as is convenient and prevent accidents But first it 's important to extract the Bullet if you can since it is its progress which marks the place which is to be dilated If you cannot follow the track which it has taken without making an Incision How to extract the Bullet you put the Patient into the same posture he was in when wounded that you may easier trace the Bullet and observe the place where it stops you afterwards dilate the Wound minding two Circumstances 1. You must avoid the great Vessels 2. You must not discover the Tendons of the Joynts without necessity If the Bullet be engaged near some great Vessels When to leave the Bullet in or in the middle of the Muscles so that it cannot be extracted without causing some ill effect you may leave it in the part provided the Patient be not much incommoded with it If it be in any of the Venters you must leave it to Nature If it stick in the Bones you must gently move it to draw it out more easily because the Bone would of necessity putrifie If it be in the Nervous parts as in the Joynts you must hasten its extraction particularly when it 's sharp or of any corruptible Matter for then you must not only extract it from the Nervous parts but every part whatever You extract the strong Bodies by Attraction or by Impulsion with the Hand Instruments or Medicines according to the part they lie in If for Example a Bullet be passed the great Vessels you will be obliged to extract it from the opposite part but if it be on this side you extract it through its entrance Nevertheless that general Rule hath its exception for if some strange Body be upon the Carpus or Tarsus forc't from without inward and should have passed the Bones It would be a great temerity to Incise the bending Tendons of the Fingers to force a passage through the opposite In that case you must extract it by the same way it went it If the Bullet has ruin'd a Joynt you must cut off the part because the Ligaments and Bones being quite split to pieces and their Splinters irritating the Tendons it causes a Gangrene to seize presently on the part If the Bone of the Thigh be broken you must dilate the Wound as much as is convenient and advance the Suppuration that you may have the liberty of extracting some pieces of the separate Bones if there be any Of the rest you follow the same method as in other Compound Wounds If there be any Vessels open'd as the Subclavian Vessels you make the Ligature and if some Blood be diffused upon the Diaphragm you must come to the Operation of Empiema If the Bullet has carried off a great part of the Bone as we cannot cut proportionably so much Flesh as the substance of the Bone lost for to convey Remedies thither it happens that the Flesh that grows over it becomes callous and sometimes ossified forasmuch as the salt Juice which runs this way hardens it by little and little If the Trunk of a great Vessel be opened we are often obliged to Amputate the part because the part which receives no more Blood for its nourishment Gangrenates If the Wound be only in the Flesh you may bath it presently after the first dressing with Brandy you soak Boulsters in it and bind up the part with Compresses soaked in warm Wine strengthen'd with Spirit of Wine Accidents which attend The chiefest accidents that accompany Gunshot Wounds are Tumours Putrefaction and Hemorrhagy to dissipate the swelling we successfully use Traumatic Fomentations mixt with Spirit of Wine or Cataplasms made of Urine Rye Meal Hony and Infusion of Roses or a Lye made of Vine-Ashes in which you dissolve Sal Armoniac and Brandy If the Tumour be not big Suppuration is enough to carry it off If it be accompanied with hardness you make some slight Scarifications To excite Suppuration in these kinds of Wounds you use a Digestive made of Vngt Basilicon Linament Arcei Ol. ovor Spirit Vini If Corruption be joined you add Theriac Myrrh Aloes Sal Armoniac Ol. Absinth Anthi as you fear the Corruption you animate them the more If the Putrefaction happen to a fleshy and spongy part you dissolve Egyptiac in Spirit of Wine and mix it with the Digestive Egyptiac not to be used in Nervous parts For Egyptiac being entirely a Dissicative if it were used in Nervous parts that are wont to dry up it would dissipate the little humidity that remains there If you use Injections it 's best to use the two Aristolochias boiled in White Wine in which you dissolve Sugar Candy Camphire Myrrh and Theriac Bitter things not to be used in Injections of the Breast You must observe that Injections as well as other Remedies must be managed with prudence according to the parts where they are used Ex. Gr. If you Inject into the Breast of one troubled with an Empiema a bitter and sharp Liquor it would irritate the part so that they would augment the accidents in the like occasion we use with good success a Decoction of Barley Agrimony a very little Wormwood and Centaury Plantain Birthwort in which you dissolve Mel. Rosar If this needs to be fortified you boil them in Whitewine or Brandy The Tincture of Persicaria Maculata made with White wine is also good to resist Putrefaction if you intend to make it stronger you dissolve Myrrh Aloes and Sal Armoniac in Brandy and mix with it the Solution of Sal Armoniac in Spirit of Wine which produces the same effect and to hinder the generation of new Corruption you compass the Dressing with Spirit of Wine Camphorated The Solution of a Drachm of Mercurius sublimate or Arsnic in half a Pint of Spirit of Wine is excellent in great Putrefactions or one Ounce of Mercury in two Ounces of Aquafortis which we mix with Lime Water or Brandy We also use with very good success in these occasions the Solution of the Canstic Stone in Brandy which we mix with the same quantity of Spirit of Wine Camphorated All these Solutions are capable to waste and separate putrified and rotten Flesh and also to consume the Cariosity of Bones After the effect of all these Remedies you use Detorsive Decoctions made of red Roses Consolid Maj. Quinquesolium Plantain Agrimony Nettles Pimpernell Periwinckle St. Johns Wort Purslain Plantain and Poppy Seed with which you slightly siringe the Wound so separate the rest of the Impurities that are there When you use Detersives you ordinarily joyn Suppuratives with them as Turpentine Vnguent ex apto Balsam Arcei Ol. Hyperici If the Wound has long suppurated and the Flesh grows Luxuriant you consume it with the Spirit of Sulphure put in the Mundificative If it be the Humidity of the part which causes this proud Flesh to grow instead of the Mundificative you use Allom Water or the Aq. Phagedenica or the Decoction of the Traumatic Plants made with Lime Water or Lastly Linamentum Arcei mixt with Myrrh and Fine Bole in Powder THE END BOOKS Printed for and sold by Daniel Brown at the Black-Swan and Bible without Temple-Bar THE Secrets of the Famous Lazarus Riverius Councellor and Physician to the French King and Professor of Physick in the University of Montpelier Newly Transsated from the Latin by E. P. M. D. A Physico-Medical Essay concerning the late frequency of Apoplexies Together with a general Method of their Prevention and Cure In a Letter to a Physitian By William Cole M. D. Nova Hypotheseos ad Explicanda Febrium Intermittentium Symptomata Typos Excogitatae Hypotyposis Una cum Aetiologia Remediorum Speciatim vero de Curatione per Gorticem Peruvianum Accessit Dissertatiuncula de Intestinorum Motu Peristaltico Authore Gulielmo Cole M. D. Novum Lumen Chirurgicum Or A New Light of Chirurgery Wherein is Discovered a much more Safe and Speedy way of Curing Wounds than hath heretofore been usually Practised Illustrated with several Experiments made this Year in Flanders Authore Johan Colbatch Med. Novum Lumen Chirurgicum Vindicatum Or The New Light of Chyrurgery Vindicated from the many unjust Aspersions of some unknown Calumniators With the Addition of some few Experiments made this Winter in England By Jo. Coloatch Physitian Christian Practice Described by way of Essay upon the Life of our Saviour By Stephen Skynner Rector of Buckland in Hertfordshire and late Fellow of Trinity-College in Cambridge Rules for Explaining and Decyphering all manner of Secret Writing Plain and Demonstrative With Exact Methods for understanding Intimations by Signs Gestures or Speech Also an Account of the Secret ways of Conveying Written Messages Discovered by Trithemius Schottus Lord Fran. Bacon Bishop Wilkins c. With exact Tables and Examples By J. F. The Traveller's Guide and The Country's Safety Being a Declaration of the Laws of England against Highwaymen or Robbers upon the Road What is necessary and requisite to be done by such Persons as are robbed in order to the recovering their Damages Against whom they are to bring their Action and the manner how it ought to be brought Illustrated with variety of Law-Cases Historical Remarks Customs Usages Antiquities and Authentick Authorities By J. M. The Clerks Grammar wherein are laid down Plain and Easie Rules for the Making any Bond or Bill Obligatory or single with the several Conditions in most Cases also Instructions how to place the Names Sums and Dates of the same in true proper Latine Likewise An Exact Method of Drawing all manner of Deeds of Common use with Instructions how to Raise any Consideration Habendum Redendum Preservation or Covenant used therein made more Plain and Intelligible to the meanest Capacity than Scarron's Novels Vix The Fruitless Precaution The Hypocrites The Innocent Adultery The Judge in his own Cause The Rival Brothers The Invisible Mistress The Chastisement of Avarice The Unexpected Choice Done into English with Additions by J. D. Esq All sorts of Physick Books Latin and English
those which cover the bottom four or five days before you take them out to the end that by their stay the Matter which is stop'd become more sharp and that they may dissolve more easily the Tunicles which contain the Waters you suppurate it and dress it as an ordinary Wound Before you go further you must also observe that if the waters grow sharp and corrosive or rather lixivious they change often into Pus which makes the Testicle alter and corrupt so that you are forc'd to take it out Cure of Pneumatocele As for Pneumatocele you must use the bandage and all the carminative Remedies as well internal as external and as it 's a part of the Surgeon's prudence to order them according to his Knowledge I shou'd be ridiculous if I should boast here of Remedies which Authors are full of CHAP. XVI Of the Phymosis What Phymosis is THE Phymosis is nothing else but a shrivelling and contraction of the extremity of the Prepuce which compresses so hard the Glans that if you don't give it Air by way of Incision it becomes inflam'd and often mortifies This incommodity is either natural or accidental the natural comes from the parts being yet concentred and as it were retir'd into its Tunicle and that one has not yet betaken himself to any exercise or touching The Prepuce forms in this affect wrinkles which are like so many little Bolsters As Venery between which gathers and stagnates a tenacious Matter separated by the Glans with which the inner surface of the Prepuce is sprinkled which thickens by the heat and growing impure by its stay there is as it were a kind of Glew which fastens the Prepuce to the Glands and so straitly presses it that it will not let the Urin flow The Surgeon therefore first endeavours to free the parts pulling to him the extremity of the Prepuce then introduces at the side of the Virga an Incision knife between the Glands and Cutis piercing the Prepuce without danger and cuting all between the Instrument and Extremity of the Glans If one Incision be not enough to discover it you may boldly make another on the opposite side the sole motion of the parts being capable to extend the Fibres of the Prepuce and render them obedient and make them that they restrain and dilate themselves according to thenecessity of Nature You must not use this Operation till you have tried Fomentations Caution Emollent injections and all other Remedies in vain which method is to be observ'd in all Operations The second kind of Phymosis is caus'd by some Inflamation Shanker Ulcer Induration Callosity and often by irritative Remedies misapplied in all these cases whether the sharp Humour which comes from the Ulcers irritate the parts or corrosive Medicines it happens that the passage of the Blood and Spirits is hindred and the Inflamation becomes so considerable that the Fibres are no more in a condition to obey This is also the reason why this virulent Sanies which comes from the Shanker excoriates these parts excites sharp pains felt only at the extremity of the Yard and Inflamation which is soon followed by a Gangreen if you hinder not its progress Cause of Pulsation in the part The pulsisick pain which is felt in this part can't proceed but from the Glans which is covered with a thin and delicate Membrane humected by a great number of Vessels particularly of Nerves and that its Substance is of a very fine and sensible texture so the motion which these virulent Matters imprint on the Spirits not being able to communicate themselves to the rest of the Yard because of the force and thickness of the coverings of the cavernous Bodies the pain must needs augment and become much more sensible and acute in this part But before you resolve on the Operation use Bleeding Fomentations Suppurations mixt with some prepations of Mercury which you must introduce with the end of your Probe the cerot of GALEN Emollient injections a Ball of Lint put between the Glans and skin compresses wet in Oxycrate in a word all these Remedies must be apply'd but especially the Situation of the Virga which must be laid on the Belly and sustain'd with a little Bandage CHAP. XVII Of Paraphymosis VVhat Paraphymosis is PAraphymosis is a Disease quite contrary to a Phymosis in one the Glans being hidden in the other Strangled and so strip'd of its Prepuce that you can't cover it again The cause of this Strangulation comes sometimes from the overthrow of the Cutis Cause which forms a sort of Bolster and sometimes from Inflamation which a Shanker or some other tumor preceded if the Strangulation be considerable there must needs follow interruption of the course of Blood and Spirits in these parts and consequently a mortification In this affect the Yard-swells so hard that it forms three or four Bags as it were alternately dispos'd half a Finger's breadth one from another These pursings come partly from the obstructions and partly from the reflux of Blood and Spirits in the Body of the Virga they are commonly follow'd by a tumor which occupies the neck of the prepuce and which is full of a reddish water which by the great heat of the part so rarifies ordinarily that from an Aqueous it becomes Windy This tumor augments so considerably the Inflamation that if you don't scarifie deep the tumified places to give a discharge the Penis wou'd not fail to mortifie How to bring over the Prepuce You must endeavour to reduce the Prepuce without compressing the Glans or putting your Thumb on its extremities as most do that treat of this Disease The Reason is that when the extremity of the Glans is pressed it enlarges it self and swells more which instead of making the prepuce slip rather folds up and hinders its reduction You use almost the same Remedies as in Phymosis There be some that pour cold water on the Belly but I think it of no great use or at least see no great effects of it for want of these Remedies you may use in Inflamation some Styptick water in which dip your compresses and apply them about the part you must also keep the same Situation and Bandage as in Phymosis CHAP. XVIII Of the Stone and Lithotomy THe STONE with which Mankind of all other Animals is most troubled is called in Latin Calculus Name and those affected with it Calculosi Its origin wou'd have been always unknown to us if the Chymists Art had not discover'd to us the secret of its formation in shewing the principles which Compose it by the just Analysis that Science makes of it The Opinion of the Ancients concerning its formation All the Ancients and their Abettors have alway maintain'd with great heat that the Stone is form'd by the most Crass Course and viscous particles of Blood which being carried into the Bladder with the Urine came to be
to attack are in a very little time Drown'd We observe that the Muscles of all Hypocondriacs are deprived of a part of the Spirits which are necessary to them for their natural motion for if we consider that the Sulphur which we have supposed to be destroyed VVhat the Animal Spirits are contributes only to the generation of the Animaâ— Spirits that the little cutting Particles which this Sulphur wraps up are the Matter of them and the residue the Vehicle and true Oyl with which the Brain is imbued we shall agree that the Glands of the Brain furnish very few Spirits in these Diseas'd Persons whose Bodies are depriv'd of Fat and that consequently their Muscles must lose of their force vigour and motion from whence comes the great heaviness which they feel You must also observe that they are no more provided with this Fat which before made their Fibres supple flexible and capable of activity This being so 't is evident that their motion must be weakned that they can no more communicate any to the Vessels the course of the Liquors must be slackned and the Animal Spirits which bring some formality to every part are no more in a condition to keep the Pores open or at least so wide as ordinarily so the Vessels being as it were sunk and the Arterial Blood not having any more the power or strength to make it's way the parts are almost defrauded of Life I alledge all these reasons because they fortifie our System of the formation of the Dropsie Old Men very subject to the Dropsie which is founded on the slowness of the Circulation of the Blood which is remarkable in old Men who are most subject to Dropsies The reason is because their Blood is only a fluid Indigested and corrupt Mass having lost all its consistence and unctuosity one may say it has lost its Oyl and consequently is made incapable of sustaining its Fermentation I add that those who Inhabit Boggy places being of a cold Temperament and used to moist Food will be more liable to it than others The Dropsie which often effects Fat and full People who nevertheless are in a certain moderate repose has for its cause only the slowness of Circulation through the frequent Obstructions which ordinarily happen in the Glands and Vessels which occasions the Lympha to disengage it self and overflow some part VVhen the Dropsie is incurable The waters sometimes gather together in a Cystis which makes the Dropsie incurable This Cystis is a strange Covert at first insensible but by degrees separates it self from some other covering either of the Peritonaeum or elsewhere by the saline and lixivious nutriture which it has contracted or by the too great humidity received after the same manner as the Particles of an Egg or Seed disengage or unfold themselves This Cystis is sprinkled with a multitude of Glands and Vessels which it receives from the part from whence it derives its Origin and from other Neighbouring Parts which are as so many sources that produce new Dropsies Signs of the Dropsie The signs of this Disease are swelling of the Belly transparency of the Waters and Fluctuation Difference between corpulant persons and hydropical Before I speak of the Accidents 't is necessary to give an Idea of the difference between the swelling of the Dropsie and a good habit of body In the Dropsie the Belly is extreamly extended and even the Navels rises and terminates in a point whereas in the latter its soft and less extended being more elevated on the sides than elsewhere where the fleshy Portion of the Muscles lie and the Navel is quite hidden Symptoms of the Dropsie The Symptoms which accompany this Disease are slow Fever weak Pulse heaviness of the whole Body difficulty of Respiration considerable Swelling excessive Thirst and difficulty of Urine 1. Slow Fever The slow Fever is nothing else but an effect of the impurity of the Chyle and other levens which intimately mix with it this mixture design'd to make the life of the part happy being impressed with this brine or rather charg'd with this impure and strange Matter passes to the Heart how corrupt soever it be where it ferments and disorders its motions the Heart communicating its unruly Pulsations to the Arteries excites this kind of Fever which is only felt very slightly 2. Weakness of the Pulse The Pulse's weakness depends on the slow influence of the Animal Spirits into the Fibres of the Heart which being incapable to augment their Action in respect of the Spirits as well as Blood by reason of their scarcity maintain the blood in that little degree of precipitate motion which distinguishes this slow Fever from the other and consequently causes this weakness of the Pulse 3. Heaviness of the Body The pale colour and heaviness of the body proceeds from the slow motion of the Blood and from the dissipation and concentration of the Spirits which are stifled and choak'd as it were in the Waters now as the heat and vigor depend on the presence and natural ferment of the Blood and Spirit which should animate these parts and be carried to the Surface you must not wonder if they be so pale and if the Muscles can't sustain the weight of the Body 4. Difficulty of Respiration The difficulty of Respiration is caused by the swelling and great tension of the belly which presses the Diaphragm against the Lungs and diminishes the Diameter of the Breast so that the Lungs having not the liberty to extend themselves the Respiration grows frequent and forced The excessive thirst is rais'd from the humors that are separated from the Glands of the Stomach 5 Thirst Oesophagus and other parts of the Gula to moisten their coasts and to maintain them in the Humidity which is requisite for them it 's not enough either through the frequent setlings which are made in other parts or that the invincible and intemperate fire which the Fever kindles in all parts dissipates consumes or ratifies it which cause these parts to heat and dry and that saltish Spirits whose actions are not corrected by any dissolvent rush into the little Fibres and produce a motion in the Nerves which excites thirst As to difficulty of Urine I suppose that part of the Water which used to take its course through the Kidneys 6. Difficulty of Vrine tends another way and that the Urinous Volatil and other fixt Salts of the Urine being deprived of a part of their dissolvent stop at the entry of the Pores of the Glands and hinder the Urine from running with that liberty into its Conduit the Salts thus having the upper hand and finding nothing in the Blood capable to blunt their points irritate all the parts through which they pass particularly the Areteries and oblige the Sphincter of the Bladder to a more than usual contraction which causes the Urine to flow very difficultly and by turns I pass to
drain the source of it If you fear you should not succeed this way you must hinder the Vessel from shedding the Lympha into the bottom of the Wound by drying up its extremity and procure the generation of Flesh as fast as you can If a Wound be accompanied with contusion you must use the strongest Discutients as Spirit Vini alone or Aromatised or a Lixivium which shall be described in the Chapter of Wounds made with Fire-Arms If the Matter discuss not and that it increases you must disingage the parts by Scarification and use Medicines which awaken the particles of the Blood that are at rest and force them out by perspiration or to re-enter again in commerce with the Liquors This is the method which you must follow in great Inflammations where the Gangrene is apt to succeed The Medicines are the Decoction of the chiefest Vulneraries which we have recommended afore The Tinctures of Aloes Olibanum Myrrh made with the Spirit of Wine all Medicines where the preparations of Mercury enter Urine Sea Water Cataplasms made with Meal of Lupins Beans and Lentiles Tops of Wormwood and Scordium boiled in Oximel Simp. These are the chiefest Remedies which are to be employed in deep Scarifications some destroy and blunt the Acids some sweeten and correct the Acrimony of the Lixivial salts others strengthen the part and all together contribute to retain the spirituous particles which are ready to escape or to disengage them when concentred and produce a fermentation which separates the Morbid Leavens and restores the heat and spirits again into the part If a great flux of Blood follow upon the Wound or if any considerable Vessel be opened you must make the Ligature if the place permit or use the Vitriolic Button or some Styptic Water as that in Mr. Lemery's Chymistry and some drops of Spirit of Turpentine When to dilate the Wound If the Orifice of the Wound permit not the entry of your Dossels you must dilate it avoiding the great Vessels and Tendons This is the surest and most important practice to succeed in all Wounds where one cannot apply Boulsters because in discovering the bottom of the Wound you have the advantage to use Boulsters and reject the use of Tents which are only Beneficial in deep Wounds of the Thorax and Belly you may also better wipe the lesser corners of the Wound fill it with Dossels and hinder the Matter from cakeing or lodging it self in any corner and to hinder the formation of any Sinus I have made you observe that many Compresses and too narrow Bandages are kinds of Ligature which stop the course of the Blood and which increase the fluxion and all other accidents A Wound ought to be dressed as soon as possible to secure it from the Appulse of the Air and free the It 's of great Benefit to Cleanse the Circumference of Wounds Patient from some Pain You must also take care to cleanse well its Circumference which is a very important Circumstance because the Cataplasms and Emplasters which are applied upon it stick to the Skin and form a kind of Scab which hinders the effect of the Remedies and retain those particles of the Blood which would transpire whereas if you free the Skin from this Scabbard the Remedies presently enter through the Pores as soon as they feel the heat they favour the transpiration the part empties it self the accidents diminish and the Wound unites more easily You must observe that Emplasters compounded of Fat 's Gums and Powders serve only to retain the Dressings and to oppose the Exaltation of the Juices For which reason good Practitioners condemn them In the time when the Wound begins to cicatrise and the Flesh groweth unequally we let it increase till all Inequalities are fill'd then we dry them with Lime-water How to Cicatrise Wounds or some other Dissicative Medicine to cause an even Cicatrice If the Flesh arise too high you pass gently the Infernal Stone over it To this Method of dressing a Wound I will yet add that the situation must favour the Circulation of the Humours and the running out of the Matter These are the chiefest Circumstances which must be observed in dressing Wounds in the Fleshy parts where the Inflammation Aperture of any great Vessel great loss of substance and the Contusion doth not permit us to practice the Sutures CHAP. II. Of Punctured Wounds or those made with a small and sharp-pointed Instrument WOunds that pass through are not so dangerous as those which have but one Aperture they are sometimes cured by the help of Bandage applied outwardly with some Boulsters soaked in Spirit of Wine Signs when to dilate the Wound If one be pain'd and the part inflamed it 's an evident sign that there are some Obstructions Extraneous Bodies which hinder the unition These two Accidents do also signifie the necessity that there is to dilate it for to carry Remedies to the part and give a greater vent to the Matter we most commonly introduce two Tents of Lint of a length and thickness proportionable to the Orifices we fasten Threads to them and dip them in some Digestive made of Ol. Ovor. Spirit Vini and Turpentine which we alter according to the different degrees of Inflammation if the Suppuration be plentiful the Spirit of Wine must predominate if suppressed by the Inflammation we must correct the Spirit of Wine by putting to it more Turpentine If the Pus be good and the most intimate parts re-unite themselves you must continue this Method but if it be black and Inflammation succeed Phlebotomy reiterated Clysters and cooling and opening Fisans must not be neglected we correct the Digestives with Ol. Rosar Traumatic Injections with Brandy in this occasion are admirable If notwithstanding these precautions the Inflammation incroaches upon the neighbouring parts with putrefaction you must dilate it sufficiently to discover the place where the Matter lodges by this means you discharge the part and dress all the corners where the Matter formerly was nestling and so prevent Gangrene and Mortification Where prepared Sponge is better to dilate with than Incision Concerning the Dilatation of Wounds there be some who pretend that the prepared Sponge may supply the want of Incision I own that in places where much dilating is not wanting and where the Cicatrices would deform as in the Face and am so far from condemning the use of it that I say it 's very necessary but in all other Occasions the Incision is to be prefer'd Though a Wound goes not through and through yet if the Probe enters almost through the part you must without delay make an Incision on the opposite side The Symptomes which commonly attend Punctur'd Wounds The most frequent Symptomes that happen in these kinds of Wounds are Fever and Looseness upon which sometimes follows Dysentery The Fever excites Inflammation and retards Suppuration that the part becomes so tumified that a Gangrene often follows it It 's known