Sugar therewith and of this let him drink a good draught and it will cool and refresh him Besides take some of the guts of Hens and some slices of Radish sprinkle them with Vinegar and Salt and bind them to the soles of his feet this will draw away the heat But let not the Radish lye too long upon them because it will give a stink that may increase the head-ach wherewith the People that have the Plague are commonly troubled enough without provoking it Moreover you will do well to tye about his wrists some Rue beaten with Vinegar Anoint his Loyns and Back-bone with the Unguent of Roses or with fresh Butter but if there appear any Spots forbear to anoint him lest they should be driven in You will do well to have Epithemata of good things about you as of Rose water and Elder-vinegar to lay over the Heart with which mix some Camphir But if you find any thing of Specks c. broke out you must use no wet thing Anoint his Heart with Oyl of Scorpions take the Oyl of Sea-blossoms and of those Earth-worms that appear after rain of each six ounces of St Johns-wort Oyl two ounces of fresh Elder-blossoms and Rue each a handful and an half of the Acetum of Marigold-flowers and Roses each about three ounces of live Spiders forty five Boil all these together till the Vinegar be so qualified that when 't is thrown into the fire it cause no cracking there Then strain it and in this strained Oyl put a matter of five and twenty Spiders more of the biggest sort and add to it of Camphir dissolved in the Spirit of Roses half a drachm let it stand in Balneo Mariae or upon hot embers for twelve hours and then put to it of Treacle and Mithridate of each half an ounce and let them work together With this Oyl anoint the eight Pulses viz. both Temples behind both Ears both Hands and both Knees as also the Heart And this is an excellent Succedaneum to Scorpion-oyl much used by the Germans Besides you must refresh and strengthen the Patient with convenient Meat and Drink I mean with good Flesh or Barley-broath with a little Vinegar in it to make it savoury to him who will have appetite to little else till he have shaken off this venomous Distemper which when he hath done his stomach will be so keen that you will find work enough to keep him from surfeiting Be also careful to keep thy Patients Body open if he be obstructed use a Clister or take Butter or Hogs-grease mixing a little Salt with it or if it be to be gotten a little Mice-trickles and put it into his bowels Physick at the mouth for this purpose is not always safe When the Patient is discharged of the venom a little liquor of stew'd Prunes with some Senna-leaves in it will do well for opening the body Some fresh Butter eaten in the morning or melted in warm Broath and taken down is wont also to keep the body soluble The Drink of these Patients may be Water with some Bread soaked in it or take of such Water wherein Bread hath been soaked one quart and a little Vinegar with two or three spoonfuls of Kitchin-sugar mingling it well together If you have no Sugar use such Water with Vinegar alone This affords good Drink in malignant Fevers Among the Romans it was drunk by the Souldiers under the name of Posca You may also take a handful of well cleaned Plantain-roots and boil them up in three quarts of Water and then decant the Water which though it be somewhat bitter yet 't is very good in Fevers and a good Drink in hot Distempers If you have Oyl of Vitriol let a few drops of it fall into clear Water mingling it well and you will have a factitious Sawer-brun or Acidula But use no Metalline Vessel for this purpose With this kind of Water many People have been served in all sorts of Fevers the Oyl of Vitriol in such Distempers if rightly used being very beneficial But if a Man should have with it any Pulmonick Disease in that case he must forbear acid things and use Liquorice and content himself with Ptisane Nor is it at all good to use acids in Pestilential Pleurisies And since on this occasion we mention this case and we having above given warning not easily to blood in Pestilential Diseases yet may Venae-section be sometimes upon good consideration used in that Pleurisie provided it be done in the very beginning and the Patient be strong and full of Blood Yet this is not to lessen the blood but only to give it vent but before bleeding the Patient is to sweat by taking some of the above specified Antidotes If the Patient have violent Head-ach lay on his head Vine-leaves or fresh Cabbage-leaves and if you have no Alablaster-salve take two parts of Vinegar and one part of Oyl of Olives the Sea-blossoms Oyl and Elder-Vinegar were better dip long rags of linnen therein and having well squeez'd them again lay them lukewarm over the face and temples Even Vinegar alone is good Of such Applications you may make many of Acetum of Roses Elder-blossoms and the like with a little Camphir The expressed Milk of Peaches is also very effectual in this case If at the going off of this Distemper a hot defluxion should fall into the Eyes take Camphir and infuse it in water and often moisten the Eyes therewith and if it should be cold and windy weather you will do well to keep your self out of the open Air and not to let this water dry up in your Eyes in the cold wind In case of having lost thy hearing take of thy own Urine and with it wash thy Ears within but withal dry them very well because that moisture is very noxious to the Ears And it often happens that after the Hungarian Sickness People grow deaf or hard of hearing Others put the water of Carduus-benedictus distilled with Wine into the Ears or the Oyl of bitter Almonds If thy Throat swell or the Palate of thy Mouth be fallen down gargarize thy Throat with warm Milk wherein Figgs have been boil'd or sweetned with Sugar The Flowers of Phyllirea or Mock-privet which grows in the Hedges boiled and used for a gargarism heals also a sore Throat The same doth the middle rind of Oxyacantha or Haw-thorn if boiled with a little Allom dissolved in the Decoction If you have the Juice of Mulberries mix a little Honey of Roses with it and often take a little thereof The Roots of Sloes boiled in red Wine and the Mouth often washed therewith is also very good If thou hast the Squinancy boil Scabious in Meath and drink thereof warm when strain'd Beat Turnips and fry them in Butter or Oyl and clap them in a cloth round about thy Neck If thou cast up blood take Mouse-ear Ground-Ivy Cumfrey boil them in half Wine and half Water or in Meat and Drink often of it But if
either with hands or Bandage and mean while reduce it into its place If the Hip be forced out forward the Groin is swoln and the Buttocks fallen the Leg is neither longer nor shorter nor cannot be bent but with trouble and the Urine is suppressed Though it be not set aright yet the Patient in time will be able to go well enough upon it though sometimes it falls out that he must somewhat trail his Leg after him To restore it let the Patient lie on his sound side and strongly stretch out his Leg press it into its former place and in case the hand be too weak thrust it in with your Knee If it be dislocated backward the Patient can neither stretch out nor bend his Leg nor is he able to bring his Heel to the ground and if he should force himself to do so he would fall backward the Leg is shorter there is a hollowless in the Groins and if the Buttocks be pressed upwards you shall find an unusual swelling Though it be not put in yet the pain will in time vanish and then the Leg may be bent again but it remains shorter and straight nor is the Foot turned inward nor outward Lay the Patient on his Belly and strongly extend his Leg mean time apprehend the Thigh bone above the Knee stretch it outward from off the sound Leg press the Head into its Cavity in which yet it will not stay if thenceforth the Patient do not keep himself very quiet 10. The Dislocations of the Tibia and Fibula are cured after the same manner as those of the Cubitus and Radius 11. If the Knee pan be out of its place let the Patient stand upright and press it in again lay on the side whence it hath been forced away a hollow Splint answerable to the shape of the said Pan and below in the cavity of the Leg put one or more compressing Splints binding the whole Leg so stiff that the Knee may not bend CHAP. VII Of Ruptures HAving thus roughly handled the boney and hard parts of the Body it now follows that I treat the soft and fleshie more gently and describe their Synthesis or re-unition again Therefore I begin with the broken Peritonaeum which sometimes gives way to the Intestines at other times to the Cawl and not seldom to both to get out of their natural place into the Groins or Scrotum there causing a Rupture called Entorocele or Hernia Intestinalis if the Guts come out an Epiplocele or Hernia Omentalis if the Omentum or Cawl be out The Peritonaeum is made up of two strong but soft Membranes which do so contain whatsoever is included in the Belly or lowest Cavity that when sound nothing can fall out In Women the Os Pubis is its utmost Limit In Men its outermost Membrane reaches farther and constitutes the first proper Coat of the Testicles In the Groins it comprehends the Seminal Vessels as in a Sheath called Processus or Productio Peritonaei This being stretch'd or enlarged or coming to burst is the proximate cause to the lately mentioned Ruptures The Groins therefore are the usual places of Ruptures But do not imagine that the Peritonoeum cannot be distended or burst in other places and there to cause a Rupture It happens sometimes above the Navel yet seldom Beneath and on the side of the Navel far above the Groins I have not only seen it often with many others but seen it ordered and dressed just like an Abscess the Chirurgeon giving no other reason for his mistake than that it was not the place of Ruptures which those that love the Art and their own Honour may take notice of Most times the Ileon falls down yet sometimes the other Guts come out with it and fall into the Scrotum which cannot come to pass by a simple distention of the abovesaid process but that necessarily in all such great Ruptures it must be broken The Causes which make the Peritonaeum to burst or to dilate are Falling Leaping Blows bearing of heavy Burdens strong Vomiting or Coughing difficult going to Stool Winds retained and all vehement Motions of the Body Signs The Tumor is sometimes bigger sometimes lesser sometimes altogether vanisht but with the least Motion returning Though the Caul or Intestines should be fallen down never so much they may easily without any pain be thrust in again unless Wind or Excrement hinder it in which case the Rupture is very painful If the Intestines be full of Wind the whole belly is tense you may hear a noise and the Patient breaks Wind upwards and downwards If the Excrements be grown hard the Patient goes with difficulty to Stool and the swelling weight and hardness little by little encreaseth If the Peritonaeum be only relaxed and widened then the Tumor from little becomes bigger by degrees but if it be broken it suddenly descends Prognosticks In little Children Ruptures are easily cured in aged people slowly or not at all especially if the Peritonaeum be burst If the Intestines be filled with Wind or Excrements there follows pain and if that be not suddenly removed an Inflamation Gangrene and at last Death it self Cure Lay the Patient on his Back with his Legs on high and a little asunder by which it often comes to pass that the Caul or the Intestines return of themselves into their former place but that not happening press them in gently with your fingers And if you cannot effect this by reason of Wind or hardened Excrements then use the following Medicines Where the Excrements are indurated Take Roots of Marsh-mallows two ounces of white Lillies one ounce Leaves of Mallows Violets Pellitory of the Wall of each half a handful Flowers of Camomile and Melilot of each two pugils Bran half a handful Boil them in Water and to the Liquor Add of Barly and Bean-meal of each three ounces Lin-seed and Fenugreek of each two drams Oyl of Roses and white Lillies Ducks-Fat and Hens Fat of each an ounce Make it into Cataplasm In case this Cataplasm be not sufficient or seems not to be so then bathe the Patient two or three hours in Oyl sweet Milk or Water wherein Emollients have been boyled not forgetting in the mean time Clysters and Purges Against Wind. Take Oyl of Camomile Rue of each one ounce Oyl of Nard and Dill of each three drams Spirit of Wine two drams a little Wax Make it into an Oyntment Another Take Oyl of Wormwood one ounce Oyl of Nard and Nutmeg exprest of each half an ounce Oyl of Mace and Carraways distilled of each one dram Malmsey an ounce and half Boil it a little then add to it as much Wax as is sufficient to make it into an Ointment Inwardly use the seeds of Anise Fenel Carraways and others Medicines dispelling Wind which also are to be mixt in the peculiar Clysters requisite to this purpose Also the Cumin Plaister used by some may here do good service Or Take the Styptick Plaister of Crollius Gum-Caranna
are to use other Remedies CHAP. XVI Of Removing a Cataract of the Eye A Cataract by the Greeks called Hypochyma by the Latines Suffusio in the German and Belgick Tongue De Staer is a concretion of superfluous Humors by little and little generating a preternatural Membrane betwixt the Cornea and the Crystalline Humor covering either totally or in part the Pupil of the Eye and so depriving the Patient of his sight or hindring it Difference It is either Imperfect when the Humor is thin or the Apple of the Eye not totally covered or Perfect when it is changed into a Membrane or the Pupil is quite covered Sometimes 't is white gray yellow green sometimes of a leaden colour c. according as the green yellow or black Choler is mingled amongst it The Seat of it is between the Cornea and the Crystalline humor being sometimes nearer to this sometimes to that The Cause is a Phlegmatick Humor either collected there by the weakness of the Eyes or by the Brain transmitted thither by reason of its abundance The Prognosticks The imperfect Cataract may easily be cured in the beginning by convenient External and Internal Medicines in sound Bodies and in Patients of a middle Age. The less the Pupil is dilated the less hope of Cure The nearer the Suffusion is to the Crystalline Humor the more dangerous If the Eye be turned to the Sun and the Patient then sees no glimmering of Light there is no benefit to be expected from the Manual Operation If the Humors of the Eye be commixt by the Needle though the Membrane be removed then blindness will certainly remain If in the Operation you happen to touch the Membrane of the Eye called the Retina the Patient will after that always see the Air as if full of small Hair and Flies A Cataract commonly remains so soft unto the third year that it will not follow the Needle after the third or fourth year it is so firm and hard that it can by no Art be loosned The Blood spilt by the use of the Needle causeth no danger and soon ceaseth of it self Though the Cataract be not altogether suppressed but divided into several pieces the sight doth often perfectly return within six or eight weeks though before that time the whole Operation should seem to be fruitless which I speak from manifold Experience The Cure The Imperfect Cataract requires solely the Aid of the Physitian who by Medicines and strengthening the Stomach and Head have done much to which purpose the conserve of Marjoram Rosemary Beteny Pulv. Diambre c. are very good And outwardly use the following means Take Gum Tragacanth dissolved in Eyebright water two drams Burnt Allom one scruple Make a Collyrium Or Take Celandine water an ounce and half White wine half an ounce Spirit of Wine two drams White Vitriol six grains Prepared Tutty a scruple Glass of Antimony five grains Sugar-Candy two drams and an half Camphire six grains Mix it and make a Collyrium Or Take Juyce of Fennel of Celandine of each two ounces Leaves of Rue and Marjoram of each a Pugil Eye-bright one handful of the Gall of an Oxe four ounces the Gall of Hens an ounce Red-Myrrhe Aloes of each a dram and half Sarcocols half an ounce Camphire two scruples Mingle them and let them be dilled in B. M. If the Cataract be confirmed then let the Manual Operation be your only refuge but beware of attempting the Operation if the Patient have long before complained and still complains of Head ach or pain of his Eyes if the Body hath not been cleansed in general nor the Head in particular and if the Patient be yet molested with a Fever Sneezing Coughing or Vomiting Having chosen a convenient season of the year some morning in the decrease of the Moon and a clear and serene Air set the Patient in a Chair and against him let the Operator sit in one somewhat higher than his bind up his sound Eye and make him clap his hand about your waste without stirring them at all as long as you are busie in the Operation Let some body hold his Head fast behind and hold you asunder his Eye-lids charging him to turn the Eye towards his Nose which when he doth quickly thrust your Needle into the Cornea half a straws bredth from the Iris and bring it unto the hollow of the Eye when the Needle hath toucht the Cataract endeavour therewith to press it gently and so long from above downwards until it remains there if it be stubborn in springing up again and again divide it into several parts and keep these particles or the whole Cataract a little while under that it may not return again before the Pupil of the Eye then draw out the Needle and bind up as well the sound as the unsound Eye with Linnen-cloths moistened in some Rose water the White of an Egg and a little Allom mixed together Beware in the Operation of hurting the Crystalline Humor and the sound Tunicles CHAP. XVII Of Leeches LEeches more advantagious than Scarification and safer than Bleeding may with benefit be applied as well in strong as in weak Bodies they only draw Blood from the Cutaneous Vessels by which they cure light Diseases if only applyed to the Skin but if applyed to some greater Vessel they draw also Blood from the Internal Parts and so remove internal and more desperate Diseases There is great care required in the choice of Leeches for those with great Heads and that are green and shining with hair or blew stripes on their Backs are not without Poyson as also those that live in standing or putrid Waters But those are to be chosen that are slender and long with little heads and red Bellies and such as are nourished in clear running Water They are never to be applied to the Part new taken but after they have been taken a day or more in fair Water and fed with a little Blood that they may be cleansed of all their impurities the place where they are to be applied is to be rubb'd till it be red and if they fasten not 't is to be moistened with Cream or with Blood fresh taken from a Pigeon or the part it self to be prickt with a Needle till it bleed if they draw sluggishly cut their tails off with a pair of Scissars After they have suckt a sufficient quantity of Blood and they fall not off themselves put upon their Heads a little Ashes or Salt and they will suddenly desist from their work they are not to be pull'd off by force lest they leave their heads behind them from whence incurable wounds and oftentimes Death succeeds 'T is to be noted that they rather draw Arterial Blood than Venal therefore they ought to suck the less CHAP. XVIII Of the Cutting in the Hard Parts THe Section which is used in the Hard and Bony Parts is of four kinds viz. Scraping Filing Sawing and Perforating that is Trepanning Scraping is used in a
set down to the which I refer the Reader The End of the first Part. BARBETTY'S CHIRURGERY The Second Part. Which treats of Tumors Wounds and Ulcers In three Books The First Book of the Second Part of Chirurgery Of Tumors CHAP. I. Of Tumors in general A Tumor besides Nature is a Disease in which the Parts of the Body are indecently inlarlarged and extended so that they are rendred unfit to perform its Actions The Differences of Tumors are taken 1. From the Part affected as an Inflammation of the Eyes Jaws c. 2. From the Causes The Causes are 1. The Parts of the Body removed out of their Natural place 2. The Four Humors as well Natural as Preternatural viz Blood Choler Phlegm Melancholy to which likewise we add Serum and Wind. Tumors for the most part are generated from the Humors and that either by Congestion or Fluxion They come by Congestion when the Natural heat of the Part being diminished the good Humors are ill concocted or the vicious are not sufficiently evacuated By Fluxion from a two-fold Cause External viz. a Fall Blow External Heat too great Motion c. Internal viz. Pain Superabundancy Thinness Acrimony of Humors c. The Signs of Tumors are an Extention of the Part Pain Redness Heat Hardness c. But these are better explained in particular Tumors than in general The times of Tumors for all curable Tumors have four are as followeth Beginning when the Part begins to swell Increase the swelling pain and other Symptoms are augmented State the Symptoms stand at a stay and grow not worser Declination when the Symptoms are diminished Prognostick Tumors produced from Phlegm or Melancholy are hard of Cure Those are dangerous which are generated from corrupt Blood or Choler which seizeth the Internal Parts which shew themselves about the greater Vessels Joynts Nerves and the Membranous or Noble Parts Those that are of great bigness and that happen in Cacochymick Bodies They are Terminated four ways 1. By Dissipation which the lessening of the Symptoms do declare 2. By Suppuration wherein the Pain and Pulsation is increased together with a Fever 3. By Induration which the too often and immoderate use of Repelling and Dissipating Medicines hath caused 4. Degenerating into a Gangrene from the defect of Natural Heat The Cure is performed two ways 1. By hindering any further Flux to the Part. 2. In removing that which is already gathered in the Part. We stay the Flux of Humors 1. By Intercepting 2. By Repelling 3. By Revelling 4. By Derivation 5. By Corroborating the Part it self The Matter already gathered is taken away 1. By Astringing and Repelling Medicines to wit when 't is thin and sticks not too firm to the Parts 2. By Resolvents when it is thick and adheres more firmly to the Part. 3. By Suppuratives when the other are too weak 4. By Fire and Cutting when other means effect nothing CHAP. II. Of Inflammation A Phlegmon or Inflammation is a Tumor besides Nature from Blood thrown forth into the Skin or Subjacent Muscles causing Heat Redness Pain Pulsation and Tension Difference 'T is Perfect when from Blood alone Imperfect when Choler Phlegm or Melancholy is mix'd with the Blood and then 't is called Phlegmone Erysipelatodes Oedematodes Schirrhodes The Cause is sometimes Blood alone sometimes mixt with other Humors Signs are Heat Redness Pain Pulsation Shining Tension Hardness Renitency Prognosticks An Inflammation of the External Parts frees the Internal from many Diseases always wholesome except from its too great Extention it produceth a Gangrene dangerous and of hard cure is that which seizeth on the Eyes Jaws Penis Pudendum Muliebre and Joynts In a young Person and in Summer soon cured longer of Cure in a fat than a lean Body The Cure hath four Indications The first of these respects a good Diet let him chuse a clear Air his Meat and Drink little and that cooling all hot sweet and fat things as Pepper and Ginger are hurtful as also the motion of the Body especially of the Part affected Sleep is very convenient All Costivenefs Anger and Venery are noxious Second that stops the further Flux of the Humor which may be performed by Revulsion Derivation Repelling and Interception therefore let a Vein be opened as soon as possible it being most necessary Revulsion is made in the Opposite and most Remote part Derivation in the nearest If you may not open a Vein you must use Leeches and Scarifications Whilst these things are done seeing the Body is seldom clean but that always there are ill Humors mixt with the Blood by Purging rightly used and often repeated as also Bleeding we effect much In the mean time the Part affected requires Repelling Medicines from which we must abstain Where 1. The Noble Parts send the Humors to convenient places and to the Glandules 2. Where the Humors are Malignant 3. When Critical 4. When the Body is very impure 5. When the part affected is very weak or painful 6. Where the Inflammation is about some Noble Part. Repelling Medicines The Roots of Bistort Tormentil the Leaves of Cyprus Mirtles Plantain and Oak the Flowers of Balaustians and Roses Quince-seeds Red Sanders Galls Acacia Dragons Blood Whites of Eggs Vinegar Red Wine Allum Bole Oyl of Roses Myrtles Empl. de Spermate Ranarum Take Rose-Vinegar two ounces Whites of Eggs beat together No. 2. Bole-Armenick three drams Lap. Hematitis a dram Mix them Take the Juice of Housleek Purslane and Plantane of each an ounce Rose-Vinegar sowr Red Wine of each an ounce and half Oyl of Myrtles an ounce Stir them together in a Leaden Morter adding to them of the Powder of Pomegranate Rinds and Bistort of each a dram Make it into a Linament 3. Indication requires the taking away the Humor already in the Part. Here Resolvents are first to be used but they not effectual then Suppuratives Resolvents or Discussives Roots of Galangal Orrise Dill Southernwood Rue Savin Flowers of Camomil Melilot Elder 2 Aniseeds Carraways and Cummin Ammoniacum Bdellium Sagapenum Tacamahac Oyl of Dill Nard Rue Bays Ointment of Agrippa Martiatum Emplaisters of Betony Oxicroceum Diachilon Leaven the Dung of Beasts Spirit and Lees of Wine Take Roots of Orrise Marsh-Mallows of each an ounce and half the tops of Wormwood Flowers of Camomile Melilot of each one Pugil Herbs of Pellitory of the Wall Mullein of each one handful Meal of Barley and Fenugreek as much as is sufficient Boil them in White Wine then being beaten together add of Oyl of Orrise and Camomile of each an ounce Make it into a Cataplasm Or Take Cows-dung three ounces Juice of Hemlock one ounce Oyl of Camomile half an ounce Castor two drams Bole-Armonick half a dram Red Myrrhe two drams Saffron one dram Meal of Lupines as much as sufficeth to make it into a Poultice Suppuratives Marsh-Mallow Roots Mallows Camomile-Flowers Figs Galbanum Bdellium Sagapenum Ammoniacum Fat of Hogs Geese Ducks Hens Oyl of White-Lillies Ointment of Marsh-Mallows both
the Tendons Arteries or Veins 't is not easily cured but for the most part the Tendon and Nerve are corrupted with it No Ulcer can be cured whilst the Bone remains foul Cure The corrupted Bone ought to be corrected either with Medicines or with Chirurgery or by both Therefore the flesh must be divided as soon as may be that the Carious Bone may be laid open left some considerable Nerve Tendon or Artery be hurt according to the length of the Part and the Ductus of the Fibres not transverse then let those Medicines be applied that may separate the Corrupted Bone from the Sound and that may preserve the Sound from Corruption Medicines against Corruption of the Bone Roots of round Birthwort Briony Orrise Dragons Hores-strong Guaiacum Bark of the Pine Aloes Euphorbium Mirrhe Alom Chalcanthum Lime Chrysocalla burnt Pumice the Scales of Brass Aqua-fortis Spirit of Brimstone of Vitriol Salt Tartar Oyl of Vitriol Brimstone Antimony Take Mummy Sarcocols of each half a dram Euphorbium a dram Mix them and make a Powder Take Roots of Round Birthwort Orrise Hore-strong of each half an ounce Mirhe Aloes of each a dram and half Bark of the Pine Scales of Brass of each a dram Earth-worms two drams Honey as much as sufficeth to make it into an Ointment Take Juice of Celandine the greater two ounces Spirit of Wine an ounce Mirrhe Aloes of each two drams White-Vitriol a scruple Mingle them for an Injection If the corruption of the Bone be so great that it cannot be removed by Medicaments then we must come to Chirurgery and either scrape the foul Bone if the corruption be small or Perforate it if great or rather use an actual Cautery for without these you will scarce be able perfectly to cure it CHAP. VI. De Vlcere Depascente c AN Ulcer further and deeper spreading is call'd Depascens and if it be with putrefaction is called 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 if without it Phagaedaena if only in the Skin Herpes if ill-natured Cacothe Cause is the salt Serum of the Blood salt Phlegm burnt Choler or some other Malignant Humor These Ulcers can scarce be cured unless the Cause be first removed and the whole Blood purified therefore here must be observed a good Diet often Purging and sometimes Bleeding External Medicines for Depascent Ulcers Plantain Night-shade Flowers of Red-Roses Balaustians Cypress-Nuts Pomegranate rinds Frankincense Mastick Tutty Ceruse Litharge Red-Lead Burnt-Lead Brimstone Pepper Ginger Mercury Ung. Aegyptiacum Fuscum Diapompholigos Emplast de plumbo de minio Gryseum de ranis cum Mercurio Take flowers of Red Roses Balaustians of each a handful Leaves of Plantain half a handful Cypress-nuts Mirtle-berries Pomegranate rinds of each half an ounce Boil them in Red Wine Wash the Ulcer with it then use over it this following Take prepared Tutty half an ounce Burnt-Lead washed Ceruse of each an ounce Bole-Armenick half an ounce Ung. Aegyptiacum as much as is sufficient to make it into an Ointment Or Take Long-Pepper half a dram Ginger a scruple Flower of Brimstone Litharge of Gold each two drams Gunpowder a dram Ung. Fusci of Felix Wurtz three drams Ung. Album Camphoratum as much as sufficeth Make it into an Ointment Take Mastick Frankincense Mirrhe of each three drams Litharge of Gold Burnt-Lead of each half an ounce Quicksilver extinct in Turpentine two drams Brimstone half an ounce Pitch and Wax as much as is sufficient to make it into a Plaister Concerning the Cure of these Ulcers 't is to be noted 1. External Medicaments ought to be changed three or four days for Nature rejects the best longer applied 2. They ought not to be drest above once or twice a day except the Matter be very sharp that the Medicine may not be disturbed in its Operation 3. Repellent and Mercurial Medicines are not to be used except with continual Purging you drain the Body of its Impurities 4. These Ulcers are seldom cured without the use of purging or drying Decoctions made of China Guaiacum Sarsa c. CHAP. V. Fistula's A Fistula is a long narrow hollowness or a sinewous Ulcer narrow and callous not easily receiving Cure for the most part taking its beginning from an Abscess Difference are straight oblique simple manifold that is having many hollownesses some going to the Bone some to the Veins Tendons or Nerves Signs The edges of this Ulcer are white hard without pain or but little sometimes moist but commonly dry Outwardly the Cavity may be perceived in one place or other by pressing the Part in which also sometimes there is a noise perceived and the Matter now in lesser quantity otherwhiles in greater is prest out through the Orifice of the Fistula By a Probe we can search the Cavity of a straight Fistula but in an oblique we use a Wax-Candle instead of a Probe That is more convenient when the Fistula penetrates to the Bone this when it is in the fleshy and sensible parts If the Fistula remains only in the fleshy parts that which is touched by the Probe is soft and the Matter that comes out is white equal and in great quantity If it extend to the Nerve there is great pain in searching it to the bottom of the hollowness and the Matter is fat and oyly but is less in quantity and the action of that Member which the Nerve goes to is rendred very uneasie If it passeth to the Bone that which is touched by the Probe is hard not yielding and painful where the Periostium is not consumed The Bone is foul is rough and seems unequal to the touch the Matter is black stinking and very thin If the Cavity joins to a Vein the Matter is like dregs but reder and thicker where the Vein is eroded If it penetrates the Arteries that which comes forth is thin and shining and comes forth with a leaping Prognostick All Fistulas are of hard Cure some incurable others that ought not to be cured to wit those by which the superfluous Humors have for long time been vented A recent Fistula and not deep in a young body and otherwise sound is easily cured but an old deep Fistula having many Sinew's in an ancient emaciated cachochimick Body is very difficult Those are also difficultly cured yea for the most part incurable which touch the Tendons Nerves Veins Arteries Bones and those that are in the joints Vertebra's Cavity of the Breast and lower Belly the Womb Bladder or Guts Fistulas are wont to come in those places where Nature is accustomed to discharge her self of vitiated Humors to wit in the Abdomen Groins Buttocks Fundament Cod and Perinaeum Where the edges are not very hard but somewhat soft and mattery they do promise speedier Cure Cure of Fistulas are twosold one Real and the other Palliative by this the Fistula is dried within and skinned without the hollowness nevertheless remaining commonly continuing some little while closed but easily breaks forth again except by a good Diet often Purging
found four Cavities sometimes seven in which many of the branches of the Carotide-Arteries are inserted afterwards joining with the Jugular Veins These Cavities have the use and substance of Veins so that they may not unproperly be reckoned among the Veins The Pia Mater is more sensible hath more Arteries than the Dura which doth not only invest the whole Brains but also enters the winding every where which for this cause may more easily be separated We do divide the Brain into three Parts which are 1. The Brain it self 2. The Spinal Marrow 3. The Cerebellum or little Brain The Brain is of an Ashy colour and of a softer substance than Marrow which is both whiter and solider whence also it was wont to be call'd Rind it receives several Branches from the Carotide-Artery and is destitute both of Nerves and Sense It hath divers turnings and windings which fold in deeply especially those in the fore-part of the Head where the great Fissure divides the Brain outwardly even to the Marrow The Marrow is the Mother of all Nerves within the Skull 't is call'd the Marrow of the Brain but without it is termed the Spinal Marrow The Cerebellum or little Brain is more of an Ash-colour than White receives Arteries from the Cervicalis and Carotide yet there are fewer branches here than in the Brain as being much less It hath no windings but is made up as it were of several thin plates lying one upon another These being thus considered the Anatomist takes off some part of the Brain with a Knife forthwith the Corpus Callosum and the Fornix joyning to it come in view Under these laterally lie two great Ventricles in figure resembling a Horse-hoof which the Septum Lucidum distinguisheth into the right and left or into the first and second In them is contained the Rete-Mirabile or Plexus Choroides consisting of many little Glandules composed from the branches of the temporal Artery twisted together in form of a Net In the fore-part these Ventricles are united and make a third In this third Ventricle are two Cavities the first of them runs to the Infundibulum and to the Glandula Pituitaria the other to the fourth Ventricle contained in the Cerebellum above this Ventricle are observed four round Bodies which are call'd Testes and Nates to which joyns the Glandula Pinealis which is falsly call'd by some the seat of the Soul Of late the famous Sylvius hath demonstrated it not to reside in the Ventricles but without them by whom also it is esteem'd but a Glandule and that with more reason because that both he and I have found in it not seldom two or three Stones but sometimes four which we yet keep by us The Bodies being removed eight pair of Nerves appear which we have already treated of on the fore-part of whom joyns the Rete Mirabile of Galen which is a complication of the Cervical and Carotide-Arteries After these the Cerebellum comes in view like a double Globe in the midst of which is the Processus vermiformis and Pons Varolii under it lies the fourth Ventricle Last of all the Spinal Marrow shews it self divided in its beginning into two Parts not unlike a Writing-Pen which descending down the Back imparts its branches over the whole Body Chirurgical Considerations 1. In Wounds of the Dura Mater two Symptoms render their Cure very troublesome to wit a Flux of Blood and extream Pain if the Skill be not sufficiently open without any delay the Trepan is to be applied on the Part affected and forthwith the extravasated and grumous Blood being discharged let this Ointment be applied Take Manna of Frankincense two drams Aloes one dram Mirrhe a dram and half the softest Hares hair half a scruple white of an Egg as much as sufficieth to make it into a Liniment The Powder is also very useful that is described in the Chapter of particular Wounds in the second Part of this Chirurgery To mitigate the pain Oyl of Roses Violets and Myrtles used warm as also the warm Blood of a Hen or Pigeon c. is very much commended The Flux of Blood and the Pain being ceased the following Medicines are to be used which are not to be left off unless the Matter begins to flow too plentifully Take Oyl of Turpentine two ounces Spirit of Wine Syrup of Wormwood of each an ounce Mix them But if a Gangrene or Putrefaction should happen the following Liniment is of great use Take Sarcocols Mirrhe Aloes of each a dram Syrup of Wormwood Honey of Roses of each two drams Ung. Aegyptiacum two drams and an half Aq. vitae an ounce and half White-Wine an ounce Let them boil gently then strain them Neither do I apprehend any danger is to be feared in the taking off part of this Membrane when putrifi'd so that you can come at it with a pair of Scissers and that the Sinus or Pia Mater be not hurt 2. When the Pia Mater is likewise affected the Chirurgion must abstain from all Oyls although they be drying lest a Corruption of the soft Brain be caus'd Drying Cephalick powders are very convenient to be used here But seeing that these Wounds for the most part are Mortal I shall say no more of them CHAP. III. Of the Neck THe Neck under the Scarf-skin Skin and fleshy Membrane and the common and proper Membrane of the Muscles hath of each side four Muscles Of these the Longus and Scalenus bend it Transversalis and Spinatus draw it back of each side It hath five Veins Cervicalis Muscula Superior and Inferior Carotis Interna and Externa And as many Arteries Cervicalis Muscula Superior Inferior Carotis Interna Externa It hath Nerves from the Par Vagum and the Spinal Marrow In the fore-part of it are many Glandules which are greater in Women than in Men. Under these the Larinx the Organ of the sound lies composed of five Cartilages which are 1. Thyroides or Buckler-like 2. Crycoides or Annular 3. Arytenoides 4. Glottis 5. Epiglottis It is moved by six pair of Muscles which are 1. Hyothyrodaei the pair that lift up the Larinx 2. Bronchii the pair that pull it down 3. Cricothiroidaei antici the pair that dilate 4. Cricothiroidaei laterales pursing it together 5. Thyro-arythenoidaei that open it 6. Arythenoidaei Sphincters that close it After these the Almonds or Paristhima by some call'd Tonsils offer themselves then the Pharynx to which appertain seven Muscles by whose assistance the Meat and Drink are swallowed 1 2 Sphenopharyngaei which raise up the Pharinx 3 4. Cephalopharyngaei moving it inward 5 6. Stylopharyngaei dilating it 7. Constrinctor or sphynctor which closeth the Gullet The back-part of the Neck hath seven Vertebra's the processes of some of which are perforated to give passage to the Vessels that carry the Blood into the Brain Chirurgical Considerations 1. We have already sufficiently treated of the Cure of Scrophulas or the Kings Evil I will only give you here
besides Sudorificks we use discussing Oyls and Plaisters In the same folding is Water also sometimes included which promiseth no certain hope of Cure Steatoma's and other Abscesses are often generated in the Caul by reason of its great quantity of Fat and its many Glandules which are very difficultly cured 3. The Guts which move themselves variously like to Worms sometimes they fall inwardly into one another especially when afflicted with great pain in this case the Excrements cannot pass to the Fundament this Malady is call'd Miserere mei or the Iliack Passion ordinary means effecting nothing a great Cupping-glass without Scarification is often to be applied to the Part affected and taken off again but whether it is not better to divide the Muscles of the Abdomen and the Peritonaeum and draw out with the Fingers the fallen-in Gut than to suffer the Patient inevitably to die 4. The Mesentery from it self and also from the great number of the Glandules is subject to Inflammation Tumors Vlcers and to Corruption These Diseases seeing they are very difficultly distinguished from others require an experienced Physitian we llkewise speak the same of the Sweet-bread and of the Spleen Yet in the mean time I will communicate to you this Plaister whose virtues I have often experienced in the Cure of the Tumor of the said Parts Take Gum Caranna Ammoniacum of each a dram Quicksilver kill'd with Turpentine half an ounce Make it into a Plaister 5. The Ligaments of the Liver which joyns it to the Diaphragm and to the Sword-like Cartilage are often so much relaxt that the Liver descends to the Region of the Navel this we remedy with this Plaister Take Roots of Bistort three ounces Bole-Armenick two drams Cummin-seeds a dram Gum Galbanum an ounce Ol. Nucistae exprest a dram Make it according to Art into a Plaister Moreover the Liver is not freed from Inflammations Vlcers nay not from Gangrene it self 6. The Gall may be broke from an extream Cough a Stone also nay sometimes many are generated in it I was last year with a certain Scot who in the space of four weeks voided two hundred Stones and more by Stool and was cured only by the use of the following purging Conserve Take Electuary of the juyce of Roses an ounce Powder of Jalop a dram Spirit of Salt a scruple Make it into a Conserve Let him take each day or each other day the quantity of a Nutmeg 7. For Wounds and Vlcers of the Kidneys our Chirurgery furnisheth you with sufficient Medicines The Vreters are also subject to Exulcerations but are cured by the same means which are proper in Vlcers of the Kidneys If they are broke either by a great Stone or other Cause the Disease is accounted incurable 8. Besides Stones Worms also are generated in the Bladder which may be expelled by Diureticks mixt with those things that kill Worms Take Aqua Antinephritica an ounce Water of grass two ounces Spirit of Salt six drops Corallin a scruple Syrup of Wormwood an ounce Mix them Let the Patient take one half in the Morning the other in the Evening This injection also is covenient it bringing them forth in a short time Take Holy-Thistle-water six ounces Mirrhe Aloes dissolved in Spirit of Wine of each a scruple Honey of Centaury half an ounce Mix them 9. The Testicles may as well as the other parts be inflamed where besides the general means these outwardly are convenient In the beginning let this Cataplasm be applied Take Powder of Red-Roses Myrtles Balaustians of each two drams Barley-Meal two ounces and an half Oyl of Roses Elder-Vinegar of each an ounce Red Wine as much as is sufficient to make it into a Poultice In a vehement pain Take Meal of Linced Barley and Fenugreek of each an ounce Leaves of Henbane a handful Mallows half a handful Hogs-grease an ounce Oyl of Poppy-seeds an ounce and half Milk as much as sufficeth to make it into a Cataplasm If after the Inflammation an Ulcer follows let the Chirurgeon assist Nature with Suppuratives the following Plaister is excellent to mollifie ease pain and to suppurate which is also very good in any other Tumor Emplastrum Filii Zachariae Take Yellow-wax Oxes-marrow Hens and Ducks-grease of each a pound the Mussilage of Linseed Marshmallows Fenugreek of each four ounces Oyl of Linseed as much as sufficeth to make it into a Plaister The matter being come to suppuration must be discharged which the Chirurgeon may do with a Launcet for I cannot commend to him here a potential Cautery from which I have observed very ill success Let the Orifice be little and penetrate only the Tunicles For in this case although the matter be good nevertheless the disease is dangerous and easily degenerates into a Cancer or Gangrene which cannot be taken away more conveniently than with a Knife and must be done at the first appearance of it then let the Chirurgeon endeavour to cure the Ulcer as soon as possible after the following manner let the Part be defended from all cold and continually corroborated by Medicines that the natural heat may be preserved in it This Lotion used warm is good Take Flowers of Balaustians Red-roses Myrtles of each two pugils Aloes a dram Franckincense two scruples Plantane-water three ounces Red-wine as much as sufficeth Boil them and strain them This being used apply the following Ointment putting over it a Plaister or Cataplasm moderately discussing Take prepared Tutty Ceruse washt of each two drams Red-lead Litharge of Gold of each a dram Sarcocols three drams Burnt-lead two drams Vnguentum Apostolorum half an ounce Oyl and Wax as much as sufficeth to make it into an Ointment 10. If the Yard be wounded for the most part it is mortal This Ointment is very excellent Take washt Ceruse three drams Mirrhe Litharge of each a dram and half Sarcocols prepared Tutty of each a dram Tragaganth two drams Oyl of Roses as much as sufficeth to make it into an Ointment An Inflammation of it is cured in the same manner as an inflammation of other sensible parts but if an External Vlcer should happen the Cure must be performed both by Internal and External Medicines lest it contracts a Malignity and degenerates into a Sphacelus Take Litharge half an ounce Burnt-lead three drams prepared Tutty two drams Aloes a dram and half Pine-bark dried four scruples Lapis Haematitis a dram Seeds of Dill burnt of Gourds burnt of each two scruples Oyl of Roses Quicksilver of each three drams Wax as much as sufficeth to make an Ointment But if it yields not to this by reason of its foulness Take Verdigreece half a dram Water of Plantane and Roses of each two ounces White-wine four ounces Spirit of Wine an ounce Mix them and boil them a little To this may be added Mercury precipitate if there be occasion A Sphacelus in this case hath no certainer cure than extirpation in part or wholly lest the mischief creep inwardly and kills the Patient
and Dr. Francis Vanderschagen wherewith we thought it necessary to oppose that pernicious Enemy with which we were to contend Our Prophylactick Water Take Roots of Angelica Zedoary of each an ounce Roots of Butter-Bur two ounces Leaves of Rhue four ounces Leaves of Balm Scabious Marrigold-Flowers of each two ounces unripe Walnuts sliced two pound fresh Citrons sliced a pound let them be all bruised together then poure upon them six quarts of the best Wine-Vinegar distilled by it self in a Glass Cucurbit in Sand. Let them digest a night then distil them with a gentle fire of Embers to driness but without burning and preserve this Vinegar for your use If you desire an Extract or Salt poure some of the distilled Liquor upon the Caput Mortuum or to the remander and let it digest for three days till it hath drawn out a Tincture with filtre and distil the filtred Liquor in Balneum Mariae to the consistence of an Extract After the Extract calcine the Caput Mortuum and draw forth the Salt Our Prophylactick Conserve Take fresh Citrons two pounds the Juice hard prest out the outward Coats separated from the inward Pulp and bruised very small adding Conserve of White-Roses half a pound of Red-Roses of Borage-Flowers of each half a pound preserved Orange-peels four ounces Make it into a Conserve Our Alexipharmick Powder Take Roots of Contrayervae half an ounce Pestilent-wort Tormentil Elicampane of each 2 drams sealed Earth Bole-armenick of each three drams Shavings of Harts-horn Ivory of each a dram Red Coral prepared four scruples Biting Cinamon two drams Diaphoretick Antimony half an ounce Make it into a Powder I have made use of these three foregoing Medicines with very great success as have also those famous Physicians before-mentioned when they have applied them to several that have been visited with the Plague When I have given them for a Preservative against the Plague I seldom mixed any other with them but for the Cure of it I never made use of them single but have always given them with these or some such like viz. Take Diascordium of Fracastorine four scruples Salt Prunella a scruple Salt of Wormwood half a scruple our Prophylactick Water Holy-Thistle-water Syrup of Barberries of each an ounce Mix them for a draught Or Take our Alexipharmick Powder a scruple Vitriolated Tartar eight grains Salt of Coral 15 grains Confection of Alkermes half a dram our Prophylactick Water an ounce and half Rue-water as much as sufficeth Syrup of Holy-Thistle an ounce Mix it for a draught Or Take Antimony Diaphoretick a scruple Salt of Scordium of Rue of each half a scruple our Prophylactick water an ounce Fumitory-water as much as is sufficient Julep of Roses an ounce Mix it for a draught Take Confection of Hyacynth Diascordium Threacle of each two scruples our Prophylactick extract fifteen grains Spirit of Salt half a scruple Mix it into a Bole. Take our Prophylactick Conserve a dram and half prepared Crabs-Eyes a scruple our Prophylactick-water half an ounce Syrup of Limons an ounce Elder-Vinegar half an ounce Mix it for a draught Take Bezoartick Minera fifteen grains Sal Prunella a scruple Lozenges of Sugar pearl'd half a dram Make it into a Powder Let the sick person take some of these Medicaments for the provoking of Sweat plentifully to which purpose let him take Mutton or Chicken-broth an hour or two after he hath taken his Medicament let the Sweat be gently wiped off with a warm Cloth and another applied to his Breast For we have found it not safe to change the Shifts and other Linnen about the Patient unless they are too much moistened by Sweat We may safely administer these or the like Sudorificks twice in a day to the Patient or thrice in 24 hours and that very much to his benefit There are some who every six hours have very advantagiously made use of a new Sudorifick Nor are you easily to be persuaded to cease from the use of these means although the Patient should tell you that he is well in health lest you find the treacherous Disease of a sudden to surprize you both again For young Children who do usually abhor the taking of Physick I have found nothing better than the following Powder given them in their ordinary Drink two or three times in the space of 24 hours the Sugar may be omitted if the Patient digusts sweet things Take Diaphoretick Antimony 15 grains Lozenges of Sugar pearl'd a scruple and half Make it into a Powder Or Take Crabs-Eyes prepared Shavings of Ivory Bezoartick Mineral of each six grains Make it into a Powder We will treat of Juleps when we come to discourse of the Cure of the Plague The Symptomes of the Plague THey are many and very various but most of them are accompanied with some others which when the former are cured the latter are very easily removed We therefore think it very needless to give an account of them all in this place it will be sufficient to instance in the chief of them amongst which we in the first place encounter with A Fever Of such a Nature that it admits not of any purging or letting of Blood which the Experience of several hath sufficiently confirmed The Sudorificks before prescribed are no less useful for this Sympton than for the Plague it self but the Fever and great driness of the Tongue requiring such things as refrigerate they are not to be administred except they are mixed with Sudorificks as we have shewn before Take Water of Borage Sorrel of each two ounces our Prophylactick Water an ounce and an half Juice of sowre Oranges fresh Citrons of each two drams Julep of Roses as much as will make it conveniently sweet Oriental Bezoar fifteen grains Mix them Let the Patient often take the quantity of a spoonful hereof at once whereby his thirst will be much better allayed than if he should drink ten times the quantity of Beer and that without any check or hinderance to the Sweat Or Take Holy-Thistle-Water a pint our Prophylactick Water two ounces Syrup of sour Pomgranates two ounces and an half Mix them Or Take Scorzonera-roots Butter-bur-roots of each an ounce Sorrel-leaves two handfuls Boil them in Barley-water to a pint of the Liquor add Syrup of Violets two ounces Sal Prunella two scruples or Spirit of Salt as much as is sufficient Mix them For the Rich such like Juleps as these may be prepared which are both pleasant to the Palate and very Cordial Take Borage-water three ounces Holy-Thistle-water a pint Rose-water an ounce Lozenges of Sugar pearl'd an ounce Amber-greece two grains Musk a grain Juice of Citrons as much as sufficeth Mingle them Wesop-Ale or some such like which is well boyl'd may here be very useful especially if some Nutmeg scrap'd or a piece of calcin'd Harts-horn be tied up steeped in it Nor need we fear any mischief from exceeding either in the quantity or the frequent repeating of it but we must take heed that
do not disapprove the use of it though as much as I can I void the Smoak An inordinate Diet is very hurtful at all seasons but especially in a Pestilential one There can be nothing prescribed in general which may agree with each man in particular there is very much to be allowed to Custom but we must at all times industriously avoid all Meats that are difficult to be concocted and take great care that the Stomach be not overcharged For our Diet if we can so contrive it we ought to make choice of Veal Mutton Beef Pullets Capons Peacocks Larks Chaffinches Quails Hares Conies c. Perch Pike Whiting Sole Salmon c. Eggs Butter Green and Parma Cheese Buttermilk Cichory Endive Sorrel Lettuce Chervil Parsley Rosemary Sharp-Apples Quinces Limons Oranges Capers c. On the other side Flesh and Fish which hath been dried and salted are very hurtful as Bacon and Pork Haddocks Eels Crabs Shrimps Green Fruit and all things that are hard of Digestion Walnuts are very much commended and not without good reason for there may be very much use made of them The green ones preserved do much good to those that abound with Choler but such as are come to their full ripeness whether you take them fresh gathered or when they are more dried all that make use of them will tell you that they are very pernicious The strongest Beer and Wine of a middle strength are very useful at such times if moderately taken but we cannot allow that any except such as are very ancient should dayly make use of strong and sweet Wines nor of Spirit of Wine and Brandy Go not forth into the Air with an empty Stomach but always take some Preservative against Infection Take our Prophylactick Water 6 ounces Julep of Roses 3 ounces Mix them take the quantity of a spoonful or two each morning Or Take our Prophylactick Conserve 3 ounces take the quantity of a Chestnut in the morning or as often as you are to go to an infected place Vinegar and all sharp things have been commended to us by long experience but they will not well agree with such as are troubled with a Cough weakness of Stomach or the Cholick if they are taken either alone or in too great a quantity I never had any great esteem for outward means but those that can fancy it may wear about their Neck this Amulet Take Arsenical Magnet a dram Benzoes as much as is sufficient make them into great rowls and sew them up in red Lawn We have before described the Arsenical Magnet when we treated of the Bubo Sleep and Watching exercise of the Body and the use of Women if immoderate are very hurtful Costiveness is prejudicial but not so much as a great loosness Sadness Fear and Anger will make very strange alterations in the Blood he who knows how to moderate those Passions is most prudent Practical Observations I. A Young Man aged twenty two years being lately returned from the East-Indies on the 21 of July 1655. in the Evening was suddenly taken with a great pain in his Head and a shivering through his whole Body having that day received much injury from the Water and Air the day following he became exceedingly delirous so that he could not by four men be kept in his Bed The Plague at that time raged very much in the next Town which was very populous but there had as yet appeared no Symptoms of it in this of ours We met with no outward signs of any Malignity nor did those within appear so considerable as to forbid the breathing of a Vein which the Delirium did very much press us upon I therefore prescribed a Cordial Mixture which might also be Sudorifick whereof 2 spoonfuls was to be taken each quarter of an hour and after the space of one hour a Vein to be opened in the right Arm and seven ounces of Blood to be taken from thence I had more than once before made trial of this Mixture in a Pleurisie which was accompanied with Spots The Description of it is as followeth Take Waters of Borage Holy-Thistle Bawm of each an ounce Alexipharmick Water an ounce and half Cinamon-water half an ounce Confection of Alkermes without Amber-greece and Musk a dram and half Syrup of the juyce of Citrons an ounce Mix them The mixture was taken and a Vein opened and such things as we thought fitting applyed to the Temples the Neck and the Soals of the Feet but all was not sufficient to overcome the Malignity of the Disease for he dyed that night II. A Man and his Wife on the 5 th of July were both taken with Buboes in their Groin She was very drowsie Feverish and Anxious but by the use of Sudorificks and drawing Plaisters she was by the 10 th day following restored to perfect health He was seized on by a pain in the Head and a small Delirium which continued till the 5 th day on which he was taken with a great fit of Bleeding which with some intermission continued for two days this according to the opinon of all Practical Physicians was to be judged very dangerous But when I considered that his strength was not at all hereby impaired but on the otherside the pain in the Head and the Fever abated nor did the Bubo strike inward I cast away fear and concluded that the Judgments of men by time and experience might be much corrected I therefore thought it not the best course to continue here the use of Sudorificks but rather to strengthen the Heart and to incrassate the Blood and thereby to stop the Flux of it To which purpose I prescribed this which followeth to be taken by a spoonful at a time Take Water of Roses and Plantane of each four ounces Cinamon-water six drams Dragons-Blood red Coral prepared of each a scruple Confection of Hyacinth a dram Spirit of Salt eight drops Syrup of Barberies an ounce and half Mix them Upon the taking of this the Bleeding and the Delirium both ceased and thereupon the Patient grew well the Bubo continuing for ten weeks after III. A Maid on the 4th of September was taken with a Fever a pain at the Heart and in the Head and with a Bubo which broke out about the inward part of the bending of the left Arm and seized on the Tendon of the Muscle Biceps from hence proceeded a very acute pain not only in that part where the Bubo appeared but also about the Armpits by consent of parts although there was no swelling which thereabouts appeared I gave her this Sudorifick forthwith Take Diascordium of Fracastorius four scruples Sal Prunella a scruple Alexipharmick-water an ounce and half and Holy-Thistle-water as much as is sufficient Syrup of Limons half an ounce Mix it for a draught To the Bubo I applied the Divine Plaister The Sweat came plentifully but the pain of her Arm a Delirium and continual watchings after the use of several other things forced us
as he is dressed find the pain abated if the pain do somewhat encrease the first and second night and there be perceived the third day without the place of binding a little swelling yielding to your hands The Bone is well placed if in the second dressing you find all even Before you rowl the Ligature about the Member bathe the part with Spirit of Wine or Red Wine or with Oyl Wine and Vinegar mix'd together Or take the White of an Egg with some Bolus Frankincense Dragons-Blood c. Or anoint it with Oyl of Roses Mirtles Violets c. or lay Plaisters on it In Winter the Oxycroceum will do well At all times that which follows Take Mastick Frankincense of each two drams Aloes Gum Tragacanth Dragons-Blood Bole-Armonick of each a one dram Lapis Haematitis Burnt Talch of each one dram Whites of Eggs and Oyl of Roses as much as is sufficient Make it into a Plaister If a Wound accompany the Fracture then ought you to extend the Part first yet somewhat gentler than in a simple Fracture then you are to join the Bones together next to observe the Wound to bring the Lips thereof together with Plaisters rather than with a Needle and to guard it with a Defensive And lastly rowl the Part and lay it conveniently If there be a Cominution or great shattering of the Bones joined with the Wound then endeavour with Forceps to remove the small loose Bones leaving those to Nature that are yet any way fixed for she will though somewhat later of her self throw them out and sometimes she will unite them again to the whole Yet to forward her you may assist Nature with the following Medicaments Take Ashes of Earth-worms three drams Virgins-Honey an ounce and half mix them and make an Oyntment Or Take Aloes Myrrhe of each half a dram Roots of Comfrey the great Round-Birthwort of each three drams Euphorbium two drams Turpentine and Wax as much as is sufficient with a little Oyl of Lillies to make it into an Oyntment If the Bone be bare cover it with its own skin and Nuscles and defend it from the Air as much as is possible If it be bare and also started out endeavour to reduce it again into its place but if it be got out too far take away the pieces thus started out with Saw or Nippers Now these Manual Operations being well performed the Patient must observe a good Diet open a Vein upon occasion and afterwards purge the Blood In the Fractures of the lower parts purging is not convenient but if the Patients Belly be bound he must take a Suppository In the Fractures of the upper parts Purging or administring Clysters is oftner necessary and may be done by the ensuing compounded or simple Medicines which may also serve you in all other Accidents that we may describe in this whole Treatise Medicines purging Choler Rhubarb Cassia fistula yellow Myrobalans Tamarinds Manna Scammony Syrup of Sicchory with Rhubarb Elect. Catholicum Hiera picra Lenitivum Diaprunum solutivum Succus Rosarum Pil. de Aloe Rosata Aureae Aloephanginae Ruffi Take Electuary Lenitive two drams Elect. of the Juice of Roses one dram Cassia fresh extracted two drams Cream of Tartar two scruples Succory-water as much as is sufficient Spirit of Vitriol a little Make it into a Potion Or Take Rhubarb Senna of each two drams Cream of Tartar one dram Aniseeds half a dram Infuse them two hours in a sufficient quantity of Sorrel-Water let it boil a little and to three ounces of the strained Liquor Add of the Elect. of Diaprun Sol. one dram or a dram and half and drink it Or Take of Pilulae Aureae Extract Catholicum Rhubarb of each half a scruple Make them into seven Pills Or. Take Cream of Tartar Sal Prunella of each xij grains vitriolated Tartar Diagredium of each vj. grains Make it into a Powder Medicines that purge Phlegm The Roots of Asarum Mechoacan white and black Hellebore Colocinth Myrabolani Belliric Emblici Chebuli Agarick Turbith Syrup of Diacarthanum Electuaries of Hierae with Agarick Diaphoenicon Diacarthamum Confection of Hamech Powder of Diaturbith Pills of Cechiae Foetidae the greater Aggregativae Lucis the greater Assajeret of Avicen Troches of Agaric Alhandal Take Roots of Grass two drams Flower-de-luce Trochiscatum Agarick Turbith of each one dram Aniseeds Fenel seeds of each one scruple Let them infuse for three hours in a sufficient quantity of Parssy water boil it and strain it and to three ounces of it Add of Electuary of Diaphenicon one dram and half Make it into a Potion Or Take Electuary of Diacarthamum Confection of Hamech of each two drams powder of Jalop eight grains Cream of Tartar two scruples Fennel water as much as sufficeth Make a Potion Or Take of Pill Aureae six grains of Pill Cochiae Pill Faetidae the greater of each twenty grains Make them into seven Pills and gild them Or Take Extract of Catholicum xiij grains of the Troches of Alhandal one grain Make three Pills and gild them Medicines purging Melancholy Roots of black Helebore Polipody Senna Lapis Lazuli Syrup of Roses solutive with Senna Electuaries of Diacatholicon lenitive Confection of Hamech The Powder of Dia Senna Pills of Lucis minoris Troches of Alhandal Myrobalans of India Take Bark of Tamarisk three drams Roots of Polypody two drams Staechas Flowers half a pugil Senna one dram and half Aniseeds half a dram Mirobolans of India one dram Infuse them two hours in a sufficient quantity of Borage-water boyl it and strain it and to four ounces of the strained Liquor Add An ounce of Syrup of Roses with Senna Spirit of Salt as much as will give it a little acidity and make it into a Potion Or Take Electuary of Diacatholicon one dram the Electuary of Diaphoenicon Confection of Hamech of each a dram and half Cream of Tartar two scruples Powder of Jalop six grains Whey a sufficient quantity Make a Potion Or Take of Pill Indiae of Aggregativae the greater of each fifteen grains Diagridium three grains Troches of Alhandal one grain Make seven Pills and gild them Note All these Receipts are set down for full-grown Bodies their quantities being to be lessen'd according to the younger age and strength of the Patient CHAP IV. Of particular Fractures of Bones THe Fractures of the Skull are divided into six several kinds A Fissure Contusion Fracture Incision Puncture and Contra fissure A Fissure is made by a hard and blunt Instrument and passeth sometimes through both Tables sometimes through one only A Fracture is made when a part of the Skull is separated from the whole An Incision is made by a cutting Instrument where sometimes one part of the Bone is rais'd up and separated as it were but is yet fast to the rest of the Bone sometimes a part is quite taken away sometimes there remains a mark in the Bone according to the Figure of the Instrument A Puncture is made by a pungent or
Simple and Compound Basilicon the Plaisters of Diachylon of Mussilages and Melilot Take Onions roasted in Embers three ounces Figs No. x. beat them together adding of Ointment of Basilicon six drams Ducks-Grease an ounce Virgins-Honey and the Meal of Linseed of each as much as is sufficient to make it into a Cataplasm Or Take the Roots of White-Lillies Marsh-Mallows of each an ounce ane half Leaves of Mallows Cows-Parsnips of each an handful Figs No. viij Raisins six drams Meal of Marsh-Mallow-Roots or of Wheat two ounces Venice-Sope three drams being boil'd and strain'd add to them of Hogs-grease on ounce Oyl of Camomil two ounces Mix them according to Art and make a Cataplasm 4. Indication respects the Symptoms which if not removed hinder the Cure the chief of which are 1. A Fever The chief of which concerns a Physician except it be removed by Bleeding 2. Hardness whose Cure look for in the Chapter of Schirrhus 3. A Gangrene Which is treated of in a particular Chapter 4. Pain Which we do remove by the following Medicines Anodines Marsh-Mallows Dill Mallows Camomil Henbane Tobacco Lin-seed Seed of Poppy Fenugreek Sperma Ceti Cream White of Eggs Oil of White-Lillies Linseed Ointment of Populeon fat of Hogs Hens and Mans Opium The great Vertues of the following Poultice I have not seldom experimented Take Flowers of Dill Camomil of each a handful Elder a handful and half Linseed-Meal four ounces Oil of Dill White-Lillies of each half an ounce Boil them in Milk to the consistence of a Poultice CHAP. III. Erysipelas ERysipelas is a Tumor besides Nature from Choler thrown forth for the most part only into the Skin it self sometimes on the subjacent Muscles causing Pain Heat and other Symptoms Difference 'T is perfect when sprung from Choler alone as it is imperfect when Blood Phlegm or Melancholy is mixt with it from whose Appellation it likewise takes its name and is called Erysipelas Phlegmonodes Oedematodes Scirrhodes sometimes an Ulcer is joined with it which sometimes consumes only the Skin other times the Flesh it self Cause is Choler seldom alone sometimes mixt with Phlegm and Melancholy but oftentimes with Blood or Serum whence those Medicines that are proper for a Phlegmon oftentimes do good in an Erysipelas Signs Great heat sharp pain Redness mixt with Yellowness easily giving way to the touch but as suddenly returning the Swelling and Extention of the part little and the Pulsation lesser which last gave occasion to Authors of questioning whether an Erysipelas ought to be reckoned amongst Tumors It is accompanied always with a Fever except from an External Cause Prognosticks An Erysipelas is seldom dangerous except the Matter be repell'd from the External parts to the Internal yet more dangerous when it seizeth on the Noble Parts and Jaws and when a Wound Fracture Dislocation or Putrefaction are join'd with it Cure What concerns Diet here is first and chiefly to be considered Air Meat and Drink must be cooling all sharp hot fat and sweet things hurt as likewise do too great Motion of the Body Watchings Costiveness Venery and Anger Purging is very necessary therefore those Medicines described in the third Chapter of the first Part are here convenient A perfect Erysipelas admits not of Bleeding for the fatness of the Blood bridles the sharpness of the Choler But if the Fever be vehement the Flux great and any Blood which for the most part happens be mingled with the Choler 't is convenient to bleed especially in Plethorick Bodies In delicate and weak Bodies Cupping-Glasses with Scarification or Leeches if things should require will serve These being thus done to provoke Sweat is the best of all other Remedies Outwardly to the affected part ought not to be applied 1. Oyl or any fat thing as those things which yield matter to the Choler easily increase Putrefaction But if yet it is your pleasure to use them they must be tempered by mixing them with other Medicines 2. Repellents except the Erysipelas be very little the Part affected remote from the Noble Part and the Humors be yet flowing and then they ought not to be used without Resolvents mixt with them The Cataplasms described in the foregoing Chapter may for the most part be applied here with success The Plaister of Diapalma dissolved in Vinegar is in dayly use the leaves of Tobacco Colewort and Henbane applied to the part affected strongly draw forth the heat There are those which use Sheeps dung boiled in Wine-Vinegar as also the Flowers of Camomil Mellilot and Elders boyl'd in new Milk Chalk powdred put upon the Part laying Cap-paper over it quickly and safely Cures The following Fomentations I have experienced to be of great Virtue Take Red Myrrhe powdred two drams Saccarum Saturni one dram Camphire a Scruple Opium 25 grains White-Wine six ounces Let Linnen Clothes be dipt in it and applyed warm to the Part often renewing them when dryed or cold Another Take the white Troches of Rhasis one dram Camphire one Scruple Spirit of Wine an ounce Elder-water six ounces Mingle and apply it as before Fumes of Mastick and Frankincense may likewise be used five or six times a day especially if the Erysipelas be in the Face When an Ulcer accompanies it Take the white Troches of Rhasis two drams Red Mirrhe Litharge of Gold of each a dram Flower of Brimstone half a dram Sarcocol two Scruples whites of Eggs as much as is sufficient to make it into a Linament CHAP. IV. Of Oedema OEdema is a Tumor beside Nature arising from Pituitous Matter white soft without pain oftner caused by Congestion than by Fluxion Difference It is perfect when it proceeds only from Phlegm Imperfect when mixt with other Humors Thus Oedema Phegmonodes Erysipelatodes Schirrhodes Cause is Phlegm sometimes alone sometimes confused with other Humors for the most part it is produced from the ill disposition of the Limphaeducts Signs are Whiteness Softness yielding to the Fingers little Pain and less Pulsation Prognosticks If an Oedema degenerate into a Scirrhus or Abscess it is hard of Cure It is dangerous if a Consumption or Dropsie accompany it it oftner happens in old People Phlegmatick bodies in the Winter time and in all those who with immoderate eating and drinking continually debilitate the natural heat Cure This as the precedent Tumors requires a good Diet Meat and Drink as also the Air must be moderately hot and dry Rosted Meat is better than Boiled Fruit Cheese and Fish hurt as also too great a quantity of Meat and Drink Wine either of it self or altered with hot Herbs is good moderate Exercises of the body before Meals is as profitable as much Sleep especially diurnal is prejudicial Costiveness Rest and Sadness are Noxious Bleeding is altogether here unprofitable and very seldom used but Sweating and Purging very necessary sometimes Vomiting Always regard must be had to the Stomach To the Tumor it self In the beginning we apply Repelling Medicines mixt with Discussives but so that the
is to be powred upon it and mixt with it but first it ought to he seven times rectified You must make this Conjunction in a Matrace a Glass-Vessel so called by reason of its roundness in the bottom and long neck and in a warm Balneum till the Calx hath imbibed its Spirit then in a Glass-Alembick you shall separate by Balneum whatsoever of waterish Humidity can be separated and there will remain in the bottom the Buttery Calx of Arsenick of great virtue which must be kept in a Glass-Vessel well stopt Take some of this Powder mix it with Basilicon or a Digestive and thus mixt apply to the ulcerated Cancer CHAP. XIV Of a Gangrene and Sphacelus A Gangrene is a beginning Mortification of the the soft Parts of the Body most commonly following a great Inflammation or ill cured Sphacelus Necrosis Syderatio is a perfect Mortification not only of the soft but of the hard parts also Differences In a Sphacelus the parts are altogether dead but in a Gangrene they begin but to die and the sense is not perfectly abolished there the Skin is first pallid suddenly livid then black here in a manner red greater stink in that than in this The Causes of both are six 1. The External Cold of the Air or Repelling Medicines 2. External Heat from burning or use of Corrosive Medicines 3. A Defect of Nutriment as in an Atrophia either by the compression or obstruction of the Vessels by reason of which straightness the Blood cannot pass to the Part. 4. The stopping of the Pores or Perspiration hindred from whence comes a Suffocation of the Natural Heat 5. Malign Humor either begotten in the Body or contractee from venomous Beasts or Medicines 6. The Scurvy which by a peculiar property causeth the Parts sometimes to mortifie Signs A Sphacelus is easily to be known the Part looks black Spungy Flesh Sense Heat and Pulsation abolish'd But the Signs of a Gangrene vary according to the variety of the Causes If contracted from Cold a great pricking Pain is felt in the affected Part First 't is red then pale at length black The Natural heat by degrees is extinguished and there happens a shaking not unlike that in a Quartane Ague If caused from an External Heat or stopping of the Pores the Redness is changed into White then into Black Pulsation and Pain cease the Senses lessened and at last there appear some Pustules from whence issue a gleety Humor If from defect of Aliment there is neither Pain Inflammation or Tumor the Body waxeth cold and for the most part seizeth upon the Joynts If from a venomous Creature or Humor great Pain and Fever always accompany it frequent Faintings and oftentimes Deliriums Here ariseth a Pustule under which appears a black Spot which spreads it self over the whole part If from the Scurvy it for the most part begins at the Toes it shews it self outwardly with blackish spots and lines which degenerates into a dry Crust upon which follows a Numness of the Part and at length a Mortification it self without any Stink Sometimes without pain other times very great especially in them that are given to Passion or Sadness Prognosticks Except a Gangrene be suddenly stopt it degenerates into a Sphacelus easilier cured in young than old People The Humors continually flowing to the part affected bring danger with them and that very great if they are Malignant In the Cavities of the Body to wit in the Mouth Privy Parts and Fundament c. a Gangrene is always difficult of Cure as also that which happens among the Nerves and Tendons in Hydropicks always mortal That which happens from the Scurvy may be spun out from many Months but seldom cured A Sphacelus is not cured but by the Knife and Fire Cure Diet must be good the Air Meat and Drink generally cooling and drying But seeing the Causes are various we leave it to the Physitian to prescribe what is convenient who also must well distinguish concerning Bleeding and Purging when to be used with advantage or disadvantage Sudorisicks and Cordials are of great use here and because that in this and other Diseases they are often used I thought it convenient to set them down in this Place Diaphoreticks or Sudorisicks Roots of Angelica Scorzonera Lovage Contrayerva Herbs Holy-Thistle Fumitory Scordium Harts Horn Unicorns-Horn Bezoar the Stone of an Indian Hog called Pedro Porco Waters of Threacle Alexipharmick Diascordium Threacle Mithridate Species Liberantis Antimony Diaphoretick Salts of Wormwood Prunella Holy-Thistle Rob. Sambuct Take Diascordium Farcastorii one dram Alexipharmick-Water two drams Holy-Thistle water as much as is sufficient Syrup of Limons half an ounce Make a Potion Cordials Waters of Roses Borage Bugloss Conserves of Rosemary-flowers of Roses Violets Borage Bezoar Harts horn Unicorns horn Confections of Alchermes Hiacynthus Rob. of Red Currans of Barberries of Scorzonera Roots Candied Citron and Orange-peels Candied Saccharum Perlatum Salt of Coral Take Water of Borage Bugloss of each two ounces and an half Alexipharmick-water three Drams Cinnamon-water two Drams Saccharum Perlatum half an ounce Confection of Hiacinth half a Dram prepared Crabs eyes two Scruples Spirit of Salt four Drops Mix them Let the Patient now and then take one or two Spoonfuls Externally Cupping glasses and Leeches but chiefly Scarification must be used although there are some of our Chirurgeons which altogether reject Scarification nevertheless happily curing their Patients by the following Medicines which resist Putrefaction External Medicaments against a Gangrene Roots of Angelica round Birthwort Herbs of Wormwood Holy-Thistle Tobacco Rue Colewort Germander Flowers of Elder St. John's Wort Mellilot Camomil Lye Brine Ink Urine Spirit of Wine Treacle Ung. Aegyptiacum Fuscum of Felix Wortz Horse-dung Some mix Hemlock in Plaisters or Poultices and use it with success Or Take the Tops of Wormwood Camomil and Elder flowers of each half a handful Leaves of Germander a handful and half Rue half a handful Crums of brown Bread seven ounces Horse-dung three ounces Boyl them in Brine in the end adding to them Ink two ounces Spirit of Wine three ounces Make it into a Cataplasm The sound part ought also to be preserved partly by keeping the Humors from flowing and partly by keeping the Gangrene from spreading For this purpose the Red defensive Plaister or the Cerot of Virgo is good as also this following Cataplasm Take Bolearmonick half an ounce Powder of Galls Cypress-nuts Pomegranate-rinds of each three Drams Barley-meal six Ounces Oxymel simplex as much as is sufficient to make it into a Cataplasm Or Take Seal'd Earth Bolearmenick of each half an ounce prepared Harts-horn a dram Camphire a Scruple Rose-vinegar an Ounce Oyl of Mirtles three ounces white of an Egg Make it into a Linament Cure of a Gangrene caused from Cold. The part gangren'd if not grown black but as yet appears very red with pain the Patient is to be placed at the Fire but not too near but at a distance
that the heat by degrees may be again restored to the part and to that purpose strongly rubbing it with Snow or cold Water giving also to the Patient Treacle or Mithridate in warm Wine If the pain and cold remit let the part be embrocated very warm with Oyl of Dill Camomil bitter Almonds or Earth-worms c. A Decoction of congeal'd Turnips is good to foment withal then are required both stronger and hotter Medicines viz. Oyl of Earth of Tiles Turpentine Castor Treacle-water Mithridate Or use the following Fomentation Take Herbs of Scordium a handful and half Swallow-wort a handful Rue half a handful Seeds of Roman Nettle Cresses of each three Drams boyl them in White-wine let them be strained and to a Pint of the Liquor add Spirit of Wine two ounces Mingle it When the part hath begun to Mortifie Scarifie continue the use of the above prescribed Medicines Cure of a Gangrene from external Heat or hindred by Perspiration Let the cause of the Disease be removed if possible which if it happens from external Ligature Hot or two Astringent Medicines let them be forthwith removed from the part affected and let it be washed being first Scarified with the following Decoction Take the Water of Endive Night-shade of each six Ounces of Sorrel-water eight Ounces Vinegar half a pint Salt an Ounce and half Scordium a handful Lupines half an Ounce Mix them and boyl them to the Consumption of the third part Then let the Chirurgeon use Ung. Aegyptiacum or any other of the above prescribed Medicines Cure of a Gangrene from the Defect of Nutriment Let the Patient use nourishing Aliments all strong External or Internal Dryers hurt Friction of the part with moderately hot Medicines as with Oyl of Sweet Almonds Olives Earth-worms Scorpions Vipers Man's Fat Bears or Hens is good Scarifie if necessity require Discussives here are very injurious Cure of a Gangrene from a venemous Humor If the malignant Humor be in the Body it self Sudorifick cooling and Cordial Medicines are best For Purging and Bleeding I have seen them oftner to do hurt than good Outwardly Defensives are useless but Cupping-glasses Leeches and attractive Medicines are necessary But if the Malignant Humor come from an external Cause the surest remedy is an actual Cautery lest the Malignity spread it self which is to be used the very first time and also to put a further stop apply a Defensive to the sound part two fingers breadth distance from the wounded part so also it will put a stop to the Flux of Humors or else all the hope consists in Leeches Cupping-glasses Attractive Medicines and others set down above Cure of a Gangrene sprung from the Scurvy Internal Remedies we commit to the Physitian Externally these are commended Take Seeds of Broom Roman-Nettle Rue of each a Dram Tops of Wormwood two Drams Gum Galbanum Ammoniacum dissolv'd in Vinegar of each six drams Oyl of Juniper three drams Wax as much as is sufficient to make it into a Plaister Or Take Oyl of Earth-worms Bayes Rue of each two Drams Castor a Dram Spirit of Wine three Drams Make it into a Linament Or Take the Raspings of Guaiacum Sassafras of each an ounce Root of Angelica Celandines the greater Tamarisk-bark of each six Drams Leaves of Scurvy-grass Water-cresses of each a handful Fennel-seeds an ounce Spirit of Wine a pint and half Infuse them a Night then distil them in Balneo Mariae Foment the part affected with this and scarifie if there be occasion and let the Chirurgeon proceed according to Art Where a Gangrene hath degenerated into a Sphacelus especially in the Joynts let the Part be amputated concerning which look in the First Part. CHAP. XV. Of a Paronychia PAnaritium or Paronychia is a Tumor very painful in the end of the Finger from a sharp Malignant Humor corroding the Tendons Nerves Periostium and Bone it self Cause is a sharp humor proceeding from Choler or Serum Signs are an intollerable pain about the Nail tormenting the Patient day and night an Inflammation oftentimes extending over the whole Arm A Fever for the most part and sometimes Delirium Prognostick By how much the Humor is the more malignant the greater Symptoms it raiseth corrupting sometimes the Bone the Finger the whole Hand and sometimes from extream pain it occasions the death of the Patient Cure Foment the Finger a while in this Decoction Take Flowers of Camomile Mellilot Elder of each half a handful Linseed and Fenugreek each two drams Boil them in Milk Or let this Cataplasm be applied Take Flowers of Dill Elder Leaves of Hen-Bane of each a handful Poppy-seeds and Linseed of each three drams Marsh-mallow-powder an ounce and half Boil them in Milk to the consistence of a Cataplasm Then make Incision upon the Part affected according to the length of the Finger and for the most part there appears one or more red spots containing a sharp Matter but little in quantity which is the cause of the Disease After the Apertion of the Tumor at the first dressing apply to the Finger Treacle dissolv'd in Spirit of Wine and a Defensive to the whole Hand so in a day or two the Cure will be perfected But if this Part should be gangren'd or Sphacelated either by the neglect of Patient or Chirurgeon let it be taken off Except you will commit the business to Nature which oftentimes separates and throws out this Bone A great Inflammation sometimes here produceth a Fleshy Excrescency occult and sensless this is removed by Knife or exeding Medicines Then cure according to Art But if being too late call'd you find a great collection of Humors let Discussives or Suppuratives be applied then the Tumor being either broke or opened take great care lest the Tendons which do very easily putrifie or incline to putrefaction Separation is here necessary whether it be by Medicines or a cutting Instrument Repellents in this case greatly hurtful CHAP. XVI Of an Aneurism ANeurisma is a Tumor besides Nature from a Rupture of an Artery continually beating easily yielding to the Fingers and as suddenly returning Cause All Arteries except those that are dispersed through the Brain and upper parts consist of a double Tunicle the inmost of which being either corroded or broke the External may be extended so much without a Rupture of it whatsoever others say as to cause an Aneurism Nevertheless where the Tumor is of the bigness of ones Fist it cannot be but that the External also must be either corroded or broke Anatomy doth confirm this Opinion which the Studious in the Art of Chirurgery may enquire into This Tumor also may be caused where an Artery be divided so that the External Tunicle united to the Muscles the Internal by reason of the continual pulsation remains open Signs A Swelling increasing by degrees of the same colour as the skin a continual Pulsation If the Tumor be little it easily yields to the Fingers so that it altogether disappears but suddenly returns
when we spoke concerning a Phlegmon Erysipelas Oedema Schirrhus Then Care is to be had of the Blood seeing it affords assistance to the matter and serves to unite the Wound Where it is vitiated it requires purging But if it flow in too great quantity Intercipients Repellents Revellents and Derivation must be us'd If it flow in too small quantity Aliments that nourish are convenient as also Medicines that strengthen and that move Sweat Outwardly gentle Frictions and Embrocations moderately hot Then the Cure is to be perfected by External Medicines which shall be declared in the following Chapter when we speak of the removal of the Symptoms and the Cure of Wounds themselves CHAP. IV. Of the Symptoms of Wounds THe chief Symptoms of Wounds are 1. A Fever whose Cure we commend to the Physitian ' 2. A Flegmon or Inflamation 3. An Erysipelas Of the Cure of both which look in the second and third Chapter of the first Book 4. Hemorage which not only impedes the Cure but also deprives of strength and life it self therefore great Care is to be taken that it be stopped as soon as possible which in the greater Vessels especially the Arteries is very hard to do therefore those Wounds are for the most part Mortal For Medicines that stop Blood are too weak and hard Ligatures occasion a Gangrene the surest way therefore in my opinion is an actual Cautery the lesser Vessels may and will close Some close the Wound of the Vessels with their Fingers and so hold them there while the Blood is coagulated and the Flux stopt but this Operation seldom succeeds besides the long holding of the Finger in the Wound is hurtful Therefore let the Wound together with the Vessels be forthwith clos'd by the Fingers but if you cannot come to do this outwardly make a compress upon the Vessel which done wipe away the Blood with a Spunge then sprinkle some restringent Powder but not over the whole Wound which is used to be done by the ignorant but only upon the Vessels then bind up the Wound continuing the use of the Medicines stopping Bleeding while there appears no longer any Blood not neglecting in the mean time Generals viz. Scarification and Bleeding c. Medicines that stop a Flux of Blood Roots of Bistort Cinquefoil Tormentil Comfrey the greater Red Saunders Lignum Leutisci Pomegranate-rinds Mastick Talk Acacia Dragons-Blood Amber Sarcocols Frankincense the hairs of a Hare Os sepiae burnt-Crabs Whites of Eggs Mummy Cobwebs red Coral Chalk Bloodstone Bole-Armenick Aloes succotrine Frogs dried and powdered crude Vitriol burnt Vitriol Take fine Meal three ounces Dragons-Blood Frankincense of each an ounce and half Bole Sealed Earth of each two drams Talk six drams dried Frogs an ounce Hares hair cut very small a dram and a half Whites of Eggs dried in the Sun and powdered half an ounce New Spunges torrified an ounce white Vitriol a dram Mix them and make them into a fine Powder 5. Pain which must of necessity be eased because it creates watchings and dejects the Spirits and is cause of the Flux of Humors to the Party affected and of Inflamation Fever and Gangrene but the Causes are diligently to be considered For if either Medicines that are sharp or too hot occasion it they are presently to be altered 'T is better to confess the Error than pertinaciously to persevere in it If any foreign Body remains in the Wound it must be drawn forth If pain comes from the choaking in of the Matter you must allow it a free passage If an Inflamation be the cause of it its Remedies are set down in the second Chapter of the first Book You must apply to the Wound those things which ease pain and are anodine as Oyl of Roses Linseed Camomile Worms sweet Almonds Poppies c. Take Oyl of Roses of Poppy-seeds of Camomile of each an ounce the White of an Egg Saffron a scruple Mix them But if the pain cease not with these or the like Medicines it is a sign that some Nerve is wounded or affected by consent The Cure shall be set down in the following 6. Convulsion or Spasm this shews the Malignity of the Humor or the ill constitution of the Nerves neither of them promising any good Here must be used both Internal and External Medicines appropriated to the Disease the Internal by reason of the diversity of causes we commend to the Physitian External Medicines for a Convulsion Balsam of Peru the fat of Geese Castor Foxes Rams Mans Horse-dung Oyls of Juniper Lavender Ol. Philosophorum Amber Turpentine Rue Marjoram Worms Castor Orise Bays Petraeleum Ointments of Agrippa Martiatum Ung. Nervorum Spirit of Wine Take Oyl of Snails Worms Sesamin of each an ounce of the Grease of Rams and Foxes of each half an ounce fresh Butter six drams Spirit of Wine three ounces Let them boil till the Spirit be consumed then add Oyl of Spike distilled Rosemary Amber of each two drams Mix it into an Ointment Against a Convulsion there cannot a better Remedy be invented than distill'd Oyl of Lavender some few drops being given in some convenient Liquor and anointing well the convulsed part 7. Hypersarcosis or too great increase of flesh which if it happens from abundance of Blood the flesh is solid and otherwise well conditioned but if from the too weak quality of drying Medicines it is spungy of the same nature as when the Bone underneath is rotten In the former Case Bleeding is convenient and sometimes fasting and the use of strong drying Medicines In the latter the Medicines must be very strongly drying that are applied Detersive and Corroding Remedies are here good Medicines against too great increase of Flesh Burnt-Spunges Burnt-Allom Galls Aloes the Bark of Frankincense Tutty Verdigrease burnt Vitriol Praecipitate Arsenick A Green Corrosive Water Take crude Allom Verdigrease of each two drams boil them in eighteen ounces of white-Wine to a wasting of the fourth part strain them and add Camphire a dram Mix them A Powder very drying and somewhat corroding Take Galls Balaustions burnt-Allom Frankincense Myrrhe of each a dram Dragons-Blood Ceruse Verdigrease of each half a dram Make it into a Powder 8. A Gangrene and Sphacelus concerning which look in the fourteenth Chapter of the first Book of the second Part of Chirurgery CHAP. V. Of the drawing forth Extraneous Bodies out of the Wound NO Wound ought to be joined together as long as any Extraneous Body remains in it for otherwise after some little time it will break out into an Ulcer The Blood by which Nature unites the divided Parts if it flow in great quantity to the wounded Part and there coagulates 't is to be removed by Expression sucking it out or by any other way for so there will be less Matter generated and the Symptoms fewer but where an Haemorage is feared all the Blood is not to be cleansed away Where Hairs are about the Wound they are to be removed If Sand or any such like thing remain
within the Lips of the Wound they are to be washed away with warm Wine Broken-Bones if loose are to be taken away the first dressing except an Haemorage hinder but if they yet stick to the other Bones then Natures endeavours are to be expected and see whether they will be united again to the other Bone or separated from it If a piece of Glass Thorn Arrow or Bullet or any like thing remains in the Wound 't is forthwith to be taken forth but before the Chirurgeon goes about to draw them forth let him consider well whether the Patient that Extraneous Body being extracted can live or not lest the Chirurgeon be thought to have occasioned the Patients death Of the manner of Extracting Bullets we have treated before and Arrows are to be drawn forth almost after the same manner but they are not in use at this day among Christian Soldiers But if neither with the Hand nor Instruments what remains in the wound can be drawn forth then you must endeavour it with Medicines indeed with an extractive quality Medicines drawing forth Thorns Bones Bullets c. Roots of Aron Birthwort Bastard Dittany Masterwort Polypody Radishes Valerian Herbs Southernwood Pimpernel Anemone Red-Beet Ditany Gums Ammoniacum Galbanum Sagapenum Succinum Pitch the Brains and Grease of Hares Crabs a live Mouse cut in two Common Flies Earth-worms Burnt Frogs Goose-dung Load-stone Leaven Plaister of Opodeldoch Take Roots of round Birthwort Ditany of Crete of each a dram and an half Rosin of the Pine Colophony of each six drams yellow Amber three drams Gum Ammoniacum Appoponax of each an ounce Pigeons dung three drams Oyl of Bays half an ounce Turpentine and Pitch as much as to make it into a Plaister CHAP. VI. Of the manner of joining the Lips of Wounds together THe Lips of the Wound are joined together either by Ligature or Stitching Ligature is convenient in Wounds made according to the length of the Member and not deep let the Bandage be neither too hard nor too loose and of that breadth that it may take in the whole Wound If it be a long Wound the Rowler must be three Fingers broad and laying the midst of it upon the Wound rowl one part upward and the other downward which must neither be too loose for then it will not keep the Lips of the Wound together nor too straight lest it cause an Inflamation In the Winter the Rowlers must be of greater length than in the Summer In great Wounds besides Rowlers the Surgeon stands in need of Boulsters Stitching is performed either by Needle or sticking Medicines It is requisite that the Chirurgeon never be without a Needle for by it he frees his Patient from Pain the Wound from Inflamation and himself from many inconveniences and the Wound so requiring it let him take a three-pointed Needle with a waxed Thred which let him pass through the Skin and sometimes also through the subjacent Flesh taking Care that the Tendons be not prickt and also that the Stitches be not too few nor too many but keeping such distance between each that the Skin may be drawn together and the edges themselves joyned leaving a little part for the putting in of a Tent that may give passage to the superfluous Matter These Tents are not necessary in little Wounds and in great they must neither touch the Nerve or Tendon nor reach to the bottom of the Wound Where Ligature is not sufficient and a Stitch with a Needle not convenient the sticking Plaister is very necessary for so firmly doth this Plaister adhere to the Wound that neither the matter flowing out of the Wound nor the Blood nor any other moisture loosens it Oftentimes in this case is used the Stiptick Plaister of Crollius or Paracelsus but this sticks more firmly Take Sarcocols Bole Mastick Dragons-blood Rosin of the Pine of each a dram Gum-Tacamahack a dram and an half Naval-pitch as much as sufficeth Make it into a Plaister CHAP. VII Of Medicines necessary for the Curing of Wounds MEdicines necessary for the Cure of Wounds are of three sorts 1. Digestives or moving matter 2. Sarcoticks or generating Flesh 3. Epuloticks or inducing a Cicatrice Experience hath taught that a Wound may be cured oftentimes only by Digestive or Sarcotick Medicines but this is better and more certain when they are both mixt together In the Fleshy Parts Digestives may alone serve but in Tendinous Nervous Membranous or other drier Parts Sarcoticks are convenient either alone or mixt with Digestives Digestives Common Oyl Oyl of Roses Mastick fresh Butter and May-Butter Gum-Elemny Turpentine Frankincense Mastick the Flower of Wheat Barley Fenugreek Yolks of Eggs Honey Take Oyl of Olives two ounces yellow Wax half an ounce Frankincense Mastick of each a dram the yolk of an Egg fresh Butter as much as is sufficient Make it into an Ointment Sarcoticks Roots of Birthwort Orrise Sanicle Comfrey the greater Herbs Betony Centaury Comfrey St. John's-wort Pimpernel Plantain Scabious Scordium Vervain of Seeds Beans Fenugreek Linseed Barley Frankincense Aloes Bole sealed Earth Colophony Gums of Elemny Pine Laudanum Mastick Myrrhe Dragons-Blood Sarcocols Turpentine Tragacanth Wax Honey Mummy Cadmia Ceruse Lapis Calaminaris Litharge Burnt-Lead Phomholix Lapis Haematitis Oyls of St. John's wort Bays Mastick Myrrhe Ointment Aureum Basilicum Fuscum of Felix Wurtz Diapompholigos Plaisters Stipticum of Crollius and Paracelsus Oppodeldoch of Betony Diasulphuris of Rulandus Balsoms of Peru of Crollius of Magatus Aqua vitae the fat of Geese Foxes Bears Goats Mans. An Excellent Vulnerary Balsom Take Turpentine half a pound Gum Galbanum Elemny Ivy Frankincense Mastick Myrrhe of each an ounce Aloes Xylo aloes Galangal Cloves Cinamon Nutmegs Cubebs of each half an ounce Infuse them four and twenty hours in a sufficient quantity of Spirit of Wine distil them and preserve the Oyl for your use Another Take Oyl of Violets eight ounces of Bays an ounce Oyl of Venice-Turpentine half an ounce of Spike distill'd of Junipers Verdigreace of each a dram Rosin of the Pine Turpentine Colophony Mastick of each half an ounce white Calcanthum a dram and half Boil them a little then strain them for your use Another Take Flower of Brimstone three ounces Mirtle three drams Camphire one dram Venice-Turpentine five ounces distil them and preserve the Oyl for your use A Vulnerary Plaister Take the Roots of round Birthwort and Comfrey the greater of each half an ounce Mummy Colophony Aloes Mastick Dragons blood Litharge of Gold Tutia of each two drams Gum Elemny two ounces Turpentine as much as sufficeth to make it into a Plaister Another most excellent both in old and new Wounds Take Gum Galbanum ten drams Ammoniacum three ounces and an half Oppoponax an ounce Bdellium three ounces Yellow Wax twenty ounces Olibanum three ounces Litharge of Gold a pound Myrrhe ten drams Verdigreace Mastick Roots of long Birthwort of each an ounce Loadstone two ounces prepared Tutia Lapis Calaminaris of each two drams old Oyl of Olive a
pint and half Dissolve the Gums in Vinegar and let the rest be powdered mingle them according to Art and boil them into the form of a Plaister Epulotick or drying Medicines Roots of Comfry Tormentil Herbs St. Johns-wort Plantain Sanicle Fluellin Betony Flowers of Balaustians Red Roses Saunders Aloes Myrrhe Mastick Sarcocols Lapis Calaminaris Red Lead Lead Litharge Tutty Ointments of Diapompholigos Album Camphoratum Plaisters Gryseum de plumbo Opâ—deldoch de Minio Barbarum Take Oyl of Roses of unripe Olives of each three ounces of Myrtles Ointment of Poplars of each an ounce and half Leaves of Plantain and Night-shade of each an handful let them steep together eight days afterwards add to the strain'd Liquor Wax two ounces mingle them over the fire adding Litharge of Gold three ounces Ceruse an ounce Tutty a dram Burnt Lead three drams Burnt Brass a dram and an half Camphire a dram let them be rubb'd in a Leaden Mortar into the form of an Ointment Take Roots of Tormentil Bistort round Birth-wort burnt Egg-shels Frankincense Dragons-blood of each half an ounce Lapis Calaminaris a dram Litharge two drams Make it into a Powder Take Ung. Pompholigos Diapalmae Grisei of each an ounce Gum Elemny two drams Saccharum Saturni half a dram Wax as much as sufficeth to make it into a Plaister I never knew any better Medicine if applied in a fitting time to bring to a Cicatrice than an Amalgama of Mercury of which this is the description Take two ounces of Lead melt it then add to it two ounces of Quick silver pour it upon Paper dried and powdered it may be mixt with the Plaister of Lead or Diapompholigos To these External Remedies we join also Internal Medicines which have been observed to profit much at all times in the Cure of Wounds Vulneraries Wintergreen Sanicle Ladies-Mantle Comfry Mugwort Saxifrage Tormentil Agrimony Milfoil Horse-tail Hounds-tongue Betony Periwincle Mouse Ear Golden rod Birthwort Bistort Dictany Centory the less Gentain A Wound Dring Take Roots of Comfrey the greater half an ounce of Wintergreen two handfuls of Sanicle two pugils Straw-berries Ladies-Mantle Sage of each an handful boil them in red Wine and to a pint and half of the strained Liquor add of the whitest Sugar as much as is sufficient Dose three ounces Another very effectual even when the Bone is hurt Take Roots of round Birthwort an ounce and half Sowbread an ounce Self-heal Crane-bill of each an handful Savin three drams Mummy two drams Crabs-eyes half an ounce Galangal two drams powdered and cut boil them in red-Wine and to three pints of the strained Liquor add of the Syrup of Comfry of Fernelius four ounces mingle them Dose two ounces If any desires an Ointment that many boast is able to cure the wound though the Patient be absent this is its best description A Sympathetick Ointment Take Moss two ounces Mummy half an ounce Mans fat two ounces Mans-blood half an ounce Oyl of Linseed two drams Oyl of Roses Bole of each an ounce Mix it and make an Ointment Some use only Vitriol calcin'd in the Sun but whosoever shall use them without Superstition shall find many things attributed to Medicines that are due to Nature therefore 't is safest to proceed in the beaten way CHAP. VIII Of Wounds of the Nerves IN Treating of the Wounds of the Nerves we also comprehend those of the Tendons because there is scarce any difference in the Cure it self 'T is to be distinguished here where the Nerve or Tendon be divided or only prick'd This Wound is known 1. By considering the wounded place and by Anatomy which teacheth in what Members the Nerves are inserted but the Tendons seeing they terminate near the Joynts the Hands and Feet having many if a Wound should be inflicted in these parts who would not fear them to be so hurt especially if it be with a transverse wound 2. From the great Pain which causes Pulsation Inflamation Convulsion and Delirium c. except the Nerves be wholly transversly divided and then the Symptoms are altogether not so grievous Prognosticks All the wounds of the Nerves are dangerous a Puncture more dangerous than an Incision Wounds of Tendons are less dangerous than Nerves Convulsion is an ill sign Nerves and Tendons wounded do easily putrifie Cure In all Wounds of Nerves or Tendons seeing pain greatly molests occasioning many Symptoms care is to be taken that it be alleviated as soon as possible Outward cold things do here hugely injure not only the Air but Medicines themselves For Experience hath taught us that cold moist and astringent Medicines do nought but hurt therefore 't is best to use Medicines moderately hot and drying but void of any sharpness The Wound also is to be kept open till the Cure be absolutely performed that the Matter may flow freely forth which if kept in may increase the pain and cause the putrefaction of the Nerve which if it should happen the corrupt Part is to be cut off or removed by an actual Cautery Moreover it is to be observed whether the Nerve or Tendon lies bare or not if bare warm Medicines are convenient but if covered hotter Medicines are required in the mean time Purging and Bleeding are not to be neglected External Medicines in Wounds of the Nerves and Tendons Old Oyl of Olives of Earth-worms of Dill Rue Rosemary Costmary white-Lillies St. John's wort Castore of Turpentine Wax Lavender Balsom of Peru Gums Elemi Tacamahac Caranna Opobalsamum Capayvae Spirit of Wine Take Venice-Turpentine Tears of the Fir-tree of each an ounce Gum Tacamahac half an ounce of Caranna two drams Balsom of Peru three drams Propoleos six drams Oyl of St. John's wort an ounce Make it into an Ointment Oyl of Wax Lime water and the brown Ointment of Faelix Wurtz are here excellent if rightly used CHAP. IX Of Wounds by Gun-shot ALthough daily practice teaches us that Bullets may be poison'd yet they are not so of their own nature for the pain in part and the other Symptoms arise from the solution of the continuity and the contusion Here first the Bullet and any thing else that accompanies it is to be drawn forth lest pain and inflamation coming upon it may hinder and care is to be had that neither of them increase and the contused Part by the following Medicines be brought to suppuration Take Oyl of white Lillies of Violets of each two pints two Puppies newly whelp'd boil them till their Bones be almost dissolv'd then add Oyl of Earth-worms a pint and boil them again strain them and add of Venice-Turpentine three ounces Spirit of Wine an ounce Make it into a Liniment A Wound-Ointment Take Venice-Turpentine an ounce Galbanum two drams Calfs-marrow half an ounce Powder of Scorzonera and Scordium Roots of each two scruples Oyl of St. John's-wort half an ounce the Yolk of an Egg Threacle a dram Make it into an Ointment Another more effectual Take Roots of Birthwort powdred a scruple and an half Mummy
a Wound penetrating into the Cavity it self all the Tunicles being divided the Wound of the Abdomen ought to be united by a Stitch a little Orifice being left through which a Tent is to be put which must not enter the Wound of the Stomach but only outwardly touch it let it be armed with this or the like Take Oyl of Mastick of Fir-tree of each an ounce Manna of Frankincense two drams Powder of the Roots of Tormentil of the greater Comfrey of each a dram Saffron a Scruple Earth-worms half a dram White-Wine two ounces boil them to the Consumption of the Wine and make a Liniment Take Turpentine half an ounce Yolk of an Egg Oyl of St. John's-wort an ounce Mix it and make a Liniment Wounds of the Small-Guts sometimes though seldom may be cured this I can prove by a notable Example Those of the Great-Guts are more easie Where the Small-Guts are hurt the Chyle and sometimes the Meat Drink comes forth through the Wound there is great pain with a Fever and Nauseousness Where the Great-Guts the Excrements come out at the Wound or at least the scent the Body is bound the Wound is forthwith to be stitcht together and the Gut to be restored into its natural place well cleansed with warm Water and this following Powder sprinkl'd upon it Take Aloes Mastick Frankincense Mummy Dragons-blood of each a dram Make it into a Powder Wounds of the Liver and Spleen require bleeding and if the Belly be bound Clisters are daily to be injected to the Wound it self are to be applied Astringent and Drying Medicines Wounds of the Kidneys are difficultly and slowly cured If made into the Cavity it self the Blood that comes forth is Serous otherwise more pure This Liniment is of great esteem to be used outwardly Take Rosin of the Pine six ounces Oyl of Bays and Turpentine of each an ounce Gum Elemny four ounces and an half Mingle them Inwardly are to be given the Troches of Alkakingi Gordonius de Carabe or Sealed-Earth Bole Turpentine and Wound-Drinks Wounds of the Bladder are generally cured after the same manner but it is very seldom that they leave not behind them a Fistula The following Pills are of great use in Wounds and Ulcers in the Kidneys and Bladder Take Mans Bones calcin'd three drams Chalk Burnt Talk of each a dram Troches of Winter Cherries three drams Venice-Turpentine a little boil'd as much as is sufficient Make them into Pills about the bigness of little Pease rowling them in the Liquoras-powder let the Patient take morning and evening six of these The End of the Second Part of the Second Book BARBETTY'S CHIRURGERY The Third Book of the Second Part Of CHIRURGERY Of Vlcers CHAP. I. Of the Nature Differences Causes and Signs of Vlcers AN Ulcer is a Solution of continuity with Diminution of Magnitude in the soft Parts from a Corroding Matter Differences are taken .1 From the Form of the Ulcer so 't is great little long short broad narrow right transverse equal unequal deep superficial 2. From the Part affected which sometimes is the Skin and Flesh only sometimes the Tendons Nerves and Vessels that carry the Blood 3. From the Causes which shall be presently spoken of 4. From the Symptoms so 't is painful itching obstinate verminous carious Cause is a sharp and corrosive Humor and that is twofold 1. Internal as Choler Melancholy Serum Salt Phlegm and other Malignant Humors 2. External as Burning and Corrosive Medicines the Sweat of Man infected with the Itch Leprosie or Pox. Signs of Ulcers in general are manifest enough the particulars you shall have in their places Prognostick By how much deeper the Ulcer is so much the longer 't is in Curing Ulcers in Parts that are subject to much Humidity are difficultly cured If an Ulcer cannot be cured in a long time or when Cicatriz'd breaks out again the Cause is the Bone being foul under it Ulcers near to the Nerves Veins or Tendons are dangerous In Cacochimick Bodies their Cure is tedious If the Matter which comes from them be good it gives hope of an easie Cure Good Matter is of a middle consistence between thin and thick white light equal and not at all stinking That which is ill is thin and fluid pale livid and of ill smell Old and inveterate Ulcers are not cured without danger except the Body be well purged and a good order of Diet observed otherwise some Diseases will ensue CHAP. II. Of the Cure of Vlcers PUrging and Bleeding are here often necessary but a good ordered Diet always Hot Meats and Drinks hurt as also all Sweet and Salt things Outwardly the Humor ought to be concocted and turned into Matter the lost flesh ought to be repaired and then to be skinn'd Remedies necessary to perform these are Digestives Sarcoticks and Epuloticks which are set down in the seventh Chapter of the second Book of the second Part. We will add some Compounds A Defensive Take Guaiacum-Wood long Birthwort-Roots of each an ounce Centaury the less Wormwood Agrimony of each a handful Boil them in white Wine and to two ounces and an half of the strained Liquor add of the Meal of Orobus half an ounce Myrrhe powdered two drams of honey of Roses two ounces Spirit of Wine an ounce Venice-Turpentine as much as is sufficient to make it into a Liniment A Sarcotick Take the Brown Ointment of Foelix Wurtz three drams Basilicon half an ounce Gum Elemni two drams Turpentine six drams Colophony Mirrhe Aloes Mastick of each half an ounce Litharge of Gold three drams Oyl of Roses as much as sufficeth to make it into an Ointment An Epulotick Take Sacchar Saturn Litharge of each two drams Lapis Calaminaris one dram Roots of Tormentil Bistort round Birthwort Dragons-Blood burnt Egg-shels of each half an ounce Make them into a Powder Let it be sprinkled upon the Ulcer or mingled Gall half an ounce Honey as much as sufficeth to make it into a Linament CHAP. III. Of an Vlcer with foul Bones IT falls out sometimes that the Bone which lies underneath the Ulcer to be foul Bones are corrupted and contract a rottenness either from the long Flux of Humors or from the Acrimony and Malignity of them or from an Occult quality or from a Contusion in some manner injuring the bone it self or from sharp Medicines Signs of Corruptions are many Where the Bone lies open to the sight at first it appears of the colour of fat then yellow afterwards black and unequal but where it cannot be seen Chirurgeons may judge that there it is a Corruption 1. If a Fistula preceded or the Ulcer hath been of long continuance 2. If the Ulcer being skinn'd break out again 3. If the flesh above it becomes loose spungy pale or livid 4. If with the Probe you find no resistance but an Inequality 5. If the Matter be much thin and stinking Prognostick If the Caries be near the Nervous parts or in the Joynts or about
Nerves are corrupted and the whole Member subject to danger In this case you must not flatter your self that Medicines can effect any thing before you come to the bottom that is the Bone it self And the Bone being made sound the Ulcer will be cured and the flesh return unto its natural Constitution It is therefore necessary to make Incision even down to the Bone it self and if there be a great excrescency extirpate it and if it be observed to rise again apply an actual Cautery always consideration being had of the Bone Remedies proper against Putrefaction of the Bones are already both by us and others sufficiently described To take away the Excrescency of the Flesh Oyl of Vitriol Oyl of Antimony Spirit of Vitriol Ung. Aegyptiacum Fuscum of Felix Wurtz are very good and this Powder is excellent Take the Restaurative Powder an ounce white Vitriol a dram prepared Arsenick two drams Mix them Sprinkle it upon the proud Flesh laying over it a drying Plaister and it will make a thick Escar without great pain which may be taken off the next day 2. The Cause of a Cancer of the Bone by the Dutch named een Beenvreeter is a sharp Humor first corroding the Bone then making its way through the Periostium then follows an Ulcer of the Flesh and Skin incurable before the Bone be made sound its Orifice is very little the edges are pale the Matter that flows forth is thin the Flesh soft and somewhat swell'd at least as we have spoken in an Ulcerous Excrescency encreaseth of its own accord Here also is Incision necessary made according to the length of the Part to the Bone it self forthwith must be applyed those things that correct Putrefaction to wit Euphorbium Spirit of Vitriol mixt with Spirit of Wine e. I have not only once experienc'd the Powder of Turpentine hardned by boiling to be of great virtue mixt with Ung. Fuscum of Felix Wurtz or Aegyptiacum an actual Cautery is very convenient The Cure also will be accelerated if instead of Tents made of Lint you use Elder-pitch because this inbibes the sharp and thin Humors by which the Action of Nature is promoted Seeing that for the most part these Diseases arise from the distemperature of the whole Mass of Blood and when one Cancer is almost cured another appears in some other place therefore 't is highly necessary to have regard to the whole Body For which purpose the following or the like Medicines may be taken Take Roots of Comfry the great Osmund Royal China Sarsaparella of each an ounce Guaiacum Bark two ounces Rhubarb six drams Senna ten drams Agarick six drams Cloves a dram Cinamon two drams Infuse them 24 hours in a sufficient quantity of Barley water then boil them with a gentle fire and to two quarts of the strained Liquor add of Syrup of Comfrey of Fernelius four ounces Make it into an Apozeme Let the Patient of a middle age take three four or five ounces it purgeth gently forwards the Cure and preserves from further mischiefs 3. The Bones also are subject to certain Tubercles called Tophs and Nodes These for the most part are the Symptoms of the Pox. I shall only set down here some External Medicines approved by long Practice Take Oyl of Venice-Turpentine of Euphorbium of Guaiacum destilled of each two drams Crude Opium half a dram Make it into a Liniment Or Take Mastick Male-Frankincense of each two drams Ladanum half an ounce Quick-silver extinct in Turpentine an ounce Crude Antimony three drams Crude Opium a dram Venice-Turpentine as much as sufficeth to make it into a Plaister Or Take the Juice of Housleek Henbane Celandine the greater of each a dram Mans-fat three drams Oyl of white Lillies Camomile of each two drams Boil them to the Consumption of the Juices afterwards add of Mercury sublimate a dram and scruple Venice-Sope two drams Crude Antimony three drams Mummy Opium of each a dram Ladanum and Wax as much as is sufficient to make it a Plaister according to Art 4. Moreover it is to be observed that no Fat or Oyly Medicines are to be used to the Bone except they are dxtream drying or that by Distillation have lost all their Unctiousness CHAP. IV. Of a Cartilage A Cartilage is a similar spermatick Part drier and harder than a Ligament but moister and softer than a Bone rendring the Articulation the more pliable and defending several parts from external injuries Difference Some are softer especially about the Joynts others harder and differing not much from the nature of a Bone 'T is nourish'd by little Arteries It is endowed neither with Nerves nor Membranes and by consequence without sense It s use is to facilitate motion and to defend some Parts from external injuries whereupon it is scarce subject to any Chirurgical Considerations Not seldom are the Cartilages together with the Bones both corrupted and cured other particular Diseases it scarce hath any besides too great a hardness or softness Of both which we will give Examples 1. The Epiglotis sometimes is so indurated as that it not only deprives of Speech but also hinders the Patient from swallowing except a great piece for Drink and all other liquid things pass into the Wind-pipe as not being well closed by the stiff Epiglotis This Disease is incurable 2. Glottis or Chink of the Larinx either from Meat or Drink or Medicine is sometimes so straight closed together as the Patient cannot make any noise this we remedy by the following Medicines Purging and Bleeding if necessary having gone before Take Milk six ounces Yolk of an Egg White-Sugar three drams Mingle them let the Patient take often a spoonful or two Or Take Frankincense Mirrhe of each a scruple Eastern Saffron half a scruple Juice of Liquoras a dram and an half Gum Tragaganth two drams Sugar as much as sufficeth to make them into Troches always holding one of them in the Mouth and swallowing them down I deem those Anatomists to have committed a great Error who have ascribed this Malady to be an Inflamation of the Larinx although I deny not but that the Cartilages may be inflamed and also corrupted yet 't is certain that which they have set down is not of the Cartilages but of the neighbouring Glandules and of the fleshy parts of the Jaws for it would not be so frequently cured because an Inflamation and Corruption of the Larinx I always esteemed a mortal Disease 2. The Sword-like Cartilage of the Breast is oftner than Practitioners take notice of unnaturally bent inward from Humors flowing in too great quantity and so inclining with the point inward presseth the Stomach from whence comes a diminution of the Appetite a Vomiting of what is taken in with a continual pain of the Stomach and a wasting of the whole Body 't is easie for an Anatomist by the touch to apprehend this Malady and in the space of few hours to cure it for otherwise men are miserably troubled for many years
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
it ought to be ascribed to many Nerves that are distributed through them yet the Causes in this Case are various and must be well distinguished to wit 1. a hot Distemperature 2. a cold distemperature 3. a sharp humor 4. a solution of continuity In a hot distemper Bleeding and Purging is very necessary apply Cupping-glasses to the Neck and Shoulders let the Head be purged with Errhins In the beginning this Water being held in the Mouth profits much Take the Roots of Tormentil an ounce Leaves of Vervain a handful and a half Flowers of Balaustians two Pugils Cypress Nuts two drams red-Saunders three drams Scales of Iron one dram Vitriol two scruples Rose-Vinegar two ounces Let them boil in a sufficient quantity of Red-wine to a pint and half keep it for your use The Flux being stayed we discuss the remaining with the following Decoction Take the Roots of Bistort three drams of Flower-de-luce two drams Leaves of Sage Hysop of each half a handful Galls a dram Frankincense Sandarach of each two drams Juniper-Berries an ounce Boil them in Red-Wine In a cold Distemperature the Patient must avoid all cold potable Medicaments yea the very Air it self those Medicines that purge Phlegm profit Bleeding hurt The following Medicine which is of great vertue may be held in the Mouth My Spirit for the Tooth-ach Take shavings of Guaiacum four ounces Seeds of Stavesacre Pomgranate-rinds Galls White-Frankincense of each an ounce Crude Opium red flowers of Poppy Camphore White-Ginger Cloves Long-Pepper of each half an ounce Leaves of Sage Arsmart Tobacco Horse mint of each one handful Roots of Henbane Pellitory of Spain Mandrake Hounds tongue Nettles the less of each an ounce and half Let them infuse fourteen days in a sufficient quantity of Spirit of Wine then distil it in Balneo Mariae A sharp Humor falling upon the Teeth is cured almost in the same manner as a hot distemperatur but if those Remedies are not sufficient the following Mixture is to be used in a Spoon which is not only of great virtue in this but in all the other kinds of Tooth ach Take water of Plantane an ounce and half of Roses Mint of each an handful Alexipharmick water half an ounce Cinamon-water two drams Julip of Roses or Syrup of Red Poppies an ounce Laudanum Opiatum three grains Mix them In solution of continuity and rottenness of the Teeth it is best to pull them out In the Breeding of Teeth in Children the pain may be mitigated with fresh-butter and Virgins-Honey or with a Decoction of the Brains of a Hare or Coney in Ale but in a long pain it is very convenient to cut the Gum to give passage to the Tooth 9. From the Blood and mixt Humors ariseth the Ophthalmia sometimes true sometimes spurious sometimes seizing on one Tunicle of the Eye sometimes on more that which happens only in the great corner of the Eye is call'd Aegylops the white of the Eye may be vexed with little Bladders called Phlyctenae which being broke there follows an Ulceration except stayed corrupting the whole Eye But if this Ulcer seizeth only the Caruncle that the Punctum Lachrymale afterwards grows callous it becomes a Fistula Lachrymalis If these Diseases yield not to these Remedies proposed in our Chirurgery others are to be made use of Phlectenae are soon removed by the following Powder Take white Sugar-Candy prepared Tutty of each half an ounce red Coral prepared Camphore white Vitriol Saccharum Saturni of each two scruples Mix them and make them into a Powder A beginning Ulcer of the Eye requires first mundifying afterwards consolidating Medicines A Mundifying Medicine Take Mirrhe 15. grains Aloes six grains Sugar-Candy one dram the yolk of an Egg Goats-milk three ounces Mix them A Consolidating Medicament Take red Coral prepared burnt Harts horn Sarcocol of each a scruple Dragons Blood half a scruple burnt-Lead a scruple Starch half a dram Crocus Metallorum half a scruple Gum Tragaganth dissolved in Rose-water a dram Horse-tail-water as much as sufficeth to make it into a Collyrium If the Punctüm Lachrymale in the great Glandule of the Eye be callous and from the continual Flux of Humors degenerates into a Fistula first the Callosity is to be removed before the other accidents will cease for which the following are used by us the Phlegm and Spirit of Vitriol burnt Alom blew Vitriol Verdigreece Mercury water Aqua Fortis Unguentum Aegyptiacum but the best of all is Unguentum Fuscum of Felix Wurtz boil'd to the consistence of a Suppository and put into the Fistula The Callosity being taken away the Ulcer may be cured by the following Medicine Take Roots of Flower-de-luce round Birthwort Bark of Frankincense of each dram and half Mirrhe Mastick Sarcocols Aloes Cadmia Fossilis of each a dram Honey as much as is sufficient to make it into an Ointment If the Os Lachrymale or Zygomaticum be foul the Skin being divided an actual or potential Cautery must be applied that the Caries may be removed otherwise it is impossible to cure the Fistula that not taken away 10. The pain of the Ears proceeds from a cold or hot distemperature or from a solution of continuity which oftentimes an Ulcer follows for a cold distemperature and what accompanies it the Wind besides the common and particular Medicines outwardly may be applied this with very good success Take Oyl of Rue Henbane of each half a dram of distilled Marjoram half a scruple Castor six grains Eastern-Saffron four grains Mix them The Smoke of Tobacco blown through the bole of a Pipe put into the Ear hath done good to many for the pain of the Ears and for Deafness oftentimes also a decoction of Cloves in Red Wine hath profited if two or three drops of it be instill'd warm into the Ear and the Ear afterwards be stopt with one of the boil'd Cloves Two drops of the following Spirit Morning and Evening dropt into the Ear is excellent My Spirit for the Ears Take Ants-Eggs N o 100 Castor Pulp of Coloquintida Marjoram Savin Wormwood Rue a handful Seeds of Cummin Anise Fennel Caraways of each three drams Bay-berry-husks pull'd off Juniper-berries of each half an once Pomegranate-rinds six drams Roots of black Hellebore round Cyprus Raddishes Sow-bread of each an ounce middle-siz'd Onions N o vij bitter Almonds two ounces Infuse them 14 days in a sufficient quantity of rectified Spirit of Wine then distil them in Balneo Mariae In a hot distemperature first we ought to divert the Flux of humors by Bleeding Purging Scarifications Glisters c. then the following Medicines by Cotton inbibed we may put into the Ear. Take womans-Milk two ounces Whites of Eggs well beaten half an ounce Oriental Saffron half a scruple Goose-grease dissolved two drams Crude Opium five grains Mix them Or Take Oyl of Violets sweet Almonds Rose-Vinegar of each an ounce Philonium Romanum two drams Eastern Saffron half a scruple boil them and strain them for your use Or Take
which is a round Ligament comprehending the many Tendons of the Hand as it was in a Circle easily divisible into many others 2. Vagina Membranosa which hold in the Tendons contained in the Hand 3. Fissura oblonga framed in each Tendon for the passage of the Tendons of the Muscles moving the third Joynt this serves in nature of a Pully 4. Ossa Sesamoidea Chirurgical Considerations 1. The Shoulder oftentimes is broken or put out of joynt but is oftner afflicted with a Cathar and Gout In a cold Gout I never found any thing more efficacious than the Stiptick Plaister of Crollius mixt with Oyl of Bricks or Philosophers as also the following Plaister Take Naval-Pitch Colophony of each three ounces Mussilages of Marshmallow-roots two ounces and an half Ammoniacum Galbanum Mastick Mirrhe Frankincense of each an ounce and half Propoleos Misletoe of the Oak round Birthwort burnt Brass yellow-Wax Turpentine of each three ounces Oyl of Earth two ounces Make it into a Plaister according to Art In a hot Cathar or the like Gout I have always found this Fomentation of singular use Take Vitriol white and green of each half an ounce prepared Nitre six drams Crude Alom one dram Mirrhe two drams Opium a dram White-Wine half a pint rectified Spirit of Wine ten drams Elder-Vinegar three ounces Mix them for a Fomentation Under the Arm-pits Veneral Buboes appear as well as in the Groins 2. Often tough Phlegm seizeth upon the Joynt of the Shoulder and Elbow from whence comes a stiffness I have learnt by experience to esteem much in this case of Balsom of Peru as also of the following Ointment Take Fox-grease and Rams-grease Fresh-Butter of each two ounces Oyl of Earth-worms an ounce rectified Spirit of Wine four ounces boil them to the consumption of the Spirit of wine then add Oyl of Rosemary of Amber of each three drams of Tiles or of the Philosophers two drams Mix them and make it into an Ointment One or more of the little Bones of the Carpus oftentimes are dislocated which if not presently reduced becomes an incurable evil A Ganglion is here very frequent besides the Cathar and Gout whose cure we have but just now taught 4. In the Metacarpus and Fingers both above and below meet many Tendons which are easily injured in Wounds and Ulcers which is carefully to be observed lest a Palsie follow In which no other Medicines are needful than what we have already in the foregoing declared But these are chiefly to be considered of 1. That the Bandage is not to be bound too hard 2. You must not put in the Probe too deep nor too often 3. The Hand and Fingers are to be placed upright not depending 4. These Parts are easily affected with a Sphacelus which these signs certainly denounce When there is no matter in due time the Lips in the beginning are dry or yield a little thin moisture the heat pulsation and redness is greater here than in the fleshy parts afterwards the Lips are turned in and become livid and at length black In this case all those Medicines are to be applied that may put a stop to the Gangrene and as formerly we have set down CHAP. II. Of the Foot THe Foot is also divided into three parts to wit into the Thigh Leg and Lower Foot The Thigh hath but one Bone to whose motion serves fourteen Muscles Two Flexors Psoas and Illiacus Three Extensors Glutaeus Major Medius and Minimus Three Adductors Triceps Six Abductors Quadragemini obturatoris duo The Abductors and Adductores working together rowl about the Thigh The Thigh-Bone is the greatest of all the Bones of the Body outwardly it buncheth forth and is a little bended inwardly and so descends internally oblique to the Knee It hath three Processes easily separable in Infants The Leg consists of two Bones the greater of which is in the inside and is called Tibia or the greater focile the lesser which is in the outside is call'd Fibula or the lesser Focile both very much resembling the Bones of the Cubit they are a little distant one from the other but are tied together by a Ligament It is moved by eleven Muscles which are Four Extensors Rectus Crureus Vasti duo Four Flexors Biceps Semimembranosus Seminervosus Gracilis Two Adductors Longus and Poplitous One Abductor Fascialis Between the Thigh and Leg lies the Patella or Knee-pan in Infants Cartilaginous in old people hard and strong placed on the outside of the Joynt The Foot is divided into three parts the Tarsus Metatarsus and Toes The Tarsus is moved by six Muscles viz. Two Flevors Tibiaeus anticus Peronaeus Four Extensors Biceps two Gemelli and Soleâ—s to which many add a fifth Tibeaeus posticus Three of these Extensors from one very strong Tendon which is called Cordia Hipocraâ—â—â—a It is made up of seven Bones which are 1. Talus or Astragalus 2. Calx or Os Calcis 3. Os Naviculare or Cimbiforme 4. Os Tesserae or Cuboides 5 6 7. Ossa tria Cuneiformia or Shpaenoidea The Metatarsus consists of five Bones The Toes have fourteen Bones for the great Toe hath but two Joynts The Matacarpus hath no Muscles except Plantaris which is not unlike Palmaris The Muscles of the Toes are seventeen to wit Two Flexors One Extensor of the four Toes for which use 't is furnished with a fourfold Tendon Four Adductors or Lumbricales Ten Abductors or Interossei To the great Toe are peculiar One Flexor One Extensor Two Adductors One Abductor Here also as in the Hand are observed the Ossa sessamoidea which are always placed between the full grown Joynts partly that they may corroborate the Joynts partly that they may defend the tender Joynts in old people they are alwayes numbred from ten to twenty never in Children Chirurgical Considerations The Foot in its natural constitution as also in its Diseases hath many things agreeing with the Hand therefore it would be superfluous to repeat them over again 1. Considerable here is the Sciatick pain caused from a sharp Humor gathered in the Joynt where the Thigh-bone joyns with the Os Ischium when the Ligament tying these Bones together is from such an Humor relaxed the Bone recedes from the natural places and brings upon that part a lameness If the Bone or Cartilage be corroded and the Vessels comprest there follows an Atrophy of the Legs and sometimes of the whole Body 2. Tumors in the Knee are very dangerous and hard of Cure by reason of the firmness of Muscles the great number of Ligaments Tendons and Bones and the cold and dry nature of the parts not being of force sufficient to dissipate the moisture therefore 't is most necessary to assist it with warm Medicines as soon as possible and if any signs of Suppuration appear forthwith let it be opened lest otherwise the Patient becomes lame the Part wastes and at last happens death it self Upon the opening of the Abscess for the most part there follows a gleet