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A08912 The method of curing vvounds made by gun-shot Also by arrowes and darts, with their accidents. Written by Ambrose Parie of Laual, counsellor and chiefe chirurgean to the French King. Faithfully done into English out of the French copie, by Walter Hamond chirurgean.; Methode de traicter les playes faictes par hacquebutes et aultres bastons à feu. English Paré, Ambroise, 1510?-1590.; Hamond, Walter, fl. 1643. 1617 (1617) STC 19191; ESTC S100857 68,060 147

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that is to say to restore the part in its naturall temperature and that the blood offend not neyther in quantity nor quality That being done as saith Galen nothing will hinder neyther the regeneration of the flesh nor the vnion of the vlcer Bu● sometimes it is not possible to put the aforesayde Indications in execution either because of the greatnesse of the wound or the excesse and disobedience of the Patient or because of some other indisposition which hath happened through the ignorance of the Chirurgian or from the ill or disordered application of the Medicines And therefore by meanes of these things there followeth great paines Feauers Apostumes Gangrenaes vulgarly and abusiuely called Estiomenes Mortifications and oftentimes death it selfe Moreouer those that receyue wounds by Gunshot do eyther dye or else remaine maymed and defectiue all their life after CHAP. X. How the Chirurgian shall proceede in the handling of the saide wounds IN the beginning therefore great regard ought to bee taken to mittigate the payne as much as may be by repercussing the defluxion by ordayning a dyet according to the six vnnatural things and they annexed by anoyding all hot and sharp things and by diminishing or altogether prohibiting wine lest it should heat subtillize make the humors flow to the part His maner of liuing ought in the beginning to be very slender thereby to make revulsion For when the stomacke is not filled sufficiently it attracteth from all partes vnto it by meanes whereof the externe parts hauing affinity therewith do remaine empty And this is the reason wherefore the patient ought to keepe a slender dyet in the first dayes of his hurt Venus is altogether contrary vnto them inasmuch as it enflameth the humors and spirits more then any other motion and for this cause it maketh the wound to bee much enflamed and subiect to defluxion And it wil not be amisse in the beginning if there be a sluxe of bloode to let it moderately flow thereby to discharge the body and the part and where it hath not sufficiently flowed you ought the day following to vse revulsiue Phlebotomy and to take away according to the fulnesse and vertue of the patient You neede not feare of making of auersion of the blood toward the Noble part● For as we haue saide there is no venomous quality th●rein neuerthelesse it is generally ●bserued that such wounds at that i●stant doe send forth b●t little bloode because of the great con●usion made by the Bul●et and t●e vehemence of the agitated aire which doth repulse and driue back the spirits into the inw●rd parts and into the circumiacent parts of the wound as we haue sayd before This is ordinarily knowne in those who haue had a member carried away with a great shot for at the instant of their hurts there issue●h but little blood forth of their wounds although that there be many great Veines and Arteries broken dilacerated But a certaine time afterwards as in the fourth fift or sixt day and sometimes later the blood will yssue foorth in great abundance by meanes of the returning of the spirits and natural heate into the affected pa●ts As for the purgatiue Medicines I leaue them to the Doctors Neuerthelesse in their absenc● it is necessarie to relaxe and moue the belly of the patient at the least once a day either by a●t or by Nature which shal be done r●ther by Custers then Purgations especially in the fi●st dayes because that the agitation of the humors in that case is to be suspected least they shold ma●e a greater defluxion to the wounded part N●uerthelesse Galen in the fourth booke of his Method Cap 6. speaking of the Indications of bleeding and purging where he saith That bleeding and purging are necessary according to the greatnesse of the disease althogh that the pati●nt be without repletion or cacochymy or euill constitution Paine ought to be appeased according to the intention and remission thereof which to do if it happen that there is an inflammati●n you may apply thereto as a locall medicine Vnguentum nutritum composed with the i●yce of Plantane Housleeke and Night-shade and such like Also the Emplaister Diachalciteos describ●d by Galen in his first Booke of the Composition of Medicines according to their kinds chap. 6. dissolued vvith the oyle of Poppy of roses and a little Vinegar and it is of no little efficacy for that purpose Also vng de bolo and many others of that facultie if they be not properly anodins for all Anodins are hot in the first degree or at the least agreeing in heate with our bodies as saieth Galen in his first Booke and 19. chap. of Simples ●nd the aforesaid medicines are cold yet not so much as that thereby they should become Naucotick the which are cold in the fourth degree But to bee short the aboue-mentioned in the aforesaid case do appease the paine very comm●diously because they are contrary vnto hot dist●mperatures and doe prohibit the defluxions of humors which oftentimes are sharpe and chollericke which are more apte to flow then the cold and do cause a greater pain After the vsage of repercussiues I do meruellously approue this Cataplasme ℞ Micae panis infusae in lacte vaccino lb j. ss bulliant parum addendo olei violacei ros● an ℥ iij vitellos ouorum numer quatuor pul rosar rubr florum chamemel melior an ℥ ij far fabar hord ana ℥ j. misce fiat cataplasma secundum artem Or for a Medicine sooner prepared thou must take of the crummes of bread and so let it be a little boyled with Oxycrat and the Oyle of Roses As concerning the curation of such Apostumes which happen in these Woun●es it is expedient that their Medicines should bee diuersied according to their times For some medicines are proper in the beginning others in the augmentation and others in other times as hath beene sufficiently declared by Galen in his thirde Booke and ninth chapter of the faculty of Medicines And by Guido in the curation of Apostumes and by those that haue written thereof And where Nature shall incline to suppuration it is most needful to attend her as sayth Hippocrates for the Physitian and Chirurgean are but the ministers and helpers of Nature to ayde her in those thinges whereunto commodiously she enclineth CHAP. XI Of such Bu●lets which haue remained in certain parts a long time after the Curation of the wounds SOmetimes the Bullets of Lead haue remayned a long time within the members as for the space of seuen or eight yeeres and more there following neuerthelesse not any euill accident nor hinderance of the consolidation of the wound they haue continued there so long till they haue bene thrust forth by the expulsiue vertue discending downe by meanes of their grauity and heauinesse into the inferiour parts in the which they will manifest themselues and then ought to bee drawne forth by the operation of
stinking Sanies whereby the part salleth into a Gangrena vnlesse it be preuented by Egyptiacum and other sharpe medicines And for this cause they haue bene very much approued by the saide Botal and Ioubert and of all good Chirurgeans yet neuertheles our Physitian maintaineth that they are venomous because saith he that being applyed in woundes by Gunne shot they haue beene the cause of the death of many persons which is a thing so absurd and against reason that I will leaue the resolution thereof to the Towne-Barbers who I am sure are of skill sufficient to confute the grossenes of that imputation or if their want of iudgement be such that they cannot yet the consideration of euerie one of the ingredients of the sayde Aegyptiacum would suffice to shew that it is so free from anie venomous quality that it doth resist is directly contrary to all sorts of poisons and putrifactions which may happen in the fleshy partes by reason of any wound or vlcer He saith moreouer that the disposition of the aire cānot be the cause to infect or restore wounds more daungerous at one time then at another Herein also he is of this opinion alone But if hee had well read and vnderstood Hippocrates he had not so lightly contemned the constitution of the seasons and the infection proceeding from the aire not simple and Elementary for being simple it neuer acquireth any putrifaction but by addition and commixtionwith other corrupted vapors as I haue written in my treatise of the Pestilence For inasmuch as the aire that doth incompasse inclose vs is perpetually necessary vnto our liues it followeth therefore that according to the indisposition thereof our bodies also altered in manie and sundry manners because we do draw it continually by meanes of the Lungs and other partes seruing vnto respiration and also by the pores euery little inuisible hole throughout the bodye and by the Arteries dispersed in the skinne And this is done both for the generation of the spirite of life and also to refresh and foment our naturall heate For this cause if it be immoderately hotte cold moist or dry or otherwise distempered it altereth and changeth the temperature of our bodies vnto its owne quality This is cleerely seene for when it is infected by the putrified and Cadaueruous vapors produced from a great multitude of dead bodies that haue not bene buried soone enough as of men of ho●ses and other beasts As it happeneth after any battell or when many men haue perished by shipwracke and haue bene cast ashore through the violence of the waues As for example the memory is yet f●esh of the corruption of the aire which proceeded from deade bodies at the castle of Pene situate vpon the riuer of Lot in which place in the yeare 1562. in the moneth of September whiles the first troubles hapned about Religion there was a great number of dead bodies fell into a pit of an hundred fathome deepe or thereabouts from whence two moneths after there was eleuated such a stinking and venomous vapor which dispersed it selfe ouer all the countries of Agenois and the neighbouring places within the compasse of thirty miles round that thereby many were infected with the pestilence whereof we need not wonder for the wind blowing and driuing the exhalations and corrupted vapors from one countrey to another doeth infect them with the saide pestilence In like manner the euill constitution of the aire whether the cause be manifest or hidden may make wounds to become putrified alter the spirits and the humors and cause death This therefore ought not to be attributed vnto the woundes because that they which are hurt and those that are not are both equally infected and fall into the same inconueniences Mounsi●●r d' Alechamps in his French Chirurgery spea●●ng o● these thinges which hinder the c●●●t●on of Vlcers hath not omitted that when either the pes●●lence or any Epidemicall Disease reigneth in any Proui●ce through the corruption of the Aire it ma●●th Vlcers become incureable or of most ●●fficult curation The good old man Guido in his Treatise of Vlcers hath also writ ●hat the wounds of the heade were more h●r●er to cure at Paris then at Auignō and that the Vlcers of the legges were more difficult at Auignon then at Paris forsomuch as at Paris the aire is cold and moist which is a contrarie thing especially to wounds in the head Likewise in Auignon the heare of the aire doe liquefie and subtilize the humors and therefore more easilie and in greater abundance do the humors fall into the Legges whereby the curation of the Vlcers in those partes is more difficult at Auignon then at Paris But if any one alledging experience shall say the contrary that the wounds in the head are for the most part mortall in hot countreyes To him I answere that that proceedeth not from the aire as it is more hot and dry but rather because of some superfluous humidity and euil vapor communicated with the aire as in the places about Prouence and of Italy neere vnto the Mediterrenean sea Now there is not a Chirurgean of so little vnderstanding that knoweth not but if the aire be hot and moyst the wounds doe easily degenerate into a Gangrena and putrifaction As for experience I wil giue him a familiar example Wee see that in hot and moyst weather and when the Southerly winds blow that flesh doth putrifie in lesse then two houres though it were neuer so lately killed in such fort that Butchers in those times do kill no meate but euen as they sell it Also there is no doubt to be made but that humane bodies doe fall into affections against Nature when the qualities of the seasons are peruerted through the euil disposition of the aire as hath bene seene that in some yeres wounded persons haue bin most hard to cure and oftentimes dyed of very smal wounds what diligence soeuer the Physitians and Chirurgians could vse The which I noted well at the siedge which was planted before Roan for the corruption of the aire did alter and corrupt the blood and humors in such sort by the meanes of inspiration and transpiration that the wounds became so putrid and faetide that they sent forth a Cadauerueous smell and if it hapned that one day had bene omitted wherein they had not beene drest you shall finde the next day a great companie of wormes in them with a meruellous stench from whence were eleuated many putrified vapours which by their communication with the hart caused a continual F●uer with the Liuer hinderance of the generation of good bloode and with the Braine they produce alienation of the spirits fainting convulsion vomitings and by consequence death and when their bodies were opened you should finde Apostumes in many partes of theyr bodies full of a greene stinking Sanies in such sort that those that were within the Town seeing these things that their wounded persons coulde not be cured saide that those