any further enquiry thereinto we wil therefore make the more accurate search after thereby to find out the Cause of an Inflammation in this manner following There would be no Tumor at any time generated in any part of the Body were it not that either its substance as it were boyling over with heat is poured out or that from without some new substance makes its approach For there are but two only causes to be assigned of the augmentation of the bulk and quantity in any thing whatsoever For either the radical moisture through an internal or external heat is resolved into an aery substance which as it is wel known requires a far greater space room for dilatation then formerly it had or else as we said before some new substance is extrinsecally from some other place superadded thereunto Now therefore of necessity it is that one of these two causes must be present when as in that hot and burning Tumor which we commonly call a Phlegmone the part is lifted up into a greater bulk than is ordinary or agreeable to the intention of Nature But now that the fervency and boyling up of the natural moisture or the effusion thereof is not the Cause appears by this because that every thing that is poured forth and converted as it were into spirits when it is cooled it assumes again its pristine quantity and as we may so express it puts off and laies aside the Tumor as by common experience it is most apparent But as for the parts inflamed let them be never so vehemently cooled yet wil they never return into the former state and condition nor ever cast off the Tumor or Swelling Furthermore if by reason of the effusion of the part and its conversion into spirits a Tumor should be caused in the part inflamed then necessarily upon the incision of the part the spirit should appear which yet as we see is nothing so but that rather there follows an effusion of Blood and the whole place by its colour and the looks thereof seems altogether full of Blood It remains therefore that the accession of some new substance is the cause of a Phlegmone But now that this new substance is the Blood appears from hence to wit that the Phlegmone is exceeding red both within and without Now this red colour is only proper unto and inseparable from the Blood Blood the nighest cause of an Inflammation for there is nothing that waxeth red in the Body beside the Blood and the Flesh which later notwithstanding viz. the Flesh cannot by any means be the cause of a Phlegmone For if the increment of the flesh were the cause of an Inflammation there would be indeed a Tumor or Swelling in the part yet so as notwithstanding the internal heat should remain sound and in an healthful plight without the least distemper and that also it should not in the least vary its pristine nature when as in no one thing that is augmented according to its substance the heat may properly be said to be heightned and encreased so far forth that the increment of the substance and quantity should any way differ from the change or alteration of the qualities But now the case is otherwise in a Phlegmone wherein the colour is changed and the heat grown to be more intense the said colour evidently demonstrating not only the quantity but likewise the quality of the substance Moreover that the Blood is cause of a Phlegmone may be manifestly evidenced by this that the place in the greatest Inflammations especially which now and then happen in Ulcers appears and seems all bloody round about which certainly would never be if blood were not the cause of the Inflammation Furthermore that Blood is Cause of the Inflammation that generating of the Inflammation which happeneth in Wounds doth evidently demonstrate For in new and fresh Wounds the Blood its true at the first flows forth but then afterward being compressed and kept in either by the hand or else with Ligatures or Medicaments that stop the issuing forth of blood or else lastly being suppressed and staid of its own accord it is then reteined either in the Orifice or Cavities of the dissected Vessels and there it is compacted and so wrought that it grows together like as clotted blood useth to do and there by a continued heaping up of the blood abundantly flowing thereunto it lifts up the part into a Tumor or Swelling and causeth an Inflammation An Inflammation what it is Since therefore the Conjunct Cause of an Inflammation is proved to be the Blood preternaturally flowing thereunto it is no hard matter thence to collect that an Inflammation is a preternatural Tumor of the fleshy parts as Galen in the place alleadged takes and understands the name of Flesh arising from the preternatural afflux of the blood and that therupon it must necessarily be hot red extended and accompanied with a kind of renitency or resisting property pain and pulsation or beating The manner how an Inflammation is bred But now that there may not be left to remain any the least obscurity about the nature of an Inflammation we will here add the manner also how a Phlegmone is generated and this we wil do out of Galen who in his Book touching the unequal Intemperies Chap. 3. hath in these words described it it is saith he a hot fluxion or flowing the which when it hath seized upon and seated it self in some muscelly part at first the greater Veins and Arteries are fil'd up and distended and next after them the lesser and so it is carried on untill that at length it arrives even at the least of them In these when the matter of the fluxion is forcibly impacted and cannot therein be any longer conteined it is then transmitted unto the outward parts partly through their own Orifices and partly by a percolation as it were and straining or sweating out of it through the Tunicles and then the void spaces which are betwixt the most principal parts are filled full with the fluxion And so all those parts or places are on all sides very much heated and overspread Those parts or Bodies are the Nerves Ligaments Membranes the Flesh it self and before al these the Veins and Arteries For whereas the Veins and Arteries run along unto each particular part by the which is received both nourishment and vital Spirit so long as the blood flows in a due measure and just proportion and is conteined within those its receptacles the part is not wont to suffer any Inflammation at all but then only when at the length the blood is overcopiously and all on a huddle emptied and poured forth into the substance of the part by the Veins and Arteries By which very thing also a Phlegmone is distinguished from other fluxions in which the matter is diffused without the Veins into the whole substance of the part and there doth distend and dilate it For in a Phlegmone although all the
their Ears with Snow or have plunged as we may so say their almost frozen feet into cold Water or Snow And the same Fabricius in the place alleadged relateth That a Noble man of good esteem and reputation told him that when he travelled in those Regions he himself on a time lighted upon one travelling as he was upon the Road whom finding to be stiff with cold and almost dead he caused to be put into a Cart and having brought him into an Iune his Host the man of the house immediately plunged him over head and ears as we say in cold water which was no sooner done but instantly there issued forth from al parts of him a kind of frostiness in such a manner that his whol body seemed as if it had been al over covered with Ice like as with an Iron shield and then he gave him to drink a Cup of Hydromel putting thereinto the pouder of Cinnamom Cloves and Mace upon which he fel into a swear in his Bed and soon after the sick person returned unto his former state and became perfectly wel recovered The Cure When now the said congelation is asswaged and qualified and the cold for the most part extracted and drawn forth or else hath exhaled of its own accord which is known by this that the pricking pain is much moderated if not quite ceased then the part is to be fomented and cherished with sweet Milk made blood warm in which there have been boyled Rosemary Organy Sage the Leaves of Rue and Bayberries It wil be likewise very commodious this being a remedy that is also very wel known to thrust deep into warm Water in which Rape Roots especially those that were formerly congealed and frozen with cold have been boyled the Hands or the Feet Or Take White Wine one pint Allum an ounce boyl the Allum with the Wine and let the part be wel washed therewith the Decoction also of Lupines is good and helpful and after it let the part be anointed over with Honey in which live Sulphur hath been boyled This is likewise very efficacious Take of the Oyl of Bayes two ounces Honey one ounce Turpentine half an ounce Mingle c. Or Take Turpentine unsalted Butter and Mace of each alike and what you please for the proportion Mingle them c. Or else Let the part be anointed with Oyl of Wax If the part be already exulcerated Allum poudered and mingled with a like portion of Frankincense pondered likewise is very helpful and wel approved of a little Wine being thereto added or the Oyl of Roses boyled in a Rape Root or in the Reddish Root made hollow and the pith taken al out and then squeezed and pressed forth Or else let an Unguent be made of River Crabs burnt with Honey and the Oyl of Roses Or Take Rue the Marrow of a Bull the Vnguent of Roses of each as much as you think fit mingle them c. Or Take Wax the fat of a Hog of each an ounce Litharge of Silver or Lead ten drams the rind of the Pine two ounces of Manna thur is one ounce Oyl of Roses a sufficient quantity Make an Vnguent Chap. 16. Of the Tumor Ecchymoma THere is likewise somtimes poured forth blood the Skin continuing stil whol and sound into the spaces of the parts from whence there ariseth an Affect which by the Greeks is termed Ecchymoma or Ecchymosis and by the Latines Effusio Suffusio Sugillatio For an Ecchymosis is nothing else but Chymeon ecchysis that is an Effusion or pouring forth of the Humors to wit the blood into the next adjoyning spaces by reason of the opening of the Veins to wit if the Skin abiding whol the Veins pour forth that juyce which they contain that is the blood as Galen speaketh in his second Book of Fractures Comment 16. and either the orifices of the Vessels gape which happeneth in an Anastomosis or else the blood doth as it were sweat forth and strain it self out through the Tunicles of the Vessels being rarefied which the Greeks cal Diapedesis or else by contusion the Vessels are loosened which chanceth if one fal from an high place or else be oppressed and over laid by the weight of somthing that is heavy lying upon him or else be smitten and hurt with a club stone stump of a Tree or else lastly that by some violent motion and extension a Vessel be broken Then the Skin remaining who the blood is poured forth into the neer adjoyning spaces whereupon the color of the part is changed and at first indeed it seemeth reddish afterward it becometh Leaden colored then yellowish green blackish whereupon it is that Galen in his Book of Preternatural Tumors Chap. 10. and tenth Book of the Composition of simple Medicaments Chap. 9. maketh two species of this Ecchymosis one which by the general name he calleth Ecchymoma when the part obtaineth a middle color betwixt red and black which indeed may properly be termed Pelidna that is of a livid or leaden color and the Affect may likewise be called Livor to wit paleness or wanness the other he termeth Melasmata that is blacknesses which latter are especially familiar unto old persons as often as their Veins are bruised or opened upon any other cause and these happen upon any smal or sleight occasion like as on the contrary Pelidna and Livores befal Children and those that are young and Women and such as are of a white color But now although oftentimes and indeed for the most part the part is not lift up into a Tumor or Swelling but the Blood poured forth doth so insinuate it self into the spaces of the parts that there is no Tumor at all appearing yet notwithstanding somtimes the part doth swell up if there be great store of Blood poured out and this also is now and then wont to happen after Venefection to wit if the whol Vein be smitten or if the Wound that is in the Skin shall be closed up but that which is in the Vein it self left open and unshut For from hence by that Wound that is in the Vein the blood is poured forth for which when there is no issue or passage open the Wound in the Skin being closed up it is oftentimes under the Skin poured out into the whole Arm and somtimes it exciteth also a certain swelling but however it alwaies dyeth the Skin of a Red and livid or leaden colour Ecchymosis But the Affect is various and different and the Ecchymosis ariseth in a different manner since that the blood is not evermore poured forth without the Veins but oftentimes by reason of the great abundance of the Spirits and Blood the Veins and Arteries that are terminated in the Skin are filled full of blood and thereupon the Body becometh coloured as appeareth out of Hippocrates Epid. 2. Sect. 4. in the end thereof where he writeth thus That all diligence and care must be taken that the passion and anger of the Mind may be
whensoever it is easily and gently pressed together it returneth and it 's altogether hidden like as we see it to happen in Ruptures And this Opinion very many and indeed most of the latter Physitians do follow Yea and Platerus himself likewise who is otherwise wont to take liberty enough in examining the Opinions of the Ancients writeth That Aneurysma doth not only arise from the dilatation of the Artery it yet remaining shut and entire but also that more frequently it not alwaies if it be in the exterior parts it proceedeth from a certain manifest and apparent opening thereof For then the thin and sprightful blood breaking forth of the Artery under the skin lifteth it up into a Tumor or Swelling and there formeth and frameth unto it self a hollow nook and there in the Artery causeth this pullation in this Tumor even almost in the same manner as the Arteries are wont to empty themselves naturally into the hollow nooks of the thick Membrane of the Brain so here they do it preternaturally by pouring forth the blood with and in breathing in its Diastole and in its Systole receiving it in again But this is an Opinion that I could never approve of and therefore in the yeer 1606. when I interpreted Galen's little Book of Tumors I altogether rejected it and I then likewise propounded another which out of those Lectures of mine that noted and famous man Dr. Bernhard of Sweden made use of and Inserted likewise in his Treatise of the Inspection of Wounds For if Aneurysma should proceed from the Effusion of the Arterial blood under the Skin then certainly the said blood would diffuse and disperse it self in length and breadth and round about and would dye and colour the Skin of another Hieu like as we see it to happen in Contusions and in the opening of a Vein when it is not exactly and rightly performed to wit when either the Vein is wholly cut through or else when the Wound thereof by reason of the impetuousness and violence of the Blood is not rightly closed For then the blood is very often poured forth under the Skin even unto the extream and utmost part of the Hand and the Skin is dyed with a Red Green and Yellow colour Which must necessarily happen so much the more if an Artery be opened in regard that the Arterial blood is thinner and floweth forth with a greater force violence which yet notwithstanding never happeneth in Aneurysma in the which that Tumor is conteined within its own Limits and as it were in a Bladder neither is the Skin dyed with any other color And moreover if Aneurysma proceeded from a Blood poured forth under the Skin in progress of time it would so happen that this Blood consisting and abiding in a strange and unfit place would putrefie like as we see it usually doth in Ecchymoma as we told you before in the seventeenth Chapter Antonius Saporta indeed in his first Book of Preternatural Tumors and Chap. 43. doth his endeavor to salve and answer these objections whiles he thus writeth The Blood saith he if it altogether leaveth its own proper Vessels and cast it self forth into a greater Venter or Cavity being left destitute of the influx of the heat that should flow in unto it wil necessarily putrefie but in Aneurysma which proceedeth from the opening of an Artery it is not so far forth left destitute by the heat thereof and by the rest of the Blood that is contained therein that its native heat and colour should perish neither is it expelled forth into any great space or Venter that it should corrupt and putrefie For it is cherished by the vital spirits contained in the Artery since that its matter remaineth yet entire and continued For albeit the Artery be divided and the Blood causing the Tumor doth pass forth yet notwithstanding the Flesh and the Skin that cover the Artery continuing stil whol and entire it doth not alwaies so insinuate it self into any large and ample space that it should be made thereby to putrefie and rendered destitute of the help and assistance of Nature But the truth is he doth not here by all that he alleadgeth acquit and free the Ancients from the aforesaid Objections For if the Blood that is flown forth may be cherished by the vital Spirits and the heat of the Artery why then is not the same done likewise when a Vein is smitten and pierced through and when the Blood the Vein being not as yet consolidated and exactly closed issueth and floweth forth Neither doth the Blood only then putrefie when it is poured forth into a large and sensible Cavity but likewise whensoever it is shed forth under the Skin Furthermore as we have said that Blood which we call Arterial is not poured forth round about as the Vein Blood is which yet notwithstanding it ought much rather to do in regard that it is thinner and more spiritful For it is not sufficient what Platerus writeth that the Blood poured forth under the Skin doth there form and frame for it self a Sinus or hollow nook not unlike the hollow spaces into which the Arteries in the thick Membrane of the Brain do insinuate themselves and that the Skin is instead of an Artery unto that Blood that is poured forth out of the Artery and that the Blood may from thence uninterruptedly repass and flow back again into the Artery without any Corruption For the Sinus's are framed by Nature and so exactly shut up with Membranes that nothing at all can possibly flow forth of them But now the Arterial blood can no manner of way frame for it self any such Sinus but whensoever it falleth forth without the Artery it diffuseth it self every where round about and in regard that under the Skin all things are confluid therefore the Blood easily maketh an irruption into the adjacent parts by that way and passage that is opened the which we may likewise see the Veiny Blood to do which is much thicker and then the said Blood being out of its own and in a strange place soon putrefieth Which appeareth even from that very History that Antonius Saporta writeth as conceiving it to make much for the confirmation of what he had written touching Aneurysma in his first Book of preternatural Tumors and Chap. 43. Neither in truth was that Disease which he there describeth an Aneurysma but only an effusion of the Arterial Blood upon the rupture of the Artery into the places lying neer about it and there corrupting But this is the Story that he telleth us Whenas Johannes Fabri that most acute and sedulous Scribe of the Palace at Montpelier had spent the chiefest part of his youth in riotous and inordinate Revellings and Feastings and in a frequent and unseasonable Drinking of the strongest sort of Wines without any diluting or qualifying the heat thereof he began about the fiftieth yeer of his age to draw his breath with much difficulty and to be affected with
Mortification the Radical humidity being consumed and the Native heat dissipated ariseth from thence ulcers hard to cure are likewise from thence excited the motion of the part is abolished and there are filthy and deformed Cicatrices left remaining 2. Burning by Lightening is likewise very dangerous and for the most part deadly 3. By how much the purer the Body is by so much the more easily is the burning cured But if the Body be either Plethorick or Cacochymical then from the pain and heat there is very easily caused an afflux of the humors and from thence Inflammations putrid ulcers and other evils are excited 4. The Burning is likewise somtimes more and somtimes less dangerous according to the Nature and condition of the parts affected For if there be but only one part burnt there is then less danger than if many parts or the whol body be burnt For when many parts or the whol body be burnt it is very rare that the persons thus burnt should ever be perfectly wel and sound but most commonly they die miserably by the very vehemency of the Symptoms 5. If the burning be so deep that it reach even unto the greater Veins Arteries and Nerves it is then dangerous For when the exsiccated Vessels are contracted and shut up the blood and the spirit cannot then flow unto the affected part from whence there is caused an Atrophy a Gangrene and a deprivation of sense and motion 6. The burnings of the Abdomen are not cured without much difficulty for the Skin is there softer and those Muscles by reason of their various motions are variously extended and contracted 7. If the burning reach even unto the Intestines it is then deadly 8. The burning likewise of the Groyns is very dangerous since that those places are moist and therefore the more fit to receive the afflux of humors 9. The burnings of the Eyes are also dangerous For although they be but light yet notwithstanding they may produce either a stark blindness or a deprivation of the sight or at least a dimmution thereof 10. If the hairy parts be ever a whit grievously burnt they alwaies continue smooth and slick for hairs are never generated in that hard Cicatrice that is brought over the affected part The Cure Indeed some there are that from the ordinary and wel known Axiom of Physitians viz. That Contraries are the Remedies of Contraries are of opinion that such Members as are burnt ought so be cooled and therefore they think that unto those parts that are burnt there must Coolers be immediately applied But this their opinion hath its original from that vulgar but false Conceit viz. That the burning is only an alteration and the introducing of a hot quality whenas notwithstanding the very fire it self and likewise its Atomes are communicated unto the part that is burnt and an Empyreuma as al of them are forced to confess is produced for what indeed else is this Empyreuma which al of them tel us ought to be called forth then the smal parts or particles of the very fire that have penetrated themselves into the burnt part and Experience it self teacheth us That cold things wil not cure burnings but that on the contrary by the said Coolers the fiery particles being thereby thrust down much lower the pain is wonderfully augmented and inflammations yea and the Gangrene it self and the Sphacelus excited but that such things as are hot and that cal forth the Empyreuma are very helpful from whence likewise it is as we al wel know that the burnt parts are not to be plunged into cold water but rather to be put somwhat neer unto the fire Which although that Platerus seem to find fault therewith yet use hath tâ—ught even the very vulgar the truth of this and Aristotle long since took notice hereof as appeareth in his Sect. 2. Problem 56. Neither are those things that are applied hot applied in the nature of Anodynes since that al Anodynes wil not do it as by and by in the Cure it wil appear but only those of them which have virtue and power in them of calling forth the Empyreuma But now similitude and likeness begetteth attraction and the external fire calleth forth the incrinsecal fire that is to say that very fire that it self conveyed into the burnt part as Ambrose Parry tels us very truly in his Book 11. Chap. 9. In the Cure therefore of Burnings let the first care be to cal forth the Empyreuma to wit in the same manner like as we have told you in Part 1. Chap. 15. touching Kibes that the cooled parts are not rightly cured if they be put neer unto the fire or plunged into hot water since that hence the pain becometh so much the more intense and vehement yea and that oftentimes a Gangrene and Sphacelus are excited but if they be first rubbed with Snow or dipt into cold water then the cold is drawn forth so if the Empyreuma be called forth by those things that are hot which is done by means of the similitude or likeness then this Malady is soon taken away Which that it may be rightly done the Cure is to be instituted and ordered according to the degrees of the Burning above propounded First of al therefore if the Burning be but light The Cure of a light burning we must prevent what we can the breeding and arising of Pustules or blisters for if this be done the sick person is then already freed from al the evil of the burning But now this is to be speedily done and therefore whatsoever Medicament we have ready at hand we must forthwith make use thereof and therefore the Member if the nature and condition thereof wil so bear it is to be put a little neer unto the fire or else deeply plunged into hot water or else fomented with a Spunge or a Linen cloth doubled and then wel soaked in warm water that so the Empyreuma by reason of the likeness may be extracted or else immediately a Linen cloth dyed in Varnish is to be imposed upon the burnt Member or a Linen cloth wel wetted in the Ley or water in which unslaked Lime hath been extinguished And then presently Onions bruised in a Mortar with Salt are to be laid upon the burnt part or else this Unguent Viz. Take of a raw Onion one ounce and half Salt Venice Sope of each half an ounce mingle them in a Mortar pouring in unto them as much of the Oyl of Roses as wil suffice and make an Vnguent Or Take Venice Sope three ounces raw Onion one ounce Salt six drams the Oyl of Eggs half an ounce Oyl of Roses and sweet Almonds of each one ounce and half the Mucilage of Quince seeds one ounce mingle them and make an Vnguent Or Take the green Rind of the Elder tree or the first shoots of the Elder let them he wel bruised and then boyled in Butter that is new and unsalted and then strain them Or Take Vnslaked Lime
that they contract these Clefts especially about the Joynts yet nevertheless this same happeneth somtimes likewise unto the Feet It may be Cured most speedily and most conveniently by this Unguent Take Litharge of Silver Myrrh and Ginger of ech alike parts bruise and pouder them very small and so with Virgins Wax Honey and common Oyl as much as wil suffice make an Vnguent unto which for the rendering it the more grateful to the smel Musk and Ambar may be added THE FIFTH BOOK THE FOURTH PART Of WOVNDS Chap. 1. Of the Nature Causes and Differences of a Wound AMong the external preternatural Affects of the Body and such as are obvious unto the senses there remain Wounds Fractures and disjoyntings of which we will now speak in order And First of all as touching a Wound that it is a solution of Unity in a part Bone and softer Cartilage is without al doubt and controversie But yet nevertheless it is sometimes taken largely and somtimes in a more strict sence Celsus taketh it in the largest sence of all whn in his fifth B. and sixth Chap. he thus writeth That Wound saith he is far worse and more dangerous which it caused only by a Bruise then that which is made by incisiom and dividing the part so that it is also far better to be wounded by a sharp and keen edged Weapon then by that that is blunt It is taken in a large acceptation when it is attributed unto all kind of solution of Unity made by any sharp instrument whether this solution be made by pricking or by cutting like as Galen in his Sixth B. of the Meth. of Physick the first and following Chap. calleth the pricking of the Nerves the wounding of them It is taken strictly when it is distinguished from a pricking that a wound is the solution of Unity in a soft part made by a Cut from any keen and cutting instrument but a pricking is that solution of unity that is caused in a soft part by a prick from an instrument that is cutting By which it appeareth that the solution of Continuity in a soft part is wider and broader then a Wound whether it be made by cutting or by pricking For Unity may also be dissolved in a soft part by a thing that is not sharp but only hard and heavy and this may be the Skin either appearing whole or even broken likewise which happeneth in those Wounds that are inflicted by Bullets from Guns Moreover also the Unity of the soft part may be dissolved by extension which in special in the similary parts is called Rupture but in the Compound Apospasma to wit when those fibrous Ligaments and Threads by which the parts are fastned together the one to the other being broken the parts themselves likewise become broken A Wound what it is By all which it appeareth that a Wound is the solution of Unity in a soft part caused by a cutting and sharp instrument But if as Guido in the Second B. of his Chirurgery and Fernelius in the seventh B of his Meth. of Physick Chap sixth rightly admonish us the Wound become sordid and foul and that some thing be by the Pus or filthy corroding matter eaten away from the substance of the wounded part then the Wound passeth into an Ulcer or certainly we may very well say that an Ulcer is conjoyned with the said Wound The truth indeed is that Rudius in his B. of Wounds and first Chap. doth impugn this Opinion but al to little purpose For neither is it absurd as he without Reason thinketh that one Disease should be changed into another or that one should be added and Joyned to another The Wound and Ulcer they are both of them the solution of Unity in the soft part buâ— the Wound is made by section of cutting alone whereas the Ulcer is caused within it by Erosion and therefore it is that in an Ulcer there is somwhat that is lost from the substance of the part If therefore in a Wound of any part somthing shall be Eaten away and consumed from the substance of the flesh it is then altogether to be granted that now there is likewise present even an Ulcer also Which nevertheless is not so to be taken as though so soon as ever on the fourth day the Pus or filthy corrupt matter doth begin to appear in the Wound that then likewise an Ulcer may be said to be present For that said Pus proceedeth from the blood that is shed forth without the Veins or some Aliment that sticketh in the Capillary Veins and spaces of the parts neither is there then any thing Eaten away from the substance of the part But if there be so great an abundance of the Pus gathered together whatsoever the Cause thereof be that somthing be Eaten away from the substance of the part then it cannot be denied but that there is an Ulcer likewise present seeing that there are then present all things that are required unto the Essence of an Ulcer and in this Case the Cure is no longer to be ordered as in a single and simple Wound but as in an Ulcer But since that a Wound is to be accounted in the number of Diseases there may be enquiry made and that upon good grounds what actions they are that are hurt thereby Unto which it may be rightly answered that all the Actions of the said part and the severall uses thereof unto which the part is destined are hurt by the Wound whether that part perform those actions either as a similary or as an instrumental part That the Organical Actions may oftentimes be hurt by a Wound to wit when the part destined for motion is Wounded cannot be denied â—t being a thing so manifest since that the wounded Member can no longer be moved in a due and right manner As likewise the Vein that is cut assunder can no longer convey the blood unto the part for the nourishment thereof neither a dissected Artery the vital blood and spirits or a Nerve the Animal Spirits But indeed the truth is that the temperament of the part is not next of all and immediatly hurt by the Wound but yet never the less it is mediatly hurt to wit when the Vessels being cut assunder and the blood poured forth the heat of the part is withal dissipated and the influx of the Blood spirits and heat flowing in this last being so necessary and requisite unto the temperament of the part is altogether hindred For all which Causes the attraction of the part the Concoction the Nutrition and the expulsion is hurt And from hence it happeneth that the temperament being changed there are more Excrements generated in that part then otherwise were wont to be And from thence also it proceedeth that the Pus is not presently generated in the very beginning of the Wound but afterward to wit about the fourth day when the heat of the part that was dissipated is again restored The Use is
ceased and his strength by degrees returned there being no purulent spittle at all that offered to come forth his Cough likewise and difficult breathing were not very urgent and troublesom neither for the first Week did any heat and thirst very much affect the sick person in the interim the wounds being handled after the Vsual manner there daily flowed forth an indifferent Quantity of well concocted pus or purulent matter These means being continued unto the second month and the External wounds being purified and consolidated the sick person was suddenly taken with a most dangerous suffocation so that he was in great peril of being strangled by an Asthma as it were and he was likewise very much afflicted with a cough Atrophy and Hectick Feaver until at length the imposthume of the Lungs brake and with the Cough five or six pints of purulent matter were cast up at his mouth after which the exulceration of the Lungs being cured by fit and proper Remedies the consumption Fever Hectick and all the rest of the symptoms remitted and the Patient was restored unto his perfect health To wit those Wounds of the Lungs are not mortal in which only the substance of the Lungs is hurt and not the great vessels and such as are not so great that they abolish respiration or suddenly destroy the vital faculty either by their dislipating the sprits through some notable Hemorrhage or else suffocating the heart by pouring out the blood upon the Lungs and upon the heart On the contrary if the wound of the Lungs be great and that not only the substance of the Lungs but likewise the great vessels that are therein to wit those notable and observable branches of the Arterial vein and the veiny Artery be wounded those wounds are mortal being such as in which the blood and vital spirit is poured forth and dissipated or else through the overgreat abundance of the blood the Lungs and heart are oppressed and the Patient suffocated Hippocrates in the place alleadged in Coacis addeth yet another cause of death which yet nevertheless doth not bring so sudden a destruction unto any person as those in the former case even now mentioned where the wound being great it is not the vessels containing the blood that are indeed hurt but the great and rough Artery so that by reason of the largness of the wound there is more breath that goeth forth by the wound then by the mouth for then by reason of the sympathy the heart is affected the vital spirits dissipated the Lungs and heart by the ambient Air altered and offended And indeed those wounds of the Lungs bring death likewise in which either the substance of the Lungs beginneth to be exulcerated and that a Consumption is excited or in which the blood is poured forth into the Cavity of the Thorax where it beginneth to putrefy and where it causeth either a feaver or an Empyema But in regard that this doth not alwaies happen and not at al in some wounds of the Lungs and that likewise when it doth happen there is no necessity that the Patient die for this cause therefore those wounds of the Lungs are not to be accounted necessarily Mortal For Felix Platerus in his 3. B. of Obsrv Page 690. relateth that a certain person that he knew falling into a Consumption from a Wound of the Lungs was yet nevertheless Cured and perfectly recovered A certain Coffermaker sayth he one of our Citizens having from a servant of his received a wound very deep in the lowest part of the Thorax by a prick from the point of a knife by the wound he voided forth a most stinking and loathsom pus or matter by the ill savor whereof the whol neighborhood was infected and offended and likewise some certain smal parcells of his Lungs in which the cartilaginous branches of the rough Artery did manifestly appear which persevering a long time albeit that he was in a manner wholly wasted away yet nevertheless at the length the flowing forth of the purulent matter remitting the wound was closed and he restored unto perfect soundness living after this many years as a foot-post in carrying of letters and thus he prolonged his life for forty years safe and found as we say although as it is very probable he wanted great part of his Lungs in one side The wounds of the rough Artery Fifthly That the wounds of the great rough Artery commonly called Aspera Arteria are not mortal but that they may be cured even the Laryngotomy or Cutting of the Laryinx of which we have spoken before in the Second Book of our Pract Part. 1. Chap. 24. doth evidently demonstrate To wit those of them are cured that are not great and in which the membranes only by which the rings of the rough Artery are fastened and linked together are wounded examples of which Schenkius in the Second Book Of his Observat hath collected And I my self also have twice seen such like wounds cured But if those very cartilaginous rings be wounded by reason of their hardness the part cannot again be made to grow together as formerly as Hippocrates teacheth us in the sixth of his Aphorisms Aph. 19. And in the seventh of his Aphorisms Aph. 28. and Galen in Book 5. of his method of Physick Chapt. 7. And yet notwithstanding such like Wounds do not cause a sudden death but a flow and lingering one while that the Lungs are either altered and weakned by that Air that violently breaketh in upon the Lungs thorow the wound or else that a certain smal gobbet of flesh grow unto the wound which by intercepting the breath at the length choaketh the Person But those wounds alone of the rough Artery throttle the Party in which the jugular veins and Arteries being hurt the blood violently and al at once rusheth into the Lungs intercepteth the breathing and so suffocateth the wounded person which yet nevertheless happeneth not by reason of the wound of the said rough Artery but by reason of the wound of the Jugular vein or the soporal i. e. more plainly the sleep-conveying Artery that is very neer unto it Wounds of the Diaphragm Sixthly Hippocrates reckoneth up the Wounds of the Diaphragm among those wounds that are mortal But Galen in his Book 5. of the Method of Physick Chapt. 9. distinguisheth between those wounds of the diaphragm that are inflicted upon the nervous part therof those that are made in its fleshy part and those he wil have to be mortal but these latter Curable And yet nevertheless in the Sixth of the Aphorism Aph. 18. he writeth that the wounds of the nervous part of the Diaphragm are not alwaies mortal but that the great wounds therein are only so For then it is indeed that those grievous symptoms plainly appear viz. a deliry or stupid dotage difficult breathing Feavers Convulsions and as Aristotle hath likewise observed in his third Book of the parts of living Creatures and tenth Chapt. the
miraculous unto many men as well Courtiers as Citizens And thus this Boor in the space of a few weeks by the use of fit and convenient remedies administred unto him by that most expert Chirurgeon without any further sickness and trouble alwaies eating wel and drinking and sleeping as somtimes he told me himself by the blessing of God and the liberal Charity of many people toward him in his low and poor condition contrary unto the determinate assertion of Physical Aphorisms fully recovered his wonted perfect health and soundness and not long after he married a Wife But those wounds of the Stomack are especially mortal that are inflicted upon the superiour orifice thereof in regard that it hath those considerable Nerves that arise from the sixth Conjugation of the Brain and thereby obteineth a very neer consent with the Brain and Heart so that it being wounded most grievous Symptoms may very easily be excited And Benivenius in his tenth B. of the hidden Causes of Diseases that are curable Chap. 110. reporteth that a certain Fuller with one blow of his fist upon the Stomack of a young Man smote him so violently that he immediatly died thereof Eightly The wounds of the smal Guts The Wounds of the smaller Guts are by Hippocrates accounted and reckoned up among those that are Mortal And more especially the wounds of the Jejunum or hungry Gut among al the wounds of the Intestines are especially Mortal by Reason of the greatness of the Vessels and the almost Nervous substance of the Tunicle of that Gut from whence for the most part there follow great torments and pains of the Intestines Sobbings and Faintings as is to be seen in the Histories related by Valleriola in his 2 B. Observat 8. and 9. And indeed the wounds of the smaller Guts are then most especially incurable when the said Guts are wholly cut assunder in a transverse manner since that the Lips thereof standing wide one from the other cannot possibly by any means be Joyned and made to grow together But now the wounds of the thicker Guts are less dangerous and especially if they be not great and that oftentimes such like wounds have been Cured appeareth from the many extant Observations of Physitians which Schenckius in his Observations hath Collected Ninthly VVounds of the Liver Hippocrates likewise accounteth the wounds of the Liver in the number of such as are Mortal which yet nevertheless wanteth a limitation For Aegineta hath truly told us in his 6. B. and 28. Chap. that the Liver having been wounded and a part thereof cut away yet that the wounded person may be preserved And Gemma relateth in the first B. of his Cosmocrit and 6. Chap. that a Spanish youth a great part of whose Liver brake forth by the wound of the right Gut was yet notwithstanding Cured And Bertinus also in his 13. B. and 7. Chap. writeth that a Noble person after a wound inflicted neer about the Region of his Liver and a smal part of the substance thereof drawn forth and cut off yet escaped and became sound again And the same hath likewise been observed by others Guilhelmus Fabricius in his 2. Cent. Observ 34. relateth that a certain Helvetian thirty years old in a Duel was with an Helvetian Sword hurt in that part that is opposite unto the Liver and that he received a very great wound one span long and that hereupon there was taken from him a good big piece of his Liver And yet nevertheless this Man notwithstanding the superveising of most grievous and violent Symptoms by the blessing of God was perfeâ—â—ly recovered And Matthias Glandorpius in his Speculum Chirurgic Observ 34. Page 160 hath a History of a youth dangerously wounded in his Liver who yet nevertheless recovered perfect soundness And yet notwithstanding we say that they only recover who have the superficies alone or the substance of their Liver only wounded without any hurt at all of the great Vessels For if there be wounded any one of the greater Vessels the wounded person cannot possibly escape and by reason of the large effusion of the Blood the Man before that the wound can be Sodered and Agglutinated dieth And of these some indeed for a very short time have their life protracted but others of them die in an instant or at least in a very short space For as Hippocrates in his 5. Epidem telleth the story a certain person having had a dart thrust into his Liver immediatly the colour of a dead Carcass was dispersed all his Body over his Eyes sunk in his Head a difficulty of breathing together with an aestuation or sudden vehement passions followed after this and the same day he died Another Boy being strucken upon his Liver by a Mule died the fourth day after and before his Death he was troubled with a short and thick breathing neither understood he any thing but all the while until he died lay under a feaver Wounds of the spleen Tenthly The Wounds of the Spleen are almost of the same Nature and alike dangerous as those of the Liver For if only the Parenchyma of the Spleen be wounded without any hurt of the Vessels the wounded person may possibly escape But if the Vessels of the Spleen be wounded such like wounds are not only dangerous but also deadly and Mortal For seeing that the Spleen hath stâ—re of Veins and especially of Arteries these being wounded by Reason of the great effusion of Blood and Dissipation of the Spirits the wounded person must of necessity perish VVounds of the Bladder Eleventhly The Wounds of the Bladder are likewise found in Hippocrates his Catalogue of Mortal Wounds But yet nevertheless here also a distinction is requisite For a smal wound is soon sodered together by the intervening of flesh as Galen in the 6. of the Aphorism Aph. 18. and Experience teach us But if the whole Bladder chance to be cut quite through which wound Hippocrates calleth Diacope the Wound is then yet more dangerous And indeed that is most especially perillous which is inflicted at the very bottom of the Bladder and the Nervous paâ— thereof for by Reason of the sharpness and extremity of the pain the inflammation following thereupon and the continual feaver the party dyeth soon after But as for these Wounds that are inflicted at the Neck of the Bladder which is fleshly they are Curable as we are taught even by the Cutting of the Stone And yet nevertheless it hath been observed that the Bladder wounded even in the very bottom thereof hath likewise been Cured the truth of which we have confirmed unto us by those examples we meet with in the Observations of Schenckius For the whole Bladder is not altogether Nervous but the Exterior Membrance thereof is more fleshy whereupon Hieronymus Fabricius ab Aquapendente and Spigelius account the said Membrane for the Muscle that shutteth the Bladder But it is very rare that such a like wound of the Bladder is
perfectly Cured albeit that the wounded person die not thereof but a Callousness being brought over it the Pipe still remaineth by which the Urine is voided forth But yet nevertheless it is not long that a man can continue to live with such a like wound and therefore we say here again as we said also before that there is a difference to be made between a wound Mortal and a wound incurable But yet notwithstanding touching al the Wounds of the bowels hitherto mentioned this is to be observed that albeit there have been observed some examples of such like wounds that have been Cured yet that this hath happened very rarely and that among these those are to be numbered touching which Averrhoes saith that in the Cure of Diseases there are somtimes Miracles wrought For when fit and proper Medicaments cannot be applied unto internal wounds but that the whole work must be committed unto Nature if in this Case Nature be not very strong and Vigorous the wounded person is very hardly Cured but for the most part an inflammation Convulsions Faintings and Swoundings and other the like Symptoms supervening the party dieth And therefore Hippocrates saith rightly in the sixth of his Aphorism Aphor. 18. that such wounds are Mortal and in his Coaca that most commonly and for the most part men die of such Wounds And therefore if upon the receiving of such a wound the sick person die within a short time after the Cause of his Death ought to be imputed unto the Wound since that much help is not to be hoped for from the Physitian as we shal also anon shew you And Lastly Hippocrates reckoneth up the Wounds of the greater Veins among those that are Mortal Wounds of the great Veins and indeed rightly But now by the word Phlebae he understandeth both the Veins and Arteries and by Pacheis he meaneth great and lying hid within which elsewhere he termeth Aimorrhous that is to say pouring forth Blood such as are the great hollow Vein and the great Artery and the great branches of these For such veins and arteries seeing that they cannot be shut close by any ligature whatsoever the blood and the spirits plentifully flowing forth of them the strength and powers of the Body are soon dejected or else the blood that is fallen forth without its own proper Vessels if it hath no passage forth but that it be still deteined in the Body it Clotteth together and putrefieth and getteth unto it self a very evil corrupt and Malignant Nature causeth a Gangreen and exciteth most grievous Symptoms and at length bringeth even death it self upon the party And indeed this danger is most grievous and formidable in the Arteries when the Blood and vital spirits being poured forth the powers of the Body are dejected and the mans life endangered neither can the Arteries be easily brought to close by Reason of their continual motion and hard substance And these are the Wounds that as Hippocrates rightly saith are Mortal Of which notwithstanding as I told you before some are simply or altogether Mortal which Prosper Farinaceus Tit. de Homicidis Quest 125. Part 3. defineth that they are such that require not the Care and advice of Physitians but are such of which the Wounded person dyeth that is by Reason of which although they be Cured by all the Art and industry of the most skilful Physician yet nevertheless the Wounded person instantly dieth thereof And others of them are not altogether Mortal and certain in their causing of death which the same Prosper Farinacius defineth to be such of which the Wounded party dieth not suddenly and of which somtimes he dieth not at all But what Wounds of the latter sort are Mortal that is of which although some are now and then cured and recover their perfect health and strength yet nevertheless this or that particular person may truly be said to have died of them will indeed plainly appear from what we said before touching the Mortal Wounds of each single and particular part And yet nevertheless this is likewise to be added that we are especially to Judg by the Event whether any such Wound be actually Mortal or not For although some strong and lusty Boor or a Man otherwise exactly found and healthful shall recover of some such wound yet Nevertheless it will not necessarily follow that therefore an old person a Child a Woman or any other that is but of a weak constitution must recover of the like wound but albeit the former of these was cured of the like wound yet this latter may necessarily die of the same But now whether or no such dangerous Wounds be Mortal in this or that particular person Nicolaus Boerius in his 323. Decision Num. 11. teacheth us how we may discover it by fix Conjectures The first whereof is the shortness of the time to wit if the sick person die very suddenly after the Wound of which space of time albeit there be very many opinions touching it yet notwithstanding he saith that the principal is this if the wounded person shall die within three daies after the wound received But yet however there are some that extend this space of time unto the fifth or even also unto the eighth day But others notwithstanding extend this term even unto the eighth month or a whole year and this seemeth unto me most probable And unto this space of time the Mosaical Law Exod. Chap. 21. seemeth to have respect The Second Conjecture is the persevering of the vomiting and feaver and other Symptoms that from the very first signifyed and threatened death And this is a right Conjecture and according to the Opinion of all Physicians yea even of Galen and Hippocrates himself For those great and mortal Wounds have their Decretory and Critical daies like as Acute Diseases have as Hippocrates tels us 2 Prorrhet in the which good or evil Symptoms are wont to happen And therefore if grievous Symptoms such as are Convulsions Vomitings sobbings Dotages Syncopes and the like which otherwhiles also are wont to presage Death in such as are wounded presently and even from the very first invade the wounded person or else appear upon him on the Critical day and after continually persevere they then signifie that they were necessarily brought upon the Party by the Wound and therefore that the Wound is altogether mortal The third Conjecture is the breadth and depth of the Wound For a Wound that is very great and dangerous in it self may yet although it be great yet not be dangerous if by it no Noble part be hurt The fourth Conjecture is the quality of the instrument with which the Wound is given and by which the person inflicting the Wound is convinced that he had a will and purpose to kil the party Wounded But this conjecture concerneth rather the Court of Justice then the Colledg of Physitians who inquire not so much after the will and intention of the person wounding as simply and
notable Haemorrhage to accompany them which oftentimes causeth Faintings and Swoundings and other dangerous Symptoms But now the Blood floweth either out of the Veins or out of the Arteries and of these somtimes indeed out of the greater and sometimes out of the lesser and either out of one alone or else out of many And although that the wound inflicted upon the Vessel be the prime and principal Cause of the Haemorrhage yet it happeneth and that very often also that the blood may indeed now and then be stopt for a while and yet it may afterwards suddenly break forth again and this more especially chanceth upon the Commotion of the minde and provocation to anger And so likewise the presence of the Patients Adversary that gave him the wound maketh greatly for the causing of a new and fresh Haemorrhage in the Wound for which very Cause it is somtimes found by experience that the Blood that was before stanched and stopt begins again to flow forth a fresh And I my self remember that one Brother having wounded another and while the Wound was binding up the Brother that gave the Wound coming in to visit the other albeit that they were now reconciled the Blood suddenly brake forth afresh and this without doubt from the secret commotion of the minde for upon his departure and being forbidden to give any more visits the Blood again stanched Signs Diagnostick But now seeing that the Blood floweth either out of the Veins or else out of the Arteries that which floweth forth of the Veins is more thick more black and dark and less hot and it floweth forth without any great violence and rushing and with an equal pulse and doth far less deject the spirits all things else being answerable then that which cometh forth of the Arteries But now that that cometh out of the Arteries may rather be said to leap forth with violence then to flow and in the pouring out it is more hot and fervent more thin more yellow and more frothy and it is evermore accompanied with some notable change and alteration in the Pulse together with a weakness and dejection of the Patients strength If it be one of the greater Vessels that is opened then the Blood floweth forth in the greater abundance and with so much the greater violence but with far les if it be one of the less Vessels that is opened and wounded But now what Vein or Artery it is that is wounded and whether only one or more of them be wounded this must be known from those that are expert in Anatomy Prognosticks 1. An overgreat Haemorrhage in Wounds is very dangerous for the Blood is the Treasure of the Life and when the vital spirits are called forth it causeth a weakness of the Pulse it being so smal that it can hardly be discerned as also a frequency and inequality thereof and somtimes an intermission therein a fainting and swounding a Syncope an extream Coldness and Chilness of the outward parts and inordinate sweats a Convulsion sighings and sobbings Deliries and at length death it self And hence it is that Hippocrates in the 5. Sect. of his Aphorism Aphor. 3. saith that a Convulsion or Sighing happening upon an abundant flux of the Blood is alwaies very evil and dangerous And in the 7. Sect. Aphorism 9. that a Deliry or a Convulsion also happening from the abundant flowing forth of the Blood is evil and ful of danger And indeed it is so much the more dangerous if a Convulsion be joyned with a Deliry and that the Deliry happen not alone without the Convulsion 2. And this is more especially caused by the effusion of the Arterial Blood in regard that with it there is very much of the heat flowing in as also the vital Spirits that are most chiefly Necessary for the preservation of the life poured forth and dissipated 3. And moreover also for this reason the Wounds of the Arteries are more dangerous then the Wounds of the Veins because that they are more difficultly Cured and Consolidated by reason of their hardness their perpetual motion and the violent rushing forth of the Arterial Blood 4. And those Wounds of the Arteries are yet likewise far more dangerous and bring a long with them a greater Haemorrhage and such as is more difficult to Cure that are inflicted according to the length of the Artery or rransversly or obliquely then those in which the whole Artery is cut assunder as experience it self testifyeth so that indeed and as the Physitians are wont to perswade if the Haemorrhage cannot otherwise be stopt and stanched in regard that the whole Artery is not cut quite through it is then wholly to be cut assunder in a transverse manner For if that the Artery be thus transversly cut in twain it will again be contracted and its orifices will again close and shut and thereupon they wil the more easily meet and grow together again and the sooner be covered and shut up by the circumjacent flesh lying round about it neither will the Wound so gape and stand so wide while the Artery is dilated But if that the Artery be Cut long waies or obliquely or if it be wholly cut assunder any otherwise then transversly since that it is moved with the continual motion of the Dilatation and Contraction by this motion and especially the distention the Wound is more dilated and in every Diastole it gapeth whereupon the Blood is poured and leapeth forth with violence and rushing The Cure As in every over great Haemorrhage so likewise in this that proceedeth from a wound we meet with a twofold indication the one that which the wounded Vessels themselves suggest unto us which requireth a Union and Glutination The other that which the Haemorrhage suggesteth which if it be excessive and overgreat so that it dejecteth the strength and powers of the Body requireth that it be stanched even before ever that the Vessels be shut up and united For whereas unto the Union of the Vessels there is some space oftimes required so that the Patient may in the mean while run a great hazard of his Life the Blood is therefore immediately to be stanched That the Flux of the Blood therefore may be stopt although that the Wound of the Vessel be not as yet grown close together al those things are to be performed which may hinder and inhibite the motion thereof Now the Flux of Blood it impeded if with convenient Remedies and the binding up the orifice of the wound be closed and shut up In which manner if the Blood cannot be restrained and that it also break through the Wound closed and shut up in any manner whatsoever and all by reason of the impetuous violence of the Blood then all those things that do any waies help forward the violent motion of the Blood are to be removed such as are the overgreat abundance of the Blood stirring up and continually provoking the expulsive faculty Anger drinking of Wine hot and thin Humors
flame it self penetrateth unto the Pouder or else that the Bullet striking against Iron or some Stone is kindled by the sparks of Fire just as we see it to be in the striking together of the Steel and the Flint-stone Fourthly if instead of the Leaden bullet either Papper pellets or pellets of Hurds be ram'd into the Gun and then shot forth there will not appear any the least tokens of any burning in them caused either by the Gun-pouder or else from the vehemency of motion but only that somtimes they are sullied by the Gun-pouder and made a little black and they are oftentimes drawn forth of the very Wounds as whole and entire as they went in Fifthly Those who are thus wounded do not feel any heat or burning from these bullets but only a pain from the bruising and tearing of the flesh Sixthly That those bullets are not made hot either by the flame of the Gun-pouder or else by the swiftness of their motion we are sufficiently assured of it even by this that a bullet made of Wax and shot forth of a Gun doth not at all melt but that it even pierceth through a two inch board or any piece of Wood two Fingers thick And from this alone it may appear very manifest-that those bullets whatsoever it be that they do it is not by the power and virtue of any Fire that they have in them but what they effect is meerly by their force and violence But now that I may a little open unto you my thoughts The Decision of al the opinions and give my Judgment touching this Controversie I conceive the third Opinion well weighing the Reasons that are brought for it to be the most agreeable to truth But those Arguments that are brought for the two former Opinions may easily be answered For the first of the three who defend that those Wounds are poysonous they do not prove it by this that first of all grievous and dangerous Symptoms do infest those that are wounded in this manner For all those Symptoms may possibly proceed from a Contusion if it be not rightly Cured or if it be overgreat and that there be from hence a putridness excited For when that bullet doth with the greatest violence that may be penetrate through those parts against which it hitteth it dashet together all whatsoever lieth in its way briuseth and teareth it by which said violence not only the Capillary Veins and the Arteries and Nerves that be every where up and down dispersed throughout the flesh are rent and torn but the greater Vessels likewise are battered and broken insomuch that the Natural flux of the Blood and the Spirits is hereby hindered whereupon the bruised parts being deprived of their Natural and Vital heat are easily corrupted and soon putrifie Neither can it truly be said that the trembling of the Heart and the like Symptoms do happen unto all that are thus wounded But as for what they say in the second place that Alexipharmaca or Counter-poysons have been somtimes found very good and commodious for the person thus wounded we answer that this is not true of all Wounds made by Gun-shot but of those only when by the Contusion and the great putridness following thereupon and the neer approaching of a Gangrene the Heart is hurt by the putrid Vapors ascending from the Wound through the Arteries and thereupon it is by Alexipharmick and Cordial Medicaments to be defended from them and withal strengthened But that those Wounds are a long time to be kept open this is not therefore to be done that so the poyson may be evacuated but that the Pus that is continually generated from the bruised parts may be emptied forth which is done too slowly in regard that in such Wounds as these there is very much of that that is bruised And Lastly for what they alleadg that in many battles the most of those that have been wounded either they have Died or else they have been preserved with very great pains and much difficulty this did not therefore happen because that the Wounds inflicted by Gun-shot were poysonous since that in very many other battles no such thing hath been observed but it happened from hence to wit either by reason of the bad and unhealthful Constitution of the Air or else from the vitious and unsound Constitution of the Body and the great store of depraved Humors in these wounded persons such as is most commonly wont to be in those that follow the Camp But now in special and particularly the poysonousness of those Wounds cannot be proved to arise either from the Gun-pouder or from the bullet For as we also told you before neither is the Sulphur nor the Nitre nor yet the Coals all or any one of them poysonous and therefore surely of these there can nothing be compounded that is poysonous And that Sulphur and Nitre may be safely administred appeareth out of Dioscorides his 5. B. and 83. Ch. and out of Hippocrates in his B. of the Nature of Women and others both Ancient and Modern Now the kindling and inflaming of these and the Fire following thereupon would rather dissipate this poyson if any such were present then any waies produce it Neither do those that make this pouder stop their Mouths and Nosethrils by reason of any poysonous quality that it hath but to keep out the pouder that is otherwise very troublesom when it gets into the Mouth of Nosethrils neither yet do all that make pouder stop the aforesaid places although some do for the reason I have given you And moreover much less can this poysonousness be produced from the Lead For although it being long deteined in the Body and there resolved like unto other Metals if it contract any rustiness it may possibly do hurt but yet nevertheless that in this its moment any passage through the Body there should be any poyson imprinted by it upon the Body this can no way be And as we told you above these bullets have somtimes been known to lie in the Body for many yeers together without any inconvenience or hurt yea and moreover from lead there are many very useful Medicaments to be made for External Ulcers But this we easily and of our own accord yield unâ—o and readily grant them that those Bullets as also all other Weapons may be infected with poyson For although the Lead be thick enough yet nevertheless since that Iron that is yet far more solid may be infected with Poyson why may not Lead also be poysoned Now that Iron may be infected with poyson there is no doubt at all to be made the truth whereof is sufficiently testifyed by the Histories both Ancient and Modern of those Nations that as yet use Arrows And this we are assured of by Dioscorides in his sixth Book and 21. Chapt. and by Paulus Aegineta in his sixth B. and 88. Chap. and by Virgil in the tenth B. of his Aeneids and elsewhere as also by Ovid in his
to be cured in that manner we told you of in its own proper place Touching the Inflammation Now very often there happeneth unto Wounds an Inflammation and somtimes likewise an Erysipelas And indeed an Inflammation doth most commonly if not evermore follow upon the inflicting of a Wound and more especially in the Nervous parts in regard that the afflux of Blood unto the part affected stirreth up and causeth a pain therein and moreover because that the Blood when it cannot sufficiently flow forth from thence it putrifieth and very easily exciteth an Inflammation which is prevented by a due and sufficient efflux of the Blood touching which Hippocrates thus writeth in his B. of Vlcers If there flow forth of the Wound Blood more or less according to the strength of the wounded person then both the Wound it self and those parts that are neer about it are the less troubled and affected with any Inflammation that shall follow upon the Wound And therefore if there be any cause to fear an Inflammation and if the blood hath not sufficiently flown forth then forthwith a Vein is to be opened in the opposite place and the Blood is to be evacuated according to the strength of the sick person and as he is well able to bear it Yea and moreover if there be already present an Inflammation and that the Patients strength will bear it and necessity so require Venesection and Purgation are both of them to be administred according as there shall be need If the Inflammation be excited from pain then we are to endeavour that the said pain be taken away and withal that the afflux of Humors be repressed Avicen for this use highly commendeth the Cataplasm that is made of the Pomegranate boyled in astringent Wine then bruised in a Mortar and so made up into the form of a Cataplasm There may likewise a Cataplasm be made of the meal of Barley of Sea-lentiles Mouse Ear and Oyl of Roses But if the Inflammation be not removed by these the rest of the Cure is then to be performed as we shewed you before in the first Part Chap. 5. Touching an Inflammation Of the Erysipelas If an Erysipelas follow upon the Wound this will soon appear from those Signs that we gave you in the first Part and 7. Chapter touching an Erysipelas And in what manner it is to be cured is manifestly declared by those things that are there spoken of And the truth is Hippocrates in his B. of Ulcers teacheth us that whensoever an Erysipelas shall follow upon an Ulcer that then the Body is to be purged And indeed if it be so that Choler abound lest that there should be an afflux thereof unto the Wound it will be very expedient wholly to evacuate the same And yet notwithstanding because that the Erysipelas which we cal Rosa hath its original rather from the thinnest of the Blood and that part of it that is peculiarly corrupted Sudorificks are therefore most especially useful as there we told you Hippocrates was wont to impose upon the part affected the Leaves of Woad or the Juyce thereof with Clay We may likewise apply unto the place affected Cataplasms of Barley meal and Eldern Water and other the like such as we have there mentioned to wit in the place before alleadged Of the Super-excrescent Flesh And sometimes likewise it so happeneth that the Flesh becometh Luxuriant and proud as we term it and groweth forth beyond all reason and measure which hidereth the production of the Cicatrice and its covering over of the Wound or at least it causeth the same to be unfightly and deformed But this happeneth through the unskilfulness or want of care in the Physitian who administred Medicaments that were not sufficiently drying And therefore what Flesh we finde to be superfluous we must take it away that so the Wound may be shut up with a Cicatrice But now this is the work of the Physitian who is to consume the superfluous Flesh with Medicaments that are sufficiently strong in their drying cleansing and if need so require somwhat Corroding likewise But now what those Medicaments are with which this may be done we have told you before in the 2. Part and 7. Chapt. whither we refer you Of all which Medicaments there mentioned the most useful and principal is the Green Water there spoken of which both consumeth the superfluous flesh and likewise bringeth the Cicatrice over the Wound when it is cured Of the Haemorrhage There happen also many Symptoms unto Wounds which partly deject the strength of the Patient and partly render the Curing of the Wound more difficult then otherwise it would have been And first of all there oftentimes happeneth indeed an extraordinary great Haemorrhage and profusion of the Blood which doth not only deject the strength and Spirits depriving the Patient oftentimes of his Life but it likewise very much hindereth the Cure For so long as the Flux of Blood lasteth there can nothing at all be done in the Cure Now that said Haemorrhage happeneth upon the wounding of the greater Veins as also the Arteries not only the greater of them but the mean and middle sort of these Arteries But touching this Symptom we have already spoken above in the 14. Chapter where you may see further Of pain with the VVound And oftentimes likewise there is an extraordinary vehement pain following and accompanying the Wound For although there be indeed hardly any Wound without pain yet nevertheless very usually this pain is tollerable and such as the Patient can wel bear But somtimes it is vehement and altogether intollerable which happeneth more especially when the Nerves and the Nervous parts are hurt and Wounded and an extream vehement pain arising immediatly upon the inflicting of the Wound is a sure and certain Sign and token that either a Nerve or a Nervous part is wounded The Cause Now this pain is excited in Wounds somtimes by reason of Errors committed by the Patient in the Course of his Dyet whiles he eateth all manner of bad and corrupt food as Cabbage and Cole-worts salt Fish Swines flesh or the like whiles he exposeth the wounded part unto the cold Air and moveth it overmuch by exercise And somtimes also this pain happeneth by the Carelesness of the Chirurgeon who administreth Medicaments that are overhot and too sharp hindeth the part too hard and streight placeth â— not aright thrusteth into the Wound Tents over long or thick leaveth the Pus over long in the Wound and suffereth some piece of bone to prick and molest the part that lieth next unto it And somtimes also without any of these Causes a pain may be excited by an internal afflux of the Humors and this pain oftentimes invadeth the wounded person suddenly and with a certain unwonted coldness and Chilness and this is oftentimes a very shrewd sign of some great Inflammation instantly to follow or even of a Gangrene very nigh at hand and this especially if together with the pricking
to the Pecten and the neck of the Joynt is sustained in its Cavity again on the outer side the buttock appears hollow because the head of the Thigh is fallen to the inner part and the Thigh towards the Knee is forced to look outwards to the outer part in like manner the Leg and Foot whenas in all luxated bones one extreamity alwaies looks to the contrary part to that which is fallen forth They whose joynt is fallen forth after this manner and not reduced when they go they wheel about their Thigh outwardly for whenas the faulty Thigh is made longer and by reason of weakness they cannot readily bend the bone and by reason of pain they refuse to do it it remains that they must bring it about See more of these things in Hippoc. 3. de artic from t. 68. to t. 105. al which for brevities sake I would not transcribe hither Prognosticks 1. There is great danger in the Thigh lest that it be hardly reduced or being reduced that it fall out again Celsus l. 8. c. 20. 2. An old Luxation of the Thigh which hath already contracted a callus and in which the bosom is filled up with humors is judged incurable 3. If by reason of the plenty of the humor collected in the Cavity that Ligament be preternaturally extended that it cause the Thigh to be moved out of its seat or if the same Ligament be so relaxt by the humor that it cannot contain the bone in its seat although the bone be reduced yet it staies not in its place but fals out again viz. if the humor remain but if the humor be dried up the Joynt may remain in its seat of which Hippocrates 6. Aphor. 60. They who being troubled with a long continued pain of the Hip have the head of the Thigh fallen forth of the Hip their Thigh wasteth and becomes lame unless they be burnt 4. The same comes to pass if that Ligament be broken 5. If the luxated Thigh be not reduced the neighboring parts are wasted by degrees for both the Arteries and Veins are streightened and comprest that there is not a free passage open for the blood and spirits to those parts and because the part is not moved after its due manner the heat fadeth whence the nourishment of the part is not rightly accomplisht and the Thigh-bone is not encreased according to the proportion of the rest of the bones The Cure Whereas after the same manner almost as the Shoulder is joyned with the Shoulder-blade so the Thigh is with the Hip-bone so the way of reducing them both is almost the same The Patient must be placed upon a Bench or Table putting a Pillow or Bed under him with his Face downward if the Luxation be made outward or backward with his face upwards if inwards and upon his side if forwards and this reducing is done somtimes only with the Hands without any extension as first of all either let the head of the Thigh be so long wheeled about the Loyns till it come into its Cavity which way notwithstanding is not so safe or secondly to wit in a Luxation made to the inner part let the Thigh most quickly and strongly be bent to the Groyns and by this means let the head of the Thigh fallen forth be forced outward into its place but if no good be done by these waies the Patient must alwaies be so placed that the part into which the head of the Thigh is fallen be uppermost but that from which it is departed lowermost afterwards convenient extension must be made and at length the Thigh must be forced into its Cavity alwaies a way contrary to its falling forth but how a lawfull and convenient extension is to be made either with the hands to wit in soft bodies a new luxation or with Reins Ropes and the like to wiâ— in strong bodies and an old luxation doth sufficiently appear from those things which are said in the precedent patt c. 11. of the Fracture of the Thigh and truly the extension may be common to the four species of a luxated Thigh but the manner of forcing and restoring the head of the Thigh into its place varies according to the variety of the parts to which it is fallen for that which is fallen inwards must be forced outwards that outwards inwards and so of the rest when the bone is reduced which is known by the free motion of the Thigh and without any pain the Medicines of which we spake formerly in general c. 1. must be laid on the Joynt and with rowling the Joynt must be kepâ— in its place straw beds also as in Fractures must be applied and both Thighs be kept in its place straw beds also as in fractures must be applied and both Thighs be bound that the luxated Member may be kept in its place and this provision must not be loosed before the fourth day and let the Patient keep himself long enough in bed nor let him walk lest by unseasonable walking the bone fal forth again See more in Hippocrates Paulus Aegineta l. 6. c. 119. Ambrose Parry l. 15. from c. 39. to c. 48. Chap. 10 Of a Luxation of the patel Bone THe Thigh in its lower part hath two eminent heads tending to the hinder part with which it is inserted into two bosoms of the leg-bone only superficial ones and no waies deep and pargetted over with a smooth cartilage it hath moreover in its hinder part a certain bosom into which the bunching forth of the Leg-bone that stands forth betwixt its two bosoms is inserted but lest that by reason of this looser Articulation which is by a Ginglymus the Knee should be subject to frequent Luxations on the fore part the patel bone is set over the bone of the Thigh and Legg and firmly joyned to them by benefit of the thick Tendons of the Muscles extending the Leg besides on the out side of the greater bone stands the Bracer which at its upper part in the inner side hath a bosom covered with a Cartilage by which the little side head is received which subsists at the upper Appendix of the great Bone but at its lower part with its acute angle 't is inserted into the external and oblong bosom of the lower Appendix of the great Bone and makes the outward Ankle whenas therefore here concur many Articulations also many Luxations may happen A Luxation of the Knee-pan And truly first of al The Patel Bone whenas it hath no obstacle on the sides hindering its dislocation may be most easily luxated to the upper lower outward and inner part but never to the hinder part in regard that the bones of the greater Focil and Thigh which it covers do hinder it The Causes The Causes of this Luxation are a fal from on high jumping blows and an undecent distension of the Leg. Signs Diagnostick The Luxation of the Patel Bone is easily known by the sight and touch and the Thigh cannot rightly be
an extream troublesome palpitation and beating of his Heart For the removal of this great Distemper there were many Remedies prescribed and administred not only by my self but likewise by the most expert Physitians of our Vniversity there All which when they could not in the least prevail over this contumacious and head-strong Disease by reason of the Patients continuing and persevering in his accustomed ill course of Diet he grew the worse thereby and after some few months were passed in the which by the advice of the Physitians he took no Physick at all for they were willing to commit unto Nature a part of the Cure of this Chronical Affect he began to complain of that part that lieth under his left Shoulder-blade The place of his grief being lookt upon and throughly considered there appeared unto me a notable Tumor soft unto the touch and attended with a beating and when pressed down with the Fingers it was then seemingly wholly hid and non-apparent but these were no sooner taken off but forthwith it returneth as before In short the Disease having gotten deep rooting being now become incurable our Patient within a very short time after departed this life But now that we might get the truth and certainty both of the nature and constitution of this Disease as also of the Cause thereof we dissected that part that was affected with the Tumor out of which there issued forth great store of Blood unsavory and stinking as it was all which Blood being wholly evacuated and throughly cleansed there appeared the prime and principle Artery under the Heart having its original from the great Vein in its ascending up into the Head exceedingly dilated and extreamly torn This Vein descending downward creepeth along through the Region of the Intercostal Muscles the Blood that flowed forth of it being heaped up in the spaces of the Muscles and in tract of time putrefying and corrupting had so vitiated and marred the Vertebra and Rib of that place that it seemed unto us altogether rotten and putrefied And therefore say we some other way and means of the generating of this Tumor is to be sought and found out The Author of the Book of the Medicin Definitions defineth Aneurysma by the relaxation of an Artery And so likewise Fernelius in the seventh Book of his Patholog and Chap. 3. asserteth that Aneurysma is a dilatation of an Artery ful of spiritful blood but all this while they do not express the manner how this is done Neither is it ever a whit credible that Aneurisma is caused by the dilating of both the Tunicles of the Artery but only by the widening of one of them For the Atteries have indeed a double Membrane one external which is slender thin and soft having of straight Fibres very many but of oblique ones very few and of transverse ones none at all the other internal which is close thick and hard having transverse Fibres but wanting straight and oblique ones And therefore if the Internal Tunicle be either broken by extension as easily it may be in regard of its hardness or else if it be opened by Section it doth not easily Cement and close together again because it is hard but now the external Tunicle in regard of its softness doth easily and soon grow together again and because it is so soft and wanteth both oblique and transverse Fibres it is thereupon extended by the Blood and the vital Spirit seeking their passage forth in an imperious and violent manner and so this kind of Tumor cometh to be excited in the which the force and the impetuous violence of the blood and the vital spirit may be discovered by the very touch Neither is that which Platerus objecteth of any weight or moment to wiâ— when he tels us that upon the alone bare Section that he saw made in the skin that covered over the Tumor the blood forthwith at first hid it self but then instantly sprang forth amain and this oftentimes saith he is in so great abundance that it cannot by any one use he what means he wil be any more stanched but that it issueth forth in greater abundance insomuch that the whol stock of Blood being almost spent it hath oftentimes brought a sudden Death upon the sick Person But indeed if we should determine that the Aneurisma proceedeth from the dilatation of these Tunicles of the Artery this Objection would then carry some weight along with it But in regard that according to the truth of the matter we have already asserted and determined that an Aneurysma ariseth from the dilatation of the exterior Tunicle alone of the Artery the internal being opened either by Section or by Rupture we cannot therefore by any means grant that the Arterial blood lieth hid under the whole Skin but because the external Tunicle is extraordinarily extended it cohereth and sticketh so close unto the Skin that it is extended together with it and is in a manner so become one therewith that it is almost impossible to cut the Skin without cutting the external Tunicle of the Artery And so then the result of al that hath been said wil be this to wit The nighest cause of Aneurisma That the proxime and nighest cause of Aneurysma is the opening of the interior Tunicle of the Artery and the dilatation of the external Now it is very frequently opened by Section when unexpert Chirurgeons instead of a Vein open an Artery or when at least together with the Vein they cut through the Artery that lieth under it Now if this at any time happen the external Tunicle in regard of its softness and neer alliance with the Tunicles of the Veins very easily and soon closeth together again but the interior by reason of its hardness remaineth open from whence through the patent and open place the Blood and vital Spirit endeavoreth to break forth and by this means distendeth the external Tunicle and causeth this kind of Tumor The same may likewise happen if the internal Tunicle of the Artery be broken either by the violent and impetuous motion of the Arterial blood or by any violent external cause and the overgreat distension of the Artery the external Tunicle that is more apt for extension being al this while safe and sound But now Whether or no that pulsation of the Arteries of which Platerus maketh mention in his Tract touching the palpitation of the Heart and touching which out of Fernelius and Ludovicus Mercatus we have already treated in the fourth Book of our Practice Part 2. Sect. 3. Chap. 9. may or ought properly to be referred unto Aneurysma I very much doubt For whenas the Membrane of either Artery is then whol and entire it seemeth rather to be an Affect in the Veins of kin to the swoln and distorted Veins that we cal Varices than this Tumor Aneurysma of which we are now treating Signs Diagnostick The Aneurysma is easily known and discerned from Ecchymosis because that in Aneurysma the color
is like unto the rest of the skin and the Tumor is soft and loose and for the most part giveth way and yieldeth unto the compression of the fingers the blood running back into the Artery from whence it instantly again floweth forth There is likewise a Pulse to be felt in an Aneurysma Although that Paraeus hath observed that somtimes in the Aneurysma if it be great there is neither any pulse to be perceived not any return of the blood upon the compression unto the more internal parts and this I also observed my self in a certain Woman but then notwithstanding there is to be perceived a motion and as it were the loud noise of boyling water and that not only when it is pressed down with the fingers but likewise at other times and this hissing or singing noise is not only to be perceived upon the touch of the fingers but also upon the putting of the Ear close thereto which proceedeth from the motion of the vital spirit in its passage through streight and narrow places All which signs proceed not from the effusion of the blood under the skin but from the dilatation of the Artery Prognosticks 1. Al Aneurysma's are very hard to cure 2. Yet notwithstanding those of them that are less and newly arisen wil admit of a Cure But such of them as are old and greater in regard that that blood cannot be driven back by Astringents neither may the Artery be consolidated and so they are no waies to be cured but by Section wil hardly admit of any cure at al. For the Tumor being opened and the Artery as it is necessary being cut the Arterial blood floweth forth together with the vital spirit abundantly al as it were at once and with great violence so that the sick person is oftentimes precipitated into extream hazard and danger of death And there are many remarkable instances that might be given of such sick persons as in the opening of the Aneurysma have died under the hands of unskilful Chirurgeons 3. Neither hath the Tumor that is joyned with an Aneurysma any great danger in it but that the life may together with it be lengthened out for a long time I knew a certain neer Neighbor of mine in whom an unskilful Chirurgeon when he should have opened a Vein cut an Artery and it is now already above thirty yeers that she hath had an Aneurysma as big as a Walnut in the inward bending of the Arm and al this while hitherunto she hath enjoyed and stil even at present doth perfect health as if she ailed nothing at al. And therefore we conclude that better it is somtimes for the Patient to bear and undergo this sleight inconvenience than to submit himself unto a dangerous Cure The Cure And therefore forthwith even in the very first rise of it so soon as ever we perceive that there is an Aneurysma excited for it is not suddenly done but that dilatation of the exterior Tunicle of the Artery is caused sensibly and by degrees let Astringents and Repellers be imposed upon the place affected that so the force of the blood may be abated and qualified and the open hole of the Artery may be shut up For which end and purpose there may likewise very fitly be administred a thin Leaden plate which doth repel thicken and bind close together the loosened Artery There may also be administred astringent Cataplasms and the Emplaster against a Rupture And because that the Aneurysma somtimes also ariseth from the cutting of an Artery we must do out endeavor that if an Artery be cut whether it be purposely done or whether it happeneth by any ill accident that it may immediately shut and close up again and that may right manner which in regard that it is not here so easily effected because of the violent and impetuous motion of the Artereal blood as it is in the Veins therefore we prescribe the following Medicament as very fit and proper for the Consolidating of the Wound of the Artery Take of Frankincense two parts of Aloes one part and an half Mingle them and having shaken them wel together with the white of an Egg tye up all with the Flâ—x of a Hare as much as wil suffice and let them be laid upon the Wound of the Artery And of this kind there are divers other Medicaments to be prepared of the Roots of the greater Comfry Mustick Frankincense Pomegranate Rinds Acacia or binding Bean-tree Hypocistis or the hardened juyce of Cystus Myrtle Gals Aloes sealed Earth of Lemnos Bole-armenick Lapis Hemarites or the Blood-stone and the Emplaster Diachalcitis If in this manner and by these means the growth and encrease of the Aneurysma cannot be hindered there are indeed some that advise and perswade us unto Section and the Tumor being opened the Artery that is to be cut must be intercepted by binding it about with two bands and then it must be dissected between the two bonds and these bonds as they teach us are not to be loosened until that Nature hath covered over the wound with fleshâ— and that now al the fear of the bloods issuing forth and al the danger of an Hemorrhage be past and gone Now as for the manner of cutting the Aneurysma Aegineta acquaints us with it in his sixth Book of Physick Chap. 37. in these words If the Tumor saith he be caused by opening then we use to inflict upon the skin a straight Section made longwaies and then after this the lips of the skin being parted and far sundred by little hooks we make bare the Artery severing it from its Membranes by Instruments very fit for this purpose and then after the transmission of a Needle under it we tie it with two threds and then so soon as we have pricked with a Pen-knife the middle part of the Artery and have evacuated what was therein contained we then betake our self unto the suppurative cure until at length the ties of the threds fal off But now if the dilatation be caused from the rupture of an Artery then it behoveth us as far forth as possibly we can to lay hold upon the whol with our fingers together with the skin then to cast through it beneath that we have laid hold on with the fingers a Needle that may if you please have in it two threds or rather one thred doubled and after the casting through of the Needle and thred we are then to cut in two the every bandle as I may so cal it of the double thred and so to bind about the Tumor on this side and on that with the two threds But if there be any cause to fear lest these threds should slip and fail then in this case there is likewise another Needle to be cast through that may throughout lie and press upon the former and this Needle may likewise draw after it two threds or a double thred and the handle thereof being cut in sunder we then bind about the Tumor with four
in the Stomack and that accordingly blood be bred in the Liver yet it is oftentimes discussed and wasted by some certain Causes such as are overmuch exercise Watchings Cares Griefs and Diseases which melt away dissolve and discuss the aliment so that there is too great an evacuation hereof by the Belly by Sweats and by the flux of Blood and such likewise are immoderate Rest Meats and Medicamens that dry excessively Fevers especially such of them as are acute and Malignant But the Nutriment is not rightly assimilated by the parts in regard of some vitious quality it hath in it by reason of which it cannot be assimilated by the parts and so likewise the Nutrition may be frustrated by some external error or else by reason of the Object to wit because the Blood is such that it cannot by the nourishing faculty be perfectly overcome and assimilated But now in regard of the faculty there is not a sufficient Nutrition â— In regard of the nourishing faculty by reason of some defect and want of native heat and radical moysture For Nature maketh great use of this Native heat as of the next instrument in nourishing And this especially happeneth by reason of the preternatural affects of the Heart and principally its heat and driness whether it be that the Heart be primarily affected as it is in the Hectick Fever or else that it suffer through some default of the neighboring parts as it happeneth in the Ulcer of the Lungs For whereas the nourishing faculty as we said erewhile maketh great use of the innate and Native heat as its principal Instrument in reteining Concocting agglutinating and assimilating and it being so that the innate heat is cherished by the heat that floweth in if the temper of the Heart be not right and as it ought to be then the heat that floweth in and consequently the innate heat likewise wil be much amiss and not rightly tempered and so it can be no fit Instrument of the nourishing Faculty And that that Hectick Feavers do but slowly and sensibly bring to pass this the burning and melting Feavers accomplish in a very short time by the heat whereof not only the aliment and substance of the body is consumed and melted away but likewise the temperament both of the Heart and also of the whol body is converted into that which is more hot and dry The same happeneth by reason of over hard labors cares long continued diseases and in general al causes that are able to consume the Radical moisture and weaken the Native heat Now this Atrophy happeneth especially in the softer parts The subject the fat and the flesh and indeed the fat is first of al wasted and then afterward the flesh is likewise extenuated But now as for the harder parts such as are the Membranes Cartilages and especially the Bones although these may also in the like manner be dried yet notwithstanding they cannot possibly be so extenuated and diminished that thence the whol body should decrease And hence it is likewise that the said extenuation and Atrophy of the body doth appear especially in those parts in which there is much fatness and where there are more or greater Muscles as in the Eyes and Temples The particular Atrophy The Atrophy that happeneth in the parts is various It happeneth oftentimes privately in the Limbs the Arms and the Thighs And hither belongeth the Atrophy of the Eye The causes thereof which are the same As for the Cause of the particular Atrophy like as the Causes of the Atrophy of the whol body consist in some one principal Bowel whose action is necessary for the nutrition of the whol Body or is indeed universal and such as may exsiccate and dry the whol body so in like manner the particular Atrophy of any one part hath a private cause or at least such a one as belongeth unto that particular part Yet notwithstanding the Causes are the same as of the universal Atrophy to wit the weakness of the Nutritive Faculty The weakness of the Nutritive Faculty and the defect of Aliment The Faculty is hurt when the part is over cooled and left destitute of its proper heat For if this happen the part can neither attract nor retain not alter nor assimilate the Aliment Now the part is refrigerated and the heat decayed and rendered dul and unfit for action not only from the external Air as also from cold water but likewise it may proceed from overmuch rest in the Palsie or else from the streightness of the passages through which the Spirits flow in The defect of nutriment The Nutriment faileth especially by reason of the narrowness of the passages through which it floweth unto the part that needeth it And this happeneth for the most part from external causes when the Veins that carry the blood unto the part for its Nutriment are pressed together by the bones when they are loosened and out of joynt or else from some certain Tumor that is nigh unto it or by the brawniness and hardness of the flesh or else lastly when the Veins that convey the Nutriment are cut in sunder See likewise Galen's Book of Marcor a Species hereof arising from an Hectick Feaver Signs Diagnostick The extenuation of the whol body as likewise of some one particular part thereof is visibly apparent to the sight so that there wil be no need of many signs For if the whol body be greatly wasted by an Atrophy then the Face fals away and becometh lean the Temples fal down the seat of the Eyes is rendered hollow and deep the Nostrils become sharp and such kind of Face because that Hippocrates describeth it in his Prognosticks they commonly cal an Hippocratical Face Al the Ribs are conspicuous the shoulder blades and the Chanel bones stick out the Neck is extenuated and the Larynx or the top of the cough Attery buncheth forth the Belly falleth down the Buttocks become withered and weak the Thighs Arms Hands and Feet are emaciated and grow lean But in regard that the Atrophy hath its dependance upon many and several causes they are therefore al of them to be inquired into that so the Cure of them may the more rightly be proceeded in And therefore enquiry must be made whether external Causes to wit tasting cares grief over hard labor and the like went before If we find no such thing we are then to make enquity into the internal Causes to wit whether there be present a Hectick or any putrid Feaver or whether there had not been one a little while before and likewise a discovery must be made touching the Stomach Spleen and Liver in what state and condition they are for by the Diseases of the Bowels it may easily be known what the Cause of the Atrophy is Prognosticks 1. By how much the more the Atrophy is but recent and newly begun by so much the more easily it is cured but by how much the longer it hath
likewise hurt in the Wounded parts The Skin being Wounded can no longer cover the parts lying underneath it neither the dissected Peritonaeum the Intestines the Cornea Tunicle of the Eye can no longer contain the Humors neither can the Arteries when they are once cut in sunder any longer contain or convey the Blood neither can the Nerves carry the Animal Spirits The Differences The Differences of Wounds some of them are Essential and others of them Accidental The Essential are taken from the very Nature of the Wound to wit from the form thereof in which respect according to the Figure some of them are straight other of them oblique and these indeed likewise of a very various Figure in respect of their Magnitude some of them are smal and others great some deep others of them only superficial and hither also may this be referr'd that a wound being inflicted either there is â—omwhat cut off from the substance of the part or else there is not any thing at all cut away Although if we would but rightly and accurately Judg of the thing these are no proper and Essential Differences in regard that they are taken not 〈◊〉 the very Essence of the Wound but rather from some certain Accidents that happen thereto to wit the greatness the figure c. From the part affected which is somtimes the Musculous Flesh somtimes a Nerve now and then a Ligament and very often a â—endon now this or that part is affected And indeed in one and the same part there is great respect to be had in what particle of the part the wound is as for example whether the Wound be in the beginning or in the end or else in the middle of the Muscle and whether or no in the Wound of any Bowel the Parenchyma or the Vâ—ssels therein be wounded From the Cause because that the wound afflicted is either by cutâ—ing which is in special call d a wound or by pricking which in special is called a 〈◊〉 or pr â—king or else together with the 〈◊〉 there is likewise present an incision 〈…〉 or else all these three incisâ—â—â— pâ—â—eking and Contusion are Joyned together But the Accidental Differences are such as are drawn from those things that are without the Definition of the Wound Galen in the Third B. of his Meth. of Physick and last Chap. hath reduced them to three Chapters and he teacheth us that they are taken either from the manner of their Generation to wit that there is a total incision or a total disruption or else that there is only a part cut or a part broken Secondly From the situation of the Wound to wit when in a wound obliquely inflicted one part of the Wound is in sight and another part lieth hid under the Skin And â—hirdly From the time that one wound is fresh and new made another old and inveterate There are likewise certain other Accidental Differences we may rather call them improper taken from those things that are conjoyned with the Wound to wit that that wound is poysonous that is inflicted by a poysoned sword or else by the biting of some venemous beast that there hath chanced unto the wound some inflammation or an Eryfipelas or that there is a Fracture or disioynting Joyned therewithall or else that there is conjoyned an Hemorrhage Pain or some other Symptom The Causes We need not say much touching the Causes of Wounds The Causes of a Wound that is made by cutting are al those things that have in them a power of Cutting Swords Glass and the like Of a Puncture or pricking the Causes are whatsoever things are sharp-pointed as Arrows Needles and the teeth of living Creatures Of Ruptures such things as distend the soft parts and pul them into Contrary parts such as the lifting or carrying of some extraordinary weight a Fall Blow lowd speaking and the like Those things that bruise are all things Heavy Hard and Blunt as Stones Wood Lead and among these Leaden Bullets shot out of Guns have in them a power of perforating Chap 2. Of the Diagnostick Signs THe Truth is that the wound it self is of it self sufficiently manifest unto the senses and therefore needeth not any signs whereby it may be known But although that place in the Skin that is wounded be obvious and open to the sense yet nevertheless if the Wound penetrate unto the more inward parts what parts they are that are wounded within is oftentimes very obscure and hidden from us But this may be known first from the situation of the parts Secondly from the Action that is hurt and the Use Thirdly From the supervening Symptoms and Fourthly from the Excrements For if the wound of the Head be so inflicted that it be very deep it sheweth that the Brain is wounded and if the whole Thorax or Chest be run through with a Sword it argueth that the Lungs are likewise wounded and so of all the other parts For the exact and perfect knowledg of which the Scituation of the parts is to be learnt from Anatomy Secondly the Actions that are hurt do demonstrate the Wounded part And so after a Wound received in the Privy parts if the Urine flow forth of its own accord it sheweth that the Sphincter of the Bladder is hurt But here notwithstanding we are wisely and carefully to consider in case any Action be hurt whether the hurt of the said Action be not by Consent of some other part And therefore other Signs are to be conjoyned If a wound being received in the Abdomen the Intestines fall forth it is an Argument that the Peritonaeum is cut a asunder As for what concerneth the Excrements if Chyle flow forth upon the receiving of a Wound it is a sign that the Stomach is wounded or the smal Bowels if the Excrements of the Belly that the greater and thicker Intestines are wounded if Urine flow forth of the Wound then it sheweth that the bladder is wounded if out of the Wound of the Thorax or Chest Air pass forth it is a sign that the Lungs are wounded Whether it be a Vein or an Artery that is hurt and wounded the efflux of the Blood will shew since that what floweth forth from an Artery cometh forth Leaping and Dancing as it were and is more Red then that from the Veins We have notice likewise given us of the part that is wounded from the supervening Accidents And so a vehement pain suddenly happening manifesteth that some Nerve is wounded Chap. 3. Of the Prognosticks and foretelling of the Event of Wounds BEfore the Physitian attempt the Cure of a Wound he ought First to be very Sollicitous and Inquisitive touching the Prognosticks To wit in the first place he ought to foreknow whether the Wound be Curable or altogether incurable And then if it be indeed curable whether the Cure will be easie or difficult and whether or no the wounded person be like to have his former perfect soundness restored unto him or else whether
that out of it store of Blood be poured forth unto the Heart overwhelming it and suffocating the heat thereof Thirdly Al the internal wounds of the greater Vessels that cannot by any art be closed upon regard they cause the Blood being plentifully poured forth either out of the Veins or the Arteries that the spirits be suddenly dissipated therefore of necessity they speedily suffocate the wounded person Fourthly All those Wounds are said to be Mortal that suddenly take away the Respiration and hinder the ventilation of the Heart so that the Native heat of the Heart is suffocated and so cause that the Man die even almost in the very same manner as Apoplectical persons are wont to die And such like wounds are especially the Wounds of the Brain but yet not all of them since that there are many Wounds of the Brain that are not Mortal as afterwards we shall shew you and as we have already told you in the first B. of our Practice first part and 23. Chapter But those great Wounds and such as are the Cause that the Animal spirits be suddenly dissipated or that the blood being poured forth of the Vessels the Orifice of the Nerves be quite stopped and so by this means the influx of the Animal Spirits be hindered or that from the same an inflammation of the Brain or a feaver be excited And this is not only done by the Wounds of the very Brain it self but likewise by the strokes and vehement Confusions of the Head by which the Vessels of the Brain and those neer about it are broken and the Blood poured forth of them unto the beginning of the Nerves and there subsisting hinder the influx of the Animal Spirits And this may also happen if the Sinus or hollow places of the Brain chance to be hurt so that out of them blood be poured forth unto the Basis of the Brain and so it is likewise in the Wounds of the Eyes if they penetrate so deep that they open either the Vessels of the Brain or those that are in the Basis thereof or those that are neer about the said Basis of the Brain and so that the Blood poured forth unto the Basis of the Brain hinder the influx of the Animal spirits by compressing the beginning of the Neryes For although that the Blood if it be poured forth above upon the Brain may possibly be emptied forth by perforating and opening of the Cranium or Skul yet nevertheless if it be poured forth unto the Basis of the Brain it is impossible that it should ever be evacuated There seemeth yet nevertheless to be another way whereby the Blood poured forth into the Brain or about the Brain bringeth Death within a vâ—ry few daies if it cannot be evacuated For when as it is without the Vessels it beginneth to putrefie usually about the fifth day from whence feavers deliries and Convulsions are excited so that the man dieth in the same manner almost as one in a Phrensie That which is done by the Wounds of the brain the very same happeneth likewise from the spinal Marrow if it be indeed wholly cut assunder in the superior part thereof for then the motion of all the inferior parts and so of the Thorax likewise is abolished and the wounded persons are suffocated And unto one of these four waies I conceive that al kinds of Mortal Wounds may be referred And therefore if a Wound penetrate into any interior part of the Body so that thereupon the wounded person die within a short space of time we are then to Judg that that Wound was Mortal and if diligent inquiry be made I am of Opinion that it may be referred unto some one kind or other of these Mortal Wounds whether that Wound hurt the vital faculty it self immediatly or else hurt it by the intervening of some other Disease or Symptom For as Nicolaus Boetius writeth out of Felinus in his 323. Decision Numb 10. it is all one whether a Wounded man die of his Wound or of some infirmity caused by the same Which yet nevertheless is so to be understood if the Wound necessarily attract that Disease or that Symptom which is the Cause of Death But as for all the other Wounds whatsoever that cannot be referred unto some one of these manners I conceive that they cannot simply nor necessarily be accounted Mortal The which that it may be made the more plainly to appear we have it now in our purpose in special to weigh and discover unto you the Wounds of all parts that are to be accounted Mortal Now Hippocrates Judgeth the wounds of seven parts to be Mortal What Wounds accounted Mortal by Hippocrates whilest in his sixth Sect. Aphor. 18. he thus writeth Whosoever hath his Bladder out through or his Brain or his Heart or his Midriff or any of his smal Guts or his Stomack or his Liver that Wound is Mortal Which Aphorism notwithstanding in his Coaca or his Tract of Playsters Aphor. 509. he both Limiteth and Amplifieth when he thus saith From a Wound even Death it self may almost happen if any one be wounded in his Brain or in his spinal Marow or in his Liver or in his Midriff or in his Heart or in his Bladder or in any one of the greater Veins Death likewise soon followeth if any extraordinary great Blows be inflicted upon an Artery and upon the Lungs so that the Lungs being wounded the Breath that passeth out at the Mouth is less then that which issueth forth at the Wound But they suddenly perish whosoever they are that have received a Wound in the interior Nerves whether smal or g eat if the Blow or Wound be both Transverse and great but if the Wound be but smal and straight there are some that escape the danger But there is neither Death nor any great dangâ—r impending from those Wounds that are inflicted on those parts of the Body in the which there are none of these or which are as far distant at may be from these Indeed he limits the Aphorism whilest that he doth not simply write that such like wounds are altogether Mortal but almost and for the most part He amplifyeth it whilest that he addeth the spinal Marrow the greater and thicker Veins the rough Artery and the Lungs and the interior Nerves And therfore we wil in order consider the wounds of these parts For it is without doubt that the Wounds of the rest of the Parts are not at all of theâ—selves Morâ—al and this Hippocrates himself teacheth us in the above mentioned Aphorism 509. in Coacis Celsus in his 5. B. and 26. Chap. thus rendereth the foresaid Opinion of Hippocrates He cannot possibly be preserved that hath the Basis of his Brain his Heart his Stomack the parts of his Liver the Marrow in his Back-bone wounded or that person that hath either the middle of his Lungs or the Jejunum i. e. the hungry Gout or any of the smaller Guts or the Stomack or the Reins be
Butter or with the fat of an Hog or with some other fit Digestive But if the hole be not wide and large enough it may very easily be dilated to wit if either a little piece of Spunge or Gentian root or Rape root dry be put thereinto For these things aforesaid when they are filled full with humidity they are then dilated and so consequently widen and enlarge the hole The Spunge is thus to be prepared the Spunge is to be wel soaked in the white of an Egg twice or thrice throughly shaken together then afterwards let it be close squeezed together on all sides and then let it be leisurely dried in the shade a smal portion of this when it is dried is to be taken and put upon the Ulcer But in regard that the crustiness thereof wil not fall off in a few daies time and that all this while the Pus or filthy corruption unless it stick immediately under the Skin is detained and imprisoned in the Impostume for this very cause if there were no other it is by far the safer way to open the Impostume with an Iron The Impostume being now opened whatever the way of opening it hath been the Pus or matter is to be evacuated but yet this needs not evermore to be wholly all at once or altogether For if the Impostume be great and contain much Pus within it neer unto the Arteries and Veins the whole matter and filth ought by no means to be evacuated all at once lest that together therewith much of the Spirits be likewise evacuated and dissipated and so by this means the sick Person should be caused to faint and swoon or be debilitated and weakned but rather the corruption is to be emptied forth by some and some especially if the Patient be weak or a Woman with Child or in case the Patient be a Child or lastly if the sick party be very aged When the Pus is evacuated if either pain manifest it self or else any reliques of the matter not suppurated appear in the circumference and it be so that the Pus it self be not wel and perfectly ripened then the pain is to be mitigated and more especially the remainder of the matter is speedily to be converted into the said Pus by some concocting Medicament which they commonly call a Digestive And such is that which is made of the Oyl of Roses and the Yelks of Eggs for it greatly mitigates the pain and helps forward the generating and breeding of the Pus so often mentioned Or Take Turpentine one ounce one Yelk of an Egg the Pouder or Dust of Frankincense one dram Oyl of Roses three drams mingle them wel together Likewise the Emplaster Diachylon simplex is very profitable in this case When this is once accomplished even while the concoction doth yet appear we must come to those things that throughly cleanse and purge it for neither can there flesh be bred nor any conglutination by drawing together the Lips of the Impostumated part be made unless the part be first cleansed Which to effect Take Clear Turpentine one ounce Honey of Roses six drams the Yelk of one Egg let them boyl together a little and afterward add of Saffron one scruple and a little quantity of Barley meal If there be need of a greater cleansing you may then add the juyce of Smallage As Take of crude Honey Barley meal of each alike one ounce of the Juyce of Smallage half an ounce Saffron half a scruple and mingle them If yet there be occasion for a more forcible cleanser there may be added of the Vngueut Egyptiack as much as wil suffice Centaury the less and round Birthwort is here likewise very useful As Take the juyce of the lesser Centaury two ounces Smallage one ounce Honey three ounces let them boyl together and after add of Barley meal and the Vetch Orobus of each six drams when they are taken from the fire add of Turpentine one ounce of the Pouder of the Flower-de-luce root one dram mingle them The Impostume being throughly cleansed such Medicaments as breed cause flesh are to be administred Now of what sort these are Galen in his third Book of the Method of Physick the second third and fourth Chapters teacheth us at larhe and we have likewise declared them in our Book of Institutions As for example Take Frankincense Mastick of each half an ounce Colophony two ounces Oyl of Roses and Honey of each as much as is sufficient let them be mingled Or Take The greater Comfrey one handful Betony Saint Johns-wort Hors-tail Grass of each half a handful boyl them in Wine and bruise them wel out of the mash of them squeez forth a Juyce and add of Frankincense and Mastick of each one ounce half Dragons blood an ounce Honey and Turpentine of each a sufficient quantity boyl them until the juyce be consumed and make an Vnguent Or Take Myrrh Aloes Sarcocol of each an ounce Honey six drams White Wine as much as wil suffice boyl them to an indifferent thickness When the Ulcer is filled up with Flesh then those Medicaments which we cal Epuloticks that is such as bring to a Scar are to be administred of which we have in like manner spoken in our Institutions such as are the Emplaster Diapalma or Diachalciteos de minio of Vigo and others which are every where known Chap. 6. Of the Sinus in the Tumor BUt it oftentimes so happeneth that although the said Pus or snotty filth be emptied forth of the Impostume yet notwithstanding it becomes again replenished from whence it comes to pass that the adjacent Skin doth not close fasten and grow together with the Flesh that is underneath it but there is a certain cavity or hollowness left to remain and at length there ariseth a certain difficulty if not impossibility of cementing and conjoyning the skin with the Bodies lying underneath which affect the Greeks cal Colpos and the Latines term it Sinus to wit when the enterance into the Impostume and Ulcer appears narrow enough but the deeper and more profound part thereof diffuseth it self into a breadth The Causes Now for the most part the Causes of this Sinus are Impostumes or Suppurated Tumors over-slowly opened or not wel cleansed For the corruption if it be longer deteined in the deep place than it ought to be acquireth a certain kind of sharp corroding quality and there causeth divers winding passages and turnings such like as we find in Coney-borrows and so unto the part in this manner affected there flow together from the neighboring parts yea from all the whole body such excrements and such humors as superabound from whence afterwards it chanceth that this kind of Sinus or windings to and fro can very hardly be conglutinated and filled up with Flesh The Differences But now of these Sinus there is an exceeding great diversity for they differ not only in the dimension of quantity that one should be less and shorter and another
the Liver Ibid. P. 7. Sect. 1. Chapt. 11. Of the Wounds of the Reins Ibid. P. 8. Sect. 1. Chapt. 5. Of the Wounds of the Bladder Ibid. P. 9. Sect. 1. Chapt. 5. Of the Wounds of the Testicles Ibid. Chap. 11. Of the Wounds of the Yard Ibid. P. 10. Chap. 15. Of the Wounds of the Abdomen Book 4. P. 1. Sect. 2. Chapt. 1. We treated of the Wounds of the Womb. Chap. 23. Of the Diseases and Symptoms that happen unto Wounds And now since that it often happeneth that other Diseases as likewise divers symptoms do happen unto Wounds and follow upon them al which yield forth peculiar Indications and so draw the cure to themselves deject and weaken the strength of the Patient and render the Wounds very difficult to be cured and dangerous we ought therefore to treat of those also and to shew you how and by what means they are to be removed and taken way until which be done no Cure of the wound is to be expected Of Feavers And indeed in the first place it happeneth very often that Fevers follow upon Wounds And therefore although I have already treated of Feavers in a peculiar Tract by its self yet nevertheless in regard that it much concerneth us to know and rightly to understand the differences of Feavers that follow upon Wounds that so we may the better remove them we wil therefore herein this place speak somthing of them inspeciall and particularly And therefore first of al we are diligently to inquire what the nature of this Feaver is that followeth upon the Wound and what the Cause of it For these kind of Feavers are very various some of them being every day Feavers having their Original from the great disturbance of the spirits and the boyling heat of the blood by reason of anger Fear and upon all occasions of the humors being disturbed by the motion of the body or the commotion of the Mind And moreover also Secondly these feavers happen while the Pus and especially if there be great store of it is in breeding according to that of the 47. Aphor. of the second Sect. Thirdly from an Inflammation Fourthly and somtimes these putrid Feavers are likewise generated from the putridness that is in the wounded part And fifthly from the store of the vitious humors The first kind of Feavers invadeth the Patient at the first in the very beginning The first kind of seaver from the disturbance of the humors and as I told you before it proceedeth from the passion of the mind and the motion of the body and the disturbance of the blood and spirits following thereupon And hitherto also belongeth most vehement pain which by dsturbing the humors and causing restlesness may both set on fire those humors and the spirits and likewise excite a Feaver Their Signs Now these Feavers are known by this that they invade the wounded person instantly upon the inflicting of the Wound and together with it But yet notwithstanding because that the putrid Feavers may likewise somtimes invade the person immediatly and even from the very first beginning therefore by what Signs these Ephemerae or every day Feavers may be discerned from the putrid we have told you before and the difference will sufficiently appear from what we have written hereof in our first Book of Feavers and sixth Chapter Prognosticks And the truth is these Feavers of themselves bring with them no danger at all unto the sick person and yet Nevertheless neither can they at all promise any safety unto him seeing that then the time of the fluxion and Inflammation that are wont to follow upon the Wound is not as yet overpassed and gone The Cure But now this Feaver requireth not any peculiar Cure but if the Patient will but only submit himself unto the strict Rules of Dyet soon vanisheth of its own accord But yet nevertheless all the Causes thereof if they be yet present or that there be any fear of their returning are to be removed for otherwise they may easily draw upon the person some kinde of danger And in regard that otherwise about the fourth day Inflammations and fluxions are wont to happen these Feavers if they continue so long as until the said fourth day may possibly attract and augment those Evils And then again while the Pus is in breeding A Feaver from the generating of Pus and especially if there be a great abundance thereof generated Feavers are caused as Hippocrates telleth us in the 2 Aphorism Sect. 27. For then whatsoever over aboundeth in the wounded part and cannot be changed into the substance of the part beginneth to putrefie and there is caused as it were a certain kinde of boyling forth of putrefied mattier And yet notwithstanding Nature doth what lieth in her power and what she is not able to turn into the substance of the part she doth what she can so to work and frame it that it may not be altogether corrupted but most of it turned into Pus And therefore from this Ebullition or boyling there is indeed a heat of the blood in the Veins and Arteries communicated unto the Heart which when it is thither come it kindleth a Feaver that is like unto an Ephemera of many daies rather then to putrid Feavers properly so called Signs And therefore the Signs of Putridness are absent and appear not and so likewise for the Signs of an Inflammation and these Feavers invade the wounded person at that time wherein the Pus is wont to be generated and especially about the fourth day The heat is much but withall sweet the pulse great swift and frequent The Urine differeth and recedeth but little from its Natural state and there is no ill and dangerous Symptom Joyned together with it to accompany it Prognostick This Feaver of it self hath no danger at all in it but soon after ceaseth Cure And this that it may so much the sooner be done there is a passage forth to be made for the Pus and this so much the more speedily if the Pus be conteined in a more noble part or in a part that hath consent with some one of the more principal and noble parts and withal we are to endeavour that al the afflux of the Humors may be hindered and prevented And Thirdly Feavers from an Inflammation Feavers are somtimes kindled from the Inflammation that followeth and happeneth unto the wounded part somtimes Quotidians or every day Feavers and somtimes putrid Feavers even according as the Spirits Wax hot and this heat is communicated unto the Heart and also according as the putrid Vapours transfused into the Veins and Arteries do penetate unto the Heart and heat it Signs Now these like Feavers are known from the Signs of an Inflammation touching which we have spoken in the first Part and 5. Chapter But whether the Feaver be a Quotidian or a right putrid Feaver this may be known by the Signs of them both of which we have likewise