And you must observe that when we say the body or any part of it is hot wee understand more hot than is fit for one of that kinde which is tempered to justice as when we say a man hath a hot liver wee meane his liver is hotter than a man justly tempered should have for all other tempers whether of the whole body or any of the parts thereof are to be referred to this and in the cure of diseases we must looke upon it as the marke and labour to preserve it by the use of convenient things as much as lies in our power Wherefore because it is very necessary to know the distinction of temperaments I have thought good in this place briefly to handle the temperaments of the parts of the body ages seasons of the yeare humors and medicines Therefore the temperaments of the parts of our body are of this nature not onely by the judgement of the touch of a mans hand which is justly tempered who is often deceived by flowing heate which spread from the heart into all the body imparts a certaine kinde of heate to all the parts but also by the rule of their reason composure and sustance as A Bone is the most drie and cold A Gristle lesse than it A Ligament lesse than a Gristle A Tendon is so much drier and colder than the membrane by how much it in the same temper exceedes a Veine and Arterie Then follow the harder veines for the softer are in a middle temper of drinesse and moisture like as the skinne although all both soft and hard are of a cold temper Wherefore all these parts of their owne nature are cold and without bloud although the veines and arteries waxe hot by reason of the heate of the bloud they containe which notwithstanding also borroweth that heat from the heart as a part most hot and softer than the skinne the liver next followeth the heart in the order of the hotter parts which is far softer than the skinne it selfe for if according to Galens opinion the heart is somewhat lesse hard than the skinne and that is farre harder than the liver as appeares by touching them it must necessarily follow that the liver much exceedes the skinne in softnesse I understand the skinne simple and separated from the flesh lying under it to which it firmely cleaves The flesh is more moist and hot than the skinne by reason of the bloud dispersed in it The spinall marrow is colder and moister than the skinne but the braine so much exceeds it in moisture as it is exceeded by the fat The lungs are not so moist as the fat and the spleene and kidnies are of the like nature and neverthelesse they are all moister than the skinne According to the diversities of ages the temperaments both of the whole body and all its parts undergoe great mutations for the bones are farre harder in old men than in children because our life is as it were a certaine progresse to drinesse which when it comes to the height consequently causeth death Wherefore in this place we must speake of the Temperaments of ages when first we shall have defined what an age is Therefore an age is defined a space of life in which the constitution of the bodie of its selfe and owne accord undergoeth manifest changes the whole course of life hath foure such ages The first is childhood which extends from the birth to the eighteenth yeare of age and hath a hot and moist temper because it is next to the hot and moist beginnings of life seed and bloud Youth followeth this which is prolonged from the eighteenth to the twentie fift yeare and is temperate and in the midst of all excesses Mans estate succeedeth youth which they deny to extend beyond the thirtie fift yeare of age in its proper temper it is hot and drie whereby it commeth to passe that then the heate is felt more acride and biting which in childhood seemed milde because the progresse of the life to drinesse hath much wasted the native humiditie Then succedes old age ever devided into two parts the first whereof extends from the thirtie fift to the fortie ninth yeare those of this age are called old men but we commonly call them middle aged men The latter is as it were devided by Galen into three degrees the first whereof are those who having their strength sound and firme undergoe civill affaires and businesses which things those which are in the second degree of old age cannot doe because of the debilitie of their now decaying strength but those which are in the last degree are afflicted with most extreme weakenesse and miserie and are as much deprived of their sences and understanding as of the strength of their bodies whereof arose this Proverbe Old men twice children Those old men of the first ranke are pleasant and courteous and those we say are beginning to grow old or in their greene old-age those of the second sort delight in nothing but the boord and bed but old decreepit men of the last order thinke of nothing else than their graves and monuments Their firme and solid parts are of a cold and drie temperature by reason of the decay of the radicall moisture which the inbred heate causeth in the continuance of so many years Which thing may happen in a short space by the vehement flame of the same natural heate turned by feavours into a fiery heate But if any to prove old men moist will object that they cough up and spit much I will answer him as an old Doctor once said That a pitcher filled with water may powre forth much moisture yet no man will deny but that such a vessell of its owne terrene nature and matter is most drie so old men may plainely be affirmed to be moist by reason of their defect of heate and aboundance of excrements But this description of ages is not to be taken so strictly as alwayes to be measured by the spaces and distances of yeares for there are many which by their owne misdemeanour seeme elder at fortie than others doe at fiftie Lastly the famous Philosopher Pythagoras devided man life into foure ages and by a certaine proportion compared the whole course thereof to the foure seasons of the yeare as childhood to the Spring in which all things grow and sprout out by reason of plenty and aboundance of moisture And youth to the Summer because of the vigour and strength which men enjoy at that age And mans estate or constant age to Autumne for that then after all the dangers of the forepassed life the gifts of discretion and wit acquire a seasonablenesse or ripenesse like as the fruits of the earth enjoy at that season And lastly he compares old age to the sterile and fruitlesse Winter which can ease and consolate its tediousnesse by no other meanes than the use of fruits gathered and stored up before which then are of a
situate above the Perinaum It hath connexion with the fundament the necke of the wombe and bladder by both their peculiar orifices It hath a middle temper betweene hot and cold moist and drie It hath the same use as a mans Praeputium or fore-skinne that is that together with the Numpha it may hinder the entrance of the aire by which the wombe may be in danger to take cold The lips of the privities called by the Greekes 〈◊〉 〈◊〉 〈◊〉 〈◊〉 〈◊〉 by the Latines Ala containe all that region which is invested with haires and because we have falne into mention of these Nympha you must know that they are as it were productions of the musculous skinne which descend on both sides from the upper part of the share-bone downewards even to the orifice of the necke of the bladder oft times growing to so great a bignesse that they will stand out like a mans yard Wherefore in some they must be cut off in their young yeares yet with a great deale of caution left if they be cut too rashly so great an effusion of bloud may follow that it may cause either death to the woman or barrennesse of the wombe by reason of the refrigeration by the too great effusion of bloud The latter Anatomists as Columbus and Fallopius besides these parts have made mention of another particle which stands forth in the upper part of the privities and also of the urinary passage which joynes together those wings wee formerly mentioned Columbus cals it Tentigo Fallopius Cleitoris whence proceeds that infamous word Cleitorizein which signifies impudently to handle that part But because it is an obscene part let those which desire to know more of it reade the Authors which I cited The thirteenth Figure shewing the parts of women different from these in men A. B. C. D. The Peritonaeum reflected or turned backward above and below E. F. the gibbous part of the liver 〈◊〉 the cave or hollow part E. G. The trunke of the gate veine H. the hollow veine I. the great artery K. the rootes of the Coelicall artery which accompanieth the gate veine L. M. the fatty veine going to the coate of the kidneies N. O. the fore-part of both the kidneies T. V. the emulgent veines and arteries aa the right ureter at the lowest a cut from a part which neere to b sticketh yet to the bladder because the bottome of the bladder is drawne to the left-side c. the left ureter inserted into the bladder neere to r. dd the spermaticke veine which goeth to the left testicle marked with i. ee the spermaticke veine which goeth to the left testicle with i also f. the trunke of the great arterie from whence the spermaticall arteries doe proceed g. h. the spermaticall arteries ii the two testicles ll a branch which from the spermaticke vessels reacheth unto the bottome of the wombe mm. the leading vessell of the seede which Falopius calleth the tuba or trumpet because it is crooked and reflected n. a branch of the spermaticke vessel compassing the leading vessell oo a vessell like a worme which passeth to the wombe some call it Cremaster p. the bottome of the wombe called fundus vteri q. a part of the right gut r. s the bottome of the bladder whereto is inserted the left ureter and a veine led from the necke of the wombe neere unto r. t. the necke of the bladder u. the same inserted into the privitie or lap x. a part of the necke of the wombe above the privity yy certaine skinnie Caruncles of the privities in the midst of which is the slit and on both sides appeare little hillocks The Figures belonging to the Dugges and Breasts αα The veines of the Dugs which come from those which descending from the top of the shoulder are offered to the skinne β. the veines of the dugges derived from those which through the arme-hole are led into the hand γ. the body of the Dugge or Breast δδ the kernels and fat betweene them εε the vessels of the Dugges descending from the lower part of the necke called iugulum under the breast bone CHAP. XXXV Of the Coats containing the Infant in the wombe and of the Navell THe membranes or coates containing the infant in the wombe of the mother are of a spermaticke and nervous substance having their matter from the seede of the mother But they are nervous that so they may be the more easily extended as it shall be necessary for the child They are of good length and bredth especially neare the time of deliverance they are round in figure like the wombe Their composition is of veines arteries and their proper substance The veines and arteries are distributed to them whether obscurely or manifestly more or fewer from the wombe by the Cotyledones which have the same office as long as the child is contained in the wombe as the nipples or pappes of the nurses after it is borne For thus the wombe brings the Cotyledones or veines degenerating into them through the coates like certaine paps to the infant shut up in them These coates are three in number according to Galen one called the Chorion Secundine or afterbirth the other Allantoides the third Amnios I find this number of coates in beasts but not in women unlesse peradventure any will reckon up in the number of the coats the Cotyledones swollen up and grown into a fleshie masse which many skilfull in Anatomy doe write which opinion notwithstanding we cannot receive as true I could never in any place finde the Allantoides in women with child neither in the infant borne in the sixth seventh eight or in the full time being the ninth moneth although I have sought it with all possible diligence the Midwives being set apart which might have violated some of the coates But thus I went about this businesse I devided the dead body of the mother cross-wise upon the region of the wombe and taking away all impediments which might either hinder or obscure our diligence with as much dexteritie as was possible wee did not onely draw away that receptacle or den of the infant from the inward surface of the wombe to which it stucke by the Cotyledones but we also tooke away the first membrane which we called Chorion from that which lies next under it called Amnios without any rending or tearing for thus we powred forth no moisture whereby it might be said that any coate made for the containing of that humor was rent or torne And then we diligently looked having many witnesses and spectators present if in any place there did appeare any distinction of these two membranes the Allantoides and Amnios for the separating the contained humors and for other uses which they mention But when we could perceive no such thing we tooke the Amnios filled with moisture on the upper side and having opened it two servants so holding the apertion that no moisture might flow out of it into the
humors composing the masse of blood if they at any time offend in quantity or quality For whether if any thing abound or digresse from the wonted temper in any excesse of heat cold viscosity grossenes thinnes or any such like quality none of the accustomed functions will be well performed For which cause those cheife helpes to preserve and restore health have beene divinely invented Phelebotomy or bloodletting which amends the quantity of too much blood and purging which corrects and drawes away the vicious quality But now let us begin to speak of the Humors taking our beginning from the definition An Humor is called by Phisitions what thing so ever is Liquide and flowing in the body of living Creatures endued with Blood that is either natural or againstnature The naturall is so called because it is fit to defend preserve and sustaine the life of a Creature Quite different is the nature reason of that which is against nature Again the former is either Alimentary or Excrementitious The Alimentary which is fit to nourish the body is that Humor which is contained in the veines and arteries of a man which is tēperate perfectly wel which is understood by the general name of blood which is let out at the opening of a veine For blood otherwise taken is an Humor of a certaine kind distinguished by heate and warmnesse from the other Humors comprehended together with it in the whole masse of the blood Which thing that it may the better be understood I have thought good in this place to declare the generation of Blood by the efficient and materiall causes All things which we eate or drink are the materialls of blood which things drawne into the bottome of the ventricle by its attractive force and there detained are turned by the force of concoction implanted in it into a substance like to Almond Butter Which thing although it appeare one and like it selfe yet it consists of parts of a different nature which not only the variety of meats but one the same meate yeelds of it self We terme this Chylus when it is perfectly concocted in the stomacke But the Gate-veine receives it driven from thence into the small guts and sucked in by the Meseraicke veins and now having gotten a litle rudiment of Change in the way carries it to the Liver where by the blood-making faculty which is proper and naturall to this part it acquires the absolute and perfect forme of blood But with that blood at one and the same time and action all the humors are made whether Alimentary or excrementitious Therefore the blood that it may performe its office that is the faculty of nutrition must necessarily be purged and clensed from the two excrementitious humors Of which the bladder of Gall drawes one which we call Yellow Choler and the Spleen the other which we terme Melancholy These two humors are naturall but not Alimentary or nourishing but of another use in the body as afterwards we will shew more at large The blood freed from these 2. kinds of excrements is sent by the veines and Arteries into all parts of the body for their nourishment Which although then it seeme to be of one simple nature yet notwithstanding it is truly such that foure different and vnlike substances may be observed in it as blood properly so named Phlegme Choler and Melancholy not only distinct in colour but also in taste effects and qualities For as Galen notes in his booke De Natura humana Melancholy is acide or soure choler bitter Blood sweet Phlegme unsavory But you may know the variety of their effects both by the different temper of the nourished parts as also by the various condition of the diseases springing from thence For therefore such substances ought to be tempered and mixed amongst themselves in a certaine proportion which remaining health remaines but violated diseases follow For all acknowledge that an Oëdema is caused by Phlegmatick a Scirrhus by Melancholike an Erysipelas by Cholericke and a Phlegmone by pure and laudable blood Galen teaches by a familiar example of new wine presently taken from the presse that these 4 substances are contained in that one Masse and mixture of the blood In which every one observes 4. distinct Essences for the flower of the wine working up swims at the top the dregs fall downe to the bottome but the crude and watery moisture mixed together with the sweet and vinous liquor is every where diffused through the body of the wine the flower of the wine represents Choler which bubling up on the superficies of blood as it concretes and growes cold shineth with a golden colour the dregs Melancholy which by reason of its heavines ever sinketh downward as it were the Mudd of the blood the crude and watery portion Phlegme for as that crude humor except it be rebellious in quantity or stubborne by its quality there is hope it may be changed into wine by the naturall heate of the wine so Phlegme which is blood halfe concocted may by the force of native heat be changed into good and laudable blood Which is the cause that nature decreed or ordained no peculiar place as to the other 2. humours whereby it might be severed from the blood But the true and perfect liquor of the wine represents the pure blood which is the more laudable and perfect portion of both the humors of the confused Masse It may easily appeare by the following scheme of what kind they all are and also what the distinction of these foure humors may be  NATVRE CONSISTANCE COLOVR TASTE VSE Blood is Of Nature aery hot and moyst or rather temperate Of indifferent consistance neither too thicke nor too thin Of Colour red rosy or Crimson Of Taste sweete Of such use that it cheifly serves for the nourishment of the fleshyparts and caried by the vessels imparts heate to the whole body Phlegme is Of Nature watery cold and moist Of Consistance liquid Of Colour white Of Taste sweet or rather unsavory for we commend that water which is vnsavory Fit to nourish the braine and al the other cold and moist parts to temper the heate of the blood and by its slipperines to helpe the motion of the joynts Choler is Of Nature fiery hot and drie Of Consistance Thin Of Colour yeallow or pale Of Taste bitter It provoketh the expulsive faculty of the guts attenuates the Phlegme cleaving to them but the Alimentary is fit to nourish the parts of like temper with it Melancholy is Of Nature earthly cold and dry Of Consistance grosse and muddy Of Colour blackish Of taste acide soure or biting Stirs up the Appetite nourishes the spleene and all the parts of like temper to it as the Bones Bloud hath its neerest matter from the better portion of the Chylus and being begunne to be laboured in the veines at length gets forme and perfection in the
liver but it hath its remote matter from meates of good digestion and quality seasonably eaten after moderate exercise but for that one age is better than another and one time of the yeare more convenient than another For bloud is made more copiously in the Spring because that season of the yeare comes neerest to the temper of the bloud by reason of which the bloud is rather to be thought temperate than hot and moist for that Galen makes the Spring temperate and besides at that time bloud-letting is performed with the best successe youth is an age very fit for the generation of bloud or by Galens opinion rather that part of life that continues from the 25. to the 35. yeare of our age Those in whom this humor hath the dominion are beautified with a fresh and rosie colour gentle and well natured pleasant merry and facetious The generation of Phlegme is not by the imbecillity of heat as some of the ancients thought who were perswaded that choler was caused by a raging bloud by a moderate and phlegme and melancholy by a remisse heate But that opinion is full of manifest errour for if it be true that the Chylus is laboured and made into bloud in the same part and by the same fire that is the liver from whence in the same moment of time should proceed that strong and weake heate seeinge the whole masse of the bloud different in its foure essentiall parts is perfected and made at the same time and by the same equall temper of the same part action and bloud-making facultie therefore from whence have we this varietie of humors From hence for that those meates by which wee are nourished enjoy the like condition that our bodies doe from the foure Elements and the fouré first qualities for it is certaine and wee may often observe in what kind soever they be united or joyned together they retaine a certain hot portion imitating the Fire another cold the water another dry the earth and lastly another moist like to the Aire Neither can you name any kinde of nourishment how cold soever it be not Lettuce it selfe in which there is not some fiery force of heate Therefore it is no marvell if one and the same heate working upon the same matter of Chylus varying with so great dissimilitude of substances doe by its power produce so unlike humors as from the hot Choler from the cold Phlegme and of the others such as their affinity of temper will permit There is no cause that any one should thinke that varietie of humors to be caused in us rather by the diversity of the active heate than waxe and a flint placed at the same time and in the same situation of climate and soile this to melt by the heat of the Sunne and that scarse to waxe warme Therefore that diversitie of effects is not to be attributed to the force of the efficient cause that is of heate which is one and of one kinde in all of us but rather to the materiall cause seeing it is composed of the conflux or meeting together of various substances gives the heate leave to worke as it were out of its store which may make and produce from the hotter part thereof Choler and of the colder and more rebellious Phlegme Yet I will not deny but that more Phlegme or Choler may be bred in one and the same body according to the quicker or slower provocation of the heate yet neverthelesse it is not consequent that the originall of Choler should be from a more acride and of Phlegme from a more dull heat in the same man Every one of us naturally have a simple heate and of one kinde which is the worker of diverse operations not of it selfe seeing it is alwayes the same and like it selfe but by the different fitnesse pliablenesse or resistance of the matter on which it workes Wherefore phlegme is generated in the same moment of time in the fire of the same part by the efficiency of the same heate with the rest of the bloud of the more cold liquide crude and watery portion of the Chylus Wherby it comes to passe that it shewes an expresse figure of a certaine rude or unperfect bloud for which occasion nature hath made it no peculiar receptacle but would have it to run friendly with the bloud in the same passages of the veines that any necessitiehappening by famin or indigency and in defect of better nourishment it may by a perfecter elaboration quickly assume the forme of bloud Cold rude nourishmēt make this humor to abound principally in winter and in those which incline to old age by reason of the similitude which phlegme hath with that season and age It makes a man drowsie dull fat and swollen up and hasteneth gray haires Choler is as it were a certaine heate and fury of humors which generated in the liver together with the bloud is carried by the veines and arteries through the whole body That of it which abounds is sent partly into the guts and partly into the bladder of the gall or is consumed by transpiration or sweates It is somewhat probable that the Arteriall bloud is made more thinne hot quicke and pallid than the bloud of the veines by the commixture of this Alementarie choler This humor is chiefely bred and expeld in youth and acrid and bitter meates give matter to it but great labours of bodie and minde give the occasion It maketh a man nimble quicke ready for all performance leane and quicke to anger and also to concoct meates The Melancholicke humor or Melancholy being the grosser portion of the bloud is partly sent from the Liver to the Spleene to nourish it and partly carried by the vessels into the rest of the body and spent in the nourishment of the parts endued with an earthly drinesse it is made of meates of grosse juyce and by the perturbations of the minde turned to feare and sadnesse It is augmented in Autumne and in the first and crude old age it makes men sad harsh constant froward envious and fearefull All men ought to thinke that such humors are wont to move at set houres of the day as by a certaine peculiar motion or tide Therefore the bloud flowes from the ninth houre of the night to the third houre of the day then Choler to the ninth of the day then Melancholy to the third of the night the rest of the night that remaines is under the dominion of Phlegme Manifest examples hereof appeares in the French-Poxe From the elaborate and absolute masse of the bloud as we said before two kindes of humors as excrements of the second concoction are commonly and naturally separated the one more grosse the other more thinne This is called either absolutely choler or with an adjunct yellow choler That is called Melancholy which drawne by the Spleene in a thinner portion and elaborate by the heate of the Arteries which
privately and properly drawes the hip in an oblique manner towards the Cartilago Scutiformis or brest-blade Then follow the oblique ascendant who haue the same substance quantity figure composure number and temper the descendant have They are scituate between the descendant and transverse with whom they have connexion especially by the vessels which are brought from the parts beneath All the fleshy parts arise from the rackbones of the Haunch to the ends of the bastard ribs which they seeme to admit above and below being fleshy even to the fourth and then becomming membranous they take their way to the white line with a double aponeurôsis which passes through the right Muscles above and below as wee may plainely see from the navill downewards In their fleshy part they draw their originall from the spine of the Haunch bones a little lower than the descendent end in their fleshy parte But for their membranous parts they arise before from the share bone but behinde from the spondiles of the Holy bone and Vertebra's of the loines obliquely ascending vpwards to the white line into which they are terminated by an aponeourôsis or membranous tendon which seemes to penetrate the right Muscle vpwards and downewards especially vnder the navil but by their fleshy part at the ends of all the bastard ribbes which they seeme to receive above and below And because these muscles are terminated in the white line they have also another use yet such as is common to all the muscles of the Epigastrium that is to presse down the Guts Their action is if they performe it together to draw downe the chest and dilate the brest but if their actions be separate they draw the chest to the hip with an oblique motion After these follow the right muscles so called because they descend according to the length of the body because they have right or streight fibers Wee will say nothing to shunne prolixitie which in all other places wee will avoid of their substance and other conditions which they have common with the fore mentioned Muscles They are scituate in the eminentest or extuberating region of the belly bounding the Epigastrium taken in generall or the superficiary belly they are devided by the manifest intercourse of the white line even to the Navell in which place they seeme to be united even to the place of their insertion They draw their originall not from the share bone as some would have it but according to the insertion of their nerves from the sides of the Cartilago scutiformis the ends of the sixt seventh and eight ribbs but they end in the share bone where they make a common tendon sufficiently strong and short Syluius Vesalius and Columbus thinke they arise from the share bone because they cannot be inserted into that bone because it is immoveable You may perceive in these Muscles certaine nervous transverse intersections often times three in number for the strength of these Muscles of which Galen makes no mention although they may be seene in Apes And also in the inner side of these muscles you may see foure veines and as many arteryes of which some creepe upwards others run downwards The upper called the Mamillary descend from the Axillarie by the side and lower partes of the Sternon the slenderer portions thereof being distributed by the way to the Mediastinum and about the fourth and fift rib to the Dugges from whence they take their name That which remaines breaking out by the sides of the Brest-blade inserts it selfe into those muscles creeping along euen almost to the navell in which place they are manifestly united that is the veines with the veines and arteries with the arteryes with the Epigastricke which ascend from the vpper part of the Iliackes on each side under the said muscles untill they meet with these 4 mamillary vessels That you may finde this concourse of the veines and arteryes about the navill you must follow both the upper and the lower somewhat deepe into the flesh pressing the blood on both sides from above downewards and from below upward untill you shall finde the exosculation of these vessels which will appeare by this that the blood will flow from this into that and from that into this otherwise you can scarce perceiue it by reason of the smallnes of such vessels which want blood But that by the benefit of such concourse of the vessels the matters may be communicated and transported both from the wombe to the dugs and againe from the dugs to the wombe appeares in Nurses who want their courses when the milke comes into their dugs and on the contrary lose their milke when their courses flow plentifully Otherwise to what purpose should there be such concourse betweene the vessels of the pappes and wombe for there are veines and arteries diffused to the sides of the wombe from the roote of the Epigastrickes for indeed the Epigastrickes which in their ascent meete with the mamillary goe not to the wombe though they be next to them and arise from the same truncke with the Hypogastricke veine of the wombe The Action of these muscles is to move or drawe neere together the parts of the Hypogastrium to the praecordia or Hypochondryes Their use in Columbus opinion is to draw the Brest downewards so to dilate it At the ends of these Nature hath produced two other small Muscles from the upper part of the share bone of a triangular figure for the safety of the thicke and common tendon of the right Muscles whereupon they are called Succenturiati or assisters Some moved with I know not what reason would haue these two small Muscles to help the erection of the yeard Columbus thinkes they should not be separated from the right and that they only are the fleshy beginnings of the right But on the contrary Fallopius manifestly proves them different and separate from the right and shewes their vse The Transverse remine to be spoken of so called by reason of their fibers which make right angles with the fibers of the right Muscles They haue a quadrangular figure scituate vpon the greatest part of the Peritonaeum to which they sticke so close that they scarse can be separated They take their originall from the production of the loines the Eminency of the Haunch-bone the transverse productions of the vertebra's of the loynes and the ends of the bastard ribs contrary to the opinion of many whom the insertion of the nerve convinces but they end in the white line as all the rest doe Their action is to presse the guts especially for the expulsion of excrements But all the 8 recited Muscles besides their proper use haue another common that is they stand for a defence of Bulwarke for all the parts lying under them and serve for the expulsion both of the excrements infant and vapoures and also for the strenghtening of the voice as experience
one root To these are ioyned two in each Iaw that is on each side of the other one which are called Canini dentes Dogges-teeth because they are sharp and strong like dogges teeth these also have but one roote but that is farre longer than the other have Then follow the Molares or Grinders on each side five that is tenne above and as many below that they may grinde chaw and breake the meat that so it may be the sooner concocted in the stomack for so they vulgarly thinke that meat well chawed is halfe concocted those grinders which are fastened in the upper jaw have most commonly three roots and oft times foure But these which are fastened in the lower have only two roots and sometimes three because this lower jaw is harder than the upper so that it cannot be so easily hollowed or else because these teeth being fixed and firmely seated needed not so many stayes as the upper which as it were hang out of their seats The shearing teeth cut the meat because they are broad and sharp the Dog-teeth break it because they are sharp pointed and firme but the grinders being hard broad and sharp chaw and grind it asunder But if the grinders had beene smooth they could not fitly have performed their duty for all things are chawed and broken asunder more easily by that which is rough and unequall Wherefore they sharpen their Milstones when they are smoother than they should be by picking them with a sharp Iron The teeth are fastened in the jawes by Gomphosis that is as a stake or naile so are they fixed into the holes of their jawes for they adhere so firmely thereto in some that when they are pluckt out part thereof followes together with the tooth which I have often observed to have beene also with great effusion of blood This adhesion of the teeth fastened in their jawes is besides strengthened with a ligament which applyes it selfe to their roots together with the nerve and vessels The teeth differ from other bones because they have action whilest they chaw the meat because being lost they may be regenerated and for that they grow as long as the party lives for otherwise by the continuall use of chawing they would be worne and wasted away by one another You may perceive this by any that have lost one of their teeth for that which is opposite to it becomes longer than the rest because it is not worne by its opposite Besides also they are more hard and solide than the rest of the bones and indued with a quick sense by reason of the nerves of the third conjugation which insert themselves into their roots for if you rub or grind a tooth newly pluckt out you may see the remaines of the nerve they have such quick sense that with the tongue they might judge of tastes But how feele the teeth seeing they may be filed without paine Fallopius answeres that the teeth feele not in their upper or exterior part but only by a membrane which they have within And the teeth have another use especially the fore-teeth which is they serve for distinct and articulate pronuntiation for those that want them faulter in speaking as also such as have them too short or too long or ill rancked Besides children speak not distinctly before they have their foreteeth And you must note that the infant as yet shut up in its mothers womb hath solide and bony teeth which you may perceive by dissecting it presently after it is borne But even as there are two large cavities in the forehead bone at the eye-browes filled with aviscous humor serving for the smelling and in like manner the aire shut up in the mamillary processes is for hearing so in the jawes there be two cavities furnished with a viscide humor for the nourishment of the teeth CHAP. III. Of the Broade Muscle NOw we should prosecute the containing parts of the face to wit the skin the fleshy pannicle and fat but because they have beene spoken of sufficiently before I will onely describe the sleshy pannicle before I come to the dissection of the eye that wee may the more easily understand all the motions performed by it whether in the face or forehead First that you may more easily see it you must curiously separate the skin in some part of the face For unlesse you take good heed you will pluck away the fleshy pannicle together with the skinne as also this broad muscle to which it immediatly adheres and in some places so closly and firmely as in the lips eye-lids and the whole forehead that it cannot be separated from it Nature hath given motion or a moveing force to this broad muscle that whilest it extends or contracts it selfe it might serve to shut and open the eye It will be convenient to separate the muscle thus freed from the skin beginning from the forepart of the clavicles even to the chin ascending in a right line and then turning backe as far as you can for thus you shall shew how it mixes it selfe with the skinne and the muscles of the lips When thou shalt come to the Eyes thou shalt teach how the eye is shut and opened by this one muscle because it is composed of the three sorts of fibers although by the opinion of all who have hitherto written of Anatomy those actions are said to be performed by the power of two muscles appointed for that purpose one of which is at the greater corner on the upper part the other resembling a semicircle at the lesser corner from whence extending it selfe to the midle of the gristle Tarsus it meets with the former ending there but they are in part extended over all the eyelid whereby it commeth to passe that it also in some sort becometh moveable But although in publike dissections these two muscles are commonly wont to be solemnly shewed after the manner I have related yet I thinke that those which shew them know no more of them than I doe I have grounded my opinion from this that there appeares no other musculous flesh in these places to those which separate the fleshy pannicle or broad muscle than that which is of the panicle it selfe whether you draw your incision knife from the forehead downewards or from the cheeke upwards Besides when there is occasion to make incision on the eye-browes we are forbidden to doe it transverse least this broad muscle falling upon the eye make the upper Eye-lid unmoveable but if such a cut be received accidentally we are commanded presently to stitch it up which is a great argument that the motion of the upper eye-lid is not performed by its proper muscles but wholy depends and is performed by the broad muscle Now if these same proper muscles which we have described should be in the upper eye-lid it should be meet because when one of the muscles is in action the other which is its opposite
called the median veine because it arises from two branches and is seated betweene them They usually open this median veine in the diseases of the head and liver which require Phlebotomy but if it shall not be sufficiently manifest when you judge it must be opened for a generall evacuation of the whole body you may cut one of these branches by whose concourse it is made which you shall think the fitter and because each branch drawes from the next parts according to the straightnesse of the fibers rather than from the opposite side if you would evacuate the head and liver equally by opening either of these branches it is convenient that opening that branch for example which comes from the Cephalicke you presently lay your thumbe upon it untill you suppose you have drawne a just quantity of bloud from the liver by the Basilica or liver veine which done you may take off your thumbe and suffer the bloud to follow freely by the open branch of the Cephalicke untill you have drawne as much bloud as you shall judge requisite otherwise you will draw it but from one part to wit the head So you shall evacuate it onely from the liver if you open the branch which comes from the Basilica and concurs to the generation of the median Moreover when there is neede to open the Basilica and it shall be no where conspicuous the Cephalicke or median being easie to be discerned at the same time you may in stead thereof open the median or if it be not to be found the Cephalicke pressing but the trunke thereof with your thumbe as we said before lest the head should be evacuated in stead of the liver You may doe the same in the Basilica if when there shall be necessitie to open the Cephalicke it shall not appeare Most of those which at this day open a veine in stead of the median open that branch of the Basilica which ascends together with the Cephalicke to make the median But you must understand that the median descends betweene the two bones of the cubit even to the end thereof and then devided into many branches it is at length spent on the backe of the hand behinde the thumbe the fore and middle fingers or the afterwrest Sometimes it runs backe into the following branch and then at the wrest it departs from it to be bestowed upon the forementioned parts The other branch of the Cephalicke which we may call the fore and outward Cephalicke descending directly downe to the midst of the wand thence wanders overthwart into the hinde part of the arme where encreased with a branch from the Basilica it is distributed over all the backe of the hand which with the median it nourishes But the branches of these veines doe so run through the forenamed parts that by the way they yeeld them necessary provision CHAP. XXII The Description of the Axillary veine THe Axillary arising at the insertion of the pectorall muscle or a little higher after it hath produced the two Thoracicae it is devided under the tendon of that muscle into two faire branches that is to say into the inner deepe Axillary and the skinne or outward axillary The deepe or inner having still for his companion in his descent the axillary artery and the nerves of the third conjugation after it hath produced the small externall musculous of the arme it goes into the bending of the elbow where running somewhat deepe with the artery and nerve into the muscles of the cubite it is devided into three other branches of which one descending with the wand slides under the ring into the inner side of the hand and hath bestowed two small branches on the thumbe two others on the fore and one upon the middle finger so that all of them ascend by the sides of these fingers the other descending with the artery as the former alongst the cubite sends branches to the rest of the fingers like as the former The third goes on the foreside betweene the two bones even to the wrest and the square muscle But you must note that the veines of which we now treate doe not onely make these devisions mentioned by us but infinite others besides as well in the parts which they goe to as also in the inner muscles of the hand which they nourish And thus much of the internall and deepe axillary veine For the externall or skin Axillary which first appeares under the skinne especially in leane bodies a little above the inward production of the arme it is devided in that place into two branches the one whereof descending to the bending of the arme meets and is united with the Cephalike branch sooner or later that so it may produce the median as we formerly mentioned The other branch having sent forth many shoots of a different length and thicknesse as well into the skinne as into the other neighbouring parts descending alongst the lower side of the bone of the cubite properly so called is at length spent upon the fore and outward Cephalicke branch which we said descended alongst the wand and thus united they runne over all the hand where in the right hand betweene the middle and fore finger they make the Salvatella but in the left in the same place they produce the Splenitica But alwayes remember if in dissection you finde any thing otherwise than wee have delivered it that the distribution of the vessels is so various especially in the hands that there can no certaine rule be delivered thereof CHAP. XXIII The Distribution of the Axillary Artery THe Axillary artery from the first originall which is presently after the two Thoracica descending betweene the muscle called Biceps or the two headed muscle and the Brachiaeus with the deepe axillary veine distributes a large branch amongst the outward muscles of the arme which extend the cubite and is spent in the externall muscles of the same which arise without from the productions of the arme And this is called the Ramus Musculus or Musculous branch as also the veine that accompanyes this Arterye Then this Arterye when it comes to the bending of the cubite thrusting it selfe into the muscles bending the fingers communicates certaine branches to the parts pertaining to the dearticulation of the cubit with the shoulder and other parts there situate as it did in the upper parts by which it descended hither Verily it may it may be a generall rule that every vessell sends or bestowes certaine portions thereof by the way to all the parts by which it passes But if you should aske why I have not prosecuted these productions I would answer I never intended to handle other than large and faire branches of vessels by rash incision of which there may happen danger of death or a disease For it would be both an infinit and needles busines to handle all the small divarications of the veines arteryes and nerves Therfore this Artery sunke into these muscles
and condition of the matter which flowes downe and generates the tumor also they are knowne by such accidents as happen to them as colour heat hardnesse softnesse paine tension resistance Wherefore paine heate rednesse and tension indicate a sanguine humor coldnesse softnesse and no great paine phlegme tension hardnesse the livide colour of the part and a pricking paine by fits melancholy and yellowish and pale colour biting paine without hardnesse of the part choler And besides Impostumes have their periods and exacerbations following the nature and motion of the humors of which they are generated Wherefore by the motion and fits it will be no difficult matter to know the kinde of the humor for as in the Spring so in the morning the bloud is in motion as in the Summer so in the middest of the day choler as in Autumne so in the evening melancholy as in Winter so on the night the exacerbations of phlegme are most predominante For Hippocrates and Galen teach that the yeare hath circuits of diseases so that the same proportion of the excesse and motion of humors which is in the foure seasons of the yeare is also in the foure quarters of each day Impostumes which are curable have foure times their beginning increase state and declination and we must alter our medicines according to the varietie of these times We know the beginning by the first swelling of the part The increase when the swelling paine and other accidents do manifestly encrease and enlarge themselves the state when the foresaid symptoms increase no more but each of them because at their height remaine in their state immoveable unlesse the very matter of the tumor degenerate and change it selfe into another kinde of humor The declination when the swelling paine feaver restlesnesse are lessened And from hence the Chirurgion may presage what the end of the tumor may be for tumors are commonly terminated foure manner of wayes if so be that the motion of the humors causing them be not intercepted or they without some manifest cause doe flow backe into the body Therefore first they are terminated by insensible transpiration or resolution secondly by suppuration when the matter is digested and ripened thirdly by induration when it degenerates into a Scyrrhus the thinner part of the humor being dissolved the fourth which is the worst of all by a corruption and Gangrene of the part which is when overcome with the violence or the abundance or quality of the humor or both it comes to that distemper that it looses its proper action It is best to terminate a tumor by resolution and the worst by corruption suppuration and induration are betweene both although that is far better than this The signes by which the Chirurgions may presage that an Impostume may be terminated by resolving are the remission or flacking of the swelling paine pulsation tension heat and all other accidents and the unaccustomed livelinesse and itching of the part and hot Impostumes are commonly thus terminated because the hot humor is easily resolved by reason of its subtilty Signes of suppuration are the intension or encrease of paine heat swelling pulsation and the feaver for according to Hippocrates paine and the feaver are greater when the matter is suppurating then whan it is suppurated The Chirurgion must be very attentive to know and observe when suppuration is made for the purulent matter oft times lies hid as Hippocrates saith by reason of the thicknesse of the part lying above or over it The signes of an Impostume degenerating into a Scyrrhus hardnesse are the diminution of the tumor and hardnesse remaining in the part The causes of the hardnesse not going away with the swelling are the weakenesse of nature the grosnesse and toughnesse of the humor and unskilfulnesse of the Chirurgion who by too long using resolving things hath occasioned that the more subtile part of the humor being dissolved the rest of the grosser nature like earthy dreggs remaines concrete in the part For so potters vessels dried in the Sunne grow hard But the unskilfull Chirurgion may occasion a Scyrrhous hardnesse by another meanes as by condensating the skinne and incrassating the humors by too much use of repercussives But you may perceive an Impostume to degenerate into a Gangrene thus if the accidents of heat rednesse pulsation and tension shall be more intense than they are wont to be in suppuration if the paine presently cease without any manifest cause if the part waxe livide or blacke and lastly if it stinke But we shall treate of this more at large when we come to treate of the Gangrene and Sphacelus A sodaine diminution of the tumor and that without manifest cause is a signe of the matter fallen backe and turned into the body againe which may be occasioned by the immoderate use of refrigerating thinge And sometimes much flatulencie mixed with the matter although there be no fault in those things which were applied Feavers and many other maligne Symptomes as swoundings and convulsion by translation of the matter to the noble parts follow this flowing backe of the humor into the body CHAP. IIII. Of the Prognosticks in Impostumes TVmors arising from a melancholy phlegmaticke grosse tough or viscors humor aske a longer time for their cure than those which are of bloud or choler And they are more difficultly cured which are of humors not naturall than those which are of humors yet contained in the bounds of nature For those humors which are rebellious offend rather in qualitie than in quantitie and undergoe the divers formes of things dissenting from nature which are joyned by no similitude or affinitie with things naturall as suet poultis hony the dregs of oile and wine yea and of solid bodies as stone sand coale strawes and sometimes of living things as Wormes Serpents and the like monsters The tumors which possesse the inner parts and noble entrailes are more dangerous and deadly as also those which are in the joints or neere to them And these tumors which seaze upon great vessels as veines arteries and nerves for feare of great effusion of bloud wasting of the spirits and convulsion So impostumes of a monstrous bignesse are often deadly by reason of the great resolution of the spirits caused by their opening Those which degenerate into a Scyrrhus are of long continuance and hard to cure as also those which are in hydropicke leprous scabby and corrupt bodies for they often turne into maligne and ill conditioned vulcers CHAP. V. Of the generall cure of Tumors against Nature THere be three things to be observed in cure of impostumes The first is the essence thereof the second the quality of the humor causing the impostume the third the temper of the part affected The first indication drawne from the essence that is from the greatnesse or smallnesse of the tumor varies the manner of curing for the medicines must
Sanguine as if they were of bloud alone Wherefore if any Tumors resemble the nature of one simple humor truely they are not of any naturall humor but from some humor which is corrupt vitiated and offending in quality for so bloud by adustion degenerates into choler and melancholy Therefore a true Phlegmon is defined by Galen A tumor against nature of laudable bloud flowing into any part in too great a quantity This tumor though most commonly it be in the flesh yet sometimes it happens in the bones as Hippocrates and Galen witnesse A Phlegmon is made and generated thus when bloud flowes into any part in too great a quantity first the greater veines and arteries of the affected part are filled then the middle lastly the smallest and capillary so from those thus distended the bloud sweats out of the pores and smal passages like dew and with this the void spaces which are between the simular parts are first filled then with the same bloud all the adjacent parts are filled but especially the flesh as that which is most fit to receive defluxions by reason of the spongious rarity of its substance but then the nerves tendons membranes and ligaments are likewise stuffed full whereupon a Tumor must necessarily follow by reason of the repletion which exceeds the bounds of nature and from hence also are tension and resistance and paine also happens at the same time both by reason of the tension and preternaturall heate And there is a manifest pulsation in the part specially whilest it suppurates because the veines arteries and nerves are much pained being they are not onely heated within by the influxe of the fervide humor but pressed without by the adjacent parts Therefore seeing the paine comes to all the foresaid parts because they are too immoderately heated and pressed the arteries which are in the perpetuall motion of their Systole diastole whilest they are dilated strike upon the other inflamed parts whereupon proceeds that beating paine Hereunto adde the Arteries then filled with more copious and hot bloud have greater neede to seeke refrigeration by drawing in the encompassing Aire wherefore they must as of necessitie have a conflict with the neighbouring parts which are swollen and pained Therefore from hence is that pulsation in a Phlegmon which is defined by Galen an agitation of the arteries painefull and sensible to the Patient himselfe for otherwise as long as we are in health we doe not perceive the pulsation of the arteries Wherefore these two causes of pulsation or a pulsiâ—icke paine in a phlegmon are worthy to be observed that is the heate and aboundance of bloud contained in the vessels and arteries which more frequently than their wont incite the arteries to motion that is to their Systole and Diastole and the compression and streightning of the said arteries by reason of the repletion and distention of the adjacent parts by whose occasion the parts afflicted and beaten by the trembling and frequent pulsation of arteries are in paine Hence they commonly say that in the part aflected with a Phlegmon they feele as it were the sense or stroke of a Mallet or Hammer smiting upon it But also besides this pulsation of the arteries there is as it were another pulsation with itching from the humors whilst they putrefie and suppurate by the permixtion motion and agitation of vapours thereupon arising The cause of heate in a Phlegmon is bloud which whilest it flowes more plentifully into the part is as it were troden or thrust downe and causes obstruction from whence necessarily followes alprohibition of transpiration and a putrifaction of the bloud by reason of the preternaturall heate But the Phlegmon lookes red by reason of the bloud contained in it because the humor predominant in the part shines through the skinne CHAP. VIII Of the causes and signes of a Phlegmon THe causes of a Plegmon are of three kindes for some are primitive some antecedent and some conjunct Primitive are falls conâ—usions straines immoderate labour frictions application of acrid ointments burnings long staying or labouring in the hot Sun a diet unconsiderate and which breeds much bloud The antecedent causes are the great abundance of bloud too plentifully flowing in the veines The conjunct the collection or gathering together of bloud impact in any part The signes of a Plegmon are swelling tension resistance feaverish heate paine pulsation especially while it suppurates rednesse and others by which the abundance of bloud is signified And a little Phlegmon is often terminated by resolution but a great one by suppuration and sometimes it ends in a Scyrrhus or a Tumor like a Scyrrhus but otherwhiles in a Gangren that is when the facultie and native strength of the part affected is overwhelmed by the greatnesse of the deflxion as it is reported by Galen The Chirurgion ought to consider all these things that he may apply and vary such medicines as are convenient for the nature of the Patient and for the time and condition of the part affected CHAP. IX Of the cure of a true Phlegmon THe Chirurgion in the cure of a true Phlegmon must propose to himselfe foure intentions The first of Diet This because the Plegmon is a hot affect and causes a feaver must be ordained of refrigerative and humecting things with the convenient use of the sixe thingsnot naturall that is aire meat and drinke motion and rest sleepe and waking repletion and inanition and lastly the passions of the minde Therefore let him make choise of that aire which is pure and cleere not too moist for feare of defluxion but somewhat coole let him command meates which are moderately coole and moist shunning such as generate bloud too plentifully such will be brothes not to fat seasoned with a little Borage Lettuce Sorrell and Succory let him be forbidden the use of all spices and also of Garlicke and Onions and all things which heate the bloud as are all fatty and sweet things as those which easily take fire Let the Patient drinke small wine and much alaied with water or if the feaver be vehement the water of the decoction of Licoris Barly and sweet almonds or water and sugar alwayes having regard to the strength age and custome of the Patient For if he be of that age or have so led his life that he cannot want the use of wine let him use it but altogether moderately Rest must be commanded for all bodies waxe hot by motion but let him chiefely have a care that hee doe not exercise the part possessed by the plegmon for feare of a new defluxion Let his sleepe be moderate neither if he have a full body let him sleepe by day specially presently aâ—er meate Let him have his belly soluble if not by nature then by art as by the frequent use of glisters and suppositories Let him avoid all vehement perturbations of minde as hate anger brawling let him wholly abstaine from
which followes a cooling of the habite of the whole body yea and many by meanes of Phlebotomy have their bellye 's loosed and sweate both which are much to be desired in this kinde of Feaver This moved the ancient Physitions to write that we must draw blood in this disease even to the fainting of the Patient Yet because thus not a few have poured out their lives together with their blood it will be better and safer to divide the evacuations and draw so much blood at severall times as the greatnesse of the disease shall require and the strength of the Patient may beare When you have drawne blood forthwith inject an emollient and refrigerative clyster lest that the veines emptied by Phlebotomy may draw into them the impurity of the Guts but these clysters which coole too much rather bindethe belly than loose it The following day the Morbiâ—icke matter must be partly evacuated by a gentle purge as a bole of Cassia or Catholicon then must you appoint Syrupes which have not onely a refrigerative quality but also to resist putrefaction such as the Syrupe of Lemmons Berberries of the Iujce of Citrons of Pomgranats Sorrell and Vineger let his diet be absolutely cooling and humecting and also slender for the native heate much debilitated by drawing of a great quantity of blood cannot equall a full diet Therefore it shall suffice to feed the Patient with chicken and veale brothes made with cooling herbes as Sorrell Lettuce and Purslaine Let his drinke be Baâ—ly water Syrup of Violets mixed with some pretty quantity of boiled water Iulepum Alexandrinum especially if he be troubled with scouring oâ— laske But the Physition must cheifly have regard to the fourth day for if then there appeare any signes of concoction in the excrements the Crisis must be expected on the seventh day and that either by a loosenesse of the belly or an aboundance of urine by vomits sweats or bleeding Therefore we must then doe nothing but commit the whole businesse to nature But for drinking cold water which is so much commended by Galen in this kinde of Feaver it is not to be suffered beforethere appeare signes of concoction moreover in the declining of the disease the use of wine will not be unprofitable to helpe forwards sweats CHAP. XII Of an Erysipelas or Inflammation HAving declared the cure of a Phlegmon caused by laudable blood wee must now treate of these tumors which acknowledge Choler the materiall cause of their generation by reason of that affinity which interceeds betweene Choler and Blood Therefore the tumors caussed by naturall Choler are called Erysipelata or Inflammations these conteine a great heate in them which cheifly possesses the skin as also oftentimes some portion of the flesh lying under it For they are made by most thin and subtle blood which upon any occasion of inflammation easily becomes cholericke or by blood and choler hotter than is requisit and sometimes of choler mixed with an acride serous humor That which is made by sincere and pure choler is called by Galen a true and perfect Erysipelas But there arise three differences of Erysipelaes by the admixture of choler with the three other kinds of humors For if it being predominant be mixed with blood it shall be termed Erysipelas Phlegmonodes if with phlegme Erysipelas oedematodes if with Melancholy Erysipelas Sâ—irrhodes So that the former and substantive word shewes the humor bearing dominion but the latter or adjective that which is inferiour in mixture But if they concurre in equall quantity there will be thereupon made Erysipelas Phlegmone Erysipelas oedema Erysipelas scirrhus Galen acknowledges two kinds of Erysipelaes one simple and without an ulcer the other ulcerated For Choler drawne and severed from the warmnesse of the blood running by its subtlety and acrimony vnto the skin ulcerates it but restrained by the gentle heat of the blood as a bridle it is hindred from peircing to the top of the skin and makes a tumor without an ulcer But of unnaturall choler are caused many other kinds of cholericke tumors as the Herpes exedens and Miliaris and lastly all sorts of tumors which come betweene the Herpes and Cancer You may know Erysipelaes cheifly by three signes as by their colour which is a yellowish red by their quicke sliding backe into the body at the least compression of the skin the cause of which is the subtlety of the humor and the outward site of it under the skin whereupon by some an Erysipelas is called a Disease of the skin Lastly by the number of the Symptoms as heat pulsation paine The heat of an Erysipelas is far greater than that of a Phlegmon but the pulsation is much lesse for as the heat of the blood is not so great as that of choler so it farre exceeds choler in quantity and thicknesse which may cause compression and obstruction of the adjacent muscle For Choler easily dissipable by reason of its subtlety quickly vanishes neither doth it suffer it selfe to be long conteined in the empty spaces betweene the muscles neither doth an Erysipelas agree with a Phlegmon in the propriety of the paine For that of an Erysipelas is pricking and biting without tension or heavinesse yet the primitive antecedent and conjunct causes are alike of both the tumors Although an Erysipelas may be incident to all parts yet principally it assailes the face by reason of the rarity of the skin of that place and the lightnesse of the cholericke humor flying upwards It is ill when an Erysipelas comes upon a wound or ulcer and although it may come to suppuration yet it is not good for it shewes that there is obstruction by the admixture of a grosse humor whence there is some danger of erosion in the parts next under the skin It is good when an Erysipelas comes from within outwards but ill when from without it retires inward But if an Erysipelas possesse the wombe it is deadly and in like manner if it spread too far over the face by reason of the sympathy of the membranes of the braine CHAP. XIII Of the cure of an Erysipelas FOr the cure of an Erysipelas we must procure two things to wit evacuation and Refrigeration But because there is more need of cooling than in a Phlegmon the cheefe scope must be for refrigeration Which being done the conteined matter must be taken away and evacuated with moderatly resolving medicines We must doe foure things to attaine unto these forementioned ends First of all we must appoint a convenient manner of Diet in the use of the sixe things not naturall that is we must incrassate refrigerate and moisten as much as the nature of the disease and patient will suffer much more than in a Phlegmon then we will evacuate the Antecedent matter by opening a veine and by medicines purging choler And that by cutting the Cephalicke veine if there be a portion of the blood
rebellious and untractable as that which contemnes milde remedies and becomes more fierce by acride and strong the paine feaver and all the symptomes being encreased from whence the powers are dejected the wasting and consumption of the body followes and lastly death Yet if it be small and in a part which may suffer amputation the body being first purged and bloud drawne the strength of the Patient not disswading it will be convenient to use the hand and to take hold of and cut away whatsoever is corrupt even to the quicke that no feare of contagion may remaine or be left behind The amputation finished the bloud must not be preseÌ„tly stopped but permitted to flow out in some measure yea verily pressed forth all about it that so the veines swollne with blacke and melancholicke bloud may be disburdened When you have taken a sufficient quantity of bloud the place must be scared with an actuall cautery For that will strengthen the part affected draw forth the venenate quality and also stay the defluxion Then must you apply mitigaâ—… medicines procure the falling away of the Eschar To conclude that which remâ—… must be performed according to the cure of other ulcers Now we know and â—…stand that all the Cancer is cut away and all the malignity thereof extinct when â—…lcer casts forth laudable matter when that good flesh begins to growâ—… little â—…ittle like to the graines of a Pomeganate the pricking paine and â—…e symptomes being asswaged Yet the cure of an ulcerated Cancer which shall possesse the lips may be more happily and mildly performed no causticke medicine being applied after section so also that scarse any deformity will be left when it is cicatrized Which new and never formerly tried or written of way as farre as I know I found and performed in a man of fifty yeares old Doctor Iohn Altine a most learned Physition being called to Counsell Iames Guillemeaâ—… and Master Eustachius the Kings Chirurgions and Iohn Le Ieune the Duke of Guise his most worthy Chirurgion being present The way is this The Cancer must be thrust through the lips on both sides above and below with a needle and threed that so you may rule and governe the Cancer with your left hand by the benefit of the threed least any portion thereof should scape the instrument in cutting and then with your Sizers in the right hand you â—…ut it off all at once yet it must be so done that some substance of the inner â—…the lippe which is next to the teeth may remaine if so be that the Cancer be not growne quite through which may serve as it were for a foundation to generate flesh to fill up the hollownesse againe Then when it hath bled sufficiently the sides brinkes of the wound must be scarified on the right and lift sides within and without with somewhat a deepe scarification that so when we would draw together the sides and lips of the wound by that manner of stitching which is used in an hare-lippe we may have the flesh more pliant and tractable to the needle and threed The residue of the cure must be performed just after the same manner as we use in hare-lips of which we shall treate hereafter CHAP. XXX Of the Topicke medicines to be applied to an unlcerated and not ulcerated Cancer WE at the beginning use repercussive medicines such as are the juyces of Nightshade Plantaine Henbane Lettuce Sorrell Houseleeke Water Lentill or Duckes-meate Knotgrasse Pomegranates and the like Also Oleum rosarum omphacinum the powders of Sumach Berberies Litharge Ceruse Burnt-lead Tutia Quicksilver and the like Of which you may compose Fomentations Liniments Ointments Cataplasmes Emplaisters Emplastrum Diacalcitheos dissolved with juice of Nightshade and oile of Roses is very fit for not ulcerated Cancers Pompholix or Tutia washed in juice of Nightshade or Plantaine is very good for ulcerated Cancers Besides this following medicine is very coÌ„mendable â„ž Lytharg cerus an â„¥ j terantur in mortario plumb cum oleo rosar donec reducantured consistentiam linimenti vel unguenti and there may be use of a resolving and repercassive ointment as â„ž plumbi usti loti pomphol thuris an Ê’ijss absinth pontic â„¥ ss olei rosarum â„¥ iij ceraeÊ’vj succi solani quantum sufficit ad unguenti crassitudinem They very much commend Theodorickes Emplaister to asswage the paine of ulcerated Cancers â„ž Olei ros cerae alb an â„¥ ijss succigranat solani an â„¥ ij cerusae lotae â„¥ j plumbi usti loti tuthiae praepar an â„¥ ss thuris mastich an Ê’ij fiat empl molle This following ointment I have often used with good successe â„ž Therciac veter â„¥ j succi cancrorum â„¥ ss succi lactucae olei rosar an â„¥ iss vitel ovorum sub cinerib coct ij camphor Ê’ss pistentur omnia in mortario plumb fiat unguentunâ— â„ž spum argent axungiae porei recentis cerae alb an lib. ss olei boni â„¥ viij vitel ovorum assat iiij fiat unguent servetur usui And when you will vse it mixe it with a little ointment of Roses I have also mitigated great paine by applying Leaches to an unulcerated Cancer in that part where the torment was most vehement by disburdening the part of some portion of the maligne humor which same thing I have done by application of young Whelpâ—… or Kitlings or Pidgions or Chickins cut long wayes and presently applied to the ulcer and now and then changed as soone as their heat seemes dissolved and â—…hers applied for the naturall heat in an anodyne or mitigating medicine Iohn Baâ—…â—heodosius in his Epistles writes that a cataplasme of the herbe Erysimum or Câ—…cke being beaten is very good to be applied to a Cancer not ulcerated but if the Cancerâ—…cerated â—…cerated he boiles this same herbe in Hydromel and so by injections and lotions â—…ses the ulcer and mitigates the paine If the Cancer affect the wombe the patient feeles the pricking of the paine in the groines above the pecten and in the Kidneyes is often troubled with a difficulty of making water but when it is ulcerated it poures forth filth or matter exceeding stinking carion-like and that in great plenty the filthy vapour of which carryed up to the heart and braine causes often swounding Now to mitigate the paines of such like places the following medicines are of good use â„ž Mucag. semin lini foenugr extract in aqua rosar plantaginis quod satis est Of this being warme make a fomehtation â„ž Rad. Atheae lb ss coquatur in hydromelite pistetur traijciatur addendo olei rosar parum fiat Cataplasma Also you shall make divers pessaries according to the different kinds of paine also make injections of the juice of Plantaine Knotgrasse Lettuce Purslaine mixed together and agitated or laboured in a leaden mortar wiâ—… oyle of Roses for this kinde of medicine is commended by Galen in every kinde of
flesh and cicatrized which doth not seldome happen in opening of Arteries unskilfully performed and negligently cured therefore Aneurismaes are absolutely made by the Anastomasis springing breaking Erosion and wounding of the Arteries These happen in all parts of the body but more frequently in the throat especially in women after a painfull travaile For when as they more strongly strive to hold their breath for the more powerfull expulsion of the birth it happens that the Artery is di ated and broken whence followes an effusion of bloud and spirits under the skin The signes are a swelling one while great another small with a pulsation and a colour not varying from the native constitution of the skinne It is a soft tumor and so yeelding to the impression of the fingers that if it peradventure be small it wholy vanisheth the Arterious bloud and spirits flying backe into the body of the Artery but presently assoone as you take your fingers away they returne againe with like celerity Some Aneurismaes doe not onely when they are pressed but also of themselves make a sensible hissing if you lay your eare neare to them by reason of the motion of the vitall spirit rushing with great violence through the straitnes of the passage Wherefore in Aneurismaes in which there is a great rupture of the Artery such a noyse is not heard because the spirit is carryed through a larger passage Great Aneâ—rismaes under the Arme pits in the Groines and in other parts wherein there are large vessells admit no cure because so great an eruption of blood and spirit often followes uppon such an incision that death prevents both art and Cure Which I observed a few yeares agoe in a certaine preist of Saint Andrewes of the Arches M. Iohn Maillet dwelling with the chiefe President Christopher de Thou Who having an Aneurisma at the setting on of the shoulder about the bignes of a Wall-nut I charged him hee should not let it be opened for if it did it would bring him into manifest danger of his life and that it would be more safe for him to breake the violence thereof with double clothes steeped in the juyce of Night-shade and Houselike with new and whayey cheese mixt therewith Or with Vnguentum de Bolo or Emplastrum contra rupturam and such other refrigerating and astringent medicines if hee would lay upon it a thin plate of Lead and would use shorter breeches that his doublet might serve to hold it too to which hee might fasten his breeches instead of a swathe and in the meane time he should eschew all things which attenuate and inflame the blood but especially he should keepe himselfe from all great straining of his voyce Although he had used this Diet for a yeare yet he could not so handle the matter but that the tumor increased which he observing goes to a Barber who supposing the tumor to be of the kinde of vulgar inpostumes applies to it in the Evening a Causticke causing an Eschar so to open it In the Morning such an abundance of blood flowed forth from the tumor being opened that he therewith astonished implores all possible ayde and bidds that I should be called to stay this his great bleeding and he repented that he had not followed my directions Wherefore I am called but when I was scarce over the thre should he gave up his ghost with his blood Wherefore I diligently admonish the young Chirurgion that hee do not rashly open Aneurismas unlesse they be small in anignoble part and not indued with large vessells but rather let him performe the cure after this manner Cut the skinne which lyes over it untill the Artery appeare and then separate it with your knife from the particles about it then thrust a blunt and crooked needle with a thred in it under it binde it then cut it off and so expect the falling off of the thred of it selfe whiles nature covers the orifices of the cut Artery with new flesh then the residue of the cure may be performed after the manner of simple wounds The Aneurismaes which happen in the internall parts are uncurable Such as frequently happen to those who have often had the unction and sweat for the cure of the French disease because the blood being so attenuated and heated therewith that it cannot be contayned in the receptacles of the Artery it distends it to that largenesse as to hold a mans fist Which I have observed in the dead body of a certaine Taylor who by an Aneurisma of the Arâ—erious veine suddenly whilest hee was playing at Tennis fell downe dead the vessell being broken his body being opened I found a great quantity of blood powred forth into the Capacity of the Chest but the body of the Artery was dilated to that largenesse I formerly mentioned and the inner Coate thereof was bony For which cause within a while after I shewed it to the great admiration of the beholders in the Physitions Schole whilest I publiquely dissected a body there the whilst he lived said he felt a beating and a great heate over all his body by the force of the pulsation of all the Arteryes by occasion whereof hee often swounded Doctor Syluius the Kings professor of Physicke at that time forbad him the use of Wine and wished him to vse boyled water for his drinke and Crudds and new Cheeses for his meate and to apply them in forme of Cataplasmes upon the grieved and swolne part At night he used a ptisan of Barley meale and Poppy-seedes and was purged now and then with a Clyster of refrigerating and emollient things or with Cassia alone by which medicines hee said hee found himselfe much better The cause of such a bony constitution of the Arteries by Aneurismaes is for that the hot and fervid blood first dilates the Coates of an Artery then breakes them which when it happens it then borrowes from the neighbouring bodies a fit matter to restore the loosed continuity thereof This matter whilest by litle and litle it is dried and hardened it degenerats into a Gristely or else a bony substance just by the force of the same materiall and efficient causes by which stones are generated in the reines and bladder For the more terrestriall portion of the blood is dried and condensed by the power of the unnaturall heat contayned in the part affected with an Aneurismae whereby it comes to passe that the substance added to the dilated and broken Artery is turned into a body of a bony consistence In which the singular providence of nature the handmaide of God is shewed as that which as it were by making and opposing a new wall or bancke would hinder and breake the violence of the raging blood swelling with the abundance of the vitall spirits unlesse any had rather to refer the cause of that hardnesse to the continuall application of refrigerating and astringent medicines Which have power to condensate and harden as may
their figures that you may use either as occasion shall serve The Figure of Pipes with fenestels in them and Needles fit for Sutures The second Suture is made just after the same manner as the Skinners sowe their â—els or forrs And the guts must be sowed with this kind of Suture if they shall be at any time wounded that the excrements come not forth by the wound The third Suture is made by one or more needles having threed in them thrust through the wound the threed being wrapped to and againe at the head and the point of the needle as boyes use to fasten their needle for feare of losing it in their caps or clothes This kind of Suture is fit in the curing and healing of Hare-lips as we shall shew you hereafter expressed by a Figure The fourth kind of Suture is tearmed Gastroraphia invented for the restoring and uniting the great Muscles of the Epigastrium or lower belly cut with a great wound together with the Peritonaeum lying under them The manner whereof we will shew in due place The fifth kind is called the Dry Suture which we use onely in the wounds of the face which also we will describe in its proper place CHAP. VII Of the Flux of blood which usually happens in wounds OFt times great bleeding followes upon wounds by reason of some vessell cut broken or torne which there is neede to heale and helpe diligently because the blood is the treasure of nature without which life cannot consist The Blood which floweth from an Artery is thus knowne It is more subtile it runs forth as it were leaping by reason of the vitall spirit contained together with it in the Arteries On the contrary that which floweth from a Veine is more grosse blacke and slow Now there are many wayes of stenching blood The first and most usuall is that by which the lips of the wound are closed and unlesse it be somewhat deepe are contained by Medicines which have an astringent cooling drying and glutinous faculty As terrae sigill Boli Armeni ana â„¥ ss thuris Mastichis Myr hae Aloes ana Ê’ ij Farinae volat molend â„¥ j. Fiat pulvis qui albumine ovi excipiatur r Or â„ž Thuris Aloes ana partes aequales Let them bee mixt with the white of an Egge and the downe of a hare and let the pledgets bee dipped in these Medicines as well those which are put unto the wound as those which are applied about it Then let the wound be bound up with a double clop and fit Ligature and the part bee so seated as may seeme the least troublesome and most free from paine But if the blood cannot be stayed by this meanes when you have taken off all that covereth it you shall presse the wound and the orifice of the Vessell with your thumbe so long untill the blood shall bee concrete about it into so thick a clott as may stop the passage But if it cannot be thus staied then the Suture if any be must be opened and the mouth of the Vessell towards the originall or roote must bee taken hold of and bound with your needle and threed with as great a portion of the flesh as the condition of the part will permit For thus I have staid great bleedings even in the amputation of members as I shall shew in fit place To performe this worke wee are often forced to divide the skin which covereth the wounded Vessell For if the Iugular veine or Artery be cut it will contract and withdraw it selfe upwards and down-wards Then the skinne it selfe must bee laid open under which it lieth and thrusting a needle and threed under it it must be bound as I have offen done But before you loose the knot it is fit the flesh be growne up that it may stop the mouth of the Vessell least it should then bleed But if the condition of the part shall be such as may forbid this comprehension and binding of the Vessell we must come to Escharoticks such as are the powder of burnt Vitriol the powder of Mercury with a small quantity of burnt Allume and Cawsticks which cause an Escar The falling away of which must be left to Nature and not procured by art least it should fall away before that the orifice of the Vessel shall be stopt with the flesh or clotted blood But some times it happens that the Chirurgion is forced wholly to cut off the vessell it selfe that thus the ends of the cut vessell withdrawing themselves and shrincking upwards and downewards being hidden by the quantity of the adjacent and incompassing parts the fluxe of blood which was before not to bee staid may bee stopped with lesse labour Yet this is an extreame remedy and not to bee used unlesse you have in vaine attempted the former CHAP. VIII Of the paine which happens upon wounds THe paines which followes upon wounds ought to be quickly aswaged because nothing so quickly dejects the powers and it alwayes causes a defluxion of how good soever a habite and temper the body be of for Nature ready to yeeld assistance to the wounded part alwayes sends more humours to it than are needfull for the nourishment thereof whereby it comes to passe that the defluxion is easily encreased either by the quantity or quality or by both Therefore to take away this paine the author of defluxion let such Medicines bee applyed to the part as have a repelling and mitigating faculty as â„ž Olei Myrtini Rosarum ana â„¥ ij Cerae alb â„¥ j. Farinae hordei â„¥ ss Boli armeni terra sigillat ana Ê’ vj. Melt the Waxe in the Oyles then incorporate all the rest and according to Art make a Medicine to be applyed about the part or â„ž Emplast Diacalcith â„¥ iv Ole Rosar aceti ana â„¥ ss liquefiant simul and let a Medicine be made for the fore mentioned use Irrigations of oyle of Roses and Mirtiles with the white of an Egge or a whole Egge added thereto may serve for lenitives if there be no great inflammation Rowlers and double cloathes moistened in Oxycrate will be also convenient for the same purpose But the force of such Medicines must be often renewed for when they are dryed they augment the paine But if the paine yeld not to these we must come to narcoticke Medicines such as are the Oyle of Poppy of Mandrake a Caraplasme of Henbane and Sorrell adding thereto Mallowes and Marsh-mallows of which we spoke formerly in treating of a Phlegmon Lastly we must give heed to the cause of the paine to the kind and nature of the humour that flowes down and to the way which Nature affects for according to the variety of these things the Medicines must be varied as if heat cause paine it will be aswaged by application of cooling things and the like reason observed in the contrary if Nature intend suppuration you must helpe forwards
alimentary juice to the braine wanting marrow that is blood to nourish it as we have formerly shewed in our Anatomie But from hence proceeds the effluxe of blood running betweene the scull and membraines or else betweene the membraines and braine the blood congealing there causeth vehement paine and the eyes become blinde vomitting is caused the mouth of the stomacke suffering together with the braine by reason of the Nerves of the sixt conjugation which runne from the braine thither and from thence are spread over all the capacitie of the ventricle whence becomming a partaker of the offence it contracts it selfe and is presently as it were overturned whence first these things that are conteined therein are expelled and then such as may flow or come thither from the neighbouring and communne parts as the Liver and Gall from all which choler by reason of its naturall levity and velocity is first expelled and that in greatest plenty and this is the true reason of that vomiting which is caused and usually followes upon fractures of the scull and concussions of the Braine Within a short while after inflammation seizes upon the membranes and braine it selfe which is caused by corrupt and putrid blood proceeding from the vessels broken by by the violence of the blow and so spread over the substance of the braine Such inflammation communicated to the heart and whole body by the continuation of the parts causes a feaver But a feaver by altering the braine causes Doting to which if stupidity succeed the Patient is in very ill case according to that of Hippocrates Stupidity and doting are ill in a wound or blow upon the head But if to these evills a sphacell and corruption of the braine ensue together with a 〈◊〉 difficulty of breathing by reason of the disturbance of the Animall facâ—… which from the braine imparts the power of moving to the muscles of the Chest the instruments of respiration then death must necessarily follow A great part of these accidents appeared in King Henry of happy memory a little before he dyed He having set in order the affaires of France and entred into amitie with the neighbouring Princes desirous to honour the marriages of his daughter and sister with the famous and noble exercise of Tilting and hee himselfe running in the Tilt-yard with a blunt lance received so great a stroake upon his brest that with the violence of the blow the visour of his helmet flew up and the trunchion of the broken Lance hit him above the left eye-brow and the musculous skinne of the fore-head was torne even to the lesser corner of the left eye many splinters of the same trunchion being strucke into the substance of the fore mentioned eye the bones being not touched or broken but the braine was so moved and shaken that he dyed the eleaventh day after the hurt His scull being opened after his death there was a great deale of blood found betweene the Dura and Pia Mater poured forth in the part opposite to the blow at the middle of the suture of the hinde part of the head and there appeared signes by the native colour turned yellow that the substance of the braine was corrupted as much as one might cover with ones thumbe Which things caused the death of the most Christian King and not onely the wounding of the eye as many have falsly thought For wee have seene many others who have not dyed of farre more greevous wounds in the eye The history of the Lord Saint Iohns is of late memory he in the Tilt-yarde made for that time before the Duke of Guises house was wounded with a splinter of a broken Lance of a fingers length and thicknesse through the visour of his Helmet it entring into the Orbe under the eye and peircing some three fingers bredth deepe into the head by my helpe and Gods favour hee recovered Valeranus and Duretus the Kings Physitions and Iames the Kings Chirurgion assisting me What shall I say of that great and very memorable wound of Prancis of Loraine the Duke of Guise He in the sight of the Citty of Bologne had his head so thrust thorough with a Lance that the point entring under his right eye by his nose came out at his necke betweene his eare and the vertebrae the head or Iron being broken and left in by the violence of the stroke which stuck there so firmely that it could not be drawn or plucked forth without a paire of Smiths pincers But although the strength violence of the blow was so great that it could not be without a fracture of the bones a tearing and breaking of the Nerves Veines Arteries and other parts yet the generous Prince by the favour of God recovered By which you may learne that many die of small wounds and other recover of great yea very large and desperate ones The cause of which events is chiefly and primarily to be attributed to God the author and preserver of mankinde but secondarily to the variety and condition of temperaments And thus much of the commotion or conclussion of the braine whereby it happens that although all the bone remaines perfectly whole yet some veines broken within by the stroake may cast forth some bloud upon the membranes of the braine which being there concreate may cause great paine by reason whereof it blindes the eyes if so be that the place can be found against which the paine is and when the skinne is opened the bone looke pale it must presently be cut out as Celsus hath written Now it remaines that we tell you how to make your prognostickes in all the forementioned fractures of the scull CHAP. X. Of Prognostickes to be made in fractures of the scull VVEE must not neglect any wounds in the head no not these which cut or bruise but onely the hairy scalpe but certainely much lesse these which are accompanied by a fracture in the scull for oft times all horride symptomes follow upon them and consequently death it selfe especially in bodies full of ill humors or of an ill habite such as are these which are affected with the Lues venerea leprosie dropsie Pthisicke and consumption for in these simple wounds are hardly or never cured for union in the cure of wounds but this is not performed unlesse by strength of nature and sufficient store of laudible blood but those which are sicke of hecticke feavers and consumptions want store of blood and those bodies which are repleate with ill humors and of an ill habite have no affluxe or plenty of laudible blood but all of them want the strength of nature the reason is almost the same in those also which are lately recovered of some disease Those wounds which are brused are more difficult to cure than those which are cut When the scul is broken than the continuity of the flesh lying over it must necessarily be hurt broken unlesse it be in a Resoâ—itus
with a desire to vomit or goe to stoole or with yawning and when hee shall change his colour and his lips looke pale then you must stop the blood as speedily as you can otherwise there will be danger lest hee poure forth his life together with his blood Then he must bee refreshed with bread steeped in wine and put into his mouth and by rubbing his temples and nosethrilles with strong vinegar and by lying upon his backe But the part shall bee eased and freed from some portion of the impact and conjunct humor by gently scarifying the lippes of the wound or applying of Leaches But it shall bee diverted by opening these veines which are nighest to the wounded part as the Vena Puppis or that in the middest of the forehead or of the temples or these which are under the tongue besides also cupping-glasses shal be applied to the shoulders sometimes with scarification sometimes without neither must strong and long frictions with course clothes of all the whole body the head excepted be omitted during the whole time of the cure for these will be available though but for this that is to draw backe and dissipate by insensible transpiration the vapours which otherwise would ascend into the head which matters certainly in a body that lyes still and wants both the use and benefit of accustomed exercise are much increased But it shall bee made manifest by this following and notable example how powerfull blood-letting is to lessen and mitigate the inflammation of the Braine or the membranes thereof in wounds of the head I was lately called into the suburbs of Saint German there to visite a young man twenty eight yeeres old who lodged there in the house of Iohn Martiall at the signe of Saint Michaell This young man was one of the houshold servants of Master Doucador the steward of the Lady Admirall of Brion He fell downe headlong upon the left Bregma upon a marble pavement whence he received a contused wound without any fracture of the scull and being he was of a sanguine temperature by occasion of this wound a feaver tooke him on the seaventh day with a continuall delirium and inflammation of phlegmonous tumor of the wounded Pericranium This same tumor possessing his whole head and necke by continuation and sympathy of the parts was growne to such a bignesse that his visage was so much altred that his friends knew him not neither could he speake heare or swallow any thing but what was very liquide Which I observing although I knew that the day past which was the eight day of his disease he had foure saucers of blood taken from him by Germaine Agace Barber-surgion of the same suburbs yet considering the integrity and constancie of the strength of the patient I thought good to bleed him againe wherefore I drew from him foureteene saucers at that one time when I came to him the day after and saw that neither the feaver nor any of the fore mentioned symptomes were any whit remitted or aswaged I forthwith tooke from him foure saucers more which in all made two twenty the day following when I had observed that the symptomes were no whit lessened I durst not presume by my owne onely advice to let him the fourth time blood as I desired Wherefore I brought unto him that most famous Physition Doctor Violene who as soone as he felt his pulse knowing by the vehemencie thereof the strength of the Patient and moreover considering the greatnesse of the inflammation and tumor which offered its selfe to his sight hee bid mee presently take out my Lancet and open a veine But I lingred on set purpose and told him that hee had already twenty two saucers of blood taken from him Then sayd he Grant it be so and though more have beene drawne yet must we not therefore desist from our enterprise especially seeing the two chiefe Indications of blood-letting yet remaine that is the greatnesse of the disease and the constant strength of the Patient I being glad of this tooke three saucers more of blood hee standing by and was ready to take more but that he wished mee to differ it untill the after noone wherefore returning after dinner I filled two saucers more so that in all this young man to his great benefit lost twenty seaven saucers of blood at five times within the space of foure dayes Now the ensuing night was very pleasing to him the feaver left him about noone the tumor grew much lesse the heat of the inflammation was aswaged in all parts except in his eyelids and the lappes of his eares which being ulcerated cast forth a great quantitie of Pus or matter I have recited this history purposely to take away the childish feare which many have to draw blood in the constant strength of the patient and that it might appeare how speedy and certaine a remedy it is in inflammations of the head and braine Now to returne from whence we digressed you must note that nothing is so hurtfull in factures and wounds of the head as venery not onely at that time the disease is present but also long after the cure thereof For great plenty of spirits are conteined in a small quantity of seed the greatest part thereof flowes from the braine hence therefore all the faculties but chiefly the Animall are resolved whence I have divers times observed death to ensue in small wounds of the head yea when they have beene agglutinated and united All passions of the minde must in like sort be avoided because they by contraction and dissipation of the spirits cause great trouble in the body and minde Let a place be chosen for the Patient as farre from noise as can be as from the ringing of bells beatings and knocking 's of Smithes Coopers and Carpenters and from high-wayes through which they use to drive Coaches for noyse encreases paine causes a feaver and brings many other symptomes I remember when I was at Hisdin at the time that it was beseiged by the forces of Charles the fifth that when the wall beaten with the Cannon the noise of the Ordinance caused grievous torment to all those which were sicke but especially those that were wounded on their heads so that they would say that they thought at the discharging of every Cannon that they were cruelly strucken with staves on that part which was wounded and verily their wounds were so angred herewith that they bledde much and by their paine and feavers encreased were forced with much sighing to breathe their last Thus much may serve to be spoken of the cure in generall now we will out of the monuments of the ancients treate of the particular CHAP. XV. Of the particular cure of Wounds of the head and of the musculous skinne LEt us beginne with a simple wound for whose cure the Chirurgion must propose one onely scope to wit Vnion for unlesse the wound pierce to the scull it is
name of the villaine the author of this fact so that hee was taken and fastened to the wheele and having his limbes broken lost his wretched life for the life of the innocent wounded man who dyed the fourth day after he was hurt The like hurt befell a certaine Germane who laye at the house of one Perots in the streete of Nuts hebeing franticke in the night cut his throate with a sword I being called in the morning by his friends who went to see him drest him just after the same manner as I dressed the Englishman Wherefore he presently recovering his speech which before could not utter one sillable freed from suspition of the caime and prison the servant who lying in the same chamber with him was upon suspition committed to prison and confessing the thing as it was done living foure dayes after the wound being nourished with broathes put into his fundament like clysters and with the gratefull vapour of comfortable things as bread newly drawne out of the Oven and soked in strong wine Having thus by the Art of Chirurgery made the dumbe speake for the space of foure dayes CHAP. XXX Of the Wounds of the Chest SOme wounds of the Chest are on the fore side some behinde somepenetiatc more deepe others enter not into the capacity thereof other some peirce even to the parts contained therein as the Mediastinum Lungs heart midriffe hollow veine and ascendent artery Other some pasle quite through the body whereby it happens that some are deadly some not You shall thus know that the wound penetrates into the capacity of the Chest if that when the patients mouth and nose be shut the breath or winde breakes through the wound with noyse so that it may dissipate or blow out a lighted candle being held necre it If the patient can scarse either draw or put forth his breath which also is a signe that there is some blood fallen downe upon the Diaphragma By these signes you may know that the heart is wounded If agreat quantity of blood gush out if a trembling possesse all the members of the body if the pulse bee little and faint if the colour become pale if a cold sweate and frequent sowning assayle him and the extreame parts become cold then death 's at hand Yet when I was at Turin I saw a certaine Gentleman who fighting a Duell with another received a wound under his left brest which pierced into the substance of his heart yet for all that he strucke some blowes afterwards and followed his flying Enemie some two hundred paces untill hee fell downe dead upon the ground having opened his body I found a wound in the substance of the heart so large as would containe ones finger there was onely much blood poured forth upon the midriffe These are the signes that the Lungs are wounded for the blood comes soamie or frothy out of the wounds the patient is troubled with a cough hee is also troubled with a great difficulty of breathing and a paine in his side which hee formerly had not he lyes most at ease when he lyes upon the wound and sometimes it comes so to passe that lying so he speakes more freely and easily but turned on the contrary side he presently cannot speake When the Diphragma or midriffe is wounded the party affected is troubled with a weight or heavinesse in that place hee is taken with a Delirium or raving by reason of the sympathy of the Nerves of the sixth conjugation which are spread over the midriffe difficulty of breathing a cough and sharpe paine trouble the patient the Guts are drawne upwards so that it sometimes happens by the vehemency of breathing that the stomacke and gutts are drawne through the wound in to the capacity of the Chest which thing I observed in two The on of these was a Maison who was thrust though the midst of the midriffe where it is Nervous and dyed the third day following I opening his lower belly and no finding his stomacke thought it a monstrous thing but at length searching diligently I found it was drawne into the Chest though the wound which was scarce an inch broade But the stomacke was full of winde but little humidity in it The other was called captaine Francis d' Alon a Native of Xantoigne who before Roshell was shot with a musket bullet entring by the breast-bone neere to the sword-like Gristle and passing through the fleshy part of the midriffe went out at the space betweene the fifth and sixth bastard ribbes The wound was healed up on the out side yet for all that there remained a weakenesse of the stomacke whereupon a paine of the guttes like to the colicke tooke him especially in the Evening and on the night for which cause he durst not sup but very sparingly But on the eighth month after the paine raging more violently in his belly than it was accustomed hee dyed though for the mitigating of the vehemency thereof Simon Malmedy and Anthony du Val both learned Physitions omitted no kinde of remedy The body of the diseased was opened by the skilfull Chirurgion Iames Guillemeau who found a great portion of the collicke gut swelled with much wind gotten into the Chest through the wound of the Diaphragma for all it was so small that you could scarse put your little finger in thereat But now let us returne from whence we digressed We understand that there is blood poured forth into the capacity of the Chest by the difficulty of breathing the vehemency of the encreasing feaver the stinking of the breath the casting up of blood at the mouth and other symptomes which usually happen to these who have putrified and clotted blood poured out of the vessells into the belly infecting with the filthy vapour of the corrupt substance the partato which it shall come But also unlesse the patient cannot lye upon his backe he is troubled with a desire to vomite and covets now and then to rise whence hee often falls into a swoond the vitall faculty which fusteines the body being broken and debilitated both by reason of the wound and concreate or clotted blood for so putting on the quality of poyson it greatly dissipates and dissolves the strength of the heart It is a signe the spinall marrow is hurt when a convulsion or Palsie that is a suddaine losse of sense and motion in the parts thereunder an unvoluntary excretion of the Vrine and other excrements or a totall suppression of them seazes upon the Patient When the hollow veine and great Artery are wounded the patient will dye in a short time by reason of the suddaine and aboundant effusion of the blood and spirits which intercepts the motion of the lungs and heart whence the party dyes sufforaced CHAP. XXX Of the cure of the Wounds of the Chest WE have read in Iohn de Vigo that it is disputed amongst Chirurgions concerning the consolidation of wounds of
potus Let him take it in the morning for foure or five dayes In steed hereof you may make a potion of one dramme of Sperma ceti dissolved in buglosse or some other of the waters formerly mentioned and halfe an ounce of syrupe of Maiden-haire if the disease yeeld not at all to these formerly prescribed medicines it will be good to give the patient for nine dayes three or foure houres before meate some of the following powder â„ž rhei torrefacti rad rub majoris centaurei gentianae aristolo rotundae an â„¥ ss give Ê’j heereof with syrupe of Venegar and Carduus water They say that the water of greene Walnuts distilled by an Alembicke is good to dissolve congealed and knotted blood Also you may use bathes made of the decoction of the rootes of Orris Elecampane Sorrell Fennell Marsh-mallowes Water-ferne or Osmund the waterman the greater Comfery the seeds of Faenugreeke the leaves of Sage Marjerome the floures of Camaemile Melilore and the like For a warme bath hath power to rarifie the skin to dissolved the clotted blood by cutting the tough mitigating the acride humors by calling them forth into the surface of the body and relaxing the passages thereof so that the rebellious qualities being orecome there ensues an easie evacuation of the matter by vomit or expectoration if it flote in the stomacke or be conteined in the chest but by stoole Vrine if it lye in the lower parts by sweates and transpiration if it lye next under the skin Wherefore bathes are good for those who have a Peripneumonia or inflammation of their Lunges or a Pleurisie according to the minde of Hippocrates if so be that they be used when the feaver begins to be asswaged for so they mitigate paine helpe forwards suppuration and hasten the spitting up of the purulent matter But we would not have the patient enter into the bath unlesse he have first used generall remedies as blood-letting and purging for otherwise there will be no small danger least the humors diffused by the heate of the bath cause a new defluxion into the parts affected Wherefore doe not thou by any meanes attempt to use this or the like remedy having not first had the advice of a Physition CHAP. III. How we must handle Contusions when they are joyned with a wound EVery great Contusion forthwith requires blood-letting or purging or both and these either for evacuation or revulsion For thus Hippocrates in a contusion of the Heele gives a vomitory potion the same day or else the next day after the heele is broken And then if the Contusion have a wound associating it the defluxion must be stayed at the beginning with an oyntment made of Bole Armenicke the whites of egges and oyle of roses and smyrtles with the pouders of red roses Allome and mastich At the second dressing apply a digestive made of the yoalke of an egge oyle of violets and Turpentine This folfowing Cataplasme shal be applyed to the neare parts to help forwards suppuration â„ž rad althae lilio an â„¥ iiij sol malv. violar senecionis an M. ss coquantur complete passentur per setaceum addendo butyrirecentis olei viol an â„¥ iij. farinae volatilis quant sufficit fiat cataplasma ad formam pultis liquidae Yet have a care in using of Cataplasmes that you do not too much exceede for too frequent and immoderate use of them makes wounds plegmonous sordide and putride Wherefore the wound after it is come to suppuration must be cleansed filled with flesh and cicatrized unlesse haply the contused flesh shall be very much torne so that the native heate forsake it for then it must be cut away But if there be any hope to agglutinate it let it be sowed and other things performed according to Art but the stitches must not be made so close together as when the wound is simple and without contusion for such wounds are easily inflamed and swell up which would occasion either the breaking of the thred or flesh or tearing of the skinne CHAP. IV. Of these Contusions which are without a wound IF the skinne being whole and not hurt as farre as can be discerned the flesh which lyes under it be contused and the blood poured forth under the skin make an Ecchymosis then the patient must be governed according to Art untill the maligne symptomes which commonly happen be no more to be feared Wherfore in the beginning draw blood on the opposite side both for evacuation and revulsion The contused part shall be scarified with equall scarifications then shall you apply cupping-glasses or hornes both for evacuation of the blood which causes the tumor and Tension in the part as also to ventilate and refrigerate the heate of the part least it turne into an Abscesse Neither must we in the meane while omit gentle purging of the belly The first topicke medicines ought to bee astrictives which must lye some short while upon the part that so the Veines and Arteries may be as it were straitned and closed up and so the defluxion hindred as also that the part it selfe may be strengthened This may be the forme of such a remedy â„ž Albumina everum nu iij. olei myrtini rosacei an â„¥ j. boli armeni sanguin dracon an â„¥ ss nucum cupress gallarum pul aluminis usti an Ê’ij incorporentur omnia addendo aceti parum fiat medicamentum Then you shall resolve it with a fomentation Cataplasme and discussing emplaisters CHAP. V. By what meanes the contused part may be freed from the feare and imminent danger of a Gangreene GReat Contusions are dangerous even for this cause for that a Gangreene and mortification sometimes followes them which Hippocrates teacheth to happen when as the affected part is growne very hard and liquide Wherefore when the part growes livide and blacke and the native colour thereof by reason of the affluxe of the concreate blood is almost extinct chiefely to ease the part of that burden cupping glasses and hornes shall be applyed to the part it selfe being first scarified with a Lancet or else the following Instrument termed a Scarificator which hath 18 little wheeles sharpe and cutting like a razour which may be straitened and slacked by the pins noted by D. and P. This instrument is to be commended for that it performes the operation quickly and gently for it makes 18 incisiones in the space that you make one with a Lancet or knife A Scarificator A. Shewes the cover B. The Boxe or Case Then shall you foment the part with strong Venegar wherein the roootes of radish or of Dragons Cuckow-pint Saelomons Seale Auripigmentum and the like have beene boyled for such acride things doe powerfully heat resolve and draw the concreate blood from the inner part of the body unto the skinne which by its setling in the part affected prohibits the entrance of the vitall spirits
then must you place the member in an indifferent posture upon a pillow stuffed with oaten huskes or chaffe Stagges haire or wheate branne It must not be stirred after the first dressing unlesse great necessity urge for foure dayes in winter but somewhat sooner in summer For the ligatures wherewith the vessells are bound they must not be loosed or otherwise taken away before the mouthes of the vessells are covered with their glue or flesh lest by too much haste you cause a new flux of blood This agglutination will be performed by applying refrigerating astringent and emplasticke medicines such as this following powder â„ž boli arm farin hord picis res gypsi an â„¥ iiij Aloës nucum cup. cort granat an â„¥ j. incorporentur omnia simul fiat pulvis subtilis herewith let the whole ulcer be strewed over for three or foure dayes space which being ended let onely the seates of the vessells be poudred therewith and that for eight or ten dayes so that wee neede no further doubt of the agglutination of the vessells In the meane space let the digestive be applyed to the rest of the Vlcer untill it bee come to suppuration for then you shall give over your digestive and betake you to detersive and mundificative medicines As â„ž terebinth ven lotae in aqua vitae â„¥ vj. mellis ros colati â„¥ iiij succi planâ—ag Apij centaur minoris an â„¥ ij bulliant omnia simul usque ad consumptionem succorum auferantur abigne addendo farinae fab hord an â„¥ j. theriac Gal. â„¥ ss aloes myrrhae aristoloch an â„¥ iij. croci ℈ j. fiat mundificativum But seeing the case stands so that the Patients imagine they have their members yet entire and yet doe complaine thereof which I imagine to come to passe for that the cut nerves retire themselves towards their originall and thereby cause a paine like to convulsions for as Galen writes in his booke De motu musculorum That contraction is the true and proper action of a nerve and muscle and againe extension is not so much an action as a motion now wee must indeavour to give remedy to this symptome Which may be done by annointing the spine of the backe and all the affected part with the following Liniment which is very powerfull against Convulsions the Palsie numnesse and all cold affects of the nervous bodies â„ž salviae chamaepytheos majoranae rorismar menth rutae lavendulae an m. j. flor chamâ—mel melilot summit aneth hyperici an p. ij baccarum lauri juniperi an â„¥ ij pyrethriÊ’ij mastic assae odorat an â„¥ iss terebinth venet lb. j. olei lumbr. aneth catell an â„¥ vj. olei terebinth â„¥ iij. axung hum â„¥ ij crociÊ’j vini albi â—doriferi lib. j. cerae quantum sufficit contundenda contundantur pulverisanda pulverisentur deinde macerentur omnia in vino per noctem postea coquantur cum oleis axungia praedictis in vase duplici fiat linimentum secundum artem in fine adde aquae vitae â„¥ iiij Besides in dressing these wounds the Chirurgion must use diligence to procure the falling away of the ends or scalls of the bones which the saw and the appulse of the aire never before comming hereto have tainted which may be done by applying to their ends actuall cauteries that is hot irons in using of which you must have a speciall care that you touch not the sensible parts with fire neither must the bones themselves bee forcibly pluckt off but gently mooved by little and little so that you shall thinke you and the patient have exceedingly well performed your parts if they fall away at the thirtyeth day after the Amputation All these things being performed you shall hinder the growth of proud flesh with the cathaereticks such as are burnt vitrioll the pouder of Mercurie and other things amongst which is Alome burnt and poudered which is excellent in these kind of wounds whether by its selfe or mixed with others You shall use these and such like even unto the perfect agglutination and cicatrization of the wound and you may of your selfe devise other things such as these as occasion shall offer its selfe CHAP. XXIIII What just occasion moved the Author to devise this new forme of remedy to stanch the blood after the amputation of a member and to forsake the common way used almost by all Chirurgions which is by application of actuall cauteries VErily I confesse I formerly have used to stanch the bleeding of members after amputation after another manner than that I have a little before mentioned Whereof I am ashamed and agreived But what should I doe I had observed my maisters whose method I entended to follow alwaies to doe the like who thought themselves singularly well appointed to stanch a flux of blood when they were furnished with various store of hot Irons and causticke medicines which they would use to the dismembred part now one then another as they themselves thought meete Which thing cannot be spoken or but thought upon without great horror much lesse acted For this kinde of remedy could not but bring great and tormenting paine to the patient seeing such fresh wounds made in the quicke and sound flesh are endewed with exquisite sense Neither can any causticke be applyed to nervous bodies but that this horrid impression of the fire will be presently communicated to the inward parts whence horrid symptomes ensue and oft times death it selfe And verily of such as were burnt the third part scarse ever recovered and that with much adoe for that combust wounds difficultly come to cicatrization for by this burning are caused cruell paines whence a Feaver Convulsion and oft times other accidents worse than these Adde hereunto that when the eschar fell away oft times a new haemorrhagye ensued for stanching whereof they were forced to use other causticke and burning Instruments Neither did these good men know any other course so by this repetition there was great losse and waste made of the fleshy and nervous substance of the part Through which occasion the bones were laid bare whence many were out of hope of cicatrization being forced for the remainder of their wretched life to carry about an ulcer upon that part which was dismembred which also tooke away the oportunitie of fitting or putting too of an artificiall legge or arme in stead of that which was taken off Wherefore I must earnestly entreate all Chirurgions that leaving this old and too too cruell way of healing they would embrace this new which I thinke was taught mee by the speciall favour of the sacred Deitie for I learnt it not of my maisters nor of any other neither have I at any time found it used by any Onely I have read in Galen that there was no speedier remedy for stanching of blood than to bind the vessels through which it flowed towards their rootes to wit the Liver and Heart This precept of Galen of binding
and is complicated in its selfe Vlcers of the bladder are healed with the same medicines as those of the reines are but these not onely taken by the mouth but also injected by the urinary passage These injections may be made of Gordonius his Trochisces formerly prescribed being dissolved in some convenient liquor but because Vlcers of the bladder cause greater and more sharpe paine than those of the Kidnyes therefore the Chirurgion must bee more diligent in using Anodynes For this purpose I have often by experience found that the oyle of hen-bane made by expression gives certaine helpe Hee shall doe the same with Caraplasmes and liniments applyed to the parts about the Pecten and all the lower belly and perinaeum as also by casting in of Glisters If that they stinke it will not be amisse to make injection of a little Aegyptiacum dissolved in wine plaintaine or rose water For I have often used this remedy in such a case with very prosperous successe CHAP. XIX Of the Vlcers of the wombe VLcers are bred in the wombe either by the confluxe of an acride or biting humor fretting the coates thereof or by a tumor against nature degenerating into an Absesse or by a difficult and hard labour they are knowne by paine at the perinaeum and the effluxe of Pus and Sanâ—es by the privity All of them in the opinion of Avicen are either putride when as the Sanies breaking forth is of a stinking smell and in colour resembles the water wherein flesh hath beene washed or else sordide when as they flow with many virulent and crude humors or else are eating or spreading Vlcers when as they cast forth blacke Sanies and have pulsation joyned with much paine Besides they differ amongst themselves in site for either they possesse the necke and are known by the sight by putting in a speculum or else are in the bottome and are manifested by the condition of the more liquid and serous excrements and the site of the paine They are cured with the same remedies wherewith the ulcers of the mouth to wit with aqua fortis the oyle of Vitrioll and antimony and other things made somewhat more milde and corrected with that moderation that the ulcerated parts of the wombe may bee safely touched with them it is requisite that the remedies which are applyed to the Vlcers of the wombe doe in a moment that which is expected of them for they cannot long adhere or sticke in the wombe as neither to the mouth Galen saith that very drying medicines are exceeding fit for the Vlcers of the wombe that so the putrefaction may be hindred or restrained whereto this part as being hot and moyst is very subject besides that the whole body unto this part as unto a sinke sends downe its excrements If an ulcer take hold of the bottome of the wombe it shall be cleansed and the part also strengthened by making this following injection â„ž hordei integri p. ij guajaci â„¥ j. rad Ireos â„¥ ss absinth plant centaur utriusque an M. j fiat decoct in aqua fabrorum ad lb. ij in quibus dissolve mellis vosati syrupi de absinthio an â„¥ iij. fiat injectio For amending the stinking smell I have often had certaine experience of this ensuing remedy â„ž vinirub lb. j. unguent agyptiaci â„¥ ij bulliant parum Thus the putrifaction may be corrected and the painefull maliciousnesse of the humor abated Vlcers when they are clensed must presently be cicatrized that may be done with Alume water the water of plantaine wherein a little vitrioll or Alume have beene dissolved Lastly if remedies nothing availing the Vlcer turne into a Cancer it must be dressed with anodynes and remedies proper for a Cancer which you may finde set downe in the proper treatise of Cancers The cure of Vlcers of the fundament was to bee joyned to the cure of these of the wombe but I have thought good to referre it to the treatise of Fistula's as I doe the cure of these of the vrinary passage to the Treatise of the Lues venerea CHAP. XX. Of the Varices and their cure by cutting AVarix is the dilatation of a Veine some whiles of one and that a simple branch otherwhiles of many Every Varix is either straight or crooked and as it were infolded into certaine windings within its selfe Many parts of the body are subject to Varices as the temples the region of the belly under the Navill the testicles wombe fundament but principally the thighes and legges The matter of them is usually melancholy blood for Varices often grow in men of a malancholy temper and which usually feed on grosse meates or such as breed grosse and melancholy humors Also women with child are commonly troubled with them by reason of the heaping together of their suppressed menstruall evacuation The precedent causes are a vehement concussion of the body leaping running a painefull journey on foote a fall the carrying of a heavy burden torture or Racking This kind of disease gives manifest signes thereof by the largenesse thicknesse swelling and colour of the Veines It is best not to meddle with such as are inveterate for of such being cured there is to be feared a refluxe of the melancholy blood to the noble parts whence there may be imminent danger of maligne Vlcers a Cancer Madnesse or suffocation When as many Varices and diversly implicite are in the legges they often swell with congealed and dryed blood and cause paine which is increased by going and compression Such like Varices are to be opened by dividing the veine with a Lancet and then the blood must be pressed out and evacuated by pressing it upwards and downewards which I have oft times done and that with happy successe to the patients whom I have made to rest for some few dayes and have applyed convenient medicines A Varix is often cut in the inside of the legge a little below the knee in which place commonly the originall thereof is seene He which goes about to intercept a Varix downewards from the first originall and as it were fountaine thereof makes the cure far more difficult For hence it is divided as it were into many rivelets all which the Chirurgion is forced to follow A Varix is therefore cut or taken away so to intercept the passage of the blood and humors mixed together therewith flowing to an Vlcer seated beneath or else least that by the too great quantitie of blood the vessell should be broken and death bee occasioned by a haemorrhagie proceeding from thence Now this is the manner of cutting it Let the patient lye upon his backe on a bench or table then make a ligature upon the legge in two places the distance of some foure fingers each from other wherein the excision may be made for so the Veine will swell up and come more in sight and besides you may also
Wherefore there must no small care be had of preparing ligatures to wit that they bee made of choyce and well woven cloth yet not course or rough and let them be of such length and breadth as the Surgeon perswaded by an artificiall conjecture shal judge to be fit for the thicknesse and length of the member and greatnesse of the fracture for ligatures ought to be of breadth to involve and cover all the fractured part and a great part of that which is sound But seeing that in my Booke of Bandages I have seemed chiefly to set downe and approve the manner of binding used by Hippocrates now I thinke good here in this place to describe that which is in common use amongst our Surgeons Our Surgeons therefore at this day require three Ligatures for fractures the first whereof they presently cast upon the hurt part whether broken or dislocated or onely strained making the first wrappings upon it so that they most and straitliest binde it there but lesse and more loosely on both sides thereof Such circumvolutions or wrappings are drawne upwards and there ended They must bee rowled thicke and not wide for so if they presently follow and lye one upon another they will hold the bones more firmely and more farre and wide presse forth and represse the superfluous blood from the sound part They presently in like sort cast the second ligature upon the verie fracture giving it two wraps then going down-wards yet so as that they are opener or wider and farther distant each from other and not so close together as the circumvolutions of the first ligature that so they may presse the humors the lesse to the extremities of the part as those which cannot receive and beare without inflammation and danger of a gangrene such abundance of humors for that they are not sufficiently spatious as also more remote from the fountaine of native heat which is greater in the center than in the circumference At the lower end of the hurt part the circumvolutions either end or else are twined thence backe againe They cast on the third ligature in that lower end of the hurt part and rowle it smoothly and gently upwards the windings being made contrarie to the windings of the first and second ligatures that they may so draw backe into their naturall state the muscles which peradventure have beene drawne aside by the force of the former wrappings These ligations finished they apply three splints of past-bord or some such matter the first below the fracture and that truly more broad and of sufficient length and then two others one on each side distant each from other some fingers breadth to the end to keep the bone that it doe not stirre to this side or that being wrapped about with Tow or Cotton Then they thinke of placing or laying the part to which purpose they propound to themselves three scopes The first is that the part may lye soft the second smooth or even the third somewhat high The hurt part ought truely to lye soft for that hard lying presses it and causes paine and inflammation which whiles the Patient cannot patiently endure he is forced to change his place whilst he everie way seeks ease for his paine and thus he now and then moves the fractured part which ought to be kept quiet without any motion It must lye smooth or even because an unequall or uneven site distorts or draws awry the part whilst one portion of the hurt part is borne up and sustained by that which lyes under it but the other hanging downe hath nothing thereunder whereupon it may rest Therefore Hippocrates bids us diligently to take heed that the heele doe not hang downe nor the foot remaine without a pillow for hence paine and a troublesome defluxion of humors is to be feared But the part ought to lye somewhat high that the defluxion may bee hindred which is easily stirred up by a prone and declining site for if the foote shall be placed in a lower figure the blood which flowes thither from the legge will cause inflammation But on the contrarie if it bee higher nothing can flow downe thereinto Therefore absolutely not only the foote but also the thigh and legge are to be placed higher than the rest of the bodie yet keeping such a meane that the part may not be too much distended as Hippocrates admonisheth us In the meane time this hurt legge or side ought to bee of equall length with the sound and for that purpose it must bee stayed on both sides with Junks as we shall shew you hereafter when we come to speak of a broken legge The bandage being performed as we have said the following night and the next day the Patient feels the member more straitly bound than when it was first wrapped yea verily the knee is lifted up into a soft tumor by the expression of the humor from the wounded part but on the contrarie the ensuing day the ligation is slackned and relaxed some portion of the humor contained in the part being digested Also the next day all things are perceived more loose there being made a larger resolution of the humor Then therefore the Bandages must be loosed and that not only lest that the fragments of the bones should fall forth of their place but also that we may gratifie the Patient by that alteration or change of place and besides that wee may avoyde itching which usually happens to parts too long bound up by reason of the suppression of acride and fuliginous excrements which use to be gathered in great quantitie in a part at rest and bound up both from the excrementitious humors wherewith the part is moistened and the alimentarie humors in a part which is idle and at quiet by reason the difflation and transpiration are hindred by want of exercise and the pores of the skinne shut up by the abundance of the ligatures so that by the suppression thereof many have not only an itching but also the skinne being broke by the acrimonie of these as well vapours as humors which are kept shut and pent up have ulcers breake forth Therefore when such accidents shall be feared the part shall so long be fomented with warme water and oyle as you shall thinke fit for such fomenting asswageth paine relaxeth that which was too much straitened by the binding and amends the refrigeration of the part caused by the repercussion and expression of the blood and spirits the native and internall heat being by this meanes revived If together with the tumor there be a contusion and sugillation it must bee the longer fomented that the excrementitious humor residing in the part may be digested But if this quantitie of time shall not suffice then must you use stronger digestives yet have a care you use them not too long for so you should hinder the generation of a Callus Therefore that saying of Hippocrates must here be remembred which saith That a
especially whereto it fell being made somwhat flat round resembling the whirl-bone its self and it shall bee bound on with ligatures and medicines so fast that it may not stirre a jot After the part shall seeme to have had sufficient rest it is fit that the patient try and accustome by little and little to bend his knee untill at length hee shall find that he may easily and safely move that joint CHAP. XLIX Of the dislocated Knee THe knee also may be dislocated three manner of waies that is into the inner outer and hinde part but very seldom towards the foreside and that not without some grievous and forcible violence for the Whirle-bone lying upon it hinders it from slipping out and holds it in The other wayes are easie because the cavity of the leg-bone is superficiary and very smooth but the cavity of the lower end of the thigh-bone is made in the maner of a spout or gutter besids the head therof is very smooth and slippery but the whole joint is much more laxe than the joint of the Elbow so that as it may be the more easily dislocated so may it the better be restored and as it may be the more easily so may it be the more safely dislocated for that inflammation is lesse to bee feared here as it is observed by Hippocrates Falls from high leaping and too violent running are the causes of this dislocation The signe thereof is the disability of bending or lifting up the legge to the thigh so that the patient cannot touch his buttocke with his heele The dislocation of the knee which is inwardly and outwardly is restored with indifferent extension and forcing of the bones into their seats from those parts whereunto they have fallen But to restore a dislocation made backwards the patient shall be placed upon a bench of an indifferent height so that the Surgeon may be behind him who may bend with both his hands bring to his buttocks the patients leg put betwixt his owne legges But if the restitution doe not thus succeed you must make a clew of yearn and fasten it upon the midst of a staffe let one put this into the cavity of his ham upon the place whereas the bone stands out and so force it forwards then let another cast a ligature of some three fingers breadth upon his knee and draw it upwards with his hands then presently and at once they all shall so bend and crooke the lame legge that the heele thereof may touch his buttocks CHAP. L. Of a knee dislocated forewards BUt if the knee bee dislocated forwards which seldome happens the patient shall be placed upon a table and a convenient ligation made above and another close beneath the knee Then the Surgeon shall so long presse downe with both his hands the bone which is out of joint untill it shall returne to its place againe To which purpose if the strength of the hand will not serve to make just extension each way you may make use of our engine as you may perceive by this following figure A figure shewing the manner of restoring a knee dislocated forwards You shall know that the bone is restored by the free and painelesse extension of the legge then will their bee place for medicines boulsters and strengthening ligatures In the meane space the patient shall forbeare going so long as the part shall seeme to require CHAP. LI. Of the separation of the greater and lesser Focile THe Fibula or lesser Focile is fastened and adheres to the Tibia leg bone or greater Focile without any cavity above at the knee and below at the ankle But it may bee pluckt or drawne aside three manner of waies that is forwards and to each side this chance happens when in going we take no sure footing so that wee slip with our feete this way and that way as in 〈◊〉 slippery place and so wrest it inwards or outwards for then the weight of our body lying upon it drawes the legge as it were infunder so that the one Focile is dislocated or separated from the other The same may happen by a fall from an high place or some grievous and bruising blow besides also their appendices are somtimes separated from them For the restoring of all these into their proper places it is fit they bee drawne and forced by the hand of the Surgeon into their seats then shall they be straitly bound up putting compresses to that part unto which the Fibula flew beginning also your ligation at the very luxation for the forementioned reasons The patient shall rest forty daies to wit as long as shall bee sufficient for the strengthening of the ligaments CHAP. LII Of the Leg-bone or greater Focile dislocated and divided from the Pasterne bone ALso the Leg-bone is sometimes dislocated and divided from the pasterne bone as well inwardly as outwardly which may bee knowne by the swelling out of the bone to this or that part if it be onely a subluxation or straine it may bee easily restored by gently forcing it into the place againe After the bone shall be restored it shall be kept so by compresses and fit deligation by crosse and contrary binding to the side opposite to that towards which the bone fell that so also in some measure it may bee more and more forced into its place In the mean time you must have a care that you doe not too straitly presse the great and large tendon which is at the heele This kinde of dislocation is restored in forty dayes unlesse some accident happen which may hinder it CHAP. LIII Of the dislocation of the Heele WHosoever leaping from an high place have fallen very heavie upon their heele have their heele dislocated and divided from the pasterne bone This dislocation happens more frequently inwardly than outwardly because the prominency of the lesser Focile embraces the pasterne bone whence it is that there it is more straitly and firmely knit It is restored by extension and forcing it in which will be no very difficult matter unlesse some great defluxion or inflammation hinder it For the binding up it must bee straitest in the part affected that so the bloud may be pressed from thence into the neighbouring parts yet using such a moderation that it may not bee painefull nor presse more straitly than is fit the nerves and grosse tendon which runnes to the heele This dislocation is not confirmed before the fortieth day though nothing happen which may hinder it Yet usually it happeneth that many symptomes ensue by the vehemency of the contusion Wherefore it will not be amisse to handle them in a particular chapter CHAP. LIV. Of the Symptomes which follow upon the contusion of the Heel IT happeneth by the vehemency of this contusion that the veines and arteries do as it were vomit up bloud both through the secret passages of their coates as also by their ends or orifices whence an
Ecchymosis or blacknesse over all the heel paine swelling and other the like ensue which implore remedies the Surgeons helpe to wit convenient diet and drawing of bloud by opening a veine of which though Hippocrates makes no mention yet it is here requisite by reason of the feaver and inflammation and if need require purgation principally such as may divert the matter by causing vomit and lastly the application of locall medicines chiefly such as may soften and rarifie the skin under the heel otherwise usually hard and thick such as are fomentations of warme water oile so that divers times wee are forced to scarifie it with a lancet shunning the quicke flesh For so at length the blood poured forth into the part and there heaped up is more easily attenuated and at length resolved But these things must all bee performed before the inflammation seaze upon the part otherwise there will be danger of a convulsion For the bloud when it falls out of the vessels readily putrefies by reason the density of this part hinders it from ventilation and dispersing to the adjacent parts Hereto may be added that the large and great Tendon which covers the heele is endued with exquisite sense and also the part it selfe is on every side spred over with many nerves Besides also there is further danger of inflammation by lying upon the backe and heele as we before admonished you in the Fracture of a leg Therefore I would have the Surgeon to bee here most attentive and diligent to performe these things which we have mentioned lest by inflammation a Gangrene and mortification for here the sanious flesh presently falls upon the bone happen together with a continued and sharp feaver with trembling hicketting and raveing For the corruption of this part first by contagion assailes the next and thence a feaver assailes the heart by the arteryes pressed and growing hot by the putride heat by the nerves and that great and notable tendon made by the concourse of the three muscles of the calfe of the legge the muscles braine and stomach are evilly affected and drawne into consent and so cause convulsions raving and a deadly hicketting CHAP. LV. Of the dislocated pasterre or Ancle-bone THe Astragalus or Pasterne bone may bee dislocated and fall out of its place to every side Wherefore when it falls out towards the inner part the sole of the foot is turned outwards when it flyes out to the contrary the sign is also contrary if it be dislocated to the foreside on the hinde side the broad Tendon comming under the heel is hardened and distended but if it be luxated backwards the whole heel is as it were hid in the foot neither doth this kinde of dislocation happen without much violence It is restored by extending it with the hands and forcing it into the contrary part to that from whence it fell Being restored it is kept so by application of medicines and fit ligation The patient must keepe his bed long in this case lest that bone which susteines and bears up the whole body may againe sinke under the burden and breake out the sinewes being not well knit and strengthened CHAP. LVI Of the dislocation of the Instep and backe of the foot THe bones also of the Instep and backe of the foot may be luxated and that either upwards or downwards or to one side though seldome sidewise for the reason formerly rendred speaking of the dislocation of the like bones of the hand If that they stand upwards then must the patient tread hard upon some plaine or even place and then the Surgeon by pressing them with his hand shall force them into their places on the contrary if they stand out of the sole of the foote then must you presse them thence upwards and restore each bone to its place They may bee restored after the same manner if they bee flowne out to either side But you must note that although the ligatures consist but of one head in other dislocatious yet here Hippocrates would have such used as have two heads for that the dislocation happens more frequently from below upwards or from above downewards than sidewise CHAP. LVII Of the dislocation of the Toes NOw the Toes may bee foure waies dislocated even as the fingers of the hand and they may be restored just after the same manner that is extend them directly forth and then force each joint into its place and lastly bind them up as is fitting The restitution of all of them is easie for that they cannot farre transgresse their bounds To conclude the bones of the feet are dislocated and restored by the same meanes as those of the hands but that when as any thing is dislocated in the foote the patient must keepe his bed but when any thing is amisse in the hand he must carry it in a scarfe The patient must rest twenty dayes that is untill he can firmely stand upon his feet CHAP. LVIII Of the symptomes and other accidents which may befall a broken or dislocated member MAny things may befall broken or dislocated members by the meanes of the fracture or dislocation such as are bruises great paine inflammation a fever impostume gangrene mortification ulcer fistula and atrophia all which require a skilfull and diligent Surgeon for their cure A confusion happens by the fall of some heavie thing upon the part or by a fall from high whence followes the effusion of bloud poured out under the skinne which if it be poured forth in great plenty must be speedily evacuated by scarification and the part eased of that burden lest it should thence gangrenate And by how much the bloud shall appear more thick and the skin more dense by so much the scarification shall be made more deepe You may also for the same purpose apply leaches Concerning paine wee formerly said that it usually happens by reason that the bones are moved out of their places whence it happeneth that they become troublesome to the muscles and nerves by pricking and pressing them Hence ensue inflammations as also impostumation and a feaver oft times a gangrene and in conclusion a mortification corrupting and rotting the bones otherwhiles a sinuousulcer or fistula But an Atrophia and leanenesse ariseth by the sloth and idlenesse of the member decaying all the strength therof and by too strait ligation intercepting the passages of the bloud otherwise ready to fall and flow thither Now the leannesse which is occasioned by too strait ligation receives cure by the slackening of the ligatures wherewith the member was bound That which proceeds from idlenesse is helped by moderate exercise by extending bending lifting up and depressing the member if so bee that he can away with exercise Otherwise he shall use frictions and fomentations with warme water The frictions must be moderate in hardenesse and gentlenesse in length and shortnesse The same moderation shall be observed in
vessels cast it forth that cure is not unprofitable which having used medicines respecting the whole body applyes astringent medicines to the shaved crown as Empl. contra rupturam which may streighten the veines and as it were suspend the phlegme useth cupping and commands frictions to bee made towards the hinde part of the head and lastly maketh a Seton in the necke There are some who cauterize the toppe of the crowne with a hot iron even to the bone so that it may cast a scaile thus to divert and stay the defluxion For locall medicines a Collyrium made with a good quantity of rosewater with a little vitrioll dissolved therein may serve for all CHAP. XII Of the Ophthalmia or inflammation of the Eyes AN Ophthalmia is an inflammation of the coate Adnata and consequently of the whole eye being troublesome by the heate rednesse beating renitency and lastly paine It hath its originall either by some primitive cause or occasion as a fall stroake dust or small sand flying into the eyes For the eye is a smooth part so that it is easily offended by rough things as saith Hippocrates lib. de carnibus Or by an antecedent cause as a defluxion falling upon the eyes The signes follow the nature of the materiall cause for from blood especially cholerike and thin it is full of heat rednesse and paine from the same allayed with phlegme all of them are more remisse But if a heavinesse possess the whole head the original of the disease proceeds therfrom But if a hot pain trouble the forehead the disease may be thought to proceed from some hot distemper of the Dura water or the pericranium but if in the very time of the raging of the disease the patient vomit the matter of the disease proceeds from the stomacke But from whence soever it commeth there is scarce that paine of any part of the body which may be compared to the paine of the inflamed eyes Verily the greatnesse of the inflammation hath forced the eyes out of their orbe and broken them asunder in divers Therefore there is no part of Physicke more blazed abroad than for sore eyes For the cure the Surgeon shall consider and intend three things diet the evacuation of the antecedent and conjunct cause and the overcomming it by topicke remedies The diet shall bee moderate eschewing all things that may fill the head with vapours and those things used that by astriction may strengthen the orifice of the ventricle and prohibite the vapours from flying up to the head the patient shall bee forbidden the use of wine unlesse peradventure the disease may proceed from a grosse and viscide humour as Galen delivers it The evacuation of the matter flowing into the eye shall bee performed by purging medicines phlebotomy in the arm cupping the shoulders and neck with scarification and without and lastly by frictions as the Physitian that hath undertaken the cure shall thinke it fit Galen after universall remedies for old inflammations of the eyes commends the opening of the veines and arteryes in the forehead and temples because for the most part the vessels therabouts distended with acride hot and vaporous blood cause great vehement paines in the eye For the impugning of the conjunct cause divers topick medicines shall be applyed according to the four sundry times or seasons that every phlegmon usually hath For in the beginning when as the acride matter flowes downe with much violence repercussives doe much conduce 〈◊〉 and tempred with resolving medicines are good also in the encrease ℞ aq ros et plantag an ℥ ss mucagin gum Tragacanth ʒii album ovi quod sufficit fiat collyrium let it bee dropped warme into the eye and let a double cloth dipped in the same collyrium bee put upon it Or ℞ mucag. sem psil cydon extractae in aq plant an ℥ ss aq solan lactis muliebris an ℥ i. trochise alb rha ℈ i. fiat collyrium use this like the former The veins of the templesmay be streightene◠by the following medicine ℞ bol arm sang drac mast an ℥ i. ss alb ovi aquae ros acet an ℥ i. tereb lot ol cidon an ℥ ss fiat defensivum You may also use ungde Bolo empl diacal or contrarupturam dissolved in oyle of myrtles and a little vineger But if the bitternesse of the paine be intolerable the following cataplasme shall be applyed ℞ medul pomor sub ciner coctorum ℥ iii. lactis muliebris ℥ ss let it be applyed to the eye the formerly prescribed collyrium being first dropped in Or ℞ mucag sem psil cidon an ℥ ss micae panis albi in lacte infusi ℥ ii aquae ros ℥ ss fiat cataplasma The bloud of a turtle Dove Pigeon or Hen drawne by opening a veine under the wings dropped into the eye asswageth paine Baths are not onely anodine but also stay the defluxion by diverting the matter thereof by sweats therefore Galen much commends them in such defluxions of the eyes as come by fits In the state when as the paine is either quite taken away or asswaged you may use the following medicines ℞ sarcocol in lacte muliebri nutritae ʒi aloës lotain aq rofar ℈ ii trochis alb rha ʒss sacchar cand ʒii aquae ros ℥ iii. fiat collyrium Or ℞ sem faeniculi fanug an ʒii flo chamae melil an m. ss coquantur in aq com ad ℥ iii. colaturae adde tuthiae praep sareoc nutritae in lacte muliebri an ʒi ss sacchari cand ℥ ss fiat collyrium ut artis est In the declination the eye shall be fomented with a carminative decoction and then this collyrium dropped thereinto ℞ nutritaeʒii aloës myrrh an ʒi aq ros euphrag an ℥ ii fiat collyrium ut artis est CHAP. XIII Of the Proptosis that is the falling or starting forth of the eye and of the Phthisis and Chemosis of the same THe Greekes call that affect Proptosis the Latines procidentia or Exitus oculi when as the eye stands and is cast out of the orbe by the occasion of a matter filling and lifting up the eye into a greater bignesse and largenesse of substance The cause of this disease is sometimes externall as by too violent strayning to vomit by hard labour in child-birth by excessive and wondrous violent shouting or crying out It sometimes happeneth that a great and cruell paine of the head or the too strait binding of the forehead and temples for the easing thereof or the palsie of the muscles of the eye give beginning to this disease Certainely sometimes the eye is so much distended by the defluxion of humors that it breakes in sunder and the humours thereof are shed and blindenesse enfues thereof as I remember befell the sister of Lewis de Billy merchant dwelling at Paris near S. Michael's bridg The cure shall be diversified according to the causes
blow they must not bee taken forth but restored and fastened to the next that remaine firme for in time they will be confirmed in their sockets as I tryed in Anthony de la Rue a tailour who had his jaw broken with the pommell of a dagger and three of his teeth loosened and almost shaken out of their sockets the jaw being restored the teeth were also put in their places and bound to the rest with a double waxed thread for the rest I fed the patient with broths gellyes and the like and I made astringent gargarismes of cypresse nuts myrtle berries and a little alum boyld in oxycrate and I wished him to hold it a good while in his mouth by these means I brought it so to passe that hee within a while after could chaw as easily upon those teeth as upon the other I heard it reported by a credible person that he saw a Lady of the prime nobility who instead of a rotten tooth she drew made a sound tooth drawne from one of her waiting maids at the same time to be substituted and inserted which tooth in processe of time as it were taking roote grew so firme as that she could chaw upon it as well as upon any of the rest But as I formerly said I have this but by heare-say Now the teeth are corroded or eaten in by an acride and thinne humour penetrating by a plenteous and frequent defluxion even to their roots and being there conteined it putrefies and becomming more acride it doth not only draw the teeth into the contagion of its putrefaction but also perforats and corrodes them The putrefaction may bee corrected if after generall medicines you put oile of vitrioll or aqua fortis into the hole of the eaten tooth or else if you burne the tooth it selfe to the roote with a small iron wyar being red hot you shall thrust this hot iron through a pipe or cane made for the same purpose lest it should harm any sound part by the touch therof and thus the putrefaction the cause of the arrosion may be stayed But if the hole bee on the one side between two teeth then shall you file away so much of the sound tooth as that you may have sufficient liberty to thrust in your wiar without doing any harme The formes of Files made for filing the teeth Wormes breeding by putrefaction in the roots of the teeth shall be killed by the use of causticks by gargles or lotions made of vinegar wherein either pellitory of Spain hath bin steeped or Treacle dissolved also Aloes and Garlike are good to be used for this purpose Setting the teeth on edge happens to them by the immoderate eating of acride or tart things or by the continuall ascent of vapours endued with the same quality from the orifice of the ventricle to the mouth or by a cold defluxion especially of acride phlegme falling from the braine upon the teeth or else by the too excessive use of cold or stupising liquors This affect is taken away if after generall medicines and shunning those things that cherish the disease the teeth bee often washed with aqua vitae or good wine wherein sage rosemary cloves nutmegs and other things of the like nature have bin boyled CHAP. XXVII Of drawing of teeth TEeth are drawne either for that they cause intolerable paines which will not yeeld to medicines or else for that they are rotten and hollowed so that they cause the breath to smell or else for that they infect the sound and whole teeth and draw them into the like corruption or because they stand out of order Besides when they are too deep and strongly rooted so that they cannot be plucked out they must oft times be broken of necessity that so you may drop some caustick thing into their roots which may take away the sense and consequently the paine The hand must be used with much moderation in the drawing out of a tooth for the Jaw is sometimes dislocated by the too violent drawing out of the lower teeth But the temples eyes and braine are shaken with greater danger by the too rude drawing of the upper teeth Wherefore they must first be cut about that the gums may be loosed from them then shake them with your fingers and doe this untill they begin to be loose for a tooth which is fast in and is plucked out with one pull oft-times breaks the jaw and brings forth the piece together therewith whence follow a feaver and a great fluxe of bloud not easily to be stayed for bloud or pus flowing out in great plenty is in Celsus opinion the sign of a broken bone many other maligne and deadly symptoms some have had their mouthes drawne so awry during the rest of their lives so that they could scarce gape Besides if the tooth be much eaten the hole thereof must be filled either with Lint or a corke or a piece of lead well fitted thereto lest it be broken under your forceps when it is twitched more straightly to be plucked out and the root remain ready in a short time to cause more grievous paine But judgement must be used and you must take speciall care lest you take a sound tooth for a pained one for oft-times the patient cannot tell for that the bitternesse of paine by neighbour-hood is equally diffused over all the jaw Therefore for the better plucking out a tooth observing these things which I have mentioned the patient shall be placed in a low seat bending back his head between the Tooth-drawers legs then the Tooth-drawer shall deeply scarifie about the tooth separating the gums therfrom with the instruments marked with this letter A. and then if spoyled as it were of the wall of the gums it grow loose it must be shaken and thrust out by forcing it with the three-pointed levatory noted with this letter B. but if it sticke in too fast and will not stirre at all then must the tooth be taken hold of with some of these toothed forcipes marked with these letters C. D. E. now one then another as the greatnesse figure and site shall seeme to require I would have a tooth-drawer expert and diligent in the use of such toothed mullets for unlesse one know readily and cunningly how to use them he can scarce so carry himself but that he will force out three teeth at once oft-times leaving that untoucht which caused the paine The effigies of Forcipes or mullets for the drawing of teeth Instruments for scraping the teeth and a three-pointed levatory The forme of another Instrument for drawing of teeth After the tooth is drawn let the blood flow freely that so the part may be freed from pain and the matter of the tumor discharged Then let the tooth-drawer presse the flesh of the gums on both sides with his fingers whereas hee tooke out the tooth that so the socket that was too much dilated and oft times torne by
bee propagated and sent by the veines arteries and nerves to the noble parts whose malignity a strong liver not enduring by the strength of the naturall expulsive facultie will send it into the groines whereon follow Abscesses therefore called venereall Bubo's These if they returne in againe and cast not forth matter by being opened they will by their falling back into the veins and arteries infect the masse of the bloud by the like tainture thence will ensue the Lues venerea Yet this disease may be got by a more occult manner of touch as by breathing only For it is not altogether besides reason and experience that a woman long troubled with this disease may by importunate and often kissing transfuse malignity into a child for the tender and soft substance of a little childe may bee altered infected and by little and little corrupted by receiving of filthy and in their whole kinde maligne vapours For it is knowne and now vulgarly believed that mid-wives by receiving the child of a woman infected with this disease to have got this affect the malignity being taken and drawne into their bodies through the pores of their hands by the passages of the veines and arteries Neither doth it spare any condition sexe nor age of men for not onely whosoever use copulation but such as onély lye with them may bee taken by this virulencie yea verily if they onely lye in the sheets or coverings which retaine his sweat or the virulencie cast forth by an ulcer The same danger may assaile those who shall drinke in the same vessell after such as are troubled with this disease For by the impure touch of their lips they leave a virulent saâ—ies and spittle upon the edges of the cup which is no lesse contagious in its kinde than the virulencie of leprous persons or the some of madde dogs Wherefore it is no marvell if children nursed by an infected nurse draw in the seeds of this disease together with the milk which is only bloud whitened in the breasts or infected sucking children by their hot and ulcerated mouthes may trans-fuse this malignity into the body of the nurse by the rare loose and porous substance of the dugs which it frequently sucketh This following history is very memorable to this purpose A certaine very good Citizen of this Citie of Paris granted to his wife being a very chaste woman that conditionally shee should nurse her owne child of which shee was lately delivered shee should have a nurse in the house to ease her of some part of the labour by ill hap the nurse they tooke was troubled with this disease wherefore shee presently infected the childe the child the mother the mother her husband and hee two of his children who frequently accompanied him at bed and board being ignorant of that malignity wherewith hee was inwardly tainted In the meane while the mother when shee observed that her nurse childe came not forward but cryed almost perpetually shee asked my counsell to tell her the cause of the disease which was not hard to bee done for the wholebody thereof was replenished with venereall scabs and pustles the hired nurses and the mothers nipples were eaten in with virulent ulcers also the fathers and the two other childrens bodies whereof the one was three the other foure yeares old were troubled with the like pustles and scabs I told them that they had all the Lues venerea which tooke its originall and first off-spring by maligne contagion from the hired nurse I had them in cure and by Gods helpe healed them all except the sucking child which died in the cure But the hired nurse was soundly lashed in the prison and should have beene whipped through all the streets of the Citie but that the magistrate had a care to preserve the credite of the unfortunate family CHAP. III. In what humour the malignity of the Lues venerea resides THough in the opinion of many the antecedent cause of this disease be the masse of bloud conteining the foure humours yet I had rather place the matter and primary and chief seat thereof in grosse and viscide phlegme infected with the maligne quality of the venereous venome and from this beginning and foundation I thinke by a certaine contagious growth it sooner or later infects the other humours as each of them is disposed or apt to suffer Of which my opinion there are many arguments but this chiefely That by the evacuation of a phlegmaticke humour whether by the mouth and salivation or by stoole urine or sweate in men of what temper soever whether cholerick sanguine or melancholy the disease is helped or cured Secondly for that the excesse of paine is more by night than by day because then the phlegme bearing sway severs the perioâ—tium from the bone or else offends it and the rest of the membranous and nervous bodies by the acrimony of its malignity Thirdly because the patients are hurt by the use of cold things but usually finde benefit by hot medicines whither they bee oyntments plasters fumigations or whatsoever else inwardly taken or out-wardly applyed Fourthly for that in venereous pustles there is found a certaine hardnesse at the roote though outwardly they make shew of choler or bloud For being opened you shall finde them stuffed with a certaine plaster-like and â—ophous matter or else with tough phlegme or viscous pus whence arise these hard tophi or bony excressences upon the bones if not from phlegmaticke humours there heaped up and concrete Fifthly for that the spermaticke and cold parts doe primarily and principally feele the harme of this disease Sixtly for that the ulcers which over-spread the body by meanes of this disease admit of no cure unlesse you first cause sweats Therefore if the matter of the disease and such ulcers as accompany it were hot and dry it would grow worse and be rather increased by a decoction of Guajacum the roots of China or sarsaparilla Seventhly because oft-times this disease the seede thereof being taken or drawne into the body so lyeth hid for the space of a yeare that it shewes no signe thereof which happens not in diseases proceeding from an hot matter which causeth quick and violent motions By this it appeareth that the basis and foundation of the Lues venerea is placed or seated in a phlegmatick humour yet may I not deny but that other humours confused therewith may be also in fault and defiled with the like contagion For there are scarce any tumours which proceed from a simple humour and that of one kinde but as in tumours so here the denomination is to be taken from that humour which carryeth the chiefe sway CHAP. IIII. Of the signes of the Lues Venerea WHen the Lues venerea is lately taken maligne ulcers appeare in the privities swellings in the groines a virulent strangury runneth oft-times with filthy sanies which proceeds either from the prostata or the ulcers of the urethra the
sugar before meate it is no lesse effectuall to put wormeseeds in their pap and in roasted apples and so to give them it Also you may make suppositories after this manner and put them up into the fundament â„ž coralli subalbi rasurae eboris cornu cerviusti ireos an ℈ ii mellis albi â„¥ ii ss aquae centiâ—odiae q. s adomnia concorporanda fiant Glandes let one be put up every day of the weight of Ê’ ii for children these suppositories are chiefly to bee used for Ascarides as those which adhere to the right gut To such children as can take nothing by the mouth you shall apply cataplasmes to their navells made of the pouder of cummin seeds the floure of lupines worme-wood southerne wood tansie the leaves of Artichokes rue the pouder of coloquintida citron seeds aloes arsemart horse mint peach leaves Costus amarus Zedoaria sope and oxegall Such cataplasmes are oft times spred over all the belly mixing therewith astringent things for the strengthening of the part as oile of myrtles Quinces and mastich you may also apply a great onion hollowed in the midst and filled with Aloes and Treacle and so roasted in the embers then beaten with bitter almonds and an oxe gall Also you may make emplasters of bitter things as this which followes â„ž fellis bubuli sucei absinthii an â„¥ ii colocyn â„¥ i. terantur misceantur simul incorporentur cum farina lupinorum make hereof an emplaster to be laid upon the Navell Liniments and ointments may bee also made for the same purpose to anoint the belly you may also make plasters for the navell of Pillulae Ruff. anointing in the meane time the fundament with hony and sugar that they may bee chafed from above with bitter things and allured downewards with sweete things Or else take wormes that have beene cast forth dry them in an iron pan over the fire then pouder them and give them with wine or some other liquor to bee drunke for so they are thought quickly to kill the rest of the wormes Hereto also conduceth the juice of citrons drunke with the oile of bitter almonds or sallade oile Also some make bathes against this affect of wormewood galls peach leaves boiled in water and then bathe the childe therein But in curing the wormes you must observe that this disease is oft times entangled with another more grievous disease as an acute and burning feaver a fluxe or scouring and the like in which as for example sake a feaver being present and conjoyned therewith if you shall give wormseeds old Treacle myrrhe aloes you shall encrease the feaver and fluxe for that bitter things are very contrary to the cure of these affects But if on the contrary in a fluxe whereby the wormes are excluded you shall give corrall and the floure of Lentiles you shall augment the feaver making the matter more contumacious by dry and astringent things Therefore the Physician shall be carefull in considering whether the feaver bee a symptome of the wormes or on the contrary it bee essentiall and not symptomaticke that this being knowne hee may principally insist in the use of such medicines as resist both affects as purging and bitterish in a feaver and wormes but bitter and somewhat astrictive things in the wormes and fluxe CHAP. VI. A short description of the Elephantiasis or Leprosie and of the causes thereof THis disease is termed Elephantiasis because the skinne of such as are troubled therewith is rough scabious wrinckled and unequall like the skin of an Elephant Yet this name may seem to be imposed thereon by reason of the greatnesse of the disease Some from the opinion of the Arabians have termed it Lepra or Leprosie but unproperly for the Lepra is a kinde of Scab and disease of the skinne which is vulgarly called Malum sancti manis which word for the present we will use as that which prevailes by custome and antiquity Now the Leprosie according to Paulus is a Cancer of the whole body the which as Avicen addes corrupts the complexion forme and figure of the members Galen thinkes the cause ariseth from the errour of the sanguifying faculty through whose default the assimulation in the flesh and habite of the body is depraved and much changed from it selfe and the rule of nature But ad Glauconem hee defines this disease An effusion of troubled or grosse blood into the veines and habit of the whole body This disease is judged great for that it partakes of a certaine venenate virulency depraving the members and comelinesse of the whole body Now it appeares that the Leprosie partakes of a certaine venenate virulency by this that such as are melancholicke in the whole habit of their bodies are not leprous Now this disease is composed of three differences of diseases First it consists of a distemper against nature as that which at the beginning is hot and dry and at length the ebullition of the humours ceasing and the heat dispersed it becomes cold and dry which is the conjunct cause of this symptome Also it consists of an evill composition or conformation for that it depraves the figure and beauty of the parts Also it consists of a solution of continuity when as the flesh and skin are cleft in divers parts with ulcers and chops the leprosie hath for the most part 3. generall causes that is the primitive antecedent conjunct the primitive cause is either from the first conformation or comes to them after they are born It is thought to be in him from the first conformation who was conceived of depraved corrupt menstruous blood such as enclined to melancholly who was begot of the leprous seed of one or both his parents for leprous persons generate leprous because the principall parts being tainted and corrupted with a melancholy and venenate juice it must necessarily follow that the whole masse of blood and seed that falls from it and the whole body should also be vitiated This cause happens to those that are already born by long staying inhabiting in maritime countries whereas the grosse and misty aire in successe of time induceth the like fault into the humours of the body for that according to Hippocrates such as the aire is such is the spirit and such the humours Also long abiding in very hot places because the blood is torrified by heate but in cold places for that they incrassate and congealing the spirits doe after a manner stupefie may bee thought the primitive causes of this disease Thus in some places of Germany there are divers leprous persons but they are more frequent in Spaine and overall Africa then in all the world beside and in Languedoc Provence and Guyenne are more than in whole France besides Familiarity copulation and cohabitation with leprous persons may be reckoned amongst the causes thereof because they transferre this disease to their familiars by their breath sweat and spittle left on the
the juice of poppie But Aëtius thinkes it superfluous to write remedies against the Basiliske when as the sight and hearing onely kills such as either see or heare her The figure of a Basiliske CHAP. XX. Of the Salamander THe Salamander kils not onely such as it bites by making a venemous impression but it also infects the fruits and herbs over which it creeps with a spittle or grosse moisture which sweats out of all the bodie to the great danger of the health and life of such as eat these things at unawares wherfore it need not seeme strange which is received by some late writers that some families have all died by drinking water out of pits whereinto a Salamander by accident was fallen For if it shall creepe upon a tree it infects all the fruit with the qualities of cold and moist poyson wherein it yeelds not to Aconite Aetius writes that such as are infected with the poyson of a Salamander certaine parts of their bodie grow livide so that they fall away often being putrefyed At the first there appeare white spots over the body then red afterwards blacke with putrefaction and the falling away of the haires The cure is to procure vomit to loose the belly with a glyster and to give them Treacle and Mithridate in potions Avicen prescribes the same things against this kinde of poyson as against opium by reason of the cold nature of them both the proper antidote is turpentine styrax nettle seeds and cypresse leaves Dioscorides writes that the Salamander is a kind of Lizard dull variegated and which is falsly reputed not to be burnt by fire But Pliny saith she is so cold that she extinguisheth the fire by her touch onely being laied upon hot coales On the contrary Mathiolus saith that cast into a great flame they are quickly consumed It is easie out of Aetius to reconcile these disagreeing opinions This creature saith hee passeth through a burning flame and is not hurt the flame dividing it selfe and giving her way but if shee continue any time in the fire the cold humour being consumed in her she is burnt Now the Salamander is black variegated with yellow spots starre-fashion The figure of a Salamander CHAP. XXI Of the Torpedo THe Torpedo hath his name from the effect by reason that by his touch and power the members become torpid numb in muddy shoars it lives upon fish which she catcheth by craft For lying in the mud she so stupefyes those that are nigh her that she easily preyes upon them she hath the same power over men for she sends a numnesse not onely into the arm of the fisherman but also over all his body although his fishers pole be betweene them The effigies of a Torpedo CHAP. XXII Of the Bitings of Aspes THE wound which is made by an Aspe is very small as if a needle were thrust into the part and without any swelling These symptomes follow upon her bite suddaine darknesse clouds their eyes much agitation in all their bodies but gentle notwithstanding a moderate paine of the stomacke troubles them their fore-heads are continually troubled with convulsive twitchings their cheeks tremble and their eye-lids fall gently to rest and sleep the blood which flowes from the wound is little but blacke death no longer deferred than the third part of a day will take them away by convulsions unlesse you make resistance with fitting remedies The male Asp makes two wounds the female four as it also happens in the bitings of vipers Now for that the poyson of Asps congeals the blood in the veines and arteries therefore you must use against it such things as are hot subtle of parts as mithridate or treacle dissolved in aqua vitae and the same powred into the wound the patient must be warmed by bathes frictions walking and the like When as the hurt part becommeth purple black or greene it is a signe that the native heat is extinct and suffocated by the malignity of the venome Therefore then it is best to amputate the member if the partie bee able to endure it and there be nothing which may hinder Vigo writes that he saw a Mountebank at Florence who that he might sell the more of his Antidotes and at the better rate let an Aspe to bite him by the finger but he died thereof some foure houres after To the same purpose you may reade Mathiolus whereas hee writes that those Impostors or Mountebanks to cozen the better and deceive the people use to hunt and take vipers and aspes long after the spring that is then whenas they have cast forth their most deadly poyson then they feed them with meats formerly unusuall to them so that by long keeping and care at the length they bring it to passe that they put off a great part of their venemous nature neither being thus satisfied they make them oftentimes to bite upon pieces of flesh that so they may cast forth into them the venome which is contained in the membraine betweene their teeth and gums Lastly they force them to bite licke and swallow downe an astringent medicine which they compose and carry about for the same purpose that so they may obstruct the passages by which the venome used to flow out for thus at length their bites will be harmelesse or without great danger This therefore is their art that so they may sell their counterfeit treacle to the people at a high rate as that which is a most safe remedy against all poisonous bites Christopher Andrew in his book called â—â—coiatria writes that the Ilands of Spaine are every-where full and stored with serpents aspes and all sorts of venemous beasts against whose bites they never observed or found any benefit in treacle But the efficacie of the following Antidote is so certaine and excellent and approved by so manifold experience that in the confidence thereof they will not bee affraid to let themselves bee bitten by an Aspe Now this medicine is composed of the leaves of Mullet Avenes red stock Gilly flowers in like quantity which they boile in sharpe vinegar and the urine of a sound man and there with foment the wounded part Yet if he have not taken nor used any thing of a good while after the wound it will be better and more certaine if the patient drinke three ounces of this decoction fasting two houres before meate CHAP. XXIII Of the biting of a Snake I Have thought good in a true history to deliver the virulent malignity of the bite of a snake and the remedies thereof When as King Charles the ninth was at Moulins Mousier Le Feure the Kings Physician and I were called to cure the Cooke of the Lady of Castelpers Who gathering hoppes in a hedge to make a salad was bit on the hand by a snake that there lay hid hee putting his had to his mouth sucked the wound to ease the
dram strain it through a cloth when it is cold let it be given the patient to drink with the juice of Citrons Those that have accustomed to drink Sider Perry Beer or Ale ought to use that drink still so that it be clear transparent and thin and made of those fruits that are somwhat tart for troubled dreggish drink doth not only engender grosse humors but also crudities windiness and obstructions of the first region of the body whereof comes a feaver Oxycrate being given in manner following doth asswage the heat of the feaver and represse the putrefaction of the humours and the fiercenesse of the venome and also expelleth the water through the veines if so bee that the patients are not troubled with spitting of blood cough yexing and altogether weake of stomacke for such must avoyd all tart things Take of faire water one quart of white or red vinegar three ounces of fine Sugar foure ounces of syrup of Roses two ounces boile them a little and then give the patient there of to drinke Or take of the juice of Lemmons Citrons of each halfe an ounce of juice of soure Pomegranates two ounces of the water of Sorrell and Roses of each one ounce of faire water boyled as much as shall suffice make thereof a Julep and use it betweene meales Or take of Sirupe of Lemmons and of red Currance of each one ounce of the water of lillies foure ounces of faire water boyled halfe a pinte make thereof a Julep Ortake of the syrups of water Lillies and vinegar of each half an ounce dissolve it in five ounces of the water of Sorrell of faire water one pinte make thereof a Julep But if the patient be young and have a strong and good stomacke and cholericke by nature I thinke it not unmeet for him to drinke a full and large draught of fountaine water cold for that is effectuall to restraine and quench the heat of the Feaver and contrariwise they that drinke cold water often and a very small quantity at a time as the Smith doth sprinkle water on the fire at his Forge doe encrease the heat and burning and thereby make it endure the longer Therfore by the judgment of Celsus when the disease is in the chiefe encrease and the patient hath endured thirst for the space of three or four daies cold water must be given unto him in great quantity so that he may drink past his satiety that when his belly and stomacke are filled beyond measure and sufficiently cooled he may vomit Some doe not drinke so much thereof as may cause them to vomit but do drinke even unto satiety and so use it for a cooling medicine but when either of these is done the patient must bee covered with many cloaths and so placed that hee may sleepe and for the most part after long thirst and watching and after long fulnesse and long and great heat sound sleep commeth by which great sweat is sent out and that is a present helpe But thirst must sometimes be quenched with little pieces of Melons Gourds Cucumbers with the leaves of Lettuce Sorrell and Purslaine made moist or soked in cold water or with a little square piece of a Citron Lemmon or Orange macerated in Rose water sprinkled with Sugar and so held in the mouth and then changed But if the patient be aged his strength weak flegmatick by nature given to wine when the state of the Feaver is somewhat past and the chiefe heat beginning to asswage he may drink wine very much allayed at his meat for to restore his strength and to supply the want of the wasted spirits The patient ought not by any meanes to suffer great thirst but must mitigate it by drinking or else allay it by washing his mouth with oxycrate and such like and he may therein also wash his hands and his face for that doth recreate the strength If the fluxe or lask trouble him he may very well use to drinke steeled water and also boyled milke wherein many stones comming red hot out of the fire have beene many times quenched For the drynesse and roughnesse of the mouth it is very good to have a cooling moistening and lenifying lotion of the mucilaginous water of the infusion of the leeds of Quinces psilium id est Flea-wort adding thereto a little Camphire with the Water of Plantain and Roses then cleanse and wipe out the filth and then moisten the mouth by holding therein a little oile of sweete Almonds mixed with a little syrupe of Violets If the roughnesse breed or degenerate into Ulcers they must be touched with the water of the infusion of sublimate or Aqua fortis But because wee have formerly made frequent mention of drinking of water I have here thought good to speake somewhat of the choice and goodnesse of waters The choice of waters is not to be neglected because a great part of our diet depends thereon for besides that we use it either alone or mixed with wine for drink we also knead bread boile meat and make broaths therewith Many thinke that rain water which falls in summer and is kept in a cisterne well placed and made is the wholesomest of all Then next thereto they judge that spring water which runnes out of the tops of mountaines through rocks cliffes and stones in the third place they put Well water or that which riseth from the foots of hils Also the river water is good that is taken out of the midst or streame Lake or pond water is the worst especially if it stand still for such is fruitfull of and stored with many venemous creatures as Snakes Toads and the like That which comes by the melting of Snow and Ice is very ill by reason of the too refrigerating faculty and earthy nature But of spring and well waters these are to be judged the best which are insipide without smell colour such as are cleare warmish in winter and cold in summer which are quickly hot and quickly cold that is which are most light in which all manner pulse turneps and the like are easily and quickly boyled Lastly when as such as usually drink thereof have cleer voices and shrill their chests sound and a lively and fresh colour in their faces CHAP. XXII Of Antidotes to bee used in the Plague NOw we must treate of the proper cure of this disease which must bee used as soone as may be possible because this kinde of poyson in swiftnesse exceedeth the celerity of the medicine Therefore it is better to erre in this that you should think every disease to bee pestilent in a pestilent season and to cure it as the Pestilence because that so long as the Ayre is polluted with the seeds of the Pestilence the humours in the body are soone infected with the vicinity of such an ayre so that then there happeneth no disease voyd of the Pestilence that is to say which is not pestilent
for your use and so soone as the patient doth thinke himselfe to be infected let him take foure ounces of that liquor then let him walke and sweate He must leave sweating when he beginneth to waxe faint and weake or when the humour that runs downe his body begins to waxe cold then his body must be wiped with warme clothes and dryed The patient ought not to sweat with a full stomacke for so the heat is called away from performing the office of concoction also he must not sleep when he is in his sweat lest the malignity goe in wardly with the heat and spirits unto the principall parts but if the patient bee much inclined to sleep hee must bee kept from it with hard rubbing and bands tyed about the extreme parts of his body and with much noise of those that are about him and let his friends comfort him with the good hope that they have of his recovery but if all this will not keepe him from sleepe dissolve Castoreum in tart Vinegar and Aqua vitae and let it bee injected into his nostrils and let him bee kept continually waking the first day and on the second and third even unto the fourth that is to say unto the perfect expulsion of the venome and let him not sleep above three or foure houres on a day and night In the meane time let the Physician that shall bee present consider all things by his strength for it is to be feared that great watchings will dissolve the strength and make the patient weake you must not let him eate within three houres after his sweating in the meane season as his strength shall require let him take the rinde of a preserved Citron conserve of Roses bread toasted and steeped in wine the meat of a preserved Myrabolane or some such like thing CHAP. XXIII Of Epithemes to be used for the strengthening of the principall parts THere are also some topick medicines to bee reckoned amongst Antidotes which must be outwardly applyed as speedily as may be as cordiall and hepaticke Epithemes for the safety of the noble parts and strengthening of the faculties as those that drive the venenate aire farre from the bowels they may be made of cordiall things not onely hot but also cold that they may temper the heat and more powerfully repercusse They must be applyed warme with a scarlet or a double linnen cloth or a soft spunge dipped in them if so be that a Carbuncle doe not possesse the regions of the noble parts for it is not fit to use repercussives to a Carbuncle You may make Epithemes after the following formes ℞ aquar ros plantag solan an ℥ iv aquae acetos vini granat aceti an ℥ iii. santal rub coral rub pulveris an ʒiii theriac vet ℥ ss camph. ℈ ii croci ℈ i. carioph ʒss misce fiat epithema Or else R. aqu ros plantag an ℥ x. aceti ros ℥ iv carioph sant rub coral rub pulveris pul diamargarit frigid an ʒiss caphurae moschi an ℈ i. fiat epithemae Or ℞ aquar rosar melissae an ℥ iv aceti ros ℥ iii. sant rub ʒi caryophyl ʒss croci ℈ ii caphurae ℈ i. boli arm terraesigil zedoar an ʒi fiat epithema Or else ℞ aceti rosat aquae rosat an lb. ss caphuraeʒss theriac mithridat an ʒi fiat epithema Or else aqu rosar nenuph. buglos acetosae aceti rosar an lb. ss sant rub ros rub an ʒiii flor nenuph. violar caphur an ʒss mithrid theriac an ʒii terantur misceantur simul omnia When you intend to use them take some portion of them in a vessell by its selfe wherewith let the affected bowell be fomented warme CHAP. XXIIII Whether purging and bloud-letting bee necessary in the beginning of pestilent diseases SO soon as the heart is strengthened corroberated with cordials antidotes we must come to phlebotomy purging As concerning bloud-letting in this case there is a great controversie among Physicians Those that wish it to be used say or affirme that the pestilent Feaver doth infixe it selfe in the bloud and therein also the pestilent malignity taketh its seate and therefore it will soone infect the other humours unlesse that the bloud be evacuated the infection that remaineth in the bloud be thereby taken away Contrariwise those that do not allow phlebotomy in this case alledge that it often commeth to passe that the bloud is voyd of malignity when the other humours are infected with the venemous contagion If any man require my judgement in this doubtfull question I say that the pestilence sometimes doth depend on the default of the aire This default being drawne through the passages of the body doth at length pierce unto the entrals as we may understand by the abscesses which breake out one while behind the eares sometimes in the arme-holes and sometimes in the groines as the braine heart or liver are infected And hereof also come Carbuncles and other collections of matter and eruptions which are seene in all parts of the body by reason that nature using the strength of the expulsive faculty doth drive forth whatsoever is noysome or hurtfull Therefore if the Physician will follow this motion of nature he must neither purge nor let bloud lest that by a contrary motion that is by drawing in from without the motion of nature which proceeds outwardly from within should be troubled So wee often see in those who are purged or let bloud for such Buboes as come through unlawfull copulation that the matter is thereby made contumacious and by drawing it inwardly it speedily causeth the French Pocks Wherefore when Buboes Carbuncles and other pestilent eruptions appeare which come through the default of the Aire we ought to abstain from purging and phlebotomie but it is sufficient to fore-arme the heart inwardly and outwardly with Antidotes that are endued with a proper vertue of resisting the poyson For it is not to bee doubted but that when nature is debilitated with both kindes of evacuation and when the spirits together with the bloud are exhausted the venemous Aire will soone pierce and be received into the empty body where it exerciseth its tyranny to the utter destruction thereof In the yeare of our Lord God 1565. in which yeare there was great mortality throughout all France by reason of the pestilence and pestilent diseases I earnestly diligently enquired of all the Physicians Chirurgians of all the Cities through which King Charles the ninth passed in his progresse unto Bayon what successe their patients had after they were letten bloud and purged whereunto they all answered alike that they had diligently observed that all that were infected with the Pestilence and were letten bleed some good quantity of bloud or had their bodies some-what strongly purged thence forwards waxed weaker and weaker and so at length dyed but others which were not let bloud nor purged but took cordiall
that it maketh an Eschar on the place where it is as we noted before CHAP. XXXIII What Prognosticks may bee made in pestilent Buboes and Carbuncles SOme having the Pestilence have but one Carbuncle and some more in divers parts of their body and in many it happeneth that they have the Bubo and Carbuncle before they have any Feaver which giveth better hope of health if there be no other maligne accident therewith for it is a signe that nature is the victor and hath gotten the upper hand which excluded the pestilent venome before it could come to assault the heart But if a Carbuncle and Bubo come after the Feaver it is mortall for it is a token that the heart is affected moved and incensed with the furious rage of the venome whereof presently commeth a feaverish heat or burning and corruption of the humours sent as it were from the center unto the superficies of the body It is a good signe when the patients minde is not troubled from the beginning untill the seventh day but when the Bubo or Carbuncle sinketh downe againe shortly after that it is risen it is a mortall signe especially if ill accidents follow it If after they are brought to suppuration they presently waxe dry without any reason thereof it is an ill signe Those Carbuncles that are generated of bloud have a greater Eschar than those that are 〈◊〉 choler because that bloud is of a more grosse consistence and therefore ocâ—… 〈◊〉 â—â—eater roome in the flesh contrariwise a cholerick humour is more small 〈◊〉 〈◊〉 and thinne and it taketh little roome in the upper part of the flesh onely as you may see in an Erysipelas And I have seene Carbuncles whose Eschars were as broad and as large as halfe the backe also I have seene others which going up by the shoulders to the throat did so eate away the flesh that was under them that the rough artery or wind-pipe might be seen bare when the Eschar was fallen away I had once a Carbuncle which was in the midst of my belly so that when the Eschar was fallen away I might very plainly see the Piritonaeum or Rim the cicatrice that remaineth is as broad as my hand but they doe not spread themselves so far without the great danger or death of the patient There are also some Carbuncles which beginning at the parts under the chin disperse themselves by little little unto the pattell bones and so strangle the patient So in many the Buboes in the groin arise above a great part of the muscles of the Epigastrium Truly of those abscesses that are so large great in quantity so terrible to be seen there is great danger of death to the patient or at least to the grieved part For after the consolidation the part remaineth as if it were leprous which abolisheth the action of the part as I have seene in many Oftentimes also the corruption of the matter is so great that the flesh leaveth the bones bare but Carbuncles often leave the joints and ligaments quite resolved through the occasion of the moisture that is soaked sunk in unto them for they often cast out putrefied virulent sanious matter whereby eating and creeping ulcers are bred many blisters pustles arising up in the parts round about it which shortly breaking into one make a great ulcer These come very seldome and slowly unto suppuration or at least to cast out laudible matter especially if thy have their original of choler because the matter is sooner burned with heat than suppurated Therefore then if they can bee brought to suppuration by no medicines if the tumour still remaine blacke if when they are opened nothing at all or else a very little sharpe moisture doth come forth they are altogether mortall and there is scarce one of a thousand who hath these accidents that recovereth health dispersed small blisters comming of vapours stirred up by the matter that is under the skinne and are there stayed and kept from passage forth doe not necessarily fore-shew death in Carbuncles But if the part be swolne or puffed up if it be of a green or black colour and if it feele neither pricking nor burning it is a signe of a mortall Gangrene Buboes or Carbuncles seldome or never come without a Feaver but the Feaver is more vehement when they are in the emunctories or nervous parts than when they are in the fleshy parts yet it is lesse and all Symptomes are lesse and more tolerable in a man that is strong and of a good temperature Carbuncles not onely affect the outward but also the inward parts and oftentimes both together If the heart be vexed in such sort with a Carbuncle that nothing thereof appeareth forth on the superficiall parts all hope of life is past and those dye suddenly eating drinking or walking and not thinking any thing of death If the Carbuncle be in the mid driffe or lungs they are soon suffocated If it be in the braine the patient becommeth frantick and so dyeth If it be in the parts appointed for the passage of the urine they dye of the suppression of their water as it happened in the Queene mothers waiting maide at the Castle of Rossilion of whom I spake before If it be in the stomacke it inferreth the accidents that are shewed in this history following While I was Surgeon in the Hospitall of Paris a young and strong Monke of the order of St. Victor being overseer of the women that kept the sicke people of that place fell into a continuall Feaver very suddenly with his tongue blacke dry rough by reason of the putrefied and corrupted humours and the vapours rising from the whole body unto that place and hanging out like unto an hounds with unquenchable thirst often swouning and desire to vomit He had convulsions over all his body through the vehemency and malignity of the disease and so hee dyed the third day wherefore those that kept the sicke people in the Hospitall thought that he had been poysoned for the certaine knowledge whereof the Governours of the Hospitall commanded his body to be opened I therefore calling to mee a Physician and Surgeon wee found in the bottome of his stomack a print or impression as if it had been made with an hot Iron or potentiall Cauterie with an Eschar or crust as broad as ones naile all the rest of his stomack was greatly contracted and shrunke up together and as it were horny which wee considering and especially the Eschar which was deepe in the substance of the stomacke we all said with one voice that he was poysoned with Sublimate or Arsenick But behold while I was sowing up his belly I perceived many blacke spots dispersed diversly throughout the skin then I asked my company what they thought of those spots truely said I it seemeth unto me that they are like unto the purple spots or markes that are in the pestilence The Physician and the
pierced through by the roots with a needle and a thread and so being lifted up by the ends of the thread they must bee cut away and the wound that remaineth must be cured according to the generall method of wounds There are some that suppose the red spots that are raised up into little knobbes and bunches may bee washed away and consumed by rubbing and annoynting them often with menstruall bloud or the bloud of the secundine or after-birth Those that are hairie and somewhat raised up like unto a Want or Mouse must bee pierced through the roots in three or foure places and straightly bound so that at length being destitute of life and nutriment they may fall away after they are fallen away the ulcer that remaineth must bee cured as other ulcers are If there bee any superfluous flesh remaining it must bee taken away by applying Aegyptiacum or the powder of mercury and such like but if it be doubted that it commeth from the root of the tumour that may happely remaine it must bee burned away by the root with oyle of vitrioll or aqua fortis There is also an other kinde or sort of spots of a livide or violet colour comming especially in the face about the lips with a soft slacke laxe thinne and unpainefull tumour and the veines as if they were varicous round about it This kinde of tumour groweth greater when it ariseth on children that are wayward and crying and in men of riper yeares that are cholericke and angry and then it will bee of a diverse colour like unto a lappet or flap of flesh that hangeth over the Turkie-cocks bill When they have done crying or ceased their anger the tumour will returne to his owne naturall colour againe But you must not attempt to cure it in people that are of these conditions CHAP. XVIII How to pull away the secundine or after-birth I Suppose that they are called secundines because they doe grieve the woman that is with child the second time as it were a second birth for if there bee severall children in the wombe at once and of different sexes they then have every one their severall secundines which thing is very necessary to bee knowne by all mydwives For they doe many times remaine behinde in the wombe when the child is borne either by reason of the weakenesse of the woman in travell which by contending and labouring for the birth of her childe hath spent all her strength or else by a tumour rising suddenly in the necke of the wombe by reason of the long and difficult birth and the cold aire unadvisedly permitted to strike into the orifice of the wombe For so the liberties of the wayes or passages are stopped and made more narrow so that nothing can come forth or else because they are doubled and foulded in the wombe and the waters gone out from them with the infant so that they remaine as it were in a dry place or else because they yet sticke in the wombe by the knots of the veines and arteries which commonly happeneth in those that are delivered before their time For even as apples which are not ripe cannot bee pulled from the tree but by violence but when they are ripe they will fall off of their owne accord so the secundine before the naturall time of the birth can hardly bee pulled away but by violence but at the prefixed naturall time of the birth it may easily be drawne away Many and grievous accidents follow the staying of the secundine as suffocation of the wombe often swouning by reason that grosse vapours arise from the putrefaction unto the mydriffe heart and braine therefore they must bee pulled away with speede from the wombe gently handling the navell if it may bee so possibly done But if it cannot bee done so the woman must bee placed as shee was wont when that the childe will not come forth naturally but must bee drawne forth by art Therefore the mydwife having her hand annoynted with oyle must put it gently into the womb and finding out the navell string must follow it untill it come unto the secundine and if it doe as yet cleave to the wombe by the cotylidons shee must shake and move it gently up and downe that so when it is shaked and loosed shee may draw it out gently but if it should bee drawne with violence it were to be feared lest that the wombe should also follow for by violent attraction some of the vessels and also some of the nervous ligaments whereby the wombe is fastened on each side may bee rent whereof followeth corruption of bloud shedde out of the vessels and thence commeth inflammation an abscesse or a mortall gangrene Neither is there lesse danger of a convulsion by reason of the breaking of the nervous bodies neither is there any lesse danger of the falling downe of the wombe If that there bee any knots or clods of bloud remaining together with the secundine the mydwife must draw them out one by one so that not any may bee left behinde Some women have veyded their secundine when it could not bee drawne forth by any meanes long after the birth of the child by the necke of their wombe piece-meale rotten and corrupted with many grievous and painefull accidents Also it shall bee very requisite to provoke the endeavour of the expulsive faculty by sternutatories aromaticke fomentations of the necke of the wombe by mollifying injections and contrariwise by applying such things to the nostrils as yeeld a ranke savour or smell with a potion made of mugwurt and bay berries taken in hony and wine mixed together or with halfe a dramme of the powder of savine or with the haire of a womans head burnt and beaten to powder and given to drink and to conclude with all things that provoke the tearmes or courses CHAP. XIX What things must bee given to the infant by the mouth before hee bee permitted to suck the Teat or Dugge IT will bee very profitable to rub all the inner side of the childes mouth and pallat gently with treacle and hony or the oyle of sweete almonds extracted without fire and if you can to cause it to swallow some of those things for thereby much flegmatick moysture will bee drawne from the mouth and also will bee moved or provoked to bee vomited up from the stomacke for if these excrementall humours should bee mixed with the milke that is sucked they would corrupt it and then the vapours that arise from the corrupted milke unto the brain would inferre most pernicious accidents And you may know that there are many excrementall things in the stomacke and guts of children by this because that so soon as they come into the world and often before they suck milke or take any other thing they voyde downewards many excrements diversly coloured as yellow greene and blacke Therefore many that they may speedily evacuate the matter that causeth the fretting of
a veine great sweats ulcers flowing much and long scabbinesse of the whole skinne immoderate grossenesse and clamminesse of the blood and by eating of raw fruites and drinking of cold water by sluggishnesse and thicknesse of the vessels and also the obstruction of them by the defaults and diseases of the wombe by distemperature an abscesse an ulcer by the obstruction of the inner orifice thereof by the growing of a Callus caruncle cicatrize of a wound or ulcer or membrane growing there by injecting of astringent things into the necke of the wombe which place many women endeavour foolishly to make narrow I speake nothing of age greatnesse with child nursing of children because these causes are not besides nature neither doe they require the helpe of the Physitian Many women when their flowers or tearmes be stopped degenerate after a manner into a certaine manly nature whence they are called Viragines that is to say stout or manly women therefore their voice is more loud and bigge like unto a mans and they become bearded In the city Abdera saith Hippocrates Phaethusa the wife of Pytheas at the first did beare children and was fruitfull but when her husband was exiled her flowers were stopped for a long time but when these things happened her body became manlike and rough and had a beard and her voice was great and shrill The very same thing happened to Namysia the wife of Gorgippus in Thasus Those virgins that from the beginning have not their monethly fluxe and yet neverthelesse enjoy their perfect health they must necessarily be hot and dry or rather of a manly heat and drynesse that they may so disperse and dissipate by transpiration as men doe the excrements that are gathered but verily all such are barren CHAP. LII What accidents follow the suppression or stopping of the monthly fluxe or flowers WHen the flowers or monethly fluxe are stopped diseases affect the womb and from thence passe into all the whole body For thereof commeth suffocation of the womb headache swouning beating of the heart and swelling of the breasts and secret parts inflammation of the wombe an abscesse ulcer cancer a feaver nauseousnesse vomitings difficult and slow concoction the dropsie strangury the full wombe pressing upon the orifice of the bladder blacke and bloody urine by reason that portion of the blood sweateth out into the bladder In many women the stopped matter of the monethly fluxe is excluded by vomiting urine and the hoemorrhoides in some it groweth into varices In my wife when shee was a maide the menstruall matter was excluded and purged by the nostrills The wife of Peter Feure of Casteaudun was purged of her menstruall matter by the dugges every moneth and in such abundance that scarce three or foure cloaths were able to dry it and sucke it up In those that have not the fluxe monethly to evacuate this plenitude by some part or place of the body there often followes difficulty of breathing melancholy madnesse the gout an ill disposition of the whole body dissolution of the strength of the whole body want of appetite a consumption the falling sickenesse an apoplexie Those whose blood is laudable yet not so abundant doe receive no other discommodity by the suppression of the flowers unlesse it be that the wombe burnes or itcheth with the desire of copulation by reason that the wombe is distended with hot and itching blood especially if they lead a sedentary life Those women that have beene accustomed to beare children are not so grieved and evill at ease when their flowers are stopped by any chance contrary to nature as those women which did never conceive because they have beene used to be filled and the vessels by reason of their customary repletion and distention are more large and capacious when the courses flow the appetite is partly dejected for that nature being then wholly applied to expulsion cannot throughly concoct or digest the face waxeth pale and without its lively colour because that the heat with the spirits go from without inwards so to helpe and aide the expulsive faculty CHAP. LIII Of provoking the flowers or courses THe suppression of the flowers is a plethorick disease and therefore must be cured by evacuation which must be done by opening the veine called Saphena which is at the ankle but first let the basilike veine of the arme be opened especially if the body bee plethoricke lest that there should a greater attraction be made into the wombe and by such attraction or flowing in there should come a greater obstruction When the veines of the wombe are distended with so great a swelling that they may be seen it will be very profitable to apply horse-leeches to the necke thereof pessaries for women may be used but fumigations of aromaticke things are more meet for maides because they are bashfull and shamefaced Unguents liniments emplasters cataplasmes that serve for that matter are to bee prescribed and applied to the secret parts ligatures and frictions of the thighes and legges are not to bee omitted fomentations and sternutatories are to be used and cupping glasses are to bee applied to the groines walking dancing riding often and wanton copulation with her husband and such like exercises provoke the flowers Of plants the flowers of St. Johns wort the rootes of fennell and asparagus bruscus or butchers broom of parsley brooke-lime basill balme betony garlicke onions crista marina costmary the rinde or barke of cassia fistula calamint origanum pennyroyall mugwort thyme hissope sage marjoram rosemary horehound rue savine spurge saffron agaricke the flowers of elder bay berries the berries of Ivie scammony Cantharides pyrethrum or pellitory of Spaine suphorbium The aromaticke things are amomum cynamon squinanth nutmegs calamus aromaticus cyperus ginger cloves galangall pepper cubibes amber muske spiknard and such like of all which let fomentations fumigations baths broaths boles potions pills syrupes apozemes and opiates be made as the Physitians shall thinke good The apozeme that followeth is proved to be very effectuall â„ž flo flor dictam an pii pimpinel m ss omnium capillar an p i. artemis thymi marjor origan an m ss rad rub major petroselin faenicul an â„¥ i ss rad paeon. bistort an Ê’ ss cicerum rub sem paeon. faenicul an Ê’ ss make thereof a decoction in a sufficient quantity of water adding thereto cinamon Ê’ iii. in one pinte of the decoction dissolve after it is strained of the syrupe of mugwort and of hissope an â„¥ ii diarrhod abbat Ê’ i. let it bee strained through a bagge with Ê’ ii of the kernells of dates and let her take â„¥ iiii in the morning Let pessaries bee made with galbanum ammoniacum and such like mollifying things beaten into a masse in a mortar with a hot pestell and made into the forme of a pessary and then let them be mixed with oile of Jasmine euphorbium an oxegall the juice of mugwort and other such
like wherein there is power to provoke the flowers as with scammony in powder let them be as bigge as ones thumbe sixe fingers long and rowled in lawne or some such like thinne linnen cloath of the same things nodula's may bee made Also pessaries may be prepared with hony boyled adding thereto convenient powders as of scammony pellitory and such like Neither ought these to stay long in the necke of the wombe lest they should exulcerate and they must be pulled backe by a threed that must bee put through them and then the orifice of the womb must be fomented with white wine of the decoction of pennyroyall or mother-wort But it is to be noted that if the suppression of the flowers happeneth through the default of the stopped orifice of the womb or by inflammation these maladies must first bee cured before wee come unto those things that of their proper strength and vertue provoke the flowers as for example if such things be made and given when the wombe is enflamed the blood being drawne into the grieved place and the humours sharpened and the body of the wombe heated the inflammation will be encreased So if there be any superfluous flesh if there be any Callus of a wound or ulcer or if there be any membrane shutting the orifice of the wombe and so stopping the fluxe of the flowers they must first bee consumed and taken away before any of those things bee administred But the oportunity of taking and applying of things must be taken from the time wherein the sicke woman was wont to be purged before the stopping or if she never had the flowers in the decrease of the moone for so we shall have custome nature and the externall efficient cause to helpe art When these medicines are used the women are not to bee put into bathes or hot houses as many doe except the malady proceed from the density of the vessels and the grossenesse and clamminesse of the blood For sweats hinder the menstruall fluxe by diverting and turning the matter another way CHAP. LIIII The signes of the approaching of the menstruall fluxe WHen the monethly fluxe first approacheth the dugges itch and become more swollen and hard than they were wont the woman is more desirous of copulation by reason of the ebullition of the provoked blood and the acrimony of the blood that remaineth her voice becommeth bigger her secret parts itch burne swell and waxe red If they stay long shee hath paine in her loynes and head nauseousnesse and vomiting troubleth the stomacke notwithstanding if those matters which flow together in the wombe either of their owne nature or by corruption be cold they loath the act of generation by reason that the wombe waxeth feeble through sluggishnesse and watery humours filling the same and it floweth by the secret parts very softly Those maides that are marriageable although they have the menstruall fluxe very well yet they are troubled with head ache nauseousnesse and often vomiting want of appetite longing an ill habite of body difficulty of breathing trembling of the heart swouning melancholy fearfull dreames watching with sadnesse and heavinesse because that the genitall parts burning itching they imagine the act of generation whereby it commeth to passe that the seminall matter either remaining in the testicles in great abundance or else powred into the hollownesse of the womb by the tickling of the genitalls is corrupted and acquireth a venemous quality and causeth such like accidents as happens in the suffocation of the wombe Maides that live in the country are not so troubled with those diseases because there is no such lying in wait for their maiden-heads and also they live sparingly and hardly and spend their time in continuall labour You may see many maides so full of juice that it runneth in great abundance as if they were not menstruall into their dugges and is there converted into milke which they have in as great quantity as nurses as we read it recorded by Hippocrates If a woman which is neither great with child nor hath born children hath milke she wants the menstruall fluxes whereby you may understand that that conclusion is not good which affirmeth that a woman which hath milke in her breasts either to be delivered of childe or to be great with childe for Cardanus writeth that hee knew one Antony Buzus at Genua who being thirty yeeres of age had so much milk in his breasts as was sufficient to nurse a child for the breeding and efficient cause of milke proceeds not onely from the engrafted faculty of the glandulous substance but much rather from the action of the mans seed for proofe whereof you may see many men that have very much milk in their breasts and many women that almost have no milke unlesse they receive mans seed Also women that are strong and lusty like unto men which the Latines call Viragines that is to say whose seed commeth unto a manly nature when the flowers are stopped concoct the blood and therefore when it wanteth passage forth by the likenesse of the substance it is drawne into the duggs and becommeth perfect milk those that have the flowers plentifully and continually for the space of foure or five daies are better purged and with more happy successe than those that have them for a longer time CHAP. LV. What accidents follow immoderate fluxes of the flowers or courses IF the menstruall flux floweth immoderately there also followes many accidents for the cocoction is frustrated the appetite overthrown then followes coldnesse throughout all the body exolution of all the faculties an ill habite of all the body leannesse the dropsie a hecticke feaver convulsion swouning and often sodaine death if any have them too exceeding immoderately the blood is sharpe and burning and also stinking the sicke woman is troubled with a continuall feaver and her tongue will bee dry ulcers arise in the gummes and all the whole mouth In women the flowers doe flow by the veines and arteries which rise out of the spermaticke vessels and are ended in the bottome and sides of the wombe but in virgins and in women great with childe whose children are sound and healthfull by the branches of the hypogastrick veine and artery which are spred and dispersed over the necke of the wombe The cause of this immoderate flux is in the quantity or quality of the blood in both the fault is unreasonable copulation especially with a man that hath a yard of a monstrous greatnesse and the dissolution of the retentive faculty of the vessels oftentimes also the flowers flow immoderately by reason of a painfull a difficult birth of the child or the after-birth being pulled by violence from the cotyledons of the wombe or by reason that the veines and arteries of the necke of the wombe are torne by the comming forth of the infant with great travell and many times by the use of sharpe medicines
of the wound is received of the Chirurgion according to the civill Law It is recorded in the workes of ancient Physitions that wounds may bee called great for three respects The first is by reason of the greatnesse of the dissolved unitie or resolution of Continuity and such are these wounds which made by a violent stroake with a backe-sword have cut off the arme or legge or overthwart the breast The second is by reason of the dignitie or worthinesse of the part now this dignity dependeth on the excellencie of the action therefore thus any little wound made with a bodkin knife in any part whose substance is noble as in the Braine Heart Liver or any other part whose action and function is necessary to preserve life as in the Weasant Lungs or Bladder is judged great The third is by reason of the greatnesse and ill habit or the abundance of ill humors or debility of all the wounded body so those woundes that are made in nervous parts and old decayed people are sayd to be great But in searching of wounds let the Chirurgion take heede that he be not deceived by his probe For many times it cannot goe into the bottome of the wound but stoppeth and sticketh in the way either because he hath not placed the patient in the same posture wherein he was when he received his hurt or else for that the stroake being made downe right slipt aside to the right or left hand or else from below upwards or from above downewards and therefore hee may expect that the wound is but little and will be cured in a short time when it is like to bee long in curing or else mortall Therefore from the first day it behooveth him to suspend his judgement of the wound untill the ninth for in that time the accidents will shew themselves manifestly whether they be small or great according to the condition of the wound or wounded bodyes and the state of the ayre according to his primitive qualities or venomous corruption But generally the signes whereby we may judge of diseases whether they bee great or small of long or short continuance mortall or not mortall are foure For they are drawne either from the nature and essence of the disease or from the cause or effects thereof or else from the similitude proportion and comparison of those diseases with the season or present constitution of the times Therefore if wee are called to the cure of a greene wound whose nature and danger is no other but a simple solution of Continuity in the musculous flesh we may presently pronounce that wound to be of no danger and that it will soone be cured But if it have an Vlcer annexed unto it that is if it be sanious then we may say it will be more difficult and long in the curing and so we may pronounce of all diseases taking a signe of their essence and nature But of the signes that are taken of the causes let this bee an example A wound that is made with a sharpe pointed and heavie weapon as with an halbeard being stricken with great violence must be accounted great yea and also mortall if the accidents be correspondent But if the patient fall to the ground through the violence of the stroake if a cholericke vomiting follow thereon if his sight faile him together with a giddinesse if blood come forth at his eyes and nosthrills if distraction follow with losse of memory and sense of feeling we may say that all the hope of life remaineth in one small signe which is to be deduced from the effects of the wound But by the comparing it unto the season that then is and diseases that then assault mans body wee may say that all those that are wounded with gunshot are in danger of death as it happened in the schirmishes at the seige of Roan and at the battall of Saint Denis For at that time whether it were by reason of the fault of the heavens or ayre through the evill humors of mans body and the disturbance of them all wounds that were made by gunshot were for the most part mortall So likewise at certaine seasons of the yeare we see the small pockes and measels breake forth in children as it were by a certaine pestilent contagion to the destruction of children onely inferring a most cruell vomit and laske and in such a season the judgement of those diseases is not difficult But you by the following signes may know what parts are wounded If the patient fall downe with the stroake if he lye senselesse as it were asleepe if he voyde his excrements unwittingly if he be taken with giddinesse if blood come out at his eares mouth and nose and if he vomit choller you may understand that the scull is fractured or pearced through by the defect in his understanding and discourse You also may know when the scull is fractured by the judgement of your externall senses as if by feeling it with your finger you finde it elevated or depressed beyond the naturall limits if by striking it with the end of a probe when the Pericranium or nervous filme that investeth the scull is cut crosse wise and so divided there from it yeeld a base and unperfect sound like unto a pot sheard that is broken or rather like unto an earthen pitcher that hath a cleft or rent therein But we may say that death is at hand if his reason and understanding faile him if he be speechlesse if his sight forsake him if he would tumble headlong out of his bed being not at all able to moove the other parts of his body if he have a continuall feaver if his tongue be blacke with drienesse if the edges of the wound bee blacke or dry and cast forth no sanious matter if they resemble the colour of salted flesh if he have an apoplexie phrensie convulsion or palsie with an involuntarie excretion or absolute supprâ—ssion of the Vrine and excrements You may know that a man hath his throate that is his weason and winde pipe cut First by the sight of his wound and next by the abolishment of the function or office thereof both wayes for the patient can neither speake nor swallow any meate or drinke and the parts that are cut asunder divide themselves by retraction upwards or downewards one from another whereof commeth sodaine or present death You may know that a wound hath peirced into the brest or concavity of the body if the ayre come forth at the wound making a certaine whizzing noyse if the patient breathe with great difficulty if he feele a great heavinesse or weight on or about the midriffe whereby it may be gathered that a great quantity of blood lyeth on the place or midriffe and so causeth him to feele a weight or heavinesse which by little and little will bee cast up by vomiting But a little after a feaver commeth and the breath is unsavory and stinking
by reason that the putrefying blood is turned into sanies the patient cannot lye but on his backe and he hath an often desire to vomit but if hee escape death his wound will degenerate into a Fistula and at length will consume him by little and little We may know that the Lungs are wounded by the foaming and spumous blood comming out both at the wound and cast up by vomiting hee is vexed with a greevous shortnesse of breath and with a paine in his sides We may perceive the Heart to be wounded by the aboundance of blood that commeth out at the wound by the trembling of all the whole body by the faint and small pulse palenesse of the face cold sweate with often swounding coldnesse of the extreame parts and suddaine death When the midriffe which the Latines call Diaphragma is wounded the patient feeleth a great weight in that place he raveth and talketh idlely he is troubled with shortnesse of winde a cough and fit of greevous paine and drawing of the entralls upwards Wherefore when all these accidents appeare we may certainely pronounce that death is at hand Death appeareth sodainely by a wound of the hollow Veine or the great Arterie by reason of the great and violent evacuation of blood and spirits whereby the functions of the Heart and Lungs are stopped and hindred The marrow of the backebone being pierced the patient is assaulted with a Palsie or convulsion very suddainely and sence and motion faileth in the parts beneath it the excrements of the bladder are either evacuated against the patients will or else are altogether stopped When the Liver is wounded much blood commeth out at the wound and pricking paine disperseth it selfe even unto the sword-like gristle which hath its situation at the Lower end of the brest bone called Sternon the blood that falleth from thence downe into the intestines doth oftentimes inferre most maligne accidents yea and sometimes death When the stomacke is wounded the meate and drink come out at the wound there followeth a vomiting of pure choler then commeth sweating and coldnesse of the extreame parts and therefore we ought to prognosticate death to follow such a wound When the milt or spleene is wounded blacke and grosse blood cometh out at the wound the patient will be very thirsty with paine on the left side and the blood breakes forth into the belly and there putrifying causeth most maligne and greevous accidents and often times death to follow When the guts are wounded the whole body is griped and pained the excrements come out at the wound whereat also often times the guts breake forth with great violence When the reines or Kidnyes are wounded the patient will have great paine in making his Vrine and the blood commeth out together therewith the paine commeth downe even unto the groine yard and testicles When the bladder and Vreters are wounded the paine goeth even unto the entralls the parts all about and belonging to the groine are distended the Vrine is bloody that is made and the same also commeth often times out at the wound When the wombe is wounded the blood commeth out at the privities and all other accidents appeare like as when the bladder is wounded When the sinewes are pricked or cut halfe asunder there is great paine in the affected place and there followeth a suddaine inflammation fluxe abscesse feaver convulsion and oftentimes a gangreene or mortification of the part whereof commeth death unlesse it be speedily prevented Having declared the signes and tokens of wounded parts it now remaineth that we set downe other signes of certaine kindes of death that are not common or naturall whereabout when there is great strife and contention made it oftentimes is determined and ended by the judgement of the discreete Physition or Chirurgion Therefore if it chance that a nurse either through drunkennesse or negligence lyes upon her infant lying in bed with her and so stifles or smothers it to death If your judgement be required whether the infant dyed through the default or negligence of the nurse or through some violent or suddaine diseases that lay hidden and lurking in the body thereof You shall finde out the truth of the matter by these signes following For if the infant were in good health before if he were not froward or crying if his mouth and nosethrills now being dead be moystned or bedewed with a certaine foame if his face be not pale but of a Violet or purple colour if when the body is opened the Lungs be found swolne and puffed up as it were with a certaine vaporous foame and all the other entralls found it is a token that the infant was stifled smothered or strangled by some outward violence If the body or dead corpes of a man be found lying in a field or house alone and you be called by a magistrate to deliver your opinion whether the man were slaine by lightning or some other violent death you may by the following signes finde out the certainety hereof For every body that is blasted or striken with lightning doth cast forth or breathe out an unholsome stinking or sulphureous smell so that the birdes or fowles of the ayre nor dogges will not once touch it much lesse prey or feede on it the part that was stricken often times sound and without any wound but if you search it well you shall finde the bones under the skinne to be bruised broken or shivered in peeces But if the lightening hath pierced into the body which making a wound therein according to the judgement of Pliny the wounded part is farre colder than all the rest of the body For lightning driveth the most thinne and fiery ayre before it and striketh it into the body with great violence by the force whereof the heate that was in the part is soone dispersed wasted and consumed Lightening doth alwayes leave some impression or signe of some fire either by ustion or blacknesse for no lightning is without fire Moreover whereas all other living creatures when they are striken with lightening fall on the contrary side onely man falleth on the affected side if hee be not turned with violence toward the coast or region from whence the lightening came If a man bee striken with lightening while he is asleepe hee will be found with eyes open contrarywise if hee be striken while hee is awake his eyes will be closed as Plinie writeth Philip Commines writeth that those bodyes that are stricken with lightning are not subject to corruption as others are Therefore in ancient time it was their custome neither to burne nor bury them for the brimstone which the lightning bringeth with it was unto them in stead of salt for that by the drynesse and fiery heate thereof it did preserve them from putrefaction Also it may be enquired in judgement Whether any that is dead and wounded received these wounds alive
the place before alledged to treate or dresse the diseased quickly safely and with the least of paine that is possible Let us come now to Reason NOw so it is that one cannot apply hot irons but with extreame and vehement paine in a sensible part void of a Gangreene which would be cause of a Convulsion Feaver yea oft times of death Moreover it would bee a long while afterwards before the poore patients were cured because that by the action of the fire there is made an eschar which proceeds from the subject flesh which being fallen nature must regenerate a new flesh in stead of that which hath beene burned as also the bone remaines discovered and bare and by this meanes for the most part there remaines an Vlcer incurable Moreover there is yet another accident It happeneth that oftentimes the crust being fallen off the flesh not being well renewed the blood issueth out as much as it did before But when they shall be tyed the ligature falls not off untill first the flesh have very well covered them againe which is prooved by Galen saying that escharoticke medicines which cause a crust or eschar whensoever they fall off leave the part more bare than the naturall habit requires For the generation of a crust proceeds from the parts subject and which are scituate round about it being also burned as I may say wherefore by how much the part is burnt by so much it looseth the naturall heate Then tell me when it is necessary to use escharoticke medicines or cautering irons T is when the flux of blood is caused by erosion or some Gangreene or putrifaction Now is it thus In fresh bleeding wounds there is neither Gangreene nor putrifaction Therefore the cauteries ought not to be there applyed And when the Ancients commanded to apply hot irons to the mouthes of the vessells it hath not beene onely to stay the flux of blood but cheefely to correct the malignitie or gangreenous putrifaction which might spoile the neighbouring parts And it must be here noted that if I had knowne such accidents to happen which you have declared in your booke in drawing and tying the vessells I had never beene twice deceived nor would I ever have left by my writings to posteritie such a way of stopping a flux of blood But I writ it after I had seene it done and did it very often with happy successe See then what may happen through your inconsiderate counsell without examining or standing upon the facility of tying the sayd vessells For see heere 's your scope and proposition to tye the vessells after amputation is a new remedy say you then it must not be used it is an ill argument for a Doctor But as for that say you one must use fire after the amputation of members to consume and drie the putrifaction which is a common thing in Gangreenes and mortifications that indeed hath no place here because the practise is to amputate the part above that which is mortified and corrupted as Celsus writes and commands to make the amputation upon the sound part rather than to leave any whit of the corrupted I would willingly aske you if when a veine is cut transverse and that it is very much retracted towards the originall whether you would make no conscience to burne till that you had found the orifice of the veine or artery and if it be not more easie onely with a Crow bill to pinch and draw the vessell and so tie it In which you may openly shew your ignorance and that you have your minde seised with much rancor and choler We daily see the ligature of the vessells practised with happy successe after the amputation of a part which I will now verifie by experiences and histories of those to whom the said ligature hath beene made and persons yet living Experiences THe 16. day of Iune 1582. in the presence of Master Iohn Liebaud doctor in the faculty of Physicke at Paris Claud Viard sworne Chirurgion Master Mathurin Huron Chirurgion of Monsieur de Souvray and I Iohn Charbonell master Barbes Chirurgion of Paris well understanding the Theoricke and Practicke of Chirurgery did with good dexterity amputate the left legge of a woman tormented the space of three yeares with extreame paine by reason of a great Caries which was in the bone Astragal Cyboides great and little focile and through all the nervous parts through which she feit extreame and intollerable paines night and day she is called Mary of Hostel aged 28 yeares or thereabouts wife of Peter Herve Esquire of the Kitchin to the Lady Duchesse of Vzez dwelling in the streete of Verbois on the other side Saint Martin in the fields dwelling at the signe of the Saint Iohns head where the sayd Charbonell cut off the sayd legge the breadth of foure large fingers below the Knee and after that he had incised the flesh and sawed the bone hee griped the Veine with the Crow bill then the Artery then tyed them from whence I protest to God which the company that were there can witnesse that in all the operation which was sodainely done there was not spilt one porrenger of blood and I bid the sayd Charbonell to let it bleed more following the precept of Hippocrates that it is good in all wounds and also in inveterate ulcers so let the blood runne by this meanes the part is lesse subject to inflammation The sayd Charbonell continued the dressing of her who was cured in two moneths without any fluxe of blood happening unto her or other ill accident and she went to see you at your lodging being perfectly cured Another history of late memory of a singing man of our Ladyes Church named master Colt who broke both the bones of his legge which were crusht in divers peeces insomuch that there was no hope of cure to withstand a gangreene and mortification and by consequence death Monsieur Helin Doctor Regent in the faculty of Physicke a man of honour and of good knowledge Claud Viard and Simon Peter sworne Chirurgions of Paris men well exercised in Chirurgery and Balthazar of Lestre and Leonard de Leschenal Master Barber Chirurgions well experimented in the operations of Chirurgery were all of opinion to withstand the accidents aforesayd to make entire amputation of the whole legge a little above the broken shivered bones the torne nerves veines arteries the operation was nimbly done by the sayd Viard and the blood stancht by the ligature of the vessells in the presence of the sayd Helin and master Tonsard great Vicar of our Ladyes Church and was continually drest by the sayd Lescheâ—al and I went to see him other whiles he was happily cured without the application of hot irons and walketh lustily on a woodden legge Another History IN the yeare 1583. the 10. day of December Toussaint Possoâ— borne at Ronieville at this present dwelling at Beauvais neare Dourdan having his Legge all
ulcered and all the bones cariez'd and rotten prayed me for the honor of God to cut off his Legge by reason of the great paine which he could no longer endure After his body was prepared I caused his legge to be cut off fowre fingers below the rotula of the knee by Daniel Powlet one of my servants to teach him and to imbolden him in such workes and there he readily tyed the vessells to stay the bleeding without application of hot irons in the presence of Iames Guillemeaâ— ordinary Chirurgion to the King and Iohn Charbonell master Barber Chirurgion of Paris and during the cure was visited by Master Laffile and Master Courtin Doctors Regents in the facultie of Medicine at Paris The said operation was made in the house of Iohn Gohell Inkeeper dwelling at the signe of the white horse in the Greve I will not here forget to say that the Lady Princesse of Montpeâ—sier knowing that he was poore and in my hands gave him money to pay for his chamber and diet He was well cured God be praysed and is returned home to his house with a wooden Leg. Another History A Gangreene happened to halfe of the Legge to one named Nicholas Mesnager aged threescore and sixteene yeares dwelling in S. Honores street at the signe of the Basket which happened to him through an inward cause so that wee were constrained to cut off his Legge to save his life and it was taken off by Anthony Renaud master Barber Chirurgion of Paris the 16. day of December 1583. in the presence of Master Le Fort and Master La Noüe sworne Chirurgions of Paris and the blood was stanched by the Ligature of the vessells and hee is at this present cured and in health walking with a woodden Leg. Another History A Waterman at the Port of Nesle dwelling neare Monsieur de Mas Postmaster named Iohn Boussereau in whose hands a Musket brake asunder which broke the bones of his head and rent and tore the other parts in such sort that it was needfull and necessary to make amputation of the hand two fingers above the wrist which was done by Iames Guillemeau then Chirurgion in ordinary to the king who dwelt at that time with me The operation likewise being redily done and the blood stancht by the Ligature of the vessells without burning irons hee is at this present living Another History A Merchant Grocer dwelling in St Denis street at the signe of the great Tournois named the Iudge who fell upon his head where was made a wound neare the temporall muscle where he had an artery opened from whence issued forth blood with great impetâ—osity in so much that common remedies would not serve the turne I was called thither where I found Master Rasse Master Cointeret Master Viard sworne Chirurgions of Paris to stay the blood where presently I tooke a needle and thread and tyed the arterie and it bled no more after that and was quickly cured Master Rousselet can witnesse it not long since Deacon of your Facultie who was in the cure with us Another History A Sergeant of the Chastler dwelling neare S. Andrew des Arts who had a stroake of a sword upon the throate in the Clackes medow which cut asunder the jugular veine externe as soone as he was hurt he put his handkercher upon the wound and came to looke mee at my house and when hee tooke away his handkercher the blood leaped out with great impetuosity I suddainly tyed the veine toward the roote he by this meanes was stanched and cured thankes be to God And if one had followed your manner of stanching blood by cauteries I leave it to be supposed whether he had beene cured I thinke hee had beene dead in the hands of the operator If I would recite all those whose vessells were tyed to stay the blood which have beene cured I should not have ended this long time so that me thinkes there are Histories enough recited to make you beleeve the blood of veines and arteries is surely stanched without applying any actuall cauteries DV BARTVS He that doth strive against experience Daignes not to talke of any learned science NOw my little Master seeing that you reproach me that I have not written all the operations of Chirurgery in my workes which the Ancients writ of I should be very sorry for it for then indeede might you justly call me Carnifex I have left them because they are too cruell and am willing to follow the modernes who have moderated such cruelty which notwithstanding you have followed step by step as appeareth by the operations here written extracted from your booke which you have drawne here and there from certaine ancient Authors such as follow and such as you have never practised nor seene The first operation TO inveterate fluxions of the eyes Migrimes Paulus Aegineta as also Albucasis command to make Arteriotomie see here the words of the same Aeginete You marke the Arteries which are behind the eares then divide them in cutting to the very bone and make a great incision the breadth of two fingers which is the will also of Aetius that the incision be made tranverse cutting or incising the length of two fingers even till that the Artery be found as you command to bee done in your booke but I holding the opinion of Galen who commands to dresse the diseased quickly safely and with the least paine that is possible I teach the young Chirurgion the meanes to remedy such evills in opening the Arteries behind the eares and those of the Temples with one onely incision as a letting blood and not to make a great incision and cut out worke for a long time The second operation TO fluxions which are made a long time upon the eyes Paul Aeginete and Albucasis command to make incision which they call Periscythismos or Augiologie of the Greekes and see heere the words of Paul In this operation first the head is shaved then taking heede of touching the temporall muscles a transverse incision must bee made beginning at the left Temple and finishing at the right which you have put in your booke word for word without changing any thing which sheweth openly you are a right wound-maker as may be sâ—ene in the Chapter which you call the Crowne cut which is made halfe round under the Coronall suture from one temple to the another even to the bone Now I doe not teach such a cruell kind of remedy but instruct the operator by reason authority and notable proofe of a sure and certaine way to remedy such affections without butchering men in this kind The third IN the cure of the Empyema Paul Aeginete Albucasis and Celsus commanded to apply some 13. others 15. Cauterles to give issue to the matter contained in the breast as the said Celsus in the aforesaid place appointeth for Asthmatick people which is a thing out of all reason with respect to their honour be it
Martigues where I prayd him that he would take order that I might remaine neare him to dresse him which he agreed to most willingly and had as much desire I should remaine with him as I my selfe Soone after the Commissioners who had charge to elect the prisoners entred into the Castle the seaventeenth day of Iuly one thousand five hundred fifty three where they made Messieurs the Duke of Boüillon the Marquesse of Villars the Baron of Culan Monsieur du Pont commissary of the Artillery and Monsieur de Martigues and I to be taken through the request that he made to them and all other Gentlemen which they could perceive were able to pay any ransome and the most part of the Souldiers and the cheefe of the Companies having such and so many prisoners as they would Afterward the Spanish Souldiers entred by the Breach without any resistance for ours esteemed they would hold their faith and composition that they should have their lives saved They entred in with a great fury to kill pillage and rifle all they retained some hoping to have ransome they tyed their stones with Arquebuse cords which was cast over a Pike which two held upon their shoulders then pulled the said cord with a great violence and derision as if they would ring a Bell telling them that they must put themselves to the ransome and tell of what houses they were and if they saw they could have no profit made them cruelly dye betweene their hands or presently after their genitall parts would have â—alne into a Gangreene and totall mortification but they kild them all with their Daggers and cut their throats See now their great cruelty and persidiousnesse let him trust to it that will Now to returne to my purpose being lead from the Castle to the Citty with Monsieur de Martigues there was a Gentleman of the Duke of Savoyes who asked mee if Monsieur de Martigues wound was curable I answered not who presently went and told the Duke of Savoy now I thought he would send Physitions and Chirurgions to visit and dresse my said Monsieur de Martigues in the meane time I thought with my selfe whether I ought to make it nice and not to acknowledge my selfe a Chirurgion for feare least they should retaine mee to dresse their wounded and in the end they would know I was the Kings Chirurgion and that they would make me pay a great ransome On the other side I feared if I should not make my selfe knowne to bee a Chirurgion and to have carefully dressed Monsieur de Martigues they would cut my throate so that I tooke a resolution to make it appeare to them he would not dye for want of good dressing and looking to Soone after see their arrives divers gentlemen accompanied with the Physition and Chirurgion to the Emperour and those of the said Duke of Savoy with sixe other Chirurgions following the Army to see the hurt of the said Lord of Martigues and to know of mee how I had dressed him and with what medicines The Emperours Physition bid me declare the essence of the wound and how I had drest it Now all the assistance had a very attentive eare to know if the wound were mortall or not I began to make a discourse that Monsieur de Martigues looking over the wall to perceive them that did undermine it received a shot from an Arquebuse quite through the body presently I was called to dresse him I saw hee cast blood out of his mouth and his wounds Moreover he had a great difficultie of breathing and cast out winde by the said wounds with a whistling in so much that it would blow out a Candle and he said he had a most sharpe pricking paine at the entrance of the Bullet I doe beleeve and thinke it might bee some little peeces of bones which prickt the Lungs When they made their Systole and Diastole I put my finger into him where I found the entrance of the Bullet to have broken the fourth Rib in the middle and scales of bones which the said Bullet had thrust in and the outgoing of it had likewise broken the fift Rib with peeces of bones which had beene driven from within outward I drew out some but not all because they were very deepe and adherent I put in each wound a Tent having the head very large tyed with a thread least by the inspiration it might bee drawne into the capacity of the Thorax which hath beene knowne by experience to the detriment of the poore wounded for being fallen in it cannot be taken out which is the cause that engenders putrifaction a thing contrary to nature The said Tents were annointed with a medicine compos'd of yolks of Egges Venice Turpentine with a little oyle of Roses My intention for putting the Tents was to stay the flux of blood and to hinder that the outward ayre did not enter into the breast which might have cooled the Lungs and by consequent the heart The said Tents were also put to the end that issue might bee given for the blood that was spilt within the Thorax I put upon the wound great Emplasters of Diacalcitheos in which I had relented oyle of Roses and Vinigar to the avoyding of inflammation then I put great stupes of Oxycrate and bound him up but not hard to the end he might have easie respiration that done I drew from him five porrengers of blood from the Basilicke veine of the right arme to the end to make revulsion of the blood which runs from the wounds into the Thorax having first taken indication from the wounded part and cheefely his forces considering his youth and his sanguine temper Hee presently after went to stoole and by his urine and seege cast great quantity of blood And as for the paine which he said he felt at the entrance of the Bullet which was as if he had beene pricked with a bodkin that was because the Lungs by their motion beate against the splinters of the broken Rib. Now the Lungs are covered with a coate comming from the membrane called Pleura interweaved with nerves of the sixt conjugation from the braine which was cause of the extreame paine he felt likewise he he had a great difficultie of breathing which proceeded from the blood which was spilt in the capacitie of the Thorax and upon the Diaphragme the principall instrument of respiration and from the dilaceration of the muscles which are betweene each Rib which helpe also to make the expiration and the inspiration and likewise because the Lungs were torne and wounded by the Bullet which hath caused him ever since to spit blacke and putrid blood in coughing The Feaver seazed him soone after he was hurt with faintings and swoonings It seemed to mee that the said feaver proceeded from the putredinous vapours arising from the blood which is out of his proper vessells which hath fallen downe and will yet flow downe The wound of the Lungs is growne great and will grow
of an hand and he said he felt there a great paine and smarting and likewise in his reines inso much that hee could not take any rest night or day neither had hee any appetite to eate but to drinke enough it was told mee hee fell often into faintings and swoonings and sometimes as it were into an Epilepsie and had often-times desire to vomit with such a trembling that hee could not carry his hands to his mouth Seeing and considering all these great accidents and the forces much abated truly I was much grieved to have gone to him because me thought there was little appearance that he could escape Notwithstanding to give him courage and good hope I told him that I would quickly set him on foote by the grace of God and the Physitions and Chirurgions helpe Having seene him I went a walking into a Garden where I prayed to God that hee would give me the grace to cure him and that hee would give a blessing to our hands and medicaments to combate against so many complicated maladies I bethought in my minde the wayes I must keepe to doe it They called mee to dinner I entred into the kitehin where I saw taken out of a great pot halfe a Mutton a quarter of Veale three great peeces of Beefe and two Pullets and a great peece of Bacon with great store of good Hearbes Then I said to my selfe this broth was full of juice and of good nourishment After dinner all the Physitions and Chirurgions assembled we entred into conference in the presence of Monsieur the Duke of Ascot and some Gentlemen that did accompany him I began to tell the Chirurgions that I mervailed much they had made no apertions in the Marquesses thigh which was all apostemated and the matter which issued out was very foule and stinking which shewed it had a long time lurked there and that I had found with my probe a Caries in the bone and small scales which were already separated they made mee answer hee would never give consent and likewise it was almost two monthes since they could winne him to put on cleane sheets on his bed neither dust one scarce touch the coverlet he fee lt so great paine Then said I for to cure him we must touch other things than the coverlet of the bed Each one said what hee thought best of the Lords greefe and for conclusion held it altogether deplorable I told them there was yet some hope because of his youth and that God and nature doe sometime such things which seeme to Physitions and Chirurgions to bee impossible My consultation was that all these accidents were come by reason of the bullet hitting neare the joynt of the knee which had broken the Ligaments tendons and aponeureses of the muscles which tye the sayd joynt together with the Os femoris also nerves veines and arteries from whence had followed paine inflammation aposteme and ulcer and that wee must begin the cure by the disease which was the cause of all the sayd accidents that is to say to make apertions to give issue to the matter reteined in the interspaces of the muscles and in the substance of them Likewise to the bones which caused a great corruption in the whole thigh from whence the vapors did arise and were carryed to the heart which caused the sincope and the feaver and the feaver an universall heate through the whole body and by consequent depravation of the whole Occonomie Like-wise that the said vapours were communicated to the braine which caused the Epilipsie and trembling and to the stomacke disdaine and loathing and hindred it from doing his functions which are cheefely to concoct and disgest the meate and to convert it into Chyluâ— which not being well concocted they ingender crudities and obstructions which makes that the parts are not nourished and by consequent the body dryes and growes leane and because also it did not doe any exercise for every part which hath not his motion remaineth languid and atrophiated because the heate spirits are not sent or drawne thither from whence followes mortification And to nourish and fatten the body frictions must be made universally through the whole body with warme linnen cloathes above below on the right side and left and round about to the end to draw the blood and spirits from within outward and to resolve any fuliginous vapours retained betweene the skinne and the flesh thereby the parts shall be nourished and restored as I have heretofore sayd in the tenth booke treating of wounds of Gunshot and wee must then cease when we see heate and rednesse in the skinne for feare of resolving that wee have already drawne and by consequent make it become more leane As for the Vlcer which he had upon his rumpe which came through too long lying upon it without being remooved which was the cause that the spirits could not florish or shine in it by the meanes of which there should bee inflammation aposteme and then ulcer yea with losse of substance of the subject flesh with a very great paine because of the nerves which are disseminated in this part That wee must likewise put him into another soft bed and give him a cleane shirt and sheets otherwise all that wee could doe would serve for nothing because that those excrements and vapors of the matter retained so long in his bed are drawne in by the Systole and Diastole of the Arteries which are disseminated through the skin and cause the spirits to change and acquire an ill quality and corruption which is seene in some that shall lye in a bed where one hath sweate for the Pox who will get the Pox by the putrid vapours which shall remaine soaked in the sheets and coverlets Now the cause why he could in no wise sleepe and was as it were in a consumption t' was because he eate little and did not doe any exercise and because hee was grieved with extreame paine For there is nothing that abateth so much the strength as paine The cause why his tongue was dry and fowle was through the vehemence of the heate of the feaver by the vapors which ascended through the whole body to the mouth For as we say in a common proverbe when an Oven is well heate the throate feeles it Having discoursed of the causes and accidents I sayd they must be cured by their contraries and first we must appease the paine making apertions in the thigh to evacuate the matter retained not evacuating all at a time for feare least by a sodaine great evacuation there might happen a great decay of spirits which might much weaken the patient and shorten his dayes Secondly to looke unto the great swelling and cold in his Legge fearing least it should fall into a Gangreene and that actuall heate must bee applyed unto him because the potentiall could not reduce the intemperature de potentiâ— ad actum for this cause hot brickes must bee applyed round about on which should bee cast