother a man of great honour and knowledg in Physick and Surgery making this Voyage I was alwaies inquisitive of the Surgeons if they had marked any rare thing of remark in their practice to the end to learn some new thing Being at Bayonne there happened two things of remark for the young Surgeons The first was that I drest a Spanish Gentleman who had a grievous great impostume in his throat he came to have been touched by the deceased King Charles for the Evil. I made incision in his Aposteme where there was found great quantity of creeping worms as big as the point of a spindle having a black head and there was great quantity of rotten flesh Moreover there was under his tongue an impostume called Ranula which hindred him to uttet forth his words and to eat and swallow his meat he prayed me with his held up hands to open it for him if it could be done without peril of his person which I immediately did and found under my Lancet a solid body which was five stones like those which are drawn from the bladder The greatest was as big as an Almond and the other like little long Beans which were five in number in this aposteme was contained a slimy humor of a yellow color which was more then four spoonfuls I left him in the hands of a Surgeon of the Citty to finish his cure Monsieur de Fontain Knight of the Kings Order had a great continual pestilent Fever accompanied with divers Carbuncles in divers parts of his body who was two dayes without ceasing to bleed at the nose nor could it be stanchd and by that means the fever ceased with a very great sweat and soon after the Carbuncles ripened and were by me dressed and by the grace of God cured I have publish'd this Apology to the end that each man may know with what foot I have alwaies marched and I think there is not any man so ticklish which taketh not in good part what I have said seeing my discourse is true
midriff the Coeliacal one then the upper Mesenterick the two emulgents as many spermatical ones at last the lower Mesenterick and the Lumbares or arteries of the loins Of these the Intercostals are scattered whilst the trunk is yet in the chest the rest whilst it passes on through the lowest belly But some of them accompany the branches of the gate-vein as the Coelicacal and both the Mesenterical arteries others those of the hollow vein as the rest Now we will treat of these in order beginning from the Intercostals or arteries between the ribs which are placed uppermost Presently therefore after the Descendent trunk Q is issued forth from its back-side it sends over little branches on both sides to the distances of the eight lower ribs which they call Intercostales inferiores Intercostales inferiores the arteries between the lower ribs the lower arteries between the ribs uuu in respect of the upper Intercostal of which we have spoken above These associating themselves with the veins and nerves of the same name go straight on by the lower side of the ribs where peculiar sinus or channels are cut out for them But as the Intercostal veins reach in the true ribs only to the gristles but in the bastard ones somewhat farther to wit to the sides of the abdomen so also the arteries end in them together with the bony parts of the ribs but in these run out a little farther And these arteries send over some propagations through the holes of the nerves to the spinal marrow and to the muscles that lye upon the rack-bones of the back just as we have said the Intercostal veins were propagated Their use But the use of them is to diffuse the vital spirit and the blood to the muscles betwixt the ribs besides which they have also another notable office to wit of carrying down the water and purulent matter that is gathered together in the chest into the great artery and from thence by the Emulgent branches to the bladder Although I am not ignorant that the most learned Fallopius and others who have read before me in this most famous University of Padua have shewn another way to their Auditors by which either purulent matter or water might be conveyed forth by help of the kidneys to wit the vein sine pari or without a companion a little branch whereof in the left side goes into the Emulgent of the left kidney But this way which we shew through the Intercostal arteries is by much the shorter that I pass by this that any matter heaped together may be more easily dispatcht away through the arteries then the veins Nor needs any one here to be afraid lest the vital spirits should be infected from these excrementitious and ill humurs whereby the heart may incurre fearful symptoms when we willingly grant which experience also hath often taught us that whilst the corrupt matter is emptied out by the urine the sick parties have often faln into fits of swounding and other diseases sometimes also have died suddenly when the peccant humor has been of too great a quantity or too bad a quality and has offered so much violence to nature that the heat and spirits have been over come therewith The explanation of a place in Hippocrates But here a certain place in Hippocrates calls upon me to explain it which has long and often troubled my minde The place is in Coacis praenotionibus where he says They who together with the heart have their whole lungs inflamed so that it falls to the side are deprived of motion all over and the parties so diseased lye cold senseless and dye the second or third day But if this happen to the lungs without the heart they live not so long Yet some also are preserved I have often thought with my self what should be that sympathy of the heart lungs with the brain and nerves that from the inflammation of those parts the patient should be so deprived of sense and motion all over when the same Hippocrates teacheth in the same place that the diseased suffer such deprivation in that part livid spots appear on the outside about the rib where-about the Aortae so he seems to call the lobes or division of the lungs being inflamed fall to the sides But if they be not much inflamed so that they fall not down to the side he sayes that there is a pain indeed all over but no deprivation of sense or motion nor any spots appear Having deliberated often with my self at length I came to be of this opinion that there was no other cause but the sympathy betwixt these Intercostal arteries and the marrow in the back-bone This sympathy arises from those propagations which we told you past through the holes of the rack-bones of the chest into the back-bone Wherefore if the lungs and heart be so mightily inflamed that great plenty of blood rush into the great artery whereupon it swels as also these vessels betwixt the ribs and consequently those surcles which go to the marrow of the back-bone truly it cannot be but that both the marrow and the nerves which issue out of it be comprest from whence what else can follow but the resolution of those parts into which those nerves are implanted to which they impart the faculty of motion This opinion seems to me to be wonderfully confirmed by a certain pretty observation which the learned Cornelius Gemma has in his book de hemititraeo pestilenti A certain studious young man sayes he through the whole course of his disease had his left eye less then the other He was paind in the left side especially all the time the fit raged but about the crisis or judication thereof the artery of his left leg being swoln up was moved according to its length that being to be seen by us it seemed to be turned upward and downward like a rope pull'd back Who will not here willingly confess that this matter was in the arteries when the crisis was made by them But from this that hath been said a reason may be also given of another observation of Galen which is l. 4 de locis affect c. 4. where he sayes thus In a certain man who was troubled with a vehement inflammation of the lungs as wel the outer as the inner parts of his arm from the cubit to the very ends of his fingers labour'd with difficulty of sense and their motion also was somewhat empair'd In the same man also the nerves which are in the first and second distances betwixt the ribs sustained harm And a little after This man was quickly restored to his health to wit a medicine being applyed to the place from whence the nerves issue forth near to the first and second spaces betwixt the ribs By reason of the same branches betwixt the ribs John Valeriola the son of that Physitian whose observations we have being yet a boy suffered Convulsion-fits in a grievous Pleurisie The arteries
fibers of the nerves are disseminated to these parts by mediation of their coat Lib. 1. de Locis affectis or membrane I say so small that they can scarce be discerned by the eyes unless as Galen saith by plucking such coats away from the parts Why the bones have such small veins But it is no marvail if Nature would have these parts in like manner to have such small veins contrary to the lungs and most part of the muscles only to yield so much nourishment to the part as should be needful for seeing the substance of the Bones is cold hard dense and solid it wastes the less Wherefore they need not so much blood for their nourishment as the hot and soft parts and besides the lesser Bones have neither Veins â—or Arteries but draw fit nourishment only by the force of the attractive faculty implanted in them Whence the difference of Bones may be taken The differences of Bones are taken from many things as from their Apophyses Epiphyses Grisles Necks Heads Solidity Cavity Eminencies Marrow Consistence Bigness Number Figure Site We will prosecute all these as they shall offer themselves in the demonstration of the Bones to which doctrine we will give a beginning at the Clavicles or Coller-bones The Clavicles or Coller-bones The Clavicles are two very hard and solid Bones without any great or notable cavity situate on each side betwixt the side and upper part of the Sternon and top of the Shoulder-blade for the strength and stability of these parts whence they take the name of Claviculae Clavicles from the Greek 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 which signifies a Key or any other Bar or fastning of a Door They carry the shape of a Surgeons Levatory But you must note that the Clavicles seem to be fastned to the Sternon by the mediation of a grisly-bone Moreover the space and cavity contained within the coller-bones is called by the Latines jugulum by the French the upper furcula because the jugular-veins pass that way Lib. 13. de usu part cap. 13. it sticks to the upper process of the shoulder by a Grisle which Galen calls the small Grisle-bone although it be nothing else but a production of the Os juguli For the Sternon which we said is framed of divers Bones as sometimes 3 sometimes 4 5 6 7 and sometimes 8 you must note they are very spongy and full of pores and of a far softer consistence than the coller-bones wherefore more subject to corruption besides they are mutually joined by interposition of muscles Their use is to be as a shield to defend the vital parts The Ribs are 24 in number on each side 12. seven of these are called true or perfect ribs The Ribs because they make a circle at the one end joyned to the Sternon on the other to the vertebra's the other are called bastard or short-ribs because they fall short in their way and come not to the Sternon but they are fastned on the foreside of the Sternon by Grisles and Ligaments but on the back-part to the transverse vertebra's of the Back-bone and to the sides of the said vertebra's But the short-ribs are only knit to the vertebra's wherefore that part of the vertebra's is called the root of the ribs The exterior or fore-part of the bastard or short-ribs is grisly that they should not be broken and that they might be the easier lifted up in the distensions of the Stomach filled with meat They are of a consistence sufficiently hard yet more towards their root than at the Sternon Their Consistence where they come nearer together and are more hardly broken they are smooth both within and without but in the midst they have some sign of being double or hollow to receive the veins and arteries which nourish their bony substance they are fashioned like a bow their use is the same with the Sternon and besides to carry and strengthen the muscles serving for respiration CHAP. V. The Anatomical administration of the Sternon THe coat investing the ribs which the common Anatomists call Pleura is the last of the containing parts of the Chest which because it lies hid in the inner part thereof it cannot be shown unless by pulling asunder of the Sternon wherefore we must now shew the manner of opening the Sternon that hereby we may not violate the original or insertion of any of the muscles Wherefore first you must understand that he which will shew in their proper place their original and insertion of the pectoral muscles of the Mastoides of the two muscles of the bone Hyois of the muscles subclavii and intercartilaginei ought first of all to separate all the pectoral muscles from the Sternon and the Grisles from the true-ribs then to cut the Ligaments next the Bones themselves even from the sixth true rib to the clavicles And then shewing the Mediastinum stretched under the Sternon all the length thereof he must separate the Sternon with his knife and bend it up to the clavicâ—es and there cut it reserving together with it the four muscles that is the two Mastoides and the two moving the Bone Hyois because they either wholly or for the most part arise from the Sternon Lastly the Clavicles being somewhat thrust upwards the Grisles must on each side be turned outward towards the arm that so the containing parts of the Chest may not lye only open to view and be easily shewed but also the muscles may be contained in their place until they come to be shewed in their order And because the Coller-bones must be lifted up very high that the recurrent nerves may be more easily seen and the distribution of the veins and arteries the two small Subclavian muscles one on each side must be shown by the way who have their original from the inner and fore-part of the Clavicles and an oblique descent to the Sternon towards the grisle of the first rib For the Clavicles cannot be thus separated but that these muscles must be violated and spoiled Also you may divide the Sternon in the midst that you may shew the inward pectoral muscles whole having separated the muscles which arise from the upper part All which things being performed as they ought we must come to the coat investing the ribs and then to the Mediastinum as arising from it CHAP. VI. Of the Pleura or coat investing the Ribs THe Tunica Subcostalis or coat investing the Ribs What the membrane investing the ribs is being the last of the containing parts of the Chest is a large and a broad membrane answerable in proportion of use and action to the Peritonaeum of the lower Belly For as the Peritonaeum generally and particularly covers all the natural parts binding and holding them in their places so this coat invests all the vital parts in general because it is stretched over all the inside of the Chest but in particular whilst it gives each a coat from it self It hath
by the bent of the knee under the skin as far as the heel 7 also to the skin of the outward enkle 8 the vein called Suralis or calf-vein because it runneth unto the muscles that make the calf of the leg 9 the division of the Sural-vein into an exterior trunk 9. and an interior 14. 10 11 the division of the exterior trunk under the knee into an external branch which along the brace attaineth unto the muscles of the foot 11 and an internal 12 13 14 which descending along the outside of the leg to the upper part of the foot is cloven into divers branches and in the back of the foot mixeth it self with Poplitea or the ham-vein 20. 15 the interior branch of the Sural-vein which runneth into the back-side of the leg 16 a branch hereof descending to the inside of the heel and the great toe and is divided into divers surcles 17 Ischias major issuing out of the internal trunk at 14 and running through the muscles of the calf 18 a propagation hereof derived unto the upper part of the foot and affording two surcles to every toe 19 the remainder of the inner trunk 14 behind the inner ankle approacheth to the bottom of the foot and is consumed into all the toes 20 the commixion of the vein Poplitea with the small or Calf-branch at 13. Where the external Jugular-vein may be fitly opened in inflammations of the parts of the mouth But when it arrives to the basis of the lower part of the head it is divided into more branches one whereof is carryed to the muscles of the bone Hyois the Larinx the Tongue and the lower part of the tongue in which place it is commonly opened in the Squinances and other inflammations of the mouth and to the coat of the nose Another is carried to the Dura mater passing on both sides through a hole situate under the bone mastoides and besides ascending to the bone of the back-part of the Scull it comes obliquely to the upper part of the future Lambdoides where these branches meeting together pass into the reduplication of the Dura mater dividing the fore-part of the Brain that so joyned and united they may make the Torcular the third ascendent is distributed upon the back-part and basis of the lower jaw to the lips the sides of the nose and the muscles thereof and in like manner to the greater corner of the eyes to the fore-head and other parts of the face and at length by meeting together of many branches it makes in the fore-head the vein which is called vena recta Vena recta or vena frontis that is the forehead-vein The fourth ascending by the glandules behind the ears after it hath sent forth many branches to them is divided into two others one whereof passing before and the other behind the ear are at length spent in the skin of the head The fifth and last wandring over all the lower part of the head going to the back-part thereof Vena pupis makes the vena pupis which extended the length of the head by the sagittal suture at length goeth so far that it meets with the vena frontis which meeting is the cause that a vein opened in the fore-head is good in griefs of the hinder-part of the head and so on the contrary But we must observe that in the Cranium of some the vena pupis by one or more manifest passages sends some portion thereof to the inner part of the head so that the vena pupis being opened may make revulsion of the matter which causeth the internal pains of the head CHAP. XIV The distribution of the Nerves or Sinews of the sixth Conjugation Three pair of Nerves of the sixt Conjugation BEcause the distribution of the Arteries cannot be well shewed unless we violate those Nerves which are carryed over the Chest therefore before we shew the distribution of the Arteries we will as briefly as we can prosecute the distribution of these nerves Now the sixth conjugation brings forth three pair of Nerves for passing out of the Skul as it comes down to the Chest it by the way sends forth some branches to certain muscles of the neck and to the three ascendent muscles of the Larinx on each side of the Sternon and upon the clavicles Then the remainder descending into the Chest is divided on each side into these three pair The first pair makes the Ramus costalis The second the Ramus recurrens The third pair the Ramus stomachicus Ramus Costalis The Ramus costalis or costal branch is so called because descending by the roots of the ribs even to the holy bone and joyning themselves to these which proceed from each of the Vertebra's of the Spine they are carryed to all the natural parts Recurrens The Recurrens or recurrent is also so called because as it were starting up from the Chest it runs upward again but these two Recurrent Nerves do not run back from the same place but the right from below the Artery called by some the Axillary by others Subclavian and the left from beneath the great Artery descending to the natural parts But each of them on each-side ascending along by the Weazon even to the Larinx and then they insinuate themselves by the wings of Cartilago scutiformis and Thyroides into the proper muscles which open and shut the Larinx An anatomical Axiome By how much the Nerves are nearer the original to wit the Brain or Spinal-marrow they are by so much the softer On the contrary by how much they are further absent from their original Why Nature would have the vocal Nerves recurrent Ramus Stomachicus they are so much the harder and stronger which is the reason that Nature would have these Recurrent Nerves to run back again upwards that so they might be the stronger to perform the motions of the muscles of the Larinx But the Stomachicus or Stomach-branch is so called because it descends to the Stomach or Ventricle For this branch descending on both sides by the sides of the gullet sends many branches from it into the inner substance of the Lungs into the coat thereof into the Pericardium and Heart and then coming into the upper orifice of the Stomach it is spent in many branches which folded after divers manners and ways chiefly makes that Mouth or Stomach which is the seat of the Animal appetite as they term it and hunger and the judger of things convenient or hurtful for the Stomach But from thence they are diversly disseminated over all the Body of the Ventricle Moreover the same branch sends forth some small branches to the Liver and Bladder of the Gall giving each part by the way so much sense as should be sufficiently necessary for it Here you must note the Stomach-branch descends on each side one knit to the gullet and by the way they divide themselves into two branches each of which goes
to the opposite side that it may there joyn it self to the Nerve of that side To which purpose the right is carryed above the Gullet the left below it so that these two Stomatick become four and again these four presently become two CHAP. XV. The Division of the Arteries THe Artery arising forth of the left Ventricle of the Heart The left branch of the ascendent Artery is less then the right The distribution of the left subclavian Artery into the is presently the two Coronal Arteries being first spred over the substance of the Heart divided into two unequal branches The greater whereof descends to the lower parts being distributed as we formerly mentioned in the third Book and 22. Chapter The lesser ascending to the upper parts is again divided into two other unequal branches the lesser of which ascending towards the left side sends forth no Artery from it until it arrive at the rib of the Chest where it produces the Subclavian Artery which is distributed after the manner following First it produces the Intercostal 1 Intercostalis and by it imparts life to the three intercostal muscles of the four upper ribs and to the neighbouring places Secondly It brings forth the Mammillary branch 2 Mammaria which is distributed as the Mammillary vein is Thirdly the Cervicalis 3 Cervicalis which ascends along the neck by the transverse productions to the Dura mater being distributed as the Vena Cervicalis is The Figure of the Arteries A The orifice of the great Artery or the beginning thereof where it issueth out of the Heart B Coronaria so called because like a Crown it compasseth the basis of the Heart C the division of the great Artery into two trunks V i. D the left Subclavian climbing obliquely upward unto the ribs E the upper Intercostol Artery or a branch which bestoweth four propagations unto the distances of the lower rib F the Neck-artery which through the transverse processes of the Rack-bones of the Neck attaineth to the Scull bestowing surcles unto the marrow and his neighbour muscles G the left Mammary Artery running under the Brest-bone and to the Navil It distributeth the surcles to the Mediastinum the muscles of the Brest and of the Abdomen H Muscula or a branch attaining to the backward muscles of the Neck I the Scapular-Arteries which go unto the hollowness of the blade and of the muscles that lie thereon K Humeraria which climbeth over the top of the shoulder L Thoracica superior sprinkled unto the forward muscles of the Chest M Thoracica inferior which passing along the sides of the Chest attaineth to the Broad muscles of the arm N the Axillary Artery running out into the Arm and affording branches unto the muscles thereof O a branch reaching to the outside of the cubit lying deep PP branches to the joint of the cubit with the arm Q the upper branch of the Artery running along the Radius und offering surcles to the thumb the fore-finger and the middle-finger R a surcle creeping unto the outside of the hand and led betwixt the first bone of the thumb and that of the after-wrist supporteth the forefinger where we use to feel the pulse S the lower branch of the artery running along the Ulna and communicating surcles to the little finger the ring-finger and the middle finger * A little branch unto the muscles about the little finger T the distribution of the upper and lower branches into the hand and the fingers V the trunk of the great Artery ascending to the Jugulum and the division thereof in that place into X Y Z. X the left Carotis or sleepy artery Y Subclavian dextra divided into branches as the right is divided Z Carotis dextra called also Apoplectica and Lethargica a the division of the left Carotis in the chops b the exteriour branch of that division going into the face the temples and behind the ears c the inner branch going to the throttle the chops and the tongue d the division hereof at the basis of the skull into two branches which enter the sinus of the Dura mater e a propagation of the branch b unto the muscles of the face f the distribution of the branch b under the root of the ear g the forebranch hereof creeping up the temples h the back-branch running on the back-side of the ear under the skin i the trunk of the great Artery descending unto the spondils of the back kkk the lower Intercostal arteries which go unto the distances of the eight lower ribs from which are offered surcles to the marrow and to the muscles that grow to the Back and to the Chest l the artery of the midriff called Phrenica or Diaphragmatica ζ Mesenterica Superior but you must note that above ζ the trunk of the Coeliacal artery is taken away lest the multitude of letters in so small a Table should breed obscurity η θ the right and left Emulgents running from the Aorta or great Artery unto the kidnies ιι κκ the spermatical arteries on either side going to the testicles λ the lower Mesenterical artery on the left below μ running especially into the Colick-gut on that side μμ the arteries called Lumbares which run overthwart and like knees affording surcles to the muscles that grow to the loins and to the Peritonaeum μ the lower Muscula superior running into the sides of the Abdomen and the muscles νν the bifurcation of the great artery into two Iliack trunks and at the sides but somewhat inward are branches which make those that are called Sacrae Τ the division of the left Iliack trunk into an inner branch at ξ and an utter at φ. ξ the inner Iliack branch ο Muscula inferior the utter propagation of the inner branch going unto the muscles which cover the branch-bone and the Coxendix Ï€ Hypogastrica the inner propagation of the inner branch going to the bladder the yard and the neck of the womb Ï the umbilical artery σ the remainder of the branch ξ assuming an addition from the utter branch neer φ and so falling through the hole of the share-bone into the leg Ï„ Epigastrica it ascendeth upward unto the right muscle of the Abdomen and about the navel is joyned with the mammary artery η Pudenda it creepeth overthwart the share-bone φ the Crural trunk without the Peritonaeum χ Muscula cruralis exterior going into the fore-muscles of the thigh ψ Muscula cruralis interior going unto the muscles of the inside of the thigh ω The conjunction of this artery with the branches Γ Poplitea going to the muscles on the back-side of the thigh ΔΔ which communicateth small branches to the joint of the knee and the muscles that make the calf of the leg Θ the division of the Crural artery under the ham into three branches Λ Tibiaea exterior it accompanieth the brace-bone and is consumed into the muscles Ξ the chief part of the crural artery Σ the upper and backer
Membranes Nerves and Tendons What we must consider in performing the cure wherefore they cannot indure acrid and biting medicines Having called to mind these indications the indication will be perfected by these three following intentions as if we consider the humor flowing down or which is ready to flow the conjunct matter that is the humor impact in the part the correction of accidents yet so that we alwayes have care of that which is most urgent and of the cause Therefore first repercussives must be applyed for the antecedent matter strong or weak having regard to the tumor as it is then only excepting six conditions of tumors What things disswade us from using repercussives the first is if the matter of the tumor be venenate the second if it be a critical abscess the third if the defluxion be neer the noble parts the fourth if the matter be gross tough and viscid the fifth when the matter lies far in that is flows by the veins which lies more deep the sixth when it lies in the Glandules But if the whole body be plethorick a convenient diet purging and Phlebotomy must be appointed frictions and bathes must be used Ill humors are amended by diet and purging If the weakness of the part receiving draw on a defluxion it must be strengthned If the part be inferior in its site let the patient be so seated or layed that the part receiving as much as may be may be the higher If pain be the cause of defluxion we must asswage it by things mitigating it If the thinness or lightness of the humor cause defluxion it must be inspissate by meats and medicines But for the matter contained in the part because it is against Nature it requires to be evacuate by resolving things as Cataplasms Ointments Fomentations Cupping-glasses or by evacuation as by scarifying or suppurating things as by ripening and opening the Impostume Lastly for the conjunct accidents as the Feaver pain and such like they must be mitigated by asswaging mollifying and relaxing medicines as I shall shew more at large hereafter CHAP. VI. Of the four principal and general Tumors and of other Impostumes which may be reduced to them THe principal and chief Tumors which the abundance of humors generate are four a Phlegmon What tumors may be reduced to a Phlegmon Which to an Eâ—â—sipelas Which to an Oedema Erysipelas Oedema and Scirrhus innumerable others may be reduced to these distinguished by divers names according to the various condition of the efficient cause and parts receiving Wherefore a Phygethlum Phyma Fellon Carbuncle Inflammation of the Eyes Squincy Bubo and lastly all sorts of hot and moist tumors may be reduced to a Phlegmon The Herpes miliaris the eating Herpes Ring-worms and Tetters and all Impostumes brought forth by choler are contained under an Erysipelas Atheromata Steatomata Melicerides the Testudo or Talpa Ganglion Knots Kings-Evils Wens watery Ruptures the Ascites and Lencophlegmatia may be reduced to an Oedema as also all flatulent tumors which the abundance of corrupt Phlegm produces Which to a Scirrhus In the kindred of the Scirrhus are reckoned a Cancer Leprosie Warts Corns a Thymus a Varix Morphew black and white and other Impostumes arising from a Melancholy humor Now we will treat of these Tumors in particular beginning with a Phlegmon CHAP. VII Of a Phlegmon What a true Phlegmon is A Phlegmon one thing and a Phlegmonous tumor another A Phlegmon is a general name for all Impostumes which the abundance of inflamed bloud produces That is called a true Phlegmon which is made of laudable bloud offending only in quantity But a bastard Phlegmon or a Phlegmonous Impostume hath some other and proper name as a Carbuncle Fellon Gangrene Sphacel and the like malign Pustuls So when there is a conflux of divers humors into one tumor divers kinds of Phlegmonous Impostumes called by divers names according to the more abundant humor arise as if a small portion of Phlegm shall be mixed with a greater quantity of bloud it shall be called an Oedematous Phlegmon but if on the contrary the quantity of phlegm be the greater it shall be named a phlegmonous Oedema and so of the rest always naming the tumor from that which is predominant in it Therefore we must observe that all differences of such tumors arise from that either because the bloud causing it offends only in quantity which if it do it causes that tumor which is properly called a Phlegmon if in quality it makes a Phlegmonous tumor because the matter thereof is much departed from the goodness of bloud But bloud is said to offend in quantity either by admixture of some other matter as Phlegm Choler or Melancholy from whence proceeds Oedematous Erysipelous and Scirrhous Phlegmons or by corruption of its proper substance from whence Carbuncles and all kinds of Gangrenes or by concretion and when Nature is disappointed of its attempted and hoped for suppuration either by default of the Air or Patient or by the error of the Physitian and hence oft-times happen Atherema's Steatoma's and Melicerides Although these things be set down by the Ancients of the simple and similar matter of the true Phlegmon yet you must know that in truth there is no Impostume whose matter exquisitely shews the Nature of one and that simple humor without all admixture of any other matter for all humors are mixed together with the bloud yet from the plenty of bloud predominating they are called Sanguine as if they were of bloud alone Wherefore if any tumors resemble the nature of one simple humor truly they are not of any natural humor but from some humor which is corrupt vitiated and offending in quality for so bloud by adustion degenerates into Choler and Melancholy Therefore a true Phlegmon is defined by Galen A tumor against Nature of laudable bloud Gal. lib. de tumoribâ—n c. ad Glauc Hippoc. lib. de vuln cap. Gal. lib. de tumor praeter naturam flowing into any part in too great a quantity This tumor though most commonly it be in the flesh yet sometimes it happens in the Bones as Hippocrates and Galen witness A Phlegmon is made and generated thus when bloud flows into any part in too great a quantity first the greater veins and arteries of the part affected are filled then the middle and lastly the smallest and capillary so from those thus distended the bloud sweats out of the pores and small passages like dew and with this the void spaces which are between the similar parts are first filled and then with the same bloud all the adjacent parts are filled but especially the flesh as that which is most fit to receive defluxions by reason of the spongious rarity of its substance but then the nerves tendons membranes and ligaments are likewise stuffed full whereupon a Tumor must necessarily follow by reason of the repletion which exceeds the bounds of Nature and from hence also are Tension and Resistance
disprove both by his writings as also by reason it self For he writes that the broad worm which he cals Taenia is as it were a certain Metamorphosis or transmutation of the inner tunicle of the smal guts into a quick living and movable body But no man ever said neither will he confess that the Dracunculi hath the material causes of their beginning from the Tunicle of the vein in which they are closed or from the fibers of a nervous body to which often they are adjoined but much less from the skin under which they lie may they draw the material causes of their original Moreover neither can there be any generation of worms nor of any other living creatures whatsoever who have their original from putrefaction unless by the Corruption of some matter of whose better and more benign part nature by the force of the vital heat produceth some animate Body 4 Meteorolog as Aristotle teacheth Wherefore to produce this effect it is fit the matter should have such a disposition to putrefaction as is required for the generation of such a creature as they would make the Dracunculus to be It is fit the helping causes should concur as assistants to the principals in the action And it is meet the place should be opportune or fit But there may be many causes found which may give life to the Dracunculi for by the common consent of all those who have written of them their generation proceeds from an humor melancholick Natural Melancholick humors is most unapt to putrefie Stink an unseparable companion to putrefaction terrestrial and gross which by its qualities both by the first coldness and dryness as also by the second that is Acidity is not only thought most unfit of all others for putrefaction but also is judged to resist putrefaction as that which is caused by heat and superfluous humidity Besides if the material cause of this disease should be from an humor putrefying and turning by putrefaction into some living Creature it was fit there should be stench also as being an unseparable accident of putrefaction for thus the excrements in the guts of which the worms are generated do smell or stink Therefore that which exhales from their bodies who are troubled with the Dracunculi should be stinking as it happens to those sick of the Pthiriasis or Lowsie-evill But none of those who have delivered the accidents or symptoms of the Dracunculi are found to have made mention hereof but of the efficient cause whereby so great heat may be raised in the places next under the skin by the efficacy whereof such a creature may be formed of a matter melancholick and most unapt to putrefie as they make the Dracunculus to be who fain our bodies to be fruitful monsters especially seeing the surface of the body is continually ventilated by the small Arteries spread under the skin as also by the benefit of insensible transpiration and breathed with the coolness of the air incompassing us But now the material and efficient causes being defective or certainly very weak for the generation of so laborious an effect what coadjutory cause can yield assistance Can the humidity of meats for those Bodies which are fed with warm and moist meats What things usually breed worms as Milk Cheese Summer fruits usually breed worms as we are taught by experience in children But on the contrary Avicen in the place before cited writeth that meats of a hot and dry temper chiefly breed this kind of disease and that it is not so frequent to moist bodies and such as are accustomed to the Bath moist meats and wine moderately taken But whether may the condition of the air of those regions in which it is as it were an Endemiall disease confer any thing to the generation of such creatures Certainly for this purpose in a cloudy warm and thick air such as useth to be at the beginning of the Spring when all the places resound with frogs toads and the like creatures breed of putrefaction But on the contrary Jacobus Dalechampius by the opinion of all the Physitians that have written of the Dracunculi Cap. 83. Chir Gallic writes that this disease breeds in the dry and Sun-burnt regions of India and Arabia but if at the least that part of our body which is next under the skin should have any opportunity to ingender and nourish such creatures they may be judged to have written that the Dracunculus is a living creature with some probability But if there be no opportunity for generation in that place nor capacity for the nourishment of such like creatures as in the guts if that region of the body be breathed upon with no warmness and smothering heat if it be defiled with none of those gross excrements as the guts usually are but only by the subtiller exhalation which have an easie and insensible transpiration by the pores of the skin which may seem to be a just cause of so monstrous and prodigious an effect but we shall little profit with these engines of reason unless we cast down at once all the Bulwarks with which this old opinion of the Dracunculi may stand and be defended For first they say Why have the ancients expressed this kind of disease by the name of a living thing that is of a Dracunculus or little Serpent I answer because in Physick names are often imposed upon diseases rather by similitude than from the truth of the thing for the confirmation whereof the examples of three diseases may suffice that of the Cancer Polypus and Elephas For these have those names not because any Crab Polypus or living Elephant may breed in the Body by such like Diseases but because this by its propagation into the adjacent parts represents the feet and claws of a Crab the other represents the flesh of the Sea-Polypus in its substance and the third because such as have the Leprosie have their skin wrinckled rough and horrid with scales and knots Why they are called Dracunculi as the skin of a living Elephant So truly this disease of which we now enquire seems by good right to have deserved the name Dracunculus because in its whole conformation colour quality and production into length and thickness it expresseth the image of a Serpent But Whence will they say if it be without life is that manifest motion in the matter We reply that the humor the cause of this disease is subtill and hot and so runs with violence into the part whence it may seem to move But when the Dracunculi are separated Why do they put their heads as it were out of their holes We answer in this the Ancients have been very much deceived because after the suppuration the ulcer being opened some nervous body being laid bare thrust forth and subjected it self to the sight which by the convulsive and shaking motion might express the crooked creeping of a Serpent But they will say Pain happens not unless to things indued
with sense and life but this Dracunculus when he is drawn too violently especially if he be broken thereby will cause extream pain We do answer that the conclusion doth not follow and is of no consequence for these pains happen not unless when the unprovident Surgion draws or puls in stead of the Dracunculus some nervous or membranous body swoln and repleat with an adust humor whence there cannot but be great pain that part being pull'd which is the author of sense But it is childish to say that the Dracunculus feels for that it causeth sharp pains to the living body in which it is Therefore that at last we may determin something of the nature essence and generation of these Dracunculi I dare boldly affirm It is nothing else but a tumor and abcess bred from the heat of the blood in a venerate kind Such blood driven by the expulsive faculty through the veins to the External parts especially the limits that is the Arms and Legs causeth a tumor round and long often stretched from the joynt of the shoulder even to the wrist or from the groin even to one of the Ankles with tension heat renitency pricking pain and a feaver But this tumor is some while stretched forth streight otherwhiles into oblique and crooked tumors which hath been the cause that many taken with this kind of disease and having their limbs so infolded as with the twinings of a Serpent would say they had a Serpent I have thus much to say of the Dracunculi especially of those of our own country For the cure it is not unlike to the cure of a Phlegmon arising from a Defluxion The Cure for here also in like manner the remedies must be varied according to the four times of the disease and the same rule of diet phlebotomy and purging must be observed which is before prescribed in the cure of a Phlegmon The mention of the Dracunculi cals to my memory another kind of Abscesse altogether as rare So the Malum pilate in Aristotle cap. 11. lib. 7. hist animal This our French men name Cridones I think á Crinibus i. from hayrs it chiefly troubles children and pricks their backs like thorns They toss up and down being not able to take any rest This disease ariseth from small hairs which are scarce of a pins length but those thick and strong It is cured with a fomentation of water more than warm after which you must presently apply an oyntment made of hony and wheaten flower for so these hairs lying under the skin are allured and drawn forth and being thus drawn they must be plucked out with small mullets I imagine this kind of disease was not known to the ancient Physitians The End of the Eighth Book The Ninth BOOK Of WOVNDS in General CHAP. I. What a wound is what the kinds and differences thereof are and from whence they may be drawn or derived A Wound is a solution of Continuity caused by a stroak fall or bite newly done What a wound properly is bloody and with putrefaction and filth They also call it a new simple Ulcer for the solution of continuity happens to all parts of the body but according to the diversity of parts it hath divers names amongst the Greeks For in the flesh it is called Helcos in the bone Catagma in the nerve Spasma in the ligament Thalasma in the vessels Apospasma in the Muscles Regma and that solution of continuity Divers appellations of wounds according to the varieties of the parts which happens in the vessels their mouths being open is termed Anastomosis that which happens by erosion Aneurosis that which is generated by sweating out and transcolation Diapedesis That these may be the more easily understood I have thought good to describe them in the following table A Table of the Differences of Wounds The differences of Wounds are drawn or taken From the nature of the parts in which they are made or happen But these parts are Either similar and these Either soft as the Glandules Flesh Fat Marrow Or hard as A Bone A Gristle Or of a midle consistence as the Membranes Ligaments Fibers Vessels Nerves Veins Arteries Or Organical and these either Principal as the Brain Heart Liver to which some add the Womb and Testicles Or serving the principal as The Weason Lungs Gullet Stomach Guts Bladder Or neither as The Ears Nose Feet Hands and other of the same kind From their proper essence from whence they are called Simple wounds When there is no complication of any other disease or symptom besides Or compound When there is a complication of some one or more diseases which unless they be taken away we must not hope for to cure the wound From their quantity according to which they are called Great Indifferent Little Long broad Deep Short Narrow Superficiary From their figure according to which they are named Streight Oblique Cornered CHAP. II. Of the Causes of Wounds Divers denominations from their causes ALl things which may outwardly assail the body with force and violence may be counted the causes of wounds which are called green and properly bloudy These things are either animate or inanimate The animate as the bitings and prickings of Beasts The Inanimate as the stroak of an Arrow Sword Club Gun Stone a Dagger and all such like things From the variety of such like causes they have divers names for those which are made by sharp and pricking things are called punctures those caused by cutting things are called wounds or gashes and those which are made by heavy and obtuse things are named Contusions or wounds with contusions CHAP. III. Of the Signs of Wounds WOunds are first known by sight and by the signs drawn from thence A caution for making reports of Wounds The Chirurgeon ought first and chiefly to consider what Wounds are curable and what not what wounds will scarse admit of cure and what may be easily cured for it is not the part of a prudent Chirurgeon to promise cure in a deadly or dangerous and difficult wound lest he may seem to have killed him whom not the unsufficiency of the Art but the greatness of the wound hath slain But when the wound is dangerous but yet without despair of recovery it belongs to him to admonish the Patient's friends which are by of the present danger and doubtful state of the wound that if Art shall be overcome by the greatness thereof he shall not be thought ignorant of the Art neither to have deceived them But as this is the part and duty of a good and prudent Chirurgeon A Jugling cheating Chirurgeon so it is the trick of a cheating and jugling Knave to enlarge small wounds that so he may seem to have done a great cure when it is nothing so But it is agreeable to reason that the Chirurgeon professing the disease easie to be cured will think himself in credit bound by such promises and his duty and therefore seek