the Extremities of the Nerves which are there terminated It also renders the same Skin even and smooth and so contributes very much to Beauty What is the Hair The Hairs are certain hollow Filaments planted in the Glandules of the Skin from whence their Nourishment is deriv'd They constitute the Ornament of some Parts cover those which Modesty requires to be conceal'd and defend others from the injury of the Weather What is a Nail The Nails are a Continuity of the Skin harden'd at the end of the Fingers to strengthen and render them fit for Work CHAP. IV. Of the general Division of a Humane Body HOW is the Humane Body divided before it is dissected in order to Anatomical Demonstration Some Anatomists distinguish it into Similar and Dissimilar Parts appropriating the former Denomination to all the simple Parts of the Body taken separately as a Bone a Vein a Nerve c. but they attribute the Name of Dissimilar to all those Members that are compos'd of many Similar or Simple Parts together such are the Arms Legs Eyes c. wherein are contain'd all at once Bones Veins Nerves and other parts Others divide it into containing and contained Parts the former enclosing the others as the Skull includes the Brain and the Breast the Lungs whereas the contained Parts are shut up within others as the Entrails within the Belly the Brain within the Skull c. Others again divide the whole Body into Spermatick and Sanguineous Parts the former being those which are made at the time of Formation and the latter all those that are grown afterward by the Nourishment of the Blood Are there not also other Methods of dividing the Humane Body Yes Many Persons consider it as a Contexture of Bones Flesh Vessels and Entrails which they explain in four several Treatises whereof the first is call'd Osteology for the Bones the second Myology for the Muscles the third Angiology for the Veins Arteries and Nerves which are the Vessels and the fourth Splanchnology for the Entrails But lastly the most clear and perspicuous of all the Divisions of the Body of Man is that which compares it to a Tree whereof the Trunk is the Body and the Branches are the Arms and Legs The Body is divided into three Venters or great Cavities viz. the Upper the Middle and the Lower which are the Head the Breast and the lower Belly The Arms are distributed into the Arms properly so called the Elbow and Hands and the Legs in like manner into Thighs Shanks and Feet The Hands being also subdivided into the Carpus or Wrist Metacarpium or Back of the Hand and the Fingers as the Feet into the Tarsus Metatarsus and Toes This Division is at present follow'd in the Anatomical Schools CHAP. V. Of the Skeleton WHY is Anatomy usually begun with the Demonstration of the Skeleton or Contexture of Bones Because the Bones serve for the Foundation Connexion and Support of all other Parts of the Body What is the Skeleton It is a gathering together or Conjunction of all the Bones of the Body almost in their Natural Situation From whence are the principal differences of the Bones derived They are taken from their Substance Figure Articulation and Use How is all this to be understood First then with respect to their Substance there are some Bones harder than others as those of the Legs compared with those of the Back-Bone Again in regard of their Figure some are long as those of the Arm and others short as those of the Metacarpium Some are also broad as those of the Skull and Omoplatae or Shoulder-Blades and others narrow as the Ribbs But with respect to their Articulation some are joined by thick Heads which are received into large Cavities as the Huckle-Bones with those of the Hips and others are united by the means of a simple Line as the Chin-Bones Lastly with relation to their Use some serve to support and carry the whole Body as the Leg-Bones and others are appointed to grind the Meat as the Teeth or else to form some Cavity as the Skull-Bone and those of the Ribs What are the Parts to be distinguished in the Bones They are the Body the Ends the Heads the Neck the Apophyses the Epiphyses the Condyli or Productions the Cavities the Supercilia or Lips and the Ridges The Body is the greatest Part and the middle of the Bone the Ends are the two Extremities the Heads are the great Protuberances at the Extremities the Neck is that Part which lies immediately under the Head the Apophyses or Processes are certain Bunches or Knobs at the Ends of the Bones which constitute a Part of them the Epiphyses are Bones added to the Extremities of other Bones the Condyli or Productions are the small Elevations or Extuberances of the Bones the Cavities are certain Holes or hollow places the Supercilia or Lips are the Extremities of the Sides of a Cavity which is at the End of a Bone the Ridges are the prominent and saliant Parts in the length of the Body of the Bone How are the Bones join'd together Two several ways viz. by Articulation and Symphysis How many sorts of Articulations are there in the Bones There are generally two kinds viz. Diarthrosis and Synarthrosis What is Diarthrosis Diarthrosis is a kind of Articulation which serves for sensible Motions How many kinds of Diarthroses or great Motions are there There are Three viz. Enarthrosis Arthrodia and Ginglymus Enarthrosis is a kind of Articulation which unites two Bones with a great Head on one side and a large Cavity on the other as the Head of the Thigh-Bone in the Cavity of the Ischion or Huckle-Bone Arthrodia is a sort of Articulation by the means whereof two Bones are join'd together with a flat Head receiv'd into a Cavity of a small depth Such is the Head of the Shoulder-Bone with the Cavity of the Omoplata or Shoulder-Blade and that of the Twelfth Vertebra of the Back with the first of the Loins Ginglymus is a kind of Articulation which unites two Bones each whereof hath at their Ends a Head and a Cavity whereby they both receive and are received at the same time such is the Articulation in the Bones of the Elbow and the Vertebrae What is Synarthrosis Synarthrosis being opposite to Diarthrosis is a close or compacted Articulation destitute of any sensible Motion How many sorts of Synarthroses or close Articulations are there There are Three viz. Sutura Harmonia and Gomphosis A Suture is that which joins together two Bones by a kind of Seam or Stitch or by a Connexion of their Extremities dispos'd in form of a Saw the Teeth whereof are reciprocally let one into another Such are the Sutures of the Skull-Bones Harmonia is the uniting of two Bones by a simple Line as the Bone of the Cheek with that of the Jaw Gomphosis is a kind of close Articulation which unites two Bones after the manner of Nails or Wooden Pins fixt in the Holes
perform'd b◠others upon the Bodies of their Patients What are the Diseases in general that belong 〈◊〉 Surgery They are Tumours Impostumes Wound◠Ulcers Fractures Dislocations and generall◠all sorts of Distempers whereto Manual Operations may be applyed What are the Instruments in general which a◠commonly used in Surgery for the curing of Diseases They are Five viz. the Hand Bandages Medicines the Incision-Knife and Fire What is the general Practice which ought to be observ'd in the Application of these different helps Hippocrates teacheth us in saying that whe◠Medicines are not sufficient recourse may b◠had to the Incision-Knife and afterward t◠Fire intimating that we must proceed by degrees Are there any Distempers that may be cured 〈◊〉 the Surgeon's Hand alone Yes as when a simple and small Dislocation 〈◊〉 only to be reduced CHAP. II. Of Chirurgical Instruments portable and not portable WHAT do you call portable and not portable Instruments Portable Instruments are those which the Surgeon carries in his Lancet-Case with his Plaister-Box and not portable are those that he doth not carry about him but is oblig'd to keep at home the former being appointed for the ready help which he daily administers to his Patients and the others for greater Operations What are the Instruments which a Surgeon ought to have in his Plaister-Box These Instruments are a good pair of Sizzers a Razor an Incision-Knife streight and crooked a Spatula a greater Lancet to open Impostumes and lesser for letting Blood They likewise carry separately in very near Lancet-Cases a hollow Probe made of Silver or fine Steel as also many other Probes streight crooked folding and of different thickness a Pipe of Silver or fine Steel to convey the cauterizing Button to a remote Part without running the hazard of burning those that are near it another Pipe or Tube serving instead of a Case for Needles which have Eyes at one end for sowing a Carlet or thick triangular Needle a small File a Steel Instrument to cleanse the Teeth a Fleam a pair of crooked Forceps to draw a Tooth a Pelican a Crow's Bill several sorts of Raspatories a Hook to hold up the Skin in cutting c. What are the Instruments which a Surgeon ought to keep in his Repository to perform the greater Operations Some of them are peculiar to certain Operations and others are common to all The Instruments appropriated to particular Operations are the Trepan for opening the Bones in the Head or elsewhere The Catheters or Probes for Men and Women afflicted with the Stone or difficulty of making Water Extractors to lay hold on the Stone in Lithotomy and to gather together the Gravel large crooked Incision-Knives and a Saw to make Amputations of the Arms or Legs great Needles with three Edges to be used in making Setons small Needles to couch Cataracts other Needles thin Plates and Buckles to close a Hair-Lip c. May not the Salvatory be reckon'd among the portable Instruments Yes because the Balsams Ointments and Plaisters contain'd therein are means whereof the Surgeon makes use to restore Health CHAP. III. Of Anatomy in general and in particular of all the Parts whereof the Humane Body is compos'd WHAT is Anatomy It is the Analysis or exact Division of all the Parts of a Body to discover their Nature and Original What is requisite to be observ'd by a Surgeon before he goes about to dissect a Body Two things viz. The external Structure of the Body and the Proportion or Correspondence between the outward Parts and those that are within Why so Because without this exterior and general Knowledge the Surgeon wou'd be often mistaken in the Judgment he is to pass concerning a Dislocation or Wound inasmuch as it is by the Deformity which he perceives in the Member that he knows the Dislocation as it is also by the means of the Correspondence which the outward Parts have with the inward that he is enabled to draw any certain Consequences relating to a Wound which penetrates into the Body What is a Part It is that whereof the whole Body is compos'd and which partakes of a common Life or Sensation with it How many sorts of Parts are there in a Humane Body We may well reckon up Fifteen distinct Parts which are the Bone the Cartilage the Ligament the Tendon the Membrane the Fibre the Nerve the Vein the Artery the Flesh the Fat the Skin the Scarf-Skin the Hair and the Nails What is a Bone It is the hardest and driest Part of the whole Body and that which constitutes its principal Support What is a Cartilage or Gristle It is a yielding and supple Part which partakes of the Nature of a Bone and is always fasten'd to its Extremities to mollifie and facilitate its Motion What is a Ligament It is a Membranous Contexture usually sticking to the Bones to contain them as also sometimes to other Parts to suspend and retain them in their proper place What is a Tendon It is the Tail or Extremity of the Muscles made by the re-union of all the Fibres of their Body which serves to corroborate it in its Action and to give Motion to the Part. What is a Membrane It is a Nervous Part the use whereof is to adorn and secure the Cavities of the Body on the inside and to wrap up or cover the Parts What is a Fibre They are fleshy Lines of which the Body of a Muscle is compos'd What is a Nerve It is a long white and thin Body consisting of many Fibres enclos'd within a double Tunick and design'd to carry the Animal Spirits into all the Parts to give them Sense and Motion What is an Artery It is a Canal compos'd of Four Coats that carryeth with a kind of Beating or Pulse even to the very Extremity of the Parts the Blood full of Spirits which proceeds from the Heart to distribute to them at the same time both Life and Nourishment What is a Vein It is a Canal made likewise of Four Tunicles which receives the Arterial Blood to carry it back to the Heart What is Flesh It is a Part which is form'd of Blood thicken'd by the natural Heat and that constitutes the Body of a Muscle What is Fat It is a soft Body made of the Unctuous and Sulphurous part of the Blood What is the Derma or Skin It is a Net compos'd of Fibres Veins Arteries Lymphatick Vessels and Nerves which covers the whole Body to defend it from the Injuries of the Air and to serve as an universal Emunctory It is very thin in the Face sticking close to the Flesh and is pierc'd with an infinite number of imperceptible Pores affording a Passage to insensible Transpiration What is the Epiderma or Scarf-Skin It is a small fine Skin transparent and insensible having also innumerable Pores for the discharging of Sweat and other Humours by imperceptible Transpiration It is extended over the whole inner Skin to dull its too exquisite Sense by covering
Apozemes or Decoctions of Endive Cicory Sorrel Becabunga and Snail-Water are in like manner very good for the same purpose Ointment of Styrax is frequently us'd in the Hospital call'd Hôtel-Dieu at Paris and apply'd to Spots and callous Swellings that arise in the Legs A TREATISE OF Wounds Ulcers and Sutures CHAP. I. Of Sutures SUTURES or Stitches are made only in recent and as yet bleeding Wounds when they cannot be re-united by Bandage as are the transverse provided there be no Contusion nor loss of Substance nor great Haemorrhages as also that the Wounds were not made by the biting of venomous Beasts that there be no violent Inflammations and that the Bones are not laid open because generally 't is necessary to cause 'em to be exfoliated neither is this Operation to be perform'd in the Breast by reason of its Motion The Instruments proper for the making of Stitches are streight and crooked Needles with waxed Thread and these Sutures are of four sorts viz. first the Intermittent Stitch for transverse Wounds the second for the Hare-Lip the third commonly call'd the Dry Stitch for superficial Wounds and the fourth term'd the Glover's Stitch. The Intermittent Stitch is that which is made at certain separated Points according to the following manner After having taken away all extraneous Bodies out of the Wound let a Servant draw together its Sides or Lips and let a Needle with waxed Thread be pass'd thro' the middle from the outside to the inside several Points being made proportionably to its length It is requisite to pierce a good way beyond the Edge of the Wound and to penetrate to the bottom lest any Blood shou'd remain in the Space that might hinder the reuniting If the Wound hath Corners the Surgeon begins to sow there and before the Knot is made causeth the Lips of the Wound to be drawn exactly close one to another The Knots must be begun with that in the middle and a single one is first made on the side opposite to the running of the Matter laying upon this Knot if it be thought convenient a small Bolster of waxed Linnen on which is tied a Slip-Knot to the end that it may be untied if any bad Accident should happen If a Plaister be apply'd to the Wound after the Stitching a small Bolster is to be laid over the Knots to prevent their sticking to the Plaister In case any Inflammation happens in the Wound the Knots may be loosen'd and ty'd again when the Symptoms cease But if the Inflammation continue the Threads are to be cut by passing a Probe underneath When the Wound is clos'd the Threads are cut in like manner with a Probe and in drawing 'em out a Finger must be laid near the Knot lest the Wound should open again To make the second sort of Stitch for the Hare-Lip a small streight Needle is pass'd into the sides of the Wound and the Thread is twisted round the Needle by crossing it above at every Stitch. To form the Dry Stitch in very superficial Wounds a piece of new Linnen-Cloth is to be taken wherein are made Digitations or many Corners the Selvedge or Hem ought to be on the side of these Corners or Digitations and a small Thread-Lace is ty'd to every one of ' em Afterward this Cloth is dipt in strong Glue and apply'd about a Finger's breadth from the Edges of the Wound so that a piece thereof being stuck on each side the Laces may be ty'd together to cause the Lips of the Wound to meet To make the Glover's Stitch the Operator having drawn together the Lips of the Wound holds 'em between two Fingers passeth a Needle underneath 'em and soweth 'em upward all along after the manner of Glovers CHAP II. Of Wounds in general WHAT is a Wound A Wound is a recent violent and bloody Rupture or Solution of the Natural Union of the soft Parts made by a pricking cutting or bruising Instrument What ought to be observ'd before all things in the curing of Wounds It is requisite to take notice of their differences as well as of the Instruments with which they were made to the end that Consequences may be drawn from thence for the Application of proper Remedies From whence arise the differences of Wounds and which be they They are taken either from their Figure or Situation With regard to their Figure they are call'd Long Broad or Wide Triangular Great Little Superficial or Deep and with respect to their Situation they are term'd Simple Complicated Dangerous or Mortal What is a Simple and a Complicated Wound A Simple Wound is that which only opens the Flesh and hath no other concomitant Circumstances but a Complicated Wound on the contrary is that which is attended with grievous Symptoms as Haemorrhages Fractures of Bones Dislocation Lameness and others of the like Nature What is a dangerous and mortal Wound A dangerous Wound is that which is complicated the Accidents whereof are dreadful As when an Artery is open'd or prick'd when a Nerve or Tendon is cut or when the Wound is near a Joynt and accompanied with a Dislocation or Fracture A mortal Wound is that which must be inevitably follow'd by Death as is that which is situated deep in a principal Part necessary for the Preservation of Life What are the Parts wherein Wounds are mortal They are the Brain the Heart the Lungs the Oesophagus or Gullet the Diaphragm the Liver the Stomach the Spleen the small Guts the Bladder the Womb and generally all the great Vessels Wherein doth the Cure of Wounds consist In helping Nature readily to procure the reuniting of the Parts that have been divided after having taken away or asswag'd every thing that might cause an Obstacle What are the things that hinder the speedy reunion of the Parts They are extraneous Bodies found therein as Bullets Flocks and Pieces of Wood or Stone c. As also sometimes the Accidents which attend 'em as an Haemorrhage or Flux of Blood Inflammation Esthiomenus or Mortification Hypersarcosis or an Excrescence of Flesh Dislocation the Fracture of a Bone the Splinter of a Bone sometimes a contrary Air. REMEDIES What are the Remedies proper for stopping an Haemorrhage or Flux of Blood The common Remedy is a kind of Cataplasm made up with the Powders of Aloes Dragons-Blood Bole Armenick and Whites of Eggs which are mix'd together and laid upon the Wound But the following is an excellent one Take two Ounces of Vinegar a Dram of Câ—ol cothar two Drams of Crocus Martis Astringens beat the whâ—â—e together steeping Muscus Quercinus therein then throw upon it the Powder of Mushrooms or of Crepitus Lupi Apply this Remedy and you 'll soon stop the Haemorrhage taking Care nevertheless to bind the Part well otherwise the Astringents do not readily take Effect To this Purpose you may also make use of Cobwebs Mill-Dust and the Powder of Worm-eaten Oak or else take Oven-Soot mixt with the Juice of the Dung of an Ass
made to receive them Such is that of the Teeth in their Sockets What is Symphysis Symphysis is the uniting of two Bones by the interposition of a Medium which ties them very streight together being also threefold Such is the Connexion of the Knee-Pan or Whirl-Bone of the Knee and the Omoplata or Shoulder-Blade Are not these three kinds of Articulations or Symphyses distinguish'd one from another Yes for tho' they are all made by the means of a third Body intervening which joins them together nevertheless every one of these various Bodies gives a different Denomination to its respectivé Articulation Thus the Articulation which is caus'd by a Glutinous and Cartilaginous Substance is properly call'd Synchondrosis as that of the Nose Chin Os Pubis c. But an Articulation which is made by a Ligament is termed Synneurosis as that of the Knee-Pan Lastly that which is wrought by the means of Flesh bears the Name of Syssarcosis as the Jaw-Bones the Os Hyoides and the Omoplata or Shoulder-Blade Have the Bones any sense of Feeling or Motion They have neither for their sense of Pain proceeds from nothing else but their Periostium or the Membrane with which they are cover'd and their Motion is perform'd only by the Muscles that draw them Doth the Marrow afford any Nutriment to the Bones No all the Bones are nourish'd by the Blood as the other Parts but the Marrow is to the Bones what the Fat is to the Flesh that is to say it is a kind of Oil or Unctuous Substance which moistens and renders them less brittle Are all the Bones of the same Colour No they follow the Temperament and Constitution of the Persons How many in number are the Bones of the Humane Skeleton There are two hundred and fifty usually reckon'd viz. 61 in the Head 67 in the Trunk or Chest 62 in the Arms and Hands and 60 in the Legs and Feet but the true Number cannot be exactly determin'd by reason that some Persons have more and others fewer for some have more Ossa Sesamoidea Teeth and Breast-Bones than others Again some have many indentings in the Lambdoidal Suture and others have none at all Can you rehearse the Number of the Bones of the Head There are Fifteen in the Skull and Forty six in the Face The Fifteen of the Skull are the Coronal for the fore-part of the Head the Occipital for the hinder-part the two Parietals for the upper-part and each side the two Temporals for the Temples the Os Sphenoides or Cuneiforme which closeth the Basis or bottom of the Skull the Os Ethmoides or Cribriforme situated at the Root of the Nose and the four little Bones of the Ear on each side viz. the Incus or Anvil the Stapes or Stirrup the Malleolus or Hammer and the Orbiculare or Orbicular Bone Of the Forty six of the Face Twenty seven are counted in the Upper-Jaw viz. the two Zygomatick or the two Bones of the Cheek-Knots the two Lachrymal in the great Corners of the Eyes toward the Nose the two Maxillar that receive the Upper-Teeth and which form part of the Palate of the Mouth and the Orbits of the Eyes the two Bones of the Nose the two Palate-Bones which are at its end and behind the Nostrils the last being single is the Vomer which makes the Division of the lower part of the Nostrils and there are generally Sixteen Upper-Teeth The Lower-Jaw contains Nineteen Bones viz. sixteen Teeth two Bones that receive them and the Os Hyoides which is single and fix'd at the Root of the Tongue How are the Teeth usually divided with respect to their Qualities Into Incisive or Cutters Canine or Dog-Teeth and Molar or Grinders There are eight Incisive and four Canine which have only one single Root as also twenty Molar every one whereof hath one two or three Roots Can you recite the Number of the Bones of the Trunk or Chest There are generally thirty and three in the Spine or Chine-Bone of the Back viz. seven Vertebra's in the Neck twelve in the Back five in the Legs five six and sometimes seven in the Os Sacrum three or four in the Coccyx and two Cartilages at its end There are twenty nine in the Breast viz. twenty four Ribs two Clavicles or Channel-Bones and commonly three Bones in the Sternum The Hip-Bones are likewise divided into three viz. Ilion Ischion and Os Pubis Do you know the Number of the Bones of the Arms There are thirty and one Bones in each Arm that is to say the Omoplata or Shoulder-Blade the Humerus or Shoulder-Bone the two Bones of the Elbow call'd Vlna and Radius eight little Bones in the Carpus or Wrist five in the Metacarpium or Back of the Hand and fourteen in the Fingers three to every one except the Thumb which hath only two Can you give us a List of the Bones of the Leg in their Order There are thirty Bones in each Leg viz. the Femur or great Thigh-Bone the Knee-Pan or Whirl-Bone on the top of the Knee the Tibia greater Focile or Shin-Bone and the Perone or Fibula or lesser Focile which are the two associated Bones of the Leg seven little Bones in the Tarsus five in the Metatarsus and fourteen in the Toes that is to say three to every one except the great Toe which hath only two Thus the Number of Bones of the Humane Skeleton amounts to two hundred and Fifty without reckoning the Sesamoides the Indentings of the Skull and some others which are not always to be found CHAP. VI. Of Myology or the Anatomy of the Muscles of a Humane Body WHAT is a Muscle It is the principal Organ or Instrument of Motion or it is a Portion of Flesh wherein there are Veins Arteries Nerves and Fibres and which is cover'd with a Membrane How many parts are there in a Muscle Three viz. the Head the Belly and the Tail The Head is that part thro' which the Nerve enters the Belly is the Body or Middle of the Muscle and the Tail is the Extremity where all the Fibres of the Muscle are terminated to make the Tendon or String which is fasten'd to the Part whereto it gives Motion Have all the Muscles their Fibres streight from the Head to the Tail No some have them streight others transverse and others oblique or circular according to the several Motions to which they are appropriated How many sorts of Muscles are there with respect to their Action There are two different kinds viz. the Antagonists and the Congenerate the former are those that produce opposite Motions as a Flexor and an Extensor a Depressor and a Levator The Congenerate are those that contribute to one and the same Action as when there are two Flexors or two Extensors and then one supplies the defect of the other whereas when one of the Antagonist Muscles is cut the other becomes useless and void of Action How is the Action of a Musole perform'd It is done
from the Throat to the Mouth of the Stomach The Stomach it self is situated immediately under the Diaphragm or Midriff between the Liver and the Spleen having two Orifices whereof the Left is properly call'd Stomachus or the Upper and the Right at its other Extremity Pylorus or the lower Orifice It s Figure resembleth that of a Bag-Pipe and the greater part of its Body lies toward the Left side It is compos'd of three Membranes viz. one Common which it receives from the Peritonaeum and two Proper the two uppermost being smooth and the innermost altogether wrinkled What is the Pancreas or Sweet-bread It is a Fat Body consisting of many Glandules wrapt up in the same Tunicle being situated under the Pylorus or lower Orifice of the Stomach It helps Digestion and hath divers other uses but its principal Office is to separate the serous Particles of the Blood to be convey'd afterward into the Gut Duodenum by a Canal or Passage nam'd the Pancreatick This Juice serves to cause the Chyle to ferment with the Choler in order to remove the grosser Particles from those that ought to enter into the Lacteal Vessels Into how many sorts are the Guts distinguish'd There are two sorts viz. the thin and the thick How many thin or small Guts are there Three that is to say the Duodenum the Jejunum and the Ileon How many thick Guts are there Three likewise viz. the Coecum the Colon and the Rectum Why are some of them call'd thin Guts and others thick Because the thin are smaller being appointed only to transport the Chyle out of the Stomach into the Reserver whereas the thick are more large and stronger serving to carry forth the gross Excrements out of the Belly Are the six Guts of an equal length No the Duodenum which is the first of the thin Guts is only twelve Fingers breadth long The Jejunum being the second so call'd because always empty is five Foot long The third is nam'd Ileon by reason of its great Turnings which oblige it to pass to the Os Ilion wherâ— it produceth a Rupture it extends it self almost twenty Foot in length The first of the thick Guts known by thâ— Name of Coecum is very short and properly only an Appendix or Bag of a Finger's length That which follows is the Colon being the largest of all and full of little Cells which are fill'd sometimes with Wind and other Matters that excite the Pains of the Colick It encompasseth the thin Guts in passing from the top to the bottom of the Belly by the means oâ—â— its great Circumvolutions and is from eight to nine Foot long The last is the Rectum oâ— streight Gut so nam'd because it goes directly to the Fundament It is no longer than ones Hand but it is fleshy and situated upon the Os Sacrum and the Coccyx or Rump-Bone What is the Peristaltick Motion of the Guts It is the successive Motion and Undulation whereby the Guts insensibly push forward from the top to the bottom the Matters contain'd in them and that Motion which on the contrary is perform'd from the bottom to the top is term'd the Antiperistaltick as it happens in the Iliack Passion or twisting of the Guts call'd Domine Miserere by reason of its intolerable Pain What is the Mesentery It is a kind of Membrane somewhat fleshy which is join'd to the Spine in the bottom and middle of the Belly and by its folding keeps all the Guts steady in their place it is all over beset with red white and Lymphatick Vessels that is to say those that carry the Blood Chyle and Lympha which serves to cause this last to run more freely and to ferment Three notable Glandules are also observ'd therein the greatest whereof lies in the middle and is nam'd Asellius's Pancreas the two other lesser are call'd Lumbar Glandules as being situated near the Left Kidney From each of these Glandules proceeds a small Branch and both are united together to make the great Lacteal Vein or Thoracick Canal This Tube conveys the Chyle along the Vertebra's of the Back to the Left Subclavian Vein from whence it passeth into the ascending Vena Cava and descends in the Right Ventricle of the Heart where it assumes the form of Blood froâ—â— whence it passeth to the Lungs thro' the Pulmonary Artery then it returns to the Hear thro' the Pulmonary Vein and goes forth agaiâ— thro' the Left Ventricle of the Heart between the Aorta or great Artery to be afterward distributed to all the Parts of the Body This iâ— the ordinary Passage for the Circulation of thâ— Chyle and the Sanguification of the Heart What is the Liver The Liver being the thickest of all the Boâ—â—els is plac'd in the Right Hypochondrium at thâ— distance only of a Fingers breadth from the Diaphragm its Figure much resembling that of 〈◊〉 thick piece of Beef It is Convex on the outside and Concave within its Substance is soâ— and tender its Colour and Consistence being likâ— coagulated Blood It is cleft at bottom and divided into two Lobes viz. one greater anâ— the other less Its Office is to purifie the Maâ— of Blood by Filtration and it is bound by two strong Ligaments the first whereof adheres 〈◊〉 the Diaphragm and the second to the Xiphoidâ— or Sword-like Cartilage Two great Veins takâ— their Rise from hence viz. the Vena Portae anâ— the Vena Cava which form innumerable Braâ—ches as it were Roots in the Body of thâ— Liver The Gall-Bladder is fasten'd to the hoâ—low part thereof and dischargeth its Choleâ— into the Gut Duodenum thro' the Vessels that beâ—â— the Name of Meatus Choledochi or Ductus Biâ—â—ares This Choler is not a meer Excremenâ— but on the contrary of singular Use in causinâ— the Fermentation of the Chyle and bringing to perfection What is the Spleen The Spleen is a Bowel resembling a Hart's Tongue in shape and situated in the Left Hypochondrium over-against the Liver Its length is about half a Foot and its breadth equal to that of three Fingers its Substance being soft as that of the Liver and its Colour like dark coagulated Blood It is fasten'd to the Peritonaeum Left Kidney Diaphragm and to the Caul on the inside as also to the Stomach by certain Veins call'd Vasa Brevia nevertheless these Ligatures do not hinder it from wandering here and there in the lower Belly where it often changeth its place and causeth many dreadful Symptoms by its irregular Motions It s Office is to Subtilize the Blood by cleansing and refining it What are the Reins The Reins or Kidneys are Parts of a Fleshy Consistence harder and more firm than that of the Liver and Spleen They are both situated in the sides of the Umbilical Region upon the Muscle Psoas between the two Tunicks of the Peritonoeum but the Right is lower than the Left Their Shape resembleth that of a French Bean and they receive Nerves from the Stomach whence Vomitings are frequently
Preparatives Of what Matter are these Swathing-Baâ—â— made They are made at present of Linnen-Cloâ—â— but in the time of Hippocrates were made Leather or Woollen-Stuff How many sorts of Swathing-Bands are there general There are two sorts viz. the Simple 〈◊〉 Compound the former are those that 〈◊〉 smooth having only two ends and the othâ—â— are those which are trimm'd with Wooll Câ—â—ton or Felt or that have many Heads that to say Ends fasten'd or cut in divers place according as different Occasions require What are the Conditions requisite in the Linnen-Cloth whereof the Swathing-Bands are maâ—â— It must be clean and half worn out noâ—â—ving any manner of Hem or List What are the Names of the different Swatâ— Bands There are innumerable but the greater paâ—â— them take their Denominations from their â—â—gure or Shape as the Long Streight Triâ—â—gular and those which have many Heads are trimm'd What is a Bandage It is the Application of a Swathing-Band to any Part. How many sorts of Bandages are there As many as there are different Parts to be bound some of them being Simple and others Compound The former are those that are made with an uniform Band as the Bandage call'd the Truss and divers other sorts The Compound are those that consist of many Bands set one upon another or sew'd together or else those that have many Heads They have also particular Names taken from the Inventers of them or from their Effect as Expulsive Bandages to drive back Attractive to draw forward Contentive to contain Retentive to restrain Divulsive to remove Agglutinative to rejoin c. There are others whereto certain peculiar Names are appropriated as Bridles for the lower Jaw Slings for the Chin the back part of the Head Shoulder and Perinaeum Scapularies for the Body after the manner of the Scapularies of Monks Trusses for Ruptures Stirrups for the Ankle-Bones of the Feet in letting Blood and upon other Occasions Lastly there are an infinite Number of Bandages the Structure whereof is learnt by Practice in observing the Methods of able Surgeons who invent them daily according to their several Manners and the first Ideals of these can only be taken in reading Authors that have treated of them What are the general Conditions to be observ'd in the Bandages There are many viz. 1. Care must be taken that the Bands be roll'd firm and thâ—â— they be not too streight nor too loose 2. They are to be untied from time to time in Fractures they must also be taken away every three oâ— four Days to be refitted 3. They must bâ—â— neatly and conveniently roll'd that the Patienâ— may not be uneasie or disquieted What ought to be observ'd in fitting the Basters Care must be taken to make them even soft and proportionable to the bigness of the Part affected to trimm them most in the uneven places that the Bands may be better roll'd over them and to keep them continually moisten'd with some Liquor proper for the Disease as well as the Bands In treating of every Disease in particular we shall shew the manner of making the particular Bandage that is convenient for it A TREATISE OF Chirurgical Diseases CHAP. I. Of Tumours in general Abcesses or Impostumes Breakin gs out Pustules and Tubercles WHAT is a Tumour A Tumour is a rising or bloated Swelling rais'd in some part of the Body by a Setling of Humours How is this setling of Humours produc'd Two several ways viz. by Fluxion and Congestion What is the Setling by Fluxion It is that which raiseth the Tumour all at once or in a very little space of time by the Fluidity of the Matter What is the Setling by Congestion It is that which produceth the Tumour by little and little and almost insensibly by reasâ—â— of the slow Progress and thickness of the Maâ—â— Which are the most dangerous Tumours thâ— that arise from Fluxion or those that derive thâ— Original from Congestion They that proceed from Congestion becauâ—â— their thick and gross Matter always renders 〈◊〉 obstinate and difficult to be cur'd Whence do the differences of Tumours proceed They are taken first from the Natural Humours Simple Mixt and Alter'd Simple the Phlegmon which is made of Blood and 〈◊〉 Erysipelas of Choler Mixt as the Erysipelas Phlegmon which consists of Blood mingl'd wâ—â— a Portion of Choler or the Phlegmonous Erysipelas which proceeds from Choler intermixt 〈◊〉 a Portion of Blood Alter'd as the Meliâ—â—â— which is compos'd of many Humours that 〈◊〉 not be any longer distinguish'd by reason of the too great Alteration Secondly the difference Tumours is taken from their likeness to some â—ther thing as the Carbuncle and the Talpa 〈◊〉 former resembling a burning Coal and the oâ—â—â—â— a Mole according to the Etymology of their 〈◊〉 tin Names Thirdly From the Parts when they are situated as the Ophthalmy in the Eâ—â—â— and the Quinsey in the Throat Fourthly from Disease that causeth 'em as Venereal and Pestilential Buboes Fifthly from certain Qualâ—â—â— found in some and not in others as the â—â—sted Tumours which have their Matter 〈◊〉 clos'd within their proper Cystes or Membraâ—â— and so of many others How many kinds of Tumours are there that comprehend at once all the particular Species They are four in Number viz. the Natural Tumours the Encysted the Critical and the Malignant What are natural Tumours They are those that are made of the four Humours contain'd in the Mass of the Blood or else of many at once intermixt together What are the four Humours contain'd in the Mass of the Blood They are Blood Choler Phlegm and Melancholy every one whereof produceth its particular Tumour Thus the Blood produces the Phlegmon Choler the Erysipelas Phlegm the Oedema and Melancholy the Scirrhus The Mixture of these is in like manner the Cause of the Erysipelatous Phlegmon the Oedomatous Phlegmon or Phlegmonous Erysipelas and the Phlegmonous Oedema according to the quality of the Humours which are predominant from whence the several Tumours take their Names What are the Encysted Tumours They are those the Matter whereof is contain'd in certain Cystes or Membranous Bags as the Meliceris and the Struma or Kings-Evil What are Critical Tumours They are those that appear all at once in acute Diseases and terminate them with good or bad Success What are Malignant Tumours They are those that are always accompany'd with extraordinary and dreadful Symptoms and whose Consequences are also very dangerous as the Carbuncle in the Plague What are Impostumes or Abcesses Breakin gs or and Pustules Indeed it may be affirm'd that all these kind of Tumours scarce differ one from another â—â—cept in their size or bigness nevertheless 〈◊〉 speak properly by the Names of Impostumes 〈◊〉 Abcesses are understood gross Tumours that 〈◊〉 suppurable or may be dissolv'd and by thâ—â— of Breakin gs out and Pustules only simple Pustâ—â— Wheals or small Tumours that appear in greâ—â— Numbers and which frequently do not coâ—â— to Suppuration some of them consisting
of â—â—ry few Humours and others altogether of dry Matter What difference is there between a Tumour 〈◊〉 an Impostume or Abcess They differ in this particular that all Tâ—â—mours are not Impostumes nor Abcesses 〈◊〉 there is no Impostume nor Abcess that is nâ—â— Tumour As for Example Wens and Gangâ—â—â— are Tumours yet are not Abcesses nor Imâ—â—stumes whereas these last are always Tumour in regard that they cause Bunches and Elevatioâ— CHAP. II. Of the general Method to be observ'd the curing of Tumours WHAT ought a Surgeon chiefly to observe Tumours before he undertake their Cuâ—â— He ought to know three things viz. 1. 〈◊〉 Nature or Quality of the Tumour 2. 〈◊〉 time of its formation And 3. It s situation The Quality of the Tumour is to be known because the Natural one is otherwise handl'd than that which is Encysted Critical or Malignant As for the time of its Formation it is four-fold viz. the Beginning Increase State and Declination wherein altogether different Remedies are to be apply'd The Situation of the Tumour must be also observ'd because the dressing and opening of it ought to be as exact as is possible to avoid the meeting with an Artery or neighbouring Tendon How many ways are all the Tumours that are curable terminated They are terminated after two manners viz. either by dissolving â—em or by Suppuration Are not the Scirrhus and the Eâ—thiomenus or Gangrene two means that â—â—â—etimes serve to terminate and cure Impostumes Yes but it is done imperfectly in regard that a Tumour or Impostume cannot be said to be absolutely cur'd as long as there remains any thing of the Original Malady as it happens in the Scirrhus where the Matter is harden'd by an imperfect dissolving of it or when the Impostume degenerates into a greater and more dangerous Distemper as it appears in the Esthiomenus or Gangrene that succeeds it Which is the most effectual means of curing Impostumes that of dissolving or that of bringing them to Suppuration That of dissolving 'em is without doubt the most successful and that which ought to be us'd as much as is possible nevertheless some Cases are to be excepted wherein the Tumours or Abcesses are Critical and Malignant for then the way of Suppuration is not only preferable but must also be procur'd by all sonâ— of means even by opening which may be done upon this occasion without waiting for their perfect Maturity What are the Precautions whereto a Surgeâ—â— ought to have regard before he undertake the opening of Tumours He must take care to avoid cutting the Fibres of the Muscles and in great Abcesses to cause all the corrupt Matter to be discharg'd at once to prevent the Patient's falling into a Swoon Ought the opening of Tumours always to be made longitudinally and according to the direct Course of the Fibres No it is sometimes necessary to open 'em with a Crucial Incision when they are large or when a Cystis or Membranous Vehicle is to be extirpated How many sorts of Matter are there that issâ—â— forth in the Suppuration of Tumours There are four sorts viz. the Pus Ichor Sanies and Virus What is Pus It is a thick Matter and white as Milk What is Ichor It is a thick Matter like the Pus but of divers Colours What is Sanies It is a watery Matter that riseth up in Ulcers almost after the same manner as the Sap in Trees What is Virus It is a kind of watry Matter being whitish yellowish and greenish at the same time which issueth out of Ulcers very much stinking and is endu'd with corrosive and malignant Qualities How many general Causes are there of Tumours There are three viz. the Primitive the Antecedent and the Conjunct The Primitive is that which gives occâ—sion to the Tumours as for Example a Fall or a Blow receiv'd The Antecedent is that which supplies it with Matter such is the Mass of Blood that thickens and maintains the Phlegmon Lastly the Conjunct Cause is the overflowing Blood or Matter which immediately forms the Tumor What regard ought to be had to these three sorts of Causes in the Cure The Primitives Cause may be prevented by avoiding the Falls Blows or other Hurts and the Antecedent by diminishing the Plethory of the Blood and cooling the whole Mass by Phlebotomy The Conjunct Cause which is the overflowing of the Blood may be also remov'd in dispersing it by dissolving or else in discharging it by Suppuration What is a Crisis It is a sudden setling of Humors which happens in Diseases whereby they are usually terminated How are these Critical Setlings effected By the Strength of Nature which either expels the peccant Humours thro' the Belly or carries them to the Habitude of the Body for in the former she causeth Fluxes of Humours Urine and Blood as in the other she excites Sweatings Tumours and even a Gangrene it self In what Parts do the Critical Tumours usually arise In the Glandules which the Ancients call'd the Emunctories of the Brain Heart and Liver for they gave the Name of Emunctories of the Brain to the thick Glandules which lie under the Ears that of the Emunctories of the Hean to those that are under the Arm-Pits and that of the Emunctories of the Liver to those under the Groin Now Malignant Tumours may arise in all these parts but the Venereal happen only in the Groin CHAP. III. Of Natural Tumours ARTICLE I. Of the Phlegmon and its Dependancies WHAT is a Phlegmon It is a red Tumour occasion'd by the Blood diffus'd in some part wherein it causeth extension pain and heat with beating Are Aneurisms and Varices which are Tumours made by the Blood to be reckon'd among the Phlegmons No because the Blood that forms the Aneruisms and Varices is not extravasated nor accompany'd with Inflammation but only a Tumour of Blood proceeding from the Dilatation of the Arteries and Veins May Echymoses or Contusions consisting of extravasated Blood be esteem'd as Phlegmons By no means in regard that it is not sufficient that the Blood be extravasated for the producing of a Phlegmon it must also cause Pain Heat and a Beating with Inflammation which is not to be found in the Echymoses except in great ones after they have been neglected for a long time where the corrupted Blood ought to be let out immediately to prevent the Inflammation overmuch Suppuration and many other ill Consequences Is the Phlegmon always compos'd of pure Blood No it may happen sometimes to partake of Choler Phlegm or Melancholy on which account it is nam'd an Erysipelatous Oedomatous or Scirrhous Phlegmon always retaining the Name of the predominant Humour which is the Blood and so of the others REMEDIES What are the Remedies proper for a Phlegmon They are of two sorts viz. General and Particular the former having regard to the antecedent cause and the other to the conjunct The Phlegmon is cur'd in its antecedent Cause by Phlebotomy or letting Blood by good Diet and sometimes by
Purgations by which means the Plethory Heat and Alteration of the Blood is diminished But Fomentations Cataplasms and Plaisters facilitate the Cure in the conjunct cause either by dissolving the Tumour or bringing it to Suppuration At what time is the Opening of a Vein necessary In the Beginning and Increase What are the Remedies proper to be us'd immediately upon the first appearing of the Tumour They are Resolvents and Anodynes such as those that are prepar'd with Chervil boil'd in Whey adding a little Saffron to wash the Tumour and soak the Linnen Cloaths apply'd thereto which are often renew'd and may be laid on with the Chervil Or else take the Urine of a healthful Person wherein is boil'd an Ounce of Saffron for a Glass and bath the Tumour with it The Sperm of Frogs is also made use of to very good purpose either alone or with Lime-Water and Soap mixt together or Oak-Leaves and Plantane beaten small and apply'd But Care must be more especially taken to avoid cooling Medicines Oils and Grease which are pernicious in great Inflammations What ought to be done in the increase of the Tumour and Pain They are to be asswag'd by mollifying and dissolving to which end a Cataplasm or Pultis is to be made with the Leaves of Elder Wall-wort or Dwarf-Elder Mallows Violet-Plants Camomile and Melilot whereto is added beaten Line-seed causing the whole Mass to be boil'd in Whey and allowing to every Pint or thereabout a Yolk of an Egg twenty Grains of Saffron a quarter of a Pound of Honey and the Crum of 〈◊〉 Bread till it comes to a necessary Consâ—â—ence Or else take Cow's Dung instead of the above-mention'd Herbs and mix with it all the other Ingredients to make a Cataplasm which must be renew'd at least every twelve Hours What is to be done in the State If the Tumour cannot be dissolv'd as was intended it must be brought to Suppuration by Cataplasms consisting of these Ingredients viz. Garlick White Lillies roasted under Embers Milk and Vnguentum Basilicon Or else only take a Glass of Milk in which an Ounce of Soap is dissolv'd to wet the Linnen apply'd to the Tumour and let it be often reiterated Otherwise make use of Sorrel boil'd with fresh Butter and a little Leaven or Yeast The Plaister Diasulphuris is also most excellent either alone or if you please mixt with Diachylon and Basilicon What is to be done in the Declination after the Suppuration The Ulcer must be at first gently dry'd with a Plaister of Diasulphuris or Diachylon and afterward that of Diapalma may be us'd and Ceruse or White Lead What Method is to be observ'd in case there be any Disposition toward a Gangrene It is requisite during the great Inflammation to make use of good Vinegar in an Ounce whereof is dissolv'd a Dram of White Vitriol with as much Sal Ammoniack to bath the Tumour Or else take the Tincture of Myrrh and Aloes with a little Vnguentum Aegyptiacum and afterward make a Digestive of Turpentine the Yolk of an Egg and Honey mingling it with a little Spirit of Wine or Brandy if there remains any Putrifaction or Rottenness Remedies for Aneurisms and Varices What is to be done in order to cure an Aneurism When it is little as that which happens after an Operation of Phlebotomy or letting Blood ill perform'd it may be sufficient to lay upon the affected Part a thin Plate of Lead or else a Piece of Money or Counter wrapt up in a Bolster and to bind it on very streight But a Piece of Paper chew'd is much better for that purpose If the Anuerism be considerable an Astringent Plaister may be us'd such as the following Take Bolus Dragon's Blood Frankincence Aloes and Hypocystis of each a Dram mingle the whole with two beaten Eggs and add Wax to give it the consistence of a Plaister which may be apply'd alone or mixt with an equal Portion of Emplastrum contra Rupturam always making a small Bandage to keep it on Emplastrum de Cicuta hath also a wonderful effect When the Aneurism is excessive it is absolutely necessary to proceed to a Manual Operation the manner whereof shall be shewn hereafter in the Treatise of great Operations What is requisite to be done in the Varices Varices are not generally dangerous but even conduce to the preservation of Health nevertheless if they become troublesome by reason of their greatness and the Pains that accompanie'em they may be mollify'd with the following Remedy Take the Mucilages of the Seeds of Psyllium and Line of each two Ounces of Populeon two Ounces Oleum Lumbricorum Hyperici of each one Ounce and of the Meal of Whear one Ounce adding Wax to make the Consistence of a Plaister part of which spread upon Linnen or Leather must be apply'd to the Varix and ty'd thereto with a small Band. If the Blood abound too much it may be discharg'd by the Application of Leeches or by a Puncture made with a Lancet Afterward lay upon the Part a Piece of Lead sow'd up in a Cloth and let it be kept close with a proper Bandage Otherwise you may make use of an Astringent such as this Take a Pomegranate cut it in pieces and boil it with as much Salt as may be taken up with the Tip of your Fingers in a Gallon of strong Vinegar then dip a Spunge in this Vinegar apply it to the Varix bind it on and continue the use of it twice a Day for a Month together Remedies for Echymoses Contusions or Bruises How are Echymoses to be treated All possible means must be us'd to dissolve 'em by laying Slices of Beef upon the Part renewing 'em very often or applying Linnen Rags dipt in Spirit of Wine impregnated with Saffron They may be also dissolv'd with the Roots of Briony grated and apply'd thereto or else with Plaister or Mortar Soot Oil of Olives and Vnguentum Divinum a Mixture whereof being made is to be put between two Rags and laid upon the Tumour or Swelling If the Echymosis happens in a Nervous Part Balsam of Peru may be us'd or for want thereof Oleum Lumbricorum Hyperici with luke-warm Wine with which the Bolsters must be soak'd to be laid upon it When the Echymosis is great and much Blood is diffus'd between the Skin and the Flesh the safest way is to make an Opening to let it out lest a too plentiful and dangerous Suppuration should ensue or even a Gangrene it self However a Surgeon ought to proceed in the curing of an Echymosis in the Face with great Circumspection which must be always prepar'd for Incision Of phlegmonous Tumors or Impostumes and of Remedies proper for ' em What are the Tumours or Impostumes that partake of a Phlegmon They are the Bubo Carbuncle Anthrax Furunculus Phyma Phygeton Panaritium or Parâ—nychia Burn Gangrene and Kibe or Chilblain What is a Bubo A Bubo is a Tumour which ariseth in the Groin being accompany'd with Heat
Cassia and as much Manna infus'd in two Glasses of Whey which are to be taken one or two Hours one after another Afterward the Patient must be often purg'd with twelve Grains of Scammony and fifteen Grains of Mercurius Dulcis and these Purgations must be continu'd till it appears that the Fluxes are neither yellowish nor greenish nor of any other bad Colour When they are become White and grown Thready they may be stopt with Astringents Amber and dry'd Bones beaten to Powder eighteen Grains of each with one Grain of Laudanum the whole Composition being taken in Conserve of Roses are very good for this Purpose Crocus Martis Astringens or else its Extract taken from half a Dram to a whole Dram in like manner performs the same Operation As soon as the Gonorrhaea is stopt to be certain of a perfect Cure a Dram of the Mercurial Panacaea is to be taken from fifteen to twenty Grains at a time in Conserve of Roses In the mean while if a small Salivation shou'd happen it must be let alone for the present since it may be stopt at pleasure by the Purgations When it is requisite to restrain the Gonorrhaea Mercury must not be given any longer in regard that it is a Dissolvent which is only good when the Glandules of the Groin or Testicles are swell'd or else when it is expedient to set the Chaudepisse a running after it hath been too suddenly stopt At the same time that the Astringents are taken with the Mouth Injections also are to be made into the Yard such as are prepar'd with Lapis Medicamentosus of which one Dram is put into eight Ounces of Plantane-Water All Astringents that are not Causticks are proper for the Syringe Of Shankers They are round Ulcers and hollow in the middle which appear upon the Glans and the Praeputium To cure 'em they must be touch'd with the Lapis Infernalis and brought to Suppuration by the means of red Precipitate mixt with the Ointment of Andreas Crucius Oleum Mercurii laid on a Pledget or Bolster is very efficacious to open Skankers and consume their Flesh The Patient must be well purg'd with Mercurius Dulcis and Scammony taking twelve or fifteen Grains of each in Conserve of Roses and after these Purgations are sufficiently reiterated he may take the Mercurial Panacaea's It is an excellent Remedy for all sorts of Pocky Distempers not yet consummated or arriv'd at the greatest height of Malignity Of Bubo ' s. Bubo's are gross Tumours or Abcesses that arise in the Groin the perfect Maturity of which is not to be waited for in order to open 'em because it is to be fear'd lest the corrupt Matter remaining therein too long might be convey'd into the Blood by the Circulation and so produce the grand Pox Therefore it is necessary to open 'em betimes with a Lancet or else with a Train of potential Cauteries if they are too hard They ought to be Suppurated for a considerable time The Patient must be well purg'd with Scammony and Mercurius Dulcis He must also take the Mercurial Panacaea's Of the Pox. This loathsome Disease begins sometimes with a virulent Gonorrhaea and a weariness or faintness at the same time seizeth on all the Members of the Body It is usually accompany'd with Salivation and the Head-ach which grows more violent at Night Pricking Pains are also felt in the Arms and Legs the Palate of the Mouth being sometimes ulcerated If it be an inveterate Pox the Bones are corrupted and Exostoses happen therein divers Spots with dry round and red Pustules appear in the Skin and the Cartilages or Gristles of the Nose are sometimes eaten up But when this Disease is come to its greatest height of Malignity the Hair falls off the Gums are ulcerated the Teeth are loose and drop out the whole Body is dry'd up the Eyes are livid the Ears tingle the Nose becomes stinking the Almonds of the Ears swell the Vvula or Palate is down Ulcers break out in the Privy-Parts Bubo's arise in the Groin as also Warts in the Glans and Praeputium and Condyloma's in the Anus Indeed the Pox may be easily cur'd in the beginning but when it hath taken deep Root by a long Continuance it is not extirpated without much difficulty more especially if it be accompany'd with Ulcers Caries and Exostoses the Person afflicted with it being of an ill Constitution and his Voice grown hoarse The Spring and Summer are the proper Seasons of the Year for undertaking the Cure of this Disease In order to which it is necessary that the Patient begin with a regular Diet lodging in a warm place and taking such Aliments as yield a good Juice as Jelly-broath made with boil'd Fowl Let him drink Sudorifick Decoctions prepar'd with the Wood of Guayacum China-Root and Sarsaparella and let him abstain from eating any thing that is high season'd Let him take Clysters to keep his Body open sometimes also he may be let Blood and purg'd with half a Dram of Jalap and fifteen Grains of Mercurius Dulcis The Purgations may be re-iterated as often as it shall be judg'd convenient and then the Patient may be bath'd for nine or ten Days every Morning and Evening during which time he may take volatile Salt of Vipers the Dose being from six to sixteen Grains or else Viper's-Grease from half a Dram to a whole Dram in Conserve of Roses Afterward it will be necessary to proceed to Fluxing which is caus'd by the means of Frictions with Vuguentum Mercurii which is made of crude Mercury stirr'd about in a Mortar with Turpentine and then the whole mingled with Hog's-Grease one part of Mercury being usually put into two parts of Hog's-Grease The Rubbing is begun at the Sole of the Feet ascending to the Legs and the inside of the Thighs but the Back-Bone must not be rubb'd at all When the Persons are tender or of a weak Constitution a single Friction may be sometimes sufficient Thus the Patient must be rubb'd at the Fire after he hath taken a good Mess of Broath but I would not advise it to be done with more than one or two Drams of Mercury at a time without reckoning the Grease Then the Patient must be dress'd with a Pair of Linnen-Drawers or Pantaloons and laid in his Bed where his Mouth may be lookt into from time to time to see whether the Mercury hath taken effect which may be easily known by reason that his Tongue Gums and Palate swell and grow thick his Head akes his Breath is strong his Face red and he can scarce swallow his Spittle or else he begins to Salivate If none of these Signs appear the Rubbing must be begun again in the Morning and Evening then if no Salivation be perceiv'd for sometimes four or five Frictions are made successively a little Mercurial Panacaea may be taken inwardly to promote it During the Frictions the Patient is to be nourish'd with Eggs Broaths and Gellies he must also
Knot at the end of the Thread to be stopt upon the Bolster Afterward he pierceth the Tendon from the outside to the inside at a good distance lest the Thread shou'd tear it and proceeds to pass the Needle in like manner under the other end of the Tendon upon which is laid a small Bolster for the Thread to be ty'd in a Knot over it Then he causeth the Extremities of the Tendons to lie a little one upon another by bending the Part and dresseth the Wound with some Balsam It may not be improper here to observe that Ointments are never to be apply'd to the Tendons which wou'd cause 'em to putrisie but altogether Spirituous Medicaments and that the Part must be bound up lest the Extension of it shou'd separate the Tendons CHAP. XX. Of the Caesarian Operation WHEN a Woman cannot be deliver'd by the ordinary means this bold and dangerous Operation hath been sometimes perform'd with good Success The Woman boing laid upon her Back the Surgeon makes a Longitudinal Incision beneath the Navel on the side of the White-Line till the Matrix appears which he openeth taking great care to avoid wounding the Child Then he divides the Membranes with which it is wrapt up separates the After-Burden from the Matrix and takes out the Child Lastly he washeth the Wound with warm Wine and dispatcheth the Gastroraphy or Stitching up of the Belly without sowing the Matrix After the Operation Injections are to be made into the Matrix to cause a Flux of Blood and a pierc'd Pessary must be introduc'd into its Neck CHAP. XXI Of the Operation of Amputation with its proper Dressings and Bandages THE Leg is usually cut off at the Ham the Thigh as near as can be to the Knee and the Arm as near as is possible to the Wrist But an Amputation is never made in a Joynt except in the Fingers and Toes In order to cut off a Leg the Patient is to be set on the side of his Bed or in a Chair and supported by divers Assistants one of 'em being employ'd to hold the Jâ—eg at the bottom and another to draw the Skin upward above the Knee to the end that the Flesh may cover the Bone again after the Operation In the mean while a very thick Bolster is laid under the Ham upon which are made two Ligatures viz. the first above the Knee to stop the Blood by screwing it up with the Tourniquet or Gripe-Stick and the second below the Knee â—o render the Flesh firm for the Knife Before the Ligature is drawn close with the Gripe-Stick a little piece of Paste-board is to be put underneath for fear of pinching the Skin Thus the Leg being well fixt the Surgeon placeth himself between both the Legs of the Patient to make the Incision with a crooked Knife turning it circularly to the Bone and laying one Hand upon the Back of the Knife which must have no Edge Afterward the Periosteum is to scrap'd with an Incision-Knife and the Flesh with the Vessels that lie between the two Bones are to be cut When the Flesh is thus separated a Cleft Band is to be laid upon it with which the Heads are cross'd to draw the Flesh upward to the intent that the Bones may be cut farther and that it may cover 'em after the Amputation as also to facilitate the Passage of the Saw Then the Surgeon holds the Leg with his Left-hand and saweth with his Right which he lets fall upon the two Bones to divide 'em asunder at the same time beginning with the Perone or Fibula and ending with the Tibia But it is necessary to incline the Saw and to go gently in the beginning to make way for it and afterward to work it faster The Leg being cut off the Ligature must be unty'd below the Knee loosening the Gripe-Stick to let the Blood run a little and to discern the Vessels with greater facility and then the Gripe-Stick may be twisted again to stop the Blood which some Surgeons effect by laying Pieces of Vitriol upon the Opening of the Arteries and Astringent Powders on a large Bolster of Cotton or Tow to be apply'd to the end of the Stump but if such a method be us'd it is requisite that some Person be employ'd to keep on the whole Dressing with his Hand during twenty four Hours However this Custom hath prevail'd in the Hospital of Hôtel-Dieu at Paris Others make a Ligature of the Vessels taking up the ends of 'em with a pair of Forceps having a Spring or with the Valet a Patin which is a sort of Princers that are clos'd with a small Ring let down to the bottom of the Branches These Pincers being held by a Servant the Surgeon passeth a Needle with wax'd Thread into the Flesh below the Vessel bringing it back again and with the two ends of the Thread makes a good Ligature upon the same Vessel then he looseth the Gripe-Stick and the Band the Stump is to be somewhat bended and the Flesh let down to cover the Bones The Dressing and Bandage After the Operation it is requisite to lay small Bolsters upon the Vessels and dry Pledgets upon the two Bones as also many other Folds of Linnen strew'd with Astringent Powders and over all another large Bolster or Pledget of Cotton or Tow cover'd in like manner with Astringent Powders then the whole Dressing is to be wrapt up with a Plaister and a Bolster in form of a Malta Cross so that there are three or four Longitudinal Bolsters and one Circular The Surgeon usually begins to apply the Milta Cross and Bolster under the Ham crossing the Heads or Ends upon the Stump and causeth 'em to be held by a Servant that Supports the Part then he likewise crosseth the other Heads and layeth on the two Longitudinal Bolsters that cross each other in the middle of the Stump together with a third Longitudinal which is brought round about the Stump to stay the two former These Bolsters ought to be three Fingers broad and very long to pass over the Stump Afterward he proceeds to apply The Bandage commonly call'd Capeline by French Surgeons or the Head-Bandage Which is prepar'd with a Band four Ells long and three Fingers broad roll'd up with one Ball three Circumvolutions being made on the side of the cut Part the Band is to be carry'd upward with Rollers passing obliquely above the Knee and is brought down again along its former Turns If it be thought fit to make this Bandage with the same Band it must be let down to the middle of the cut Part and carry'd up again to the Knee many back-folds being made which are stay'd with the Circumvolutions till the Stump be entirely cover'd and the whole Bandage wrapt up with Rollers or Bolsters The Capeline or Head-Bandage having two Heads is made with a Band of the same breadth but somewhat longer This Band being at first apply'd to the middle of the cut Part or Wound the