Spirits Therefore now wee must speake of the Spirits CHAP. X. Of the Spirits THe spirit is a subtile and Aery substance 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 approch doe 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 Animall another Vitall another Naturall The Animall hath taken his seate in the braine for there it is prepared and made that from thence conveyed by the Nerves is may impart the power of sence and Motion to all the rest of the members An argument heereof 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 stiffe the hands numme and all the other parts are dull destitute of their accustomed a gillity of motion and quicknesse of sense It is called Animall not because it is the Life but the cheife and prime instrument thereof wherfore it hath a most subtile and Aery substance and enjoyes divers names according to the various condition of the Sensoryes or seates 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 eyes as sparkling like fire That which is conveyed to the Auditorie 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 Animall spirit is made and laboured in the windings and foldings of the veines and Arteryes of the braine of an exquisite subtile portion of the vitall brought thither by the Carotidae Arteriae or sleepy Arteryes and sometimes also of the pure aire or sweete vapour drawne in by the Nose in breathing Hence it is that with Ligatures we stoppe the passage of this spirit from the parts we intend to cut off An Humor which obstructs or stopps its passage doth the like in Apoplexies and Palsies whereby it happens that the members scituate under that place doe languish and seeme dead sometimes destitute of motion sometimes wanting both sence and motion The Vitall spirit is next to it in dignitie and excellency which hath its cheife mansion in the left ventricle of the Heart from whence through the Channells of the Arteryes it flowes into the whole body to nourish the heate which resides fixed in the substance of each part which would perish in short time unlesse it should be refreshed by heat flowing thither together with the spirit And because it is the most subtile next to the Animall Nature lest it should vanish away would have it conteined in the Nervous coat of an Artery which is five time more thicke than the Coate of the veines as Galen out of Herophilus hath recorded It is furnished with matter from the subtile exhalation of the blood and that aire which we draw in breathing Wherefore it doth easily and quickly perish by immoderate dissipations of the spirituous substance and great evacuations so it is easily corrupted by the putrifaction of Humors or breathing in of pestilent aire and filthy vapours which thing is the cause of the so suddaine death of those which are infected with the Plague This spirit is often hindred from entring into some part by reason of obstruction fulnesse or great inflammations whereby it followes that in a short space by reason of the decay of the fixed and inbred heat the parts doe easily fall into a Gangrene and become mortified The Naturall spirit if such there be any hath its station in the Liver and Veines It is more grosse and dull than the other and inferior to them in the dignitie of the Action and the excellencie of the use The use thereof is to helpe the concoction both of the whole body as also of each severall part and to carry blood and heate to them Besides those already mentioned there are other spirits fixed and implanted in the simular and prime parts of the body which also are naturall and Natives of the same place in which they are seated and placed And because they are also of an Aery and fiery nature they are so joyned or rather united to the Native heate that they can no more be separated from it than flame from heate wherefore they with these that flow to them are the principall Instruments of the Actions which are performed in each severall part And these fixed spirits have their nourishment and maintenance from the radicall and first-bred moisture which is of an Aery and oyly substance and is as it were the foundation of these Spirits and the inbred heat Therefore without this moisture no man can live a moment But also the Cheife Instruments of life are these Spirits together with the native heate Wherefore this radicall Moisture being dissipated and wasted which is the seate fodder and nourishment of the Spirits and heate how can they any longer subsist and remaine Therefore the consumption of the naturall heate followeth the decay of this sweet and substance-making moisture and consequently death which happens by the dissipating and resolving of naturall heate But since then these kinde of Spirits with the naturall heate is conteined in the substance of each simular part of our body for otherwise it could not persist it must necessarily follow that there be as many kinds of fixed Spirits as of simular parts For because each part hath its proper temper and encrease it hath also its proper spirit and also it s owne proper fixed and implanted heat which heere hath its abode as well as its Originall Wherefore the spirit and heate which is seated in the bone is different from that which is impact into the substance of a Nerve Veine or such other simular part because the temper of these parts is different as also the mixture of the Elements from which they first arose and sprung up Neither is this contemplation of spirits of small account for in these consist all the force and efficacy of our Nature These being by any chance dissipated or wasted wee languish neither is any health to be hoped for the floure of life withering and decaying by litle and litle Which thing ought to make us more diligent to defend them against the continuall effluxe of the threefold substance For if they be decayed there is left no proper Indication of curing the disease so that we are often constrained all other care laid aside to betake our selves to the restoring and repayring the decayed powers Which is done by meats of good juyce easie to be concocted and distributed good Wines and fragrant smells
are extended all together as it were with an unanimous consent the whole member is wrinkled as contracted into it selfe as on the contrary it is extended when they are relaxed Some of these are bestowed upon the animall parts to performe voluntary motions others upon the vitall to performe the agitation of the Heart and Arteries others upon the naturall for attraction retention and expulsion Yet we must observe that the attraction of no simular part is performed by the helpe of the foresaid fibers or threds but rather by the heat implanted in them or by the shunning of Emptinesse or the familiarity of the substance The flesh also is a simple and soft part composed of the purer portion of the blood insinuating it selfe into the spaces betweene the fibers so to invest them for the uses formerly mentioned This is as it were a certaine wall and Bulwarke against the injuries of heat and cold against all falls and bruises as it were a certaine soft pillow or cushion yeelding 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 kinde is more pallid even in perfect creatures having blood such is the flesh of the heart stomacke weasond guts bladder wombe The third is belonging to the entrails or the proper substance of each entrail as that which remaines of the Liver the veines arteries and coate being taken away of the bladder of the Gall braine kidneys milt Some adde a fourth sort of flesh which is spongy and that they say is proper to the tongue alone A veine is the vessel pipe or channel of the blood or bloody matter it hath a spermaticke substance consists of one coate composed of 3 sorts of fibers An Artery is also the receptacle of blood but that spirituous and yellowish consisting in like manner of a spermaticke 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 thicke and dense than the utmost interwoven with transverse fibers and it doth not onely conteine blood and spirit but also a serous humor which wee may beleeve because there bee two emulgent Arteryes aswell as veines But the inner coat of an Artery is therefore more thick because it may containe blood which is more hot subtle and spirituous for the spirit seeing it is naturally more thin and light and in perpetuall motion would quickly flye away unlesse it were held in a stronger hold There is other reason for a veine as that which containes blood grosse ponderous and slow of motion Wherefore if it had acquired a dense and grosse coate it could scarse bee distributed to the neighbouring parts God the maker of the universe foreseeing this made the coats of the vessels contrary to the consistance of the bodyes contained in them The Anastomosis of the veines and Arteryes that is to say the application of the mouthes of the one to the other is very remarkeable by benefit of which they mutually communicate and draw the matters contained in them and so also transfuse them by insensible passages although that anastomosis is apparent in the veine and artery that meet together at the Ioint and bending of the Arme which I haue sometimes shewed in the Physicke schooles at such time as I there dissected Anatomyes But the action or function of a muscle is either to move or confirme the parte according to our will into which it is implanted which it doth when it drawes it selfe towards its originall that is to say it 's head But wee define the head by the insertion of the nerve which wee understand by the manner of the working of the Muscle CHAP. XI Of the Muscles of the Epigastrium or lower belly NOw seeing that wee haue 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 remaines that wee come to the particular explication of each Muscle begining with those of the lower belly as those which we first meet withall in dissection These are 8 in number 4 oblique 2 on each side two right or direct one on the right another on the left side and in like manner 2 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 adde to this number the 2 little Supplying or Assisting muscles which are of a Pyramidal forme and arise from the share-bone above the insertion of the right muscles Of the oblique muscles of each side the one ascends the other descends whereupon it comes to passe that they are called the Oblique descendant and Ascendant Muscles Those oblique which wee first meet with are the descendant whose substance is partly sanguine partly spermaticke for they are fleshy nervous ligamentous veinous arterious and membranous Yet the fle shy portion is predominant in them out of which respect Hippocrates is wont to expresse the muscles by the name of fleshes their greatnes is indifferent betweene the large and the small muscles their figure 3 square They are composed of the fore-mentioned parts they are two in number their site is oblique taking their beginning from the touching of the great saw Muscle and from the sixt and seventh true ribbes or rather from the spaces between the sixe lower ribbes and rather on the forepart of the muscles than of the ribbes themselues from whence shunning the Veriebra's of the loines the fleshy parts of them are terminated in the externall and upper eminency of the Haunch-bone and the Membranous end in the lower eminency of the share-bone and the White-line Yet Columbus dissenting from this common description of the oblique Muscles thinks that they are onely terminated in the White line and not in the share-bone For saith he wherefore should they be inserted into the share-bone which is not moved But because it would bee an infinite labour and trouble to set downe at large the severall opinions of all Authors of Anatomy I haue thought it sufficient for me to touch them lightly by the way Their connexion is with the oblique ascendant lying vnder them and with the direct or right Their temperament is twofold the one hot and moist by reason of the belly and the fleshy portion of them the other cold dry in respect of their ligamentous and tendinous portion Their action is to draw the parts into which they are inserted towards their originall or els to unite them firmely Yet each of these
the entrance of the hollow veine into the heart the lesse at the entrance of the veinous and of the great Artery with which parts they both have connexion We have formerly declared what use they have that is to break the violence of the matters and besides to bee stayes or props to the Arteria venosa and great Arterye which could not sustaine so rapid and violent a motion as that of the Heart by reason of their tendernesse of substance Of the ventricles of the Heart THe ventricles are in number two on each side one distinguished with a fleshy partition strong enough having many holes in the superficies yet no where pearcing through The right of these ventricles is the bigger and incompassed with the softer and rarer flesh the left is the lesser but is engirt with a threefold more dense and compact flesh for the right ventricle was made for a place to receive the blood brought by the hollow veine and for distributing of it partly by the vena arteriosa into the Lungs for their nourishment partly into the left ventricle by sweating through the wall or partition to yeild matter for the generation of the vitall spirits Therefore because it was needfull there should be so great a quantity of this blood it was likewise fit that there should be a place proportionable to receive that matter And because the blood which was to bee received in the right ventricle was more thicke it was not so needfull that the flesh to containe it should be so compact but on the contrary the arterious blood and vitall spirit have need of a more dense receptacle for feare of wasting and lest they should vanish into aire and also lesse roome that so the heat being united might become the stronger and more powerfully set upon the elaboration of the blood and spirits Therefore the right ventricle of the heart is made for the preparation of the blood appointed for the nourishment of the Lungs and the generation of the vitall spirits as the lungs are made for the mitification or quallifying of the Aire Which works were necessary if the Physicall Axiome bee true That like is nourished by like as the rare and spongious lungs with more subtle blood the substance of the heart grosse and dense with the veinous blood as it flowes from the Liver that is grosse And it hath its Cororall veines from the Hollow veine that it might thence drawe as much as should be sufficient But the left ventricle is for the perfecting of the vitall spirit and the preservation of the native heat Of the Orifices and Valves of the Heart THere be foure Orifices of the heart two in the right as many in the left ventricle the greater of the two former gives passage to the veine or the blood carried by the hollow veine to the heart the lesser opens a passage to the vena arteriosa or the cholerick blood carryed in it for the nourishment of the lungs The larger of the two other makes a way for the distribution of the Artery Aorta and the vitall spirit through all the body but the lesser gives egresse and regresse to the Arteria venosa or to the aire and fuliginous vapours And because it was convenient that the matters should bee admitted into their proper ventricles by these orifices by the Diastole to wit into the right ventricle by the greater orifice and into the left by the lesser and because on the contrary it was fit that the matters should be expelled by the systole from their ventricles by the fore-mentioned orifices Therefore nature to all these orifices hath put cleaven valves that is to say sixe in the right ventricle that there might bee three to each orifice five in the left that the greater orifice might have three and the lesser two for the reason we will presently give These valves differ many wayes first in action for some of them carry in matter to the heart others hinder that which is gone out that it come not back againe Secondly they differ in site for those which bring in have membranes without looking in those which carry out have them within looking out Thirdly in figures for those which carry in have a pyramidall figure but those which hinder the comming back againe are made in the shape of the Roman letter C. Fourthly in substance for the former for the most part are fleshy or woven with fleshy fibers into certaine fleshy knots ending towards the point of the heart The latter are wholy membranous Fiftly they differ in number for therebe only five which bring in three in the right ventricle at the greater orifice and two in the left at the lesser orifice those which prohibite the comming back are sixe in each ventricle three at each orifice Lastly they differ in motion for the fleshy ones are opened in the Diastole for the bringing in of blood and spirit and contrary wise are shut in the systole that they may containe all or the greater part of that they brought in The membranous on the contrary are opened in the systole to give passage forth to the blood and spirits over all the body but shut in the Diastole that that which is excluded might not flow backe into the Heart But you shall observe that nature hath placed onely two valves at the Orifice of the Arteria Venosa because it was needfull that this Orifice should bee alwayes open either wholy or certainely a third parte thereof that the Aire might continually be drawne into the heart by this orifice in inspiration and sent forth by exspiration in the contraction of the heart Whereby we may gather this that there is but one third part of that Aire we draw into the heart in breathing sent forth againe in the forme of vapour in exspiration because nature would have but one third part of the orifice to ly open for its passage out Therefore the exspiration or breathing out and the systole of the heart and arteryes is shorter than the inspiration so that we may truely say that the inspiration or drawing the breath in is equally so long as the exspiration is together with the rest which is in the middest between the two motions CHAP. XII Of the Distribution of the Vena arteriosa and the Arteria venosa HAving hitherto shewed the originall of each of the vessels of the Heart we must now speake of their distribution The Vena arteriosa or the arterious veine and the arteria venosa or the veinous arterie each proceeding out of his proper ventricle that is the right and left are divided into two large branches one of which goes to the right and the other to the left hand the one lying crosse wayes over the other the veine alwaies riding over the arterye as you may understand better by the sight of your eyes than by reading of bookes These branches at their
and condition of the matter which flowes downe and generates the tumor also they are knowne by such accidents as happen to them as colour heat hardnesse softnesse paine tension resistance Wherefore paine heate rednesse and tension indicate a sanguine humor coldnesse softnesse and no great paine phlegme tension hardnesse the livide colour of the part and a pricking paine by fits melancholy and yellowish and pale colour biting paine without hardnesse of the part choler And besides Impostumes have their periods and exacerbations following the nature and motion of the humors of which they are generated Wherefore by the motion and fits it will be no difficult matter to know the kinde of the humor for as in the Spring so in the morning the bloud is in motion as in the Summer so in the middest of the day choler as in Autumne so in the evening melancholy as in Winter so on the night the exacerbations of phlegme are most predominante For Hippocrates and Galen teach that the yeare hath circuits of diseases so that the same proportion of the excesse and motion of humors which is in the foure seasons of the yeare is also in the foure quarters of each day Impostumes which are curable have foure times their beginning increase state and declination and we must alter our medicines according to the varietie of these times We know the beginning by the first swelling of the part The increase when the swelling paine and other accidents do manifestly encrease and enlarge themselves the state when the foresaid symptoms increase no more but each of them because at their height remaine in their state immoveable unlesse the very matter of the tumor degenerate and change it selfe into another kinde of humor The declination when the swelling paine feaver restlesnesse are lessened And from hence the Chirurgion may presage what the end of the tumor may be for tumors are commonly terminated foure manner of wayes if so be that the motion of the humors causing them be not intercepted or they without some manifest cause doe flow backe into the body Therefore first they are terminated by insensible transpiration or resolution secondly by suppuration when the matter is digested and ripened thirdly by induration when it degenerates into a Scyrrhus 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 the violence or the abundance or quality of the humor or both it comes to that distemper that it looses its proper action It is best to terminate a tumor by resolution and the worst by corruption suppuration and induration are betweene both although that is far better than this The signes by which the Chirurgions may presage that an Impostume may be terminated by resolving are the remission or flacking of the swelling paine pulsation tension heat and all other accidents and the unaccustomed livelinesse and itching of the part and hot Impostumes are commonly thus terminated because the hot humor is easily resolved by reason of its subtilty Signes of suppuration are the intension or encrease of paine heat swelling pulsation and the feaver for according to Hippocrates paine and the feaver are greater when the matter is suppurating then whan it is suppurated The Chirurgion 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 thicknesse of the part lying above or over it The signes of an Impostume degenerating into a Scyrrhus hardnesse are the diminution of the tumor and hardnesse remaining in the part The causes of the hardnesse not going away with the swelling are the weakenesse of nature the grosnesse and toughnesse of the humor and unskilfulnesse of the Chirurgion who by too long using resolving things hath occasioned that the more subtile part of the humor being dissolved the rest of the grosser nature like earthy dreggs remaines concrete in the part For so potters vessels dried in the Sunne grow hard But the unskilfull Chirurgion may occasion a Scyrrhous hardnesse by another meanes as by condensating the skinne and incrassating the humors by too much use of repercussives But you may perceive an Impostume to degenerate into a Gangrene thus if the accidents of heat rednesse pulsation and tension shall be more intense than they are wont to be in suppuration if the paine presently cease without any manifest cause if the part waxe livide or blacke and lastly if it stinke But we shall treate of this more at large when we come to treate of the Gangrene and Sphacelus A sodaine diminution of the tumor and that without manifest cause is a signe of the matter fallen backe and turned into the body againe which may be occasioned by the immoderate use of refrigerating thinge And sometimes much flatulencie mixed with the matter although there be no fault in those things which were applied Feavers and many other maligne Symptomes as swoundings and convulsion by translation of the matter to the noble parts follow this flowing backe of the humor into the body CHAP. IIII. Of the Prognosticks in Impostumes TVmors arising from a melancholy phlegmaticke grosse tough or viscors humor aske 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 naturall than those which are of humors yet contained in the bounds of nature For those humors which are rebellious offend rather in qualitie than in quantitie and undergoe the divers formes of things dissenting from nature which are joyned by no similitude or affinitie with things naturall as suet poultis hony the dregs of oile and wine yea and of solid bodies as stone sand coale strawes and sometimes of living things as Wormes Serpents and the like monsters The tumors which possesse the inner parts and noble entrailes are more dangerous and deadly as also those which are in the joints or neere to them And these tumors which seaze upon great vessels as veines arteries and nerves for feare of great effusion of bloud wasting of the spirits and convulsion So impostumes of a monstrous bignesse are often deadly by reason of the great resolution of the spirits caused by their opening Those which degenerate into a Scyrrhus are of long continuance and hard to cure as also those which are in hydropicke leprous scabby and corrupt bodies for they often turne into maligne and ill conditioned vulcers CHAP. V. Of the generall cure of Tumors against Nature THere be three things to be observed in cure of impostumes 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 drawne from the essence that is from the greatnesse or smallnesse of the tumor varies the manner of curing for the medicines must
happen without the fault of any bowells and to such a patlent as will be governed by the Physition in his Diet infer no greater harme but free him from more grievous and long diseases as Melancholy the Falling sicknesse Convulsions Madnesse because the Melancholy humor the author of such diseases is expelled every fourth day by the force of the fit of the Quartaine A Quartane Feaver if there be no error committed commonly exceeds not a yeare for otherwise some Quartanes have beene found to last to the twelfth yeare according to the opinion of Auicen the Quartane beginning in Autumne is oft times ended in the following spring the Quartane which is caused by adust blood or choler or Salt flegme is more easily and sooner cured than that which proceeds from an adust Melancholy humor because the Melancholy humor terrestriall of its owne nature and harder to be discussed than any other humor is againe made by adustion the subtiller parts being dissolved and the grosser subsiding more stubborne grosse maligne and acride The cure is wholy absolved by two meanes that is by Diet and medicines The Diet ought to be prescribed contrary to the cause of the Feaver in the use of the sixe things not naturall as much as lyes in our power Wherfore the Patient shall eschew Swines flesh flatulent viscide and glutinous meats fenny fowles salt meats and Venison and all things of hard digestion The use of white wine indifferent hot and thin is convenient to attenuate and incide the grosse humor and to move urine and sweat yea verily at the beginning of the fit a draught of such wine will cause vomiting which is athing of so great moment that by this one remedy many have been cured Yet if we may take occasion and opportunity to provoke vomit there is no time thought fitter for that purpose than presently after meate for then it is the sooner provoked the sibers of the Stomach being humected relaxed and the stomach is sooner turned to vomiting whereupon followes a more plentifull happy and casie evacuation of the Flegmatique and Cholericke humor and lesse trouble some to nature and of all the crudities with which the mouth of the ventricle abounds in a Quartaine by reason of the more copious afflux of the Melancholike humor which by his qualities cold and dry disturbes all the actions and naturall faculties Moreouer exercises and frictions are good before meat such passions of the minde as are contrary to the cause from which this Feaver takes his originall are fit to be cherished by the patient as Laughter Ieasting Musique and all such like things full of pleasure and mirth At the beginning the patient must be gently handled and delt withall and we must abstaine from all very strong medicines untill such time as the disease hath beene of some continuance For this humor contumacious at the beginning when as yet nature hath attempted nothing is againe made more stubborne terrestriall and dry by the almost fiery heat of acride medicines If the body abound with bloud some part thereof must be taken away by opening the Median or Basilick veine of the left arme with this caution that if it appeare more grosse and blacke we suffer it to flow more plentifully if more thin and tinctured with a laudable red Colour that we presently stay it The matter of this Feaver must be ripened concocted and diminished with the Syrrupes of Epithymum of Scolopendrium of Mayden hayre Agrimony with the waters of Hopps Buglosse Borage and the like I sincerely protest next unto God I have cured very many quartaines by giving a potion of a little Treakle dissolved in about some two ounces of Aqua vita also sometimes by two or three graines of muske dissolued in Muskadine given at the beginning of a particular fitt towards the generall declination of the disease after generall purgations the humor and body being prepared and the powers strong And certainly an inveterate Quartaine can scarce ever be discussed unlesse the body be much heated with meates and medicines Therefore it is not altogether to be disproved which many say that they have driven away a quartaine by taking a draught of wine every day as soone as they came forth of their bed in which some leaves of Sage had bin infused all the night Also it is good a little before the fit to anoint all the spine of the backe with oyles heating all the nervous parts such as are the oyle of Rue Wallnuts of the Peppers mixing therewith a little Aqua vitae but for this purpose the oyle of Castoreum which hath beene boyled in an apple of Coloquiâ—tida the Kernells taken out uppon hot coles to the consumption of the halfe part mixing therewith some little quantity of the powders of Pepper Pelitory of Spaine and Euphorbium is excellent Certainly such like Inunctions are good not onely to mitigate the vehemency of the terrible shaking but also to provoke sweats for because by their humid heat they discusse this humor being dull and rebellious to the expulsive facultie for the Melancholy is as it were the drosse and mudde of the bloud Therefore if on the contrary the Quartaine feaver shall be caused by adust choler we must hope for and expect a cure by refrigerating and humective medicines such as are Sorrell Lettuce Purflane brothes of the decoction of Cowcumbers Gourds Mellons and Pompions For in this case if any use hot medicines he shall make this humor most obstinate by the resolving of the subtiller parts Thus Trallianus boasts that hee hath cured these kinds of Quartane Feaver by the onely use of refrigerating Epithemaes being often repeated a little before the beginning of the fit And this is the summe of the Cure of true and legitimate intermitting Feavers That is of those which are caused by one simple humor whereby the Cure of those which they call bastard intermitting Feavers may be easily gathered and understood as which are bred by a humor impure and not of one kinde but mixt or composed by admixture of some other matter for example according to the mixture of diverse humors Flegmatique and cholericke the medicines must also be mixt as if it were a confused kinde of Feaver of a Quotidian and tertian it must be cured by a medicine composed of things evacuating flegme and choler CHAP. XXXII Of an Aneurisma that is the dilatation or springing of an Artery veine or Sinnew AN Aneurisma is a soft tumor yeelding to the touch made by the bloud and spirit powred forth under the flesh and Muscles by the dilatation or relaxation of an Artery Yet the author of the definitions seemes to call any dilatation of any venous vessell by the name of an Aneurisma Galen calls an Aneurisma an opening made of the Anastomasis of an Artery Also an Aneurisma is made when an Artery that is wounded closeth too slowly the substance which is above it being in the meane time agglutinated filled with
their figures that you may use either as occasion shall serve The Figure of Pipes with fenestels in them and Needles fit for Sutures The second Suture is made just after the same manner as the Skinners sowe their â—els or forrs And the guts must be sowed with this kind of Suture if they shall be at any time wounded that the excrements come not forth by the wound The third Suture is made by one or more needles having threed in them thrust through the wound the threed being wrapped to and againe at the head and the point of the needle as boyes use to fasten their needle for feare of losing it in their caps or clothes This kind of Suture is fit in the curing and healing of Hare-lips as we shall shew you hereafter expressed by a Figure The fourth kind of Suture is tearmed Gastroraphia invented for the restoring and uniting the great Muscles of the Epigastrium or lower belly cut with a great wound together with the Peritonaeum lying under them The manner whereof we will shew in due place The fifth kind is called the Dry Suture which we use onely in the wounds of the face which also we will describe in its proper place CHAP. VII Of the Flux of blood which usually happens in wounds OFt times great bleeding followes upon wounds by reason of some vessell cut broken or torne which there is neede to heale and helpe diligently because the blood is the treasure of nature without which life cannot consist The Blood which floweth from an Artery is thus knowne It is more subtile it runs forth as it were leaping by reason of the vitall spirit contained together with it in the Arteries On the contrary that which floweth from a Veine is more grosse blacke and slow Now there are many wayes of stenching blood The first and most usuall is that by which the lips of the wound are closed and unlesse it be somewhat deepe are contained by Medicines which have an astringent cooling drying and glutinous faculty As terrae sigill Boli Armeni ana â„¥ ss thuris Mastichis Myr hae Aloes ana Ê’ ij Farinae volat molend â„¥ j. Fiat pulvis qui albumine ovi excipiatur r Or â„ž Thuris Aloes ana partes aequales Let them bee mixt with the white of an Egge and the downe of a hare and let the pledgets bee dipped in these Medicines as well those which are put unto the wound as those which are applied about it Then let the wound be bound up with a double clop and fit Ligature and the part bee so seated as may seeme the least troublesome and most free from paine But if the blood cannot be stayed by this meanes when you have taken off all that covereth it you shall presse the wound and the orifice of the Vessell with your thumbe so long untill the blood shall bee concrete about it into so thick a clott as may stop the passage But if it cannot be thus staied then the Suture if any be must be opened and the mouth of the Vessell towards the originall or roote must bee taken hold of and bound with your needle and threed with as great a portion of the flesh as the condition of the part will permit For thus I have staid great bleedings even in the amputation of members as I shall shew in fit place To performe this worke wee are often forced to divide the skin which covereth the wounded Vessell For if the Iugular veine or Artery be cut it will contract and withdraw it selfe upwards and down-wards Then the skinne it selfe must bee laid open under which it lieth and thrusting a needle and threed under it it must be bound as I have offen done But before you loose the knot it is fit the flesh be growne up that it may stop the mouth of the Vessell least it should then bleed But if the condition of the part shall be such as may forbid this comprehension and binding of the Vessell we must come to Escharoticks such as are the powder of burnt Vitriol the powder of Mercury with a small quantity of burnt Allume and Cawsticks which cause an Escar The falling away of which must be left to Nature and not procured by art least it should fall away before that the orifice of the Vessel shall be stopt with the flesh or clotted blood But some times it happens that the Chirurgion is forced wholly to cut off the vessell it selfe that thus the ends of the cut vessell withdrawing themselves and shrincking upwards and downewards being hidden by the quantity of the adjacent and incompassing parts the fluxe of blood which was before not to bee staid may bee stopped with lesse labour Yet this is an extreame remedy and not to bee used unlesse you have in vaine attempted the former CHAP. VIII Of the paine which happens upon wounds THe paines which followes upon wounds ought to be quickly aswaged because nothing so quickly dejects the powers and it alwayes causes a defluxion of how good soever a habite and temper the body be of for Nature ready to yeeld assistance to the wounded part alwayes sends more humours to it than are needfull for the nourishment thereof whereby it comes to passe that the defluxion is easily encreased either by the quantity or quality or by both Therefore to take away this paine the author of defluxion let such Medicines bee applyed to the part as have a repelling and mitigating faculty as â„ž Olei Myrtini Rosarum ana â„¥ ij Cerae alb â„¥ j. Farinae hordei â„¥ ss Boli armeni terra sigillat ana Ê’ vj. Melt the Waxe in the Oyles then incorporate all the rest and according to Art make a Medicine to be applyed about the part or â„ž Emplast Diacalcith â„¥ iv Ole Rosar aceti ana â„¥ ss liquefiant simul and let a Medicine be made for the fore mentioned use Irrigations of oyle of Roses and Mirtiles with the white of an Egge or a whole Egge added thereto may serve for lenitives if there be no great inflammation Rowlers and double cloathes moistened in Oxycrate will be also convenient for the same purpose But the force of such Medicines must be often renewed for when they are dryed they augment the paine But if the paine yeld not to these we must come to narcoticke Medicines such as are the Oyle of Poppy of Mandrake a Caraplasme of Henbane and Sorrell adding thereto Mallowes and Marsh-mallows of which we spoke formerly in treating of a Phlegmon Lastly we must give heed to the cause of the paine to the kind and nature of the humour that flowes down and to the way which Nature affects for according to the variety of these things the Medicines must be varied as if heat cause paine it will be aswaged by application of cooling things and the like reason observed in the contrary if Nature intend suppuration you must helpe forwards
name of the villaine the author of this fact so that hee was taken and fastened to the wheele and having his limbes broken lost his wretched life for the life of the innocent wounded man who dyed the fourth day after he was hurt The like hurt befell a certaine Germane who laye at the house of one Perots in the streete of Nuts hebeing franticke in the night cut his throate with a sword I being called in the morning by his friends who went to see him drest him just after the same manner as I dressed the Englishman Wherefore he presently recovering his speech which before could not utter one sillable freed from suspition of the caime and prison the servant who lying in the same chamber with him was upon suspition committed to prison and confessing the thing as it was done living foure dayes after the wound being nourished with broathes put into his fundament like clysters and with the gratefull vapour of comfortable things as bread newly drawne out of the Oven and soked in strong wine Having thus by the Art of Chirurgery made the dumbe speake for the space of foure dayes CHAP. XXX Of the Wounds of the Chest SOme wounds of the Chest are on the fore side some behinde somepenetiatc more deepe others enter not into the capacity thereof other some peirce even to the parts contained therein as the Mediastinum Lungs heart midriffe hollow veine and ascendent artery Other some pasle quite through the body whereby it happens that some are deadly some not You shall thus know that the wound penetrates into the capacity of the Chest if that when the patients mouth and nose be shut the breath or winde breakes through the wound with noyse so that it may dissipate or blow out a lighted candle being held necre it If the patient can scarse either draw or put forth his breath which also is a signe that there is some blood fallen downe upon the Diaphragma By these signes you may know that the heart is wounded If agreat quantity of blood gush out if a trembling possesse all the members of the body if the pulse bee little and faint if the colour become pale if a cold sweate and frequent sowning assayle him and the extreame parts become cold then death 's at hand Yet when I was at Turin I saw a certaine Gentleman who fighting a Duell with another received a wound under his left brest which pierced into the substance of his heart yet for all that he strucke some blowes afterwards and followed his flying Enemie some two hundred paces untill hee fell downe dead upon the ground having opened his body I found a wound in the substance of the heart so large as would containe ones finger there was onely much blood poured forth upon the midriffe These are the signes that the Lungs are wounded for the blood comes soamie or frothy out of the wounds the patient is troubled with a cough hee is also troubled with a great difficulty of breathing and a paine in his side which hee formerly had not he lyes most at ease when he lyes upon the wound and sometimes it comes so to passe that lying so he speakes more freely and easily but turned on the contrary side he presently cannot speake When the Diphragma or midriffe is wounded the party affected is troubled with a weight or heavinesse in that place hee is taken with a Delirium or raving by reason of the sympathy of the Nerves of the sixth conjugation which are spread over the midriffe difficulty of breathing a cough and sharpe paine trouble the patient the Guts are drawne upwards so that it sometimes happens by the vehemency of breathing that the stomacke and gutts are drawne through the wound in to the capacity of the Chest which thing I observed in two The on of these was a Maison who was thrust though the midst of the midriffe where it is Nervous and dyed the third day following I opening his lower belly and no finding his stomacke thought it a monstrous thing but at length searching diligently I found it was drawne into the Chest though the wound which was scarce an inch broade But the stomacke was full of winde but little humidity in it The other was called captaine Francis d' Alon a Native of Xantoigne who before Roshell was shot with a musket bullet entring by the breast-bone neere to the sword-like Gristle and passing through the fleshy part of the midriffe went out at the space betweene the fifth and sixth bastard ribbes The wound was healed up on the out side yet for all that there remained a weakenesse of the stomacke whereupon a paine of the guttes like to the colicke tooke him especially in the Evening and on the night for which cause he durst not sup but very sparingly But on the eighth month after the paine raging more violently in his belly than it was accustomed hee dyed though for the mitigating of the vehemency thereof Simon Malmedy and Anthony du Val both learned Physitions omitted no kinde of remedy The body of the diseased was opened by the skilfull Chirurgion Iames Guillemeau who found a great portion of the collicke gut swelled with much wind gotten into the Chest through the wound of the Diaphragma for all it was so small that you could scarse put your little finger in thereat But now let us returne from whence we digressed We understand that there is blood poured forth into the capacity of the Chest by the difficulty of breathing the vehemency of the encreasing feaver the stinking of the breath the casting up of blood at the mouth and other symptomes which usually happen to these who have putrified and clotted blood poured out of the vessells into the belly infecting with the filthy vapour of the corrupt substance the partato which it shall come But also unlesse the patient cannot lye upon his backe he is troubled with a desire to vomite and covets now and then to rise whence hee often falls into a swoond the vitall faculty which fusteines the body being broken and debilitated both by reason of the wound and concreate or clotted blood for so putting on the quality of poyson it greatly dissipates and dissolves the strength of the heart It is a signe the spinall marrow is hurt when a convulsion or Palsie that is a suddaine losse of sense and motion in the parts thereunder an unvoluntary excretion of the Vrine and other excrements or a totall suppression of them seazes upon the Patient When the hollow veine and great Artery are wounded the patient will dye in a short time by reason of the suddaine and aboundant effusion of the blood and spirits which intercepts the motion of the lungs and heart whence the party dyes sufforaced CHAP. XXX Of the cure of the Wounds of the Chest WE have read in Iohn de Vigo that it is disputed amongst Chirurgions concerning the consolidation of wounds of
and overheated part The bleeding must not bee stanched presently upon the receiving of the wound for by the more plentifull effluxe thereof the part is freed from danger of inflammation and fulnesse Wherefore if the wound bleede not sufficiently at the first you shall the next day open a veine and take blood according to the strength and plenitude of the patient for there usually flowes no great store of blood from wounds of this nature for that by the greatnesse of the contusion and vehemencie of the mooved ayre the spirits are forced in as also I have observed in those who have one of their limbes taken away with a Cannon bullet For in the time when the wound is received there flowes no great quantity of blood although there be large veines and arteries torne in sunder thereby But on the 4 5 6. or some more dayes after the blood flowes in greater abundance and with more violence the native heate and spirits returning into the part The belly must be so qualified that he may have at the least one stoole a day either by nature or Art and if by Art then rather with a glister than purging medicines taken by the mouth for that the agitation of humors chiefely in the first dayes of the disease is to be susspected least we increase the defluxion falling downe upon the wounded part Yet Galen writes that both the evacuations are heere needefull that is blood-letting and purging though the Patient bee neither phethoricke nor repleate with ill humors But the care hereof must be committed to the judgement of the learned Physition Paine if ioyned with inflammation shall be mitigated by anointing the parts neere unto the wound with Vnguent nutritum composed with the juyce of Plantaine Housleeke Nightshade and the like Vnguentum Diacalcitheos described by Galen dissolved with vinegar oyle of Poppyes and Roses is of no lesse efficacy nor unguent de bolo nor divers other things of the same faculty though properly no anodynes as those which are not hot and moyst in the first degree but rather cold but yet not so as to have any narcoticke faculty Now these forementioned things asswage paine for that they correct the hot distemper and stay the acride and cholericke defluxions whose violence is more than cold After the use of repercussives it will be good to apply this following cataplasme â„ž Micae panis infusae in lacte vaccino lb. j. ss bulliant parum addendo olei violacei rosar an â„¥ iij. vitellos ovorum nu iiij pulver rosar rub flor chamaem meliloti an â„¥ ij farin fabar hordei an â„¥ j. misce fiat cataplasma secundum artom Also in this case you may easily make a medicine of bread crummes boyled in Oxycrate and oyle of Roses The cure of Tumors if any associate the wound may be found in their proper place Natures motion whether to suppuration or any such thing must still be observed and helped by the Physition and Chirurgion as the ministers or servants thereof CHAP. X. Of Bullets which remaine in the body for a long time after the wound is healed up LEaden Bullets lye in some parts of the body some whiles seaven eight or more yeares so that they neither hinder the agglutination of the wound neither doth any other symptome happen thereupon as I have diverse times observed untill at length by the strength of nature forcing them and their proper weightines bearing them downewards they shew themselves in some lower part by their swelling or bunching forth and so must be taken forth by the hand of the Chirurgion For they say Lead hath a certaine sympathy and familiarity with mans body chiefely the fleshy parts thereof Wherefore it neither putrifies its selfe nor causeth the flesh to putrifie besides it hath an excellent faculty in cicatrizing old ulcers But bullets of stone Iron and of any other mettall are of another nature for they cannot remaine any long time in the body without hurt for Iron will grow rusty and so corrode the neighbouring bodyes and bring other maligne symptomes Yet a Leaden bullet cannot remaine any long time in nervous or noble parts without danger CHAP. XI How to correct the constitution of the ayre so that the noble parts may be strengthened and the whole body besides BVt because as we have formerly told you there are some times wherein even small wounds made by Gunshot prove deadly not by their owne fault but the fault of the ayre therefore also the Chirurgion must have this care that he correct the ayre with all diligence and reduce it to a certaine quality and moderation of substance and strengthen the noble parts and whole body besides which may be performed by the following medicines which are to be taken inwardly and applyed outwardly In the morning three houres before meate let the Patient take some certaine quantity as the Physition shall thinke fit of the electuary Diarbodon Abbatis or Aromaticum rosatum triasantalon biamoschum laetificans Galeni or some such other like And you shall apply some such Epitheme as is heere described to the heart and Liver â„ž aquae rosar â„¥ iiij aquae buglossae aceti boni an â„¥ ij coriandri praeparati â„¥ ss an.Ê’j. sant rub Ê’ss utriusqueÊ’ss camphorae ℈ j. croci ℈ ss pulver diarhod Abbat Ê’ij theriacae Mithridatij an â„¥ ss pul flo chamaem melil an Ê’iij misce fiat epithema Let it be applyed warme by dipping a scarlet cloath therein You shall frequently put odorifferous and refrigerating things to the patients nose to strengthen the animall faculty as â„ž aquaerosar aceti boni an â„¥ iij. an.Ê’j. Let a linnen ragge dipped herein be now and then put to the patients nose for the same purpose he shall carry a Pomander about him and often smell thereto As â„ž ros rub violar an Ê’iij baccarum myrti juniperi santal rub an Ê’ijss styracis calamit Ê’ij aq rosarum quantum satis est lique fiat simul cum cerae albae quod sufficit fiat ceratum ad comprehendendos supradictos pulvers cum pillillo calido ducatur in pomum Or â„ž rad Ireos Florent majoran calam aromat ladani â—enzoini rad cyperi caryophll an Ê’ij Moschi gra 4. fiat pulvis cum gummi tragacanth quod sufficit Or else â„ž ladani puri â„¥ j. Benzoini â„¥ ss styracis calamit Ê’vj ireos Flor. â„¥ ss caryophyll Ê’iij majoran ros rub calami aromat an Ê’ss in pollinem redigantur omnia bulliant cum aqua ros quantum sufficit colentur colata liquefiant cum justa cerae albae quantitate styracis liquidae â„¥ j fiat ad modum cerati moschiÊ’j Also you may corroborate the animall faculty by application of frontalls as also procure sleepe and ease the paine of the head as â„ž aq ros â„¥ ij olei ros papav an â„¥ iss aceti boni â„¥ j. trochis de camphora Ê’ss fiat
or mortification but too loose is unprofitable for that it doth not contain the parts in that state we desire It is a signe of a just ligation that is neyther too strait nor too loose if the ensuing day the part be swolne with an oedematous tumor caused by the blood pressed forth of the broken place but of too strait ligation if the part be hard swolne and of too loose if it bee no whit swolne as that which hath pressed no blood out of the affected part Now if a hard tumor caused by too strait binding trouble the patient it must presently bee loosed for feare of more grievous symptomes and the part must be fomented with warme Hydraeleum and another indifferent yea verily more loose ligature must be made in stead thereof as long as the paine and inflammation shall continue in which time and for which cause you shall lay nothing upon the part which is any thing burdensome When the patient beginnes to recover for three or foure dayes space especially if you find him of a more compact habit and a strong man the ligature must be kept firme and not loosed If on the third day and so untill the seventh the spires or windings be found more loose and the part affected more slender then wee must judge it to be for the better For hence you may gather that there is an expression and digestion of the humors causing the tumor made by force of the ligation Verily broken bones fitly bound up are better set and more firmely agglutinated which is the cause why in the place of the fracture the ligation must bee made the straiter in other places more loosely If the fractured bone stand forth in any part it must there be more straitly pressed with boulsters and splints To conclude the seventh day being past we must binde the part more straitly than before for that then inflammation paine and the like accidents are not to bee feared But these things which we have hitherto spoken of the three kindes of Ligatures cannot take place in each fractured part of the body as in the chaps collar-bones head nose ribs For seeing such parts are not round and long a Ligature cannot be wrapped about them as it may on the armes thighes and legges but only bee put on their outsides CHAP. VI. The uses for which Ligatures serve BY that which wee have formerly delivered you may understand that Ligatures are of use to restore those things which are separated and moved forth of their places and joyne together those which gape as in fractures wounds contusions sinewous ulcers and other like affects against nature in which the solution of continuitie stands in neede of the helpe of Bandages for the reparation thereof Besides also by the helpe of Bandages these things are kept asunder or separated which otherwise would grow together against nature as in Burns wherein the fingers and the hams would mutually grow together as also the arme-pits to the chests the chin to the breast unlesse they be hindered by due Ligation Bandages doe also conduce to refresh emaciated parts wherefore if the right legge waste for want of nourishment the left legge beginning at the foote may bee conveniently rowled up even to the groine If the right arme consume binde the left with a strait Ligature beginning at the hand and ending at the arme-pit For thus a great portion of blood from the bound-up part is sent back into the vena cava from whence it regurgitates into the almost emptie vessels of the emaciated part But I would have the sound part to bee so bound that thereby it become not painefull for a dolorifick ligation causes a greater attractation of blood and spirits as also exercise wherefore I would have it during that time to bee at rest and keep holy-day Ligatures also conduce to the stopping of bleedings which you may perceive by this that when you open a veine with your launcet the blood is presently stayed laying on a boulster and making a ligature Also Ligatures are usefull for women presently after their delivery for their womb being bound about with Ligatures the blood wherewith their womb was too much moistened is expelled the strength of the expulsive facultie being by this means stirred up to the expulsion thereof and it also hinders the empty wombe from being swolne up with winde which otherwise would presently enter thereinto This same Ligature is a helpe to such as are with childe for the more easie carrying of their burden especially those whose Childe lyes so farre down-wards that lying as it were in the den of the hippes it hangs betweene the thighes and so hinders the free going of the mother Therefore the woman with childe is not only eased by this binding of her wombe with this Ligature which is commonly termed the navill Ligature but also her childe being held up higher in her wombe she hath frâ—eâ—r and more liberty to walke Ligatures are in like sort good for revulsion and derivation as also for holding of medicines which are layd to a part as the necke breast or belly Lastly there is a triple use of Ligatures in amputation of members as armes and legges The first to draw and hold upwards the skinne and muscles lying under it that the operation being performed they may by their falling downe againe cover the ends of the cut-off bones and so by that meanes helpe forwards the agglutination and cicatrization and when it is healed up cause the lame member to move more freely and with lesse paine and also to performe the former actions this as it were cushion or boulster of musculous flesh lying thereunder The second is they hinder the bleeding by pressing together the veines and arteries The third is they by strait binding intercept the free passage of the animall spirits and so deprive the part which lyes thereunder of the sense of feeling by making it as it were stupid or num CHAP. VII Of Boulsters or Compresses BOulsters have a double use the first is to fill up the cavities and those parts which are not of an equall thicknesse to their ends Wee have examples of cavities in the Arme-pits Clavicles Hams Groines and of parts which grow small towards their ends in the armes towards the wrests in the legges towards the feet in the thighes towards the knees Therefore you must fill these parts with boulsters and linnen cloathes that so they may be all of one bignesse to their ends The second use of boulsters is to defend and preserve the first two or three Rowlers or Under-binders the which we sayd before must be applyed immediately to the fractured part Boulsters according to this two fold use differ amongst themselves for that when they are used in the first mentioned kind they must be applied athwart but when in the latter long-wayes or down-right You may also use Boulsters lest the too strait binding of the Ligatures
feavers we open a veine to breathe out that bloud which is heated in the vessels and cooling the residue which remaines behind The fift is to prevent imminent diseases as when in the Spring and Autumne we draw bloud by opening a veine in such as are subject to spitting of bloud the squinancie pleurisie falling sicknesse apoplexie madnesse gout or in such as are wounded for to prevent the inflammation which is to be feared Before bloud letting if there bee any old excrements in the guts they shall bee evacuated by a gentle glyster or suppository lest the mesaraicke veines should thence draw unto them any impuritie Bloud must not be drawne from ancient people unlesse some present necessity require it lest the native heat which is but languid in them should be brought to extreme debility and their substance decay neither must any in like sort be taken from children for feare of resolving their powers by reason of the tendernesse of their substance rareness of their habit The quantity of bloud which is to be let must bee considered by the strength of the patient and greatnesse of the disease therefore if the patient bee weake and the disease require large evacuation it will bee convenient to part the letting of bloud yea by the interposition of some dayes The veine of the forehead being opened is good for the paine of the hind part of the head yet first we foment the part with warme water that so the skin may be the foster and the bloud drawne into the veines in greater plenty In the squinancie the veines which are under the tongue must be opened assant without putting any ligatures about the neck for feare of strangling Phlebotomie is necessary in all diseases which stop or hinder the breathing or take away the voice or speech as likewise in all contusions by a heavie stroake or fall from high in an apoplexie squinancie and burning feaver though the strength be not great nor the bloud faulty in quantity or quality bloud must not be let in the height of a fever Most judge it fit to draw bloud from the veines most remote from the affected and inflamed part for that thus the course of the humours may be diverted the next veines on the contrary being opened the humours may be the more drawne into the affected part and so increase the burden and paine But this opinion of theirs is very erroneous for an opened veine alwaies evacuates and disburdens the next part For I have sundry times opened the veines and arteries of the affected part as of the hands feet in the Gout of these parts of the temples in the Megrim whereupon the paine alwayes was somewhat asswaged for that together with the evacuated bloud the malignitie of the Gout and the hot spirits the causers of the head-ach or Megrim were evacuated For thus Galen wisheth to open the arteries of the temples in a great and contumacious defluxion falling upon the eyes or in the Megrim or head-ach CHAP. LX. How to open a veine and draw bloud from thence THE first thing is to seat or place the patient in as good a posture as you can to wit in his bed if he be weak but in a chaire if strong yet so that the light may fall directly upon the veine which you intend to open Then the Surgeon shall rub the arme with his hand or a warme linnen cloth that the bloud may flow the more plenitfully into the vein Then he shall bind the veine with a ligature a little above the place appointed to be opened and hee shall draw back the bloud upwards towards the ligature from the lower part and if it be the right arme he shall take hold thereof with his left hand but if the left then with his right hand pressing the veine in the meane time with his thumbe a little below the place where you meane to open it lest it should slip away and that it may bee the more swolne by forcing up the bloud Then with his naile hee shall marke or designe the place to be opened and shall annoint it being so marked with butter or oyle whereby the skin may be relaxed and the lancet enter more easily and therefore the section may be the lesse painefull He shal hold his lancet between his thumb and fore finger neither too neer nor too far from the point he shall rest his other three fingers upon the patients arme that so his hand may be the more steddy lesse trembling Then shall he open the vein with an incision agreeable to the magnitude of the vessell the indifferent thicknesse of the conteined bloud somewhataslant diligently avoiding the artery which lies under the basilica the nerve or tendon of the two-headed muscle which lyes under the Median veine But for the Cephalicke it may be opened without danger As much bloud as is sufficient being drawne according to the minde of the Physician he shall loose the ligature and laying a little boulster under hee shall with a ligature bind up the wounded part to stay the bleeding the ligation shall be neither too strait nor loose but so that the patient may freely bend and extend his arme wherefore whilest that is in doing he must not hold his arme streight out but gently bended otherwise he cannot freely bend it The figure of a Lancet to let bloud withall CHAP. LXI Of Cupping-glasses or ventoses CUpping-glasses are applyed especially when the matter conjunct and impact in any part is to be evacuated and then chiefly there is place for sacrification after the cupping-glasses yet they are also applyed for revulsion and divertion for when an humour continually flowes down into the eyes they may be applyed to the shoulders with a great flame for so they draw more strongly and effectually They are also applyed under womens breasts for to stop the courses flowing too immoderately but to their thighes for to provoke them They are also applyed to such as are bit by venemous beasts as also to parts possessed by a pestiferous Bubâ— or Carbuncle so to draw the poyson from within outwards For as Celsus saith a Cupping-glasse where it is fastned on if the skin be first scarified drawes forth bloud but if it bee whole then it draws spirit Also they are applyed to the belly when any grosse or thick windinesse shut up in the guts or membraines of the muscles of the Epigaâ—trium or lower belly causing the Collick is to bee discussed Also they are fastned to the Hypocondry's when as flatulency in the liver or spleene swels up the entraile lying thereunder or in too great a bleeding at the nose Also they are set against the Reines in the bottome of the belly whereas the ureters run downe to draw downe the stone into the bladder when as it stops in the middle or entrance of the ureter You shall make choice of greater and lesser Cupping-glasses according
weakeness of this or that entrall being translated from the parent to the childe There are some which suppose this falling of the seed from the whole body not to be understood according to the weight and matter as if it were a certaine portion of all the blood separated from the rest but according to the power and forme that is to say the animall naturall and vitall spirits being the framers of formation and life and also the formative faculty to fall down from all the parts into the seed that is wrought or perfected by the Testicles for proofe and confirmation whereof they alledge that many perfect sound absolute and well proportioned children are borne of lame and decrepit parents CHAP. I. Why the generative parts are endued with great pleasure A Certaine great pleasure accompanieth the function of the parts appointed for generation and before it in living creatures that are of a lusty age when matter aboundeth in those parts there goeth a certaine fervent or furious desire the causes thereof are many of which the chiefest is That the kind may be preserved and kept for ever by the propagation and substitution of other living creatures of the same kinde For brute beasts which want reason and therefore cannot bee solicitous for the preservation of their kinde never come to carnall copulation unlesse they be moved thereunto by a certaine vehement provocation of unbridled lust and as it were by the stimulation of venery But man that is endued with reason being a divine and most noble creature would never yeeld nor make his minde subject to a thing so abject and filthy as is carnall copulation but that the venerous ticklings raised in those parts relaxe the severity of his mind or reason admonish him that the memory of his name ought not to end with his life but to be preserved unto all generations as farre as may be possible by the propagation of his seed or issue Therefore by reason of this profit or commodity nature hath endued the genitall parts with a far more exact or exquisite sense than the other parts by sending the great sinewes unto them and moreover she hath caused them to be bedewed or moistened with a certain whayish humour not much unlike the seed sent from the glandules or kernells called prostatae situated in men at the beginning of the necke of the bladder but in women at the bottome of the wombe this moisture hath a certaine sharpenesse or biting for that kinde of humour of all others can chiefly provoke those parts to their function or office and yeeld them a delectable pleasure while they are in the execution of the same For even so whayish and sharpe humours when they are gathered together under the skinne if they waxe warme tickle with a certaine pleasant itching and by their motion inferre delight but the nature of the genitall parts or members is not stirred up or provoked to the expulsion of the seed with these provocations of the humours abounding either in quantity or quality onely but a certaine great and hot spirit or breath conteined in those parts doth begin to dilate it selfe more and more which causeth a certaine incredible excesse of pleasure or voluptuousnesse â—…erewith the genitalls being replete are spread forth or distended every way unto their full greatnesse Tâ—… yard is given to men whereby they may cast out their seed directly or straightly into the womans wombe and the necke of the wombe to women whereby they may receive that seed so cast forth by the open or wide mouth of the same necke and also that they may cast forth their owne seed sent through the spermaticke vessels unto their testicles these spermaticke vessels that is to say the veine lying above and the artery lying below do make many flexions or windings yet one as many as the other like unto the tendrills of vines diversly platted or foided together and in these folds or bendings the blood and spirit which are carryed unto the testicles are concocted a longer time and so converted into a white seminall substance The lower of these flexions or bowings doe end in the stones or testicles But the testicles for as much as they are loose thin and spongeous or hollow receiving the humour which was begun to be concocted in the forenamed vessels concoct it again themselves but the testicles of men concoct the more perfectly for the procreation of the issue the testicles of women more imperfectly because they are more cold lesse weake and feeble but the seed becommeth white by the contact or touch of the testicles because the substance of them is white The male is such as engendereth in another and the female in her selfe by the spermaticke vessels which are implanted in the inner capacity of the womb But out of all doubt unlesse nature had prepared so many allurements baits and provocations of pleasure there is scarce any man so hot or delighted in venereous acts which considering and marking the place appointed for humane conception the loathsomnesse of the filth which daily falleth downe unto it and wherewithall it is humected and moistened and the vicinity and neerenesse of the great gut under it and of the bladder above it but would shun the embraces of women Nor would any woman desire the company of man which once premeditates or forethinkes with her selfe on the labour that shee shall sustaine in bearing the burthen of her childe nine moneths and of the almost deadly paines that she shall suffer in her delivery Men that use too frequent copulation oftentimes in stead of seed cast forth a crude and bloody humor and sometimes also meere blood it selfe and oft times they can hardly make water but with great pain by reason that the clammy and oily moisture which nature hath placed in the glandules called prostatae to make the passage of the urine slippery to defend it against the sharpenesse of the urine that passeth through it is wasted so that afterward they shal stand in need of the help of a Surgion to cause them to make water with ease without pain by injecting a little oile out of a siringe into the conduit of the yard For generation it is fit the man cast forth his seed into the wombe with a certaine impetuosity his yard being stiffe and distended and the woman to receive the same without delay into her wombe being wide open lest that through delay the seed waxe cold and so become unfruitfull by reason that the spirits are dissipated and consumed The yard is distended or made stiffe when the nervous spongeous and hollow substance thereof is replete and puffed up with a flatulent spirit The womb allures or drawes the masculine seed into it selfe by the mouth thereof and it receives the womans seed by the hornes from the spermatick vessels which come from the womans testicles into the hollownesse or concavity of the womb that so it
by reason that the putrefying blood is turned into sanies the patient cannot lye but on his backe and he hath an often desire to vomit but if hee escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the Lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting hee is vexed with a greevous shortnesse of breath and with a paine in his sides We may perceive the Heart to be wounded by the aboundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse palenesse of the face cold sweate with often swounding coldnesse of the extreame parts and suddaine death When the midriffe which the Latines call Diaphragma is wounded the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortnesse of winde a cough and fit of greevous paine and drawing of the entralls upwards Wherefore when all these accidents appeare we may certainely pronounce that death is at hand Death appeareth sodainely by a wound of the hollow Veine or the great Arterie by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindred The marrow of the backebone being pierced the patient is assaulted with a Palsie or convulsion very suddainely and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood commeth out at the wound and pricking paine disperseth it selfe even unto the sword-like gristle which hath its situation at the Lower end of the brest bone called Sternon the blood that falleth from thence downe into the intestines doth oftentimes inferre most maligne accidents yea and sometimes death When the stomacke is wounded the meate and drink come out at the wound there followeth a vomiting of pure choler then commeth sweating and coldnesse of the extreame parts and therefore we ought to prognosticate death to follow such a wound When the milt or spleene is wounded blacke and grosse blood cometh out at the wound the patient will be very thirsty with paine on the left side and the blood breakes forth into the belly and there putrifying causeth most maligne and greevous accidents and often times death to follow When the guts are wounded the whole body is griped and pained the excrements come out at the wound whereat also often times the guts breake forth with great violence When the reines or Kidnyes are wounded the patient will have great paine in making his Vrine and the blood commeth out together therewith the paine commeth downe even unto the groine yard and testicles When the bladder and Vreters are wounded the paine goeth even unto the entralls the parts all about and belonging to the groine are distended the Vrine is bloody that is made and the same also commeth often times out at the wound When the wombe is wounded the blood commeth out at the privities and all other accidents appeare like as when the bladder is wounded When the sinewes are pricked or cut halfe asunder there is great paine in the affected place and there followeth a suddaine inflammation fluxe abscesse feaver convulsion and oftentimes a gangreene or mortification of the part whereof commeth death unlesse it be speedily prevented Having declared the signes and tokens of wounded parts it now remaineth that we set downe other signes of certaine kindes of death that are not common or naturall whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgement of the discreete Physition or Chirurgion Therefore if it chance that a nurse either through drunkennesse or negligence lyes upon her infant lying in bed with her and so stifles or smothers it to death If your judgement be required whether the infant dyed through the default or negligence of the nurse or through some violent or suddaine diseases that lay hidden and lurking in the body thereof You shall finde out the truth of the matter by these signes following For if the infant were in good health before if he were not froward or crying if his mouth and nosethrills now being dead be moystned or bedewed with a certaine foame if his face be not pale but of a Violet or purple colour if when the body is opened the Lungs be found swolne and puffed up as it were with a certaine vaporous foame and all the other entralls found it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corpes of a man be found lying in a field or house alone and you be called by a magistrate to deliver your opinion whether the man were slaine by lightning or some other violent death you may by the following signes finde out the certainety hereof For every body that is blasted or striken with lightning doth cast forth or breathe out an unholsome stinking or sulphureous smell so that the birdes or fowles of the ayre nor dogges will not once touch it much lesse prey or feede on it the part that was stricken often times sound and without any wound but if you search it well you shall finde the bones under the skinne to be bruised broken or shivered in peeces But if the lightening hath pierced into the body which making a wound therein according to the judgement of Pliny the wounded part is farre colder than all the rest of the body For lightning driveth the most thinne and fiery ayre before it and striketh it into the body with great violence by the force whereof the heate that was in the part is soone dispersed wasted and consumed Lightening doth alwayes leave some impression or signe of some fire either by ustion or blacknesse for no lightning is without fire Moreover whereas all other living creatures when they are striken with lightening fall on the contrary side onely man falleth on the affected side if hee be not turned with violence toward the coast or region from whence the lightening came If a man bee striken with lightening while he is asleepe hee will be found with eyes open contrarywise if hee be striken while hee is awake his eyes will be closed as Plinie writeth Philip Commines writeth that those bodyes that are stricken with lightning are not subject to corruption as others are Therefore in ancient time it was their custome neither to burne nor bury them for the brimstone which the lightning bringeth with it was unto them in stead of salt for that by the drynesse and fiery heate thereof it did preserve them from putrefaction Also it may be enquired in judgement Whether any that is dead and wounded received these wounds alive or
spirits so consequently the continuall nourisher of the vitall heate the first living and last dying which because it must have a naturall motion of it self was made of a dense solide and more compact substance than any other part of the body The flesh thereof is woven with three sorts of fibers for it hath the right in the inner part descending from the basis into the point that they might dilate it and so draw the blood from the hollow veine into the receptacles thereof and the breath or aire from the lungs by the Arteria venosa it hath the transverse without which passe through the right at right angles to contract the Heart and so drive the vitall spirits into the great Artery Aorta and the cholericke blood to the Lungs by the vena arteriosa for their nourishment It hath the oblique in the midst to containe the Aire and blood drawne thither by the forementioned vessels untill they be sufficiently claborate by the heart All these fibers doe their parts by contracting themselues towards their originall as the right from the point of the heart towards the basis whereby it comes to passe that by this contraction of the fibers the heart dilated becomes shorter but broader no otherwise than it is made more long and narrow by the contraction of the transverse but by the drawing of the oblique it is lessened in that part which lookes towards the vertebra's which chiefly appeares in the point thereof It is of an indifferent bignes but yet in some bigger in some lesse according to the diverse temper of Cold or hot men as wee noted in the liver The figure thereof is Pyramidall that is it is broader in the basis and narrower at his round point It is composed of the most dense flesh of all the body by the affusion of blood at the divisions and foldings of the vessels and there concrete as it happens also to the other Entrailes For the blood being there a litle more dryed than that which is concrete for the making of the Liver turnes into a fleshy substance more dense than the common flesh even as in hollow ulcers when they come to a cicatrize It hath the Coronall veines and arteryes which it receives either on the right side from the hollow veine or on the left from the basis at the entranc of the Artery Aorta You cannot by your Eye discerne that the Heart hath any other Nerves than those which come to it with the Pleura Yet I have plainely enough observed others in certaine beasts which have great Hearts as swine they appeared seated under the fat which covers the vessels and basis of the heart lest the humid substance of these parts should be dissolved and dissipated by the burning heat of the Heart Whereby you may perceive that the heat of the heart is different from the Elementary heat as that which suffers fat to grow about this Entraile where otherwise it doth not concrete unlesse by cold or a remisse heat which thing is chiefly worth admiration The Heart is one alone scituate most commonly upon the fourth Vertebra of the Chest which is in the midst of the Chest Yet some thinke that it inclines some-what to the left side because we there feele the motion or beating thereof but that happens by reason of its left ventricle which being it is filled with many spirits and the beginning of the arteryes it beats far more vehemently than the right It required that seat by the decree of Nature because that Region is the most safe and armed and besides it is here on every side covered as it were with the hands of the Lungs It hath connexion with the fore mentioned Vertebra's but by the parts composeing it with those parts from whence it hath them with the Lungs by the Vena arteriosa and the Arteria venosa and lastly with all the parts of the body by the Arteries which it sends to them all It is of a hot and moist temper as every fleshy part is The action thereof is first to prepare the blood in its right ventricle for the fit nourishment of the Lungs for from hence it is that Galen saith this right ventricle was made for the necessity of the lungs Secondly to generate the vitall spirits in its left ventricle for the use of the whole body But this spirit is nothing els than a certaine middle substance between aire and blood fit to preserve and carry the native heat wherefore it is named the vitall as being the author and preserver of life In the inner parts of the heart there present themselves to our consideration the ventricles and the parts contained in the ventricles and between them such are the Valvulae or valves the vessels and their mouthes their distribution into the lungs the wall or partition and the two productions or Eares of the heart which because they are doubtfull whether they may be reckoned amongst the externall or internall parts of the heart I will here handle in the first place Therefore these Auriculae or Eares are of a soft and nervous substance compact of three sorts of fibers that so by their softnesse they might the more easily follow the motions of the heart and so breake the violence of the matters entring the heart with great force when it is dilated For otherwise by their violent and abundant entrance they might hurt the heart and as it were overwhelme and suffocate it but they have that capacity which we see given by nature that so they might as it were keep in store the blood and aire and then by litle and litle draw it forth for the use or necessity of the heart But if any enquire if such matters may be drawne into the heart by the only force of the Diastole ad fugam vacui for avoiding of emptinesse I will answere that that drawing in or attraction is caused by the heat of the heart which continually drawes these matters to it no otherwise than a fire drawes the adjacent Aire and the flame of a candle the tallow which is about the weake for nourishments sake Whilest the heart is dilated it drawes the aire whilest it is drawne togeather or contracted it expells it This motion of the heart is absolutely naturall as the motion of the Lungs is animall Some adde a third cause of the attraction of the heart to wit the similitude of the whole substance But in my judgment this rather takes place in that attraction which is of blood by the venae coronales for the proper nourishment of the heart than in that which is performed for attraction of matters for the benefit of the whole body These eares differ in quantity for the right is far more capacious than the left because it was made to receive a greater aboundance of matter They are two in number on each side one scituate at the Basis of the heart The greater at
Animall Spirit and necessary sense serving the whole body and to subject it selfe as an instrument to the principall faculties as to reason The braine is twofold the fore and hinde The hinde by reason of its smallnesse is called the Cerebellum the litle or After-braine But the fore by reason of its magnitude hath retained the absolute name of the braine Againe this fore-braine is two-fold the right and left parted by that depression which wee formerly mentioned of the Meninges into the body of the braine But this division is not to be here so absolutely taken as though the Braine 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 Braine is soft but the inward hard callous and very smooth when on the contrary the outward appeares indented and unequall with many windings and crested as it were with many wormelike foldings CHAP. VII Of the ventricles and mamillary processes of the Braine FOr the easie demonstration of the ventricles of the braine it is convenient you cut away a large portion thereof and in your cutting observe the blood sweating our of the pores of it But besides it is fit you consider the spongy substance by which the excrements of the braine are heaped up to be presently strained out and sent away by the hollow passage In the substance of the braine you must observe 4 ventricles mutually conjoined by certaine passages by which the spirits endued with the species of things sensible may goe from one into another The first and two greater one on each side are placed in the upper braine The third is under them in the middle part of the braine The fourth and last at the fore side of the Cerebellum towards the beginning of the spinall marrow The two formost are extended the length way of the braine in the forme of a semicircle whose hornes looke or bend outwards They are spacious and large because it was meet the Spirits contained there together with their excrements should be there purified and clensed but in other ventricles the pure and already elaborate spirits are onely received These ventricles are white and smooth in their inner superficies but that on each side they have an extuberancy at the midst of the semicircle scituate at the basis of the Pillar of the middle ventricle towards the nose under the Septum lucidum or cleere partition severing or parting in sunder these two ventricles This Septum lucidum or cleare or thin partition is nothing else than a portion of the braine indifferently solide but very cleere that so through this partition the animall spirits contained in these two ventricles may mutually passe and bee communicated and yet no other grosser substance may peirce the thin density thereof Wherefore it is not to be feared that the water contained in one of the ventricles may passe to the other through this partitiō as I have oft times observed to the great admiration of the spectators in the dead bodyes of such as dyed of the Palsy in which I have found the ventricle of that side which was taken with the palsy much dilated according to the quantity of the water contained therein the other being either wholy empty and without any or certainly no fuller than in any other dead through any other occasion For some affirme that there is a certaine kind of waterish moisture alwaies to be found in the ventricles which may be made by the condensation of the Animall spirits by the force of the deadly cold But these two first ventricles of the braine goe into one common passage as both the bellowes of a fornace whereby the spirit instructed with the species of things goes into the under or middle ventricle from theformer In these same first ventricles the Plexus Choroides is to be considered and in like manner the passage by which the grosser excrements are driven or sent into the pituitary Glandule The Third Figure represents the Cerebellum with the wormy processes separated from it AB The right and left part of the After-braine C D The anterior and posterior regions of the middle part of the After braine E The anterior wormy processe F The posterior wormy processe GG In this place the After-braine did grow to the spinall marrow H The cavity in the spinall marrow maketh the forth ventricle I K. The anterior and posterior processes of the braine called vermi-formes or the wormy processes This Plexus Choroides is nothing else but a production of the Pia mater diversly folded with the mutuall implication of veines and arterys woven in the forme of a net These vessels are of magnitude and capacity sufficient both to yeild life and nourishment to that particle to which they are fastened as also for the generation of the Animall spirits as which take fit matter from the veines stretched fourth into this same Plexus the hinde artery and veine Torcular and also from the aire entring into the braine by the mamillary processes But the mamillary processes are certaine common waies for conveyance of the aire and smells into the braine and carrying of excrements from the braine For thus in them who have the Catarrhe and Corizae or pose neither the aire nor smels can penetrate into the braine whence frequent sneesings ensue the braine strongly moving it selfe to the expulsion of that which is troublesome to it But of the excrements of the braine whether bred there or proceeding from some other part some are of a fumide and vaporous nature which breathe insensibly through the Sutures of the skull Others are grosse and viscide of which a great part is expelled by both these productions or through each of them For thus in the Pose you may see some who have one of their nosthrils stopt the other running and some who have both obstructed The most proper benefit of the two first ventricles of the braine is to entertaine the Phantasie as in a convenient seat and habitation seeing the minde there estimates and disposes in order the species of things brought in from the externall senses that so it may receive a true judgement of them from reason which resides in the middle ventricle The third ventricle is seated betweene the hindermost extremityes of the former ventricles and the last ventricle of the Cerebellum In this sixe parts present themselves to our consideration that is the Psalloides or Arch the Conarium or pine Glandule the Buttockes wormelike productions the Bason and passage which is from this middle into the last and hindemost ventricle The Psalloides or arch is nothing els but the cover of the middle ventricle resembling a roofe borne up with three stayes or pillars the one whereof is extended to the nose under the Septum lucidum the two other on each side one looke
flesh and cicatrized which doth not seldome happen in opening of Arteries unskilfully performed and negligently cured therefore Aneurismaes are absolutely made by the Anastomasis springing breaking Erosion and wounding of the Arteries These happen in all parts of the body but more frequently in the throat especially in women after a painfull travaile For when as they more strongly strive to hold their breath for the more powerfull expulsion of the birth it happens that the Artery is di ated and broken whence followes an effusion of bloud and spirits under the skin The signes are a swelling one while great another small with a pulsation and a colour not varying from the native constitution of the skinne It is a soft tumor and so yeelding to the impression of the fingers that if it peradventure be small it wholy vanisheth the Arterious bloud and spirits flying backe into the body of the Artery but presently assoone as you take your fingers away they returne againe with like celerity Some Aneurismaes doe not onely when they are pressed but also of themselves make a sensible hissing if you lay your eare neare to them by reason of the motion of the vitall spirit rushing with great violence through the straitnes of the passage Wherefore in Aneurismaes in which there is a great rupture of the Artery such a noyse is not heard because the spirit is carryed through a larger passage Great Aneâ—rismaes under the Arme pits in the Groines and in other parts wherein there are large vessells admit no cure because so great an eruption of blood and spirit often followes uppon such an incision that death prevents both art and Cure Which I observed a few yeares agoe in a certaine preist of Saint Andrewes of the Arches M. Iohn Maillet dwelling with the chiefe President Christopher de Thou Who having an Aneurisma at the setting on of the shoulder about the bignes of a Wall-nut I charged him hee should not let it be opened for if it did it would bring him into manifest danger of his life and that it would be more safe for him to breake the violence thereof with double clothes steeped in the juyce of Night-shade and Houselike with new and whayey cheese mixt therewith Or with Vnguentum de Bolo or Emplastrum contra rupturam and such other refrigerating and astringent medicines if hee would lay upon it a thin plate of Lead and would use shorter breeches that his doublet might serve to hold it too to which hee might fasten his breeches instead of a swathe and in the meane time he should eschew all things which attenuate and inflame the blood but especially he should keepe himselfe from all great straining of his voyce Although he had used this Diet for a yeare yet he could not so handle the matter but that the tumor increased which he observing goes to a Barber who supposing the tumor to be of the kinde of vulgar inpostumes applies to it in the Evening a Causticke causing an Eschar so to open it In the Morning such an abundance of blood flowed forth from the tumor being opened that he therewith astonished implores all possible ayde and bidds that I should be called to stay this his great bleeding and he repented that he had not followed my directions Wherefore I am called but when I was scarce over the thre should he gave up his ghost with his blood Wherefore I diligently admonish the young Chirurgion that hee do not rashly open Aneurismas unlesse they be small in anignoble part and not indued with large vessells but rather let him performe the cure after this manner Cut the skinne which lyes over it untill the Artery appeare and then separate it with your knife from the particles about it then thrust a blunt and crooked needle with a thred in it under it binde it then cut it off and so expect the falling off of the thred of it selfe whiles nature covers the orifices of the cut Artery with new flesh then the residue of the cure may be performed after the manner of simple wounds The Aneurismaes which happen in the internall parts are uncurable Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease because the blood being so attenuated and heated therewith that it cannot be contayned in the receptacles of the Artery it distends it to that largenesse as to hold a mans fist Which I have observed in the dead body of a certaine Taylor who by an Aneurisma of the Arâ—erious veine suddenly whilest hee was playing at Tennis fell downe dead the vessell being broken his body being opened I found a great quantity of blood powred forth into the Capacity of the Chest but the body of the Artery was dilated to that largenesse I formerly mentioned and the inner Coate thereof was bony For which cause within a while after I shewed it to the great admiration of the beholders in the Physitions Schole whilest I publiquely dissected a body there the whilst he lived said he felt a beating and a great heate over all his body by the force of the pulsation of all the Arteryes by occasion whereof hee often swounded Doctor Syluius the Kings professor of Physicke at that time forbad him the use of Wine and wished him to vse boyled water for his drinke and Crudds and new Cheeses for his meate and to apply them in forme of Cataplasmes upon the grieved and swolne part At night he used a ptisan of Barley meale and Poppy-seedes and was purged now and then with a Clyster of refrigerating and emollient things or with Cassia alone by which medicines hee said hee found himselfe much better The cause of such a bony constitution of the Arteries by Aneurismaes is for that the hot and fervid blood first dilates the Coates of an Artery then breakes them which when it happens it then borrowes from the neighbouring bodies a fit matter to restore the loosed continuity thereof This matter whilest by litle and litle it is dried and hardened it degenerats into a Gristely or else a bony substance just by the force of the same materiall and efficient causes by which stones are generated in the reines and bladder For the more terrestriall portion of the blood is dried and condensed by the power of the unnaturall heat contayned in the part affected with an Aneurismae whereby it comes to passe that the substance added to the dilated and broken Artery is turned into a body of a bony consistence In which the singular providence of nature the handmaide of God is shewed as that which as it were by making and opposing a new wall or bancke would hinder and breake the violence of the raging blood swelling with the abundance of the vitall spirits unlesse any had rather to refer the cause of that hardnesse to the continuall application of refrigerating and astringent medicines Which have power to condensate and harden as may
extreame remedies are best to be applyed Yet first be certaine 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 downe the signes whereby you may know a perfect and absolute mortification CHAP. XVII The signes of a perfect Necrosis or Mortification YOu shall certainly know that a Gangreene is turned into a Sphacell or mortification and that the part is wholly and throughly dead if it looke of a blacke colour and bee colder than stone to your touch the cause of which coldnesse is not occasioned by the frigiditie of the aire if there bee a great softnesse of the part so that if you presse it with your finger it rises not againe but retaines the print of the impression If the skinne come from the flesh lying under it if so great and strong a smell exhale especially in an ulcerated Sphacell that the standers by cannot endure or suffer it if a sanious moisture viscide greene or blackish flow from thence if it bee quite destitute of sense and motion whether it be pulled beaten crushed pricked burnt or cut off Here I must admonish the young Chirurgion that hee be not deceived concerning the losse or privation of the sense of the part For I know very many deceived as thus the patients pricked on that part would say they felt much paine there But that feeling is oft deceiptfull as that which proceeds rather from the strong apprehension of great paine which formerly reigned in the part than from any facultie of feeling as yet remaining A most cleare and manifest argument of this false and deceitful sense appeares after the amputation of the member for a long while after they will complaine of the part which is cut away Verily it is a thing wondrous strange and prodigious and which will scarse be credited unlesse by such as have seene with their eyes and heard with their eares the patients who have many moneths after the cutting away of the Legge grievous ly complained that they yet felt exceeding great paine of that Leg so cut of Wherefore have a speciall care least this hinder your intended amputation a thing pittifull 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 signes of a Sphacell 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 Vstions and Terebrations must bee performed as soone as neede requires CHAP. XVIII Where Amputation must be made IT is not sufficient to know that Amputation is necessary but also you must learne in what place of the dead part it must bee done and herein the wisedome and judgement of the Chirurgion is most apparent Art bids to take hold of the quicke 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 selfe in these difficulties Let us suppose that the foote is mortified even to the anckle here you must attentively marke in what place you must cut it off For unlesse you take hold of the quicke flesh in the amputation or if you leave any putrefaction you profit nothing by amputation for it will creepe and spread over the rest of the body It befits Physicke ordained for the preservation of mankind to defend from the iron or instrument and all manner of injurie that which enjoyes 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 quicke 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 certaine ornament thereof changes this counsell For if you take these two things into your consideration they will induce you in this propounded case and example to cut off the Legge some five fingers breadth under the knee For so the patient may more fitly use the rest of his Legge and with lesse trouble that is he may the better goe on a woodden Legge 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 Legges in stead or two For I so knew Captaine Francis Clerke when as his foote was strucken off with an iron bullet shot forth of a man of warre and afterwards recovered and healed up hee was much troubled and wearied with the heavy and unprofitable burden of the rest of his Legge wherefore though whole and sound he caused the rest thereof to bee cut off some five fingers breadth below his knee and verily hee useth it with much more ease and facility than before in performance of any motion Wee must doe otherwise if any such thing happen in the Arme that is you must cut off a little of the sound part as you can For the actions of the Legges much differ from these of the armes and chiefly in this that the body restsnot neither is carried upon the armes as it is upon the feete and Legges 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 yolkes of Egges and bread tosted and dipped in Sacke or Muskedine Then let him bee placed as is fit and drawing the muscles upwards toward the sound parts let them be tyed with a straite 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 haire withall This ligature hath a threefold use the first is that it hold the muscles drawne up together with the skin so that retiring backe presently after the performance of the worke they may cover the ends of the cut bones and serve them in stead of boulsters or pillowes when they are healed up and so suffer with lesse paine the compression in susteining the rest of the body besides also by this meanes the wounds are the sooner healed and cicatrized for by how much more flesh or skinne is left upon the ends of the boner by so much they are the sooner healed and cicatrized The second is for that it prohibites the fluxe of blood by pressing and shutting up the veines and arteries The third is for that it much dulls the sense of the part by stupefying it the animall spirits by the straite compression being hindred from passing in by the Nerves Wherefore when
sleepy arteryes and fils the braine disturbing the humours and spirits which are conteyned there tossing them unequally as if one ran round or had drunk too much wine This hot spirit oft-times riseth from the heart upwards by the internall sleepy arteryes to the Rete mirabile or wonderfull net otherwhiles it is generated in the brain its selfe being more hot than is fitting also it oft-times ariseth from the stomack spleen liver and other entrals being too hot The signe of this disease is the sudden darkening of the sight and the closing up as it were of the eyes the body being lightly turned about or by looking upon wheeles running round or whirle pits in waters or by looking downe any deepe or steep places If the originall of the disease proceed from the braine the patients are troubled with the head-ach heavinesse of the head and noyse in the eares and oft-times they lose their smell Paulus Aegineta for the cure bids us to open the arteries of the temples But if the matter of the disease arise from some other place as from some of the lower entrals such opening of an artery little availeth Wherefore then some skilfull Phisitian must be consulted with who may give directions for phlebotomie if the original of the disease proceed from the heat of the entrals by purging if occasioned by the foulenesse of the stomack But if such a Vertigo be a criticall symptome of some acute disease affecting the Crisis by vomit or bleeding then the whole businesse of freeing the patient thereof must be committed to nature CHAP. IV. Of the Hemicrania or Megrim THE Megrim is properly a disease affecting the one side of the head right or left It sometimes passeth no higher than the temporall muscles otherwhiles it reacheth to the toppe of the crowne The cause of such paine proceedeth eyther from the veynes and externall arteryes or from the meninges or from the very substance of the braine or from the pericranium or the hairy scalpe covering the pericranium or lasty from putride vapours arising to the head from the ventricle wombe or other inferiour member Yet an externall cause may bring this affect to wit the too hot or cold constitution of the encompassing ayre drunkennesse gluttony the use of hot and vaporous meates some noysome vapour or smoake as of Antimony quick-silver or the like drawne up by the nose which is the reason that Goldsmythes and such as gilde mettals are commonly troubled with this disease But whence foever the cause of the evill proceedeth it is either a simple distemper or with matter with matter I say which againe is either simple or compound Now this affect is either alone or accompanied with other affects as inflammation and tension The heavinesse of head argues plenty of humour pricking beating and tension shewes that there is plenty of vapours mixed with the humours and shut up in the nervous arterious or membranous body of the head If the paine proceed from the inflamed meninges a fever followeth thereon especially if the humour causing paine doe putresie If the paine be superficiary it is seated in the pericranium If profound deepe and piercing to the botome of the eyes it is an argument that the meninges are affected and a feaver ensues if there be inflammation and the matter putresie and then oft times the tormenting paine is so great and grievous that the patient is affraid to have his head touched if it be but with your finger neither can hee away with any noise or small murmuring nor light nor smels however sweet no nor the fume of Vine The paine is sometimes continuall otherwhiles by fits If the cause of the pain proceed from hot thin vaporous bloud which will yeeld to no medicines a very necessary profitable speedy remedy may be had by opening an artery in the temples whether the disease proceed from the internall or externall vessels For hence alwayes ensueth an evacuation of the conjunct matter bloud and spirits I have experimented this in many but especially in the Prince de la Roche sur-you His Physitians when hee was troubled with this grievous Megrim were Chapaine the Kings and Castellane the Queenes chiefe Phisitians and Lewes Duret who notwithstanding could helpe him nothing by bloud-letting cupping bathes fictions diet or any other kind of remedy either taken inwardly or applyed outwardly I being called said that there was onely hope one way to recover his health which was to open the artery of the temple in the same side that the paine was for I thought it probable that the cause of his pain was not contained in the veins but in the 〈◊〉 in which case by the testimony of the ancients there was nothing better than the opening or bleeding of an artery whereof I had made tryall upon my selfe to my great good When as the Physitians had approved of this my advice I presently betake my selfe to the work and choose out the artery in the pained temple which was both the more swolne and beat more vehemently than the rest I open this as wee use to doe in the bleeding of a veine with one incision and take more than two sawcers of blood flying out with great violence and leaping the paine presently ceased neither did it ever molest him againe Yet this opening of an Artery is suspected by many for that it is troublesome to stay the gushing forth bloud and cicatrize the place by reason of the density hardnesse and continuall pulsation of the artery and lastly for that when it is cicatrized there may be danger of an Aneurisma Wherefore they thinke it better first to divide the skin then to separate the artery from all the adjacent particles and then to binde it in two places and lastly divide it as we have formerly told you must be done in Varices But this is the opinion of men who fear all things where there is no cause for I have learnt by frequent experience that the apertion of an artery which is performed with a Lancet as wee doe in opening a veine is not at all dangerous and the consolidation or healing is somewhat flower than in a veine but yet will bee done at length but that no flux of bloud will happen if so bee that the ligation be fitly performed and remaine so for foure dayes with fitting pledgets CHAP. V. Of certaine affects of the eyes and first of staying up the upper eye-lidde when it is too laxe OF the diseases which befall the eies some possess the whole substance thereof as the Ophthalmia a Phlegmon therof others are proper and peculiar to some parts thereof as that which is termed Gutta ferena to the opticke nerve Whence Galen made a threefold difference of the diseases of the eyes as that some happened to the eye by hurting or offending the chiefe organ thereof that is the crystalline humour others by hindering the animall faculty the chiefe causer of sight from
Therefore universall medicines being premised cupping glasses shal be applyed to the originall of the spinall marrow and the shoulders as also cauteries or Setons the eye shall be pressed or held downe with clothes doubled and steeped in an astringent decoction made of the juice of Acacia red roses the leaves of poppy henbane roses and pomegranate pills of which things poultisses may bee made by addition of barly meale and the like There is sometimes to bee seene in the eye an affect contrary to this and it is termed Atrophia By this the whole substance of the eye growes lanke and decayes and the apple it selfe becomes much lesse But if the consumption and emaciation take hold of the pupill onely the Greekes by a peculiar name and different from the generall terme it a Phihisis as Paulus teacheth Contrary causes shall bee opposed to each affect hot and attractive fomentations shall be applyed frictions shall be used in the neighbouring parts and lastly all things shall be applyed which may without danger be used to attract the bloud and spirits into the parts There is another affect of the eye of affinity to the Proptosis which by the Greeks is termed Chemosis Now this is nothing else than when both the eye-lids are turned up by a great inflammation so that they can scarce cover the eyes and the white of the eye is lifted much higher up than the blacke Sometimes the Adnata changing his wont looketh red besides also this affect may take its originall from externall causes as a wound contusion and the like But according to the variety of the causes and the condition of the present affect fixed and remaining in the part divers remedies shall be appointed CHAP. XIV Of the Ungula or Web. THE Ungula Pterygion or Web is the growth of a certaine fibrous and membranous flesh upon the upper coate of the eye called Adnata arising more frequently in the bigger but sometimes in the lesser corner towards the temples When it is neglected it covers not onely the Adnata but also some portion of the Cornea and comming to the pupill it selfe hurts the sight thereof Such a Web sometimes adheres not at all to the Adnata but is onely stretched over it from the corners of the eye so that you may thrust a probe betweene it and the Adnata it is of severall colours somewhiles red somewhiles yellow somewhiles duekish other-whiles white It hath its originall either from externall causes as a blow fall and the like or from internall as the defluxion of humours into the eyes The Ungula which is inveterate and that hath acquired much thicknesse and breadth and besides doth difficultly adhere to the Adnata is difficultly taken away neither may it bee helped by medicines whereby scars in the eyes are extenuated But that which covereth the whole pupill must not bee touched by the Surgeon for being cut away the scar which is left by its density hindereth the entrance of objects to the cristalline humour and the egresse of the animall spirit to them But oftentimes it is accompanied with an inflammation of the eyes a burning itching weeping defluxion and swelling of the eye-lids That the cure may rightly and happily proceed hee must first use a spare diet purging medicines shall be given and bloud taken away by opening a veine especially if there be great inflammation For particular remedies this excrescence shall be eaten away or at least kept from growth by dropping into the eye collyrium of vitrioll described in wounds of the eyes But if that wee profit nothing by this meanes it remaineth that wee take it away with the hand after the following manner You shall set the patient upon a forme or stoole and make him leane much backe and be so held firmely that he may not fall nor stirre then must you open his sore eye putting therein the speculum oculi formerly described in treating of the wounds of this part and then must you lift up the Web it selfe with a sharpe little hook with the point turned a little in and put under the midst of the Web when you have lifted it a little up thrust a needle threaded with a smoth threed between it the Adnata then taking hold of the hooke and the two ends of the threed drawne through with the needle and lifting up the Web by them you shall gently begin to separate it from the substance of the eye lying there-under beginning at the originall thereof with a crooked incision knife and so prosecute it even to the end yet so as you hurt no part of the Adnata nor Cornea The figures of little hookes a needle and crooked incision knife Little Hookes A needle A crooked incision knife Then must it bee cut off with a paire sissers and the white of an egge beaten with some Rose-water laid thereon and often renewed Afterwards the eye must every day be opened lest comming to cicatrization the eye-lids shall be glewed together in that part whereas the Web is taken away which also shall bee hindred by putting of common salte sage and cummin seeds into the eye being first champed and chawed in the mouth There are some who in stead of the crooked knife separate the Web from the Adnata with a horses haire others do it with a goose quill made ready for the same purpose taking heed that they hurt not the caruncle at the corner by the nose for it will follow if that you draw the Web away too violently and if it be cut there will remain a hole through which during the rest of the life a weeping humour will continually flow a disease by the Greeks termed Rhyas If after the cutting there be fear of inflammation linnen rags moystned in repelling medicines formerly prescribed in wounds of the eye shall bee layd thereupon CHAP. XV. Of the Aegilops fistula lachrimosa or weeping Fistula of the eye AT the greater corner of the eye there is a glandule made for the receiving and contayning the moysture which serveth for the lubricating and humecting the eye least it should dry by continuall motion This Glandule sometimes by a sanguine or pituitous defluxion falling violently from the brain swels impostumates ulcerates with an ulcer not seldome degenerating into a fistula so that in successe of time it rotteth the bone that lyeth under it of such fistulaes some are open outwardly and these usually have their originall from a phlegmon other some are inwardly and those are such as at first swelled by the defluxion or congestion of a phlegmaticke matter so that there appeareth no hole outwardly but onely a tumor of the bignesse of a pease this tumor being pressed floweth with a sanious serous and red or otherwise with a white and viscide matter and that either by the corner of the eye or by the inside of the nose Some have this matter flowing continually others have it onely monethly which is proper
for in so doing on the twentieth day you shall finde the Chicke perfectly formed with the navell That little skin that so compasseth the infant in the wombe is called the secundine or Chorion but commonly the after-birth This little skinne is perfectly made within sixe dayes according to the judgment of Hippocrates as profitable and necessary not onely to containe the seeds so mixed together but also to sucke nutriment through the orifices of the vessels ending in the wombe Those orifices the Greekes doe call Cotyledones and the Latines Acetabula for they are as it were hollowed eminences like unto those which may bee seene in the feete or snout of a Cuttle fish many times in a double order both for the working and holding of their meate Those eminences called Acetabula doe not so greatly appeare in women as in many brute beasts Therefore by these the secundine cleaveth on every side unto the wombe for the conservation nutrition and encrease of the conceived seede CHAP. VII Of the generation of the navell AFter the woman hath conceived to every one of the aforesaid eminencies groweth presently another vessell that is to say a veine to the veine and an artery to the artery these soft and yet thin vessels are framed with a little thin membrane which being spread under sticketh to them for to them it is in stead of a membrane and a ligament and a tunicle or a defence and it is doubled with the others and made of the veine and artery of the navell to compasse the navell These new small vessels of the infant with their orifices doe answer directly one to one to the cotyledones or eminences of the womb they are very swall and little as it were the hairy fibres that grow upon roots that are in the earth and when they have continued so a longer time they are combined together that of two they are made one vessell until that by continuall connexion all those vessels go and degenerate into two other great vessels called the umbilicall vessels or the vessels of the navell because they do make the navell and do enter into the childs body by the hole of the navell Here Galen doth admire the singular providence of God and Nature because that in such a multitude of vessels and in so long a passage or length that they go or are produced the vein doth never confound it selfe nor stick to the artery nor the artery to the veine but every vessell joyneth it selfe to the vessell of its owne kinde But the umbilicall veine or navell veine entering into the body of the child doth joyne it self presently to the hollow part of the liver but the artery is divided into two which joine themselves to the two iliack arteries along the sides of the bladder are presently covered with the peritonaum by the benefit thereof are annexed unto the parts which it goes unto Those small veines and arteries are as it were the rootes of the child but the veine and artery of the navell are as it were the body of the tree to bring down the nutriment to nourish the child For first we live in the wombe the life of a plant and then next the life of a sensitive creature and as the first tunicle of the child is called Chorion or Allantoides so the other is called Amnios or Agnina which doth compasse the seed or child about on every side These membranes are most thin yea for their thinnesse like unto the spiders web woven one upon another and also connexed in many places by the extremities of certaine small and hairy substances which at length by the adjunction of their like do get strength wherby you may understand what is the cause why by divers and violent motions of the mother in going and dancing or leaping and also of the infant in the wombe those membranes are not almost broken For they are so conjoyned by the knots of those hairie substances that betweene them nothing neither the urine nor the sweate can come as you may plainely and evidently perceive in the dissection of a womans body that is great with child not depending on any other mans opinion be it never so old or inveterate yet the strength of those membranes is not so great but that they may bee soone broken in the birth by the kicking of the child CHAP. VIII Of the umbilicall vessels or the vessels belonging to the navell MAny of the ancient Writers have written that there are five vessels found in the navell But yet in many nay all the bodies I sought in for them I could never finde but three that is to say one veine which is very large so that in the passage thereof it will receive the tagge of a poynt and two arteries but not so large but much narrower because the childe wanteth or standeth in need of much more bloud for his conformation and the nutriment or increase of his parts than of vitall spirit These vessels making the body of the navell which as it is thought is formed within nine or tenne dayes by their doubling and folding make knots like unto the knots of a Franciscan Friers girdle that staying the running bloud in those their knotty windings they might more perfectly concoct the same as may be seene in the ejaculatory spermatick vessels for which use also the length of the navell is halfe an ell so that in many infants that are somewhat growne is is found three or foure times doubled about their neck or thigh As long as the childe is in his mothers wombe hee taketh his nutriment onely by the navell and not by his mouth neither doth hee enjoy the use of eyes eares nostrils or fundament neither needeth hee the functions of the heart For spirituous bloud goeth unto it by the arteries of the navell and into the iliack arteries and from the iliack arteries unto all the other arteries of the whole body for by the motion of these onely the infant doth breathe Therefore it is not to bee supposed that aire is carryed or drawne in by the lungs unto the heart in the body of the childe but contrariwise from the heart to the lungs For neither the heart doth performe the generation or working of bloud or of the vitall spirits For the issue or infant is contented with them as they are made and wrought by his mother Which untill it hath obtained a full perfect and whole description of his parts and members cannot be called a child but rather an embrion or an imperfect substance CHAP. IX Of the ebullition or swelling of the seed in the wombe and of the concretion of the bubbles or bladders or the three principall entralls IN the sixe first dayes of conception the new vessels are thought to bee made and brought forth of the eminences or cotylidons of the mothers vessels and dispersed into all the whole seede as they were fibres or hairy strings Those as they
runs when he goes being compared to the slow and womanish pace of the Spaniard which is the cause that Spaniards are delighted with French servants for their quicke agillity in dispatching busines The Easterne people are specially endued with a good firme and well tempered wit not keeping their counsels secret and hid For the haste is of the nature of the Sunne and that part of the day which is next to the rising of the Sunne is counted the right-side and stronger and verily in all living things the right side is alwayes the more strong and vigorous But the Westerne people are more tender and effeminate and more close in their cariage and minde not easily making any one partaker of their secrets For the West is as it were subjct to the Moone because at the change it alwaies inclines to the West wherby it happens that it is reputed as nocturnall sinister and opposite to the East and the West is lesse temperate and wholsome Therefore of the windes none is more wholsome than the Eastwinde which blowes from the west with a most fresh and healthfull gale yet it seldome blowes and but onely at Sun-set The Northerne people are good eaters but much better drinkers witty when they are a litle moistened with wine and talkers of things both to be spoken and concealed not very constant in their promises and agreements but principall keepers and preservers of shamefastnes and chastity farre different from the inhabitants of the South who are wonderfull sparing sober secret and subtle and much addicted to all sorts of wicked Lust Aristotle in his Problemes saith that those nations are barbarous and cruell both which are burnt with immoderate heate and which are opprest with excessive cold because a soft temper of the Heavens softens the Manners and the minde Wherfore both as well the Northerne as Scythians and Germans and the Southerne as Africans are cruell but these have this of a certaine naturall stoutnes and souldierlike boldnes and rather of anger than a wilfull desire of revenge because they cannot restraine by the power of reason the first violent motions of their anger by reason of the heat of their blood But those of a certaine inbred and inhumane pravity of manners wilfully and willingly premeditating they performe the workes of cruelty because they are of a sad and melancholy nature You may have an example of the Northerne cruelty from the Transilvanians against their seditious Captaine George whom they gave to be torne in peeces alive and devoured by his Soldiers being kept fasting for three dayes before for that purpose who was then unbowelled and rosted and so by them eaten up The Cruelty of Hannibal the Captaine of the Carthaginians may suffise for an instance of the Southerne cruelty He left the Romane Captives wearied with burdens and the lenght of the way with the soles of their feet cut off But those he brought into his tents joyning brethren and kinsmen together he caused to fight neither was satisfied with blood before he brought all the victors to one man Also we may see the cruell nature of the Southerne Americans who dip their children in the blood of their slaine enemies then sucke their blood and banquet with their broken and squeased Limbs And as the Inhabitants of the South are free from divers Plethoricke diseases which are caused by aboundance of blood to which the Northerne people are subject as Feavers Defluxions Tumors Madnesse with laughter which causeth those which have it to leape and dance The people commonly terme it S. vittus his Evill which admits of no remedy but Musicke So they are often molested with the Frensie invading with madnesse and fury by the heat whereof they are often so ravished and carried besides themselves that they foretell things to come they are terrified with horrible dreames and in their fits they speake in strange and forraigne tongues but they are so subject to the scurfe and all kind of scabbs and to the Leprosie as their homebread disease that no houses are so frequently mett withall by such as travell through either of the Mauritania's as Hospitalls provided for the Lodging of Lepers Those who inhabit rough and Mountainous places are more brutish tough able to endure labour but such as dwell in plaines especially if they be moorish or fennish are of a tender body and sweate much with a litle labour the truth of which is confirmed by the Hollanders and Frizlanders But if the plaine be such as is scortched by the heate of the Sunne and blowne upon by much contrariety of windes it breeds men who are turbulent not to be tamed desirous of sedition and novelty stubborne impatient of servitude as may be perceived by the sole example of the inhabitants of Narbon a province of France Those who dwell in poore and barren places are commonly more witty and diligent and most patient of labours the truth of which the famous witts of the Athenians Ligurians and Romanes and the plaine 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 A Faculty is a certaine power and efficient cause proceeding from the temperament of the part and the performer of some actions of the body There are three principall Faculties governing mans body as long as it enjoyes its integrity the Animall Vitall and Naturall The Animall is seated in the propertemperament of the Braine 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 sensative the third principall The sensative consists in the five externall senses sight hearing taste smell and touch The Moving principally remaines in the Muscles and nerves as the fit instruments of voluntary motion The Principall comprehends the Reasoning faculty the Memory and Fantasie Galen would have the Common or inward sense to be comprehended within the compasse of the Fantasie although Aristotle distinguisheth betweene them The Vitall abides in the Hart from whence heat and life is distributed by the Arteryes to the whole body this is principally hindered in the diseases of the Brest as the Principall is when any disease assailes the Braine the prime action of the vitall faculty is Pulsation and that continued agitation of the Heart and Arteryes which is of threefold use to the body for by the dilatation of the Heart and Arteryes the vitall spirit is cherished by the benefit of the Aire which is drawne 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 last is the Naturall faculty which hath chosen its principall seate in the Liver it spreads or carries the nourishment over the whole body but it is distinguished into 3. other faculties The
circumference of the Chorion or womb then presently with spunges we drew out by little and little all the humiditie contained in it the infant yet contained in it which was fit to come forth that so the coate Amnios being freed of this moisture we might see whether there were any other humor contained in any other coate besides But having done this with singular diligence and fidelity we could see no other humor nor no other separation of the membranes besides So that from that time I have confidently held this opinion that the infant in the wombe is onely wrapped in two coates the Chorion and Amnios But yet not satisfied by this experience that I might yet be more certaine concerning this Allantoides having passed through the two former coates I came to the infant and I put a quill into its bladder and blew it up as forceably as I could so to trie if by that blowing I might force the aire into that coate which we questioned as some have written But neither thus could I drive any aire from hence through the navell into the controvetted coate but rather I found it to flie out of the bladder by the privities Wherefore I am certainely perswaded that there is no Allantoides Moreover I could never finde nor see in the navell that passage called the urachus which they affirme to be the beginning and originall of the coate Allantoides But if it be granted that there is no such coate as the Allantoides what discommoditie will arise hereof specially seeing the sweate and urine of the infant may easily and without any discommoditie be received collected and contained in the same coate by reason of the small difference which is betweene them But if any object that the urine by its sharpenesse and touching will hurt the infant I will answer there can be no so great sharpenesse in the urine of so small an infant and that if that there be any it is tempered by the admixture of the gentle vapour of sweat Besides if you consider or have regard to the use of such an humor which is to hold up the child lest by its weight it breakes the ties by which it is bound to the wombe wee shall finde no humour more fit for this purpose than this serous as which by its thicknesse is much more fit to beare up a weight than the thinne and to liquide sweate For so we see the sea or salt water carries greater weights without danger of drowning than fresh rivers doe Wherefore I conclude that there is no neede that the urine should be kept and contained in one coate and the sweate in another The Ancients who have writ otherwise have written from observations made in beasts Wherefore we make but onely two coats the Chorion and Amnios the one of vhich seeing it containes the other they both so encompasse the child that they vest â—on every side Fallopius in some sort seemes to be of this opinion for he onely makes two coates the Chorion and Amnios but hee thinkes the infant makes the water into a certaine pat of the Chorion as you may perceive by reading of his Observations Both these cotes are tied betweene themselves by the intercourse of most slender nervous fibes and small vessels penetrating from the outer Chorion to the inner Amnios Wherefore unlesse you warily handle these coates you may easily teare the Amnios in seprating it They are of the same temper with other membranes Their use is different for the Chorion is made both for the preservation of the vessels which it receives from the wombe for the generating of the umbilicall veines and arteries as also to keep whole and safe the parts which it invests Bt the Amnios is to receive and containe the excrementitious and ferous humors which the child shut up in the wombe is accustomed to evacuate But this coate very thinne and soft but strong and smooth lest by its touch it might hurt the infant whereupon it is called the Lamb-kinne coate CHAP. XXXVI Of the Navell THe Navell followes these coates It is a white body somewhat resembling the wreathen cord or girdle of the Franciscan Friers but that it hath not the knots standing so farre out but onely swelling in certaine places resembling a knot onely lifted up on one side it arises and takes its originall from a fleshie masse which we expressed by the name of swelling Câ—…dones and goes into the midst of the lower belly of the infant yea verily into thâ—…idst of the whole body whose roote it is therefore said to be For even as a tâ—… by the roote sucks nourishment from the earth so the infant in the wombe draw its nourishment by the navell The greatnesse of it in breadth and thicknesse eqâ—…ll the bignesse of the little finger But it is a foote and a halfe long so that children 〈◊〉 brought forth with it encompassing their middle necke armes or legges The figâ—…e of it is round It is composed of two arteries one veine and two coates It hath â—…se vessels from that great multitude of capillary veines and arteries which are seen â—…ispersed over the Chorion Wherefore the veine entring in at the navell penetraâ—… from thence into the hollow part of the liver where divided into two according â—alens opinion it makes the gate and hollow veines But the arteries caried by thâ—…selves the length of the navell cast themselves into the Iliacae which they make as also all other that from thence the vitall spirit may be carried by them over all the infant It hath its two coates from the Chorion But seeing they are mutually woven and conjoyned without any medium and are of a sufficient strength and thicknesse over all the navell they may seeme to make the infants externall skinne and fleshie pannicle I know very many reckon two umbilicall veines as also arteries and the urachus by or through which the urine flowes into the coate Allantoides But because this is not to be found in women but onely in beasts I willingly omit it because I doe not intend to mention any parts but such as belong to humane bodies Yet if there be any which can teach me that these parts which I thinke proper to brute beasts are to be found in women I will willingly confesse and that to his credit from whom I have reaped such benefit The other things that may be required concerning the navell as of its number site connexion temper and use may easily appeare by that we have spoken before For we hove apparently set downe the use when we said the navell was made for that purpose that the infant may be nourished by it as the tree by the roote by reason of the continuation of the vessels thereof with the preparing spermaticke vessels made by God for that purpose to whom be honour and glory for ever and ever Amen The End of the third Booke THE FOURTH BOOKE TREATING OF THE Vitall parts contained in
expulsion in vomiting and breaking of winde These two coats are continued with the two coats of the stomacke and have the like site Besides the Gullet hath these parts composing it as a veine from the Gate and Hollow ascendent veine a nerve from the sixt conjugation an Artery from that which creepes alongst the bottome of the stomacke with the vena Gastrica or else from the Arteryes ascending the hollow part therof but also besides all these vessels it may have a third coat from the membrane investing the Ribs or Pleura The magnitude of the Gullet is large enough yet some be bigger some lesse according to the variety of bodyes The figure of it is round that so it might be more large to swallow meat and lesse subject to offence It is placed betweene the backe bone and the weazon from the roots of the tongue even to the stomacke But as it discends alongst the backe bone when it comes to the fourth Vertebra of the Chest it turnes to the right side to give way to the great Artery Aorta and the descendent Artery then it turnes to the left side to the stomacke or mouth of the ventricle Nature hath fastened it to the Diaphragma with strong membranous tyes lest that if it had laine upon the Artery it should have hindred the passage of the vitall spirit to the lower parts It is onely one and that tyed to the forementioned parts both by its vessels and membranes It is of temper rather cold than hot as all those parts which are more nervous than fleshy are The Action thereof is to draw and carry downe the meat and to cast forth such things by vomit as trouble the stomacke Here you must note that whilest we swallow downe the Gullet is drawne downewards and the weazon upwards which is the cause that wee cannot sup and blow swallow and breathe together at the same instant which wee must thinke to happen by Gods singular providence to whose name be glory for everlasting Amen The End of the fourth Booke THE FIFTH BOOKE OF THE ANIMALL parts contained in the Head CHAP. I. A Generall description of the Head HAving hitherto declared two generall parts of mans body that is the Naturall and vitall it is now fit to betake our selves to the last that is the Animall beginning with the head Whrefore we will first define the head then divide it into its parts thirdly describe each of these parts fourthly demonstrate them after the order they offer themselves to our sight in dissection The head therefore is the seat of the senses the Pallace and habitation of reason and wisedome from whence as from a fountaine infinite actions and commodities arise It is seated above the rest of the body that the Animall spirit from thence as from a tower may governe and moderate the whole body and performe all actions according to the praescript of nature By the head we understand all that which is contained from the Crowne of the head to the first vertebra of the neck The best figure of the head is round lightly flatted on each side extuberating something to the fore and hinde part thereof For from hence is taken an argument of the goodnesse of the senses on the contrary those which are exactly round or acuminate and sharp towards the top are not thought good The head is devided into the face forehead temples the forepart the crowne and hinde part By the face we understand whatsoever is contained between the Eye-browes and the lower part of the chin By the forehead all the space from the eye-browes even to the Coronall future By the temples whatsoever is hollowed from the lesser Corner of the eye even to the eares By the forepart of the head whatsoever runnes in length from the top of the forehead or the Coronall suture even to the suture lambdoides and on each side to the Ossa petrosa the stony bones or scaly sutures By the Crowne we signifie a certaine point exquisitely in the midst of the Sagittall future which is suffyciently knowne By the Occiput or hindepart of the head that which is terminated by the suture lambdoides and the first vertebra of the neck Of all these parts there be some simple some compound besides some are containing some contained Of the containing some are common to all the parts of the head as the skinne the fleshy pannicle and pericranium others are proper to certaine parts as the fleshy panicle to the neck face forehead and skin covering the Cranium the common coat of the muscles to the fat and face The skull and both the Meninges to the braine The parts contained are the substance of the braine the foure ventricules and the bodyes contained in them the nerves the mamillary processes the Plexus Choroides or Rete Admirabile the Glandula Basilaris and others of which we will speak hereafter Wee must now speak of the containing parts beginning with the skinne for the order of teaching requires that we take our Exordium from the more simple but first we will say some thing of the haires The haire is nothing els than an excrement generated and formed of the more grosse and terrene portion of the superfluities of the third concoction which could not be wasted by insensible transpiration The benefite of it is that consuming the grosse and fuliginous or sooty excrements of the braine it becomes a cover and ornament for the head This haire of the head and eye-browes have their originall from the first conformation of the infant in the wombe the rest of the haires of the body arise and grow forth as the body growes and becomes more dry of which sort are the haires which cover the Chin armeholes groines and other parts of our bodyes CHAP. II. Of the musculous skinne of the Head commonly called the hairy scalpe and of the Pericranium THe skinne which covers the Scull and is covered with the haire is farre more fleshy thick hard and dry than any other part of the body especially which wants haire The skinne hath almost the like condition of quality as those parts have which it doth simply cover but is as it were lost in them or growne into one with them as in the lips and forehead with the fleshy pannicle wherefore it is there called musculous in other places it adheres to the gristles as on the sides of the nosethrilles and corners of the Eyes whereupon it is there called gristlely It hath connexion with the Pericranium because joined to it it receives nerves from the first and second vertebra of the necke and from the third conjugation of the braine which are disseminated through all its substance whereby it comes to passe that the wounds contusions and impostumes that happen in or upon this skinne are not to be neglected The Pericranium but I suppose it should be the Periostium is a most thin membrane which next and immediately covers
next to the first passing entire forth of the skull imparts some small branches to certaine 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 bellyes it passes even to the bladder and testicles as wee shewed in the former booke The seventh is inserted and spent upon the muscles of the bone Hyois the tongue and some of the throtle to give them motion it passes forth of the skull by the hole of the nowle bone at the extuberancies thereof CHAP. IX Of the Rete Mirabile or wonderfull Net and of the Wedge-bone THe Animall spirit is made of the vitall sent from the heart by the internall sleepy Arteryes to the braine For it was requisite that it should be the more elaborate because the action of the Animall is more excellent than that of the vitall nature hath framed a texture of Arteryes in many places running crosse one another in the forme of a Net diverse times doubled whereupon it had the name of the wonderfull Net that so the spirit by longer delay in these Labyrinthean or maze-like turnings might be more perfectly concocted and elaborate and attaine to a greater fitnesse to performe the Animall functions This wonderfull Net scituate at the sides of the Apophyses clinoides or productions of the wedgebone is twofold that is divided by the pituitary Glandule which is scituate betweene the said Apophyses Clinoides having the wedgebone lying under them next to the Crassa Meninx being perforated on the right and left side next to which lye bones as rare as a sponge even to the Pallate by which the Phlegme is purged by the mouth and nose and therehence I thinke that spattle flowes which such as have a moist braine continually spit out of their mouth The Eight figure of the braine A The Braine B The Cerebellum or after braine C A processe of the brain but not that which is called Mammillaris D D The marrow of the backe as it is yet within the skul E The Mammillary processe or instrument of smelling F The opticke nerve G The coate of the eye into which the opticke nerve is spread H The nerve that moveth the eye or the second payre I The third conjugation or the harder and lesser branch of the nerves of the third conjugation brought forward K The fourth conjugation or the greater and thicker nerve of the third payre bending downward L A branch of the nerve marked with I which goeth to the fore-head M Another branch of the nerve I reaching to the upper jaw NN A nerve proceeding from the branch I intexed or woven with the coat of the nose O The nerve of the temporall muscle issuing from the branch I. P A nerve contorted of the nerves K and b. Q A nerve proceeding from the branch K to the sockets of the upper teeth R A nerve creeping from the nerve K to the lower jaw S. A surcle of the branch R offered to the lower lip TT Other surcles from the branch R attaining to the lower teeth VV A branch of the nerve K diffused into the coate of the tongue X X The fourth paire of sinews which goe into the coat of the pallat Y The fifth paire of sinews which are the nerves of hearing a the membrane of the eare unto which that fifth nerve goeth b c two small branches of the fifth conjugation uniting themselves with the nerve P. à the eight conjugation or a nerve of the fifth paire attaining unto the face ee the sixt paire of nerves f A branch from the nerve e reaching to the muscles of the neck g Small branches derived unto the throttle or larynx h the byfurcation of the nerve into two branches iii An inner branch hanging to the rackbones and strengthning the intercostall nerves and is therefore called Intercostalis kk Surcles of the utter branch going to the heads of the muscles to the breast-bone and to the coller-bones l m branches of the right nerve l making the right Recurrent nerve m n the insertion of the recurrent sinews into the muscles of the larinx o p branches of the left nerve making the left recurrent sinew p. qq branches from the sixt conjugation going to the coate of the lungs r small nerves of the heart and of the purse thereof called the Pericardium as also some approaching to the coats of the lungs s nerves on either side sent to the stomack t the right stomacke nerve going to the left orifice of the stomack u u the left stomack nerve going to the right orifice of the stomack x a nerve from the branch u passing into the hollownes of the liver y the nerve belonging to the right side of the kell z the nerve belonging to the collick gut α a nerve creeping to the gut called duodenum and the beginning of the ieiunum or empty gut β a nerve implanted in the right side of the bottome of the stomacke γ a nerve belonging to the liver and bladder of gall δ a nerve reaching unto the right kidney 〈◊〉 a branch reaching the Mesenterium and the guts ζ a branch sprinkled to the right part of the bladder η a branch going through the left part of the kel θα surcles derived to the collick gut and the kel χ small branches inserted into the spleen λλ a nerve approaching to the left side of the bottome of the stomack μ a branch belonging to the left side of the Mesentery and the guts ν a branch which attaineth to the left kidney ξ small nerves creeping through the left side of the bladder o the seven paire of finewes 〈◊〉 a branch derived from the sixt coniugation to the muscles which arise from the processe called Styloides 〈◊〉 a branch of the seaventh coniugation which goeth to the muscles of the tongue of the bone hyois and of the throtle or larinx 〈◊〉 A coniunction or coition of the 6. and 7. paire into one nerve These Apophyses clinoides are certaine productions of the Osbasilare or wedge-bone called the Saddle thereof between which as I said the pituitary glandule lies with part of the wonderfull net There is a great controversie amongst Anatomists concerning this part for Vesalius denies that it is in man Columbus admits it yet hee seemes to confound it with the Plexia Choroides Truely I have observed it alwayes after the manner as Sylvius alledges against Vesalius It remaines that we recite the perforations of the skull because the knowledge of these much conduces to the understanding of the insertions of the veines arteryes and nerves CHAP. X. Of the holes of the inner Basis of the Scull IN the first place are reckoned the holes of the bone Ethmoides then those of the optick nerves thirdly of the nerves moving the eyes Fourthly of that portion of the nerves of the fourth conjugation which goe to the temporall muscles Fifthly are reckoned these holes scarse visible
scituate under the pituitary glandule by which the spettle is evacuated Sixthly that hole which is in the wedge bone made for the entrance of the internall sleepy Arteries composing the wonderfull Net and then passing into the braine by a great slit That perforation which we reckon in the seventh place is commonly double made for the entrance of one of the branches of the internall Iugular veine The eight hole is some-what long of an ovall figure by which part of the third conjugation and all the fourth conjugation passes forth The ninth are the auditory passages The tenth are very small holes and give way to the veine and artery going to the auditory passage above the for a men coecum In the eleaventh place are reckoned the perforations which yeild passage forth to the sixth paire of nerves to part of the sleepy Arteries and of the internall jugular In the twelvth those which yeild a way out to the seventh conjugation The great hole of the Nowle bone through which the spinall marrow passes is reckoned the thirteenth The fourtenth is that which most commonly is behinde that great hole by which the Cervicall veines and arteries enter in CHAP. XI Of the perforations of the externall Basis of the Braine THere is a hole on each side at the Eye-browes by which passes a small nerve from the third conjugation comming out of the cavity of the Orbe of the eye and going by the forehead bone to the eye-browes that it may give motion to the two muscles of the upper eye-brow and forehead Yet oftentimes the hole is but to bee seene on one side oft times there is a cleft instead thereof otherwhiles it is not perforated nor cleft at all The second is the perforation of the greater corner of the eye by which a portion of the nerves of the third coniugation descends to the coate of the nose in this hole the Glandula Lachrymalis is seated The third is seated under the eye that it may give way to the other portion of the nerves of the third coniugation going to the parts of the face and the teeth of the upper jaw The fourth is at the beginning of the pallate amongst the cutting or shearing teeth through which a veine an artery and the coate of the pallate passes out In the fifth order are reckoned the perforations of the pallate by which the nerves descend from the fourth coniugation to give or cause the taste In the sixt order are rancked the holes of the pallate serving for respiration and the flegme falling from the braine by the nosethrils And there is a cleft under the yoake bone ascending into the Orbe of the eye by which there is a way as wel for the nerves of the third coniugation to the Temporall muscles as also for certaine veines and arteryes But also there is noted another hole at the mammillary processe which is not perforated in the iudgement of the sense Besides there is thought to be another at the hinde roote of the same processe by which a certaine small veine passes from the Iugular to the Torcular But I have onely noted these three passages by the way because there is so much variety in them that nothing can be certainely said of them CHAP. XII Of the Spinall Marrow or Pith of the Backe THe spinall Marrow is like a River running from the fountaine of the braine This sends nerves for sense and motion to all the neighbouring parts under the head spreading its branches as from the body of a tree These branches as we shall hereafter shew are on each side thirty This same spinall marrow is covered with the two membranes investing the braine distinguished by no distance of place as in the braine But also it hath another membrane added to these being very hard and dense which keeps it from being broken and violated by the violent bending of the body forewards and about The diseases of this marrow doe almost cause the like Symptomes as the diseases of the braine For they hurt the sense and motion of all the parts lying beneath them as for example If any of the vertebra's of the back bone be moved out of their place there followes a distortion or wresting aside of the Marrow but then especially if it happen that one of the vertebra's be strained so sharpe and bitter a compression urges the marrow by reason of the bony body of the vertebra that it will either rend it or certainely hinder the passage of the spirit by it But by these same holes of the vertebra's the veines and arteryes goe to the spinall marrow for to give life and nourishment to it as the nerves by them passe forth into aâ—… the lower parts of the body Figure 1. sheweth the forme of the spinall marrow properly so called with its membranes and the nerves proceeding from it Figure 2. The spinall marrow naked and bare together with its nerves as most part of Anatomists have described it The tenth figure of the spinall marrow A The beginning of the spinall marrow where it fals out of the skull B The thicknesse thereof in the spondels or rack-bones of the loynes C The division thereof into strings or hairy threds D the seven nerves of the necke From D to E or from 7 to 19 shew the nerves of the backe From E to F the nerves of the loynes From F to G the nerves of the os sâ—crum or holy bone H the end of the marrow I K L do shew how the nerves doâ— issue from the marrow in strings M M the knots of the sinewes made of the conjunction of those strings N O the membranes that invest the marrow Figure 2. A The beginning of the spinall marrow in the scull 3 4 5 6 7 These Characters shew according to Vesalius opinion how the conjugations of the nerves of the braine doe take their originall from the marrow remaining yet within the Skull B The egresse of the spinall marrow out of the skull C The cords or strings whereinto it is divided D 7 The marrow of the necke and seven paire of sinewes E 19 twelve paires or conjugations of nerves proceeding from the marrow of the Chest F 24 The marrow of the loynes and 5. paire of sinewes G 30. the marrow of the holy-bone and 6 paire of sinewes H the extremity or end of the spinall marrow The End of the Fifth Booke THE SIXTH BOOKE TREATING OF the Muscles and Bones and the other Extreme parts of the Body The Preface PEradventure some may wonder that I have ended my fifth booke of Anatomie before I have fully described all the parts of the head the which seemed as it were onely appointed for that purpose Therefore I must yeeld a reason of this my intention I have a desire in one Treatise and as it were at one breath to prosequute the Anatomy of the Muscles Wherefore because the parts of the head not yet described principally consist of the Muscles
or Antagonist rests or keeps holieday that when that which is said to open the eye is imployed the opposite thereof resting the upper eye-lid should be drawne towards its originall as we see it happens in convulsions because the operation of a muscle is the collection of the part which it moves towards its originall Therefore seeing such a motion or collection appears not any where in the eye-lid I thinke it therefore manifest that all the motion of this upper eye-lid depends upon this broad muscle and that it alone is the author of the motion thereof The originall of this broad muscle is from the upper part of the Sternon the clavicles the shoulder blades and all the spines of the vertebra's of the neck but it is inserted into all these parts of the head which want haire and the whole face having diverse fibers from so various an originall by benifit of which it performes such manifold motions in the face for it so spreads it selfe over the face that it covers it like a vizard by reason of the variety of the originall and the production of the divers fibers of this muscle But I have not in the description of this muscle prosecuted those nine conditions which in the first booke of my anatomy I required in every part because I may seeme to have sufficiently declared them in the description of the muscles of the Epigastrium Wherfore hence forward you must expect nothing from me in the description of muscles besides their originall insertion action composition and the designation of their vessels CHAP. IIII. Of the Eye-lids and Eye-browes BEcause wee have fallne into mention of the Eye-lids and Eye-browes and because the order of dissection also requires it we must tell you what they are of what they consist and how and for what use they were framed by nature Therefore the Eye-browes are nothing els than a ranck of haires set in a semicircular forme upon the upper part of the orbe of the Eye from the greater to the lesser corner thereof to serve for an ornament of the body and a defence of the eyes against the acrimony of the sweat falling from the forehead But the Eye-lids on each side two one above and another below are nothing els than as it were certaine shuttings appointed and made to close and open the eyes when need requires and to containe them in their orbes Their composure is of a musculous skin a gristle and haires set like a pale at the sides of them to preserve the eyes when they are open chiefly against the injuries of small bodyes as motes dust such like These haires are alwaies of equall and like bignesse implanted at the edges of the gristly part that they might alwaies stand straight and stiffe out They are not thick for so they should darken the eye The gristle in which they are fastened is encompassed with the pericranium stretched so far before it produce the Coniunctiva It was placed there that when any part thereof should be drawne upwards or downewards by the force of the broad muscle or of the two proper muscles it might follow entirely and wholy by reason of its hardnes They call this same gristle especially the upper Tarsus The upper and lower eye-lid differ in nothing but that the upper hath a more manifest motion and the lower a more obscure for otherwise nature should have in vaine encompassed it with a musculous substance CHAP. V. Of the Eyes THe Eyes are the instruments of the faculty of seeing brought thither by the visive spirit of the opticke nerves as in an aqua-ducte They are of a soft substance of a large quantity being bigger or lesser according to the bignesse of the body They are seated in the head that they might overlooke the rest of the body to perceive and shum such things as might endanger or endamage the body for the action of the eyes is most quick as that which is performed in a moment which is granted to none of the other senses Wherefore this is the most excellent sense of them all For by this wee behold the fabricke and beauty of the heavens and earth distinguish the infinite varietyes of colours we perceive and know the magnitude figure number proportion site motion and rest of all bodyes The eyes have a pyramidall figure whose basis is without but the Cone or point within at the opticke nerves Nature would have them contained in a hollow circle that so by the profundity and solidity of the place they might be free from the incursions of bruising and hurtfull things They are composed of six muscles five coats three humors and a most bright spirit of which there is a perpetuall afflux from the braine two nerves a double veine and one artery besides much fat and lastly a Glandule seated at the greater angle thereof uppon that large hole which on both sides goes to the nose and that lest that the humours falling from the braine should flow by the nose into the eyes as we see it fares with those whose eyes perpetually weep or water by reason of the eating away of this glandule whence that affect is called the Fistula lachrymalis or weeping Fistula But there is much fat put between the muscles of the eye partly that the motion of the eyes might be more quick in that slipperines of the fat as also that the temper and complexion of the eyes and chiefly of their nervous parts might be more constant and lasting which otherwise by their continuall and perpetuall motion would be subject to excessive drynesse For nature for the same reason hath placed Glandules flowing with a certaine moisture neere those parts which have perpetuall agitation CHAP. VI. Of the Muscles Coats and humors of the Eye THere are sixe muscles in the eye of which foure performe the foure direct motions of the eye they arise from the bottome of the orbe and end in the midst of the eye encompassing the opticke nerve When they are all moved with one endevour they draw the eye inwards But if the upper only use its action it drawes the eye upwards if the lower downewards if the right to the right side if the left to the left side The two other muscles turne the eye about the first of which being the longer and slenderer arises almost from the same place from which that muscle arises which drawes the eye to the right side to the greater corner But when it comes to the utmost part of the inner angle where the Glandula lachrymalis is seated it ends in a slender Tendon there peircing through the middle membrane which is there as through a ring from whence it presently going backe is spent in a right angle towards the upper part of the eye betwixt the insertions of those 〈◊〉 muscles of the which one draws the eye upwards the other directly to the outward corner as it is
the same decoction for such heat which is actuall resuscitateth strengtheneth 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 Bathes that so he may receave 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. Iuniper Conquassatar ana â„¥ j. Caryophyl Ê’ ij Aquae fontanae Vini albi ana lb. iv Let them be all put in the Vessell mentioned in the Treatise lately described for use The patient shall keepe himselfe in that Bathing-tub as long as his strength will give him leave then let him be put into his bed well covered where he shall sweat againe bee dried and rest Then let him be presently anointed with the following ointment which Leonellus Faventinus 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 Synap Granor. lunip Gummi hederae anacard Ladani puri an â„¥ j. ss Terantur misceantur omnia cum Olets Vino bulliant in vasi duplici usque ad Vini consumptionem facta forti expressione adde Galbani Bdillit Euphorbil Myrrhae Castorei adipis ursi Anatis Ciconiae an Ê’ij Make an ointment in forme of a liniment adding a little wax if need shall require Or you shall use the following remedy approved by many Physitions â„ž Myrrhae aloes Spicaenardi Sanguinis draconis thuris opopanacis Bdellii Carpobalsami amemi sarcocollae eroci mastio gumml arabici styrac liquidae ladani castorei ana â„¥ ij Moschi Ê’ j. aquae vitae â„¥ j. Terebinthinae venetae ad pondus omnium pulverabuntur pulverisanda gummi eliquabuntur cum aqua vitae aceti tantillo And let them all be put in fit vessels that they may be distilled in Balneo Mariae and let the spine of the back and paralytick limbes be anointed with the liquor which comes from thence I have often tried the force of this following Medicine â„ž rad Angel Ireos floren gentian cyperi ana â„¥ j. Calami aromat Cinam Caryophil nucis Mosch macis ana Ê’ ij Salviae major Iuae arthriticae Lavend rorism satureiae puleg. calament mentastri ana M. ss florum chamaem melil hyperic anthos staechad ana P. j. Concisa omnia contundantur in Aqua vit Vini malvat. an lb. ij infundantur And let them be distilled in Balneo Mariae like the former let the affected parts be moistened with the distilled liquor of which also you may give the patient a spoone full to drinke in the morning with some Sugar For thus the stomach will be heated and much phlegme contained therein as the fuell of this disease will be consumed You must also appoint exercises of the affected parts and frequent and hard frictions with hot linnen clothes that the native heat may be recalled and the excrements contained in the parts digested You may also use the Chymicall oyles of Rosemary Tyme Lavander Cloves Nutmegs and lastly of all spices the maner of extracting whereof we shall hereafter declare in a peculiar Treatise CHAP. XIV Of Sowning SOwning is a suddaine and pertinacious defect of all the powers but especially the Vitall In this the Patients lie without motion and sense so that the Ancients thought that it differed from death onely in continuance of time The cause of sowning which happens to those that are wounded is bleeding which causeth a dissipation of the spirits or feare which causeth a suddaine and joint retirement of the spirits to the heart Whence followes an intermission of the proper duty as also of the rest of the faculties whilest they being thus troubled are at a stand Also Sowning happens by a putrid and venenate vapour carried to the heart by the Arteries and to the Braine by the Nerves by which you may gather that all sowning 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 a feare 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 ill humors and in poysonous wounds The signes of Sowning are Palenes a dewy and sudden sweat arising the failing of the pulse a sudden falling of the body upon the ground without sense motion a coldnesse possessing the whole body so that the Patient may seeme rather dead than alive For many of these who fall into a sowne dye unlesse they have present helpe Therefore you shall helpe them if when they are ready to fall you sprinckle much cold water in their face if that the sowning happen by dissipation of the 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 aire you shall give them a little Mithridat or Treacle in Aqua vitae with a spoone as I usually do to those which have the plague or any part affected with a Gangreene or sphacell But if the patients cannot be raised out of their sownes by reason of the pertinatious oppression and compression of the spirits about the heart you must give them all such things as have power to diffuse callforth and resuscitat the spirits such as are strong wines to drink sweet perfumes to smell You must call them by their owne name lowd in their eare and you must pluck them somewhat hard by the haires of the Temples and neck Also rub the temples nostrils wrests and palmes of the Hands with Aquavitae wherin Cloves Nutmegs and Ginger have beene steeped CHAP. XV. Of Delirium i. Raving Talking idly or Doting DOting or talking idly here is used for a symptome which commonly happeneth in feavers caused by a wound and inflammation and it is a perturbation of the phantasie and function of the mind not long induring Wherefore such a doting happens upon wounds by reason of vehement paine and a feaver when as the nervous parts as the joynts stomach and middriffe shall be violated For the Ancients did therefore call the Middriffe Phrenae because when this is hurt as if the mind it selfe were hurt a certaine phrensie ensues that is a perturbation of the Animall faculty which is imployed in ratiocination by reason of the community which the Diaphragma hath with the Braine by the nerves sent from the sixth Conjugation which are carried to the stomach Therefore doting happens by too much bleeding which
it hath not bin sufficiently explained why a convulsion in wounds of the head seazes on the part opposite to the blow Therefore I have thought good to end that controversie in this place My reason is this that kinde of Symptome happens in the sound part by reason of emptinesse and drynesse but there is a twofold cause and that wholy in the wounded part of this emptinesse and drynesse of the sound or opposite part to wit paine and the concourse of the spirits and humors thither by the occasion of the wound and by reason of the paines drawing and natures violently sending helpe to the afflicted part The sound part exhausted by this meanes both of the spirits and humors easily falls into a Convulsion For thus Galen writes God the creatour of nature hath so knit together the triple spirituous substance of our bodies with that tye and league of concord by the productions of the passages to wit of Nerves Veines 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 axiome hath no truth in the vessells and passages of the body For it hath not every where doubled the vessels for there is but one onely veine appointed for the nourishment of the braine 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 though that occasion cause it to have a convulsion by too much drynesse Verily it is true that when in the opposite parts the muscles of one kinde are equall 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 braine For the two parts of the braine the right and left each by its selfe performes that which belongs thereto without the consent conspiratiou or commerce of the opposite part for otherwise it should follow that the Palsie properly so called that is of halfe the body which happens by resolution caused either by mollification or obstruction residing in either part of the braine should inferre together with it a Convulsion of the opposite part Which notwithstanding dayly experience convinces as false Wherefore wee must certainely thinke that in wounds of the head wherein the braine 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 Chirurgiry renders another reason of this question That saith he the truth of this proposition may stand firme and ratified we must suppose that the convulsion of the opposite part mentioned by Hippocrates doth then onely happen when by reason of the greatnesse of the inflammation in the hurt part of the braine which hath already inferred corruption and a Gangraene to the braine and membranes thereof and within a short time is ready to cause a sphacell in the scull 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 Gangraenes through the extinction of the native heate Besides the passages of the animall spirit must necessarily bee so obstructed by the greatnesse 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 braine and if it should flow thither it will be unprofitable to carry the strength and facultie of sense and motion as that which is infected and changed by admixture of putred and Gangraenous vapours Whereby it cometh to passe that the wounded part destitute of sense is not stirred up to expell that which would be troublesome to it if it had sense wherefore neither are the Nerves thence arising seased upon or contracted by a Convulsion It further more comes to passe that because these same nerves are deprived of the presence and comfort of the animall 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 cutting or obstruction of a Nerve or the madefaction or mollification thereof by a thinne and watry humor or so affected by some vehement distemper that it cannot receive the Animall spirit But for the opposite part and the convulsion thereof it is knowne and granted by all that a convulsion is caused either by repletion which shortens the Nerves by distending them into bredth or by inanition when as the native and primitive heate of the Nerves being wasted their proper substance becomming dry is wrinckled up and contracted or else it proceedes from the vellication and acrimonie of some vapour or sanious and biting humor or from vehemencie of paine So wee have knowne the falling sicknesse caused by a venenate exhalation carried from the foote to the braine Also wee know that a convulsion is caused in the puncture of the Nerves when as any acride and sanious humor is shut up therein the orifice thereof being closed but in wounds of the Nerves when any Nerve is halfe cut there happens a convulsion by the bitternesse of the paine But verily in the opposite part there are manifestly two of these causes of a convulsion that is to say a putride and carionlike vapour exhaling from the hurt and Gangraenate part of the braine and also a virulent acride and biting Sauies or filth sweating into the opposite sound part from the affected and Gangraenous the malignitie of which Sanies Hippocrates desirous to decipher in reckoning up the deadly signes of a wounded head hath expressed it by the word Ichor and in his booke of fractures he hath called this humor Dacryodes et non Pyon that is weeping and not digested Therefore it is no mervaile if the opposite and sound part endewed with exquisite and perfect sense and offended by the flowing thereto of both the vaporours and sanious matter using its own force contend and labour as much as it can for the expulsion of that which is trouble somethereto This labouring or concussion is followed as we see in the falling sicknesse by a convulsion as that which is undertaken in vaine death being now at hand and nature over-ruled by the disease Thus saith Dalechampius must we in my judgement determine of that proposition of Hippocrates and Avicen But he addes further in wounds of the head which are not deadly practitioners observe that sometimes the hurt part is taken with the palsie and the sound with a convulsion otherwhiles on the contrary the wounded part is seazed by a
being present it is dangerous to draw the nerves and tendons too violently for hence would ensue an impostume convulsion gangrene and mortification Therefore Hippocrates forbids you to defer such extension untill the third or fourth day Fractures are thought dangerous whose fragments are great and fly out especially in these bones which are filled with marrow on the inside When broken or dislocated bones cannot be restored to themselves and their naturall place the part wasts for want of nourishment both for that the naturall site of the veines arteries and nerves is perverted as also because the part it selfe lyes immoveable or scarce moveable whereby it commeth to passe that the spirits doe not freely flow thereto as neyther the nutritive juice commeth thither in sufficient plentie When the dislocated or broken member is troubled with any great inflammation it is doubtfull whether or no a convulsion will happen if wee attempt to restore it or the parts thereof to their seat therefore it is better if it may bee done to deferre the reducing thereof so long untill the humor which possesses the part be dissolved the tumor abated and the bitternesse of paine mitigated CHAP. IV. The generall cure of broken and dislocated bones TO cure a broken and dislocated bone is to restore it to its former figure and site For the performance whereof the Surgeon must propose three things to himselfe The first is to restore the bone to its place The second is that he containe or stay it being so restored The third is that he hinder the increase of maligne symptomes and accidents or else if they doe happen that then he temper and correct their present malignitie Such accidents are paine inflammation a feaver abscesse gangrene and sphacell For the first intention you may easily restore broken or dislocated bone if presently as soon as the mischance is got or else the same day you endeavour to restore it for the bitternesse of paine or inflammation which may trouble the patient is not as yet verie great neyther is the contraction of the muscles upwards as yet very much or stubborne Therefore first of all the Patient with his whole bodie but especially with the broken or dislocated part as also the Surgeon must bee in some place which hath good and sufficient light Then let trusty and skilfull attendants be there good ligatures and also if need so require good engines His friends which are present let them see and hold their peace neyther say nor do any thing which may hinder the Worke of the Surgeon Then putting one hand above that is towards the center of the body and the other below as neare as hee can to the part affected let him stretch forth the member for if you lay your hand any distance from the part affected you wil hurt the sound part by too much compression neyther will you much avayle your selfe by stretching it at such a distance But if you only endeavour below with your hand or ligature assisting to make extension thereof it will be dangerous if there bee nothing above which may withstand or hold lest that you draw the whole bodie to you This being done according as I have delivered it is fit the Surgeon make a right or straight extension of the part affected for when the bone is eyther broken or out of joynt there is a contraction of the muscles towards their originall and consequently of the bones by them as it is observed by Galen Wherefore it is impossible to restore the bones to their former seat without the extension of the muscles But the part being thus extended the broken bones will sooner and more easily be restored to their former seate Which being restored you shall presently with your hand presse it downe if there be any thing that bunches or stands out And lastly you shall binde it up by applying boulsters and splints as shall bee fit But if the bone bee dislocated or forth of joynt then presently after the extension thereof it will be requisite to bend it somwhat about and so to draw it in The Surgeon is sometimes forced to use engines for this worke especially if the luxation be inveterate if the broken or luxated bones be great and that in strong and rustick bodies and such as have large joynts for that then there is need of greater strength than is in the hand of the Surgeon alone For by how much the muscles of the Patient are the stronger by so much will they bee contracted more powerfully upwards towards their originals Yet have a care that you extend them not too violently lest by rending and breaking a-sunder the muscles and nerves you cause the forementioned symptomes paine convulsion a palsie and gangrene all which sooner happen to strong and aged bodies than to children eunuches women youthes and generally all moyst bodies for that they are lesse hurt by violent extension and pulling by reason of their native and much humiditie and softnesse For thus skins of leather moystened with any liquor are easily retched and drawn out as one pleaseth but such as are dry hard being lesse tractable will sooner rend and teare than stretch further out Therefore the Surgeon shall use a meane in extending and drawing forth of members as shall be most agreeable to the habits of the bodies You may know the bone is set and the setting performed as is fit if the paine be asswaged to wit the fibres of the muscles and the other parts being restored to their former site and all compression which the bones moved out of their places have made being taken away if to your feeling there bee nothing bunching out nor rugged but the surface of the member remaine smooth and equall and lastly if the broken or dislocated member compares with its opposite in the composure of the joynts as the knees and ancles answer justly and equally in length and thicknesse For which purpose it must not suffice the Surgeon to view it once but even as often as he shall dresse it For it may happen that the bone which is well set may by some chance as by the Patients unconsiderate turning himselfe in his bed or as it were a convulsive twitching of the members or joynts whilest he sleepes the muscles of their owne accord contracting themselves towards their originals that the member may againe fall out and it will give manifest signes thereof by renewing the paine by pressing or pricking the adjacent bodies which paine will not cease before it bee restored to its place and hereof the Surgeon ought to have diligent care For if whilest the Callus is in growing one bone ride over another the bone it selfe will afterwards be so much the shorter and consequently the whole member so that if this errour shall happen in a broken legge the Patient will halt ever after to his great griefe and the Surgeons shame Wherefore the Patient shall take heed as much
so to apply one on each side of the dislocated vertebrae and so with your hands to presse them against the bunching forth vertebrae untill you force them backe into their seats just after the manner you see it here delineated In the meane while have a care that you touch not the processes which stand up in the ridge of the Spine for they are easily broken You may know that the vertebrae are restored by the equall smoothnesse of the whole Spine It is fit after you have restored it to binde up the part and lay splints or plates of Lead neatly made for that purpose upon it but so that they may not presse the crists or middle processes of the vertebrae which I formerly mentioned but only the sides then the Patient shall be layd upon his backe in his bed and the splints long kept on lest the vertebrae should fall out againe CHAP. XVII A more particular inquirie of the Dislocation of the Vertebrae proceeding from an internall cause THe vertebrae are in like sort luxated by the antecedent cause as wee have formerly said which is caused by the naturall imbecillitie of the parts principally of the nervous ligament by which all the vertebrae are bound each to other this ligament comes not to the spinall marrow but onely bindes together the vertebrae on their outsides For besides the two membranes proceeding from the two Meninges of the Braine wherewith the marrow is covered there is a third strong and nervous coate put upon it lest whilest the spine is diversly bended the bended marrow should bee broken This third coate arises from the pericranium as soone as it arrives at the first vertebrae of the necke Now that Ligament wherewith we said the joynts of the vertebrae were mutually knit and fastened is encompassed with a tough and glutinous humor for the freeâ—r motion of the vertebrae Sometimes another cold crude grosse and viscide humor confused and mixed herewith by great defluxions and catarrhes begets a tumor which doth not only 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 drawne 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 Greeke Cyphosis Those thus affected we may call Bunch-backt But when it is depressed it is named Lordosis Such we may terme Saddle-backt But when the same is luxated to the right or left side it maketh a Scoliosis or Crookednesse which wresting the spine drawes it into the similitude of this letter S. Galen addes a fourth default of the vertebrae which is when their joynts are moved by reason of the loosenesse of their ligaments the vertebrae yet remaining in their places and he cals it a Seisis or shaking They also note another defect peculiar to the Spinall marrow which is when as it the vertebrae being not moved whereto it adheres is plucked and severed from them this disease is occasioned by a fall from on high by a great stroake and by all occasions which may much shake and consequently depresse the spinall marrow or by any other meanes 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 thinke upon But let us returne to the internall cause of Luxations Fluid and soft bodies such as Childrens usually are very subject to generate this internall cause of defluxion If externall occasions shall concurre with these internall causes the vertebrae will sooner be dislocated Thus Nurses whilst they too straitly lace the breasts and sides of girles so to make them slender cause the breast-bone to east its selfe in forwards or backwards or else the one shoulder to bee bigger or fuller the other more spare and leane The same error is committed if they lay children more frequently and longupon their sides than upon their backs or if taking them up when they wake they take them only by the feete or legges and never put their other hand under their backs never so much as thinking that children grow most towards their heads CHAP. XVIII Prognosticks of the Dislocated Vertebrae of the backe IF in Infancie it happen that the vertebrae of the backe shall bee dislocated the ribbs will grow little or nothing in breadth but runne outwards before therefore the chest loseth its naturall latitude and stands out with a sharpe point Hence they become asthmaticke the lungs and muscles which serve for breathing being pressed together and straitened and that they may the easâ—ier breathe they are forced to hold up their heads whence also they seeme to have great throats Now because the weazon being thus pressed the breath is carried through a strait passage therefore they whease as they breath and snort in their sleepe for that their lungs which receive and send forth the breath or ayre be of lesse bignesse besides also they are subject to great distillations upon their lungs whereby it commeth to passe that they are shorter lived But such as are bunch-backed below the midriffe are incident to diseases of the kidneyes and bladder and have smaller and slenderer thighes and legges and they more slowly and sparingly cast forth haire and have beards to conclude they are lesse fruitfull and more subject to barrennesse than such as have their crookednesse above their midriffe The Bunches which proceede from externall causes are oft times cureable but such as have their originall from an inward cause are absolutely uncureable unlesse they be withstood at the first with great care industrie Wherefore such as have it by kinde never are helped Such as whilest they are yet Children before their bodies bee come to perfect growth have their Spine crooked and bunching out their bodies use not to grow at the Spine but their legges and armes come to their perfect and full growth yet the parts belonging to their breasts and backe become more slender Neither is it any wonder for seeing the veines arteries and nerves are not in their places the spirits doe neither freely nor the alimentarie juices plenteously flow by these straitned passages whence leannesse must needs ensue but the limbs shall thence have no wrong for that not the whole bodie but the neighbouring parts onely are infected with the contagion of this evill When divers vertebrae following each other in order are together and at one time dislocated the dislocation is lesse dangerous than if one alone were luxated For when one only vertebrae is dislocated it carries the Spinall marrow so away with it that it forces it almost into a sharpe angle wherefore being more straitly pressed it must necessarily bee eyther broken or hurt which is absolutely deadly for that it is
want of nourishment both because the part it self is forced to desist from the accustomed actions and functions as also for that the veines arteries and nerves being more straitned and put out of their places hinder the spirits and nourishment from flowing so freely as they ought to the part whence it comes to passe that the part it self made more weak the native heat being debilitated through idlenesse it can neither attract the alimentary juice neither can it digest assimulate that little therof which flowes and falleth thereto Verily the Thigh-bone as long as it is forth of the cavity growes no more after the manner as the other bones of the body doe and therefore in some space of time you may perceive it to bee shorter than the sound bone Notwithstanding the bones of the legge and foote are not hindered of their growth for that they are not out of their proper places Now for that the whole leg appears more slender you must think that happens only by the extenuation leannesse of the proper muscles thereof The same thing happens to the whole hand in the largest acception when as the shoulder is out of joint unlesse that the calamity and losse hereof is the lesse For the shoulder being forth of joint you may do something with your hand whereby it will come to passe that no small portion of nourishment may flow downe into these parts But the Thigh-bone being dislocated especially inwards in a child unborn or an infant much lesse alimentary nourishment flowes to that part because it can much lesse use the foot and legge by reason of the dislocation of the Hipp than it can doe the hand by a luxation of the shoulder But now wee must thus understand that which is said by Hippocrates That dislocated bones and not restored doe decrease or are hindred from their just growth to bee onely in those who have not yet attained to their full and naturally appointed growth in every demension For in men of full growth the bones which are not restored become more slender but yet no shorter as appeares by that which hee hath delivered of the shoulder CHAP. XLI Of the signes of the Hipp dislocated outwardly or inwardly THe thigh-bone or Hipp when it is dislocated outwardly and not restored after some time the paine is asswaged and flesh growes about it the head of the bone weares it selfe a new cavity in the adjoyning Hipp whereinto it betakes it selfe so that at the length the patients may go without a staffe neither so deformed a leannesse will waste their legge But if the luxation happen inwards a greater leannesse will befall them by reason that the vessels naturally run more inwardly as Galen observes in the dislocation of the Vertebrae to the inside therefore it comes to passe that they are more grievously oppressed besides the thigh-bone cannot wagge or once stirre against the share-bone wherefore if the bone thus dislocated bee not restored to its joynt againe then they must cast their legge about as they walke just as wee see oxen doe Wherefore the sound legge whilest they go takes much lesse space than the lame because this whilest it stirreth or moveth must necessarily fetch a compasse about but that performeth its motion in a right line Besides whilest the patients stand upon their lame legge to put forwards the sound they are forced to stand crooked whereupon they are forced to stay themselves with a staffe that they fall not Furthermore those who have this bone dislocated either backwards or outwards so that it cannot bee restored have the part it selfe grow stiffe and hard which is the cause why the ham may bee bended without great paine and they may stand and goe upon the tops of their toes besides also when they desire â—o goe faster they are forced to stoope and strengthen themselves by laying their hand on their lame thigh at every step both for that their lame legge is the shorter as also because the whole weight of the body should not lye wholly or perpendicularly upon the joynt or head of the thigh-bone Yet in continuance of time when they are used to it they may goe without any staffe in their hands Yet in the interim the sound leg becomes more deformed in the composure figure because whilest it succours the opposite and lame leg by the firme standing on the ground it beares the weight of the whole body in performance wherereof the ham must necessarily now and then bend But on the contrary when as the head of the thigh being dislocated inwards is not put into the joynt if the patient be arrived at his full growth after that the head of the bone hath made it selfe a cavity in the neighbouring bone wherein it may rest he may bee able to walke without a staffe because the dislocated leg cannot easily be bended towards the groine or ham and he will sooner rest upon his heele than upon his toes This kinde of dislocation if it bee inveterate can never be restored And these things happen when as the thigh-bone is dislocated inwards or when the internall ligament which fastens the dearticulation shall be broken or relaxed But the contrary shall plainely appeare if the dislocation shall happen to bee outwards for then the lame legge becomes the shorter because the head of the thigh flyes into a place higher than its cavity and the muscles of that part are contracted towards their originall and convulsively draw the bone upwards together with them The whole leg together with the knee and foot looketh inwards they cannot goe upon their heels but upon the setting on of the toes The legge may bee bended which it cannot bee in a dislocation of the thigh inwards as Paulus shewes Therefore wee must diligently observe that sentence of Hippocrates which is read with a negative in these words Sed neque conflectere quemadmodum sanum crus possunt that they ought to bee read with an affirmative after this manner Sed conflectere c. quin crue ipsum c. But now the lame legge will better sustaine the weight of the body in an externall than in an internall dislocation for then the head of the thigh is more perpendicularly subject to the whole weight of the body Therefore when in successe of time it shall by wearing have made it selfe a cavity in the neighbouring bone which in time will be confirmed so that there will remaine no hope of restoring the dislocation neverthelesse the patient shall be able to goe without a staffe for that then no sense of paine will trouble him whence it followes that the whole leg also will become lesse leane for that going is lesse painfull neither are the vessels so much pressed as in that dislocation which is made inwardly CHAP. XLII Of the thigh-bone dislocated forewards IT seldome happeneth that the thigh is dislocated forwards yet when as it shall happen it is knowne by these signes The head of the
discerned from unripe and uncurable ones IF the sound eye being shut the pupill of the sore or suffused eye after it shall be rubbed with your thumbe bee presently dilated and diffused and with the like celerity returne into the place figure colour and state it is thought by some to shew a ripe and confirmed cataract But an unripe and not to bee couched if the pupill remaine dilated and diffused for a long while after But it is a common signe of a ripe as also more dense and consequently uncurable suffusion to bee able to see nor distinguish no visible thing beside light and brightnesse for to discerne other objects sheweth that it is not yet ripe Therefore the sound eye being shut and pressed the pupill of the other rubbed with your thumbe is dilated enlarged swelleth and is more diffused the visive spirits by this compression being as it were forced from the sound into the fore eye But these following cataracts are judged uncurable that is such as are great such as when the eye-lid is rubbed are nothing dilated or diffused whose pupill becommeth no broader by this rubbing for hence you may gather that the stopping or obstruction is in the opticke nerve so that how cunningly and wellsoever the cataract bee conched yet will the Patient continue blind you shall do no more good in couching a cataract which is in an eye consumed and wasted with a Phthisis Also that cataract is uncurable which is occasioned by a most grievous disease to wit by most bitter and cruell paines of the head or by a violent blow Such as are of a plaister-like green blacke livid citrine and quicksilver-like colour are usually uncurable On the contrary such as are of a Chesnut colour or of a skye or sea-water colour with some little whitnesse yeeld great hope of a happy and successefull cure CHAP. XXII Of the couching a Cataract AFter you shal know by the forementioned signes that the Cataract is curable it remains that you attempt the couching thereof but so that there be nothing which may hinder For if the paine of the head cough nauseousnes or vomiting at that time trouble the patient you shal then bestow your labour in vaine Wherefore you must expect untill these symptomes be gone Then make choice of a season fitting for that purpose that is in the decrease of the moon when the aire is not troubled with thunder nor lightening and when as the Sunne is not in Aries because that signe hath dominion over the head Then let the Surgeon consult a Physitian whether purging or bloud-letting be convenient for the Patient so to resist plethoricke symptomes otherwaies ready to yeeld matter for relapse Two dayes after you must make choice of a place furnished with indifferent or competent light and the Patient being fasting shall be placed in a strait chaire so that the light may not fall with the beames directly upon him but sidewise The eye which shall bee cured must bee made more steddy by laying and binding wooll upon the other Then the Surgeon shall feate and place himselfe directly against the Patient upon a seat somewhat higher and bidding the Patient put his hands downe to his girdle he shall hold the patients legges betweene his knees One shall stand at the Patients backe who shall hold his head and keepe it from stirring for by a little stirring hee may lose his sight for ever Then must you prepare and make ready your needle and thrust it often into some strong thicke cloth that it may bee as it were smoothe by this motion and for the performance of the worke in hand with the lesse paine somewhat warmed It must bee made of iron or steele and not of gold or silver it must be also flatted on the sides and sharpe pointed that so it may the better pierce into the eye and wholly couch the Cataract once taken hold of and lest it should slip in the Surgeons hand and be lesse steddy it shall bee put into a handle as you may see by the following figure A needle inserted in a handle for the couching of Cataracts All things being thus in a readinesse you must bid the patient to turne the sight of his eye towards his nose and the needle must be boldly thrust for it is received in a place that is voyde and onely filled with spirits directly by the coat Adnata in the middle space between the lesser corner the horny coat just against the midst of the Cataract yet so as that you hurt no vein of the Adnata then by stirring it as it were diversly untill it come to the midst of the pupill and suffusion When it is come thither the needle must bee inclined from above downewards to the suffusion and there to be stirred gently untill by little and little it couch or bring downe the Cataract as whole as may be beneath the compasse of the pupill let him still follow it though couched with his needle and somewhat violently depresse and keep it down for some short space that so it may rest and stay in that lower place whether it is depressed The Surgeon shall try whether it firmely remaine there or no bidding the patient presently to move his eye For if it remaine constantly so and doe not returne againe the cure is perfect Then must the needle be lifted up by little and little neither must it presently be taken forth that if the Cataract should beare up or rise againe that it might againe and so often whilst the worke is yet hot and all things in a readinesse be couched towards the lesser corner untill it be fully and surely hid Then must you draw backe the needle gently and after the same manner as you put it in lest if you use not moderation you bring backe the Cataract from whence you couched it or grievously offend the crystalline humour the prime instrument of sight or the pupill with danger of dilating thereof Some as soone as the worke is done give the patient something in his hand to looke upon but Paulus approves not thereof for hee feares lest his endeavouring or striving to see may draw backe the Cataract Wherefore it is more wisedome and better presently after the drawing forth of the needle to put on a soft ragge the white of an egge beaten in rose-water with a little choice alume and so apply it to the eye and neighbouring parts for to binde and binder the inflammation then also you must together therewith bind up the sound eye lest by stirring to see it might together therewith draw and move the fore eye by reason of the sympathy and consent they mutually have by the opticke nerves After all things are thus performed the patient shall bee laid in a solt bed so placed that his head may lye somwhat high let him be laid far from noise let him not speake nor eate any hard thing that may trouble
glasses applyed with much flame to sundry parts of the body are good Also bathes of warme water with a decoction of such things as resist poyson as southerne wood calaminte rue betony horehound penny royall bayes scordium smallage scabious mints valerian and the like are good in this case Also sweates are good being provoked so much as the strength of the patient can endure But if he be very wealthy whom we suspect poysoned it will be safer to put him into the belly of an oxe horse or mule and then presently into another assoone as the former is cold that so the poyson may bee drawne forth by the gentle and vaporous heate of the new killed beast yet doe none of these things without the advise of a Physitian if it may conveniently be had CHAP. VII How the corrupt or venemous Ayre may kill a Man THE aire is infected and corrupted by the admixture of maligne vapours either arising from the unburied bodies of such as are slaine in great conflicts or exhaling out of the earth after earth-quakes for the aire long pent up in the cavities and bowells of the earth and deprived of the freedome and commerce of the open aire is corrupted and acquires a maligne quality which it presently transferreth unto such as meet therewith Also there is a certaine malignity of the aire which accompanieth thunders and lightnings which favoures of a sulphureous virulency so that whatsoever wilde beastes shall devoure the creatures killed therewith they become madde and dye immediately for the fire of lightning hath a farre more rapid subtle and greater force than other fires so that it may rightly be termed a Fire of Fires An argument hereof is that it melteth the head of a spear not harming the wood and silver and gold not hurting the purse wherein it is conteined Also the aire is infected by fumigations which presently admitted into the body and bowels by the mouth and nose in respiration by the skinne and arteries in perspiration doth easily kill the spirits and humours being first infected and then within a short space after the solid substance of the principall parts chiefly of the heart being turned into their nature unlesse the man be first provided for by sneesing vomiting sweating purging by the belly or some other excretion For that poyson which is carryed into the body by smell is the most rapid effectuall by so much as a vapor or exhalation is of more subtle quicklier piercing essence than an humor Yet not withstanding wilt thou say it is not credible that any can be kild by any vapor raised by the force of fire as of a Torch or a Warming-pan for that the venenate quality of the thing that is burnt is dissipated and consumed by the force of the fire purging and cleansing all things This reason is falsly faigned to the destruction of the lives of carelesse people for sulphureous brands kindled at a cleere fire doe notwithstanding cast forth a sulphureous vapour Whether doe not Lignum aloes and Juniper when they are burnt in a flame smell lesse sweetly Pope Clement the seventh of that name the Uncle of our Kings Mother was poysoned by the fume of a poysonous Torch that was carryed lighted before him and dyed thereof Mathiolus telleth that there were two Mountebanks in the market place of Sicnna the one of which but smelling to a poysoned gilly-flower given him by the other fell downe dead presently A certaine man not long ago when he had put to his nose and smelled a little unto a pomander which was secretly poysoned was presently taken with a Vertigo and all his face swelled and unlesse that hee had gotten speedy helpe by sternutatories and other meanes hee had died shortly after of the same kinde of death that Pope Clement did The safest preservative against such poysons is not to smell to them moreover some affirme that there are prepared some poysons of such force that being anointed but on the saddle they will kill the rider others that if you but anoint the stirrops therwith they will send so deadlie poysonous a qualitie into the rider through his boots that he shall die therof within a short time after which things though they be scarce credible because such poysons touch not the naked skin yet have they an example in nature whereby they may defend themselves For the Torpedo sends a narcoticke and certainelie deadlie force into the arme and so into the bodie of the Fisher the cords of the net being between them CHAP. VIII That every kinde of Poyson hath its proper and peculiar Signes and Effects AS poysons are distinct in species so each species differs in their signes and effects neither is it possible to find anie one kinde of poyson which may be accompanied or produce all the signes and effects of all poysons other-wise Physitians should in vaine have written of the signes and effects of each of them as also of their proper remedies antidotes For what kind of poyson shall that be which shall cause a burning heat in the stomack bellie liver bladder kidneies which shall cause a hicketting which shall cause the whole body to tremble and shake which shall take away the voice and speech which shall cause convulsions shall weaken the pulsificke facultie which shall intercept the freedome of breathing which shall stupesie and cast into a dead sleepe which shall together and at once cause a Vertigo in the head dimnesse in the sight a strangling or stoppage of the breath thirst bleeding feaver stoppage of the urine perpetuall vomiting rednesse lividnesse and paleness of the face resolution of the powers and manie other things all which are caused by all sorts of poyson Lastly no bodie will denie but that hot poysons may kill more speedily than cold for that they are more speedily actuated by the native heat CHAP. IX The Effects of Poysons from particular venemous things and what Prognosticks may thence bee made IT is the opinion of Cornelius Celsus and almost of all the antients That the bite of everie beast had some virulencie but yet some more than othersome They are most virulent that are inflicted by venemous beasts as Aspes Vipers Water-snakes and all kindes of Serpents Basiliskes Dragons Toads Mad dogges Scorpions Spiders Bees Waspes and the like They are lesse maligne which are of creatures wanting venome as of Horses Apes Cats Dogges not mad and manie other things which though of their owne nature they are without poison yet in their bites there is something more dolorisicke and ill natured than in common wounds inflicted by other occasions I beleeve that in their slaver or sanies there is something I know not how to terme it contrarie to our nature which imprints a maligne qualitie in the ulcer which also you may observe in the tearings or scratchings of such creatures as have sharpe clawes as Lions and Cats Moreover manie affirme that they have found by
either in a marish or sandy ground cannot prosper well also a mola contained in the wombe the falling down of the wombe the leannesse of the womans body ill humours bred by eating crude and raw fruits or great or over-much drinking of water whereof obstructions and crudities follow which hinder her fruitfulnesse Furthermore by the use of stupefactive things the seminall matter is congealed and restrained and though it flow and be cast out yet it is deprived of the prolificke power and of the lively heat and spirits the orifices or cotylidones of the veines and arteries are stopped and so the passage for the menstruall matter into the wombe is stopped When the Kall is so fat that it girdeth in the wombe narrowly it hindereth the fruitfulnesse of the woman because it will not permit the mans seed to enter into the wombe Moreover the fat and fleshy habit of the man or woman hinder generation For it hindreth them that they cannot joyne their genitall parts together and by how much the more bloud goeth into fat by so much the lesse is remaining to be turned into seed menstruall bloud which two are the originals principals of generation Those women that are speckled in the face some what lean pale because they have their genitals moystned with a saltish sharp and tickling humour are more given to venery than those that are red fat Finally Hippocrates sets downe foure causes onely why women are barren and unfruitfull The first is because they cannot receive the mans seede by reason of the default of the neck of the wombe the second because when it is received into the wombe they cannot conceive it the third is because they cannot nourish it the fourth because they are not able to carry or beare it untill the due and lawfull time of birth These things are necessary to generation the object wil faculty concourse of the seeds and the remaining or abiding thereof in the wombe untill the due and appointed naturall time CHAP. XXXIX The signes of a distempered wombe THat woman is thought to have her wombe too hot whose courses come forth sparingly and with paine and exulcerate by reason of their heate the superfluous matter of the bloud being dissolved or turned into wind by the power of the heat whereupon that menstruall bloud that floweth forth is more grosse and black For it is the property of heat by digesting the thinner substance to thicken the rest and by adustion to make it more black Furthermore shee that hath her genitals itching with the desire of copulation will soone exclude the seede in copulation and shee shall feele it more sharpe as it goeth through the passages That woman hath too cold a wombe whose flowers are either stopped or flow sparingly and those pale and not well coloured Those that have lesse desire of copulation have lesse delight therein and their seed is more liquid and waterish and not stayning a linnen cloth by sticking thereunto and it is sparingly and slowly cast forth That wombe is too moist that floweth continually with many liquid excrements which therefore will not hold the seed but presently after copulation suffereth it to fall out which will easily cause abortion The signes of too dry a wombe appeare in the little quantity of the courses in the profusion of a small quantity of seed by the desire of copulation whereby it may be made slippery by the moysture of the seede by the fissures in the necke thereof by the chaps and itching for all things for want of moysture will soone chap even like unto the ground which in the summer by reason of a great drought or drynesse will chap and chinke this way and that way and on the contrary with moisture it will close and joyne together againe as it were with glew A woman is thought to have all opportunities unto conception when her courses or flowers doe cease for then the wombe is voyd of excrementall filth and because it is yet open it will the more easily receive the mans seede and when it hath received it it will better retaine it in the wrinkles of the cotylidones yet gaping as it were in rough and unequall places Yet a woman will easily conceave a little before the time that the flowers ought to flow because that the menstruall matter falling at first like dew into the wombe is very meet and fit to nourish the seede and not to drive it out againe or to suffocate it Those which use copulation when their courses fall downe abundantly will very hardly or seldome conceive and if they doe conceive the child will be weake and diseased and especially if the womans bloud that flowes out be unfound but if the bloud bee good and laudable the childe will bee subject to all plethoricke diseases There are some women in whom presently after the fluxe of the termes the orifice of the wombe will be closed so that they must of necessity use copulation with a man when their menstruall fluxe floweth if at lest they would conceive at all A woman may beare children from the age of fourteene untill forty or fifty which time whosoever doth exceed will beare untill threescore yeares because the menstruall fluxes are kept the prolificall faculty is also preserved therefore many women have brought forth children at that age but after that time no woman can beare as Aristotle writeth Yet Pliny saith that Cornelia who was of the house of the Scipioes being in the sixty second yeare of her age bare Volusius Saturnius who was Consull Valescus de Tarenta also affirmeth that he saw a woman that bare a childe on the sixty second yeare of her age having borne before on the sixtieth and sixty first yeare Therefore it is to bee supposed that by reason of the variety of the ayre region diet and temperament the menstruall fluxe and procreative faculty ceaseth in some sooner in some later which variety taketh place also in men For in them although the seede be genitable for the most part in the second seventh yeare yet truely it is unfruitfull untill the third seventh yeare And whereas most men beget children untill they bee threescore yeers old which time if they passe they beget till seventy yet there are some knowne that have begot children untill the eightieth yeere Moreover Pliny writeth that Masinissa the King begot a sonne when hee was fourescore and sixe yeeres of age and also Cato the Censor after that he was fourescore CHAP. XL. Of the falling downe or perversion or turning of the wombe THe wombe is said to fall downe and be perverted when it is moved out of its proper and naturall place as when the bands and ligatures thereof being loosed and relaxed it falleth downe unto one side or other or into its owne necke or else passeth further so that it comes out at the necke and a great portion thereof appeares without the privie parts
veine great sweats ulcers flowing much and long scabbinesse of the whole skinne immoderate grossenesse and clamminesse of the blood and by eating of raw fruites and drinking of cold water by sluggishnesse and thicknesse of the vessels and also the obstruction of them by the defaults and diseases of the wombe by distemperature an abscesse an ulcer by the obstruction of the inner orifice thereof by the growing of a Callus caruncle cicatrize of a wound or ulcer or membrane growing there by injecting of astringent things into the necke of the wombe which place many women endeavour foolishly to make narrow I speake nothing of age greatnesse with child nursing of children because these causes are not besides nature neither doe they require the helpe of the Physitian Many women when their flowers or tearmes be stopped degenerate after a manner into a certaine manly nature whence they are called Viragines that is to say stout or manly women therefore their voice is more loud and bigge like unto a mans and they become bearded In the city Abdera saith Hippocrates Phaethusa the wife of Pytheas at the first did beare children and was fruitfull but when her husband was exiled her flowers were stopped for a long time but when these things happened her body became manlike and rough and had a beard and her voice was great and shrill The very same thing happened to Namysia the wife of Gorgippus in Thasus Those virgins that from the beginning have not their monethly fluxe and yet neverthelesse enjoy their perfect health they must necessarily be hot and dry or rather of a manly heat and drynesse that they may so disperse and dissipate by transpiration as men doe the excrements that are gathered but verily all such are barren CHAP. LII What accidents follow the suppression or stopping of the monthly fluxe or flowers WHen the flowers or monethly fluxe are stopped diseases affect the womb and from thence passe into all the whole body For thereof commeth suffocation of the womb headache swouning beating of the heart and swelling of the breasts and secret parts inflammation of the wombe an abscesse ulcer cancer a feaver nauseousnesse vomitings difficult and slow concoction the dropsie strangury the full wombe pressing upon the orifice of the bladder blacke and bloody urine by reason that portion of the blood sweateth out into the bladder In many women the stopped matter of the monethly fluxe is excluded by vomiting urine and the hoemorrhoides in some it groweth into varices In my wife when shee was a maide the menstruall matter was excluded and purged by the nostrills The wife of Peter Feure of Casteaudun was purged of her menstruall matter by the dugges every moneth and in such abundance that scarce three or foure cloaths were able to dry it and sucke it up In those that have not the fluxe monethly to evacuate this plenitude by some part or place of the body there often followes difficulty of breathing melancholy madnesse the gout an ill disposition of the whole body dissolution of the strength of the whole body want of appetite a consumption the falling sickenesse an apoplexie Those whose blood is laudable yet not so abundant doe receive no other discommodity by the suppression of the flowers unlesse it be that the wombe burnes or itcheth with the desire of copulation by reason that the wombe is distended with hot and itching blood especially if they lead a sedentary life Those women that have beene accustomed to beare children are not so grieved and evill at ease when their flowers are stopped by any chance contrary to nature as those women which did never conceive because they have beene used to be filled and the vessels by reason of their customary repletion and distention are more large and capacious when the courses flow the appetite is partly dejected for that nature being then wholly applied to expulsion cannot throughly concoct or digest the face waxeth pale and without its lively colour because that the heat with the spirits go from without inwards so to helpe and aide the expulsive faculty CHAP. LIII Of provoking the flowers or courses THe suppression of the flowers is a plethorick disease and therefore must be cured by evacuation which must be done by opening the veine called Saphena which is at the ankle but first let the basilike veine of the arme be opened especially if the body bee plethoricke lest that there should a greater attraction be made into the wombe and by such attraction or flowing in there should come a greater obstruction When the veines of the wombe are distended with so great a swelling that they may be seen it will be very profitable to apply horse-leeches to the necke thereof pessaries for women may be used but fumigations of aromaticke things are more meet for maides because they are bashfull and shamefaced Unguents liniments emplasters cataplasmes that serve for that matter are to bee prescribed and applied to the secret parts ligatures and frictions of the thighes and legges are not to bee omitted fomentations and sternutatories are to be used and cupping glasses are to bee applied to the groines walking dancing riding often and wanton copulation with her husband and such like exercises provoke the flowers Of plants the flowers of St. Johns wort the rootes of fennell and asparagus bruscus or butchers broom of parsley brooke-lime basill balme betony garlicke onions crista marina costmary the rinde or barke of cassia fistula calamint origanum pennyroyall mugwort thyme hissope sage marjoram rosemary horehound rue savine spurge saffron agaricke the flowers of elder bay berries the berries of Ivie scammony Cantharides pyrethrum or pellitory of Spaine suphorbium The aromaticke things are amomum cynamon squinanth nutmegs calamus aromaticus cyperus ginger cloves galangall pepper cubibes amber muske spiknard and such like of all which let fomentations fumigations baths broaths boles potions pills syrupes apozemes and opiates be made as the Physitians shall thinke good The apozeme that followeth is proved to be very effectuall â„ž flo flor dictam an pii pimpinel m ss omnium capillar an p i. artemis thymi marjor origan an m ss rad rub major petroselin faenicul an â„¥ i ss rad paeon. bistort an Ê’ ss cicerum rub sem paeon. faenicul an Ê’ ss make thereof a decoction in a sufficient quantity of water adding thereto cinamon Ê’ iii. in one pinte of the decoction dissolve after it is strained of the syrupe of mugwort and of hissope an â„¥ ii diarrhod abbat Ê’ i. let it bee strained through a bagge with Ê’ ii of the kernells of dates and let her take â„¥ iiii in the morning Let pessaries bee made with galbanum ammoniacum and such like mollifying things beaten into a masse in a mortar with a hot pestell and made into the forme of a pessary and then let them be mixed with oile of Jasmine euphorbium an oxegall the juice of mugwort and other such
then stopped with the grossenesse of the vapour of the coales whereby it appeareth that both these parts were in fault for as much as the consent and connexion of them with the other parts of the body is so great that they cannot long abide sound and perfect without their mutuall helpe by reason of the loving and friendly sympathy and affinitie that is betweene all the parts of the body one with another Wherefore the ventricles of the braine the passages of the lungs and the sleepie Arteries being stopped the vitall spirit was prohibited from entring into the braine and consequently the animall spirit retained and kept in so that it could not come or disperse its selfe through the whole body whence happened the defect of two of the faculties necessary for life It many times happeneth and is a question too frequently handled concerning womens madenheads whereof the judgement is very difficult Yet some ancient women and Midwives will bragge that they assuredly know it by certaine and infallible signes For say they in such as are virgins there is a certaine membrane or parchment-like skin in the necke of the womb which will hinder the thrusting in of the finger if it be put in any thing deepe which membraine is broken when first they have carnall copulation as may afterwards be perceived by the free entrance of the finger Besides such as are defloured have the necke of their womb more large and wide as on the contrary it is more contracted straite and narrow in virgins But how deceitfull and untrue these signes and tokens are shall appeare by that which followeth for this membraine is a thing preternaturall and which is scarce found to be in one of a thousand from the first conformation Now the necke of the womb will be more open or straite according to the bignesse and age of the party For all the parts of the body have a certaine mutuall proportion and commensuration in a well made body Ioubertus hath written that at Lectoure in Gasconye a woman was delivered of a child in the ninth yeare of her age and that she is yet alive and called Ioane du Perié being wife to Videau Beche the receiver of the amercements of the King of Navare which is a most evident argument that there are some women more able to accompany with a man at nine yeares old than many other at fifteene by reason of the ample capacity of their wombe and the necke thereof Besides also this passage is enlarged in many by some accident as by thrusting their owne fingers more strongly thereinto by reason of some itching or by the putting up of a Nodule or Pessarie of the bignesse of a mans yard for to bring downe the courses Neither to have milke in their breasts is any certaine signe of lost virginity For Hippocrates thus writes But if a woman which is neyther with child nor hath had one have milke in her breasts then her courses have failed her Moreover Aristotle reports that there be men who have such plenty of milke in their breasts that it may be sucked or milked out Cardan writes that he saw at Venice one Antony Bussey some 30. yeares old who had milke in his breasts in such plenty as sufficed to suckle a child so that it did not onely drop but spring out with violence like a womans milke Wherefore let Magistrates beware least thus admonished they too rashly assent to the reports of women Let Physitions and Chirurgions have a care least they doe too impudently bring magistrates into an errour which will not redound so much to the judges disgrace as to theirs But if any desire to know whether one be poysoned let him search for the Symptomes and signes in the foregoing and particular treatise of poysons But that this doctrine of making Reports may be the easier I thinke it fit to give presidents in imitation whereof the young Chirurgion may frame others The first president shall be of death to ensue a second of a doubfull judgement of life and death the third of an impotency of a member the fourth of the hurting of many members I A. P. Chirurgion of Paris this twentieth day of May by the command of the Counsell entred into the house of Iohn Brossey whom I found lying in bed wounded on his head with a wound in his left temple piercing the bone with a fracture and effracture or depression of the broken bone scailes and mâ—ninges into the substance of the braine by meanes whereof his pulse was weake he was troubled with raving convulsion cold sweate and his appetite was dejected Whereby may bee gathered that certaine and speedy death is at hand In witnesse whereof I have signed this Report with my owne hand By the Coroners command I have visited Peter Lucey whom I found sicke in bed being wounded with a Halbard on his right thigh Now the wound is of the bredth of three fingers and so deepe that it pierces quite through his thigh with the cutting also of a veine and Artery whence ensued much effusion of blood which hath exceedingly weakned him and caused him to swound often now all his thigh is wollâ—e livide and gives occasion to feare worse symptomes which is the cause that the health and safety of the party is to be doubted of By the Iustices command I entred into the house of Iames Bertey to visite his owne brother I found him wounded in his right harme with a wound of some foure fingers bignesse with the cutting of the tendons bending the legge and of the Veines Arteries and Nerves Wherefore I affirme that he is in danger of his life by reason of the maligne symptomes that usually happen upon such wounds such as are great paine a feaver inflammation abscesse convulsion gangreene and the like Wherefore he stands in neede of provident and carefull dressing by benefit wherof 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 affirme under my hand We the Chirurgions of Paris by the command of the Senate this twentieth day of March have visited Master Lewis Vertâ—man whom wee found hurt with five wounds The first inflicted on his head in the middle of his forehead bone to the bignesse of three fingers and it penetrates even to the second table so that we were forced to plucke away three splinters of the same bone The other was atwhart his right cheeke and reacheth from his eare to the midst of his nose wherefore wee stitched it with foure stitches The third is on the midst of his belly of the bignesse of two fingers but so deepe that it ascends into the capacity of the belly so that we were forced to cut away portion of the Kall comming out thereat to the bignesse of a wallnut because having lost its naturall colour it grew blacke and putrified The fourth was upon
of an hand and he said he felt there a great paine and smarting and likewise in his reines inso much that hee could not take any rest night or day neither had hee any appetite to eate but to drinke enough it was told mee hee fell often into faintings and swoonings and sometimes as it were into an Epilepsie and had often-times desire to vomit with such a trembling that hee could not carry his hands to his mouth Seeing and considering all these great accidents and the forces much abated truly I was much grieved to have gone to him because me thought there was little appearance that he could escape Notwithstanding to give him courage and good hope I told him that I would quickly set him on foote by the grace of God and the Physitions and Chirurgions helpe Having seene him I went a walking into a Garden where I prayed to God that hee would give me the grace to cure him and that hee would give a blessing to our hands and medicaments to combate against so many complicated maladies I bethought in my minde the wayes I must keepe to doe it They called mee to dinner I entred into the kitehin where I saw taken out of a great pot halfe a Mutton a quarter of Veale three great peeces of Beefe and two Pullets and a great peece of Bacon with great store of good Hearbes Then I said to my selfe this broth was full of juice and of good nourishment After dinner all the Physitions and Chirurgions assembled we entred into conference in the presence of Monsieur the Duke of Ascot and some Gentlemen that did accompany him I began to tell the Chirurgions that I mervailed much they had made no apertions in the Marquesses thigh which was all apostemated and the matter which issued out was very foule and stinking which shewed it had a long time lurked there and that I had found with my probe a Caries in the bone and small scales which were already separated they made mee answer hee would never give consent and likewise it was almost two monthes since they could winne him to put on cleane sheets on his bed neither dust one scarce touch the coverlet he fee lt so great paine Then said I for to cure him we must touch other things than the coverlet of the bed Each one said what hee thought best of the Lords greefe and for conclusion held it altogether deplorable I told them there was yet some hope because of his youth and that God and nature doe sometime such things which seeme to Physitions and Chirurgions to bee impossible My consultation was that all these accidents were come by reason of the bullet hitting neare the joynt of the knee which had broken the Ligaments tendons and aponeureses of the muscles which tye the sayd joynt together with the Os femoris also nerves veines and arteries from whence had followed paine inflammation aposteme and ulcer and that wee must begin the cure by the disease which was the cause of all the sayd accidents that is to say to make apertions to give issue to the matter reteined in the interspaces of the muscles and in the substance of them Likewise to the bones which caused a great corruption in the whole thigh from whence the vapors did arise and were carryed to the heart which caused the sincope and the feaver and the feaver an universall heate through the whole body and by consequent depravation of the whole Occonomie Like-wise that the said vapours were communicated to the braine which caused the Epilipsie and trembling and to the stomacke disdaine and loathing and hindred it from doing his functions which are cheefely to concoct and disgest the meate and to convert it into Chyluâ— which not being well concocted they ingender crudities and obstructions which makes that the parts are not nourished and by consequent the body dryes and growes leane and because also it did not doe any exercise for every part which hath not his motion remaineth languid and atrophiated because the heate spirits are not sent or drawne thither from whence followes mortification And to nourish and fatten the body frictions must be made universally through the whole body with warme linnen cloathes above below on the right side and left and round about to the end to draw the blood and spirits from within outward and to resolve any fuliginous vapours retained betweene the skinne and the flesh thereby the parts shall be nourished and restored as I have heretofore sayd in the tenth booke treating of wounds of Gunshot and wee must then cease when we see heate and rednesse in the skinne for feare of resolving that wee have already drawne and by consequent make it become more leane As for the Vlcer which he had upon his rumpe which came through too long lying upon it without being remooved which was the cause that the spirits could not florish or shine in it by the meanes of which there should bee inflammation aposteme and then ulcer yea with losse of substance of the subject flesh with a very great paine because of the nerves which are disseminated in this part That wee must likewise put him into another soft bed and give him a cleane shirt and sheets otherwise all that wee could doe would serve for nothing because that those excrements and vapors of the matter retained so long in his bed are drawne in by the Systole and Diastole of the Arteries which are disseminated through the skin and cause the spirits to change and acquire an ill quality and corruption which is seene in some that shall lye in a bed where one hath sweate for the Pox who will get the Pox by the putrid vapours which shall remaine soaked in the sheets and coverlets Now the cause why he could in no wise sleepe and was as it were in a consumption t' was because he eate little and did not doe any exercise and because hee was grieved with extreame paine For there is nothing that abateth so much the strength as paine The cause why his tongue was dry and fowle was through the vehemence of the heate of the feaver by the vapors which ascended through the whole body to the mouth For as we say in a common proverbe when an Oven is well heate the throate feeles it Having discoursed of the causes and accidents I sayd they must be cured by their contraries and first we must appease the paine making apertions in the thigh to evacuate the matter retained not evacuating all at a time for feare least by a sodaine great evacuation there might happen a great decay of spirits which might much weaken the patient and shorten his dayes Secondly to looke unto the great swelling and cold in his Legge fearing least it should fall into a Gangreene and that actuall heate must bee applyed unto him because the potentiall could not reduce the intemperature de potentiâ— ad actum for this cause hot brickes must bee applyed round about on which should bee cast a