and if it be where there is a double Bone as in the Leg and below the Elbow the Flesh and Ligaments between them is to be divided which being performed let the Bone be separated with a very sharp Saw If the Flux of Blood be not great to apply only those Medicines that stop Blood will be sufficient but if great an actual Cautery is to be used which is only to be applied upon the great Vessels then let the Ligature be taken off and the Part be fitly bound up If either the Patient or Chirurgeon be averse to the use of a Cautery then as soon as the Member is taken off let the Skin together with the Flesh in four distinct places opposite one to the other be taken up with a Needle and waxed Thread and the Ligature being loosened above or drawn down that if possible they may meet So by this way is the Hemorage staid the Bone preserved from all danger and the Wound sooner cured But this way is painful and troublesom therefore ought it the seldomer to be used Aquapendens his way When the principal design of Art in this Operation is to put a stop to Putrefaction to cause as little pain as may be and to stay the Flux of Blood all which the above-quoted Author thinks may be done if the Member be amputated in the dead Part but near to the sound then the Bone being divided with burning-hot Irons let the remainder of the dead Part be cauterized till the Patient perceive the heat of the Fire So he writes that by this course a Flux of Blood is not to be feared less pain is caused and within the space of two or three days will appear a separation of the Mortified Part from the Sound but in my opinion we ought to consider well of the Cause For in a Spacelus sprung from an Internal Cause in a Body otherwise sound this way is the best but in a Spacelus caused from a defect of innate Heat the former is more profitable CHAP. XXV Of the Fleshy Rupture SArcocele which is a Fleshy Rupture is a Tumor besides Nature produced from impure Blood flowing in too great quantity itno the Testicles and there degenerated into Flesh In this Definition received by the best Physitians and Chirurgeons I note two things 1. The cause of this Tumor not to be impure Blood seeing the best may produce it not simply abounding in quantity because it also happens in wasted Bodies though 't is not so soon generated nor arrives to such a greatness in these as in those Bodies but the true cause is the Erosion Rupture or Dilatation of the Membranes which close the Mouths of the Capillary Vessels that the nutritious Blood may not flow too suddenly into the Part from whence more Blood flows into the Part than what is required for its nourishment and Nature changeth that Blood which otherwise would purifie into a fleshy Substance 2. This flesh sometimes grows to the second of the common Tunicles of the Scrotum and not to the Testicles in which case it may be taken aways without either hurting or cutting of them out Signs are the hardness and slow encrease of the Tumor which is rather more troublesome than painful except accompanied with sharp Humors no appearance of any Tumor in the Groin Prognosticks A Sarcocele is hardly cured by the help of Medicines and seldom by manual Operation without taking off the Testicle if it extends it self into the Groins for the most part incurable Cure In the beginning when the Membranes of the Vessels being eroded broke or dilated do give leave for too much leave to issue forth Bleeding and the use of Repelling and Restringent Medicines profit much but when it hath begun to augment then we may use these following means Let there be made a little Orifice into the Scrotum rather in its Superior then Inferior Part through which by the help of Plegets let Suppurating Medicines be applied so that if possible to waste the Flesh every dressing diligently wiping away the Matter but not at all that the remaining Flesh may be the better consumed If these things succeed not draw forth the Testicle and by Incision take off as much Flesh as may be done without injury to it then restore it again into its place and the remainder of the Flesh endeavor to consume by Suppuration But if there be no hope of curing this Rupture by the recited means draw forth the Hernious Testicle as far as you may then pass once or twice a Silken Thred above the Tumor by the Process of the Peritonaeum then pass both ends of the Silk through the Orifice it self so that which was on the right side may be on the left and that of the left on the right and having ordered that the process of the Peritonaeum may be tied with a knot then cut off the Testicle letting both the ends of the Silk hang out of the Scrotum and so cure it as another Wound I cannot here but friendly advise 1. The Chirurgeon ought to consider well of the Cause before he comes to the Operation it self for sometimes the Parastates are so swell'd especially the Testicles being Scirrhous that they may easily deceive a very curious Examiner 2. The Ligature ought to be made as near to the Tumor as possible for by how much the higher part of the Process of the Peritonaeum be perforated it is observed to be so much the thicker which thing will retard the Suppuration and the falling of the Thread in the mean time Convulsions coming on denounce death 3. The Spermatick Vessels detain'd in the Scrotum oftentimes by Natures variety exceed the Testicles themselves in greatness which causes no other inconvenience but only Fear which I have observed to be true in more than one CHAP. XXVI The Extraction of the Stone out of the Bladder THe Stone is a hard Body concreted from Slimy Salt or Earthy Matter by a peculiar Lapidifying quality causing Pain Obstruction and other Symptoms in the place where it is detained The Cause is a Pituitous Salt or Earthy Matter which neither by heat nor cold by a peculiar lapidifying quality is changed into a Stone Signs The Urine is white slimy crude and troubled suddenly adhering to the Urinal sometimes it is bloody sometimes sandy or gravelly sometimes full of little Threads and not seldom supprest a great thirst a frequent making of Urine but with pain and by drops The Patients place themselves with their Thighs across always holding their Privy-Parts in their hands pressing the bottom of their Belly the Privy-Part is always erected very painful to go or walk in the Region of the Belly a weight perceived the Patient seldom making Water without going to Stool the Intestine commonly falls out especially in young People Although all these Signs seem plain yet they may sometimes deceive a Phisician it was formerly the Custom with a Catheter passed through the Ureter into the Bladder then
of others if thou dilligently require of what parts the Fabrick of thy Body consists to this end first we will shew the simple parts and their use then after the division of the whole Body the compounded Parts The Chirurgical use Seeing 't is very necessary even at first sight that thou shouldst know the nature and temperaments of Men because they give the Rules of what is to be done in the curing of each Disease we have thought it convenient in the very beginning of this Treatise to describe their Signs The Sanguine abound with Hair but lank and yellowish in process of time declining into blackish handsom red cheek'd freshy strong When young addicted to Venery not enduring â—â—â—ours easily sweating phthisical affable in their Conversation and Discourse not suspicious equally prone to laughter and tears they sleep soundly their dreams are pleasant Pulse is great and strong Urine yellowish and in great quantity soluble They hate Women and except in their company seldom think of them They bear Bleeding provided it be at a fitting time and in a convenient quantity otherwise they easily fall into a Dropsie Strong Purges to wit Euphorbium Scammony Colloquintida and those that are compounded of them they cannot bear though gentle Medicines easily as Cream of Tartar Manna Tamarinds Pruines Syrup of Roses with Senna Syrup of Succory with Rhubarb Pulp of Cassia Electuaries of Diacatholicum Lenitive c. As they easily fall into a Disease so they quickly again recover The Cholerick have black Hair and for the most part curled lean but very strong Coition profitable they are judicious and swift in action avoiding idleness they trust neither the words or gestures of Men soon subject to Laughter if the thing require it otherwise grave When irritated addicted to strike more inclined to Drink and Watching than to Eating and Sleep their dreams are of Fire Thunder Quarrels Battels Pulse strong quick and great Urine high-coloured as also their Excrements Choler requires not Bleeding yet permits it if there be a quantity of Blood joined with it but it must neither be excessive nor oftner repeated than just necessity requires lest the Choler shews its Malignity gentle Purges relieve it but strong irritate it it produceth vehement and dangerous Diseases and for the most part short Phlegmatick have long Flaxen Hair which easily falls off and as easily grows again Pale-fac'd cold and weak Body long ere they desire Marriage and soon debilitated by it sloathful unfit for Conversation not sollicitous about publick Affairs difficulty brought to Laughter or Anger which then lasts not long They eat and drink little prone to sleep Dreams are of Fish of the Water and Rain Pulse small and slow Urine pale and sometimes thin but generally thick and darkish the Belly soluble they bear not Bleeding except upon necessity they endure strong Purging their Diseases are long but not dangerous The Melancholick are almost destitute of Hair which is lank and black of a grim Countenance the whole skin livid lean slow and addicted to Venery prudent morose in conversation readier to give counsel to others than to themselves not subject to Laughter or Anger but long before appeased they eat and sleep much Urine copious Excrements little grievous Dreams Pulse small slow and hard Bleeding is hurtful Purging profitable the Diseases which it begets are stubborn and tedious and oftentimes more dangerous in the end than in the beginning Let these general Signs suffice in this place But 't is to be observed that the Temperaments are mixt and then the Signs are also Yea many Mutations Vices and Dissimulations as also Virtues and Ingenuity may be attributed to them which is your part judiciously to distinguish but we assent not to Galen who held that the dispositions of the Mind relie upon the Temperaments CHAP. II. Of the Parts in general· A Part properly so call'd is a firm limited Body which is nourished by other living Parts but doth not nourish having a peculiar use and operation for the advantage of the whole It is distinguished 1. Into the Principal Parts or or those not so Principal are those that perform some Noble Operation common to the whole Body as the Heart Liver Brain Testicles Those not so are those that serve the Principal and whence they are call'd their Servants as the Eye Ear Hands c. This distinction pleased some Anatomists many years since whom I much esteem yet not me For if the Liver and Heart are numbred amongst the Principal Parts because they elaborate the Blood for the advantage of the whole Body why is not the Tongue accounted a Principal Part also which is not only an Instrument of Speech by which we are distinguished from Beasts but also of Tastes by whose assistance we chuse those Aliments which are best which if wanting how the Heart and Liver could supply the Body with good Nutriment I see not The Brain governs all but how I beseech you If the Intestines did not perform their Orifice aright what would it effect How should we be esteem'd if like an Oister we should want Eyes and Ears How despised are the Feet and Hands yet in how many conditions do they serve For those not stirring both Chilification would be impaired and the Blood and the Spirits rendred thicker and the Brain made unfit for all actions In how short a time would the Limpha of our Body be corrupted if besides its own motion it was not also moved with the whole Body All things in our Body are joyned together as in a Clock one cannot be without the other neither is the most despicable Wheel less necessary than the Hand of the Clock itself without which it cannot be accounted a Clock 2. Into similar Parts and dissimilar A similar which divided into many parts yet whose single parts be of the same Nature with the whole Dissimilar are made up of more or less similars as the Hand Fingers Feet There are ten Similars found in the Body a Bone Cartilage Ligament Membrane Fibre Nerve Vein Artery Flesh Skin the eight former are made of Seed Flesh of Blood alone the Skin of both This Division is subject to greater difficulties than the former but seeing it is not convenient to reject it without the greatest confusion in the practice of Physick let us consider the thing it self committing the Disputes concerning the Name to the Schools Chirurgical Considerations 1. A Principal Part being affected or wounded renders the whole Cure dangerous therefore Prognosticks are not to be given here but with limitation lest the sudden alteration be rather ascribed to thee than to the Disease 2. Wounds of the similar Parts are less dangerous than of the dissimilar yea oftentimes they are sooner cured by simple Medicines than by compound the consent of the Parts by reason of the Vital and Animal Spirits is so great that scarce a Joint of the Finger being hurt can be cured without regard had to the whole Body In deed by the
it remains for some time in the same condition 3. When it relaxeth so that it is restored into its former seat and quiet by its Antagonist The Glandulous flesh is white thick and spungy formed of seed from whence it cannot properly be call'd flesh to this purpose ordained 1. To prop up the Vessels 2. To receive the superfluous Humidities whence they are called the Emuâ—ctories of the noble Parts Some Anatomists make strange diversities of them but it will appear to any one that diligently enquires into all the Glandules that they differ not so much in substance as in their Use and Humor The Viscerous flesh or the Parenchemick is red hard convenient to prop the Vessels and to serve for many particular and various operations this is the flesh of the Lungs Heart Liver Spleen which shall be treated of in their places Chirurgical Considerations The Muscles are subject to many Diseases very many of which are of so little consequence that they shall not be numbred here some we have declared in another place the following require consideration oftentimes wonderfully exercising the patience and diligence of the Chirurgeon 1. An Atrophy of the whole Body oftentimes comes from an Internal Cause But if of the Finger Hand Arm Foot for the most part from an External Cause Thus a Fracture Luxation Contusion Tumor too hard Ligature and the like so vehemently compressing the Veins and Arteries that it hinders the free passage of the Blood to the Parts upon which happens an Emacitation for where the Vessels are wholly divided or stopt so that the least quantity of Blood cannot be carried to the Parts there follows not a Wasting of the Part but a Mortification in this Case the External Causes must be removed And care is to be taken that the Blood may again be carried to the Part Here chafing the Part and the use of Nettles as many will is good the Chymists commend much Alumen Plumosum all hot Oyls likewise are here good and this Oyntment is of excellent vertue Take fresh tops of Savin Juniper Lovage of each two handfuls Camomile Flowers Juniper-berries of each two handfuls Oyl of Bayes White-Lillies of each twelve ounces Hogs-grease three ounces Dogs-grease an ounce and half Aqua vitae two ounces Boil them to the consumption of the moisture then add to the express'd Liquor Oyl of Spike three drams Juniper a dram Mustard-seed in Powder half a an ounce Roots of Pellitory of Spain Long-Pepper powdred of each two draws Yellow wax as much as is sufficient to make it into an Ointment Or Take Pulvis Amianti three drams Roots of Pellitory of Spain a dram and half Castor Euphorbium Oyl of Earth of each two drams Gum Ammoniacum an ounce and half Laudanum and Wax as much as sufficeth to make it into a Plaister 2. The true reason of the generation of Wens in my opinion is this the mouths of the Arteries appointed to carry nourishment to the Muscles sometimes are more opened than they ought to be whether it be by Fall or Blow or from an internal Cause especially in Plethorick People and in Parts disorderly moved the native heat converts the extravasated Blood into Flesh But seeing the Member requires not so great a quantity of nourishment it increaseth into a preternatural Swelling and if this Blood be impure Choler produceth Pain Phlegm Viscousness Melancholy a Cartilaginous hardness and 't is to be attributed to these Humors that this preternatural flesh is more yellow white or livid 'T is seldom included in a proper Tunicle except where Phlegm is its greatest Cause and then those Tumors are generally in the Neck The Veins grow big according to the increase of the Tumor so that under the Skin they appear as thick as ones Thumb 'T is not in it self malignant yet by ill applications may be easily made so Air is very hurtful if the Tumor be exposed to it For the most part the best Remedies are here used to little purpose on the contrary the Tumor more and more increasing You cannot promise any Cure except you take it away by a Thred Knife or both In the beginning the Medicines that are to be applied ought to be very astringent and repelling the Part is gently to be rouled having applied to it either a Plate of Lead or a Diachalcitheos Plaister or of Frogs with Mercury or the following Take Pomegranate-rinds Bistort-roots of each one dram Scales of Iron Quick-silver Burnt-Lead of each two drams Bole-armenick Lapis Haematitis of each a dram and half Turpentine Wax as much as is sufficient to make it into a Plaister according to Art In the mean time Purging Bleeding Scarification and the Application of Leeches are not to be neglected Sweating also Watchings and Abstinence profit very much But if the Tumor yields not to these Remedies but daily increaseth Suppuratives are to be applied but if these within few days effect nothing and the Tumor continuing in the same state an actual Cautery may be used which let not the contrary Opinions either of Chirurgeons or standers-by hinder for by its use the increase of the Tumor will be stayed for a long time yea sometimes the Disease will be wholly eradicated But if the Flesh begins to repullulate again beyond expectation the Surgeon ought not to defer to endeavour either by a Thred or Knife its extirpation the Thred being small and strong must be twice wound about the neck of the Tumor and tied with a double knot which must be straightned the same day and so every day until the Tumor be deprived of its colour sense and life which is within seven or eight days then 't is to be taken off with a crooked Knife which is very easie to perform seeing neither any great pain or flux of Blood is to be feared If the Thred be wet in Mercurial or Arsenick-water it hastens the mortification of this Tumor But in this Operation a Phlegmatick Body is required for in other Bodies pain and inflamation do so much afflict the Patient that 't is seldom that the Thred in a short time should take them off yet the Chirurgeon may to lessen the Symptoms and to cool anoint with a Feather the part which the Thred toucheth with white camphorated Ointment of Roses or the like continually putting the Patients in mind how that others bear it more quietly But if you design to use a Knife only the whole Tumor must be endeavoured to be taken away except you will consume the remaining by Medicines which is very rarely effected besides the Chirurgeon must have a Care that he divides not the greater Vessels lest there follows a Flux of Blood not to be stopped 3. The Viscerous Flesh belongs rather to the Physicians care than the Chirurgeons 4. Of the Glandulous Flesh we have treated particularly in several places In general 't is to be noted 1. That the Glandules are of a cold temperament therefore require hot Medicines but very ill suffers cold 2.
when we spoke concerning a Phlegmon Erysipelas Oedema Schirrhus Then Care is to be had of the Blood seeing it affords assistance to the matter and serves to unite the Wound Where it is vitiated it requires purging But if it flow in too great quantity Intercipients Repellents Revellents and Derivation must be us'd If it flow in too small quantity Aliments that nourish are convenient as also Medicines that strengthen and that move Sweat Outwardly gentle Frictions and Embrocations moderately hot Then the Cure is to be perfected by External Medicines which shall be declared in the following Chapter when we speak of the removal of the Symptoms and the Cure of Wounds themselves CHAP. IV. Of the Symptoms of Wounds THe chief Symptoms of Wounds are 1. A Fever whose Cure we commend to the Physitian ' 2. A Flegmon or Inflamation 3. An Erysipelas Of the Cure of both which look in the second and third Chapter of the first Book 4. Hemorage which not only impedes the Cure but also deprives of strength and life it self therefore great Care is to be taken that it be stopped as soon as possible which in the greater Vessels especially the Arteries is very hard to do therefore those Wounds are for the most part Mortal For Medicines that stop Blood are too weak and hard Ligatures occasion a Gangrene the surest way therefore in my opinion is an actual Cautery the lesser Vessels may and will close Some close the Wound of the Vessels with their Fingers and so hold them there while the Blood is coagulated and the Flux stopt but this Operation seldom succeeds besides the long holding of the Finger in the Wound is hurtful Therefore let the Wound together with the Vessels be forthwith clos'd by the Fingers but if you cannot come to do this outwardly make a compress upon the Vessel which done wipe away the Blood with a Spunge then sprinkle some restringent Powder but not over the whole Wound which is used to be done by the ignorant but only upon the Vessels then bind up the Wound continuing the use of the Medicines stopping Bleeding while there appears no longer any Blood not neglecting in the mean time Generals viz. Scarification and Bleeding c. Medicines that stop a Flux of Blood Roots of Bistort Cinquefoil Tormentil Comfrey the greater Red Saunders Lignum Leutisci Pomegranate-rinds Mastick Talk Acacia Dragons-Blood Amber Sarcocols Frankincense the hairs of a Hare Os sepiae burnt-Crabs Whites of Eggs Mummy Cobwebs red Coral Chalk Bloodstone Bole-Armenick Aloes succotrine Frogs dried and powdered crude Vitriol burnt Vitriol Take fine Meal three ounces Dragons-Blood Frankincense of each an ounce and half Bole Sealed Earth of each two drams Talk six drams dried Frogs an ounce Hares hair cut very small a dram and a half Whites of Eggs dried in the Sun and powdered half an ounce New Spunges torrified an ounce white Vitriol a dram Mix them and make them into a fine Powder 5. Pain which must of necessity be eased because it creates watchings and dejects the Spirits and is cause of the Flux of Humors to the Party affected and of Inflamation Fever and Gangrene but the Causes are diligently to be considered For if either Medicines that are sharp or too hot occasion it they are presently to be altered 'T is better to confess the Error than pertinaciously to persevere in it If any foreign Body remains in the Wound it must be drawn forth If pain comes from the choaking in of the Matter you must allow it a free passage If an Inflamation be the cause of it its Remedies are set down in the second Chapter of the first Book You must apply to the Wound those things which ease pain and are anodine as Oyl of Roses Linseed Camomile Worms sweet Almonds Poppies c. Take Oyl of Roses of Poppy-seeds of Camomile of each an ounce the White of an Egg Saffron a scruple Mix them But if the pain cease not with these or the like Medicines it is a sign that some Nerve is wounded or affected by consent The Cure shall be set down in the following 6. Convulsion or Spasm this shews the Malignity of the Humor or the ill constitution of the Nerves neither of them promising any good Here must be used both Internal and External Medicines appropriated to the Disease the Internal by reason of the diversity of causes we commend to the Physitian External Medicines for a Convulsion Balsam of Peru the fat of Geese Castor Foxes Rams Mans Horse-dung Oyls of Juniper Lavender Ol. Philosophorum Amber Turpentine Rue Marjoram Worms Castor Orise Bays Petraeleum Ointments of Agrippa Martiatum Ung. Nervorum Spirit of Wine Take Oyl of Snails Worms Sesamin of each an ounce of the Grease of Rams and Foxes of each half an ounce fresh Butter six drams Spirit of Wine three ounces Let them boil till the Spirit be consumed then add Oyl of Spike distilled Rosemary Amber of each two drams Mix it into an Ointment Against a Convulsion there cannot a better Remedy be invented than distill'd Oyl of Lavender some few drops being given in some convenient Liquor and anointing well the convulsed part 7. Hypersarcosis or too great increase of flesh which if it happens from abundance of Blood the flesh is solid and otherwise well conditioned but if from the too weak quality of drying Medicines it is spungy of the same nature as when the Bone underneath is rotten In the former Case Bleeding is convenient and sometimes fasting and the use of strong drying Medicines In the latter the Medicines must be very strongly drying that are applied Detersive and Corroding Remedies are here good Medicines against too great increase of Flesh Burnt-Spunges Burnt-Allom Galls Aloes the Bark of Frankincense Tutty Verdigrease burnt Vitriol Praecipitate Arsenick A Green Corrosive Water Take crude Allom Verdigrease of each two drams boil them in eighteen ounces of white-Wine to a wasting of the fourth part strain them and add Camphire a dram Mix them A Powder very drying and somewhat corroding Take Galls Balaustions burnt-Allom Frankincense Myrrhe of each a dram Dragons-Blood Ceruse Verdigrease of each half a dram Make it into a Powder 8. A Gangrene and Sphacelus concerning which look in the fourteenth Chapter of the first Book of the second Part of Chirurgery CHAP. V. Of the drawing forth Extraneous Bodies out of the Wound NO Wound ought to be joined together as long as any Extraneous Body remains in it for otherwise after some little time it will break out into an Ulcer The Blood by which Nature unites the divided Parts if it flow in great quantity to the wounded Part and there coagulates 't is to be removed by Expression sucking it out or by any other way for so there will be less Matter generated and the Symptoms fewer but where an Haemorage is feared all the Blood is not to be cleansed away Where Hairs are about the Wound they are to be removed If Sand or any such like thing remain
Praeparata or Vena puppis may be cut sometimes the Temporal or Saphena In an Inflamation of the Eyes the Cephalica and if you desire to evacuate from the whole Body the Basilica or Mediana In a Quinsie the Ranina which must be but with a little Incision seeing we cannot scarce by any means stop the Flux of Blood and sometimes also the External Jugular In a Pleurisie the Basilica of the affected not opposite side here is requisite the greatest Circumspection for under it lies the Tendons of the Muscle Biceps and near it the Artery In anger fear or any Casualty c. the Mediana or Basilica In Chronick Diseases and quartane Fevers the Salvatella especially in the Full and New Moon In Women that lie in and in suppression of the Menses the Saphena In the Sciatica the Ischiatica CHAP. IX Of Arteries AN Artery is a Similar Spermatick Membranous round cavous Part joined every where to the Veins by the assistance of its Oscultations containing the Nutritious Blood with the Vital Spirit carrying it to all the Parts of the Body Difference is two-fold the great Artery or Aorta and Pulmoniack The great Artery comes from the left Ventricle of the Heart which except in the Brain and other softer parts every where else consists of a double Coat the outermost of which is of the thickness of the Veins but the inmost is five times thicker lest by continual pulsation about the hard and solid Parts it might incur an incurable Rupture It receives three Valves call'd Sigmoides looking outwardly Coming out of the Ventricle of the Heart with a great Orifice before it perforates the Pericardium it affords to the Heart it self the Coronary Artery when past the Pericardium it is divided into the Ascending and Descending Trunk The Ascending Trunk which is the lesser resting upon the Wind-pipe is separated into the two Subclavials from which being yet within the Breast proceeds 1. Intercostalis superior proper to the four upper Ribs 2. Mammaria to the Breasts 3. Cervicalis to the Muscles of the Neck 4. Carotis externa interna proper to the Larinx Tongue Neck Head and Brain When they have left the Thorax they are called Axillares and carry Nourishment to the outward part of the Breast 1 2. By the Thoracica superior inferior 3. By the Scapularis 4. By the Humeraria Then they approach the Arm where they accompany the Branches of Vena Cava and are call'd by the same name as they are The Descending Trunk which is the greater being yet within the Breast sends 1. The Intercostalis superior to the eight lower Ribs 2. The Phrenica to the Diaphragm and Pericardium Then having perforated the Diaphragm it communicates 1. The Coeliaca to the Stomach from which proceeds the Splenica and Gastro Epiploica dextra 2 3. Mesenterica superior inferior to the Mesentery 4. Emulgens to the Kidneys 5. Spermatica to the Testicles 6. Lumbaris to the Loins 7. Muscula superior to the Muscles of the Abdomen Then at length it is divided into the two Iliac Branches About this Division exhibiting 1. Muscula superior 2. Epigastrica 3. Hypogastrica 4. Umbilicalis 5. Pudenda Out of the Abdomen they change their names and are call'd Crurales and so they descend into the Feet and all along accompanied with the Veins from whom they borrow their Names Use is to carry the nutritious Blood with the Vital Spirit into all parts Arteria Pulmonalis which the Ancients did falsly call Vena Arteriosa seeing it hath Pulsation is made up of a double Coat and contains the Nutrious Blood issuing out of the left Ventriticle of the Heart with a double Branch enters the Lungs and is distributed through them by many little Branches carrying to them the Nutritious Blood And then what in the Blood is not sufficiently concocted into the Pulmoniack Vein by whose means 't is returned into the left Ventricle of the Heart It hath three Valves called Sigmoides which look outward lest the Blood that having entred it should slide back again into the Ventricle of the Heart It s Use is to convey the Blood out of the right Ventricle of the Heart into the Lungs by which they are nourished and what remains above then serves for their Nutriment is brought back again by the Pulmoniack Vein into the left Ventricle of the Heart Here it pleaseth the curious Observers of Anatomy to take notice of besides the eleven Valves which we have declared to be disposed in the four already named Vessels that many others are found in the Heart which as yet want any certain name Chirurgical Consideration In an Haemorrage of the Nose the Blood flows from the Arteries not Veins which not only the colour of the Blood witnesseth but also the great weakness which always follows such a Flux I use to stay it after this manner First let a Vein be opened then let there be applied in Men to the Testicles in Women to the Hypogastrium a Linnen Cloth four double wet in cold water or let the Face of the Patient be suddenly sprinkled with cold Water Internally let there be exhibited now and then a spoonful of the following Mixture Take Plantain-water two ounces and an half Alexipharmick-water half an ounce Cinamon-water three drams Confection of Hyacinth half a dram Dragons Blood Lapis Haematitis of each fifteen grains Julep of Roses an ounce Laudanum Opiat two grains Spirit of Vitriol six drops Mix them The following Water is also commended Take Lapis Prunella half an ounce Plantain-water six ounces let it be divided into three Doses The manner of opening Arteâ—ies delivered by the Ancients is so dangerous and frightful as that there is none of the Moderns but what dislike it yea Arteriotomy hath been wholly rejected had not the Diligence of their Posterity found out other ways That which I with others have found always to be the best of them I will here set down Chirurgeons were wont to tie a Bandage about the Neck but seeing when it is hard bound it is very troublesome it is better that the Ligature be made under the Arm-pits which must be so straight that the Jugular Veins and Carotide Artery may appear both by swelling and touch then let the Arteries be compressed by the Thumb a little below where you intend to make the Incision and being opened which must be done by a steddy and strong hand take forth as much Blood as is sufficient which done strew Astringent Powder upon the Wound then put over it a double Linnen Cloth with a Plate of Lead then bind it up with a convenient Bandage and within five or six days space it will be perfectly well In the Head-ach Madness Epilepsie great Inflamations of the Eyes or Ears the Arteries of the Forehead Temples or those behind the Ears are opened as also the Arteria puppis all of them being branches of the external Carotide In the Inflammations of the Liver and Diaphragm the Artery between the
through the Belly The Venae Lacteae consist of one very thin Tunicle but are endowed with several Valves extended from the Liver towards the Glandules they are distributed through all the Mesentery and so are carried for the most part to the small Guts especially the Jejunum but yet the great Guts are not altogether destitute of them that none of the Nutriment may be lost From the Intestine both these Vessels and the Chile contain'd in them go to the three Glandules of the Chile the greatest of which is in the middle of the Mesentery called by Asellius Pancreas the two lesser are call'd the Lumbar Glandules situate near the left Kidney Each of these Glandules send forth a Branch which joining above the left Kidney constitutes a Vessel called Vena Lactea about the bigness of a great quill This great Lactean Vein lying between the Arteria aorta and the Vertebra's of the Loins cover'd with Fat runs upwards and above the Heart ascends by the Gullet and so hastens to the left Subclavial Vein where it ends in one two or three branches here a most thin valve occurs at the very end of the Vein looking inwardly that the Chyle might not return back again or run further into the Arm out of this Subclavial they descend by the ascending Trunk of Vena Cava into the right Ventricle of the Heart that there by the help of the heat and natural quality it may be changed into Blood Being converted into Blood it passeth by the Pulmoniack Artery to the Lungs which are by part of it nourished and the rest of it goes through the Pulmoniack Vein to the left Ventricle of the Heart that it may be more perfectly elaborated thence by the great Artery is carried to all the parts of the Body communicating to them nourishment for the preservation of Life These ways of Conveyance is displeasing to some who would rather retain that by the Mesaraick veins known and so greatly cried up by the Ancients than admit of a new Truth therefore they say that the Chile together with the Blood may by this way be most conveniently carryed to the Liver seeing that the Venal Blood is carried not from the Liver to the Guts which was the false Opinion of the Ancients but from the Guts to the Liver and so not here to be allowed a contrary motion of each Liquor already sufficiently known But in truth these Opinions they defend rather by a probable Ratiocination out of their old affection to the Liver than that they can make it out by natural or demonstrative Arguments or answer these Queries following 1. What is the use of the Lacteal Veins 2. Why is their rise in the Guts 3. Why the Valves are so placed that they may hinder the regress of the Chile into the Guts 4. Why do they all go together with the Chile to the Glandule of the Chile and none of them to the Liver 5. Why are the great Lacteal Veins joyned together 6. For what end doth the Chile pass into the Subclavial Veins All which can be made appear in the Body to the sight That part of the Blood which is not altogether useless yet not fit for Nutrition passeth out of the Arteries ever joyned together by Inosculations with the Veins into the Vena Cava and Porta and so by their means is brought again into the Liver and Heart that it may be amended and again concocted I do not only say that the Blood is carried by the Vena Cava into the Heart but also by the Vena Porta into the Liver which I prove by these Reasons 1. The Liver is the biggest of all the Viscera not that I would infer its pre-eminence from its greatness see Chap. 2. but I suppose Nature would never have created so great a Body but for the performing of some extraordinary operation 2. It s greatest Vein coming out with a large Orifice forthwith goes to and enters the Heart What necessity is there for the Vena Cava to be distributed with such numerous Branches through the Liver and so presently to ascend into the Heart for indeed it ought to convey back the Blood not amended It s Trunk likewise and that of the Arteria Aorta might ascend directly up the Body to the Heart without concerning it self with the Liver especially when the Vena Porta near the Liver may also yield sufficient ways for freeing all the Blood from Choler It ought to receive the Blood concocted in the Liver and convey the same to the Heart 3. It s colour is red I well know that it is sometimes observed to be white pallid yellow green but this colour is to be ascribed to the Disease not to its natural Constitution for in all Bodies perfectly sound it is found red What wonder is it that the Liver being red in weakness should contract a whiteness doth not a red face grow pale when the Body is affected with sickness How easily likewise that the Liver separating the Choler should be died with a yellow or green colour 'T is also observed in the first xx or xxx days after conception it is naturally white neither becomes red before the maternal Blood concerning which some of the Moderns have far otherwise ascribed comes to the nourishment of the already formed parts which is the same in all Spermatick parts even in the Heart it self But will you conclude from hence that this red colour only happens to the Liver and is not more proper to it than it is to the Muscles which yet therefore do not make Blood To this I answer that the affluent Blood is so necessary here and so appropriated to the Liver that without it it cannot be called a perfect Liver but both the colour substance and number of Vessels are so difierent in a Muscle and in the Liver that in no wise the parts deserve to be said to be like one another and what absurdity is it to say that a Muscle sanguifies when even the Heart it self by the principal Anatomists and Philosophers is acknowledged a Muscle 4. The Maternal Blood comes first up the Umbilical Vein to the Liver ere it goes to the Heart of the Infant And the Valves and Ligatures evidently demonstrate that the Arterial Blood is carried by the Umbilick Arteries from the Child to the Womb but the Venal by the Umbilick Vein from the Womb to the Child but whether the Infant is nourished by the Maternal Blood or by an External Humor like as a Chicken in the Egg is to me all one when 't is evident the Blood which either coming from the Mother or Infant passeth first to the Liver before it enters the Heart 5. The Choler is separated from the Blood in the Liver for every one knows that there can no separation be made without there be first a Concoction From all these Arguments I cannot gather any thing but that the returning Blood is carried by the Vena Porta to the Liver that it may there
less danger than the next foregoing and people oftner recover upon it yea Learned Writers assure us that by this Operation and the use of Injection they have cured many of Ulcers of the Lungs Concerning the Place of Opening Authors are not agreed in it the reason whereof is obvious For the Diaphragma runs higher in some persons than in others whence it comes to pass that the collected Humors in some Patients lie higher than in others Secondly the Chest is raised in some flat in others which here much alters the case Besides the Lungs do often grow so fast to the Pleura that the sanious matter cannot easily be carried into the Cavity of the Breast In which case it would be ill done to chose the place of Opening lowest in respect of the Diaphragma And in regard that in this as in other swellings the most eminent place is esteemed the most convenient for opening it cannot be otherwise but that one Chirurgeon hath made choice of this place and another useth that place as the best Upon which account Hyppocrates Guido Amatus Lusitanus c. do make the apertion between the third and fourth Rib counting from beneath upwards Fienus Riverius and many others between the fourth and fifth Paulus Aegineta Vidus Vidius Fabritius ab Aquapendente Sennertus c. between the fifth and sixth which place in my opinion is the safest for if higher the Pericardium if lower the Diaphragma may be wounded of which there have been many sad Examples But in this difference of dissenting Writers what hath been said will direct you to pass into the safest Haven All things therefore well considered chuse the place where to make your Apertion not the forepart for before the Sternum or Breast-bone will hinder your operation here nor in the back-part for the Ribs are so close to one another that without hurting some Vessels you cannot make any Apertion there but on the side four or five inches from the Sternum Neither ought the Incision to be so near to the upper Ribs as to the lower because the intercostal Vessels viz. the Vein Artery and Nerve lie in the lower part of each Rib where Nature hath assigned them a place branching themselves into the middle of the intercostal Muscles which dissemination nevertheless hinders not but that the Incision may be made in the middle between the two Ribs After you have marked the place with Ink charge the Patient to breath forth as long as possibly he can without taking it in and in the mean time make an oblique but small Orifice and put into it a Silver or Leaden Pipe and take forth four or five ounces of Matter to run out in a day In case the Matter does not come forth well place your Patient on the wounded side and make him to cough if by reason of its toughness it will not yet come forth then inject into the cavity some abstersive exsiccating and healing Medicines As Take Goats whey eighteen ounces Honey of Roses four ounces the Juice of Celandine and Smallage of each six drams Mingle it Or Take the Roots of Comfrey the greater an ounce of Sanicle half an ounce the Leaves of Betony Agrimony Periwincle Burnet of each half a handful the Cordial Flowers two pugils the Seed of St. John'swort Holy-Thistle Roman-Nettle of each half a dram Boil them in Water and Honey to a pint and half strain it and keep it for your use Of this Injection the Patient may also drink a little twice or thrice a day It is yet further to be observed that the collected Matter is often contained in a Membrane of its own and by its rising manifests it self from without and then the Latines call it Vomica Pulmonis In which case you must not stay till the Membrane breaks of its self for by delay the Matter flowing up and down is more difficulty to be got out of the Breast but open it presently taking no other place but the most raised part of the swelling Now since an Empyema for the most part follows upon a Pleurisie and 't is dayly found that ignorant Chirurgeons take all kind of pain in the Sides Belly and Breast although caused from Winds only for a Pleurisie thereupon immediately opening a Vein I thought therefore necessary to write in this place of the Pleurisie as much as is necessary for a Chirurgeon to know for the preventing such mistakes The Pleurisie then is an inflammation of the Pleura and commonly of the Lungs themselves caused from afflux of Blood accompanied with Pain Cough spitting of Blood shortness of Breath continual Feaver strong and quick Pulse The Cause is the Blood sometimes alone when a true Pleurisie sometimes mixt with other Humors then it occasions a Bastard one The Signs as may be seen in the Description are so evident that those who know not how to distinguish it from a Cholick are not worthy of any excuse The Prognosticks The sooner the matter is concocted and the whiter and easier 't is ejected the quicker and safer is the Issue If the Cough and difficulty of breathing lessen not by a copious Expectoration 't is an ill sign If the Patient come not to spit the third or fourth day then will he scarce see the seventh If upon Bleeding and other fit means the pain cease not the Patient must either die or the Pleurisie will turn to a Consumption or an Empyema The Cure In this case Bleeding is one of the most necessary and safest means of Cure and if used in time the Patient in the very Operation and before the Vein be closed will find relief and sometimes be altogether freed of the pain Nor do I know any Disease in which there may to the Patient's benefit be so much Blood taken away at once as in this There are different Opinions concerning what side the Patient is to bleed on But those have had little Experience of this sickness who have not found that Patients at least in these Countreys are relieved much more and sooner when they are bled in the Arm of the same side where the Pain is than when it is done in the opposite side The Pain not ceasing in four and twenty hours we are necessitated to bleed twice or thrice most commonly in the same Arm but here you must well observe the Patient's strength After letting Blood sometimes Purging Swearing and Expectorating Remedies are very necessary One only Medicine I cannot conceal from you because of its Excellency The Industrious Physitian Dr. Hadden in his Cure of the Pleurisie hath much commended it and I have after once Bleeding always in the beginning used it with great success viz. Take the Juice of Dandelion an ounce and half the Water of Plantane two ounces of Holy-Thistle and Scabious Syrup of Poppies Erratick of each an ounce Crabs-Eyes a scruple and half Mix it Let the Patient every half hour take down a spoonful or two of it until the Flux be stopped After which you
are to use other Remedies CHAP. XVI Of Removing a Cataract of the Eye A Cataract by the Greeks called Hypochyma by the Latines Suffusio in the German and Belgick Tongue De Staer is a concretion of superfluous Humors by little and little generating a preternatural Membrane betwixt the Cornea and the Crystalline Humor covering either totally or in part the Pupil of the Eye and so depriving the Patient of his sight or hindring it Difference It is either Imperfect when the Humor is thin or the Apple of the Eye not totally covered or Perfect when it is changed into a Membrane or the Pupil is quite covered Sometimes 't is white gray yellow green sometimes of a leaden colour c. according as the green yellow or black Choler is mingled amongst it The Seat of it is between the Cornea and the Crystalline humor being sometimes nearer to this sometimes to that The Cause is a Phlegmatick Humor either collected there by the weakness of the Eyes or by the Brain transmitted thither by reason of its abundance The Prognosticks The imperfect Cataract may easily be cured in the beginning by convenient External and Internal Medicines in sound Bodies and in Patients of a middle Age. The less the Pupil is dilated the less hope of Cure The nearer the Suffusion is to the Crystalline Humor the more dangerous If the Eye be turned to the Sun and the Patient then sees no glimmering of Light there is no benefit to be expected from the Manual Operation If the Humors of the Eye be commixt by the Needle though the Membrane be removed then blindness will certainly remain If in the Operation you happen to touch the Membrane of the Eye called the Retina the Patient will after that always see the Air as if full of small Hair and Flies A Cataract commonly remains so soft unto the third year that it will not follow the Needle after the third or fourth year it is so firm and hard that it can by no Art be loosned The Blood spilt by the use of the Needle causeth no danger and soon ceaseth of it self Though the Cataract be not altogether suppressed but divided into several pieces the sight doth often perfectly return within six or eight weeks though before that time the whole Operation should seem to be fruitless which I speak from manifold Experience The Cure The Imperfect Cataract requires solely the Aid of the Physitian who by Medicines and strengthening the Stomach and Head have done much to which purpose the conserve of Marjoram Rosemary Beteny Pulv. Diambre c. are very good And outwardly use the following means Take Gum Tragacanth dissolved in Eyebright water two drams Burnt Allom one scruple Make a Collyrium Or Take Celandine water an ounce and half White wine half an ounce Spirit of Wine two drams White Vitriol six grains Prepared Tutty a scruple Glass of Antimony five grains Sugar-Candy two drams and an half Camphire six grains Mix it and make a Collyrium Or Take Juyce of Fennel of Celandine of each two ounces Leaves of Rue and Marjoram of each a Pugil Eye-bright one handful of the Gall of an Oxe four ounces the Gall of Hens an ounce Red-Myrrhe Aloes of each a dram and half Sarcocols half an ounce Camphire two scruples Mingle them and let them be dilled in B. M. If the Cataract be confirmed then let the Manual Operation be your only refuge but beware of attempting the Operation if the Patient have long before complained and still complains of Head ach or pain of his Eyes if the Body hath not been cleansed in general nor the Head in particular and if the Patient be yet molested with a Fever Sneezing Coughing or Vomiting Having chosen a convenient season of the year some morning in the decrease of the Moon and a clear and serene Air set the Patient in a Chair and against him let the Operator sit in one somewhat higher than his bind up his sound Eye and make him clap his hand about your waste without stirring them at all as long as you are busie in the Operation Let some body hold his Head fast behind and hold you asunder his Eye-lids charging him to turn the Eye towards his Nose which when he doth quickly thrust your Needle into the Cornea half a straws bredth from the Iris and bring it unto the hollow of the Eye when the Needle hath toucht the Cataract endeavour therewith to press it gently and so long from above downwards until it remains there if it be stubborn in springing up again and again divide it into several parts and keep these particles or the whole Cataract a little while under that it may not return again before the Pupil of the Eye then draw out the Needle and bind up as well the sound as the unsound Eye with Linnen-cloths moistened in some Rose water the White of an Egg and a little Allom mixed together Beware in the Operation of hurting the Crystalline Humor and the sound Tunicles CHAP. XVII Of Leeches LEeches more advantagious than Scarification and safer than Bleeding may with benefit be applied as well in strong as in weak Bodies they only draw Blood from the Cutaneous Vessels by which they cure light Diseases if only applyed to the Skin but if applyed to some greater Vessel they draw also Blood from the Internal Parts and so remove internal and more desperate Diseases There is great care required in the choice of Leeches for those with great Heads and that are green and shining with hair or blew stripes on their Backs are not without Poyson as also those that live in standing or putrid Waters But those are to be chosen that are slender and long with little heads and red Bellies and such as are nourished in clear running Water They are never to be applied to the Part new taken but after they have been taken a day or more in fair Water and fed with a little Blood that they may be cleansed of all their impurities the place where they are to be applied is to be rubb'd till it be red and if they fasten not 't is to be moistened with Cream or with Blood fresh taken from a Pigeon or the part it self to be prickt with a Needle till it bleed if they draw sluggishly cut their tails off with a pair of Scissars After they have suckt a sufficient quantity of Blood and they fall not off themselves put upon their Heads a little Ashes or Salt and they will suddenly desist from their work they are not to be pull'd off by force lest they leave their heads behind them from whence incurable wounds and oftentimes Death succeeds 'T is to be noted that they rather draw Arterial Blood than Venal therefore they ought to suck the less CHAP. XVIII Of the Cutting in the Hard Parts THe Section which is used in the Hard and Bony Parts is of four kinds viz. Scraping Filing Sawing and Perforating that is Trepanning Scraping is used in a
set down to the which I refer the Reader The End of the first Part. BARBETTY'S CHIRURGERY The Second Part. Which treats of Tumors Wounds and Ulcers In three Books The First Book of the Second Part of Chirurgery Of Tumors CHAP. I. Of Tumors in general A Tumor besides Nature is a Disease in which the Parts of the Body are indecently inlarlarged and extended so that they are rendred unfit to perform its Actions The Differences of Tumors are taken 1. From the Part affected as an Inflammation of the Eyes Jaws c. 2. From the Causes The Causes are 1. The Parts of the Body removed out of their Natural place 2. The Four Humors as well Natural as Preternatural viz Blood Choler Phlegm Melancholy to which likewise we add Serum and Wind. Tumors for the most part are generated from the Humors and that either by Congestion or Fluxion They come by Congestion when the Natural heat of the Part being diminished the good Humors are ill concocted or the vicious are not sufficiently evacuated By Fluxion from a two-fold Cause External viz. a Fall Blow External Heat too great Motion c. Internal viz. Pain Superabundancy Thinness Acrimony of Humors c. The Signs of Tumors are an Extention of the Part Pain Redness Heat Hardness c. But these are better explained in particular Tumors than in general The times of Tumors for all curable Tumors have four are as followeth Beginning when the Part begins to swell Increase the swelling pain and other Symptoms are augmented State the Symptoms stand at a stay and grow not worser Declination when the Symptoms are diminished Prognostick Tumors produced from Phlegm or Melancholy are hard of Cure Those are dangerous which are generated from corrupt Blood or Choler which seizeth the Internal Parts which shew themselves about the greater Vessels Joynts Nerves and the Membranous or Noble Parts Those that are of great bigness and that happen in Cacochymick Bodies They are Terminated four ways 1. By Dissipation which the lessening of the Symptoms do declare 2. By Suppuration wherein the Pain and Pulsation is increased together with a Fever 3. By Induration which the too often and immoderate use of Repelling and Dissipating Medicines hath caused 4. Degenerating into a Gangrene from the defect of Natural Heat The Cure is performed two ways 1. By hindering any further Flux to the Part. 2. In removing that which is already gathered in the Part. We stay the Flux of Humors 1. By Intercepting 2. By Repelling 3. By Revelling 4. By Derivation 5. By Corroborating the Part it self The Matter already gathered is taken away 1. By Astringing and Repelling Medicines to wit when 't is thin and sticks not too firm to the Parts 2. By Resolvents when it is thick and adheres more firmly to the Part. 3. By Suppuratives when the other are too weak 4. By Fire and Cutting when other means effect nothing CHAP. II. Of Inflammation A Phlegmon or Inflammation is a Tumor besides Nature from Blood thrown forth into the Skin or Subjacent Muscles causing Heat Redness Pain Pulsation and Tension Difference 'T is Perfect when from Blood alone Imperfect when Choler Phlegm or Melancholy is mix'd with the Blood and then 't is called Phlegmone Erysipelatodes Oedematodes Schirrhodes The Cause is sometimes Blood alone sometimes mixt with other Humors Signs are Heat Redness Pain Pulsation Shining Tension Hardness Renitency Prognosticks An Inflammation of the External Parts frees the Internal from many Diseases always wholesome except from its too great Extention it produceth a Gangrene dangerous and of hard cure is that which seizeth on the Eyes Jaws Penis Pudendum Muliebre and Joynts In a young Person and in Summer soon cured longer of Cure in a fat than a lean Body The Cure hath four Indications The first of these respects a good Diet let him chuse a clear Air his Meat and Drink little and that cooling all hot sweet and fat things as Pepper and Ginger are hurtful as also the motion of the Body especially of the Part affected Sleep is very convenient All Costivenefs Anger and Venery are noxious Second that stops the further Flux of the Humor which may be performed by Revulsion Derivation Repelling and Interception therefore let a Vein be opened as soon as possible it being most necessary Revulsion is made in the Opposite and most Remote part Derivation in the nearest If you may not open a Vein you must use Leeches and Scarifications Whilst these things are done seeing the Body is seldom clean but that always there are ill Humors mixt with the Blood by Purging rightly used and often repeated as also Bleeding we effect much In the mean time the Part affected requires Repelling Medicines from which we must abstain Where 1. The Noble Parts send the Humors to convenient places and to the Glandules 2. Where the Humors are Malignant 3. When Critical 4. When the Body is very impure 5. When the part affected is very weak or painful 6. Where the Inflammation is about some Noble Part. Repelling Medicines The Roots of Bistort Tormentil the Leaves of Cyprus Mirtles Plantain and Oak the Flowers of Balaustians and Roses Quince-seeds Red Sanders Galls Acacia Dragons Blood Whites of Eggs Vinegar Red Wine Allum Bole Oyl of Roses Myrtles Empl. de Spermate Ranarum Take Rose-Vinegar two ounces Whites of Eggs beat together No. 2. Bole-Armenick three drams Lap. Hematitis a dram Mix them Take the Juice of Housleek Purslane and Plantane of each an ounce Rose-Vinegar sowr Red Wine of each an ounce and half Oyl of Myrtles an ounce Stir them together in a Leaden Morter adding to them of the Powder of Pomegranate Rinds and Bistort of each a dram Make it into a Linament 3. Indication requires the taking away the Humor already in the Part. Here Resolvents are first to be used but they not effectual then Suppuratives Resolvents or Discussives Roots of Galangal Orrise Dill Southernwood Rue Savin Flowers of Camomil Melilot Elder 2 Aniseeds Carraways and Cummin Ammoniacum Bdellium Sagapenum Tacamahac Oyl of Dill Nard Rue Bays Ointment of Agrippa Martiatum Emplaisters of Betony Oxicroceum Diachilon Leaven the Dung of Beasts Spirit and Lees of Wine Take Roots of Orrise Marsh-Mallows of each an ounce and half the tops of Wormwood Flowers of Camomile Melilot of each one Pugil Herbs of Pellitory of the Wall Mullein of each one handful Meal of Barley and Fenugreek as much as is sufficient Boil them in White Wine then being beaten together add of Oyl of Orrise and Camomile of each an ounce Make it into a Cataplasm Or Take Cows-dung three ounces Juice of Hemlock one ounce Oyl of Camomile half an ounce Castor two drams Bole-Armonick half a dram Red Myrrhe two drams Saffron one dram Meal of Lupines as much as sufficeth to make it into a Poultice Suppuratives Marsh-Mallow Roots Mallows Camomile-Flowers Figs Galbanum Bdellium Sagapenum Ammoniacum Fat of Hogs Geese Ducks Hens Oyl of White-Lillies Ointment of Marsh-Mallows both
Simple and Compound Basilicon the Plaisters of Diachylon of Mussilages and Melilot Take Onions roasted in Embers three ounces Figs No. x. beat them together adding of Ointment of Basilicon six drams Ducks-Grease an ounce Virgins-Honey and the Meal of Linseed of each as much as is sufficient to make it into a Cataplasm Or Take the Roots of White-Lillies Marsh-Mallows of each an ounce ane half Leaves of Mallows Cows-Parsnips of each an handful Figs No. viij Raisins six drams Meal of Marsh-Mallow-Roots or of Wheat two ounces Venice-Sope three drams being boil'd and strain'd add to them of Hogs-grease on ounce Oyl of Camomil two ounces Mix them according to Art and make a Cataplasm 4. Indication respects the Symptoms which if not removed hinder the Cure the chief of which are 1. A Fever The chief of which concerns a Physician except it be removed by Bleeding 2. Hardness whose Cure look for in the Chapter of Schirrhus 3. A Gangrene Which is treated of in a particular Chapter 4. Pain Which we do remove by the following Medicines Anodines Marsh-Mallows Dill Mallows Camomil Henbane Tobacco Lin-seed Seed of Poppy Fenugreek Sperma Ceti Cream White of Eggs Oil of White-Lillies Linseed Ointment of Populeon fat of Hogs Hens and Mans Opium The great Vertues of the following Poultice I have not seldom experimented Take Flowers of Dill Camomil of each a handful Elder a handful and half Linseed-Meal four ounces Oil of Dill White-Lillies of each half an ounce Boil them in Milk to the consistence of a Poultice CHAP. III. Erysipelas ERysipelas is a Tumor besides Nature from Choler thrown forth for the most part only into the Skin it self sometimes on the subjacent Muscles causing Pain Heat and other Symptoms Difference 'T is perfect when sprung from Choler alone as it is imperfect when Blood Phlegm or Melancholy is mixt with it from whose Appellation it likewise takes its name and is called Erysipelas Phlegmonodes Oedematodes Scirrhodes sometimes an Ulcer is joined with it which sometimes consumes only the Skin other times the Flesh it self Cause is Choler seldom alone sometimes mixt with Phlegm and Melancholy but oftentimes with Blood or Serum whence those Medicines that are proper for a Phlegmon oftentimes do good in an Erysipelas Signs Great heat sharp pain Redness mixt with Yellowness easily giving way to the touch but as suddenly returning the Swelling and Extention of the part little and the Pulsation lesser which last gave occasion to Authors of questioning whether an Erysipelas ought to be reckoned amongst Tumors It is accompanied always with a Fever except from an External Cause Prognosticks An Erysipelas is seldom dangerous except the Matter be repell'd from the External parts to the Internal yet more dangerous when it seizeth on the Noble Parts and Jaws and when a Wound Fracture Dislocation or Putrefaction are join'd with it Cure What concerns Diet here is first and chiefly to be considered Air Meat and Drink must be cooling all sharp hot fat and sweet things hurt as likewise do too great Motion of the Body Watchings Costiveness Venery and Anger Purging is very necessary therefore those Medicines described in the third Chapter of the first Part are here convenient A perfect Erysipelas admits not of Bleeding for the fatness of the Blood bridles the sharpness of the Choler But if the Fever be vehement the Flux great and any Blood which for the most part happens be mingled with the Choler 't is convenient to bleed especially in Plethorick Bodies In delicate and weak Bodies Cupping-Glasses with Scarification or Leeches if things should require will serve These being thus done to provoke Sweat is the best of all other Remedies Outwardly to the affected part ought not to be applied 1. Oyl or any fat thing as those things which yield matter to the Choler easily increase Putrefaction But if yet it is your pleasure to use them they must be tempered by mixing them with other Medicines 2. Repellents except the Erysipelas be very little the Part affected remote from the Noble Part and the Humors be yet flowing and then they ought not to be used without Resolvents mixt with them The Cataplasms described in the foregoing Chapter may for the most part be applied here with success The Plaister of Diapalma dissolved in Vinegar is in dayly use the leaves of Tobacco Colewort and Henbane applied to the part affected strongly draw forth the heat There are those which use Sheeps dung boiled in Wine-Vinegar as also the Flowers of Camomil Mellilot and Elders boyl'd in new Milk Chalk powdred put upon the Part laying Cap-paper over it quickly and safely Cures The following Fomentations I have experienced to be of great Virtue Take Red Myrrhe powdred two drams Saccarum Saturni one dram Camphire a Scruple Opium 25 grains White-Wine six ounces Let Linnen Clothes be dipt in it and applyed warm to the Part often renewing them when dryed or cold Another Take the white Troches of Rhasis one dram Camphire one Scruple Spirit of Wine an ounce Elder-water six ounces Mingle and apply it as before Fumes of Mastick and Frankincense may likewise be used five or six times a day especially if the Erysipelas be in the Face When an Ulcer accompanies it Take the white Troches of Rhasis two drams Red Mirrhe Litharge of Gold of each a dram Flower of Brimstone half a dram Sarcocol two Scruples whites of Eggs as much as is sufficient to make it into a Linament CHAP. IV. Of Oedema OEdema is a Tumor beside Nature arising from Pituitous Matter white soft without pain oftner caused by Congestion than by Fluxion Difference It is perfect when it proceeds only from Phlegm Imperfect when mixt with other Humors Thus Oedema Phegmonodes Erysipelatodes Schirrhodes Cause is Phlegm sometimes alone sometimes confused with other Humors for the most part it is produced from the ill disposition of the Limphaeducts Signs are Whiteness Softness yielding to the Fingers little Pain and less Pulsation Prognosticks If an Oedema degenerate into a Scirrhus or Abscess it is hard of Cure It is dangerous if a Consumption or Dropsie accompany it it oftner happens in old People Phlegmatick bodies in the Winter time and in all those who with immoderate eating and drinking continually debilitate the natural heat Cure This as the precedent Tumors requires a good Diet Meat and Drink as also the Air must be moderately hot and dry Rosted Meat is better than Boiled Fruit Cheese and Fish hurt as also too great a quantity of Meat and Drink Wine either of it self or altered with hot Herbs is good moderate Exercises of the body before Meals is as profitable as much Sleep especially diurnal is prejudicial Costiveness Rest and Sadness are Noxious Bleeding is altogether here unprofitable and very seldom used but Sweating and Purging very necessary sometimes Vomiting Always regard must be had to the Stomach To the Tumor it self In the beginning we apply Repelling Medicines mixt with Discussives but so that the
a Wound penetrating into the Cavity it self all the Tunicles being divided the Wound of the Abdomen ought to be united by a Stitch a little Orifice being left through which a Tent is to be put which must not enter the Wound of the Stomach but only outwardly touch it let it be armed with this or the like Take Oyl of Mastick of Fir-tree of each an ounce Manna of Frankincense two drams Powder of the Roots of Tormentil of the greater Comfrey of each a dram Saffron a Scruple Earth-worms half a dram White-Wine two ounces boil them to the Consumption of the Wine and make a Liniment Take Turpentine half an ounce Yolk of an Egg Oyl of St. John's-wort an ounce Mix it and make a Liniment Wounds of the Small-Guts sometimes though seldom may be cured this I can prove by a notable Example Those of the Great-Guts are more easie Where the Small-Guts are hurt the Chyle and sometimes the Meat Drink comes forth through the Wound there is great pain with a Fever and Nauseousness Where the Great-Guts the Excrements come out at the Wound or at least the scent the Body is bound the Wound is forthwith to be stitcht together and the Gut to be restored into its natural place well cleansed with warm Water and this following Powder sprinkl'd upon it Take Aloes Mastick Frankincense Mummy dragons-Dragons-blood of each a dram Make it into a Powder Wounds of the Liver and Spleen require bleeding and if the Belly be bound Clisters are daily to be injected to the Wound it self are to be applied Astringent and Drying Medicines Wounds of the Kidneys are difficultly and slowly cured If made into the Cavity it self the Blood that comes forth is Serous otherwise more pure This Liniment is of great esteem to be used outwardly Take Rosin of the Pine six ounces Oyl of Bays and Turpentine of each an ounce Gum Elemny four ounces and an half Mingle them Inwardly are to be given the Troches of Alkakingi Gordonius de Carabe or Sealed-Earth Bole Turpentine and Wound-Drinks Wounds of the Bladder are generally cured after the same manner but it is very seldom that they leave not behind them a Fistula The following Pills are of great use in Wounds and Ulcers in the Kidneys and Bladder Take Mans Bones calcin'd three drams Chalk Burnt Talk of each a dram Troches of Winter Cherries three drams Venice-Turpentine a little boil'd as much as is sufficient Make them into Pills about the bigness of little Pease rowling them in the Liquoras-powder let the Patient take morning and evening six of these The End of the Second Part of the Second Book BARBETTY'S CHIRURGERY The Third Book of the Second Part Of CHIRURGERY Of Vlcers CHAP. I. Of the Nature Differences Causes and Signs of Vlcers AN Ulcer is a Solution of continuity with Diminution of Magnitude in the soft Parts from a Corroding Matter Differences are taken .1 From the Form of the Ulcer so 't is great little long short broad narrow right transverse equal unequal deep superficial 2. From the Part affected which sometimes is the Skin and Flesh only sometimes the Tendons Nerves and Vessels that carry the Blood 3. From the Causes which shall be presently spoken of 4. From the Symptoms so 't is painful itching obstinate verminous carious Cause is a sharp and corrosive Humor and that is twofold 1. Internal as Choler Melancholy Serum Salt Phlegm and other Malignant Humors 2. External as Burning and Corrosive Medicines the Sweat of Man infected with the Itch Leprosie or Pox. Signs of Ulcers in general are manifest enough the particulars you shall have in their places Prognostick By how much deeper the Ulcer is so much the longer 't is in Curing Ulcers in Parts that are subject to much Humidity are difficultly cured If an Ulcer cannot be cured in a long time or when Cicatriz'd breaks out again the Cause is the Bone being foul under it Ulcers near to the Nerves Veins or Tendons are dangerous In Cacochimick Bodies their Cure is tedious If the Matter which comes from them be good it gives hope of an easie Cure Good Matter is of a middle consistence between thin and thick white light equal and not at all stinking That which is ill is thin and fluid pale livid and of ill smell Old and inveterate Ulcers are not cured without danger except the Body be well purged and a good order of Diet observed otherwise some Diseases will ensue CHAP. II. Of the Cure of Vlcers PUrging and Bleeding are here often necessary but a good ordered Diet always Hot Meats and Drinks hurt as also all Sweet and Salt things Outwardly the Humor ought to be concocted and turned into Matter the lost flesh ought to be repaired and then to be skinn'd Remedies necessary to perform these are Digestives Sarcoticks and Epuloticks which are set down in the seventh Chapter of the second Book of the second Part. We will add some Compounds A Defensive Take Guaiacum-Wood long Birthwort-Roots of each an ounce Centaury the less Wormwood Agrimony of each a handful Boil them in white Wine and to two ounces and an half of the strained Liquor add of the Meal of Orobus half an ounce Myrrhe powdered two drams of honey of Roses two ounces Spirit of Wine an ounce Venice-Turpentine as much as is sufficient to make it into a Liniment A Sarcotick Take the Brown Ointment of Foelix Wurtz three drams Basilicon half an ounce Gum Elemni two drams Turpentine six drams Colophony Mirrhe Aloes Mastick of each half an ounce Litharge of Gold three drams Oyl of Roses as much as sufficeth to make it into an Ointment An Epulotick Take Sacchar Saturn Litharge of each two drams Lapis Calaminaris one dram Roots of Tormentil Bistort round Birthwort Dragons-Blood burnt Egg-shels of each half an ounce Make them into a Powder Let it be sprinkled upon the Ulcer or mingled Gall half an ounce Honey as much as sufficeth to make it into a Linament CHAP. III. Of an Vlcer with foul Bones IT falls out sometimes that the Bone which lies underneath the Ulcer to be foul Bones are corrupted and contract a rottenness either from the long Flux of Humors or from the Acrimony and Malignity of them or from an Occult quality or from a Contusion in some manner injuring the bone it self or from sharp Medicines Signs of Corruptions are many Where the Bone lies open to the sight at first it appears of the colour of fat then yellow afterwards black and unequal but where it cannot be seen Chirurgeons may judge that there it is a Corruption 1. If a Fistula preceded or the Ulcer hath been of long continuance 2. If the Ulcer being skinn'd break out again 3. If the flesh above it becomes loose spungy pale or livid 4. If with the Probe you find no resistance but an Inequality 5. If the Matter be much thin and stinking Prognostick If the Caries be near the Nervous parts or in the Joynts or about
assistance of the Ligaments Tendons Membranes c. the Parts are so straightly knit together and so abound with Sanguinary Vessels that oftentimes upon the slightest hurt the greatest Symptoms ensue if you order not every thing aright CHAP. III. Of Bones A Bone is a Similar Part cold and dry composed of Seed that it might afford strength to the Body and help its motion Naturally 1. It is hard 2. Covered with a Membrane 3. White with some Redness 4. Hollow or Spungy 5. About the Extremities covered with a Cartilage 6. Smooth 7. Moistened with a fat Humor It is nourished by Blood brought from the Arteries every where so small excepting the lower Jaw that Writers of great esteem have denied them to the Bones but especially contained in the Marrow The Marrow is invested with a Membrane it self is altogether insensible in the Cavities of great Bones 't is White mixed with Red in the lesser White in the Spungy Bones soft and juicy Its Sense it borrows from the covering Tunicle for the most curious Observer never saw Nerves The Bones are joined together partly for the greater firmness partly for the better Motion That Conjunction which is for their firmness is called Symphysis and is six-fold 1. Suture as in the Bones of the Skull 2. Harmony whigh is by a right or oblique Line as in the upper Jaw 3. Gomphosis as the Teeth in the Jaws 4. Sinchondrosis which is by an interposing Cartilage as in the Os Pubis or the Sternum 5. Syneurosis which is by the assistance of a Ligament as the Thigh-Bone with the Hips 6. Syssarcosis which is by the accession of flesh as in the Os Hyodis That Conjunction which is for Motion is call'd Articulation and is twofold 1. Diarthrosis to wit a loose Articulation And 2. Synarthrosis to wit a straighter Articulation And both is performed by three manner of ways 1. Enarthrosis When the Cavity receiving the Bone is great and the process of the Bone to be received also great as in the joining of the Thigh-bone with the Hips 2. Arthrodia When the Cavity is superficial and the Process little as in the hinder part of the Head with the first Vertebra of the Neck 3. Gynglymus When one Bone takes into its Cavity the process of another and contrariwise the other Bone receives into its Cavity the Process of the former as the Bone of the Thigh with the Tibia and the Shoulder-bone the Ulna The number of Bones is greater in Children than in adult People for by years many of them so grow together as that they cannot be separated any more also their number is much lessened when consideration of the Processes and small Bones is not had from hence it is that some reckon 360. some 304 others 249 The use of the Bones is 1. To be a stay or support to the Body 2. Together with the flesh to give it its shape 3. To help motion 4. To defend several Parts Although the Bones ought to be described in particular by us in their proper places yet an Anatomist cannot be perfect that is ignorant of the Bones therefore before we begin the Examination of other parts we think it convenient to exhibit to you the Skeleton in this place The Bones of the Head we divide into the Skull and Jaws The Skull consists of eight Bones which are 1. The Bone of the Forehead 2 and 3. Bones of the fore part of the Head 4 and 5. Bones of the Temples 6. The Bones of the hinder part of the Head 7. Os Sphoenoides 8. Os Ethmoide The upper Jaw consists of eleven Bones to wit five of each side and one common of these 1 2. Os Zygomaticum 3 4. Os Lachrymale 5 6. Os Maxillare 7 8. Bones of the Nose 9 10. Bones of the Palat. 11. Vomer The under-Jaw hath only one Bone except the Cavity for the Teeth of which are numbered 32. Four Fore-Teeth two Dogs or Eye Teeth all the rest are Grinders In the Internal parts of the Ear are four Bones which are called 1. The Hammer 2. The Anvil 3. The Stirrup 4. The round Bone The Mouth hath only one Bone called Os Hyodis The Neck is composed of seven Vertebra's of these 1. Is called Atlas 2. Epistropheus 3. Axis the rest want Names The Bones of the Breast in the upper parts are The two Collar Bones on the sides fourteen true Ribs ten Bastard in all 24. On the fore-part the Sternum with the Sword-like Cartilage In the upper part of the Back are two Shoulder Blades in the middle twelve Vertebra's The hinder part of the Abdomen exhihits five Vertebra's of the Loins to which are joined the Os Sacrum and to it is joined the Os Coccygis On the side of Os Sacrum there is the Os Innominatum or Bone of the Hip which is divided 1. Into Os Ilium which is the greatest 2. Os Ischium the lowest 3. Os Pubis in the fore-part The Arm consists of only one Bone which is called the Shoulder-Bone The Cubit of two the uppermost of which is the Ulna the lowest the Radius The Metacarpus contains eight Bones to which as yet there are no Names given the Carpus four The Fingers 10 each of which consisting of three Joints Besides these about the Joints of the Fingers are sound the Ossa Sessamoidea 10 12 15 or 20. The Thigh hath only one Bone The Leg consists of two one of which is the innermost called Tibia the other which is outermost the Fibula Between these and the Bone of the Thigh is placed forward the Knee-Bone The Tarsus hath seven Bones which are 1. Tarsus or Astralagus 2. Calx or the Heel-Bone 3. Os Naviculare or Cimbiforme 4. Os Cuboides or Tesserae 5 6 7. Ossa Cunciformia or Sphoenoidea The Metatarsus hath five Bones The Bones of the Toes are 14 for there 's only two in the great Toe The Ossa Sessamoidea are found here also 10 12 sometimes 15 or 20. Chirurgical Considerations The Bones are subject to many Diseases Fractures and Dislocations are already discoursed of as also Putrefaction But seeing there may be several ways produced we will declare those which are chiefly worth our consideration Preternatural Humors by what cause soever either General or Particular penetrating the Bone sometimes produce an Ulcerous Excrescency with moistness of the Bone sometimes a Cancer of the Bone to wit Spina Ventosa effects necessary to be distinguished which because no Physician hath made it his business to describe I will impart that which Reason and Experience hath taught us The cause of an Ulcerous Excrescency with the Humidity of the Bone which effect is called by the Dutch een Beensuyger is preternatural Phlegm depriving the Bone of its temper and hardness the flesh cannot be said from this soft foundation to keep also its Natural state but its nourishment passeth into soft spongy flesh which by degrees encreaseth and at length causeth an Ulcer from whence the Tendons Ligaments and
'T is corrected by a large-mouth'd Cupping-glass outwardly applied upon the depressed Cartilage and being there fixt let it remain till breathing is hindred then suddenly remove and the Cartilage oftentimes at the first time returning again into its natural place which if it appears not to do the Chirurgeon must repeat this Operation once or twice then having embrocated the Part with Oyl of Roses and Myrtles apply this Plaister to the Part which must remain there several days Take Bistort-Roots Cypress-Nuts of each a dram Mastick Frankincense of each half a dram Balaustians a scruple Oyl of Nutmegs Exprest one dram and an half Naval-Pitch and Turpentine of each enough to make it into a Plaister CHAP. V. Of Ligaments A Ligament is a Similar Spermatick dry part adhering firmly to the Bones tying the parts of the Body mutually together Difference Some are Broad and Membranous some Round and Nervous 'T is here to be observed that the Names Membranous and Nervous are much used both by Writers and Practitioners and hath deceived many of them for 't is requisite to know that here it hath regard only to their external form not their internal essence for the Ligaments both the Membranous and the Nervous are void of Sense which they would not be if they were composed of their true substance of Nerve or Membrane There is no Ligament hollow if you except the slender Ligaments of the Womb and are all destitute likewise of Sense of Motion as from themselves Use is to connect the parts of the Body especially the Bones and preserveth them from continual Luxation Chirurgical Considerations 1. Ligaments hurt by reason of their want of sense seldom draw other parts into consent and by the use of drying Medicines are easily cured I cannot but again in this place taught by Experience commend the Restaurative Powder of which this is the Description Take Roots of Comfrey the greater Aloes Succotrine Calcis vivae of each two ounces Mastick Mirrhe Mummy of each two drams Precipitate two ounces Make it into a Powder Here diligently at the first time is the weak heat of the Ligaments to be considered seeing it may give occasion to a copious collection of Humors and other grievous Symptoms 2. The Ligaments also are not seldom Relaxt Yea although the Ignorant do contradict sometimes they are so much extended that they may give way to a Luxation which the Sciatick pain hath more than once given us example of in such a case external Bleeding and Purging profit much outwardly the Application of corroborating and discussing Topicks The following Plaister is excellent Take Stiptick Plaister of Crollius an ounce Oyl of Earth of Tiles of each a dram Make it into a Plaister to be spread upon Leather CHAP. VI. Of Membranes A Membrane is a Similar Spermatick Part broad soft dilatable white investing the Parts and carrying sense to them Difference Some are very thin others thick some fleshy but for the most part not The Parts which invest are properly call'd Membranes those which contain the Humors Tunicles and those which cover the Brain Meninges It is endued with sense from itself for all Membranes are sensible yea the Nerves themselves owe their sense to the Membranous substance of them Membranes therefore only are the true Organs of feeling they serving the Animal Spirits to this purpose Use is 1. To invest the Parts of the Body 2. To defend it from Injuries 3. To keep them united 4. To strengthen them 5. To give them sense 6. To close the Mouth of the Vessels that the Nutritious Blood be not carried too suddenly into the Part or out of it into the Vein it self 7. To separate the Parts Chirurgical Considerations The Membranes being so very sensible they cannot bear sharp Medicines they are not endowed with great quantity of Blood whence when they suffer a solution of continuity they are not easily united again But I have observed oft entimes that by the Muscles and the assistance of the Quittour they are joyned together as in the Bladder it self whose Wounds and Ulcers otherwise are esteemed incurable CHAP. VII Of Fibres A Fibre is a Similar Spermatick Part dispersed through the Skin Flesh and Membranes to make them the stronger and being naturally distended to contract again into the same manner Differences are right oblique and transverse and some round the right attract the oblique thrust forth transverse retain round constrain but this they do not so by their own singular virtue as by the common virtue of the Member which they serve and from whom they have their sense and nourishment for of themselves they are senseless Use is to strengthen the Membranes Skin and Muscles and when dilated to reduce them into their natural state Whether the Blood it self hath Fibres as many have delivered and as it seems very probable to us shall be explained in another place Chirurgical Consideration These offer nothing worthy consideration except that when they are wounded the consolidation of the Flesh and Skin is the longer and there is a greater stiffness of the Muscles about the place and makes them difficulter to contract and extend The Ductus of the Fibres is diligently to be observed by them which are to make any curious Incision CHAP. VIII Of Veins A Vein is a Similar Spermatick Membranous long hollow Part every where joined by Anastomoses to the Arteries receiving the Blood wanting further Concoction from them and carrying it to the Heart and Liver Difference Veins of a four-fold condition are found in the Body 1. Vena Cava 2. Vena Porta 3. Vena Pulmonalis 4. Vena Lacteae Of the last of which a more convenient occasion will be offered to treat of in the following The Venae Cava and Porta take their beginning from the Liver There are those which would have them come from the heart from a weak Argument taken from unborn Embrio's But where I find many Branches inserted in the Liver few or none in the Heart yea I have observed that it hath not entred into the Heart it self but only to be joined to its right Auricle I rather embrace the old Opinion willingly granting those honours to the Liver that I think belongs to it That the Roots of the Vena Cava and Porta were united by mutual Inosculations the old Anatomists perswaded themselves but the curious Inquisition of the Moderns hath both found out and clearly demonstrated that they mutually touch one another but not so united that the Blood can pass out of one into the other for the extremities of the foresaid Vessels by means of the Parenchyma of the Liver do so mutually consent that Milk or any liquid thing cast into the Vena Porta with a Syringe finds an easie passage into the Vena Cava without either an injury of the Veins or the Parenchyma Concerning which read Glisson Anatom of the Liver pag. 272. Veins have only one Tunicle with many Valves within especially in the external Joints They are nourished
with Blood from the little Arteries not that contained within themselves They are endowed with feeling both from themselves and sometimes from the Nerves Use is to receive the Blood not sufficiently elaborated from the Arteries and return it to the Heart and Liver there to be more perfectly concocted For the better Methods sake in the following we must be forced to describe all Veins here particularly and divide them into their Branches Vena Cava taking its beginning in the Liver as is before said is separated into the ascending Trunk and descending The Ascending which is the greater perforates the Diaphragm and is divided into four Branches of these 1. Phrenica which disperseth it self through the Diaphragma and Pericardium 2. Coronaria appropriated to the Basis of the Heart proceeds from the Trunk it self after it hath penetrated the Pericardium and inwardly united it self by a large fleshy Orifice to the right Auricle of the Heart 3. Azygos or sine pari coming from the right side of the same Trunk when ascending it hath passed the upper part of the Pericardium affording chief Branches to the eight lower Ribs then about the fleshy appendices of the Diaphragm it enters the Cavity of the lower Belly where on the left side 't is inserted into the Emulgent Vein on the right into the Trunk of the Cava 4. Subclavia from whom comes forth several Branches which go both upward and downward The Superiors are 1. Muscula Superior 2. Jugularis externa interna that on both sides sometimes single sometimes double goes to the Neck Head and Face this to the thick Meninx of the Brain to whose third Sinus its greater Branch is united The Inferiors are 1. Intercostalis serving the four upper Ribs and their Intercostal Muscles 2. Mammaria which is carried to the Breasts 3. Mediastina which goes to the Mediastine and Thyme 4. Cervicalis which goes to the Neck 5. Muscula inferior which goes to the Muscles of the Neck 6 7. Thoracica inferior and superior which goes to the Muscles of the Breast The Subclavials being come out of the Breast are called Axillares then go to the Arms where they are divided into 3 great branches which are 1. Cephalica in the hand between the little Finger and its next 't is named Salvatella Its Branches are variously mixt with the Branches of the Median 2. Basilica or Liver-Vein 3. Mediana which proceeds with other branches from the Basilica The descending Trunk which is the lesser and is undivided till it comes to the fourth Vertebra of the Loins then it communicates 1. Adipsosa to the Membranes of the Kidneys 2. Emulgens to the Kidneys themselves 3. Spermatica to the Testicles 4. Lumbares two three or four to the Loins and to their Vertebra's Nearer to the Os Sacrum it is separated into two Branches called Illiaci Before they go to the Feet the Trunk it self presents 1. Muscula Superior which goes to the Muscles of the Loins and Peritonaeum 2. Sacra sometimes single sometimes double to the Os sacrum 3. Muscula Media to the Buttocks 4. Hypogastria to the Bladder and its Neck to the Sphincter Ani to the Penis and to the neck of the Womb. 5. Epigastrica to the Muscles of the Abdomen and to the Peritonaeum 6. Pudenda to the privy Parts 7. Muscula Inferior to the joint of the Hips The Iliack Branches as soon as they have left the Cavity of the Belly are called Crurales From these proceed 1. Ischiatica minor which goes to the Skin and Muscles of the Hip. 2. Ischiatica major to the Hip then to all the Toes 3. Proplitea to the Ham. 4. Suralis to the Muscles of the Calf of the Leg. 5. Saphena To the Knee Ankle and to the upper part of the Foot and to the great Toe The Vena Cava where it comes out of the Heart receives three Valves called Tricuspidales looking internally for this purpose that the Blood may freely enter into the Heart but to hinder its return The Use of the Vena Cava is to receive the cruder Blood from the Arteries and remit it to the Heart Vena Porta much lesser and looser than the Vena Cava ariseth from the Umbilical Vein and with many Roots is inserted into the Liver without the Liver it is divided into Trunk and Branches all which are distributed into several Parts contain'd in the lower Belly From the Trunk proceeds 1. Gastroepiplois which goes to the Caul and Stomach 2. Intestinalis to the intestine Duodenum 3. Cysticae Gemellae to the Gall. 4. Gastrica minor to the left side of the Stomach Then this Trunk is divided into two great branches the Splenick and Mesenterick Ramus Splenicus sometimes joyning to the Sweet-bread sometimes passing through it divides into four little Branches as soon as it hath left it which are these 1. Vena Gastrica major which goes to the Spleen communicating from thence three or four small Veins to the Stomach These being blown up in living and dead Bodies manifestly declare nothing at all can enter into the Cavity of the Stomach so by consequence no Humor coming from the Spleen as long since Learned Men have imagined taught and writ seeing they terminate in the Coats of the Stomach and open not into the Cavity it self 2. Epiploica dextra 3. Coronaria stomachi 4. Epiploica sinistra Mesenterious ramus is also divided into four others of these the 1. Retains its old name and is distributed with fourteen or more Branches through the Mesentery 2. Vena Haemorrhoidalis and goes to the Spleen the Womb and the right Intestine 3. Vena Coecalis to the blind Intestine 4. Ramus Mesocolicus and goes to the Intestine call'd Colon. The Use of the Vena Porta is to take the Blood not sufficiently elaborated from the Arteries and carry it to the Liver for the perfecter concoction and for the separation of the Choler Venis pulmonalis which the Ancients corruptly call'd Arteria venosa seeing that it hath but only one Tunicle beats not of it self nor returns the Blood coming out of the left Ventricle of the Heart with a wide Orifice goes to the Lungs to receive the more imperfect Blood from the Pulmoniack Artery and carries it to the Heart About its egress from the Heart it hath two Miter-like Valves hindring the regress of the Blood to the Lungs It s Use is to carry the Blood received from the Pulmoniack Artery into the left Ventricle of the Heart Chirurgical Considerations 1. We have in another place treated of the Wounds of Veins we shall only add that if the Bandage by which you stay the bleednig be bound too hard it will easily induce a Gangrene 2. We have admitted only four general Indications of Bleeding to wit for the Refrigeration Imminution Revulsion and Derivation of the Blood but special Diseases requiring one Vein to be chosen before the other which are these following in a Delirium and great pain of the Head the Vein of the Forehead or
The Tunicle investing them being eroded or divided the Skin cannot be consolidated before the whole Glandule together with its Tunicle be consumed with the Ulcer 3. If Corrosive Medicines cure not the Ulcers of the Glandules within the space of few weeks no hope remains of a sound Cure because of the continual Flux of Humors And this is the reason why we are for the most part compelled to take them away by Incision CHAP. XII Of the Skin THe Skin is a similar spermatick part having some Blood mixed with it reddish white loose investing the Body and serving for feeling 'T is covered by a Scarf-skin for the greater defence every where perforated with Pores to give vent to the useless Fumes and Vapors endued likewise with manifest Perforations as are the Mouth Nostrils Ears c. whose use is sufficiently known It hath Cutaneous Veins and Arteries as also Nerves It s Use is to cover the Body as moreover it is the Instrument of feeling Chirurgical Consideration 1. The Skin being discoloured by the Jaundies Freckles and other Spots this Water renders again smooth and fair Cosmetick Water of Minsicht Take white Frankincense Sugar-Candy of each two ounces white Hermodactils Florence-Orrise Venice-Borax of each an ounce Salt of Tartar Burnt Ivory Camphire of each half an ounce Flowers of white Lillies of the white Water-Lillies of the white Garden-Mallows of each three handfuls Virgin-Honey three ounces Goats-Milk two quarts Bean-flower-water and white Rose-water of each a pint and half white Lilly-water and Solomons Seal-water of each a pint being mixt let them be distilled in Balneo Mariae 2. Scars remaining after the Small Pox Wounds or Burns we take away by the following Medicines if deep and great first having used Exedents then Sarcoticks Take Venice-Borax three drams Camphire a scruple Oxes-Gall a dram Oyl of Mirrhe two drams Capons-grease half an ounce Make it into a Liniment Or. Take Powder of the Roots of Snake-weed of Orrise of each three dams Seeds of Melon blanch'd of Raddishes of each a dram Burnt Egg-shels half a dram Common white Chalk a dram and half Frankincense a dram Sugar-Candy three drams Gum Tragaganth dissolved in Rose-water an ounce Goose-grease as much as sufficeth to make it into a Liniment 3. Scabs blemishing the Skin are sometimes moist dry spreading eating crusty malignant this difference is of so small consideration that generals being well known 't is not difficult to one that well weighs every thing to proceed aright in particulars Seeing the Cause of this Disease is a sharp cholerick serous salt Humor mixt sometimes with Phlegm the often use of Purging Sweating and Vomiting of Bleeding Scarification Leeches Natural and Artificial Baths as also of cooling drying Medicines and those that temper the acrimony of the Blood Lotions and Unctions are here very profitable an Example of each I here give A Purging Decoction Take Roots of Asparagus Grass Polypody of each six drams Liquoras three drams Leaves of Fumitory Succory of each an handful Senna an ounce and half Rhubarb half an ounce Tamarinds an ounce Anifeeds two drams Cream of Tartar three drams let them infuse 24 hours in a sufficient quantity of Whey then boil them and to a pint and half of the strained Liquor add Syrup of Dianicum three ounces Make it into an Apozem Dose three ounces A Vomit Take Oxysaccharum Vomitivum Syrup of Roses solutive with Senna of each an ounce Fumitory-water as much as is sufficient Make it a draught A Sudorifick Take Flower of Brimstone Antimony Diaphoretick Salt of Holy-Thistle Sal Prunellae of each a dram Make it into a Powder to be divided into six equal Doses A Bath Take Roots of red Docks Briony of each six ounces Leaves of Fumitory six handfuls Camomile Flowers three handfuls Bran a pound Brimstone two ounces Nitre an ounce Alom an ounce and half common Salt two ounces Mix them In a grievous and rebellious Scab the Powder of Snakes is excellent this is the Preparation of it Take a Snake in March if possible before it hath laid its Eggs the Head and tail being cut off and the Skin stript off all the inward Bowels except Tongue Heart and Liver thrown away let it dry in an Oven moderately warm to a Powder The Dose from four grains to fifteen Vipers dried after the same manner excel Snakes and are commended in the Leprosie it self A Fomentation Take Burnt-Talk an ounce and half quick-Lime two ounces Litharge of Gold half an ounce Bole-armenick an ounce dry Tabacco-Leaves three ounces White-Wine a pint clear Water a quart Let them boil a little and keep the strained Liquor for use A Liniment Take Crude Brimstone two drams Venice-Sope a dram and half prepared Nitre half a dram Litharge of Gold two drams Mercurius dulcis a dram and an half White Camphorated Ointment an ounce Oyl of Rhodium eight drops Make it into an Ointment CHAP. XIII Of the Fat Nails and Hair IT hath been long disputed whether the Fat Hair and Nails ought to be accounted Parts of the Body or Excrements I neither think them Excrements nor Parts properly so call'd Not Excrements for they are Bodies enjoying with the rest Life and Nourishment but not nourishing others and are of singular use for the publick good They are not Parts properly so call'd being destitute of any certain bounds and have no particular operation Fat nourisheth in Famine the Hair and Nails without injury to the whole may be cut off Adeps or Fat is a similar soft white insensible part made to preserve the Natural Heat to help Chylification to facilitate Motion to moisten the Parts and to nourish the Body in Famine Hair is a similar Part produced by the worst part of the Blood covering some Parts and in some manner adorning them 'T is outwardly four-square inwardly hollow the variety of Colour it owes to the Temperament Age of Men to the Constitution of the Air or Country The Nail is a similar part sprung also from the impurest part of the Blood flexible hard defending the Fingers from external injuries as also adorning them It s Root is joyned to a Ligament and is very sensible by reason of the neighbouring Tendons Chirurgical Considerations 1. Blood wholly or in part destitute of Fat is not much to be commended for its abundance constitutes fleshy its unctiousness fat Bodies as where but little fat lean this fatness of the Blood dispersed into the parts of the Body changeth into natural Fat more copiously in the cold parts to wit in the lower Belly Breast c. than in the hot These Signs may confirm our Opinion as often as they are required from the Blood after the opening of a Vein for the upper part of the Blood which is erroneously taken by many to be the Phlegm of the Body and so the vitious part oftentimes is the very best of it This may be distinguished by the Fire for if it be fat it will flame if Phlegm it useth to crackle hence
be purified and in some manner concocted in which its operation that the Blood may be rendred more perfect 't is carried to the Heart especially when by reason of its continual and necessary Pulsation the Blood cannot remain long in the Heart and for this reason I judge the whole Blood must needs be moved about with a circular motion The Blood made in the Liver as is declared but now in the eighth Chapter enters the Vena Cava and from thence into the Heart And thus the Royal Liver at the same time when Kings are taken away may yet use a limited power and may remain with honour in its own Kingdom But what shall we do with the Melancholick Spleen which makes many laugh It hath many accusers and not fewer excusers 1. It was never accounted by Hippocrates the Learned Greek a receptacle of the Excrements or is it any where to be found in him that he call'd the Spleen another Liver 2. The great number of Veins and Arteries and so by consequence the abundance of Vital Spirits do not permit the Excrements to be collected here 3. It hath not any convenient Cavity wherein the Melancholy Faeculent Juice can be received 4. And if you imagine that there is no necessity here of a Cavity its Parenchyma is too thick and not porous enough therefore unfit for the reception of so thick a Humor which also is never naturally found in it 5. It is too great a Bowel to perform so vile an Office 6. In dead men where Melancholiness hath been the cause of their death upon the examination of the Internal parts there none of them less recede from its natural state than the Spleen the Heart only excepted whom the Vital Spirits do so greatly defend that it is less affected than other parts which seldom happen to the Intestines Kidneys Gall and Bladder What is therefore its Use It elaborates the Acid Humor which is very necessary but not Excrementitious and mingles it as a Ferment with the Blood by which it becomes more perfect and fitter for Circulation In my judgment the Salt of the Blood affords matter to this Humor which it greatly requires that it may not be corrupted but this Salt which proceeds from the Meat and drink is never so pure but that it hath need to be brought to a more perfect state in our Body But this is my Opinion The Supremest of the Kings is the Heart to this are two others subject the Liver and Spleen I beseech you give me leave to make use of this Similitude in favour of the Ancients the Heart makes the Blood the Liver repeats the Concoction and separates the Choler the Spleen from its own Salt by an innate vigor produceth an Acid Humor which as a Ferment by the Venal Splenic Branch it mixeth with the Blood to render it the perfecter and the more fit for Circulation if any Excrementitious part should be there separated it is all by the Caeliack Artery and the Haemorrhodal Vessels sent to the Guts If it appears to any one to be a contradictory that by Salt a Humor should be made Acid we advise that person to taste some Spirit of Salt About sixteen years since the great Anatomist Franciscus Sylvius put forth some particular things concerning the use of the Spleen he was of opinion that the Blood was not made in the Ventricles of the Heart neither that it was carried from the Heart by the Arteries to all the parts of the Body for nourishment-sake alone but that it likewise underwent some other Mutation in the rest of the Viscera's particularly that the Spleen further concocts the Arterial Blood and brings it to a higher degree yea that it more then perfects it so that the Blood in a manner in this place assumes the nature of Ferment by whose means in a short time a great quantity of Mass may become acid in the same manner he affirms that the Blood more and more concocted in the Spleen there receives strength by which it restores the returned and weakned Blood and preparing together with it the Chile that it may the sooner be turned into Blood The Reasons which he produceth for it are these 1. The Spleen receives a much greater quantity of Blood from the Heart than is necessary for its nourishment 2. That it can be returned back again to the Heart by no other way than by the Branches of the Vena Cava and Porta for what hath hitherto been delivered of the short Vessel are to be accounted but ridiculous Fictions as may most evidently be made appear in dissected Bodies 3. Seeing this Blood is continually mix'd with the returned Blood and Chile in its passage to the Heart it ought not to be an Excrement for so the Noble Parts and the whole Body would not be purged but the more injured 4. Chymistry hath long since taught us that such mutations happen daily in Nature The Remaining Part of the Blood unuseful to the Body therefore Excrementious is thrown out through the Guts Ureters and Parts of the Skin c. concerning which it is not necessary to add more here but now we are forced to describe those new watry passages which the studious in Anatomy have long and diligently inquired into The watery passages the Lymphatick Vessels have their rise both from the Liver and from the Joints and receive the liquid Juice from the Arteries with which they correspond Those which come from the Liver embrace the Vena Porta and so pass to the Misaraick Glandules of the Chile as do those also that ascend from the Feet thence they discharge their Water into the great Lacteal Vein which as we have already declared carries the Chile to the Heart Those which proceed from the Arm both lie above and under the Veins until they come to the Subclavial Vein which they enter about the same place where the great Lacteal Vein doth being furnished with a particular Valve just at their entrance and so altogether they carry the Water to the Heart This Water is Sweet not being as Urine is Salt These Vessels consist of a very thin Tunicle whence they are soon broke Use of them in my opinion is to take the superfluous Water from the Arteries and carry it to the Glandules of the Chile and Lacteal Vein by which the Chile being made more Liquid may the more conveniently be conveyed through the narrower passages thence to return the same to the Arterial Blood making it fitting to serve to the nutrition of the moist parts and to the cooling and moistening of the hot But that it may the more clearly appear in what manner I conceive how what hath already been said is perform'd in our Body observe that the Meat is converted in the Stomach into Chile to which part of the Drink is mingled this mixture is carried through the Glandules of the Chile and the great Lacteal Vein into the Heart where it is changed into Blood which is by means of
the Arteries to be conveyed through the whole Body every part of this Blood nourisheth those parts which are of the like temperament with it self the Hot part of it nourisheth the Hot the Dry the Dry the Moist the Moist c. that which is here not well concocted must be brought back again to be perfected Why we say that the Veins are not sufficient and the passages not commodious enough to perform the same whose Office we know is to bring back to the Heart the Blood not sufficiently concocted the Reason is that the Water always remaining in the Vessels rendered the Blood too thin so deprived it of its natural consistence and strength From all those so clearly and distinctly laid down it sufficiently appears what the CIRCULATION OF THE BLOOD is to wit a continual motion of the Blood out of the Arteries into the Vena Cava and Porta to the Liver and Heart that in them it may be fitted for the Nutrition and the life of the whole Body Out of the subtilest part of the Blood are the SPIRITS produced which are two-fold 1. Vital which begotten in the Heart carry life to the parts of the Body 2. Animal who out of the Vitals elaborated in the Brain impart Sense and Motion to the Body The Natural at the same time that the Circulation of the Blood was found out vanished Chirurgical Considerations 1. The Ductus Salivales when the string of the Tongue is to be cut or the Ranine Vein to be opened or any other Disease of the Tongue that is to be cured by Manual Operation warn you to have great care of those little Glandules in which they end that they might not be hurt with the Launcet lest there follow a continual spitting The great Glandule also of the Neck from whence these Ductus's take their rise when it is inflamed admits not of the use of Mercury for from hence a dangerous Salivation may very easily be raised 2. The Lacteal Veins either the greater or the lesser are oftentimes from a Contusion or Wound so greviously hurt that they cannot carry the Chile to the Heart and though the wound be cured with great diligence care and speed yet the Patient will fall into a Consumption whence follows Death inevitably This Truth will defend Chirurgeons from many Calumnies In Children and older People is often perceiv'd an induration and inflamation of the Abdomen the cause of which is the hardness of the Mesaraic Glandules which allow not passage for the Chile to the great Lecteal Vein except the very thinnest of it whence the flesh of the Muscles wasts the Body becomes heavy and weary and at length a Feaver and a wasting of the whole Body This evil I use to remedy without any great trouble with this External Liniment Take compound Oyntment of Marshmallows Ointment of Sow-bread of Martiaton of each two drams Oyl of white Lillies of Camomile of each three drams Mix it into an Ointment Inwardly the following Troches are excellent being continually used the whole time of the Cure Take prepared Steel prepared Crabs-Eyes of each a scruple Vitriolated Tartar half a dram Sal Prunella xvj grains Species Aromatici Rosati a scruple white Sugar two ounces Make them into Troches according to Art In this case Purging is not to be used but with Cassia Cream of Tartar and Laxative Syrups for the Glandules will not bear strong Purges 3. The Blood taken out upon the opening a Vein oftentimes after some few hours space appears very dry and destitute of all Serum which for the most part is ascrib'd to its too great Heat and Adustion but this Argument is very invalid for if the same day the same or another Vein be again opened there will be found a great quantity of Serum in the Blood therefore the true Cause is to be deduc'd from the Circulation of the Blood but especially in the Lymphatick Vessels which at that time draws the Serum and Humidity and so leaves the Blood dry It very often also happens that the Body becomes Tumid Turgid and Languid upon which the fearful Physitian forthwith pronounces nought but dangers When with the use of Internal and External Sudorificks the Patient in a short time may be cured The Cause of this Disease is not from the intemperature and debility of those parts the Ancients call'd Noble for it may easily be distinguished from the Dropsie which these parts occasion for although the sick persons are very dull and weary yet are they not anxious but breath free and the Belly swells not much In the Face and Joynts especially is a watry Matter collected but if the swell'd parts are compressed by the Finger we perceive much less Serum to be contained in the parts than in a true Dropsie from whence those that understand not the true Cause are wont to ascribe this Inflammation to wind But the Lymphatick Vessels when comprest broke or by any other way obstructed so that the natural motion of the Lympha is hindred occasions this evil 1. The Circulation of the Blood requires all venomous and deprav'd Humors which are thrown out either by Nature it self or that outwardly happen to the Body at the very first instant forthwith to be expelled out of the Glandules and the Skin by the means of attractive Medicines lest that the whole Blood in a very short time be infected and the Heart it self opprest and suffer under it The which doth sufficiently declare how dangerous it is to open a Vein and to purge in a Venereal and Pestilential Bubo nay in all venomous Wounds as on the contrary how necessary it is to cast forth the offending matter by the use of Sudorifick and Attracting Medicines As moreover how that the invention of the Circulation of the Blood is of very great use in the Art of Physick CHAP. XV. The Division of the Body MAn's Body is most conveniently divided into the Venters or Regions and Joynts There are three Venters 1. The Head or the supream Region or Cavity to it is joined the Neck which is its prop. 2. The Thorax Breast or middle Region 3. The Abdomen lower Belly or lower Region The Joynts are the two Arms and the two Legs Chirurgical Considerations We divide the Body after this manner that it may be known what place each part of the Body ought to keep to those that read the following every thing will become more manifest But there is so great consent of all the Parts so great concord that no part may be by it self consider'd without a consideration of the whole therefore I think it necessary that in a few words the foundation of this mutual consent be here declar'd 1. In every part is required a natural temper for the Liver being too hot the Stomach too cold the Brain too dry c. the whole Body must be out of order 2. A sufficient number for in the Hand if the least Bone Tendon or Artery c. be wanting forthwith its
found four Cavities sometimes seven in which many of the branches of the Carotide-Arteries are inserted afterwards joining with the Jugular Veins These Cavities have the use and substance of Veins so that they may not unproperly be reckoned among the Veins The Pia Mater is more sensible hath more Arteries than the Dura which doth not only invest the whole Brains but also enters the winding every where which for this cause may more easily be separated We do divide the Brain into three Parts which are 1. The Brain it self 2. The Spinal Marrow 3. The Cerebellum or little Brain The Brain is of an Ashy colour and of a softer substance than Marrow which is both whiter and solider whence also it was wont to be call'd Rind it receives several Branches from the Carotide-Artery and is destitute both of Nerves and Sense It hath divers turnings and windings which fold in deeply especially those in the fore-part of the Head where the great Fissure divides the Brain outwardly even to the Marrow The Marrow is the Mother of all Nerves within the Skull 't is call'd the Marrow of the Brain but without it is termed the Spinal Marrow The Cerebellum or little Brain is more of an Ash-colour than White receives Arteries from the Cervicalis and Carotide yet there are fewer branches here than in the Brain as being much less It hath no windings but is made up as it were of several thin plates lying one upon another These being thus considered the Anatomist takes off some part of the Brain with a Knife forthwith the Corpus Callosum and the Fornix joyning to it come in view Under these laterally lie two great Ventricles in figure resembling a Horse-hoof which the Septum Lucidum distinguisheth into the right and left or into the first and second In them is contained the Rete-Mirabile or Plexus Choroides consisting of many little Glandules composed from the branches of the temporal Artery twisted together in form of a Net In the fore-part these Ventricles are united and make a third In this third Ventricle are two Cavities the first of them runs to the Infundibulum and to the Glandula Pituitaria the other to the fourth Ventricle contained in the Cerebellum above this Ventricle are observed four round Bodies which are call'd Testes and Nates to which joyns the Glandula Pinealis which is falsly call'd by some the seat of the Soul Of late the famous Sylvius hath demonstrated it not to reside in the Ventricles but without them by whom also it is esteem'd but a Glandule and that with more reason because that both he and I have found in it not seldom two or three Stones but sometimes four which we yet keep by us The Bodies being removed eight pair of Nerves appear which we have already treated of on the fore-part of whom joyns the Rete Mirabile of Galen which is a complication of the Cervical and Carotide-Arteries After these the Cerebellum comes in view like a double Globe in the midst of which is the Processus vermiformis and Pons Varolii under it lies the fourth Ventricle Last of all the Spinal Marrow shews it self divided in its beginning into two Parts not unlike a Writing-Pen which descending down the Back imparts its branches over the whole Body Chirurgical Considerations 1. In Wounds of the Dura Mater two Symptoms render their Cure very troublesome to wit a Flux of Blood and extream Pain if the Skill be not sufficiently open without any delay the Trepan is to be applied on the Part affected and forthwith the extravasated and grumous Blood being discharged let this Ointment be applied Take Manna of Frankincense two drams Aloes one dram Mirrhe a dram and half the softest Hares hair half a scruple white of an Egg as much as sufficieth to make it into a Liniment The Powder is also very useful that is described in the Chapter of particular Wounds in the second Part of this Chirurgery To mitigate the pain Oyl of Roses Violets and Myrtles used warm as also the warm Blood of a Hen or Pigeon c. is very much commended The Flux of Blood and the Pain being ceased the following Medicines are to be used which are not to be left off unless the Matter begins to flow too plentifully Take Oyl of Turpentine two ounces Spirit of Wine Syrup of Wormwood of each an ounce Mix them But if a Gangrene or Putrefaction should happen the following Liniment is of great use Take Sarcocols Mirrhe Aloes of each a dram Syrup of Wormwood Honey of Roses of each two drams Ung. Aegyptiacum two drams and an half Aq. vitae an ounce and half White-Wine an ounce Let them boil gently then strain them Neither do I apprehend any danger is to be feared in the taking off part of this Membrane when putrifi'd so that you can come at it with a pair of Scissers and that the Sinus or Pia Mater be not hurt 2. When the Pia Mater is likewise affected the Chirurgion must abstain from all Oyls although they be drying lest a Corruption of the soft Brain be caus'd Drying Cephalick powders are very convenient to be used here But seeing that these Wounds for the most part are Mortal I shall say no more of them CHAP. III. Of the Neck THe Neck under the Scarf-skin Skin and fleshy Membrane and the common and proper Membrane of the Muscles hath of each side four Muscles Of these the Longus and Scalenus bend it Transversalis and Spinatus draw it back of each side It hath five Veins Cervicalis Muscula Superior and Inferior Carotis Interna and Externa And as many Arteries Cervicalis Muscula Superior Inferior Carotis Interna Externa It hath Nerves from the Par Vagum and the Spinal Marrow In the fore-part of it are many Glandules which are greater in Women than in Men. Under these the Larinx the Organ of the sound lies composed of five Cartilages which are 1. Thyroides or Buckler-like 2. Crycoides or Annular 3. Arytenoides 4. Glottis 5. Epiglottis It is moved by six pair of Muscles which are 1. Hyothyrodaei the pair that lift up the Larinx 2. Bronchii the pair that pull it down 3. Cricothiroidaei antici the pair that dilate 4. Cricothiroidaei laterales pursing it together 5. Thyro-arythenoidaei that open it 6. Arythenoidaei Sphincters that close it After these the Almonds or Paristhima by some call'd Tonsils offer themselves then the Pharynx to which appertain seven Muscles by whose assistance the Meat and Drink are swallowed 1 2 Sphenopharyngaei which raise up the Pharinx 3 4. Cephalopharyngaei moving it inward 5 6. Stylopharyngaei dilating it 7. Constrinctor or sphynctor which closeth the Gullet The back-part of the Neck hath seven Vertebra's the processes of some of which are perforated to give passage to the Vessels that carry the Blood into the Brain Chirurgical Considerations 1. We have already sufficiently treated of the Cure of Scrophulas or the Kings Evil I will only give you here
How the Internal Vlcers of the Yard ought to be cured we have set down in the Chapter of particular Vlcers But in this we may describe this Medicine by the use of which a Cancerous Yard was cured An Vnguent of Peter Baierus Take the juice of the tops of Bramble Stalks of Roses Vinegar of each two ounces Franckincense Mastick of each three drams Litharge of Gold an ounce Sack four ounces Juice of Housleek three ounces Aqua vitae four ounces Verdigreece two ounces and half Vitriol Burnt-alom of each a dram and half Camphire a dram Oyl of Roses four ounces Powder those things that are to be powdred very fine and being searched let them boil all together upon a gentle fire except the Camphire which is to be put in at the end to the consumption of the Juices then add the Wax and make it into an Ointment 11. The Spermatick Vessels sometimes in Women are so greatly obstructed that together with the Testicles in the side of Hypogastrium they swell to the bigness of ones Fist 12. In the Tubes of the Womb the Womans Seed is sometimes corrupted from which arise grievous Symptoms the Courses being for some Months obstructed oftentimes there follows a Dropsie the Water here collected we have observed in dead Bodies that have been opened to flow directly through the Tubes into the Duplicature of the Peritonaeum 13. The Womb from the preternatural afflux of Blood is often inflamed especially in lying-in Women and in those whose Courses flow disorderly this Inflammation oftentimes is changed into an Abscess if negligently handled whose Cure belongs to the Physitian But a Sphacelus is incurable For what the Ancients relate concerning the extirpation of the Womb to wit that it may all be taken off without any great danger is to be reckoned amongst their other Errors but whether this Animal in living Creatures this necessary part joyning to so many other parts and furnished with such abundance of Arteries may be cut out without danger of Life The same thing I believe hath hapned to them in this case as hath hapned in the describing and curing the falling down of the Womb who here and there have taken the extended Tunicles of the Vagina Vteri for the Womb it self for I easily grant these Tunicles may without any great danger be taken away But I truly esteem a Sphacelus of the whole Womb to cause certain death 14. The Neck of the Womb is subject to Haemorrhoids in the same manner as the straight Gut is these flowing may be distinguished from the Courses by these following signs in the flowing of the Courses we can observe no Branches of the Vessels in the Neck of the Womb they come out of the Womb it self and they cause no pain except in the Hypogastrium these Vessels by which the Evacuation is made are the Hypogastrick and Spermatick Arteries but the Haemorrhoids are the Branches of Vena pudenda they may be known both by the sight and feeling and there is no pain but in the privy part it self They ought to be treated in the same manner as the other Haemorrhoids are to ease pain this Ointment is excellent Take Mussilages of the Seed of Quinces Marshmallows of each half an ounce Saffron Oyl of Roses Hens-grease of each a dram the Yolk of an Egg Make it into an Ointment This Mixture is excellent Take Litharge of Gold washt Oeruse burnt-Lead of each a scruple Purslane-water five ounces Mix them Let the Haemorrhoids be washt with it and let a Linnen Cloth dipt in it be applied to the Part affected The End of the fourth Book of the third Part. The FIFTH BOOK Of the Joynts CHAP. I. Of the Hand UNder the name of the Hand we comprehend also the Arm whose Teguments both proper and common as also its Vessels are already sufficiently described It is commonly divided into three parts 1. The Shoulder 2. The Cubit 3. The Hand properly so call'd The Shoulder or upper part of the Arm consists of one Bone and nine Muscles The Muscles are 1 2. Deltoides and Supra spinatus which two raise it upward 3 4. Aniscalptor Latissimus and Rotundus major which two pull it downward 5 6. Pectoralis Perforatus or Coracoidaeus which two draw it forward 7 8 9. Infra-spinatus Rotundus minor and Immersus or Subscapularis which three move it backward By these three last moving together the Arm is as it were turned about and obliquely outwardly raised up The Bone is great and long its Head or upper extremity is invested with a Cartilage Membranous Ligament and four Tendons and furnished with a particular Cavity in which the Tendon of the Muscle Triceps lies The Lower Extremity is like unto a Pulley which permits the Cubit to be bent very much inwardly but not to extend beyond the right Line The Cubit consists of two Bones which are by proper Muscles properly moved which although out of order we are forced to set down in this place The Lower Bone which is greater and longer than the other is call'd Vlnae in its upper extremity are two triangular processes observed which are call'd Rostra or Glandes The Lower Extremity ends with a round Knob to which is joyned a sharp Process which is call'd Styloides It is moved by four Muscles of which two are Flexors 1. Biceps 2. Brachiaeus Two Extensors 1. Longus 2. Brevis The upper Bone which is less and shorter is call'd Radius or the lesser Focil it is received in the upper part by the Vlna in the lower part it receives the Vlna in the middle they are a little distant from one another which space is yet fill'd with a thin Ligament It is also moved by four Muscles whereof two are Pronatores or pullers down 1. Rotundus 2. Quadratus The other two are Supinatores or raisers up 3. Longior 4. Brevior Some add to these two other Muscles but they are very seldom found and diversly described The Hand is divided into three parts the Carpus or Wrist the Metacarpus or the distance between the Wrist and Fingers and the Fingers themselves The Carpus hath four Muscles Two Flexors the Cubitaeus and the Radiaeus internus Two Extensors the Cubitaeus and Radiaeus externus Under these lie eight little Bones as yet without name which are in the first years Cartilaginous and soft but afterwards become harder they are tied and joyned together with strong Ligaments The Metacarpus hath two Muscles call'd Palmares longus brevis And four Bones fastened to the Carpus by the assistance of the Cartilaginous Ligaments The Fingers consist of fifteen Bones which as yet have no certain names given them and fourteen Muscles whereof Two are Flexors sublimis profundus Two Extensors Four Adductors Lumbricales Six Abductors or Interossei Three are External and as many Internal Besides these the Thumb and Little Finger have a particular Flexor and Extensor These are besides to be considered in the Hand 1. The Armilla Membranosa
of some Humor which renders the Cure very difficult For this I commend the often praised Restorative Powder 3. A great Tendon is inserted in the Calcaneus or Bone of the Heel which being wounded or much contused brings Convulsions and death it self About this place comes Kibes whose cause is intense cold or heat with driness Here first are observed Fissures in the Skin then follows an Ulceration All fat things and Plaisters profit here especially the following Take Powder of Galls of round Birthwort of each half a dram red Lead a dram Mercury sublimate six grains Litharge Mirrhe of each a dram and half Camphire a scruple Franckincense two drams green Wax as much as sufficeth to make it into a Plaister In the room of green Wax you may take the Fat of Deer or of Rams 4. The Fingers or Toes being frozen must be rubb'd with Snow or with a bruised frozen Turnep then this following Plaister is much commended Take Hogs-grease fresh Oyl of Olives of each an ounce white Wax two ounces boil them a little and make a Plaister 5. Issues are often made in the Joynts we have formerly declared the place In the Arms between the Muscle Deltois and Biceps in the Thigh two fingers breadth above the Knee in the inside in the Leg the uppermost two fingers breadth below the Knee the lowermost two fingers or three above the Ankle That you may make these Issues without pain instead of a Conclusion take this Caustick which works without pain which is also very much to be commended in sordid and cancerous Ulcers and in Excrescencies Take Crude Brimstone white Arsnick Crude Antimony of each two ounces the Brimstone being melted by a gentle fire and stirred about with a Spatula add the Arsnick and Antimony powdred and mix them whilst they are incorporated with the Brimstone and look red Afterwards Take of this Mixture an ounce Caput mortuum of Vitriol half an ounce Mix them and make a Powder let it be washt six times in Spirit of wine and dried for your use A TREATISE OF THE PLAGUE THE Plague is a Disease whose nature is not to be comprehended by us the Cause thereof seems to proceed from a Spirituous and Infectious Vapour which is powerful enough to make a sudden dissolution of the consistence of the Blood by which means the Heart is deprived both of strength and life I do assert that the Nature of it is not to be comprehended by us as well because it is a Punishment inflicted on us by the immediate hand of Almighty God who vouchsafes not that his Incomprehensible Wisdom and Essence which is sometimes faintly described to us should be narrowly pryed into by his creatures as also that it is in it self so mutable that if we should seriously recollect our selves and recount the several Pestilences wherewith all former Ages have been visited we shall not thereby be able to instance in two of that whole number which have agreed with each other in all circumstances From whence we may easily infer that in the Cure of this Disease an Experienced Physician may much more safely follow the Dictates of his own Reason than adhire strictly to the Method Prescriptions of others For although it doth sometimes by the more remarkable symptoms sufficiently evidence it self yet we cannot likely discover its Nature and Essence although we should the most industriously attempt it But that we may cautiously enquire into it we must know that it is sometimes not accompanied by any Fever And it is necessary that what Physician soever is ignorant of this should either by perusing good Authors or his own Experience acquaint himself throughly with it I have been sent for to several Patients my self who although they appeared otherwise in good health not refusing their meat nor disturb'd in their sleep have nevertheless had Buboes arising in their Groin on their Neck under their Arm-pits or behind their Ears which have apparently discovered a greater Malignity than could be discerned in those Buboes which in other persons have been attended by a violent Fever And many hereupon who have been incredulous and lightly regarded the cautions which I have given them upon this account have with great danger to themselves experimented that as soon as those Buboes have sunk down the Pestilential Symptoms which have appear'd have been very dreadful and much more dangerous than in those that have carefully used the means prescribed to them who have been also much more easily and speedily cured than the other Sometimes the Plague is accompanied with a Fever and again there are some Pestilent Fevers without the Plague To distinguish this Fever from the Plague I used to observe that they that are seized with it complain of pain in their Head and Stomach which sometimes is dispersed over the whole Body sometimes it confines it self to the Arm-pits the Neck the Parts behind the Ears or to the Groin To outward appearance there is not the least swelling If the Patient by such means as is requisite be provoked to sweat at the beginning of the Disease the pain utterly ceaseth and in a few dayes he will be perfectly restored to his health the Disease not having at all discovered it self by any outward Symptoms Why such a Fever should be accounted a Species of the Plague I see no reason But there is no one but will confess it to have seized on that Body on which Buboes Carbuncles and Spots do outwardly appear The cause of the Plague is either Internal or External but unto which soever we impute it it is necessary to conclude that there is in it a power of dissolving the natural Consistence of the Blood and depriving the whole Body of its strength As to the Inward Cause which is Meat and Drink it is evident to all that it cannot produce in any Body whatsoever so great sudden a change but it is most certain that by a long continued course of bad Diet the Blood may by degrees be after such a manner dissolved weakned and corrupted that some part of it assuming to it self a malignant quality a man may be surprized by a sudden Disease sometimes be deprived of life it self which hath been observed in sick persons at several times when there hath been no contagion in the place nor any suspected who have been troubled with perfect Buboes and other Symptoms of the Plague much more intolerable than others have been at any time when the Air hath been infected As to the outward Causes every one confesseth that there are such but their Nature is known but to few The Chymists who are able by the force of Fire distinctly to separate the Parts of simple Drugs endeavour to find the Original of the Contagion in a Volatile Salt which suddenly dissolves the fixed Salt of the Blood which hath indeed some appearance of truth though it will not be relished by all men If you enquire into the Cause hereof from others their
do not disapprove the use of it though as much as I can I void the Smoak An inordinate Diet is very hurtful at all seasons but especially in a Pestilential one There can be nothing prescribed in general which may agree with each man in particular there is very much to be allowed to Custom but we must at all times industriously avoid all Meats that are difficult to be concocted and take great care that the Stomach be not overcharged For our Diet if we can so contrive it we ought to make choice of Veal Mutton Beef Pullets Capons Peacocks Larks Chaffinches Quails Hares Conies c. Perch Pike Whiting Sole Salmon c. Eggs Butter Green and Parma Cheese Buttermilk Cichory Endive Sorrel Lettuce Chervil Parsley Rosemary Sharp-Apples Quinces Limons Oranges Capers c. On the other side Flesh and Fish which hath been dried and salted are very hurtful as Bacon and Pork Haddocks Eels Crabs Shrimps Green Fruit and all things that are hard of Digestion Walnuts are very much commended and not without good reason for there may be very much use made of them The green ones preserved do much good to those that abound with Choler but such as are come to their full ripeness whether you take them fresh gathered or when they are more dried all that make use of them will tell you that they are very pernicious The strongest Beer and Wine of a middle strength are very useful at such times if moderately taken but we cannot allow that any except such as are very ancient should dayly make use of strong and sweet Wines nor of Spirit of Wine and Brandy Go not forth into the Air with an empty Stomach but always take some Preservative against Infection Take our Prophylactick Water 6 ounces Julep of Roses 3 ounces Mix them take the quantity of a spoonful or two each morning Or Take our Prophylactick Conserve 3 ounces take the quantity of a Chestnut in the morning or as often as you are to go to an infected place Vinegar and all sharp things have been commended to us by long experience but they will not well agree with such as are troubled with a Cough weakness of Stomach or the Cholick if they are taken either alone or in too great a quantity I never had any great esteem for outward means but those that can fancy it may wear about their Neck this Amulet Take Arsenical Magnet a dram Benzoes as much as is sufficient make them into great rowls and sew them up in red Lawn We have before described the Arsenical Magnet when we treated of the Bubo Sleep and Watching exercise of the Body and the use of Women if immoderate are very hurtful Costiveness is prejudicial but not so much as a great loosness Sadness Fear and Anger will make very strange alterations in the Blood he who knows how to moderate those Passions is most prudent Practical Observations I. A Young Man aged twenty two years being lately returned from the East-Indies on the 21 of July 1655. in the Evening was suddenly taken with a great pain in his Head and a shivering through his whole Body having that day received much injury from the Water and Air the day following he became exceedingly delirous so that he could not by four men be kept in his Bed The Plague at that time raged very much in the next Town which was very populous but there had as yet appeared no Symptoms of it in this of ours We met with no outward signs of any Malignity nor did those within appear so considerable as to forbid the breathing of a Vein which the Delirium did very much press us upon I therefore prescribed a Cordial Mixture which might also be Sudorifick whereof 2 spoonfuls was to be taken each quarter of an hour and after the space of one hour a Vein to be opened in the right Arm and seven ounces of Blood to be taken from thence I had more than once before made trial of this Mixture in a Pleurisie which was accompanied with Spots The Description of it is as followeth Take Waters of Borage Holy-Thistle Bawm of each an ounce Alexipharmick Water an ounce and half Cinamon-water half an ounce Confection of Alkermes without Amber-greece and Musk a dram and half Syrup of the juyce of Citrons an ounce Mix them The mixture was taken and a Vein opened and such things as we thought fitting applyed to the Temples the Neck and the Soals of the Feet but all was not sufficient to overcome the Malignity of the Disease for he dyed that night II. A Man and his Wife on the 5 th of July were both taken with Buboes in their Groin She was very drowsie Feverish and Anxious but by the use of Sudorificks and drawing Plaisters she was by the 10 th day following restored to perfect health He was seized on by a pain in the Head and a small Delirium which continued till the 5 th day on which he was taken with a great fit of Bleeding which with some intermission continued for two days this according to the opinon of all Practical Physicians was to be judged very dangerous But when I considered that his strength was not at all hereby impaired but on the otherside the pain in the Head and the Fever abated nor did the Bubo strike inward I cast away fear and concluded that the Judgments of men by time and experience might be much corrected I therefore thought it not the best course to continue here the use of Sudorificks but rather to strengthen the Heart and to incrassate the Blood and thereby to stop the Flux of it To which purpose I prescribed this which followeth to be taken by a spoonful at a time Take Water of Roses and Plantane of each four ounces Cinamon-water six drams Dragons-Blood red Coral prepared of each a scruple Confection of Hyacinth a dram Spirit of Salt eight drops Syrup of Barberies an ounce and half Mix them Upon the taking of this the Bleeding and the Delirium both ceased and thereupon the Patient grew well the Bubo continuing for ten weeks after III. A Maid on the 4th of September was taken with a Fever a pain at the Heart and in the Head and with a Bubo which broke out about the inward part of the bending of the left Arm and seized on the Tendon of the Muscle Biceps from hence proceeded a very acute pain not only in that part where the Bubo appeared but also about the Armpits by consent of parts although there was no swelling which thereabouts appeared I gave her this Sudorifick forthwith Take Diascordium of Fracastorius four scruples Sal Prunella a scruple Alexipharmick-water an ounce and half and Holy-Thistle-water as much as is sufficient Syrup of Limons half an ounce Mix it for a draught To the Bubo I applied the Divine Plaister The Sweat came plentifully but the pain of her Arm a Delirium and continual watchings after the use of several other things forced us
as also of Hereditary Maladies together with their Remedies 'T Is known seldom to fail that in an army there reigneth some Disease or other according to the nature and constitution of the Country Air and Diet. The reasons are First that amongst so great a number of Men raised from so many different places there are to be found Men of very different tempers and constitutions sound and unsound and amongst the latter some that are scabby others scorbutical others labouring under venereal Diseases many inclined to dangerous and infectious Fevers c. all which a Physitian must have a watchful eye upon and endeavour to prevent their spreading Secondly that Souldiers in an Army want conveniences wherewith to take due care of their health but are often constrain'd to expose themselves and sleep in the open Air on moist ground the vapours whereof penetrate into their bodies and they are careless or want oppertunities of expelling them out again by sweat Whence is caused an inward putrefaction in the blood and humours which sometimes proceeds so far as to assume a venemous nature and to break out into spots tumors bubo's carbuncles c. Thirdly that Souldiers commonly keep an irregular diet Sometimes they have plenty and do supperabound at other times they have nothing and then being very hungry when they come again to a place of plenty they over-feed and surfeit whence are bred crudities in the Stomach and corruption which causeth malignant Fevers in abundance Besides they often feed upon Meat that is unwholsom as stinking Venison rotten Cheese musty Bread c. which cannot but occasion many Diseases And when they come to places where Fruit abounds as Apples Pears Plums Melons Cherries Grapes c. they over-eat themselves and thereby cause Gripings in the Guts Diarrhaea's c. Lastly sometimes the Air is corrupted especially after a great Battel and slaughter of Men that remain unburied whereby the Air being tainted infects the living that take it in Which is often made worse by the exhalations of low and moorish ground and by thick Fogs These are the general Causes of the common Distempers reigning in Armies against which thou art to arm thy self accordingly First then be careful in thy Diet eat not greedily and indiscreetly every thing that comes to hand and though it be good yet eat and drink not too plentifully of it but restrain thy appetite considering how destructive every excess may be to thy health If thou canst and hast no aversion from it drink every Morning of thy own Vrine which prevents corruption in the Stomach opens obstructions in the Liver Spleen Mesaraic Veins which if not removed there will follow Fevers the Yellow Jaundice Swellings and difficulty of breathing If thou art averse from doing so eat some Bread and Butter with Rue on it or if it be not hot weather take in the morning the quantity of a Hasel-nut of Mithridate or Treacle or infuse in Brandy or rather in Spirit of Juniper-berries some Zedoary Angelica and a little Citron-peels and drink a spoonful of it in the Morning When the Air is corrupted and there be at hand a Goat rub thy self at him and let not the strong smell keep thee from it Also put Quicksilver in an empty Hasel-nut closed up with Spanish Wax and hang it about thy neck or the Zenechton prepared of Arsenic after the manner by and by to be described sowed up in thin Leather for if it should touch the bare skin it would cause Blisters and do harm This Zenechton is a Plaister out of which are cut pieces of the bigness of a Dollar which are carried about the Neck and hang down near the Heart keeping good a whole year And when the infection is past this Zenechton being reduced to Powder will yet serve to kill Rats and Mice with It is to be thus prepar'd Take of Yellow and White Arsenic of each an ounce or ¾ of an ounce of gummi Tragacanth ½ an ounce put this gummi in Rose-water or in common water over night and it will yield a slimy Water Then beat thy Arsenic in a Mortar and put so much of this gummed Water to it as is necessary to reduce it to a Paste having the consistence of Dough work it well and round it and then cut off a slice of the bigness of a Dollar somewhat thicker let this slice dry in the Air and sow it in a piece of thin Leather well-dressed Dogs-skin is the best for this purpose carry this about thy Neck so as to let it hang down upon and to touch the place of thy Heart Some mix with it a proportion of the Powder of dried Toads which I have done my self it being esteem'd more powerful Some carry about their Necks dried Spiders Theophrastus commends Celondine Leaves and Root carried about the Neck Remember also to burn frequently Juniper-wood before thy Tent though all ordinary fires cleanse the Air Upon which account Hippocrates advised great fires to be made in Greece at the time of a great Plague which was thought to have been remov'd by that means Some burn only a few Chips of Juniper-roots or some of the Berries of that shrub which is as effectual If these means cannot be had burn some Gunpowder ordering it like a Train this purifieth the Air likewise And the volleys of shot made mornings and evenings in a Camp conduce very much to the dispelling of Mist and qualifying raw weather Frankincense also Mastick and such other Perfumes as dry and clear the Air may be very usefully burnt and even a Scholars Perfume made of waste Paper is not to be despised If thou canst get Rue smell often to it And remember me for this general hint to take good notice of all Herbs that are green Winter and Summer and which are not eaten by Horses or Cattel for they are endow'd with excellent virtues for the good of Man and therefore made to grow at all seasons of the year When the Air is pestilential or breeding any Epidemical Disease then wash thy face with Vinegar every morning If thou canst get Acetum of Rue Elder-flowers Lavender Roses Marigold-flowers 't is the better Or if you have the conveniency prepare the following Acetum Take Rue Elder-flowers Burnet-roots white Dittany Carlina of each equal quantity a few Orange or Citron-peels of which the latter are the better of the two and a little Camphire and some Walnut-kernels the fresher the better leaving the bitter skins upon them put all these into common Vinegar and with this infusion moisten every morning thy Temples Mouth and Nostrils and the beating Arteries of both thy Wrists taking down a good spoonful of it and thou hast a good preservative If it be cold weather take Angelica-roots Zedoaria white Dittany some dried Citron-peels and a little Camphir infuse them all in Brandy especially in such as is made out of Wormwood or Juniper-berries Of this Liquor drink in the morning a spoonful But if thou be of a
Medicines thou canst be Master of to drive out the poyson if thou wilt save thy life I never found any thing that was considerable done in the Plague by means of Purging and Bleeding but rather on the contrary all those that had Spots if they were Purged or let Blood soon after died However I will prescribe nothing magisterially to any man let every one endeavour to do what he can give a good account of I have together with my Collegues treated many hundreds in our Hospitals infected with the Plague without ever opening a Vein and yet we have by Gods blessing recovered near 600 persons besides those that by the same mercy we have cured in their several Houses Now to procure sweat in the very beginning take the quantity of two Hasel-nuts of Treacle dissolve it in common Vinegar but if thou canst have a cordial Acetum made of Rosemary Lavender Elder-blossoms Rue Roses or Elder-berries use it much rather and give it the Patient to sweat Or take the roots of Celondine boyl them in Vinegar and dissolve some Treacle in it Or take Carduus benedictus Rue Petasites or Butter-burr a little Angelica Zedoaria or Saxifrage-roots boyl them together in half White-wine and half Vinegar or only Water dissolve a little Treacle or Mithridate in it and let the Patient take it warm to make him sweat Mithridate hath the like virtue with Treacle yet neither of them are safe to take for Women with Child old Persons and young Children You may also make use to good purpose of the Saxon-powder taking of it the weight of a Ducat in Caduus benedictus Scabius or Sorrel-water which Powder is thus to be prepared Take Valerian half an ounce Celondine or Nettel-roots of each one ounce Polypody Althaea or Marchmallow wild Angelica of each two ounces of garden Angelica four ounces of the rind of Laureola or Lowry an ounce and an half These roots are to be dug up in their best strength viz. between the middle of August and the middle of September and being cleansed they are to be cut small and then put in a glazed pot pouring a sharp Vinegar upon it so as to cover it two inches high Then lute on the cover with a lute made of whites of Eggs and Flower let all be boiled upon a gentle fire then pour off the liquor and dry the roots and reduce them to powder mixing with it some 26 berries of Herbe Paris or One-Berrie which look like Pepper-corns very good against poison and thus the powder is made This herb grows in shadowed and moderately moist places I have found of it several times in Koshinger-wood near Ingolstad It hath four leaves on one stalk and one berry on the top An herb belonging to the family of Solanum's or Night shades whence the leaves of it do very much cool Inflammations especially those of the Eyes when laid upon them Take notice of Sorrel bruise some of it and pour Vinegar on 't the Rue acetum is the best and strain the juice through a cloth put into it a little powder of Angelica about the weight of half a Ducat or of the root of Dictam or of Butter-burr or a little Treacle or Mithridate and give it to sweat On this occasion of mentioning Dictam I must add that in our Countrey there grows only the white Dictam which is among others an excellent Antidote but you must take of it the double quantity and weight to that of Creta You may boil of the root of half an ounce in half White-wine and half Vinegar or instead of the Wine in Carduus benedictus water and drink of the Decoction warm and put your self to sweat or take of the powder of it a drachm and an half in warm broth with a little Vinegar for the same purpose The Dictam of Creta hath hairy leaves and purpureous blossoms and is used in the prepation of Treacle This herb by its odour drives away Serpents The wild Goats being hurt by any Arrows eat this herb and 't is said that by this means the Arrows fall out of the wound This perhaps hath no other ground than that of the Poet Virgil affirming that Venus with this herb healed her Son Aeneas when wounded in the War His words are Aeneid 12. Hic Venus indigno nati concussa dolore Dictamnum genitrix Cretaea carpit ab Ida Puberibus caulem foliis flore comantem Purpureo non illa feris incognita Capris Gramina cum tergo volucres haesere sagittae About this time came in the Hungarian Infection which was a Disease that bred such a a putrefaction in the bodies of Men that even when they were near death they fell a vomiting but that with such a stench that no body could endure it Here those Medicines do well that preserve the body from putrefaction for the Plague Spotted Fevers and the Hungarian Distemper proceed all from inward corruption And of them the Plague attacks the Spirits residing in the Heart and so killeth very quickly whereas Spotted Fevers have their seat in the Blood and therefore do last twelve fourteen and sometimes twenty days before they kill But the Hungarian Disease is seated chiefly in the putrified Phlegm of the Head and Brains whence those that labour under it are tormented with great and maniacal head-ach But though these three Diseases have their rise from one and the same cause Putrefaction and are to be cured by the same remedies yet is therein required the discretion of a prudent Physitian for the ordering and prescribing of Medicines according to circumstances Take a drachm of Zedoary give it pulverised to the Patient in Acetum of Rue or Elder or Marrigold flowers or even in common Vinegar Let him sweat upon it 'T is good against all sorts of venom and causeth a sweet breath as resisting inward corruption In the Apothecary Shops you find an Electuary called Diascordium found by that famous Physician Hieronymus Fracastorius It is like to Treacle and Mithridate only 't is red from some Ingredients giving it that colour This may be used with safety by Women with Child young Children and all sorts of Persons whereas as was said above Treacle and Mithridate may not It is made chiefly of Scordium or Water-Germander which hath the smell of Leek when bruised Galen in his first Book De Antidotis Chap. 12. writeth that when in a great Battel some slain Bodies chanced to fall upon this Herb they rotted not as far as they were touched by this Herb. The said Fracastorius did compound this his Diascordium out of this Herb Scordium Tormentil Serpentaria Gentian Bole Armeniac and Terra Sigillata and such like Ingredients It is chiefly to be used in the hot Diseases of the Head which I have done many a hundred times Take of it the weight of about two ducats in common Vinegar or in Elder-water or rather in the expressed Juyce of fresh Sorrel and sweat upon it 'T is very good especially in the
of the Flesh is taken away and then 't is call'd a compound or hollow Wound 3. From the Causes which shall presently be set down sometimes a wound happens to be poisoned and to have many Symptoms joined with it Causes are five-fold viz. 1. All things that cut as a Knife Sword Glass 2. Al things that prick as Needles Arrows Teeth 3. Which perforate as hot Iron Bullets 4. Which break as a Fall Stroke or the carrying or lifting of any great Burdens 5. All things which contuse as a Stone Stick c. Signs External Wounds are of themselves manifest enough but those of the Internal parts are not always so easily judged of these therefore are to be known by Anatomy 1. What is the situation of each part 2. What the use 3. The Symptoms are to be considered 4. The Quality of those things are to be noted that Nature ejected through the Wound The other Signs you shall have in their proper places Prognosticks To know the Events of Wounds especially to predict which are Mortal which not is a thing absolutely necessary for a Surgeon For from this judgment oft-times depends the Life of unfortunate Man A mortal Wound is that which in the space of few hours or days of necessity causes Death and cannot by any Art be cured For those that in themselves are curable yet by reason of ill Symptoms or through the neglect either of the Patient or Chirurgeon do occasion Death ought not to be accounted mortal Wounds Incurable Wounds themselves are not to be call'd Mortal if they are not the cause of Death suddenly to the Patient but that he not only lives many weeks but oftentimes many years after 1. Among the Wounds that are Mortal are to be accounted the Wounds of the Brain but not all of them for Experience hath taught us that part of the Brain hath been taken forth and the Life preserved though the Understanding lost Therefore those Wounds of the Brain that be absolutely mortal are 1. When besides the Brains a Nerve is also wounded 2. When Blood or some other Humor obstructs the beginning of the Nerves 3. When after a few days the concrete and putrified Blood produceth a Fever Delirium and Death it self By concreted Blood I understand not that which lies between the Dura-Mater and the Skull for that is to be taken forth by the Trepan and the Patient this way may be preserved but that which is included between the Dura and Pia-Mater or between the Pia and the Brain Although sometimes that which is detained between both Membranes by the dividing of the Dura may be taken forth and so the Patient preserved 2. The Wounds of the Spinal Marrow are also mortal which happens in the Neck or nearer to the Head but those which happen lower as about the Os Sacrum are of lesser danger 3. The Wounds of the Lungs are mortal if great and deep where the great Vessels or the Branches of the Aspera Arteria are hurt Where the Vessels are divided there follows a great effusion of Blood where the Branches of the Aspera Arteria the Breath comes forth more through the Wound than the Mouth 4. Wounds of the heart are always mortal for though one or two wounded in the heart have lived two three or four days it was never found yet that ever any escaped 5. The Wound of the Wind-pipe may be cured if the Membranes only behind to which the Cartilaginous Rings are join'd be hurt but if the Rings themselves are wounded there 's no cure to be expected yet sometimes those wounds being a lingering Death so that I have seen on so wounded live Eighteen weeks before he died 6. Wounds of the Diaphragma those that are inflicted in the fleshy Part of it are curable but those that are in the Nervous Part though these always occasion not sudden Death yet 't is impossible ever to cure them 7. Wounds of the Stomach are sometimes cured those chiefly being mortal that happen in the upper Orifice or in Nerves that are distributed over the Stomach 8. The Wounds of the Small Guts are seldom cured but the Wounds of the Great Guts much oftner especially if they are not great 9. Wounds of the Liver and Spleen are mortal where the Vessels themselves are wounded where not they may be cured 10. Wounds of the Kidneys are not mortal if the Wound penetrate into the Cavity it self for the most part an Ulcer follows which consumes the whole Kidney yet the Patient may continue many years If the Parachyma only be wounded sometimes through difficulty it may be cured 11. Wounds of the Bladder are seldom so perfectly cured but that for the most part there remains a Fistula but those that are made at the neck of the bladder are daily cured 12. Wounds of the great Veins and Arteries are often mortal but every Surgeon understands not rightly to bind up such Wounds therefore the cause of death is not always to be cast upon the guilty 13. Wounds of the great Nerves are for the most part incurable and sometimes mortal 14. Wounds from poisoned Instruments or Creatures generally are mortal Wounds of Nerves Veins Tendons and Membranes are more difficultly and longer of Cure than those of the fleshy parts A Wound from a pricking Instrument is of less danger than from a bruising A Nerve Vein or Artery if wholly divided are less dangerous than if they were but in part A great Inflamation coming upon a great Wound is of no great danger except it continue too long but a great Inflamation falling upon a little Wound is an ill sign The Inflamation for the most part vanisheth by the fifth day therefore if the Wound then appear white livid or black 't is not void of danger A Fever Vomiting and Convulsion are dangerous but a Fever and Vomiting of less danger than a Convulsion CHAP. II. Of the Cure of Wounds in general HEre are required four Intentions 1. To preserve the strength and native heat of the wounded Part. 2. To remove the Symptoms 3. To endeavour that nothing remains or be left behind in the Wound 4. That the gaping Lips of the Wound be joined together and being so joined be kept CHAP. III. Of the preservation of the strength and Native heat in the wounded Part. CHirurgery removes the impediments of Cure but Nature her self cures the Disease which it will scarce effect where the Native heat is weak or the Blood vitiated or where it flows in too great or too little quantity to the Wound in flowing in too great quantity it produceth an Inflammation Pain Putrefaction and many other Symptoms where in too little quantity the Wound is robbed of its Natural Balsam necessary to consolidate it The natural strength and native heat is preserved by a convenient Diet fitted to the temperament of Mans body in general and in particular to the Part affected Of the Diet of the Sanguine Cholerick Phlegmatick and Melancholick we have treated of before